A Study to Assess the Nutritional Status and to Determine the Effectiveness of a Nutritional Awareness Programme on Knowledge Regarding Balanced Diet Among Visually Challenged Young Adults in Selected Institutions of Mysuru, Karnataka

 

Mrs. Roopa N1, Prof. Sheela Williams2

1M.Sc Nursing student, JSS college of Nursing Mysuru

2Professor cum Principal and HOD Medical Surgical Nursing, JSS College of Nursing Mysuru

*Corresponding Author E-mail: roopangowda7@gmail.com

 

ABSTRACT:

Background: Nutrition plays an important role in every human being especially visually challenged young adults. Visually challenged young adults are more exposed to various health problems. Some of the risks cannot be avoided by these adults but can boost up their health through proper health management. By inculcating Nutritional awareness programme among visually challenged young adults we can help them in improving their quality of life.

Aim: The aim of this study is to assess the nutritional status and to determine the effectiveness of a nutritional awareness programme on knowledge regarding balanced diet among visually challenged young adults in selected institutions of Mysuru, Karnataka”.

Methods: The research design selected for this study was Pre-experimental - One group pre test post test design. A pre test observation of the dependent variables is made before implementation of the treatment to the selected group, the treatment is administered, and finally a post test observation of dependent variables is carried out to assess the effect of treatment on the group. Non probability purposive sampling technique was used to select the visually challenged young adults for the study.

Results: The result of the study revealed that Nutritional awareness programme on Balanced diet was effective in increasing the knowledge of visually challenged young adults regarding Balanced diet as evidenced by computed paired ‘t’ test which was statistically  significant at 0.05 level of significance(t (99) = 1.99; p>0.05).

Conclusion: Thus it was concluded that the Nutritional awareness programme on balanced diet was effective in increasing the knowledge of visually challenged young adults regarding balanced diet. The study findings stresses the increasing responsibility of health professionals in planning and implementing various educational strategies to improve the knowledge of visually challenged young adults regarding balanced diet which in turn helps to reduce the risk of various health problems.

 

KEY WORDS: Nutritional awareness programme, balanced diet, visually challenged young adults.

 


 

INTRODUCTION:

Nutritional status of the population has a vital role in overall socio economic development of the country. The State has already implemented well formulated plans and programmes for providing food security and improving the nutritional status of its citizens, especially young adults. For the past three decades, three parallel nutrition programmes (Integrated Child Development Scheme (ICDS), The Nutritious Meal Programme (NMP), The internationally acclaimed World Bank Funded TINP I (1980-89) was the first project to focus on growth monitoring and selective nutrition supplementation to the most vulnerable population) have been launched and they cover the entire target population in the State.1

 

Nutritional status is the evident state of nutrition of an individual. A person is said to have a good nutritional status if he shows no evidence of malnutrition, whether open or latent. Nutrition is the aspect of science that interprets the relationship of food to the functioning of living organisms. It includes the uptake of food, liberation of energy, elimination of wastes and the biochemical synthesis that are essential for maintenance of normal growth and development.

 

The nutritional status of any person is his/her health as dictated by the quality of nutrients consumed, and the body’s ability to utilize them for its metabolic needs. Signs and symptoms of poor nutrition are Unexplained Fatigue, Brittle and Dry Hair, Ridged or Spoon-Shaped Nails, Mouth Problems, Diarrhea, Apathy or Irritability and Lack of Appetite.2

 

A balanced diet means getting the right types and amounts of foods and drinks to supply nutrition and energy for maintaining body cells, tissues, and organs, and for supporting normal growth and development. A well-balanced diet provides enough energy and nutrition for optimal growth and development.7

 

The first global estimate of the extent of visual impairment, in 1975, indicated that there were 28 million blind people. In the 1990s, it was estimated that the global population was likely to increase from 5.8 billion in 1996 to 7.9 billion by 2020, and most of the increase was expected to occur in the developing world. These population growth projections were used in turn to estimate the expected increase in the number of blind people. Estimates based on the 1990 world population indicated that there were 38 million blind people and almost 110 million with low vision.

