INTRODUCTION:

Chemotherapy is the use of cytotoxic drugs in the treatment of cancer. It is one of the four treatment modalities (the other being surgery, radiation therapy, and biotherapy) that provide cure, control, or palliation.¹ Cytotoxic drugs are used in the therapy of various neoplastic conditions, organ transplantation, and collagen vascular disorders and are used in oncology, radiotherapy, transplant, and immunology units².

Nurses must be aware of the safe handling of chemotherapeutic drugs, which include assessment of drug preparation, administration and disposal. ³

Nurses must be aware of the safe handling of chemotherapeutic drugs, which include assessment of drug preparation, administration and disposal⁴. It is clear that nurses remain at risk of exposure⁵. Many don’t have adequate knowledge about the effects because they are not aware of the literature, while others may be aware of the problem and are either very concerned about it, or they believe that their workplace is safe⁸. So the researcher felt the need to carry out this work.

MATERIAL AND METHOD:

Ethics:

The ethical clearance was obtained from university research ethics committee and the study was carried out in accordance with the guidelines laid by Indian Council of Medical Research ICMR (2006). The written consent from Nursing students was collected prior to the study.

Study design:

Quantitative approach with Pre-Experimental research design “one group pre-test post-test design was selected for the study.

Selection and description of participants:

A sample of 40 BSc (N) 4^th year participated in this study with the prior permission from the principals of Bee Enn college of Nursing, chak bhalwal jammu.

Inclusion criteria:

i) B.Sc. Nursing 4^th year students.

ii) B.Sc. Nursing 4^th year students who were studying in Bee Enn college of Nursing, Chak bhalwal, Jammu.

iii) Those who are willing to participate in the study.

Exclusion criteria:

i) B.Sc. Nursing 1^st, 2^nd and 3^rd year students.

ii) Those who are not willing to participate in the study.

The sample was selected through Purposive Sampling Technique. Teaching was given with Lecture cum discussion with the help of power-point presentation. The study was conducted during the period from March 2020 to June 2021 in the state of Jammu, India

Description of Data collection procedure:

The data was collected using two tools. The first tool was that of the demographic variables. It consisted of nine items related to selected sample characteristics of BSc (N) 4^th year students i.e gender, religion, type of family, area of residence, have you ever heard about safe handling of chemotherapeutic drug, if yes, specify. The second tool was the Structured knowledge questionnaire. It consists of 20 knowledge based questionnaire to assess the knowledge on safe handling of chemotherapy drugs among B.Sc. Nursing 4^th year students. Each item had a single correct answer. Every correct answer was accorded a score of one mark and every wrong answer assigned zero mark. Thus the maximum score was 20 and the minimum score was zero. The level of knowledge was categorized as very good, good, average and below average.The reliability coefficient for structured knowledge questionnaire was calculated by using Kuder-Richardson- 20 (KR₂₀) formula and it was found to be 0.8.The researcher collected the pretest on day 1 and on day 2 gave the intervention. After a period of 15 days the post test was conducted.

Statistics:

KS (Kolomogorov- smirnov) test was applied to check the normality of the data. Analysis was done by SPSS, version 16. Descriptive and inferential statistics were used. A probability value of less than 0.05 was considered to be significant.

The objectives of the study:

1. To assess the pre-test level of knowledge regarding safe handling of chemotherapy drugs among B.SC. Nursing 4^th year students.

2. To determine the effectiveness of structured teaching on safe handling of chemotherapy drugs among B.SC. Nursing 4^th year students.

3. To find out the association between the post level of knowledge score on safe handling of chemotherapy drugs with selected demographic variables.

Following hypotheses were tested at 0.05 level of significance:

H1: There will be significant differences in the level of knowledge regarding safe handling of chemotherapy drugs regarding safe handling of chemotherapy drugs between the pre-test and post test score among the 4^th year students.

H2: There will be significant influence between the post-test knowledge score on safe handling of chemotherapy drugs and the selected demographic variables among B.Sc. Nursing 4^th year students.

RESULT:

Data was entered in Microsoft excel and analysis was done with SPSS version 16. Result of the study shows that structured teaching program was effective in improving the knowledge of BSc(N) 4^th year students.

