1Lecturer, MGM Muthoot College of Nursing, Kozhencherry, Kerala, India.
2Principal and Research Guide, St. Thomas College of Nursing, Kattanam, Kerala, India.
*Corresponding Author E-mail: simithomas0704@gmail.com
ABSTRACT:
Rabies is a public health problem in developing countries like India, accounting for the second highest number of rabies related deaths worldwide. The awareness regarding rabies can lead to reduction in mortality from dog bite. The aim of the study was to assess the effectiveness of Structured Teaching Programme (STP) on knowledge and attitude regarding prevention and management of rabies among adults in selected areas of Bharanickavu Panchayath in Alappuzha District. A Quantitative method with pre-experimental one group pre-test and post-test research design was used. 150 subjects were selected by using non-probability convenient sampling technique. The researcher assessed the knowledge and attitude among adults regarding prevention and management of rabies using a structured questionnaire and attitude scale followed by a structured teaching programme. The collected data were analysed using descriptive and inferential statistics. The study revealed that among the 150 subjects nearly half of them 42% were between the age group of 40-44 years and 58% were females. During the pre-test, out of 150 subjects 26.66% had below average knowledge, 33.33% had average knowledge; 12% of the subjects had poor attitude, 72% had an average attitude. Whereas in post-test 80% had good knowledge, 13.33% had average knowledge; 94% had good attitude, 6% had average attitude regarding prevention and management of rabies. The calculated„t‟ value of knowledge and attitude was 85.769 and -18.74 which was greater than table value -1.65 at 0.05 level of significance. The study concluded that there was significant difference between pre-test and post-test knowledge and attitude scores of adults regarding prevention and management of rabies. The findings of the study revealed that structured teaching programme was very effective in improving the knowledge and attitude regarding prevention and management of rabies among adults.
KEYWORDS: Structured Teaching Programme, Knowledge, Attitude, Rabies and Adults.
INTRODUCTION:
Animal bites are major public health issues not only for the risk of acquiring secondary infection but also for the possibility of contracting rabies2. Rabies is an enzootic and epizootic disease of global burden3. It is one of the leading animal transmitted diseases in the sub-continent region; however, very little is known about this condition in general population4. It is an acute, highly fatal virus-borne disease of the central nervous system, caused by lyssa virus type 1, transmitted to both humans and animals usually by bite or licks of rabid animals such as dogs, cats, bats, and wolves‟ etc5. A bite from the mad dog is more dreaded than anything which arises from horribleness of the disease, the uncertainty of the animal being mad or of the infection being received. Dogs are the main source of human rabies deaths, contributing up to 99% of rabies transmissions to humans. Not knowing at what period to expect theeffect or to feel confident of having escaped it, keeps the person in a state of cruel suspense for months or years6. It was found that 1% dies every nine minutes and estimated around 59,000 deaths each year. The case fatality rate is almost 100% in humans and animals and more than 98% of patients were infected by dog bite or scratch. It was found that 95% of total recorded deaths were from Africa and Asian countries7.
There are many myths and false beliefs associated with wound management and this includes application of oil, herbs and red chillies on the wound inflicted by rabies animal and not washing the wound properly2. In India, rabies is a problem of considerable magnitude and accounts for 65% of the deaths due to rabies in the South-East Asia region. The National Rabies Control Program reported 6644 clinically suspected cases and deaths of human rabies between 2012 and 20228. India is one of the countries that have the highest population of stray dogs in the world9.
World rabies day was established by the Global Alliance for rabies control in 2007 and later endorsed by the World Health Organization (WHO). Every year September 28th is observed as the World Rabies Day. The theme for the year 2023: “All for One, One Health For All”. The global conference of rabies constructed a framework for the elimination of human death, from dog mediated rabies by 2030 10,11.
There are no global estimates of dog bite incidence; however studies suggest that dog bites account for tens of millions of injuries annually. More than 15 million people receive rabies prophylaxis annually, the majority live in China and India. It is estimated that in the absence of post-exposure prophylaxis, about 3,27,000 persons would die from rabies in Africa and Asia each year 3. India is endemic for rabies and accounts for 36% of the world‟s rabies deaths. There are on an average six to seven million dog bites every year in India. True burden of rabies in India is not fully known, although as per available information it causes 18,000-20,000 deaths every year and it is noted that from November to March, the aggression, bites and attack rate increases. About 30-60% of reported cases and deaths in India occur in children below the age of 15 years15.
