A study to assess the effectiveness of structured teaching programme on refractive errors among high school children (12-15years) in selected schools at Mysuru

 

Mr. Vishakantamurthy D G1, Mr. Chandrasekhar M2, Mr. Muruli Mohan A1

1Assistant Lecturer, JSS College of Nursing, Mysore

2Assistant Professor, JSS College of Nursing, Mysore

*Corresponding Author’s Email: guruvishu@gmail.com

 

ABSTRACT:

Refractive error is one of the most common determinants of visual impairment worldwide, particularly among children, and frequently remains undiagnosed for long periods. Worldwide with refractive errors range from 800 million to 2.3 billion and 5-15% of all children are considered to have refractive errors. Proper education should be given to the children to make them vigilant towards the refractive error complications. Regular eye checkups, control over diet, control over life style etc.. Can prevent the occurrence of refractive error. The research approach adopted for this study is evaluative approach. The research design adopted for this study was one group pre test and post test design. It is a pre experimental design with no control and no randomization. The data was collected through the tool which is prepared by the investigator. The sample consists of 60 high school children in selected schools at Mysuru district. There is a significant association between pre-test knowledge score of high school children and findings of the study. A statistically significant association was between the level of knowledge and income per month of high school children. Hence the hypothesis of the study is well accepted as the knowledge levels of the high school children were increased after the structured teaching programme.

 

KEYWORDS:

 

 

INTRODUCTION:

Children are our most valuable resources; raising a child is surely one of the most blissful events of any parents life .To prepare a child for sudden change, there are few things which need to be taken care of, such as the health, academic performance, social, physical, and psychological factors. For the overall development, the efficiency of the sense organ is important. Eyes are the most treasured organ of human beings.

 

School age is an initial period when most of the children experience interaction with different visual problems. Childhood visual impairment due to refractive error is one of the most common problems in school children and second leading cause of treatable blindness.

 

High school children that form a sizable segment of the community can be screened and treated for defects such as refractive errors, squint, amblyopic, trachoma etc. Promote parent-child attachment is very important component of school health service .students should be taught to practice the principles of good posture, proper lighting , avoidance of glare, proper distance and angle between the books and the eyes. Discovery of visual impairments as early as possible is essential to prevent social, physical and psychological damage to the child

OBJECTIVES:

1.     To develop a structured teaching programme on refractive errors

2.     To assess and evaluate the knowledge of school children before administration of structured teaching programme (STP).

3.      To assess and evaluate the knowledge of school children after administration of structured teaching programme (STP)

4.      To find out the association between knowledge regarding refractive errors among school children with their selected demographic variables

 

HYPOTHESES:

H1: There will be significant increase in the knowledge of children regarding refractive Errors.

 

H2: There will be significant association between the pre-test and post-test level of Knowledge of children with selected demographic variables.

 

ASSUMPTIONS:

Assumptions of the study are:-

1.                    School children may have little knowledge about refractive errors

 2.   STP provides an opportunity for learning and better understanding regarding Knowledge on refractive errors.

 

VARIABLES OF THIS STUDY

Variables are qualities, properties or characteristics of the person, things or situation that change or vary. The variables are mainly included in this study are independent variable and dependent variable. Dependent variables explain effect of independent variable.

 

DELIMITATIONS:-

The Study is delimited to:

1. Who are willing to participate during the time of study.

2. Who are available during the data collection period.

3. The sample size is limited to 60 children who are studying at selected high schools in Mysuru

4. The study includes both boys and girls who are studying in high school.

 

CONCEPTUAL/ THEORETICAL FRAME WORK:

Framework of this study is based on general system theory proposed by a biologist, Bertalanffy in 1968. Bertanlanffy‘s general system-theory describes a set of interacting components of a boundary that filters the type and rate of exchange of energy, materials and information with the environment.

 

They are characterized by,

·       Input of energy into the system.

·       Throughput during which the system process, changes and recognizes imported energy.

·       Output of energy into the environment in the form of goods, services and intellectual Products.

·       Feedback by which a part of the output returns to the system

 

METHODOLOGY:

RESEARCH APPROACH/ DESIGN

The research approach indicates the basic procedure for conducting research. Based on the nature of the problem and the objective of study a descriptive study approach was selected for this study .The research approach adapted for this study was evaluative approach.

 

An evaluative approach is the applied form of research that involves finding out how well a program, practice, procedure or policy is working.

