PT.

BHAGWAT DAYAL SHARMA UNIVERSITY OF HEALTH

SCIENCES, ROHTAK (HARYANA)

SYNOPSIS

ON

“A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE

AND ATTITUDE REGARDING EYE DONATION

AMONG COLLEGE STUDENTS IN SELECTED

COLLEGES AT HISAR WITH A VIEW TO

DEVELOP A SELF-INSTRUCTIONAL

MODULE.”

GUIDE
Mrs. Anuprabha

Associate professor cum HOD

Dept. of Community Health Nursing

MAMC, Agroha, Hisar.

BY

Abhilash Kumar
 PT. BHAGWAT DAYAL SHARMA UNIVERSITY OF HEALTH

SCIENCES, ROHTAK (HARYANA)

PERFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1. NAME OF THE CANDIDATE ABHILASH KUMAR

AND ADDRESS FIRST YEAR M.Sc. NURSING

MAHARAJA AGRASEN COLLEGE OF

NURSING, AGROHA, HISAR,

HARYANA

2. NAME OF THE INSTITUTION MAHARAJA AGRASEN COLLEGE OF

NURSING, AGROHA, HISAR,

HARYANA

3. COURSE OF THE STUDY AND MASTER OF SCIENCE IN NURSING

SUBJECT (COMMUNITY HEALTH NURSING)

4. DATE OF ADMISSION TO THE 17-10-2022

COURSE

5. TITLE OF THE TOPIC (STUDY TITLE) “A DESCRIPTIVE STUDY TO ASSESS

THE KNOWLEDGE AND ATTITUDE
REGARDING EYE DONATION AMONG
COLLEGE STUDENTS IN SELECTED
COLLEGES AT HISAR WITH A VIEW TO
DEVELOP A SELF-INSTRUCTIONAL
 MODULE.”

BRIEF RESUME OF THE INTENDED WORK

CHAPTER-I

INTRODUCTION

"Live life after death - pledge to donate your body.”

― Amit Abraham

Vision is the ability to perceive the surrounding world using light in the visible
spectrum reflected by the objects in the environment and any diminishment of function
results in visual impairment or blindness ranging from partial to complete with varying visual
acuity. According to estimates provided by the World Health Organization (WHO), someone
goes blind every five seconds, which is extremely alarming when 80% of known visual
impairments are either curable or preventable [1].

Giving someone the gift of sight and letting them see the world through eye donation
is truly a divine deed for a noble cause. Eye donation is voluntary donation of one’s eyes after
his/her death. As per Eye Bank Association of India current corneal procurement rate is
49,000 per year, however large number of these cornea are deemed unfit for transplantation
donor corneas are unfit for corneal transplantation. According to some studies 277,000 donor
eyes are needed to perform 100,000 corneal transplants in a year in India.[2]

A total of 1.285 million people are estimated to be visually impaired worldwide of

which 39 million are categorised as blind. Developing countries account for 80% of the
world’s blind population. [3].

Blindness is the condition of lacking the visual perception. Besides Cataract, damage
to cornea is the second most common cause of blindness and probably the most under-
reported and accounts for about 6-8 million cases out of the 45 million cases of blindness in
the world [4].

Eyesight restoration in cases of corneal blindness is possible by corneal

transplantation from the cornea of the donor person and corneal transplantation is still an
important option of treatment for restoring the eyesight of persons suffering from blindness
due to corneal lesions.[5]

As per the National Program for Control of Blindness (NPCB), prevalence of

blindness is 1% in India [6]. Main causes of corneal blindness globally include corneal
scaring including trachoma, corneal ulceration due to vitamin-A deficiency, ophthalmia
neonatorum, use of harmful traditional eye medicines, onchocerciasis, leprosy & ocular
trauma, etc. India has the world’s largest corneal blind population so corneal donation is one
of the major requirements in India. [7]

Although primary and secondary prevention are more cost effective, visual
rehabilitation by corneal transplantation remains a major option for restoration of vision in
those who already have corneal blindness. Nearly 1.1 million people, mostly young adults
realize the value of sight because they do not have it [8].

Eye Donation and restoration of sight through corneal transplants is a very exciting
combination of selfless charity and the miracle of medical technology. Removal of eyes takes
only twenty minutes while surgical corneal transplant can be performed in half hour. The Eye
bank’s primary mission is restoration of sight. In order to fulfill this mission, the Eye Bank
provides corneal tissue for transplantation, supports research, training and promotes public
awareness of the need for donors (Anupchand Shah Rotary Narayana Nethralaya Eye Bank).
Corneal disease is one of the leading causes of blindness in developing countries like India.
Nearly 6.8 million people in India are blind in at least one eye, and about one million are
bilaterally blind.[9]

Corneal transplantation is the only solution to reduce corneal blindness. The source of
the corneal transplant is obtained from voluntary or motivated public. But corneal donation
depends on the willingness of people to pledge eyes for donation and also depends on the
family member’s consent to donate the pledged eyes. The current cornea procurement rate in
India is a dismal 22,000 per year. Based on existing cornea utilization rates, it is estimated
that 2.7 lakh donor eyes are required to perform 1 lakh corneal transplants per year—a 20-
fold increase over existing eyes.[10]

