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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE.
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION.
Mr. SIDDESHA GOWDA B.K.
I YEAR M.SC NURSING
MEDICAL SURGICAL NURSING
YEAR 2011-2013
SRI VENKATESHWARA COLLEGE OF NURSING,
NO 98,MARUTHI INDUSTRIAL ESTATE,
PEENYA II STAGE,
BANGALORE-58
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA,BANGALORE.
1
PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION.
1. NAME OF THE
SIDDESHA GOWDA.B.K
CANDIDATE AND
I YEAR M.SC NURSING
ADDRESS
SRI VENKATESHWARA
COLLEGE OF NURSING,
NO98,MARUTHI INDUSTRIAL ESTATE,
PEENYA II STAGE, BANGALORE-58.
2. NAME OF THE
INSTITUTION
Sri Venkateshwara college of nursing,
No 98,Maruthi industrial estate,
Peenya II Stage,Bangalore -58.
3. COURSE OF THE
STUDY AND
I Year M.Sc.Nursing,
Medical Surgical Nursing.
SUBJECT
4. DATE OF
13-06-2011
ADMISSION OF
THE COURSE
5. TITLE OF THE
STUDY
“A study to assess effectiveness of structure teaching
programme regarding warning signs of cancer among
adult group (30-65 age in year) in selected area at
Bangalore”.
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6. BRIEF RESUME OF THE INTENDED WORK
6.1
INTRODUCTION
“Disease is war with the laws of our being, and all war, as a great general has said,
is hell”.
Lewis G. Janes.
The concept of perfect positive health can not become a reality because man will
never be so perfectly adapted to his environment that his life will not involve struggle,
failures and sufferings.1
Our body is composed of many millions of tiny cells, each a self-contained living
unit. Normal cells in the body grow and divide for period of time and then stop grow and
dividing .There after, they only reproduce themselves as necessary to replace defective or
dying cells. Cancer occurs when this cellular reproduction process goes out of control. In
other words cancer is a disease characterized by uncontrol, uncoordinated and undesirable
cell division.² This abnormal cell transfer abnormal DNA to the genetic mutation of cellular
DNA .this abnormal cell form’s clone and begins to proliferate abnormally. 3
In most people's minds there is no scarier diagnosis than that of cancer. Cancer is
often thought of as an untreatable, unbearably painful disease with no cure. Cancer is
undoubtedly a serious and potentially life-threatening illness. The truth of the matter is that
there are multiple types of cancer, many of which can today be effectively treated so as to
eliminate, reduce or slow the impact of the disease on patients' lives.
Cancer is the term which is originated from latin word cancer, which means
‘crab’it applied to tumors on account of the crab like pattern formed by the distended blood
vessel around affected part. 4
3
Cancer is a group of more than 200 diseases occur in all age group. Commonly it
occur in people older than 65 years of age ,over all incidence of cancer higher in men than
in women and higher in industrialized sectors and nations compare to others. Cancer can be
affecting anybody at anytime in life. There are more reasons for increase burden of cancer
such as, rise in use of cigarette, alcohol, tobacco chewing, use of chemicals, exposed to
radiation and pollution, aging process and also due to the hormonal changes. Cancer is one
of the chronic and life threatening disease its one of the major barrier for the
socioeconomic development of the country because it is one of the major cause of death of
the people. 5
The world wide incidence of cancer cases and deaths has steadily increased. The
proportion is more due to failure in identification in the early stage of cancer . Early
identification
can be achieved by creating awareness of warning signs of cancer
(CAUTION) such as, ‘change in bowel or bladder habit, a sore that doesn’t heal ,unusual
bleeding or discharge ,thickening or lump in the breast ,testicles or else, indigestion,
obvious change in size, colour or thickness of a wart mole ,nagging of cough. 6
Cancer has the potential to affect every organ in the body. The cells within
malignant tumors have the ability to invade neighboring tissues and organs, thus spreading
the disease. It is also possible for cancerous cells to break free from the tumor and enter the
bloodstream; in turn spreading the disease to other organs is called metastasis.
The effects due to cancer will be life threatening because of the alteration in the
whole body functions due to the proliferation of abnormal cells changes, It causes changes
in digestive process, decrease renal function, Sleep problems and fatigue are common
among cancer survivors and can impair their attention and memory.