India is the largest contributor to rabies mortality in the world. This is due to the misapprehension about the attitude towards dog bite wound, the first-aid, management and vaccination. There are many false beliefs and myths regarding dog bite management. People in the rural area have more faith in the indigenous methods that have an unproven efficacy. Most of the deaths are due to the ignorance and lack of access to affordable services. The only way to avoid deaths due to rabies is by early intervention, vaccination, post-exposure prophylaxis and vaccination of dogs16.
In Kerala, dogs are being increasingly viewed with suspicion and fear as the state continues to witness a rise in attacks on humans, including children. As per the livestock census in 2019, there are 2.89 lakh stray dogs in Kerala. In the year 2022, Kerala has seen 21 rabies deaths and 1.9 lakh cases of dog bites. There has been a rise in the number of dog bite cases reported over the past 5 years. While in 2017, the government hospitals reported 1.35 lakh cases of dog bites and the number rose to 2.21 lakh in 2021. Kollam district has the highest population of stray dogs with 50,869 and Thiruvananthapuram district has recorded the highest number of dog bite cases in the state with (27,343), followed by Palakkad (22,782), Kollam (21,692) and Thrissur (20,664)17.
An observational cross-sectional study was conducted on knowledge regarding Rabies at Jaipur during February 2018- July 2018 among 107 caregivers who attended the anti-rabies clinic. Data was collected using structured questionnaire. Results showed 22.5% respondents had good knowledge, 56% had fair and 21.5% had poor knowledge. Approximately, one third (36%) of the participants knew that it is an infectious disease, however, only 7.5% knew that saliva, vomitus, tear and urine of rabies patient may have rabies virus. Approximately, 15% of the attendees had a wrong concept that single injection is sufficient for immunization. This study revealed that knowledge regarding Rabies should be highlighted in National programme of India to acknowledge Indian population regarding fatal rabies18.
A cross sectional study was conducted to assess the knowledge, attitude and practices towards rabies prevention among 224 residents of Abuja Municipal area council, Nigeria in 2018 by using multistage sampling technique. The results showed that total of 123(55%) respondents owned dogs. 184(82%) respondents had satisfactory knowledge on rabies prevention, about 87% knew where to get dogs vaccinated and would seek medical treatment from the hospital when bitten by a dog. Majority (58%) did not know the frequency of anti-rabies administration for dogs and 63.3% did not know the appropriate first-aid actions following dog bites. 94% reported vaccinating dogs against rabies. They concluded that knowledge on rabies was satisfactory but with gaps in the frequency of dogs anti rabies vaccination, appropriate first-aid following dog bites and non-restriction of dog movement. To prevent rabies, these gaps need to be addressed through public enlightenment and enforcement of dog movement restrictions laws19.
A quantitative research was conducted in Chennai, India in 2019 to assess the effectiveness of structured teaching programme among 60 mothers regarding management and prevention of rabies in the children undergoing treatment for anti-rabies. On an average it was found, the mother‟s knowledge was improved from 10.13% to 21.05% following the structured teaching programme20.
A quantitative research was conducted in Jodhpur, Rajasthan among 60 general population of community to assess the knowledge regarding rabies prevention through self-structured interview.
Results showed that, out of 60 subjects, 32.7 subjects had excellent knowledge, 34 subjects had good knowledge, 17 subjects had average knowledge and 2 subjects had poor knowledge. There was no significant association between the demographic variable with level of knowledge. They concluded that awareness session on rabies prevention to be held regularly to improve the knowledge and create positive attitude and remove the misconception among general population21.