Eye donation is purely voluntary. Voluntary eye donation is possible only after
persons realize their social responsibility towards the corneal blind. There is an acute
shortage of corneal donation in India. According to the Eye Bank Association of India, the
current cornea procurement rate in India is 22,000 per year. It is estimated that a significant
proportion of donor corneas are unsuitable for corneal transplantation.[9]

One of the obstacles in eye donation is lack of awareness and a negative attitude
among general population. The prerequisite, therefore, is to make the common people more
aware about eye donation in an effort to increase the procurement of cornea. There are many
studies regarding awareness of eye donation among student groups like medical college
students, nursing college students, etc. But studies among non-professional college students
are lacking in India. Keeping this in mind the present study was conducted to assess the
knowledge and attitude of college students towards eye donation.

NEED FOR STUDY

Blindness is the most important public health issue. Visual impairment not only
hampers daily activities, it also jeopardizes access to education, opportunities for gainful
employment and participation in civil, political and social life. While it may be difficult to
quantify visual impairment’s impact in monetary terms, its socioeconomic impact and effect
on quality of life is all the more unconscionable given it is largely preventable [11].

Globally, it is estimated that at least 2.2 billion people have a vision impairment or
blindness, of whom at least 1 billion have a vision impairment that could have been
prevented or has yet to be addressed. Cataract and refractive errors form the major bulk of
blindness. According to World Health Organization, diseases affecting cornea are major cause
of blindness secondary to cataract in less developed countries [12].

Around 4.2 million people across the globe are blind because of corneal opacities
being the cause. Etiology of corneal blindness is varied but most important corneal ulcers,
corneal scarring and ocular trauma forms the major cause of corneal blindness that are under
reported but may be responsible for 1.5-2 million new cases of corneal blindness every year.
Causes of childhood blindness (about 1.5 million worldwide with 5 million visually disabled)
include xerophthalmia (3,50, 000 cases annually), ophthalmia neonatorum, and less
frequently seen ocular diseases such as herpes simplex virus infections and viral
keratoconjunctivitis. Despite these traditional eye medicine have also been implicated as a
major cause of corneal ulceration in developing countries [12].
 Blindness is a huge global concern, with at least 2.2 billion population suffer from
vision impairment. 90% cases of visually impairment are from the developing world.
According to the World Health Organization (WHO), 80% of these cases are either
preventable or treatable. Corneal diseases are significant cause of visual impairment and
blindness accounting for 12% of the world’s blind population.[13]

Most of these diseases are preventable and treatable. Though, it is more cost effective
to implement primary prevention strategies to prevent corneal blindness, yet major treatment
for visual rehabilitation remains by corneal transplantation. As per the National Program for
Control of Blindness (NPCB), prevalence of corneal blindness in India is 0.9%, cases are
expected to rise from 6.8 million to 10 million by 2020. [14]

Due to insufficient number of eye donations in India, the gap between donor and
recipient keeps on growing 30,000 cases are added every year. Thus, number of patients
waiting for corneal transplantation is keeps on increasing. [15]

The majority of blinding corneal damage in the form of trachoma affects 4.9 million
individuals. Other major causes include ocular trauma, ulceration, xerophthalmia, ophthalmia
neonatorum, onchocerciasis, leprosy, and use of traditional eye medicines.[16]

National Programme for Control of Blindness (NPCB) estimated that there are
currently 120,000 corneal blind persons in India, and every year, there is an addition of
25,000–30,000 cases with corneal blindness.[17]

A major treatment option for restoring sight in those with corneal blindness is through
corneal transplantation which can only be accomplished through cornea donation. Presently
in India, the donor eye collection is around 22,000 eyes every year, which is insignificant
with respect to the requirement. Therefore, collection of donor eyes is a priority in any
organized effort to alleviate corneal blindness. The establishment of eye banks is implemental
in the success of corneal transplants.[18]

Naik Sparsh; et. al. (2018) conducted a study on Awareness and Attitudes on Eye
Donation Among College Students in North Goa. The result shows that majority i.e. 104
(86%) were aware that eyes could be donated after death, 22 (18%) knew a person who has
donated his/ her eyes, majority i.e. 98% were unaware of any eye bank in Goa, 36% of the
participants thought that donor eyes could be bought or sold, 63 (52%) were aware that the
eyes can only be removed from the donor after death, 98 (81%) were aware that the donor
eyes need to be removed within 6 hours of death, there was limited knowledge about the
procedure of eye donation, 73 (60%) of the participants were themselves willing to pledge
their eyes, 50 (41%) said that the source of their knowledge was the television. This study
concluded that there was good level of awareness about eye donation among the college
students and limited knowledge regarding the eye donation procedure.[19]