 

This estimate was later extrapolated, first to the 1996 world population (45 million blind and 135 million people with low vision) and then to the projected 2020 population (76 million blind). These estimates indicated that the global extent of visual impairment would double in the period 1990–2020, and this realization provided the impetus for the launch of VISION 2020 in 1999. The estimated prevalence of blindness in 1990 ranged from 0.08% of children to 4.4% of persons aged over 60 years, with an overall global prevalence of 0.7%. It was also estimated that at least 7 million people become blind each year and that the number of blind people worldwide was increasing by 1–2 million per year.13

 

NEED FOR THE STUDY:

Disability is an important part of health and social problems. It affects the lives of millions of people directly and indirectly. Among all disabilities, visual disability is considered to be more important as sight is one of the five important senses possessed by man.11

 

Disability is a potential measure of health status of a population. The loss of this one sense appears far more of a catastrophic than the loss of any one of the others; even the nutritional health policy of India reiterated that blindness is an important public health problem. Blindness has profound human and socio economic consequences in all societies Disabled people in India are a silent and invisible group in spite of their significant number. We know almost nothing about the existential experience of persons who lives with visual disability.11

 

World-wide, estimates of the number of adolescents and young adults who live with a disability (Visually impaired) vary widely. Estimating the number of disabled young people is complex, for two reasons. The first is that frequently, disabled young people are grouped together with children or adults, blocking attempts to estimate their numbers as a distinct group. The second is that definitions of disability vary widely. In some nations, only individuals with significant challenges are identified; in others, even those with mild disabilities are included.11

 

Over 285 million people in the world are visually challenged, of whom 39 million are blind and 246 million have moderate to severe visual impairment (WHO, 2011). It is predicted that without extra interventions, these numbers will rise to 75 million blind and 200 million visually impaired by the year 2020 (WHO, 2010).Worldwide, vitamin A deficiency is the leading cause of childhood blindness, responsible for an estimated 70% of the 500,000 children who become blind each year.13

 

Visual impairment is a significant health problem worldwide. The WHO estimates that globally about 314 million people are visually challenged, of whom 45 million are blind. It has been estimated that over 80% of global visual impairment is preventable of treatable. The WHO estimates that in Karnataka about 93 million people are visually challenged, of whom 34 million are blind. In Mysore 323 lakhs people are visually challenged, of whom 40 lakhs are blind.14

Nutrition plays an important role in every human being especially visually challenged young adults. The quantity of nutritional information concerning symptoms of malnutrition is insufficient for visually challenged young adults. Therefore upgrading nutritional awareness and knowledge through educational courses and providing comprehensive and necessary information concerning malnutrition, signs and symptoms, and prevention of its complications can greatly improve the quality of the visually challenged young adults and to live healthy as well as productive life. So, the investigator is motivated to provide education through Nutritional awareness programme regarding Balanced diet.

 

OBJECTIVES:

1.    To assess the nutritional status among visually challenged young adults in selected institutions of Mysuru.

2.    To assess the level of knowledge regarding balanced diet among visually challenged young adults before and after administration of an awareness programme.

3.    To determine the effectiveness of an awareness programme regarding balanced diet among visually challenged young adults in selected institutions of Mysuru.

4.    To find the association between level of knowledge regarding balanced diet among visually challenged young adults and their selected personal variables.

 

HYPOTHESES:

Significance Level at 0.05:

H1: The mean post-test knowledge score regarding balanced diet among visually challenged young adults will be significantly higher than their mean pre-test knowledge score.

 

H2: There will be significant association between levels of knowledge regarding balanced diet among visually challenged young adults and their selected personal variables.

 

METHODOLOGY:

Research Approach / Design:

Pre-experimental - One group pre test post test design.

 

Study Variables:

Dependent Variable:

Knowledge regarding balanced diet.

 

Independent Variable:

Awareness programme regarding balanced diet

Selected Personal Variables:

In this study, it refers to the selected personal variables such as age, gender, religion, income, dietary pattern, problems related to GI system and previous knowledge regarding balanced diet.

 

Setting of the Study:

JSS polytechnic for the differently abled institute (visually challenged), and Helen Keller training center for visually handicapped at Mysore.

 

Population:

Visually challenged young adults.

 

Sample And Sampling:

Sample size is 40 Visually challenged young adults (30 Visually challenged young adults from JSS polytechnic for the differently abled institute and 10 Visually challenged young adults from and Helen Keller training center for visually handicapped.