Although cancer is frequently not perceived is a significant health problem in
developing countries death rate due to cancer is high in developing countries then in
developed countries. 7
4
6.2
NEED FOR THE STUDY
Non communicable diseases are among the new silent killers which the world face.
They are more prevalent in developing countries .The major chronic non communicable
diseases are cardiovascular disease, epilepsy, hypertension, diabetes mellitus, cancer and
chronic respiratory condition. Prevalence rate of non communicable disease can be
decreased by the effective health communication. It is a key strategy to inform the public
about health concerns and to maintain important health issue on the public agenda .It is
directed towards improving the health status of individuals and population health
promotion can reinforce health message, Stimulate people to seek further information and
bring about sustained healthy lifestyle. 8
In present days the cancer became most common disease due to the continuous
exposure to certain risk factor such as tobacco(25-30%), obesity (30-35%) , infection (1520 %) ,radiation (both ionizing and non ionizing up to 10%),stress ,lack of physical
activity and environmental pollutants. The global burden of cancer increases largely
because of the aging and population explosion along with that adaptation of cancer causing
behavior. Globally cancer incidence around 12.7 million people are affected by cancer and
7.6 million deaths occurred in the year of 2008. 9
A study was conducted to know about the incidence of cancer in different
geographic regions around the world. The sample has been collected from Indians residing
in different countries. The objective of the study was to find out the prevalence rate of
cancer. The result of the study shows that the lowest cancer incidence rates in India (111
and 116 per 100 000 population) and the highest among US whites (362 and 296). Cancer
incidence rates among Indians residing outside of India were: intermediate Singapore (102
and 132), UK (173 and 179) and US ranges 152–176. The study concludes that better
knowledge and health care is needed regarding carcinogens exposure. 10
The international cancer society is showing the burden of cancer is estimated to be
double by 2020 and nearly triple by 2030. According to the forecasted figures for 2030
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there are likely to be 20 to 25 million new cancer diagnoses and 13-17 million cancer
related deaths. 11
The survey reports says that, In 2005 India was one of the country which had
highest cancer rates in the world. The survey included more than 2 00 000 patients with
cancer. Aizawl district in the northeastern state of Mizoram has the world’s highest
incidence of cancer of the lower pharynx (11.5 per 100000 people). Incidences of stomach
cancer were high among men in Bangalore and Chennai. The survey also detected a “belt
of thyroid cancer” in women in coastal districts of Kerala, Karnataka, and Goa. 12
A study was conducted to assess the world wide mortality and prevalence of cancer.
The findings of the study states that 10.9 million of new cases, 6.7 million deaths and 24.6
millions person alive with cancer in one year. The most common diagnosed cancer is lung
cancer (1.35 millions), breast cancer (1.15 millions) colorectal cancer (1 millions) and most
common causes of cancer death lung cancer (1.18 million deaths). The most prevalent
cancer in the world is breast cancer (4.4 million survivors). The increasing number of
cancer prevalence is due to exposure to known or suspected risk factors related to lifestyle
or environment, and provides a clear challenge to prevention. 13
Cancer at in early stage it’s in benign from and effect area of arising only, later the
same person is continuosly exposed particular factor. the cancer cell gets metastasis
character the cancer seeding cancer enter into the circulation ,it grows some other parts of
body, during this condition treatment modilities is changing and rate of outcome rare in
some cases. 14
Cancer is most dreaded disease in the world .the incidence of cancer is increasing
with each year and it is
attributed to the changes in lifestyle and decrease in life
expectancy. Hence the investigator felt need to give planned teaching program to adult
group (30-65 age in year) about warning signs of cancer. 15
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6.3
STATEMENT OF THE PROBLEM
“A study to assess effectiveness of structure teaching programme regarding warning
signs of cancer among adult group (30-65 age in year) in selected area at Bangalore”.
6.4
OBJECTIVES OF THE STUDY:-
1. To asses the pretest knowledge regarding warning signs of cancer among adult group
(30-65 age in year).
2. To asses the post test knowledge regarding warning signs of cancer among adult group
(30-65 age in year).
3. To evaluate the effectiveness of planned teaching program regarding warning signs
of cancer among adult group (30-65 age in year).