 

Research design provides an overall blue print to carry out the study. The research design used in this study was pre experimental one group pre-test post-test design.

 

SETTING OF THE STUDY:

Setting is the general location and condition in which data collection takes place in the study.

 

The present study was conducted in selected high schools at Mysuru district.

 

POPULATION:

Population defined as the entire aggregate of cases that meet designated set of criteria.

The target population of the present study includes school children in selected high schools at Mysuru district.

 

SAMPLE

Sample is a small portion of the population selected for observation and analysis. The sample for the present study comprised of the high school children who are in selected schools at Mysuru District.

 

SAMPLING TECHNIQUE

Sampling technique is the procedure, which the researcher adopts in selecting the samples for the study. For the present study non probability –convenient sampling technique was adopted and considered appropriate to select the samples.

 

INSTRUMENT USED FOR THE STUDY

Selection of the Tool

A structured interview schedule was selected for the Study to assess the knowledge of high school children. It was found appropriate tool to explore the responses of the study participants.

Development of the Tool

The tool was developed on the basis of the objectives of the study. The following steps were adopted in the development of the tool

 

·       Review of Literature, which has provided adequate content for the tool preparation

·       Consultation with the experts of Child Health Nursing, General Physician, Pediatrician and Ophthalmologist.

·       Investigator‘s previous knowledge about refractive errors.

 

Preparation of Blue Print

A blue print was prepared to aid in the development of the tool. Five components were included for (Annexure-A) Criterion check list for validation of learning needs assessment interview schedule the preparation of the tool and questions were distributed under these five components.

 

Description of the Tool

The tool was divided into two parts.

 

Part-1

Socio-demographic Performa consists of age, sex, qualification, occupation, marital status, type of family, monthly income, type of diet, duration of illness, treatment and family history.

 

Part-2

Structured interview schedule pertaining to refractive errors. This section consisted of 30 items. These 30 items were distributed under five components, namely.

·       General Information about refractive errors (5 questions)

·       Definition of refractive errors (3 questions)

·       Incidence of refractive errors (2 questions)

·       Causes of refractive errors (1 question)

·       Classification of refractive errors (10 questions)

·       Signs and symptoms of refractive errors (1 question)

·       Diagnosis of refractive errors (3 questions)

·       Management of refractive errors (5 questions)

 

Scoring of Multiple-Choice Questionnaire.

A score value of one (1) was allotted to each correct response and wrong response as zero.

 

PLAN OF DATA ANALYSIS:

TABLE 1 Shows that the Frequencies and Percentage Distribution of Demographic Variables

Demographic variables

 Category

No of subjects

Percentage

Age in years

12 years

15

25.0%

13 years

24

40.0%

13 years

14

23.3%

15 years

7

11.7%

Gender

Male

28

46.7%

Female

32

53.4%

Education qualification

8th standard

34

56.55%

9th standard

22

36.7%

10th standard

4

0.6%

Income per month

<1000

6

10%

1000-5000

32

53.3%

5000-10000

10

16.7%

1000 and above

12

20%

Previous information

Regarding refractive error

Yes

12

23.3%

No

48

76.7%

 

 

 

TABLE 2: Comparison between pre and post test knowledge of school children (12-15years) regarding refractive errors.

Level  of  knowledge

Pre  test 

Post test

Number

Percentage

Number

Percentage

Poor (50%)

41

68.33

0

0

Moderate (50-75%)

19

31.67

39

65

Good (>75%)

0

0

21

35

 

 

TABLE 3: Comparison between pre test and pre test overall  knowledge level.

Domain

Max score

Range

Mean

SD

MEAN %

Pretest knowledge

30

9-16

12.66

2.9

42.2

Post test knowledge

30

15-28

21.62

4.17

72.1

 

 

TABLE 4: Evaluate the effectiveness of structured teaching programme in terms of post test knowledge with statistical significance  n=60

Domain

Mean

SD

Mean %

Paired t test

Pretest

12.66

2.19

42.2.

38.3*

Post test

21.62

4.17

72.1

 

*S- Significant at p<0.01 level

 

TABLE 5: Association between demographic variables andpost test knowledge scores of high school children on refractive errors.