Sudershna, (2020) conducted a study to assess effectiveness of planned teaching

program on knowledge regarding eye donation among students in selected junior college of
Navi Mumbai. The research approach is quantitative and the research design is quasi-
experimental design and non-probability convenient sampling technique is used. The sample
of the study was 50 from Bharati Vidyapeeth Junior College, Belapur. The pre-test knowledge
score is that samples with poor knowledge were 1.60% while average knowledge score were
60%, good knowledge were 38.33%, and excellent knowledge were 0. In post-test, the
sample with poor knowledge score was 0 while average knowledge were 6.66%, good
knowledge were 65%, and excellent were 28.33%. As per findings and interpretation of the
data analysis, the result shows that planned teaching program is useful for the junior college
students to update their knowledge regarding eye donation.[20]

Well informed Arts & Science students could be expected to influence eye donation
rates. The education of Arts & Science College may lead to improve eye donation rates.

As a researcher, I found that the patients for corneal transplantation are growing due
to insufficient number of eye donations in India. The gap between demand and supply is due
to low awareness. Awareness and Attitude of the population towards eye donation is the key
for successful eye donation. Lack of these maybe due various reasons. So that I feel need to
assess the knowledge and attitude regarding eye donation among college students. If they
have sufficient information and positive attitude regarding eye donation, they can impart this
knowledge to their family members and relatives and can remove their misconception related
to eye donation. Raising the level of understanding about eye donation among the college
students through self-instructional module is an important step to achieve more local eye
donations
STATEMENT OF THE PROBLEM

“A descriptive study to assess the knowledge and attitude regarding eye donation among
college students in selected colleges at Hisar with a view to develop a self-instructional
module.”

OBJECTIVES

1. To assess the knowledge and attitude regarding eye donation among college students.

2. To find relationship between knowledge and attitude regarding eye donation among college
students.

3. To find the association between the level of knowledge and attitude regarding eye donation
among college students with their selected demographic variables.

OPERATIONAL DEFINITION

1. KNOWLEDGE: In this study knowledge refers to the level of understanding of the

college students regarding eye donations.
2. ATTITUDE: In this study expressed feeling of college students regarding eye
donation.
3. EYE DONATION: It is a process of non-remunerated act of giving eyes voluntarily.
4. COLLEGE STUDENTS: It refers to any individual enrolled either on a part time or
full-time basis in any undergraduate course in a college or university.
5. SELF INSTRUCTIONAL MODULE: In this study, it is a printed material consists
of information regarding eye donation which gives more knowledge regarding eye
donation.

HYPOTHESES
H1 - There will be a significant relationship between the knowledge and attitude score of
college students regarding eye donation.
H2 - There will be a significant association between level of knowledge and attitude with the
selected demographic variables of college students.

ASSUMPTIONS
1. College students may have some knowledge on eye donation.
2. Knowledge influences the attitude regarding eye donation.

DELIMITATION
The study is delimited to:
1. Sample size will be limited to 100.
2. Data collection period will be 4 weeks.
CONCEPTUAL FRAMEWORK

The conceptual framework for the study is based on health belief model. Health
beliefs are person’ idea and attitude about health and illness. They may be based on factual
information or wrong information. The health behaviour usually results from health belief.
So, the investigator felt that Becker’s model is suitable as conceptual framework for this
study to assess knowledge and attitude regarding eye donation among college students.

Rosenstoch (1974) and Becker’s health model (1978) address the relationship
between person beliefs and behaviour. It is the way of understanding and predicting how
clients will behave in relation to their health care use of the model is based on the person
perception of susceptibility to an illness, The model help nurses to understand various
behaviour including clients (college) perception beliefs and various behaviour. The model
describe about 3 variables

1. College student’s perception :- College students will received knowledge

regarding eye donation.

2. Modifying factors: - The college students perception is influenced and modified

by demographic variables like - age, gender, religion, type of family, education,
health information resources, registered eye donor. The college student’s
perception is also influenced by cues its action like mass media, information from
elders and neighbours. Information gathering through health education,
pamphlets, individual health education, teaching by health personnel.

3. Likelihood of taking action:- This part indicates college students may try to take
action to assess received knowledge about eye donation. Perceived barriers
including cultural belief & level of Education.
 DIAGRAMMATIC REPRESENTATION OF CONCEPTUAL FRAME WORK OF
THE STUDY
Individual Perception Modifying Factor Likelihood of taking Action

Demographic Variable
Age, gender, religion, Perceived knowledge
COLLEGE and attitude regarding
type of family,
STUDENTS eye donation.
education, health
KNOWLEDGE AND
information resources, Perceived barriers
ATTITUDE including cultural belief
registered eye donor
REGARDING EYE & level of Education.
Structural Variables
DONATION
Knowledge and attitude
Regarding eye donation.

Likely-hood of taking
College students perceived threat Action knowledge
lack of knowledge regarding eye regarding eye donation
donation by Education through
self-instructional
module.

CUES TO ACTION
Mass media
Information from elders and neighbours.
Health Education by Health personnel.
Information getting by Self-instructional module.

