Title page

Title of the article: “A study to assess the effectiveness of planned teaching programme on

knowledge regarding deep vein thrombosis and its prevention among orthopedic clients

admitted at HSK hospital and research centre Bagalkot”.

Information regarding Authors:

Dr.Shridhar G Pujari*, Dr.DeelipS Natekar**

* Corresponding Author; Associate professor, Department of Medical Surgical Nursing, Shri

B.V.V.S Sajjalashree Institute of Nursing Sciences Navanagar Bagalkot Karnataka. Email:

[email protected], Mobile-9538363774

**Principal, (Ph.D. in Nursing), Shri B.V.V.S Sajjalashree Institute of Nursing Sciences,

Bagalkot, Karnataka. Email: [email protected], Mob No: 9844802937.

1. Jemu Nayak, BSc Nursing 4th year,Shri B.V.V.S.Sajjalashree Institute of Nursing

Sciences,Bagalkot, Karnataka. Email : [email protected] ,Mob No: 6362306994

2. Nagavva Patil, BSc Nursing 4th year ,Shri B.V.V.S .Sajjalashree Institute of Nursing
Sciences,Bagalkot,Karnataka. Email: [email protected] , Mob No:8431945426

3. Pooja Padalli, BSc Nursing 4th year,Shri B.V.V.S.Sajjalashree Institute of Nursing

Sciences,Bagalkot, Karnataka. Email: [email protected] ,Mob No:8310606684

4. Kalyankumar Bhajantri, Post Basic BSc Nursing 2nd year, Shri B.V.V.S.Sajjalashree
Institute of Nursing Sciences,Bagalkot,Karnataka Email: [email protected]
,Mob No:9611259262

5. Shankarguru Rotti, Post Basic BSc Nursing 2nd year, Shri B.V.V.S. Sajjalashree Institute of
Nursing Sciences,Bagalkot,Karnataka . Email: [email protected] ,Mob
No:9611673564
6. Parwathi Dinni ,Post Basic BSc Nursing 2 nd year, Shri B.V.V.S. Sajjalashree Institute o f
Nursing Sciences, Bagalkot,Karnataka . Email: [email protected] ,Mob
No:8197859135

Type of Article:Research article.

Conflict of interest:None

Word count

Total page: 14

Abstract: 432

Main Content: 1435

Total: 2000

Total number of tables: 05

ABSTRACT:
1. Background : Conceptual frame work act as a building block for research study. The

over all purpose of frame work for scientific finding meaning full and generalized. It

provides a certain frame work for reference for clinical practice, education and

research. Frame work can guide the researchers under taking of not only “what” of

natural phenomenon but also “why” of their occurrence. They also give directions for

relevant questions to practical problems.1

2. Aims:To assess the knowledge of orthopaedic clients regarding deep vein thrombosis

and its prevention. To evaluate the effectiveness of planned teaching programme on

knowledge regarding deep vein thrombosis and its prevention among orthopedic

clients. To determine the association between pre test and post test knowledge scores with

selected socio demographic variables of orthopedic patients.

 Materials and Methods:Study approach- This was an evaluative study and follow the

examination plan as pre-exploratory, for example one gathering pre-test and post-test without

control group. The population associated with this investigation was orthopedic client at HSK

Hospital and Research Center at Bagalkot. Tests are orthopedic clients at HSK Hospital and

Research center at Bagalkot. Test size is 30 (Total) orthopedic clients were remembered for

the investigation

Results:The assessment of pre test knowledge of the orthopedic patients reveals that majority

63.33% of patients had average knowledge. The pre test mean percentage of knowledge score

was 40.05% with mean and SD 13.34± 2 were as in the post test mean percentage of

knowledge score was 71.85% with mean and SD 22.72± 2.02 which reveals effectiveness of

PTP.

Conclusion: A significant difference was found between the pre-test and post-test

knowledge scores of the orthopedic clients . The study proved that PTP was effective in

improving the knowledge of orthopedic clients.