4. To find out the association between post test knowledge regarding warning signs of
cancer among adult group (30-65 age in year) with the selected demographic variables.
6.5
OPERATIONAL DEFINITION:-
1. Assess
To evaluate the level of knowledge on warning signs of cancer among adult group (30-65
age in year).
2. Effectiveness
The out come of the study identified with the help of questionnaires provided to
general public before and after conducting the structure teaching programme regarding the
warning signs of cancer among adult group (30-65 age in year).
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3. Structured teaching programme
It is a educative program to improve the knowledge among adult group (30-65 age
in year) regarding the warning signs of cancer.
4. Warning signs
Advance notification of something is exists, is occurring.
5. Cancer
Cancer is characterized by uncontrollable proliferations of abnormal cells.
6.6
ASSUMPTION:-
1. General public has inadequate knowledge regarding warning signs of cancer.
2. The structure teaching will enhance the knowledge on warning signs of cancer.
6.7
HYPOTHESIS
H1-
There will be a significant difference between the pre test and post test
knowledge regarding warning signs of cancer among adult group (30-65 age in year).
H2-
There will be a significant association between post test level of knowledge
regarding warning signs of cancer with selected demographic variables of adult group (3065 age in year).
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6.8 REVIEW OF LITERATURE
The review of literature is defined as a broad, comprehensive in depth, Systematic
and critical review of literature scholarly publications, unpublished Scholarly printed
materials, audiovisual materials and personnel communications. The review of literature is
an important aspect of research, is help to make sure that what has been done in relation to
the problem. There were several studies has been conducted in relation to warning signs of
cancer.16
A Study was conducted to assess the level of knowledge among community health
workers regarding warning signs and symptoms in case of pediatrics in Brazilian . The
questionnaire has been distributed the community health workers. The result of the study
shows that they have inadequate knowledge about the warning signs & symptoms of
pediatric cancer. The study concludes that knowledge and training is needed for community
health workers to reduce the incidence of cancer among pediatrics. 17
A study was conducted on warning signs of cancer in children the campaign was
undertaken to educate the public and the primary health workers in rural area of South
Africa .2/3rd of children with cancer never reach a specialist center for treatment, the
majority of those who present have advance disease there was statistically significant
increase in the no of new patients referred in the 6 years fowling the campaign (p=0.001).
The study concludes that knowing about the warning signs appears to be useful in
promoting the awareness of cancer. 18
A study was conducted to assess an exploration of warning signs of cancer. The aim
of the study was to explore the attitudes, knowledge and behavior of the people age group
between 35-54 years. The study was undertaken by administering the questionnaires to the
participants in the population, by listing 17 warning signs of cancer, respondent were asked
to identify the prompt seven warning signs. The result of the study shows that respondents
could able to identify around 4 warning signs correctly. The study shows that the people
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with high socio economic status and highly educated people only aware about the warning
signs of cancer. 19
A pilot study was conducted by American cancer society to evaluate the public
knowledge of cancer detection and prevention .The objective of study was to examine the
attitudes, knowledge and behavior regarding warning signs of cancer .The sample has been
collected from 172 individual .the result of study shows that 90% of people could not
identify any of the cancer warning signs .The inability to influence changes in knowledge
and practice over the past 50 years is identified. 20
A study was conducted to assess public awareness of cancer. The objective of the
study was to develop and validate a measurement tool to assess cancer awareness in the
general population. The cancer awareness measure (CAM) includes cancer warning signs,
risk factors, incidence, screening programmes and attitudes towards help seeking were
generated by expert groups. The CAM was administered to a university participant panel
(n=148), with a sub-sample (n=94). The result of study shows Cognitive interviewing
indicated that the CAM was being interpreted as intended. Internal reliability (Cronbach's
alpha=0.77) and test-retest reliability (r=0.81) were high.21
A study was conducted on public awareness of warning signs for cancer in Britain
. The objective of the study was to establish the level of public awareness of warning signs
of cancer .An interview-based survey of the UK population was undertaken; 3693 men and
women completed the interview (69%response rate). The result of study revealed that
recognition of signs ranged from 81% ('thickening or lump ;n=2994) to 37%