 

Sampling Technique:

Sampling is the process of selecting a portion of the population. Samples were drawn from selected institutions of Mysuru city by purposive sampling technique.

 

SAMPLING CRITERIA:

Inclusion Criteria

1.    Visually challenged young adults who are willing to participate in study.(18-22 yrs)

2.    Visually challenged young adults available during the period of data collection.

 

EXCLUSION CRITERIA:

1.    Visually challenged young adults who are absent at the time of data collection.

 

RESULTS:

Section- i Description of Selected Personal Variables of Study Subjects:

The study sample comprised of 40 visually challenged young adults of the JSS polytechnic for the differently abled institute and Helen Keller training center for visually handicapped, Mysuru. The selected personal variables were Age, gender, religion, monthly income, type of food, family history of GI system disorder, eating habits, previous exposure to awareness programmes  as shown in table 1.

 

TABLE: 1 Frequency and percentage distribution of visually challenged young adults according to their selected personal variables n=40 

Sl. No

Sample characteristics

Frequency

Percentage (%)

1

Age in years

 

 

 

1.1       18-20

22

55%

 

1.2       20-22

18

45%

2

Gender

 

 

 

2.1 Male

24

60%

 

2.2 Female

16

40%

3

Religion

 

 

 

3.1 Hindu

31

77.5%

 

3.2 Muslim

5

12.5%

 

3.3 Christianity

4

10%

 

3.4 Any other

 

 

4

Monthly income (in rupees)

 

 

 

4.1 <5000

14

35%

 

4.2 5000-10000

21

52.5%

 

4.3 10000-15000

5

12.5%

 

4.4 >15000

 

 

5

Type of food

 

 

 

5.1 Vegetarian

22

             55%

 

5.2 Mixed

18

45%

6

Any family history of GI system disorder

 

 

 

6.1 Yes

3

7.5%

 

6.2 No

37

92.5%

7

How many meals do you have per day?

 

 

 

7.1<2 meals

8

20%

Sl. No

Sample Characteristics

Frequency

Percentage (%)

 

7.2 2-3 meals

22

55%

 

7.3 >3 meals

10

25%

8

How frequently do you eat in hotels?

 

 

 

8.1 Daily

4

10%

 

8.2 Once in a week

17

42.5%

 

8.3 Once in a month

19

47.5%

9

Do you attend any educational programme regarding balanced diet?

 

 

 

9.1 Yes

2

5%

 

9.2 No

38

95%

 


Findings of the present study shows that majority (55%) of visually challenged young adults were in the age group of 18-20 years. Data also revealed that majority (60%) of the visually challenged young adults were males. Most (77%) of the visually challenged young adults belongs to Hindu religion. Data related to monthly income presented that 52% of the visually challenged young adults monthly income between Rs5000-Rs10000. 92.5% of visually challenged young adults do not have any family history of GI system disorders. Majority (55%) of visually challenged young adults type of food is vegetarian. Data related to meals revealed that 55% of the visually challenged young adults have their meals 2-3 times. Data also revealed that 47% of the visually challenged young adults eat frequently in hotels once in a month. Majority of visually challenged young adults have not attended educational programme regarding Balanced diet.

 

SECTION- II:

Nutritional Status Among Visually Challenged Young Adults Nutritional status was assessed using nutritional assessment tool and data were tabulated to master sheet and frequency and percentage were computed. The findings are presented in table-2

 

Table 2 Frequency and percentage distribution of visually challenged young adults according to their nutritional status n=40

Nutritional status

Frequency (f)

Percentage (%)

No deficiency

29

72.5%

Mild malnutrition

7

17.5%

Moderate malnutrition Severe malnutrition

4

 0

10%

 

It is evident from Table 2 shows that majority of visually challenged young adults (72.5%) had no deficiency, (17.5%) were had mild malnutrition and (10%) of samples had moderate malnutrition.

 

Section 3: Effectiveness of Awareness Programme Regarding Balanced Diet Among Visually Challenged Young Adults

Part-A Description of knowledge of visually challenged young adults regarding balanced diet. I. Description of knowledge level among visually challenged young adults. Knowledge of visually challenged young adults was assessed using structured knowledge questionnaire. Total knowledge scores ranged from 0-34. The knowledge scores were further arbitrarily divided as poor (0-15), average (16-23), and good (24-30).The findings are presented in Table 3.