FIG 1. CONCEPTUAL FRAME WORK FOR THE STUDY, BASED ON MODIFIED

HEALTH BELIEF MODEL
 CHAPTER-II

REVIEW OF LITERATURE
Literature review is a comprehensive summary of previous research on a topic of
interest, often prepared to put a research problem in context. It describes how the intended
research is related to previous research in statistics. It also shows the novelty and
applicability of the research problem. Literature review helps to lay the foundation for a study
and can also inspire new research ideas. The obtained literature is literature related to
knowledge and attitude regarding eye donation.

The literature reviews obtained in the study were organized and presented in the
following sections-

1. Literature review related to prevalence of blindness

2. Literature review related to knowledge and awareness regarding eye donation

3. Literature review related to knowledge and attitude regarding eye donation

1. Literature review related to prevalence of blindness

Vashist P., et. al. (2022) conducted a study on blindness and visual impairment and
their causes in India: Results of a nationally representative survey. The results of the survey
demonstrate that currently more than one fourth of persons aged 50 years and above are
visually impaired (PVA<6/12 in better eye) in India. The prevalence of blindness among them
is 1.99%, and older age and illiteracy are significantly associated with blindness. Major
causes of blindness included cataract (66.2%), corneal opacity (CO) (8.2%), cataract surgical
complications (7.2%), posterior segment disorders (5.9%) and glaucoma (5.5%). The
proportion of blindness and visual impairment that is due to avoidable causes include 92.9%
and 97.4% respectively.[21]

Yekta A, et. al. (2022) Global prevalence and causes of visual impairment and
blindness in children: A systematic review and meta-analysis. In this study, 5711 articles were
identified, and the final analyses were done on 80 articles including 769,720 people from
twenty-eight different countries. The prevalence of VI based on UCVA was 7.26% , PVA was
3.82% , BCVA was 1.67%, and blindness was 0.17% . Refractive errors were the most
common cause of VI in the subjects of selected articles (77.20%). The prevalence of
amblyopia was 7.60% and congenital cataract was 0.60%. This meta-analysis concluded that
despite differences in the definition of VI and blindness, based on PVA, 3.82%, and based on
BCVA, 1.67% of the examined samples suffer from VI.[22]

Wadhwani, M., et. al. (2021) A population-based study on the prevalence and causes
of childhood blindness and visual impairment in North India. This cross-sectional study was
conducted in 40 clusters of urban Delhi. 20,955 children aged less than 16 years underwent
visual acuity screening. Amongst 20,955 children examined for visual acuity a total of 789
children were referred to the central clinic for detailed ophthalmic examination. Of these
referred children, a total of 124 had presenting visual acuity <6/18 in the better eye. The
prevalence of visual impairment (VI) was 5.92 per thousand. The prevalence of moderate to
severe visual impairment was maximum in the age group of 11 to 15 years. The main cause
of avoidable VI in these children was a refractive error (75.7%). The prevalence of blindness
was 0.42 per thousand. This study concluded that optic nerve abnormalities were the most
important cause of blindness in children. Refractive error is the most important cause of
visual impairment amongst children and needs to be addressed.[23]

Malhotra, et. al, (2020) Prevalence of blindness in India: A systematic review and
meta-analysis. A total of 18 published articles/reports were included for recent and 20 for
previous definitions of blindness, involving 211 502 participants. The pooled prevalence
(95% confidence interval [CI]) obtained for recent and previous definitions of blindness in
India was found to be 6.11% and 9.91%, respectively. The stratified pooled prevalence (95%
CI) from rapid surveys was 4.81% and 4.68% for studies published during 1995-2005 and
2006-17, respectively, using the new definition. The corresponding figures for comprehensive
surveys were 9.22% for the period 1995-2005 and 3.81% for the period 2006-17. This meta-
analysis concluded that there is a decrease in the prevalence of blindness in India using recent
and previous definitions and a declining trend over time.[24]

Assefa, N.L., et. al. (2020) conducted a study on prevalence and associated factors of
visual impairment among adults at Debre Berhan town, North Shewa, Ethiopia. Systematic
random sampling method was employed to select the study participants from adult’s aged
≥18 years. A total of 416 participants were enrolled in the study with a 98.6% response rate.
The prevalence of visual impairment among adults aged ≥ 18 years was 16.8%. Among the
overall prevalence of visually impaired adults 27 (6.49%) had bilateral VI and 43 (10.34%)
had monocular VI. Aged > 64 years, previous eye trauma had statistically significant
association with visual impairment. This study concluded that prevalence of visual
impairment among adults was found to be a significant public health problem.[25]

Hashemi, H., Yekta, A., Jafarzadehpur, E. et al. (2017) The prevalence of visual
impairment and blindness in underserved rural areas: a crucial issue for future. Multistage
cluster sampling was used to select the participants who were then invited to undergo
complete examinations. Of 3851 selected individuals, 3314 (86.5%) participated in the study.
The prevalence of visual impairment and blindness was 6.43% and 1.18%, respectively. The
prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to
38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract
were the first and second leading causes of visual impairment; moreover, cataract and
refractive errors were responsible for 35.90 and 20.51% of the cases of blindness,
respectively. This study concluded that the prevalence of visual impairment was markedly
high in this study. [26]

