A Study to Evaluate the effectiveness of Structured Teaching Programme on Knowledge regarding Reconstructive Flap and its Management among Nurses working in a selected Hospital, Rajkot

Nahida Sipai¹, Suneesh P M², Jeenath Justin Doss K.³

¹Ⅱ Year M.Sc. Nursing, Shri Anand Institute of Nursing Opp. Ghanteshwar Park,

B/H Shainik Society, Jamnagar Road, Rajkot – 360006.

²Guide, Shri Anand Institute of Nursing Opp. Ghanteshwar Park, B/H Shainik Society, Jamnagar Road, Rajkot.

³Principal, Shri Anand Institute of Nursing Opp. Ghanteshwar Park, B/H Shainik Society, Jamnagar Road, Rajkot.

*Corresponding Author E-mail: nahidasipai91@gmail.com

ABSTRACT:

The improvement of knowledge regarding Reconstructive flap and its management among Nurses working in Burns unit, Skin ward, Reconstructive and Plastic Surgery Unit has an important role in enabling the effectiveness of Structured teaching programmed as an independence nursing intervention. The objective of the study is to assess the level of knowledge regarding reconstructive flap and its management among Nurses working in selected hospital. The research design adopted was One Group Pre-test and Post-test design. The study had been conducted in selected hospital, Rajkot. Non probability convenient sampling technique had been adopted to select the desired samples. The sample size was 60. As a part of intervention, a Structured teaching programmed on knowledge regarding Reconstructive flap and its management was provided to Nurses working in Burns unit, Skin ward, Reconstructive and Plastic Surgery Unit for 30 minutes and the data was collected by structured interview with set of questionnaires that is administered to assess the level of knowledge regarding Reconstructive flap and its management among Nurses working in Burns unit, Skin ward, Reconstructive and Plastic Surgery Unit. The data were analysed by using both descriptive and inferential statistical method paired ‘t’ test was used to evaluating the effectiveness of Structured teaching programmed on knowledge regarding Reconstructive flap and its management. The obtained value 19.29, which shows highly significant at the level of p<0.001. There is significant association between demographic variables such as Year of Experience and Previous Source of Information with post-test level of knowledge on Reconstructive flap and its management. The study concluded that the structured teaching programme was effectiveness in improving of knowledge regarding Reconstructive flap and its management.

KEYWORDS: Effectiveness, Reconstructive flap and its management among Nurses working in Burns unit, Skin ward, Reconstructive and Plastic Surgery Unit.

INTRODUCTION:

“Healing comes when we choose to walk away from darkness and moves towards a brighter light.” - Dieter F. Uchtdorf

Healing is a journey and a spontaneous event that comes about through a kind of grace. It does not mean going back to the way things were before. But it is rather allowing to move closer to a better future. There is nothing permanent in life except change. Change is in the very nature of being.¹

Living healthy is a choice. Regardless of whether our focus in healing is on the physical, mental, emotional or spiritual levels².

Healing in the common sense is “the restoration of damaged living tissue to normal function.Restoration of the damaged living tissue is mainly done by the reconstructive surgery. Reconstructive surgery is a surgical speciality involving the restoration, reconstruction or alteration of the human body.³

Reconstruction means “to repair or to make a new”. To rebuild, but not necessary as the original or as new. Reconstruction can return both form and function and provide hope to the healing of the patient. Reconstructive surgery, both physically and spiritually, helps with healing of the unseen injury of the patient.⁵ It involves the transfer of a patient’s own tissue from a donor site to a recipient site which is typically the site of a defect. This is done to fill a defect such as a wound resulting from injury or surgery. It is done when remaining tissue is unable to support a graft or to rebuild more complex anatomic structures such as breast or jaw.⁴

NEED FOR THE STUDY:

Reconstructive surgery is performed to treat structures of the body affected aesthetically or functionally by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally done to improve function and ability, but may also be performed to achieve a more typical appearance of the affected structure. Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and levels of coverage may vary greatly.⁵

Reconstructive surgery is a surgical speciality that involves the restoration or reconstruction of a physical part of a person’s body. Although it is a type of plastic surgery, reconstructive surgery is more than about simply improving a person’s looks. It is good post-operative monitoring that determines the success or failure of the reconstruction and also permits early salvage of a failing flap.⁶

Over the past 25 years, microsurgery has passed through its infancy and teenage years into maturity. Once a last ditch salvage measure, it is now used as a gold standard in a variety of difficult reconstructive situations. Microsurgical free tissue transfer has become a common procedure, usually with predictable results.⁷

Microsurgical free tissue transfer has vastly expanded the reconstructive surgeon's repertoire and enabled us to think of a variety of reconstructive possibilities, which would have been impossible to conceive in the pre-microsurgical era. Most large series of free flaps published over the last two decades have cited success rates in the range of 95-99%. Nevertheless, microsurgical free tissue transfer is a technically demanding exercise which requires meticulous attention to planning and execution. In spite of improving equipment, better training facilities and a large amount of experience; failures and complications still do occur and these can be a source of considerable heartburn to the surgical team as well as a great deal of anguish to patients and their well-wishers.

OBJECTIVES OF THE STUDY:

1. To assess the level of knowledge regarding reconstructive flap and its management among Nurses working in selected hospital, Rajkot.

2. To evaluate the effectiveness of structured teaching programme on knowledge regarding reconstructive flap and its management among Nurses working in selected hospital, Rajkot.

3. To find out the association between selected demographical variable and post-test level of knowledge score among staff Nurses working in selected hospital, Rajkot.

HYPOTHESES OF THE STUDY:

H1 The mean post-test score will be significantly higher than the mean pre-test score of knowledge regarding reconstructive flap and its management.