 

TABLE-3: I. Frequency and percentage distribution of knowledge scores of visually challenged young adults according to their pre-test and post-test scores. n = 40

Knowledge scores

Pre test n=40 f(%)

Post test n=40 f(%)

Poor knowledge

32(80%)

7(17.5%)

Average knowledge

8(20%)

24(60%)

Good knowledge

0(0%)

9(22.5%)

 

It is evident from Table 3 that, majority of the visually challenged young adults (80%) had poor knowledge and 20% of them had average knowledge regarding balanced diet in the pre-test. Data also revealed that in the post test, there was an increase in the knowledge level of visually challenged young adults i.e. (17.5%) of them have scored poor knowledge and 60% have scored average level of knowledge and (22.5%) have scored good knowledge regarding balanced diet.

 

II. Mean, median, range and standard deviation of knowledge scores:

The pre-test and post-test knowledge scores obtained from the subjects were tabulated to a master sheet and the total scores obtained from the samples were tabulated. Mean, Median, Standard deviation and Range of the scores were computed. The findings are presented in the Table 4

 

Table 4 Mean, Median, Standard Deviation, Range Of Pre-Test And Post-Test Knowledge Score Of Visually Challenged Young Adults n=40

Test

Mean

Median

Range

SD

Pre test

11.9

11

7-18

±3.104

Post test

19.9

19

14-28

±3.992

 

The data presented in Table 4 shows that, the pre-test knowledge score ranged from 7-18 and the post-test knowledge score ranged from 14-28. The mean pre-test knowledge score is 11.9 with standard deviation of ±3.104 and the mean post-test knowledge score is 19.9 with the standard deviation of ±3.992. This indicates that there was an increase in knowledge scores of visually challenged young adults after the awareness programme.

 

III. Significance of difference between the pre-test and post-test knowledge scores of visually challenged young adults regarding balanced diet.

To find the significance of difference in the mean pre-test and post-test knowledge scores of visually challenged young adults regarding balanced diet, paired ‘t’ test was computed and the findings are presented  in Table 5. The null hypothesis is stated as follows;

H01(a) : There will be no significant difference between the mean post-test and pre-test knowledge scores of visually challenged young adults regarding balanced diet.

The data presented in the Table 5 shows that the mean difference between pre-test and post test knowledge score is 8.

 

To find the significance of difference in mean knowledge level, a paired ‘t’ test was computed and obtained value of paired ‘t’= 28.97, p<0.05 is found to be significant. Hence the result does not support null hypothesis H01 and research hypothesis is accepted. It is inferred that there is significant difference between mean knowledge scores of pre and post test scores.

 

Table 5 Mean, Mean Difference, Standard Deviation Difference, Standard Error and Paired ‘T’ Value of Pre-Test and Post Knowledge Scores of Visually Challenged Young Adults. n=40

Knowledge scores

Mean

Mean Difference

S.D. Difference

Standard

Error

Paired ‘t’ test value

Pre-test

11.9

8

 

±1.7464

0.799

 

28.97*

Post-test

19.9

t(9)= 2.26   ; p<0.05* significant.

 

The data presented in the Table 5 shows that the mean difference between pre-test  and post test knowledge score is 8. To find the significance of difference in mean knowledge level, a paired ‘t’ test was computed and obtained value of paired ‘t’= 28.97, p<0.05 is found to be significant. Hence the result does not support null hypothesis H01 and research hypothesis is accepted. It is inferred that there is significant difference between mean knowledge scores of pre and post test scores.

 

Section 4 Association between the knowledge and selected personal variables of visually challenged young adults.

Association between knowledge scores of visually challenged young adults and their selected personal variables. To find out the association between the pre-test knowledge levels of visually challenged young adults with their selected personal variables, chi square was computed and following null hypothesis is stated.

 

H02: There will be no significant association between the knowledge of visually challenged young adults regarding balanced diet with selected personal variables.

Association between knowledge visually challenged young adults and their selected personal variables.