2. Literature review related to knowledge and awareness regarding eye donation

Srivastava G, et. al. (2023) conducted a cross-sectional study on awareness of eye

donation in medical students. Data was collected from One hundred and forty-five students
from 1st-year MBBS and 145 students from 2nd-year MBBS participated in the study. The
study result shows that 285 (98.28%) had awareness about eye donation. One hundred and
ten (75.8%) 1st-year students and 126 (86.9%) 2nd-year students were aware that eye
donation should be made within the first 6 h after death. The study concluded that although
the awareness of eye donation is good in medical students, the number of students pledged is
very low. To make the dream of converting the awareness into pledging and procurement of
eyes, knowledge about eye donation is highly required.[27]

Kacheri Aimanfatima; et. al. (2022) conducted a study on Eye Donation:

Awareness, Knowledge, Willingness, and Barriers among Paramedical and Allied Health
Science Students at a Tertiary Care Teaching Hospital in South India. This two-year cross-
sectional study employed a convenience sampling technique and a standardised questionnaire
to survey 150 paramedical and allied health science students at a tertiary care teaching
hospital. The study revealed a 93.3% awareness rate of the donation procedure, of which 46%
attributed their awareness to media sources. 49% of the respondents were willing to pledge
themselves as eye donors, and a majority of the unwilling respondents reported that familial
opposition was the reason for their hesitation. The study concluded that the knowledge levels
appear to be below expectations, and more effort is required to ensure that knowledge is
imparted to our healthcare practitioners, who will then transfer this knowledge to the
population, resulting in an increase in donation rates.[28]

Chowdhury, R. K., et. al. (2021) conducted a study on awareness of eye donation
among medical and nursing students: A comparative study. This study undertaken on the
occasion of eye donation fortnight among 112 medical and 115 nursing students. The study
findings show that All the medical students and 91.3% of nursing students had heard about
eye donation. Eye donation fortnight is celebrated every year to create awareness was known
to 42% of medical students and 29.5% of nursing students. Television, newspaper,
magazines, and posters were found to be important sources of information in both groups.
Eye donation can give vision to the blind was the primary motivational force both among
medical and nursing students. The ideal time of eye donation is within 6 h of death was
known to 69% of medical students and 60.9% nursing students. 88.4% of medical students
and 79.1% of nursing students are willing to donate their eyes in future. This study concluded
that the awareness of eye donation among medical students is better than nursing students.
However, the willingness to pledge their eyes is almost equal in both groups.[29]

Dhanushia G, et. al. (2021) conducted a study on awareness on eye donation among
medical and nonmedical students: A cross-sectional comparative study. The result shows that
the primary source of awareness for both groups was mass media. About 90.3% of medical
and 41.9% of the nonmedical students knew that consent for eye donation is given by the
donor while alive, also that the first-degree relatives have the right to give consent for the
dead was 88.2% and 49.5% among medical and nonmedical students, respectively. Three-
fourths of medical and half the nonmedical students knew that corneal donation could not
cure all types of blindness. Around 87.1% of medical and 36.6% of nonmedical students were
aware that eyes with corneal diseases could not be donated. The present study concluded that
participants from both groups were aware of eye donation, but the awareness among
nonmedical students was not adequate. This study also shows that mass media was the most
common source of awareness among the students, which could be used to create further
awareness among the students.[30]

Harshitha K M, Sandhya R.; (2020) Knowledge and awareness of eye donation

among undergraduate medical students. This was a cross-sectional semi self-constructed
questionnaire-based study. The study result shows that Out of the 225 responses from the
undergraduate medical students, 32.89% (74) students were pursuing final year of medical
education, 35% (81) of the students were pursuing the third year, and 31.00% (70) of the
students were pursuing second year.70.5% of the students were aware that the whole eye
could not be implanted to another person. The outcomes of this study focus on the fact that
the majority of the students are aware of eye donations but lack sufficient knowledge to
promote eye donation awareness in the community. With proper knowledge and attitude, a
medical student can be involved in eye donation campaigns and awareness programs to
spread awareness and change the attitude of the community towards eye donation.[31]

Sudarshna. (2020) conducted a study to assess effectiveness of planned teaching

program on knowledge regarding eye donation among students in selected junior college of
Navi Mumbai. In this study research approach is quantitative and the research design is
quasi-experimental design and non-proIbability convenient sampling technique is used. The
sample of the study was 50 from Bharati Vidyapeeth Junior College, Belapur. The pre-test
knowledge score is that samples with poor knowledge were 1.60% while average knowledge
score were 60%, good knowledge were 38.33%, and excellent knowledge were 0. In post-
test, the sample with poor knowledge score was 0 while average knowledge was 6.66%, good
knowledge was 65%, and excellent were 28.33%. As per findings and interpretation of the
data analysis, the result shows that planned teaching program is useful for the junior college
students to update their knowledge regarding eye donation.[32]

