INTRODUCTION:

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack).

Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardio myopathy, heart arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thrombo embolic disease, and venous thrombosis. It is associated with high mortality and morbidity. Adolescents are now exposed to multiple risk factors which makes them highly prone towards CVD at a younger age.¹Heart and blood vessel disease (also called heart disease) includes numerous problems, many of which are related to a process called atherosclerosis. Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.^2,3

The acceleration of cardiovascular diseases (CVD) has become an alarming health problem across the globe. The progressive atherosclerotic process begins in childhood and develops gradually under the influence of conventional risk factors including obesity, hypertension, dyslipidemia, cigarette smoking, family history of premature coronary artery disease, stress, and low levels of physical activity.⁴ India is undergoing a demographic transition: the population increased from 888 million in 1991 to 1.2 billion in 2011 and to 1.3 billion in 2015. Life expectancy had increased to 70 years in females and 67 years in males by 2015. In 2000, there were nearly 29 million cases of CVD, including coronary heart disease, stroke, rheumatic heart disease, and congenital heart disease in India; by 2015, this had doubled to 64 million. Although there was a significant increase in the rate of CHD, it is more evident in younger age (20–29years) and old age (60–69) compared to middle-age group (30–59years) CVD was responsible for 16 million deaths in 2000 and 34 million deaths in 2015. CVD is the greatest contributor to disability and mortality in India, and mortality rates are expected to rapidly increase in the next few years as the population ages. The number of years of life lost before the age of 60 as the result of coronary heart disease is expected to increase from 7.1 million in 2004 to 17.9 million in 2030, while the projected death rate caused by CVD will increase from 2.4 million in 2004 to 4.0 million in 2030.⁵

The National heart, lung and blood institute has estimated that half of the persons with hypertension do not know that they have prolonged elevation of blood pressure eventually damages blood vessels throughout the body mostly in the eyes, heart, kidneys and brain. The study result revealed that in pretest hypertensive clients had inadequate knowledge with the mean 33.7, attitude with the mean of 47, practice with the mean of 34.7. in post test it was found that hypertensive clients gained knowledge with the mean value of 88, attitude of 85, practice of 85.5. The overall findings of the study showed that structured teaching programme is very effective in improving the knowledge, attitude and practice on hypertension with t value 0.064 at p<0.005 level.⁶ Stroke is a life challenging event and use of coping strategies to manage burden is helpful for the caregivers to improve their health. The findings of the study demonstrated that among 100 caregivers of CVA patients surveyed, many subjects (36%) were in the age group of 31- 40 years, majority of subjects (77%) were female, maximum number of subjects (63%) were married, most of the subjects (48%) were Hindus, maximum number of the subjects (63%) belonged to joint families, about 39% of the subjects had higher secondary schooling, most of the subjects (51%) were home makers, around 32% of the subjects had monthly income of Rs 10,001- 15,000, about 39% were taking care of the patient for 7-12 months, most of caregivers (39%) were others (daughter/ daughter in-law) and about 47% of subjects had a history of stroke in the family.⁷