A cross sectional study was conducted to assess knowledge, attitude and practice towards rabies and free- roaming dogs in Shirsuphal village in Western India in 2019 among 127 rural residents by using a structured questionnaire. The results showed that the knowledge of the rural residents was found to be significantly influenced by family size (OR 2.1, 95%CI 1.0–4.6, p = 0.04) and poultry ownership (OR 2.3, 95%CI 1.1–4.9, p = 0.03), while their attitudes towards free roaming dogs was significantly influenced by age of the respondents (OR 2.6, 95% CI 1.2–5.8) and ownership of cattle/buffalo (OR 2.2, 95% CI 1.1–5.5). They concluded that although the knowledge score about rabies was high, a comprehensive understanding of the disease was lacking. Concerted efforts were recommended to widen the knowledge about rabies and promote healthier practices towards free roaming dogs22.
India‟s rabies vaccine market is growing at a steady rate. In 2022, its market value stood at $141.4 crore, while the 2023 estimated value is at $147.6 million. The Municipal Corporation of Delhi (MCD) reported that it had only 5000 doses of vaccines left for 2022, with many municipal corporation hospitals not having them at all23. Concerted efforts to widen the knowledge about rabies and promote healthier practices towards free roaming dogs are recommended 24.
The nurse in the community plays a pivotal role in educating and creating awareness among adults through education by frequent interaction with them and enforcing them to vaccinate all dogs and to prevent and manage dog bites in a proper way. The investigator experienced that the number of stray dogs in the community was high and the mortality rate due to dog bites was also high. So the investigator focused on continuous and consistent mass awareness campaigns and developed an appropriate structured teaching programme based on prevention and management of rabies in order to have proper health- seeking behaviour during the animal bites, proper bite wound management and vaccination strategies.
As a community health nurse the researcher can plan, implement and evaluate various teaching programmes for adults, making them aware about prevention and management of rabies in view of helping the community and thereby improving the knowledge of the society. Hence the researcher found that structured teaching programme was essential to create awareness regarding prevention and management of rabies among adults.
A study to evaluate the effectiveness of structured teaching programme on knowledge and attitude regarding prevention and management of Rabies among adults in selected areas of Bharanickavu Panchayath, Alappuzha district.
THE aim of the study is to evaluate the effectiveness of structured teaching programme on knowledge and attitude regarding prevention and management of Rabies among adults which would contribute to adoption of remedial measures to reduce the impact of the problem and to protect and promote the health of population.
1. To determine the level of knowledge and attitude regarding prevention and management of rabies among adults.
2. To evaluate the effectiveness of structured teaching programme on knowledge and attitude regarding prevention and management of rabies among adults by comparing the pre-test and post-test knowledge score.
3. To find the association between the pre-test knowledge and attitude score regarding preventionand management of rabies among adults with selected socio-demographic variables.
Structured teaching programme may be effective in prevention and management of rabies among adults.
H1: There will be a significant difference between mean pre-test and post-test knowledge scores regardingprevention and management of Rabies.
H2: There will be a significant difference between mean pre-test and post-test attitude levels regardingprevention and management of Rabies.
H3: There will be significant association between pre-test knowledge scores with selected demographicvariables.
H4: There will be significant association between pre-test attitude scores with selected demographicvariables.
J W Kenny’s Open system Model Theory (1990):
The inclusion criteria in the study were:
· Adults in the age group of 26-44years.
· Adults who are residing at Bharanickavu Panchayath.
· Adults who are willing to participate in the study
In the study the exclusion criteria were:
· Adults who have already attended the class on prevention of Rabies
· Adults who have difficulty in reading and understanding Malayalam.
· The final draft of the tool was prepared considering the suggestions of validators thatcomprise of 4 sections:
· Section A: Demographic variables.
· Section B: General information
· Section C: Structured knowledge questionnaire regarding rabies
· Section D: 3-point likert scale
· This part of the tool consists of socio-demographic data which includes age, gender, education, occupation, religion, residence, socio-economic status.
Section C: Structured knowledge questionnaire to assess the knowledge of adults regarding prevention and management of rabies:
To assess the knowledge regarding prevention and management of rabies, it contains 33 multiple choice questions, among them 27 questions had 4 options and remaining questions had 2 options. In that, correct answers were given a score of 1 and the wrong answers were given a score of 0. The possible maximum mark was 33 and the minimum mark was 0.