Acharya AS, et. al. (2018) conducted a study on awareness and willingness to pledge
for eye donation among adult population of an urban re-settlement colony of Delhi.
Systematic random sampling was used and every alternate adult patient >20 yrs attending the
UHC was recruited. The study result shows that majority (84.4%) had heard of eye donation.
Only 21.2% were aware about contraindications for donating eyes. A little over quarter
(27.6%) had heard of eye bank facility. When asked whether the retrieved eye can be stored
before transplantation, majority (59.2%) didn’t know. More than half (54%) didn’t know
which part of eye is removed. Mass media was major source of information in three forth
respondents (74.9%). 45.5% were willing to pledge their eyes, a similar proportion was not
willing (44.1%), five (2.4%) had already pledged and 17 (8.1%) were yet undecided to
pledge. This study concluded that majority of participants had heard of eye donation, but their
knowledge regarding certain aspects of eye donation was found to be poor.[33]
 B. Lal et al. (2018) Awareness and knowledge on eye donation among Allied Health
Sciences, medical, and nursing students in Goa. A cross-sectional descriptive study was
conducted using a standard predesigned and pretested closed-ended structured questionnaire
based on eye donation to obtain information about awareness and knowledge from AHS,
medical, and nursing students of Goa. Three hundred and forty participants participated in the
study. The study result shows that the majority of the participants [97.9%] were aware of the
existence of eye donation. Mass media (62.9%) was the foremost source of information.
However, only [42.6%] participants were willing to donate their eyes. AHS, medical, and
nursing students stood apart significantly in their awareness and knowledge. Only [17.6%]
participants were aware that the whole eye can be removed from the donor while [63.2%]
were wrongly aware that the cornea can be removed separately. The study concluded that
although awareness regarding eye donation was satisfactory, there was lack of willingness to
donate eyes. There is a need to bridge the gap between eye bank and donors.[34]

3. Literature review related to knowledge and attitude regarding eye donation

Narendran, Venkatapathy; et. al. (2022) Knowledge, awareness and attitude of eye
donation among non-clinical staff of a tertiary eye hospital in South India. Two hundred
twenty-eight non-clinical staff from 11 hospitals participated in the quiz. The study findings
shows that (79.39%) participants scored over 50% of the total 17 queries. (81.58%) and
(62.28%) participants scored over 50% in the awareness section and knowledge section,
respectively. Twenty-four (10.53%) had already taken pledge for eye donation and (76.75%)
were willing to pledge, (12.72%) were not willing to pledge. (75.86%) had no specific reason
for not pledging. Family, religious reasons, lack of clarity and fear were least cited reasons
(13.79%). The study concluded that Non-clinical staff of an eye hospital are easily
approachable and are expected to be more knowledgeable by the general public around them.
[35]

Kaiti, R., et. Al. (2021) conducted a cross-sectional study on Knowledge and Attitude
on Eye Donation among Undergraduate Medical Students of Kathmandu University School
of Medical Sciences, Nepal. The study findings show that Less than half of the medical
students (45.6%) were aware of eye donation only after death. Newspapers (72.2%) were the
major source of information. The final year medical students were more aware (Average
knowledge score = 11.56 ± 2.05) than their juniors. 80.7% of the students were willing to
donate their eyes. This study concluded that the future medical practitioners possessed
satisfactory knowledge about eye donation. Educating this cadre of human resources to
sensitize them towards the need for eye donation would be a crucial step towards reducing
the global burden of corneal blindness.[36]

Chawla, Urmil, et. al. (2021) Conducted a study on Knowledge and Attitude
Regarding Eye Donation among Students of Medical, Nursing and Allied Health Sciences at
a Tertiary Care Hospital in Northern India. The data was collected by online questionnaire
method (Google forms) from medical, nursing and allied health care students for a group of
723 students. the study findings revealed that among 723 medical, nursing and allied health
care students 449 (62.3%) were in the age group of 21-30 years with 479 (66.4%) being
females and 244 (33.8%) males. Around 80% had knowledge about eye donation and 79.1%
pledged to donate eyes. The study concluded that the awareness regarding eye donation was
high but pledge to donate eye and motivate others required further motivation. [37]

Gotekar, R., & Joshi, A. (2020) conducted a study of knowledge and attitude about
eye donation among 1st-year medical students. The study was conducted at Bharati
Vidyapeeth Deemed to be University medical college and hospital, Sangli. A total of 137
students participated in the study. The study result shows that in this study 71 (51.72 %)
participant students had a knowledge that the ideal time of eye removal was within 6 hours of
death. 120 (87.59 %) participants expressed their will for eye donation. Perceived reasons for
not pledging eyes by the students 17 (12.40 %) felt, eye donation was against their religious
belief 03 (2.1%), fear of misuse of eyes, 24 (17.51 %) and 15 (10.94%) do not wish to be
mutilated. This study revealed that all first-year MBBS student participants are well aware of
eye donations and120 (87.59 %) are willing to pledge for eye donation.[38]