H2 There will be significant association between the selected demographic variables and pre-test level of knowledge regarding reconstructive flap and its management among Nurses working in selected hospital, Rajkot.

ASSUMPTIONS:

· The Nurses may have inadequate knowledge on reconstructive flap and its management.

· Structured teaching programme may be effective in improving the knowledge of Nurses regarding reconstructive flap and its management.

DELIMITATIONS:

• Data collection period delimited to 4-6 weeks.

• Study is delimited to Nurses working in Burns unit, Skin ward, Reconstructive and plastic surgery units.

RESEARCH APPROACH:

Quantitative research approach.

RESEARCH DESIGN:

A pre-experimental study – one group pre-test & post-test design.

VARIABLES:

Independent variable

In the present study, the independent variable is the structured teaching programme regarding Reconstructive flap and its management.

Dependent variable

In this study, the dependent variable is knowledge of Nurses regarding Reconstructive flap and its management.

Demographic variables:

In this study the demographic variables are age in years, gender, educational qualification, present area of work, years of experience and previous source of information regarding reconstructive flap and its management.

SETTING OF THE STUDY:

The setting is a physical location and condition in which data collection takes place. The present research has been conducted in Vedant Multi-speciality hospital, is well known 50 beds multi-specialiy hospital which is located at the Moti tanki chowk, sadar bazar, Rajkot, Gujarat. The hospital is growing in full pledge with the support of all the medical staff and Nursing staff.

POPULATION:

The population consist of the staff Nurses working in selected hospital Rajkot.

Target population:- The target population in this study was the Nurses working in selected hospital, Rajkot.

Accessible population:- The accessible population in this study was the Nurses working in Burns units, Skin ward, Reconstructive and plastic surgery units.

SAMPLE:

SAMPLE AND SAMPLE SIZE:

The samples for the study consisted of 60 Nurses who are working in Vedant multi-speciality hospital, Rajkot.

SAMPLING TEHCNIQUE:

The sample was selected by using non probability convenient sampling technique.

CRITERIA FOR SELECTION OF THE SAMPLE:

Inclusion Criteria:-

• Nurses who are working in Burns units, Skin ward, Reconstructive and plastic surgery units.

• Nurses who are present at the time of data collection.

Exclusion Criteria:-

• Nurses who are not willing to participate in the study.

• Nurses who are not able to co-operate throughout the study.

DEVELOPMENT AND DESCRIPTION OF THE TOOL

After an extensive review of literature and discussion with experts tools were prepared on the basis of objective of the study. Structured questionnaire was developed to collect the information on knowledge regarding Reconstructive flap and its management. The tool developed was closed ended questionnaire to evaluate the knowledge on Reconstructive flap and its management. The main purpose of developing this tool was to educate the Nurses.

MAJOR FINDING OF THE STUDY:

Major study findings includes,

Findings related to demographic variables of the study

1. The majority of 35 (58.3%) samples’ age is between 21-25 yrs.

2. The majority of 50 (83.3%) samples are female staff Nurses.

3. The majority of 36 (60%) samples are GNM course.

4. The majority of 18 (30%) samples are working in ICU.

5. The majority of 17 (28.3%) samples are <1 year of experience.

6. The majority of 51 (85%) samples are are have no information.

The pre-test report 00(00%) adequate knowledge, 19(31.7%) moderately adequate and 41(68.3%) inadequate knowledge. After the structured teaching programme on knowledge regarding reconstructive flap and its management. the post-test level of knowledge was 47(78.3%) adequate knowledge, 13(21.7%) moderately adequate, and 00(00%) inadequate knowledge. It also revealed that the mean pre-test score is 13.81 and the mean post test score is 33.1. The mean difference between the pre test and post test score is 19.29.

It hence the hypothesis stated, ‘’ shows that the comparison between the pre-test and post-test knowledge score obtained by the samples on structured teaching programme the mean difference between the pre-test and post-test was 19.29 and the Standard deviation of pre-test level was 4.70 and post-test was 5.01 and the calculated value is (‘t’=22.69) is higher than the table value (p=3.232) at the level of 0.001 thus, researcher accepted the hypothesis H1.

COANCLUSION:

The main conclusion of this present study is that most of the staff Nurses had inadequate and moderately adequate level of knowledge in pre-test and they improved to moderately adequate and adequate knowledge in post-test. This shows the imperative need to understand the purpose of structured teaching programme regarding Reconstructive Flap and its Management among Nurses working in burns unit, skin ward, reconstructive and plastic surgery units.

REFERENCE:

1. Bhagyavidhata’s world. What is Healing: Available from http://www.bhagyavidhatasworld.org/healing.

2. Marry Maddux. Healing outside the box: Available from http://shirleyfeathers.com/healing.html.

3. Bloch healing: relational therapy through touch-principles and practice. What is healing therapy: Available from http://blochhealing.co.uk/what is healing therapy/4548999369.

4. Plastic surgery- wikipedia. Available from; https://en.m.wikipedia.org>plastic surgery.

5. Joseph M. Impact of reconstructive surgery: on the road to restoration: Available from: https://www.phoenix-society.org/resources/entry/reconstructive surgery-road to restoration.

6. Wikipedia, the free encyclopedia, flap surgery (online): Available from http://en.wikipedia.org/wiki/flapsurgery.

7. Mary Beth Nierengarten. The revolution and evolution of free flaps in fascial reconstructive surgery. September 1,2013: Available from: https://www.enttoday.org/article/the revolution and evolution of free flaps in fascial reconstructive surgery.

Received on 24.01.2023 Modified on 08.02.2023

Int. J. of Advances in Nur. Management. 2023; 11(2):90-92.

DOI: 10.52711/2454-2652.2023.00020