Key words: Effectiveness, Planned teaching program, Knowledge, Socio-demographic

variables,Orthopedic clients.

INTRODUCTION: Deep vein thrombosis has the longest recorded history. The oldest

known description of this condition is found in Ebers papyruses, which have been dated to

approximately 1500BC. The deep vein thrombosis are enlarged; twisted, painful deep veins

resulted from poorly functioning valves. As the condition first described the mechanism of

deep vein thrombosis formation of blood in deep venous system through the perforating

veins1.

Deep vein thrombus are very common in the age group of 30 to 70 years, more common in

women and in those persons whose job requires prolonged standing.

 The Deep vein thrombus in most people remain as simply a cosmetic concern, do not

cause

Any discomfort, but unfortunately for others deep veins thrombus veins can cause

significant discomfort and are often a sign of more serious problem kinesis, a word of Greek

origin means motion or to move. The human body is designed for physical activity and

movement. Even at rest, the normal healthy adult changes position on average every 11.6

minutes during sleep; this physiological requirement for movement is termed the minimal

physiologic mobility requirements2.

Before the 1940s, strict bed rest was the rule for two weeks after childbirth, three weeks

after herniorrhaphy, and four weeks or more after myocardial infarction. The shortages of

hospital beds and personnel during World War II led to the surprise discovery that early

mobilization of the sick and injured actually improved results and lessened complications 3.

More recent researches by the National Aeronautics and Space Administration

(NASA) produced additional evidence for the damaging effects of prolonged inactivity and

immobility.

Like muscle, bone is living tissue that responds to exercise by becoming stronger.

Those who exercise regularly generally have greater bone mass (bone density and strength)

than those who do not. Although weight-bearing activities contribute to the development

and maintenance of bone mass, weightlessness and immobility can result in bone loss 4.

Some people can't perform weight-bearing activity. They include, for example,

people who are on prolonged bed rest because of surgery, serious illness, or complications

of pregnancy; and those who are experiencing immobilization of some part of the body

because of stroke, fracture, spinal cord injury, or other chronic conditions. These people

often experience a significant bone loss and are at high risk for developing complications

live deep vein thrombosis, constipation, osteoporosis, etc. It is suggested that there is a
 good chance to fully recover the lost bone if the immobilization period is limited to 5 to 8

weeks5.

NEED FOR STUDY: Deep leg veins are the larger veins that go through the muscles of

the calf and thighs. Venous thrombi are IV deposits composed of cellular materials. They are

not the veins that we can see just below the skin .A calf vein is the common site for a deep

vein thrombosis. A thigh vein is less commonly affected. Rarely, other deep veins in the

body can be blocked by blood clots. When a person has deep vein thrombosis, the blood

flow in the vein is partially or completely blocked. An important complication of deep vein

thrombosis is the dislodgement of the clot from the deep vein, which will travel along the

circulation and reaches the pulmonary vasculature and causing pulmonary embolism 10.

Aims:

The aims of the study are as follows:

1. To assess the knowledge of orthopaedic clients regarding deep vein thrombosis and its

prevention.

2. To evaluate the effectiveness of planned teaching programme on knowledge

regarding deep vein thrombosis and its prevention among orthopedic clients

3. To determine the association between pre test and post test knowledge scores with

there selected socio demographic variables of orthopedic patients.

Materials and Methods:

 The present study was conducted on a evaluative research approach and pre-

experimental one group pre-test without control group design. The target population is the

orthopedic clients at various hospitals of Bagalkot. Accessible population is orthopedic

clients at HSK hospital and research centre Bagalkot was selected by a convenient sampling

technique and 30 orthopedic clients were selected. The data were collected by structured

closed ended knowledge questionnaire. Data analysis and interpretation were performed

using descriptive such as frequency distribution. Mean, median, percentage, and inferential

statistics such as Chi-square.

RESULTS:

Part I (SECTION-I): Description of socio-demographic characteristics of sample.

The percentage wise distribution of sample according to socio demographic

variables age in years, gender, religion, educational status, marital states, family

monthly income, area of residence, source of information, occupation, were as

follows.