Attitude scale consists of 10 statements related to prevention and management of rabies. 6 statements were positive and the rest negative statements. The attitude scale includes Agree (3), Uncertain (2), and Disagree (1). In positive statement agree was given 3 mark and the negative statement disagree was given 3 mark. The scoring range is from 1 to 30.
After getting approval from concerned authority for the study, socio-demographic data, questionnaire and lesson plan for prevention and management of rabies was designed and prepared.
150 samples were selected using convenient sampling technique as per the inclusion and exclusion criteria. Informed consent was obtained from the samples. Confidentiality was maintained. The baseline data was collected and pre-test level of knowledge was assessed through structured knowledge questionnaire, based on the convenience of the adults regarding prevention and management of rabies.
Post-test level of knowledge will be assessed after 07 days using structured knowledge questionnaire and attitude scale.
Table 1: Distribution of the subjects based on socio- demographic variables (n=150)
|
Sl.No |
Variable |
Frequency (n) |
Percentage (%) |
|
|
1. |
Age |
26-32years |
36 |
24 |
|
33-39years |
51 |
34 |
||
|
40-44years |
63 |
42 |
||
|
2. |
Gender |
Male |
63 |
42 |
|
Female |
87 |
58 |
||
|
3. |
Education |
|
|
|
|
Primary |
48 |
32 |
||
|
Secondary |
69 |
46 |
||
|
College/ university |
33 |
22 |
||
|
4. |
Occupation |
Daily wages |
36 |
24 |
|
Government sector |
12 |
8 |
||
|
Private sector |
24 |
16 |
||
|
Home maker |
78 |
52 |
||
|
5. |
Religion |
Hindu |
54 |
36 |
|
Muslim |
9 |
6 |
||
|
Christian |
87 |
58 |
||
|
6. |
Residence: All the samples are from semi-urban area |
|||
|
7. |
Socio-economic status |
‹ 3000 |
16 |
11 |
|
3001-5000 |
34 |
22 |
||
|
5001-10000 |
36 |
24 |
||
|
› 10001 |
64 |
43 |
||
Figure 1: Percentage wise distribution of subjects based on education
Figure 2: Percentage wise distribution of subjects based on socio-economic status
Table 2: Distribution of subjects based on general information regarding prevention andmanagement of rabies. n=150
|
S.No |
Variable |
Yes (n) (%) |
No (n) (%) |
|
1 |
Do you have a pet at home |
90 (60%) |
60 (40%) |
|
2 |
Is your dog vaccinated |
90 (60%) |
60 (40%) |
|
3 |
Are stray dogs present in your area |
150 (100%) |
0 |
|
4 |
Has any of your family member beenbitten by a dog |
30 (20%) |
120 (80%) |
|
5 |
Have you ever been vaccinated for Rabies |
50 (33.33%) |
100 (66.66%) |
|
6 |
Has any death occurred in your areadue to dog bite |
3 (2%) |
147 (98%) |
n=150
Figure 3: Distribution of subjects based on pre-test and post-test knowledge score regarding earlysigns and symptoms of rabies in humans. n=150
Figure 4: Distribution of subjects based on pre-test and post-test knowledge score regarding
immediate care of wound.