Nisha Singh, Seema Patel, Dinesh K Pal, 2017,Gandhi Medical College, Prevalence of Hypertension and Associated Risk Factors among Urban School Adolescents conducted a cross-sectional study in Bhopal among 404 school adolescents in Bhopal, data was collected by predesigned questionnaire and anthropometric measurement was done. Analysis was done using MS Excel and Epi- info 7A total of 404 students were included in the study, 242 males and 162 females. The mean age was 14.54 years. Prevalence of hypertension among adolescents was found to be 15.3% (14.04% among boys and 17.3 % among girls) and the prevalence of pre hypertension was 19.8% (19.0% of boys and 20.9% of girls were pre hypertensive). The overall prevalence of hypertension among adolescents (10-18 years) was found to be 15.3%. Gender, obesity, positive smoking status and lack of physical activity were identified as risk factors for hypertension.⁸. A comparative cross-sectional survey was conducted on adult stroke survivors (n=201) and patients of cardiovascular disorders who are at high risk (n=201) in neurology and cardiology wards and outpatient clinics. Demographic profile, clinical profile and knowledge questionnaire were used for data collection. .Awareness regarding risk factors and warning signs of stroke was significantly higher (p=<0.05) in patients who are at high risk as compared to stroke survivors. More than half of the patients in both groups had <50% knowledge. Only 16% of the patients with stroke and 14% of the patients who are at high risk were aware that stroke could be due to cerebral hemorrhage.⁹ The research design adopted was pre-experimental one group pre-test post test. The conceptual frame work for this study was based on Hochbaum (1950) health belief model. The study had been conducted in H. N. Shukla arts and commerce college, Rajkot. The data were analyzed by using both descriptive and inferential statistical method paired ‘t’ test was used to evaluating the effective of planned teaching programme on knowledge regarding prevention of cardio vascular disease. The obtained calculated value was 12.29, which shows highly significant at the level of 0.001.¹⁰ Overall, most of the studies of the children and adolescent has proved presence of modifiable risk factors for Cardiovascular Diseases. A multitude of risk factors contributed to the adolescent’s cardiovascular disease includes insufficient physical activity, diet pattern, body weight and BMI, smoking, alcohol intake, comorbidities, excess body fat and lipid profiles.¹¹ Hence the researcher has decided to conducted the study regarding selected cardiovascular health problems and its prevention among college students.

TITLE OF THE STUDY:

A study was conducted on effectiveness of structured teaching programme on knowledge regarding selected cardiovascular health problems and its prevention among College students.

OBJECTIVES OF THE STUDY ARE:

1. To identify the existing knowledge of students regarding cardiovascular health problems and its prevention in selected College of Bhubaneswar.

2. To administer structured teaching programme on knowledge regarding cardiovascular health problems and its prevention in College students.

3. To evaluate the effectiveness of structured teaching programme on knowledge regarding cardiovascular health problems its prevention in College students.

4. To compare the pre test and post test level of knowledge score of the students.

5. To associate the post-test level of knowledge score of students with their selected demographic variable.

RESEARCH METHODOLOGY:

A Pre experimental One group pre test post test design was used to conduct this study.

DEPENDENT VARIABLES:

Knowledge of College students.

INDEPENDENT VARIABLES:

Structured teaching program for college students regarding selected cardiovascular health problems and its prevention.

DEMOGRAPHIC VARIABLES:

Age, sex, religion, habitat, family income, habits, exercise, diet pattern, family history of cardiovascular disease and previous knowledge of cardiovascular disease.

SETTING OF THE STUDY:

The present study was conducted in selected College in Bhubaneswar, Odhisa.

SAMPLE:

In this study sample were college students who are studying in 11^th and 12^th standard, sample size was 60.

SAMPLING:

Convenience sampling technique was used for data collection.

INCLUSION CRITERIA:

1. Students who were studying in 11^th and 12^th standards.

2. Those who were present and willing to participate at the time of data collection.

3. Students who can write, read and can speak English, Hindi and Odia,

EXCLUSION CRITERIA

1. Those who were not present at the time of data collection.

DEVELOPMENT OF RESEARCH TOOL:

A structured knowledge questionnaire which include close ended questions on selected cardiovascular health problems and its prevention was developed. Questionnaires were used to assess the level of knowledge regarding selected cardiovascular health problems and its prevention.

SECTION -A:

Demographic profile: Age, sex, religion, type of family, habitat, family income, habits, exercise, diet pattern, family history of cardiovascular disease, previous knowledge of cardiovascular disease.

SECTION –B:

Seeks information regarding the introduction of cardiovascular disease, etiology and risk factor, clinical manifestation and diagnosis, management and complication and prevention of cardiovascular disease.