 

 

 

Table-6 Chi-square values between knowledge level of visually challenged young adults with their selected personal variables. n=40

Sl No

Personal variables

Poor knowledge

Average and good knowledge

chi square

1

Age in years

 

 

 

 

1.1       18-20

16

6

0.76

 

1.2       20-22

16

2

 

2

Gender

 

 

 

 

2.1 Male

18

6

1

 

2.2 Female

14

2

 

3

Religion

 

 

 

 

3.1 Hindu

25

6

0.08

 

3.2 Any other

7

2

 

4

Monthly income (in rupees)

 

 

 

 

4.1 <5000

13

1

1.16

 

4.2 5000-10000

19

7

 

5

Type of food

 

 

 

 

5.1 Vegetarian

16

6

0.76

 

5.2 Mixed

16

2

 

6

Any family history of GI system disorder

 

 

 

 

6.1 Yes

3

0

0.026

 

6.2 No

29

8

 

7

How many meals do you have per day?

 

 

 

 

7.1<2 meals

8

8

0.032

 

7.2 2-3 meals

24

0

 

8

How frequently do you eat in hotels?

 

 

 

 

8.1 Once in a week

17

4

0.056

 

8.2 Once in a month

15

4

 

9

Do you attend any educational programme regarding balanced diet?

 

 

 

 

9.1 Yes

1

1

0.032

 

9.2 No

31

7

 

 


The data presented in table 6 shows that there was statistically no significant association between the level of knowledge of the visually challenged young adults with their selected personal variables. Hence the null hypotheses is accepted inferring that there is no significant association between the level of knowledge of visually challenged young adults regarding Balanced diet with their selected personal variables.

 

IMPLICATIONS:

The findings of the present study are implicated to nursing practice, nursing education, nursing administration and nursing research.

 

Nursing Practice:

Several implications can be drawn from the present study for nursing practice. Nutrition plays an important role in every human being especially visually challenged young adults. Nursing personnel’s as the member of the health care team have an important role to play in improving the nutritional status of visually challenged young adults, well being and quality of life of visually challenged young adults by educating them regarding balanced diet. Nursing personnel’s need to take the responsibility of promoting the nutritional status of the visually challenged young adults. Periodic nutritional assessment and mass nutritional awareness programmes can be conducted to create awareness about balanced diet.

Nursing Education:

Education is the key component in improving the knowledge of an individual. The findings of the present study can be considered in planning the nursing curriculum of nursing students. Student nurses can be educated regarding balanced diet for visually challenged young adults so that they can conduct mass health education programmes, nutritional awareness programmes and give health talks to promote nutritional status.

 

Nursing Administration:

Continuing nursing education enables the learner to maintain the pace along with the changes and development in his/her field of specialty. The findings of the present study helps the nurse administrators working in the hospital and community settings to plan for periodic check up of visually challenged young adults, to identify their risk for visual impairment and to conduct workshops, seminars, and awareness programmes for them regarding balanced diet.

 

Nursing Research:

The topic has great importance in present day complexities of the health care system. The result of the present study revealed that majority of the visually challenged young adults had poor knowledge regarding balanced diet. This study findings gives scope for further research studies to be undertaken to explore the efficacy of various interventions to improve the nutritional status  among visually challenged young adults.

 

DELIMITATIONS:

The limitations of the present study were:

1.    The study is delimited to the visually challenged young adults who are identified in selected institutions at Mysuru.

 

RECOMMENDATIONS:

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

1.    Similar study can be carried out on a larger scale for broader generalization.

2.    Similar studies can be conducted to assess the effectiveness of other educational strategies to improve the knowledge of visually challenged young adults regarding balanced diet.

3.    More studies can be conducted on strategies to prevent visual impairment and promote nutritional status of visually challenged young adults.

 

CONCLUSION:

The findings revealed that Nutritional awareness programme on balanced diet was effective in increasing the knowledge of visually challenged young adults regarding balanced diet as evidenced by computed paired ‘t’ test which was significant at 0.05 level of significance.

 

Thus it was concluded that the Nutritional awareness programme on balanced diet was effective in increasing the knowledge of visually challenged young adults regarding balanced diet. The study findings stresses the increasing responsibility of health professionals in planning and implementing various educational strategies to improve the knowledge of visually challenged young adults regarding balanced diet which in turn helps to reduce the risk of  various nutritional problems. 

 

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Received on 27.01.2017          Modified on 05.09.2017

Accepted on 20.07.2017          © A&V Publications all right reserved

Int. J. Adv. Nur. Management. 2017; 5(4):281-287.

DOI:   10.5958/2454-2652.2017.00061.0