Table 4: Comparison of subjects based on pre-test and post-test knowledge score regarding prevention of rabies. n=150
|
S. No |
Various aspects regarding prevention and management of rabies |
Knowledge score in pre-test |
Knowledge score in post-test |
||||||
|
Yes |
(%) |
No |
(%) |
Yes |
(%) |
|
(%) |
||
|
1 |
Prevention of rabies inanimals. |
60 |
40% |
90 |
60% |
150 |
100% |
0 |
0 |
|
2 |
Vaccination against rabies. |
22.5 |
15% |
127.5 |
85% |
150 |
100% |
0 |
0 |
|
3 |
Post-exposure prophylaxis. |
15 |
10% |
135 |
90% |
142.5 |
95% |
|
5% |
|
4 |
Best public health measure for prevention and controlof rabies. |
45 |
30% |
105 |
105% |
150 |
100% |
|
0 |
|
5 |
Best way to identify if doghas rabies |
30 |
20% |
120 |
80% |
150 |
100% |
|
0 |
Table 5: Distribution of pre-test and post-test knowledge score of subjects regarding prevention and management of rabies. n=150
|
Level of knowledge |
Pre-test |
Post-test |
||
|
n |
(%) |
n |
(%) |
|
|
Below average |
40 |
26.66% |
10 |
6.66% |
|
Average |
50 |
33.33% |
20 |
13.33% |
|
Good |
60 |
40% |
120 |
80% |
Table 6: Mean, mean difference, standard deviation and t value of pre-test and post-test knowledge score n=150
|
Parameter |
Mean |
Standard deviation |
t value |
P value |
|
Pretest |
11 |
2.01 |
85.76957442 |
P<0.05* |
|
Post test |
31.36 |
2.32 |
Table value t149 = (-1.65) * P<0.05 Significance
Table 7: Distribution of pre-test and post-test attitude score of subjects regarding prevention and management of rabies. n=150
|
Level of attitude |
Pre-test |
Post-test |
||
|
Frequency |
Percentage |
Frequency |
|
|
|
Poor |
18 |
12% |
0 |
0 |
|
Average |
108 |
72% |
9 |
6% |
|
Good |
24 |
16% |
141 |
|
Figure 5: Distribution of pre-test and post-test attitude score of subjects regarding prevention and management of rabies.
Table 8: Mean, mean difference, standard deviation and t value of pre-test andpost-test attitude score n=150
|
Parameter |
Mean |
Standard deviation |
Mean difference |
t value |
P value |
|
Pretest |
17.1 |
1.57 |
6.82 |
-18.74 |
P<0.05* |
|
Post test |
25.16 |
2.33 |
Table value t149 = (-1.65) * P<0.05 Significance
Table 9: Association between selected demographic variables and pre-test knowledge score ofadults. n=150
|
Demographic variables |
Good |
Average |
Below average |
Total |
df |
Chi square |
Table Value |
Inference |
|
Age |
|
|||||||
|
a) 26-32 |
9 |
15 |
12 |
36 |
4 |
15.631 |
9.488 |
Significant |
|
b) 33-39 |
8 |
31 |
12 |
51 |
||||
|
c) 40-44 |
13 |
38 |
12 |
63 |
||||
|
Gender |
|
|||||||
|
Male |
12 |
29 |
22 |
63 |
2 |
13.93 |
5.991 |
Significant |
|
Female |
18 |
45 |
24 |
87 |
||||
|
Education |
|
|||||||
|
a) Illiterate |
0 |
0 |
0 |
0 |
6 |
17.605 |
12.592 |
Significant |
|
b) Primary |
10 |
16 |
22 |
48 |
||||
|
c) Secondary |
13 |
25 |
31 |
69 |
||||
|
d) College/ university |
8 |
12 |
13 |
33 |
||||
|
Occupation |
|
|||||||
|
a) Daily wages |
10 |
14 |
12 |
36 |
6 |
0.55 |
0.97 |
Not Significant |
|
b) Homemaker |
2 |
3 |
7 |
12 |
||||
|
c) Govt sector |
6 |
9 |
9 |
24 |
||||
|
d) Private sector |
14 |
36 |
28 |
78 |
||||
|
Religion |
|
|||||||
|
a) Hindu |
10 |
28 |
16 |
54 |
4 |
0.55 |
0.97 |
Not Significant |
|
b) Muslim |
1 |
5 |
3 |
9 |
||||
|
c) Christian |
10 |
39 |
38 |
87 |
||||
|
Socio-economicstatus |
|
|||||||
|
a) <3000 |
3 |
9 |
4 |
16 |
6 |
17.438 |
12.592 |
Significant |
|
b) 3001-5000 |
8 |
14 |
12 |
34 |
||||
|
c) 5001-10,000 |
8 |
16 |
12 |
36 |
||||
|
d) >10,001 |
14 |
32 |
18 |
64 |
||||
Table 10: Association between selected demographic variables and pre-test level of attitude score ofadults n=150
|
Demographic variables |
Good |
Average |
Poor |
Total |
df |
Chi square |
Table Value |
Inference |
|
Age |
|
|||||||
|
(a) 26-32 |
20 |
10 |
6 |
36 |
4 |
15.286 |
9.488 |
Significant |
|
(b) 33-39 |
23 |
18 |
10 |
51 |
||||
|
(c) 40-44 |
19 |
15 |
14 |
43 |
||||
|
Gender |
|
|||||||
|
Male |
27 |
16 |
20 |
63 |
2 |
13.286 |
5.991 |
