A pre-experimental study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of urinary tract infection among B.Sc. nursing 1 year students of Vivekananda College of Nursing, Lucknow

Introduction

Urinary tract infection is a global health issue and is a leading cause of illness among peoples internationally. In India UTl is most common in females, half of all women experience at least one time UTI by the age of 35, and approximately 20% of women between the age of 18 and about 24have a UTI annually. Urinary tract infection is common reason for health care visit. In the united states, Urinary tract infection result in an estimated 7 million office visit, 1 million emergency department visit and over l lakh hospitalizations with an associated annual cost of S1.6 million.1

The incidence of UTI hospitalizations is highly seasonal and our seasonality findings are reported. Urinary tract infections peak in the summer months and the nadir occurs during the winter. The incidence of admissions for UTls exhibits a stronger seasonal effect for women than for men. Seasonality is most pronounced among younger patients, and it diminishes with advancing age. Among women, for each year of age there was a decrease of 2.6% of a standard deviation in the range of the seasonal intensity. Among men, for cache year of age there was a decrease of 1.0% of a standard deviation. During our study period, the seasonal intensity changed.2

Among women, the seasonality increased: the incidence of UTIs for women at the beginning of our sample was less seasonal than at the end. In contrast, among men, the personality diminished. Specifically, with each passing year between 1998 and 2011, the average seasonal intensity increased by 3.0% of a standard deviation in women and decreased by 4.5% of a standard deviation in men.3

As per WHO, it is estimated that one billion women around the world suffer from non-sexually transmitted urogenital infections, including bacterial vaginitis, yeast vaginitis and urinary tract infection (UTD. In India the adolescents constitute about one fifth (1/5") of the population. Therefore, it can be considered one huge segment of the total population. Urinary tract infection is highly prevalent among adolescents with 3-5% of incident rate. The male and female sex ratio in occurrence is 1:50 which is as equal as young adults. The second leading cause of morbidity is urinary tract infection, which accounts for about 8.3 million doctor visits in a year. One woman in five develops urinary tract infection during her life time.4

A cross-sectional study was carried out among 181 adolescent and pre-adolescent girls structured interview based questioaire was used which contained. questions related to puberty, hygiene and Urinary Tract Infection. The study result revealed that there was a significant association between prevalence of Urinary Tract Infection and improper perineal washing technique (CI= 95%, p<0.001), Malnutrition(CI-95%, p<0.001) presence of vaginal discharge (C1=95%, p<0.001) and use of sanitary pads during menses (CI-95%, p<0.001). Among the total population studies the prevalence of Urinary Tract Infection among the adolescent girls was 12.7% that is 23 girls. Prevalence of urinary tract infection was found to be more (9.9%) in girls who attained menarche than those who had not (2.8%). Girls practicing improper perineal washing technique suffered more (8.3%) from urinary tract infection than those associations who did not (4.4%). The researcher concluded that by educating preventive method of UTI among adolescent girls, the incidence rate and complication can be reduced.5

A study conducted on UTI to estimate the annual incidence, cumulative probability of presumed urinary tract infection by age. About 10.8 % of women aged 18 reported at least one presumed UTI during the past 12 months. Majority of the cases occur among women with a history of two or more UTI episodes in their life. Overall, an estimated 11.3 million women had at least one presumed UTI treated with antibiotics. The researcher concluded that the adequate awareness on UTI were developed that would prevent either initial or recurrent UT. The net benefits to society would be substantial even at a developmental cost.6

Statement of the Problem

"A Pre-Experimental Study To assess The Effectiveness Of Structured Teaching Programme On Knowledge Regarding Prevention Of Urinary Tract Infection Among B.Sc. Nursing 1st Year Students of vivekananda College of Nursing Lucknow.

Objectives

Review of Literature

To know the road ahead, ask those coming back. Chinese proverb Hooton TM et.al (1996) conducted a prospective study on risk factors of symptomatic urinary tract infection in young women. Researcher selected sexually active young women who were starting a new method of contraception at a university of Washington school of medicine, USA. Researchers selected 796 women. Data was collected by using daily diaries and serial interviews. The result of the study was in mean age 29,448 women were affected. The risk of acute infection was associated with a history of recurrent infection (relative risk, 5.58 in the university group and 2.10 in the HMO group) but not with cervical cap use or delayed post-coital voiding. The study concluded that among sexually active young women the incidence of urinary tract infection is higher, and the risk is strongly associated with recent sexual intercourse.7

GharbiMyriam et.al (2019) conducted a Retrospective population based cohort study to evaluate the association between antibiotic treatment for urinary tract infection and severe adverse outcomes in elderly patients in primary care. Data collected by clinical research data link primary care records linked to hospital episodes' statistics and death records in England.8

Researchers selected157264 adults aged 65 years or older presenting to a general practitioner with at least one diagnosis of suspected or confirmed lower UTI. The result of the study shows that among 312896 UT episodes (157-264 unique patients), 7.2% (n=22 534) did not have a record of antibiotics being prescribed and 6.2% (n=19 292) showed a delay in antibiotic prescribing. 1539 episodes of bloodstream infection (0.5%) were recorded within 60 days after the initial UTI. The risk of al-cause mortality was significantly higher with deferred antibiotics. Men older than 85 vicars were particularly at risk for both blood stream infection and 60 days all called GharbiMyriam et.al (2019) conducted a Retrospective population based cohort study to evaluate the association between antibiotic treatment for urinary tract infection and severe adverse outcomes in elderly patients in primary care. Data collected by clinical research data link primary care records linked to hospital episodes' statistics and death records in England.9