Variables

X2 value

Critical value of x2

P Value

Age

12 years

13 years

14 years

15 years

1.09

7.81

0.78

NS

Gender

Male

Female

0.011

3.84

0.92

NS

Educational qualification

8th standard

9th standard

10th standard

2.36

7.81

0.31

NS

Income per month

<1000

1000-5000

5000-10000

1000 and above

8.33

7.81

0.05

S

Previous information

YES

NO

3.44

3.84

0.92

 NS

 

 

 

FINDINGS OF THE STUDY

·       About 15(25.00%) high school children were in the age group of 12 years, 24(40.00%) were in the age group of 13 years, and 14 (23.33%) were in the age group of 14 years and 7(11.7%) were in the age group of 15years.

 

·       About 28(46.67%) were male high school children and 32(53.33%) were female high school children.

 

·       About 34(56.66%) high school children belongs to 8th standard, 22(37.7%) belongs to 9th standard and 4(0.6%) to 10th standard.

 

·       About 6(10.00%) high school children were having <1000 income per month, 32(53.33%) were having 1000-5000 income per month, 10(16.73%) were having 5000-10000 income per month and 12(20.00%) were not having above10000 income per month.

 

·       About 12 (23.33 %) high school children were having previous information on refractive errors, 48(76.67 %) were having previous information on refractive errors.

 

·       Findings shows that 41(68.33%) of school children having inadequate knowledge, 19(31.67%) have moderate level knowledge and 0(0%) have an adequate knowledge regarding refractive errors.

 

·       Findings  shows that the overall pre test knowledge level score was 42.2% and post test knowledge level score was 72.1 %, difference between these two is 29.9%mean value 12.66 and 21.62, difference between these two is 8.96 and SD was 2.19 and 4.17 , difference between these two is 1.98.

 

·       Findings shows that in pretest 41(68.33%) of school children (12-15yrs) having poor knowledge, 19(31.67%) have moderate level of knowledge and 0(0%) have an good knowledge regarding refractive errors and no one has poor knowledge, 39(65.00%)have moderate level knowledge and 21(35.00%) have an good knowledge regarding refractive errors in post test.

 

·       Findings shows there is association between post levels of knowledge of school children (12-15yrs) regarding refractive errors with their selected demo graphic variables. Viz age in years, sex, educational qualifications, income per month, previous information regarding refractive errors. The association was calculated by Chi square test and there is a significant association present in income per month (chi square=7.81).

 

CONCLUSION:

The study involved selection of 60 samples by the convenient sampling technique and collection of data by structured knowledge interview schedule. One group pre-test post test design and evaluative approach was adopted to conduct the study. Data was analyzed and interpreted by using descriptive and inferential statistics. Conclusions were drawn on the basis of the major findings of the study.

 

RECOMMENDATIONS:

Keeping in view of the findings of the present study, the following recommendations were made:

1.  More studies of this nature should be conducted on large sample and their Findings should be utilized in replicating the same.

2. The study should also replicate as a longitudinal study with follow up.

3. Comparative studies should be done between different areas, group of people with different  Organizations.

4. Similar studies should be introduced among other healthcare workers to spread greater awareness and impart training.

5. An experimental study can be undertaken with control group for effective comparison.

 

REFERENCE:

1.     Rotsos T, Grigoriou D, Kokkolaki A. Children the most valuable natural Dovepress Journal , 2009Jul;3(1):429-31

2.     Gupte. Text book of paediatrics.11th edition. New Delhi. Jaypee Brothers Medical Publishers; 2009.p.675.

3.     Bronwyn H, Jennifer BD, Jojo DU, Katrina SL, Karen FM, Rhondelle O; Retrospective analysis of refractive errors in children with vision impairment 2005.p.807-816

4.     Viswanathan J and Desai A.B. Achar‘s Text book paediatrics.3rd edition. New Delhi. Orient Hongman Private Limited; 2007.p.785.

5.     WHO. Prevention of Blindness and Visual Impairment. Priority eye diseases, 2008.URL:http://www.who.int/blindness/en/

6.     David Dunaway Ian Berger. Worldwide distribution of visual refractive errors and what to expect at a particular location [online][cited 2011 Nov 4]. Available from URL http://www.infocusonline.org.

 

 

 

Received on 15.02.2016          Modified on 29.02.2016

Accepted on 06.04.2016          © A&V Publication all right reserved

Int. J. Adv. Nur. Management. 2016; 4(2): 120-124.

DOI: 10.5958/2454-2652.2016.00027.5