Significant |
|
Female |
38 |
19 |
30 |
87 |
||||
|
Education |
|
|||||||
|
(a) Illiterate |
0 |
0 |
0 |
0 |
6 |
17.583 |
9.488 |
Significant |
|
(b) Primary |
24 |
15 |
9 |
48 |
||||
|
(c) Secondary |
27 |
19 |
20 |
69 |
||||
|
(d) College/ university |
19 |
18 |
4 |
33 |
||||
|
Socio-economicstatus |
|
|||||||
|
(a) <3000 |
4 |
8 |
4 |
16 |
6 |
0.55 |
0.97 |
Not Significant |
|
(b) 3001-5000 |
15 |
12 |
7 |
34 |
||||
|
(c) 5001-10,000 |
19 |
14 |
3 |
36 |
||||
|
(d) >10,001 |
26 |
18 |
20 |
64 |
||||
The major findings of the study shows that majority of adults were in the age group between 40-44 years 63 (42%) and 87(58%) are female candidates. Most of the subjects had secondary education 69(46%) and majorities were homemakers 78(52%). Adults in the sample comprise more of Christians 87(58%) and all the subjects residing in rural area 150(100%). Majority have a monthly income of ›10001 rupees 64(43%). Of the 150 samples the number of families that had a pet was 90 (60%). As there was history of dogs at home there had been vaccination cases 90(60%). The number of any bite cases by dog or any animal showed 20(13.33%). The presence of stray dogs in the area accounted for 150 (100%). Out of 150 samples 50 dogs have been vaccinated for rabies (33.33%). There was incidence of death that has occurred due to dog bite which accounts for 3(2%). In the case of pre-test, 26.66% of sample had below average level of knowledge, 33.33% had average level of knowledge and 40% had good level of knowledge. Whereas in the post-test, majority of the sample, 80% had good level of knowledge, 13.33% had average level of knowledge and only 6.66% had below average level of knowledge.
The level of attitude among adults regarding prevention and management of rabies in the case of pre-test was, 23.33% of sample had poor attitude, 50% had an average attitude and 26.66% had good attitude towards prevention and management of rabies. Whereas, in post-test, majority of the sample 53.33% had good attitude and 13.13% had poor attitude towards prevention and management of rabies.
This study finding was supported by a cross-sectional study by A.A Thankamonamma, K.G Pinherio, C Shajahan A.C (2022) where they assessed the levels of knowledge regarding the rabies and its prevention among the 261 medical students of government T.D Medical college, Alappuzha by using convenience sampling technique. Pre-test was conducted by using a structured interview questionnaire.
The study revealed that 88.13% had adequate knowledge and 11.87% had inadequate knowledge. The level of knowledge of the participants with regards to the schedule of vaccination and knowledge of symptoms of rabies, was observed to be less than what would be desirable. Structured training and education of medical students can rectify this lacuna, and thereby bring about significant reduction in fatality rates. there was significant association between pre-test knowledge score of adults regarding prevention and management of rabies with selected demographic variables. There was significant association between pre-test attitude score of adults regarding prevention and management of rabies with selected demographic variables.
The present study was supported by a quasi-experimental study by Jeenath Justin Doss K where he assessed the effectiveness of planned teaching programme on knowledge regarding rabies and its management among 10-15 years students of Bhandu rural area, Mehsana district, Gujarat. 60 samples selected by using non probability convenient sampling technique. Pre-test was conducted by using structured interview schedule. This study revealed pretest 12(20%) were reported moderately adequate knowledge and 48(80%) were reported inadequate knowledge and after STP 11(18.33%) were reported adequate knowledge, 44(73.34%) were reported moderately adequate knowledge and only 5(8.33%) werereported inadequate knowledge.