1. Findings related to selected sample characteristics:

Among the BSc (N) 4^th year students, most of the students 36 (90%) were females and 4(10%) were Males. Regarding religion, 20(50%) were Hindus, 17(42.5%) were Muslims and 3(7.5%) were Sikhs. Most of them 33(82.5%) were residing in nuclear families and 7(17.5%) were residing in joint families. Regarding the area of residence, 10(25%) were from urban area, 13(32.5%) were from rural area and 17(42.5) were from semi-rural area. Majority of the students 37 (92.5%) were having previous knowledge regarding safe handling of chemotherapy drugs and 3(7.5%) were not aware. For less than half of the students 17 (42.5%), the source of information was Mass media, 8(20%) was printed media and 15(37.5%) was social media. Hence

2. Findings related to the effectiveness of structured teaching regarding safe handling of chemotherapy drugs

In pretest of knowledge, majority of the students 33 (82.5%) had below average and only few 7 (17.5%) had average knowledge whereas in post-test more than majority of the teachers 16(40%) had very good level of knowledge, few 12(30%) had good level of knowledge and 12(30%) had average level of knowledge.

The level of knowledge among BSc(N) 4^th year students after administration of structured teaching program was found to be statistically significant as obtained by using t test (Table 1)

Table 1: Mean, Mean difference, standard deviation of difference, standard error of mean difference ‘t’ and ‘p’ value of pretest and posttest of knowledge score of B.Sc. Nursing 4^th year students regarding safe handling of chemotherapy drugs N=40

Knowledge Score	Mean	M _D	SD_D	SE_MD	‘t’ value	p value
Pre test	8.05	7.3	2.785	0.440	16.580	0.000
Post Test	15.35

“t”(40 )= 2.021 at 0.05 level of significance**highly significant(p<=0.001)

Table 1 shows that the level of knowledge among BSc(N) 4^th year students after administration of structured teaching program. The t test was applied and the mean difference was found to be statistically significant (“t”= 16.580, p=0.000) at 0.05 level of significance. Hence, the null hypothesis (H₀₁) was rejected and research hypothesis (H₁) was accepted. Thus, it can be inferred that the Structured Teaching Practice regarding safe handling of chemotherapy drugs was effective in increasing the knowledge of B.Sc. Nursing 4^th year students.

3. Findings related to Association of the post test scores with the sample characteristics:

The ANOVA ‘t’ value of gender (0.905), religion (0.225), family (1.530), Area of residence (1.131), Have heard previously about the safe handling of chemotherapy drugs (0.012), if yes specify (0.230) were found to be statistically non-significant. It denotes no association with knowledge. Hence, null hypothesis H₀₂was accepted and research hypothesis H₂was rejected.

DISCUSSION:

The results were supported by study which highlighted the lowering of errors on cytotoxic drugs during calculation of dosage, preparation, administration, and disposal, producing an effective improvement among nurses who had undergone an education program before the educational intervention.⁶ Also the result was supported by another study which shows that the majority of the nurses had adequate knowledge on chemotherapy after the intervention .⁷

STRENGTH OF THE STUDY:

· The topic was selected on the basis of deep survey conducted in oncology department so researcher made future nurses aware about the knowledge regarding safe handling of chemotherapeutic drugs.

· Purposive sampling was used for the study that helped in easiest measure to collect data.

· Inferential statistics was used for the analysis.

· Hypothesis 01 was proved and accepted which suggested that the study was effective

LIMITATIONS OF THE STUDY:

This study was conducted only in a selected college which imposed limitations in generalization of findings. No follow-up was done after the post-test due to time constraint of the participants

IMPLICATIONS OF THE STUDY:

The findings of the study will help to

· Create awareness about safe handling of chemotherapeutic drugs through conducting work shop.

· Motivate the nursing student in creating awareness regarding safe handling of chemotherapeutic drugs among BSC Nursing 4^th year students.

· Improve the knowledge of health worker regarding safe handling of chemotherapeutic drugs.

CONCLUSION:

The structured teaching program was effective in enhancing knowledge (pretest score=8.05+ 1.584 and post test score=15.35+2.558) of BSc(N) 4^th year students on safe handing of chemotherapeutic drugs. There was no significant association of structured teaching program with post-test knowledge scores.

CONFLICT OF INTEREST:

NIL

ETHICAL APPROVAL:

The study was carried out in accordance with the guidelines laid by Indian Council of Medical Research ICMR. The permission was taken to conduct the study from the principal of the institute. The written consent from the students was collected prior to the study. The purpose for carrying out research project was explained and assurance of confidentiality was given to the participants.