· 11 items related to demographic data

· 45 items related to selected cardiovascular health problems and its prevention , items are divided into following areas:

I. Questionnaire related to introduction cardiovascular diseases, etiology, risk factor, clinical manifestation and diagnosis- 19 items

II. Questionnaire related to management and complication -7 items

III. Questionnaire related to prevention -19 items

Scoring Procedures:

The items were in English. The items were multiple choice questions with 3 options. Each correct response will carry ‘1’ and ‘0’ for incorrect response.

Table: Representing the scoring procedure of structured questionnaire (closed ended) regarding level of knowledge score among college students.

Level of knowledge	Score	Percentage of score
Poor	0-15	0-33%
Average	16-30	34-66%
Good	31-45	67-100%

RELIABILITY:

To get the reliability test-retest method was used.

The tool was found to be highly reliable (r=0.78).

PILOT STUDY:

Pilot study was conducted on 6 sample and study was feasible.

DATA COLLECTION PROCEDURES:

The data were collected within period of 14 days from Bhubaneswar. Before conducting the study, the researcher had obtained formal written permission from the principal, Prior to established questionnaires consent obtained from participants.

The following scheduled was adopted for the data collection.

Days	Data Collection Procedure
1^st day	Pre-test for experimental group
2nd Day	Intervention
7th Day	Post-test for experimental group

DATA ANALYSIS AND INTERPRETATION:

The data analysis revealed that 68.33% College students were in the age group of 15-17 years, according to their gender 60% of College students were male, majority of college students 78.33% were Hindu, 71. 66% of college students belongs to nuclear family, according to their habitat shows that 73.33% were belong to urban area, maximum percentage 40% of college students had the monthly family income between 18953-31589, majority of students 81.66% have no any habits like smoking ,alcoholism and drug addition, 61.66% students were doing exercise like cycling, 63.33% were non vegetarian, 83.33% students have no family history of cardiovascular disease and 45% students had previous knowledge of cardiovascular disease from multimedia.

Table no: 1 Pre and post test level of knowledge score among college students regarding selected cardiovascular health problems and its prevention.

Sl No	Level of Knowledge	Pre test		Post test
Sl No	Level of Knowledge	Frequency	Percentage	Frequency	Percentage
1.	Poor (0-15)	48	80%	0	0%
2.	Average (16-30)	12	20%	25	41.66%
3.	Good (31-45)	0	0%	35	58.33%

Frequency and percentage of both pre –test and post –test

Table 1 Depicts pre and post test frequency distribution of college students regarding selected cardiovascular health problems and its prevention was found by 3 point rating scale in which 80% of College students had poor knowledge and in pre test and 58.33% of College students had good knowledge in post test.

Table no 2: Comparison between overall knowledge score of pre test and post test among college students on selected cardiovascular health problems and its prevention.

Groups

Mean

Mean difference

‘z’value

Table value

(p≤ 0.05)

Pre test

12.08

4.26

20.3

18.50

2.00

Post test

32.38

7.67

Table 2 Depicts Comparison between overall knowledge score of pre test and post test among college students on selected cardiovascular health problems and its prevention.

The pre test mean knowledge scores among college students was 12.08, whereas post test means knowledge scores was 32.38. The p is 2.00 (p >0.0.5). Hence the difference is statically non significance.

The association of socio- demographic variables with post test knowledge scores was statistically non significant.

DISCUSSION:

A pre-experimental research design was used to collect data from 60 college students to assess their knowledge regarding selected cardiovascular health problems and its prevention by using structure questionnaires. A pre and post test frequency distribution of College students regarding selected cardiovascular health problems and its prevention was found by 3 point rating scale in which 80% of College students had poor knowledge in pre test and 58.33% of college students had good knowledge in post test. The pre test mean knowledge scores among college students was 12.08, whereas post test means knowledge scores was 32.38.the p is 2.00 (p>0.0.5). Hence the difference is statically non significance.

The association of socio- demographic variables with post test knowledge scores was statistically non significant.