The present study was conducted to assess the effectiveness of structured teaching programme on knowledge and attitude regarding prevention and management of rabies among adults in selected wards of Bharanickavu Panchayath, Alappuzha District. The results revealed that the mean pre-test knowledge score was 11 with a standard deviation of 2.01 and mean post-test knowledge score was 31.36 with a standard deviation of 2.32. The calculated “t” value was (85.76957442). The calculated “p” value was (5.06×10 -129) which was greater than “p” value (‹0.05) level of significance. Hence the research hypothesis H1 – there was significant difference between pre-test and post-test knowledge scores regarding prevention and management of rabies among adults in selected wards was accepted.
The present study has various implications in the field of nursing practice, nursing education and nursing research. The dissemination of knowledge takes place when the research findings are made use of in the following fields:
· Nursing personnel’s have a very important role in creating awareness among public regarding prevention and management of rabies in humans and animals.
· The study findings may help the nursing personnel to understand the need for conducting educational programmes on prevention and management of rabies on a regular basis during their visit.
· Nurses can also give mass awareness programmes to the community especially the individuals who are at risk for acquiring dog bite and rabies.
· Community health nurse can develop brochures, leaflets or pamphlets regarding the prevention and management of rabies.
· Nursing personnel’s can also be trained in prevention and management of rabies which will enhance the patients and the caregivers in the hospital.
· Nursing curriculum is a pathway to update the changes in nursing education. In nursing education curriculum, we are emphasizing on preventive and promotive aspects of nursing care.
· Nurses have a vital role in educating public regarding prevention and management of rabies.
· Conduct in-service education programmes to improve knowledge and skills of health professionals regarding prevention and management of rabies.
· Nursing students may be motivated and prepared to conduct health teaching programme to the public regarding prevention and management of rabies.
· Various audio-visual aids from the present technology can be used for educating students and health workers to equip them with necessary knowledge and to educate the community regarding prevention and management of rabies.
· The nursing students must be aware of their responsibility in early identification and prevention of further rabies cases. Nurses should arrange health teaching programme for parents and teachers.
· With advanced technology and ever-growing challenges for health care needs, the college and hospital administration have the responsibility to provide nurses, nurse educators and nursing students with continuing education on prevention and management of rabies
· The study finding will help the administrator to arrange continuing education programme for nurses regarding identification, management and prevention of rabies cases.
· The study findings can be used as implementations of the programme regarding rabies prevention and management by the health care delivery system (e.g.:- National, State or District level).
· Public health nurse should work with Panchayath to use maximum available resources to screen for rabies cases.
· The public health nurse should adapt to all IEC policies in providing health education to prevent and management of rabies.
· The present study findings can motivate the beginners to conduct similar study with differentvariables on large population especially among school children.
· The study findings reveal the current level of knowledge of adults regarding prevention and management of rabies
· There is a need of intensive and extensive research regarding prevention and management ofrabies both in the urban and rural areas.
· More research is needed for better outcome with regard to management of further upcomingrabies cases.
· Even though the samples had expressed their concerns regarding stray dog issues, I being the researcher was not in a position to take appropriate actions based on their concerns.
· The study was confined only to assess level of knowledge regarding prevention and managementof rabies.
· The study was done in selected wards of Bharanickavu Panchayath, thus limiting thegeneralization.
· The duration of the study was limited to 5 weeks.
Keeping in view the present research findings, following recommendations were made:
· The study can be replicated in large sample. This would increase generalization of findings.
· A correlative study can be conducted to find out the correlation between knowledge of communityhealth nurses regarding prevention and management of rabies and their attitude.
· An experimental study can be undertaken with a control group for effective comparison.
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Received on 18.11.2025 Revised on 09.12.2025 Accepted on 26.12.2025 Published on 23.02.2026 Available online from February 28, 2026 Int. J. of Advances in Nursing Management. 2026;14(1):47-55. DOI: 10.52711/2454-2652.2026.00011 ©A and V Publications All right reserved
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