Percentage wise distribution of orthopedic clients according to their age shows that 33.33%

are the age of 50 above, 26.67% are in the age group of 31-40, 23.33% are in the age group

of 41-50 and 16.67% are in the age group of less than 30 years.Percentage wise distribution

of orthopedic clients according to their gender shows that 63.33% are male and 36.67% are

female.Percentage wise distribution of orthopedic clients according to their religion shows

that 60% belongs to Hindu religion 20% belongs to Muslim religion 10% are Christians and

10% are others.Percentage wise distribution of orthopedic clients according to their

educational status shows that 36.67% are primary educated , 26.67% are no formal

educated , 23.33% are high school educators and 6.67% are PUC and degree

educated.Percentage wise distribution of staff nurses according to their age in years shows

that majority (44%) of the staff nurses were in age group of 22-28 years old, 30 percent of
them were in the age group of 29-35 years old, and 14 percent of staff nurses aged between

41-50 years. Least of staff nurses were in the age group of 51-60 years old 12 percent.

Part II(Section-II): Assessment of knowledge of patients regarding deep vein thrombosis

and its prevention.

(Table5.1)Percentage wise distribution of study subjects according to levels of

knowledgeinpretest.

N=30

Test Levels of knowledge Number(f) Percentage (%)

Very good 00 00%

00 00%
Good
Pre test
19 63.33%
Average

11 36.67%
Poor

00 00%
Very poor

Percentage distribution of study subjects in pre-test reveals that out of 30 subjects 2

(6.67%) had average knowledge followed by 19 (63.33%) subjects with poor knowledge and

11 (36.67%) with very poor knowledge regarding prevention of complications of

Immobilization. (Table 5.1).

Table 5.2: Percentage wise distribution of study subjects according to levels of knowledge
in post test.
 N=30

Test Levels of knowledge Number(f) Percentage (%)

Very good 05 16.67%

25 83.33%
Good
Post test
00 00%
Average

00 00%
Poor

00 00%
Very poor

Percentage distribution of study subjects in post-test reveals that out of 30 subjects 5

(16.67%) had very good knowledge, followed by 25 (83.33%) subjects with good knowledge,

and (00%) with very poor knowledge regarding prevention of complications of

Immobilization. (Table 5.2).

Part-III(Section III): Assessment of the effectiveness of the PTP on knowledge regarding

deep vein thrombosis and its prevention.

Part-I: Comparison of knowledge level of orthopedic clients in pre-test and post-test.

1. Assessment of knowledge level of patients in pre-test and post test

Knowledge wise comparison of study subjects in pre test and post test reveals the

following results. In pre-test, out of 30 subjects 63.33% had average knowledge followed by
36.67% subjects with poor knowledge and 00% with very poor knowledge regarding

prevention of complications of deep vein thrombosis. However after PTP in post test,

16.67% subject with very good, 83.33% subjects with good, 00% with average and 00%

subjects with poor knowledge regarding deep vein thrombosis and its prevention.

Part-II: Area wise effectiveness of PTP on knowledge regarding prevention of

complications of immobilization.

Table 5.3 Area wise mean, S.D and mean percentage of the knowledge scores in pretest
and post test.

N=30

Knowledge Max. Pre-test (O1) Post-test (O2) Effectiveness (O2-O1)

score
area Mean ± Mean Mean ± Mean Mean ± SD Mean %
SD % SD %
40.05
Knowledge 14 5.67 10.06 71.85 4.39 31.35%
regarding
meaning, ± ± ±
concept, signs
1.1 1.05 0.05
and symptoms

Knowledge 16 7.67 47.93 12.66 79.12 4.99 31.18%

regarding
management ± ± ±
and prevention
0.9 0.97 0.07

30 13.34+ 87.98 22.72 150.9 9.38+ 0.12 62.53

Total 2 +2.02 7
 Area wise comparison of mean and standard deviation of the knowledge scores of

the pre test and post test reveals an increase in the mean knowledge score of the patients

after PTP.