REFERENCE

1. Airley, R., Cancer Chemotherapy 2009, John Wiley and Sons, Ltd.: Chichester.

2. Textbook of Medical Surgical and Nursing Edition 3rd, Page Number 111-129.

3. Chugh SN, A Textbook of Medical Surgical and Nursing (part-2), Edition 1st (2013), Page number 1222-1238.

4. Chritensen and Kock row (2011). Foundation and Adult Health Nursing 6th edition Missouri: Elsevier Publications.

5. Joyce M Black (2012), Medical Surgical Nursing volume 1.8th edition Philadelphia: Elsevier Publication

6. Vioral AN. From an Issue Editor. Home Health Care Management and Practice. 2007;19(5):339-340. doi:10.1177/1084822307301550

7. Mohsen MM, Abdullah WH, Kholy TA El, Al-abbadi H. Effect of Nutritional Educational Intervention on Improving Dietary Habits among Recovering Colorectal Cancer Patients. 2017;4(1):327–44.

8. Walton, A.l, Mason ,S, Busshart, M, Spruill,A.D., Check, s., Lane, A.,Sabo, K. and Taylor, A.(2012).Safe handling:Implementing hazardous drug precautions. Clinical Journal of Oncology Nursing. 16(3), 251-254, doi:L10,1188/12 CJON.251-254.

9. Weingart, S.N., Li, J.W., Zhu, J., Morway, L., Stuver, S, O., Shulman, L. N and Hassett, M.J. (2012). U.S. cancer centre implementation of ASCO/oncology Nursing society chemothetrapy administration safety standards. Journal of Oncology Practice, 8(1), 7-12.

10. Whittemore, R. knafl, k. (2005). The integrative review: updated methodology. Journal of Advanced Nursing. 52, 546-553.

11. Womer RB, Tracy E, Soo-Hoo W, Bickert B, DiTaranto S, Barnsteiner Jh. Multidisciplinary system approach to chemotherapy safety; rebuiliding processes amd holding the gains. Jclin Oncol 20, 2002,4705-12.

12. Usha Rani R. A Study to Assess the Knowledge regarding the side Effects of Chemotherapy among Cancer patients in selected Hospital, Bangalore. Asian J. Nursing Education and Research. 2021; 11(1):83-85.

13. Saranya. K.V., Ramapriya. G., Ravendra Bansal, Manimegalai. S., Priya P.M. Effectiveness of Structured Teaching Program on Knowledge regarding Chemotherapy and Chemotherapy Administration Protocol among Final Year General Nursing and Midwifery Students at selected schools of Nursing Sciences Bengaluru. Asian Journal of Nursing Education and Research. 2022; 12(4):445-8.

14. Darshana. Kumari, Vashali Taksande. Assess the practice regarding safety measures used by nurses while handling Chemotherapy drugs. Int. J. Adv. Nur. Management. 2016; 4(4): 349-354.

15. Simrat Kaur, Prempati Mayanglambam, Deepika Bajwan, Nancy Thakur. Chemotherapy and its Adverse Effects – A Systematic Review. International Journal of Nursing Education and Research. 2022; 10(4):399-2.

16. Lakshyajeet Nath, Urmi Choudhury, Mangala Lahkar. A Study about the pattern of adverse effects of various oncology drugs in a Tertiary Care Hospital of North East India. Research Journal of Pharmacology and Pharmacodynamics. 2022;14(4):208-2.

17. Amy Elizabeth Jaibu, R. Shanmuga Sundaram, Krishnaveni. K, Sambathkumar R. Targeted Cancer Therapy: Promises and Reality.Research J. Pharm. and Tech 2018; 11(4): 1407-1412.

18. Jishala MI, Venkateswaramurthy N, Sambathkumar R. Cardiotoxicity associated with Cancer Chemotherapy. Research J. Pharm. and Tech. 2020; 13(5):2480-2487.

19. Casimir Adade Adade, Amine Cheikh, Hafid Mefetah, Amina Kili, Laila Hessissen, Mustapha Bouatia. Adverse effects of Anticancer Chemotherapy in Childhood Cancer: A Prospective Study in a Moroccan hospital. Research Journal of Pharmacy and Technology. 2022; 15(6):2559-4.

20. Krishnaveni K, Rosmi Jose, Sumitha SK, Teena Johny, Shanmuga Sundaram R, Sambathkumar R. A Study on Socio Demographic and Associated Risk Factors for Cancer Patients in Private Cancer Hospital, Bangalore, India. Research J. Pharm. and Tech. 2018; 11(2):677-680.

21. Punna Venkateshwarlu, Mehul M. Patel. A Review: Method Development Validation and Degradation Studies of some Anticancer Drugs. Research Journal of Pharmacy and Technology. 2021; 14(10): 5443-8.

Received on 18.03.2023 Modified on 09.05.2023

Int. J. of Advances in Nur. Management. 2023; 11(3):151-154.

DOI: 10.52711/2454-2652.2023.00035