The research design which is used to achieve objectives of this study is nonexperimental, Descriptive Design. The population was Adolescents from urban areas of Tumkur. The sample consists of 100 Adolescents from selected urban areas of Tumkur. Adolescents were selected by simple random sampling. The data was collected from Adolescents using a structured questionnaire for knowledge. The data obtained was analysed by using descriptive and inferential statistics. Result: The study findings revealed that the knowledge of adolescents was determined with mean of 26.31, SD 3.367 and mean score percentage was observed as 58.48%.¹²An illustrative framework was driven at Hillah city to know the nutritious status of adolescent's young female. The example was picked by criteria as juvenile's young female who lived with her family at the Hillah city as relative and recognized to appreciate the survey to assess her energizing status. Small scale Nutritional Assessment Questionnaire was used as a mean of data assembling; the data gathering was finished from the season of 11Jun to 21 Feb 2016. Most of female youngsters had (61.2%) at threat of an in weakness wellbeing and (28.6%) had under absence of sound sustenance status. the largeness of female youthful/Kg with (50-55 kg) as (61.2%).¹³

Quantitative, descriptive, comparative cross-sectional survey was conducted on 402 patients i.e. stroke patients (n=201) and high risk patients (n=201) in neurology and cardiology wards and outpatient clinics. Demographic profile, clinical profile and knowledge questionnaire were used for data collection. Data analysis was done using STATA 11.1, with the level of significance at p < 0.05. Both the groups were found to be statistically comparable with respect to age (p=0.280) and sex (p=0.411).¹⁴ The Quasi experimental non equivalent pre test post test control group design was used. The conceptual frame work of the study was based on the modified Imogine “King’s Goal Attainment Theory” (1981). Purposive sampling technique was used to select 60 samples for the study, 30 in experimental group and 30 in control group. The paired ‘t’ value for systolic blood pressure was 10.04 which was significant at P<0.05 level of significance. The paired ‘t’ value for diastolic blood pressure was16.2 which was significant at P<0.05 level of significance. The paired ‘t’ value for stress was 21.6which was significant at P<0.05 level of significance.¹⁵ Demographic data and structured knowledge questionnaire were used to assess the sample characteristics on life style modification on hypertension and its prevention. The data collected in the study was analyzed using descriptive and inferential statistics. The majority of the sample belonged to the age group of 40-45 years (26.66%) and 51-55 years (26.66%). Half of the sample had high school education. 16(53.33%) of them were unemployed. Majority 18(60%) of the sample had average knowledge on prevention of hypertension. 7(23.3%) of the sample had good knowledge and 5of them had poor knowledge on prevention of hypertension.¹⁶

In similar study by Grace Mary George, Kamlesh Kumari Sharma Indian Heart J. 2014 survey among 485 school children studying in classes 6, 7 and 8 in two government and one private school in New Delhi using convenience sampling, found that Cardiovascular risk factors (physical activity, diet and smoking), The mean age of the studied school children was 12.8 ± 1.6 years. The prevalence of overweight and obesity was 9.5% and 11.5% respectively. The prevalence of pre hypertension, stage 1 hypertension and stage 2 hypertension was 12.4%, 6.8% and 1.4% respectively. Of the total, 43.8% were physically active for at least 1 hour per day on all 7 days of the previous week. Daily consumption of fruits and vegetables was reported by 42% and 76% of the school children respectively. Nearly 5% of the school children reported to have used any form of tobacco. One fifth of the school children had a family history of cardiovascular disease. Of the total, 25.4% had adequate knowledge regarding cardiovascular risk factors. Cardiovascular risk factors are highly prevalent among school children. Importantly, school children lack adequate knowledge regarding cardiovascular risk factors. School based interventions are required for cardiovascular risk reduction in childhood.¹⁷

LIMITATION:

In this study the following limitation are drawn.

· It was limited to a 60 college students so generalization is not possible.

· The study was conducted among the college students from selected college at Bhubaneswar so generalization must be done with caution.

· The setting of the study was selected as per convenient of the researcher.

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Received on 14.02.2023 Modified on 19.04.2023

Int. J. of Advances in Nur. Management. 2023; 11(3):139-143.

DOI: 10.52711/2454-2652.2023.00033