Dibaba, F. K., et. Al. (2020) conducted a study on Knowledge, attitude and
willingness to donate organ among medical students of Jimma University, Jimma Ethiopia:
cross-sectional study. This study was conducted among 320 medical students from year I to
internship. The study result shows that the there was a statistically significant interaction
effect between gender and year of study on the combined knowledge questions (dependent
variables) F (25,062) = 1.755,P = 0.014, Wilk's Λ = .033. Variables which were related to a
positive attitude towards organ donation were: being of the male sex (Odds Ratio = 1.156);
having awareness about organ donation (Odds Ratio = 2.602); not having a belief on the
importance of burying intact body (Odds Ratio = 5.434); willingness to donate blood (Odds
Ratio = 4.813); and willingness to donate organ (Odds Ratio = 19.424). The study concluded
that High level of knowledge but low level of positive attitude and willingness was noticed
among the study participants toward organ donation.[39]

Ritika Verma, Rashmi Choudhary; (2019) conducted a descriptive study to assess

the awareness and attitude regarding eye donation among nursing students of a selected
college of nursing of district Mohali. A descriptive approach was selected and 150 nursing
students were selected with probability stratified disproportionate sampling technique. The
finding shows that 50.7% nursing students were having poor awareness and 79.3% nursing
students were having positive attitude regarding eye donation. There was significant
correlation between awareness and attitude among nursing students regarding eye donation.
There was significant association of awareness among nursing students regarding eye
donation with their age, course, and source of information. Moreover, there was significant
association of attitude of nursing students regarding eye donation with their course and
religion.[40]

Runda N, et. al. (2019) Knowledge and attitude towards eye donation among health
professionals of northern India. In this study researcher interviewed 600 health professionals,
comprising doctors, nurses, medical as well as nursing students, social workers and allied
paramedical staff. The study result shows that out of the 600 participants, 138 participants
(23%) had 'excellent' knowledge and 234 participants (39%) had 'good' knowledge about eye
donation. Willingness to pledge eyes for donation was observed in only 6% of the
participating health professionals. Pledging of eyes for donation was higher among older
participants. The study concluded that that there is sufficient knowledge about eye donation,
but an alarmingly low willingness to pledge eyes for donation among health professionals.
Concerted efforts are required to alter their attitude to strengthen the Hospital Cornea
Retrieval Programme.[41]

Hussen, M. S., et. Al. (2018) conducted a study on Knowledge and Attitude toward
Eye Donation among Adults, Northwest Ethiopia: A Community-based, Cross-sectional
Study. This study was conducted on 760 adults aged ≥18 years selected using multistage
systematic random sampling in Gondar town, Northwest Ethiopia. The study result shows
that the proportion of overall level of good knowledge and favorable attitude toward eye
donation was 8.4% and 59.9%, respectively. It has been also recognized that attitude was
positively associated with educational level of high school. The study concluded that the
overall level of knowledge about eye donation was poor, the proportion of favorable attitude
toward eye donation was fair. Since it was associated with educational level and awareness, it
is strategic to follow multidisciplinary approaches to facilitate multi-stakeholder partnerships
and to motivate the people to donate their eyes.[42]

Naik Sparsh; et. al. (2018) conducted a study on awareness And Attitudes on Eye
Donation Among College Students in North Goa. The result shows that majority i.e. 104
(86%) were aware that eyes could be donated after death, 22 (18%) knew a person who has
donated his/ her eyes, majority i.e. 98% were unaware of any eye bank in Goa, 36% of the
participants thought that donor eyes could be bought or sold, 63 (52%) were aware that the
eyes can only be removed from the donor after death, 98 (81%) were aware that the donor
eyes need to be removed within 6 hours of death, there was limited knowledge about the
procedure of eye donation, 73 (60%) of the participants were themselves willing to pledge
their eyes, 50 (41%) said that the source of their knowledge was the television. The study
concluded that there was good level of awareness about eye donation among the college
students and limited knowledge regarding the eye donation procedure.[43]

Swathi N, et. al. (2017) conducted a study on Impact of an educational module on the
knowledge and attitude of nursing students toward eye donation. Nursing students in their 1st
year and 4th year of training were administered a prestructured questionnaire. The finding
shows that the difference in the level of knowledge and attitude between first year and final
year students before the exposure to educational awareness video was not statistically
significant. This study concluded that inclusion of eye donation in nursing curriculum is
likely to be effective in imparting knowledge to nursing students who may be potential
counselors for eye donation.[44]