In the area of knowledge on “Related to meaning, concept, sings and symptoms”

pre-test mean knowledge score was 5.67 with SD ±1.1 which was 40.5% of total score,

where as post-test mean knowledge score was 10.06 with SD ±1.05 which was 71.85% of

total score. The effectiveness of PTP on related to meaning, concept, and sings and

symptoms mean score was 4.39 with SD ±0.05 which is 31.35% of total score.

In the area of knowledge “Related to management and prevention”, pre-test

mean knowledge score was 7.67 with SD ±0.9 which is 47.93% where as post-test mean

knowledge score was 12.66 with SD ±0.97 which is 79.2%. The effectiveness of PTP on

management and prevention, mean score was 4.99 with SD ±0.07 which is 31.18% of total

score.

The overall findings reveal that the post-test mean knowledge score 22.72

with SD ±2.02 which is 150.97% of total score was more when compared to the pre-test

mean knowledge score 13.34 with SD ±2which is 87.98% of total score. The overall

effectiveness of PTP on deep vein thrombosis and its prevention, mean score was 9.38 with

SD ±0.12 which is 62.53% of total score. Hence it indicates that the PTP was effective in

enhancing the knowledge of patients on deep vein thrombosis and its prevention.

Part-III: Testing of Hypothesis:

To evaluate the effectiveness of planned teaching programme, a research

hypothesis was formulated.

H1:- There is significant differences between pretest and post test knowledge scoresof

the orthopedic clients regarding deep vein thrombosis and its prevention.
Table 5.4:Significant difference between the pretest knowledge and post test knowledge

scores of Patients.

Test Mean Std. Error Mean Diff SD Diff Paired Table

value
t-value

Pre-test (x1) 13.33

0.62
Post-test(x2) 22.73
9.4 0.18 14.63 1.96

As the calculated t value (14.63) was much higher than table ‘t’ value (1.96) the hypothesis:

H1-there is a significant difference between the pre test knowledge and post test knowledge

scores of the patients on deep vein thrombosis and its prevention is accepted. Findings

revealing the presence of significant difference between pre-test and post-test knowledge

scores, hence the PTP on deep vein thrombosis and its prevention which is prepared by the

researcher was proved to be effective

Part IV(Section IV): Association between post test knowledge scores and selected socio

demographic variables Table 5.5: Association between post test knowledge scores and

selected socio demographic variables

SL. Socio Df Chi- Table Level of Significant

demographic square value
significance
NO variables value

1 Age 1 0.43 1.96 1.4 Not significant

2 Gender 1 0.45 1.96 1.4 Not significant

3 Religion 1 9.37 1.96 1.4 Not significant

 4 Education 1 0.11 1.96 1.4 Not significant

5 Marital status 1 1.44 1.96 1.4 Not significant

6 Income 1 4.12 1.96 1.4 Not significant

7 Residency 1 12.28 1.96 1.4 Not significant

8 1 2.71 1.96 1.4 Not significant

Source of
information

9 Occupation 1 0.03 1.96 1.4 Not significant

As the calculated values were lesser than table value (1.96) at the degree of freedom 1,

the hypothesisH2is rejected. So, there is no significant association between post -test

knowledge scores and socio demographic variables of relatives such as age, gender, type of

family, education, occupation, family, education, occupation, income, marital status, religion

and source of knowledge regarding deep vein thrombosis and its prevention. Findings

revealing that, no extraneous variables have affected on the knowledge scores and hence

the planned teaching programme is improved the knowledge regarding deep vein

thrombosis and its prevention.

*= <0.05(significant)

CONCLUSION:

A significant difference was found between the pre-test and post-test knowledge scores of

the orthopedic clients. The study proved that PTP was effective in improving the knowledge
of orthopedic clients in HSK hospital,Bagalkot.

RECOMMENDATIONS : Keeping in view the findings of the present study, the

following recommendation were made:

 A similar study can be replicated on a large sample to generalize the

findings.

 A similar study can be conducted by including additional demographic

variables.

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