Tamegnon Victorien Dougnon (2016) conducted a cross-sectional study on Catheter-Associated Urinary Tract Infections at a Hospital in Zinvie, Benin (West Africa). Researcher selected 60 inpatients from the Services of Emergencies, Medicine and Surgery of the hospital. Urine was collected twice per patient: 10 minutes and 48 hours after the insertion of the catheter. The result of the study shows that Two days later, (48 hours after the catheterization), 14 patients out of 60 (23.33%) presented with a urinary infection, of which I patient (1.66%) was already infected before the process. Gram-negative bacteria were the most isolated bacteria (79%) With Escherichia coli as the most identified species(63%)followed by Pseudomonas spp. (11%) and Acinetobacter spp. (5%). Gram-positive cocci isolates were essentially Staphylococcus aureus (21%). The study concluded that Only a few number of health workers do respect hygiene rules before and after catheterization. Therefore, it is necessary to train health workers involved in such activities on good hygiene practices during catheterization, 10

Research Methodology

“If you can't describe what you are doing as a process, you don't known what you are doing.”"- W. Edwards Deming

Research methodology involves systematic procedures which the researcher starts from initial identification of the problem to its final conclusion. The role of methodology consists of procedures and techniques for conducting a study. For every piece of research work the methodology of investigation is of vital importance. The success of any research depends upon the suitability of method.11

Criteria for Sampling Selection

The sample for the study was selected based on the following criteria:

Development of Structured Teaching Programme

The Structured Teaching Programme was prepared based on the title of the topic and objective selected for the study.

The following steps were adapted to develop the Structured Teaching Programme:

Description of Structured Teaching Programme

A structured teaching programme was developed on the basis the review of the existing literature on prevention of urinary tract infection. Guidance from experts was taken in the development of structured teaching programme. The structured teaching programme comprises of following conditions:

Structured teaching programme was given to nine experts, along with the tool for content validity. The suggestions of the experts have been incorporated in the structured teaching programme.

Ethical Clearance

Data Collection Procedure

Written permission was taken from the research and ethical committee of Vivekananda College of Nursing, Lucknow. Data was collected from 17-06-19 to 21-06-19. Sample subjects were explained about the purpose of the study and confidentiality of their response was assured. On the day 1, the pre-test knowledge was given. Structured Teaching Programme was administered to the group on the same day. Post test for knowledge was carried out on the day 5 by using the same structured knowledge questionnaire. The details of the data collection are recorded in the master data sheet.

Data Analysis and Interpretation Results

Kerlinger (1976) has defined analysis as "categorizing ordering, manipulating and summarizing of data to obtain answers to research hypothesis questions". Analysis and interpretation is the process in which investigator examine the result from the data analysis, form conclusion explore the significance of finding generalize the finding and suggest studies. The chapter deals with the analysis and interpretation of data collected to assess the effectiveness of structured teaching program on knowledge regarding prevention of urinary tract infection among students of B.Sc. Nursing 1'year of Vivekananda College of Nursing, Lucknow.

Objectives

Discussion

The study revealed that B.Sc. Nursing 1* year students had low level of knowledge related to prevention of Urinary tract infection as evident from the pre-test knowledge scores. The findings of the present study also indicated that after exposure to Structured Teaching Programme on prevention of Urinary tract infection in B.SC. NURSING 1 'Year students knowledge was increased.

These finding were found to be similar with the finding from the study by Hemavathy V(2017 feb). In pre-test knowledge of nursing students there was less knowledge 11(36.6%). After giving self-instructional module, majority of students gained adequate knowledge 26(86.7%). The comparison of mean, standard deviation of pre-test and post-test knowledge and paired t' test value among knowledge regarding Urinary Tract Infection shows that the pre-test mean score is 6.43 and the Post-test mean score is 8.7. The obtained paired r test value is 7.827 which is statisticallv significant at P-0.001.

The finding of the present study was also similar to the Vijay Purbia (1 July2014). One group pre-test post-test expert Teaching Programme on knowledge of staff nurses regarding prevention of Urinary tract infection among patients with indwelling catheters. The mean score of post-test knowledge 27.53(71.76%) was apparently higher than the mean score of pre-test13.1(45.03%) Structured Teaching Programme was effective strategy in increasing knowledge of staff nurses.

In the present study there is no association of pre-test knowledge with their selected demographic variables in contrast the study finding of Sheela Pavithran (3July 2014) showed that knowledge was significantly associated with contributing factor of Urinary tract infection like frequency of voiding during school hours, voiding in unclean toilet, taking bath during menstruation and cleaning genitalia during menstruation

Summary

This chapter gives a brief summary of the study. The present study aimed to evaluate the effectiveness of StructuredTeaching Programme on knowledge regarding prevention of urinary tract infection among B.Sc. Nursing 1' year students of Vivekananda College of Nursing. Lucknow.

The objectives of the study were-

The conceptual framework of the study based on the "Ludwig vinbertalanffy' sgeneral system theory model". The major component of the model was input, throughput, output and feedback It provides the comprehensive framework for achieving the objectives of the study. In this study literature review were composed of literature related to effectiveness of Structured Teaching Programme, literature related to prevention of urinary tract infection among B.Se. Nursing 1st year. This literature information enabled the investigator to study the extent of selected problem and to develop conceptual framework, data analysis and interpretation.

The research design chosen for the study was pre-experimental (one group pre-test and post-test design). The study was under taken in Vivekananda College of Nursing.

Lucknow. The data was collected through the self-structured knowledge questionnaire tool. The sample size consists of 48 students of B.Sc. nursing I' year. The obtained data was analyzed and interpreted on the basis of the objective of the study. The collected data of summarized and tabulated by utilization descriptive and inferential statics

The following conclusions were drawn in the basis of findings of the study:-

Source of Funding

None.

Conflict of Interest

None.