Kumar S K Arun, et. al. (2016) Knowledge and Attitude on Eye Donation among
Selected Rural and Urban Higher Secondary School Students, Ernakulam District. Data was
collected from a total of 160 higher secondary school students of age 16-18 years were
participated in the present study. The result shows that the mean level of knowledge score on
eye dentation of urban higher secondary secondary school students was 10.06 +/- 2.834 and
that of rural higher secondary school students was 8.15+/-1.93. The mean level of attitude
score of urban higher secondary school students was 60.09+/- 9.24 and that of rural higher
secondary school students was 59.03+/-8.93. There was a significant difference in knowledge
on eye donation among rural and urban higher secondary school students (Independent t test
score = 4.989 at p=0.001). The study concluded that the both the rural and urban higher
secondary school student had severe lack of knowledge regarding eye donation. While
comparing knowledge level the findings from present study revealed that urban higher
secondary school students had higher knowledge level than that of the rural higher secondary
school students, but in case of attitude there was no considerable difference. The deficit in
knowledge on eye donation of respondents may be justified by the lack of information about
this significant issue.[45]

Eze, B. I., et. al. (2014) conducted a study on knowledge and attitudes regarding eye
donation and corneal transplant: medical versus nonmedical university students in a
developing country in Africa. The study sample consist of (107 medical students, 75
environmental science students) were 117 men and 65 women aged 22.3 ± 2.2 years (range,
18-32 y). The study result shows that there were no significant intergroup differences
regarding awareness of eye donation (OR 1.71; 95% CI: 0.92-3.17; P = .0924) and
willingness to donate their own (OR 0.76; 95% CI: 0.33-1.76; P = .5260) or their relatives '
eyes (OR 0.76; 95% CI: 0.29-1.98; P = .6274). The study concluded that among medical and
nonmedical undergraduate students, there are crucial deficits in knowledge and attitudes on
eye donation and corneal transplant. Tailored donation awareness campaigns and introduction
of undergraduate course work on eye donation may reverse the trend.[46]
 CHAPTER-III

RESEARCH METHODOLOGY

RESEARCH APPROACH- Descriptive approach will be used to conduct this study.

RESEARCH DESIGN- Non experimental descriptive survey design will be adopted to
assess the knowledge and attitude of college student’s eye donation.

SETTING OF THE STUDY- The study will be conducted in selected colleges at Hisar.
POPULATION- The population selected for this study are the college students studying
in selected colleges at Hisar.

SAMPLE- The college students in between the age group of 18 - 25 years will be selected
as study samples.

SAMPLE SIZE- The sample size comprised of 100 college students.

SAMPLING TECHNIQUE- Non probability convenience sampling will be used to

select the samples.

CRITERIA FOR SAMPLE SELECTION

Inclusion Criteria-

 Both boys and girls.

 College students who are studying in Hisar.
 Those who will be available during data collection.

Exclusion criteria

 College students who will not be willing to participate in the study.

THE DESCRIPTION OF THE TOOL

PART-I: It consists of demographic variables such as age, sex, religion, type of family,
education, health information resources, registered eye donor.

PART II: It consists of structured knowledge questionnaire regarding eye donation. Which
consists of 30 multiple choice questions regarding eye donation. It has four options among
which, one is the correct response. Scores will be interrupted as follows:

Adequate >75%

Moderately adequate >50% -<75%

Inadequate <50%

PART III: It consist of Five point likert scale consists to assess the attitude of the college
students regarding eye donation.

The scale consists of 10 statements to assess the tendency of the participants towards eye
donation. Each statement has five options like Strongly Agree, Agree, Uncertain, Disagree,
Strongly disagree and the scores were distributed as 5,4,3,2,1. The maximum score is 50 and
the minimum score is 1.

For the positive attitude statements the score was measured as follows-

Strongly agree: 5

Agree: 4

Uncertain: 3

Disagree: 2

Strongly disagree: 1

For the negative attitude statements the score was measured as follows-

Strongly agree: 1

Agree: 2

Uncertain: 3

Disagree: 4

Strongly disagree: 5
Scores will be interpreted as follows:

Favourable attitude= 67 - 100%

Moderately favourable attitude= 34 - 66 %

Unfavourable attitude= 0-33 %

PILOT STUDY- Pilot study will be conducted on 10 college students who were excluded
in main study.
ETHICAL CONSIDERATION
 The proposed study will be conducted after the approval of dissertation committee.
 Consent of each subject will be obtained before the data collection.
 Confidentiality will be maintained throughout the study.

DATA ANALYSIS

The collected data will be analysed in terms of descriptive and inferential statistics.

1. To assess the knowledge and attitude of college students regarding eye donation is
analyzed by using frequency and percentage, mean, standard deviation, mean
percentage, paired ‘t’ test.
2. To determine the relationship between knowledge and attitude regarding eye donation
is analysed by Karl Pearson correlation formula
3. To Find out the association between knowledge and attitude score regarding eye
donation with their demographic variables analysed by Chi Square test
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SIGNATURE OF THE CANDIDATE

NAME OF THE CANDIDATE Abhilash Kumar

Mrs. Anuprabha
NAME AND DESIGNATION OF GUIDE
Associate professor cum HOD

Dept. of Community Health Nursing

MAMC, Agroha, Hisar/

SIGNATURE OF GUIDE

Mrs. Anuprabha
HEAD OF DEPARTMENT

SIGNATURE OF HEAD OF DEPARTMENT

REMARKS OF PRINCIPAL

SIGNATURE