('indigestion/difficulty swallowing'; n = 1356). On average participants identified 4.2 of the
signs, with only 1.6% (n = 58) identifying all seven. The study conclude that fewer than
one in ten of the UK population can recognize seven warning signs for cancer, but the
mean number recognized (4.2 signs) suggests that there is a reasonable level of public
awareness by public education needs to do more to narrow the inequalities in health
knowledge.22
10
A population based study was conducted regarding the public awareness of
cancer in Britian .The objective of study to assess public awareness of cancer warning
signs, in the British population. The method of study carried out a population-based survey
using face-to-face, computer-assisted interviews to administer the Cancer Awareness
Measure (CAM). The sample included 2216 adults (970 male and 1246 female). The result
of study states that awareness of cancer warning signs was low when open-ended (recall)
questions were used and higher with closed (recognition) questions. At end of study
conclude a combination of public education about symptoms empowerment to seek
medical advice, as well as support at primary care level, could enhance early diagnosis and
will help to reduce complications due to cancer. 23
A study was conducted on seven signals of cancer (SWSC) and screening in
India. The aim of study was use to detect cancer carrier persons who attended the Cancer
Detection Camps. Seven Cancer Detection Camps were conducted in rural and urban areas
of Andhra Pradesh, India. Out of 1,079 persons screened, 517 complained of one of the
SWSC. Fifty five malignant and eight pre malignant lesions were detected. SWSC as a tool
for detection of Cancer in a camp setting appears effective.
24
A study was conducted to find the value of warning signals of cancer in general
practice. Seven warning signals helps some patients in reducing diagnostic delay. The
usefulness of warning signals recorded by general practitioner at consultation is evaluated
for a group of 80 patients who developed cancer 0-18 months after the consultation.
Warning signals of cancer were recorded at the consultations in 20 cancer patients and in
13 matched control patients. For three cancer patients the warning signal was considered
not related to the cancer. Recognition of warning signals related to the cancer disease was
considered useful for nine out of 17 patients.25
A explolaratory study was conducted to identify knowledge, attitude and
behaviour related to cancer.preventionand early detection among egyptian .A self
administered survey has been done from 99 people .The result indicates that ,a significany
difference between males and female in warning signs of cancer . as well as prevention and
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early detection methods ,the study findings incidence the need for providing people with
information to help them to do early detection and cancer prevention practice.26
7.
MATERIALS AND METHODS
7.1 Sources of data
Data will be collected from adult group (30-65 age in year) in Hegganahalli area at
Bangalore.
7.2 Methods of data collection
I. Research design
Research design adopted for this study is quasi-experimental one group pre-test and
post- test design.
II. Research Variables
Independent variable: Structured teaching Programme regarding warning signs of
cancer.
Dependent Variable: Knowledge regarding warning signs of cancer among adult group
(30-65 age in year)
Demographic variables: it contains baseline information of general public such as age,
gender, and educational status and occupational status, previous knowledge of warning
signs of cancer and source of information.
III. Research setting
The study will be conducted in Hegganahalli area at Bangalore.
IV. Research method
The study will be done by using structured questionnaire method.
V. Population
The study population comprises of all the people in Hegganahalli area at Bangalore
12
VI. Sample
All the people who fulfill the inclusion criteria are considered as sample and the sample
size is 60.
VI. Criteria for sampling
Inclusion Criteria
1. Both male and female groups.
2. People who are all able to speak and read Kannada and English.
Exclusion Criteria
1. who are all not willing to participate.
2. Who are all not available during the period of data collection.
VII. Sampling technique
Convenient sampling technique is chosen for this study.
VIII. Tool for data collection
It consist of following section
Section A:
Selected demographic variables such as as age, gender, and
educational status and occupational status, previous knowledge of
warning signs of cancer and source of information
Section B:
Structured questionnaire to assess the level of knowledge on warning
signs of cancer among adult group (30-65 age in year).
IX. Method of data collection:
After obtaining permission from the authorities, the investigator will obtain
informed consent from the general public. The investigator individually assesses
knowledge of people by using structured questionnaires and on the same day administers
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structured teaching program. The post test knowledge will be assessed after seven days by
using the same structured questionnaire.
Duration of study : 4-6 Weeks
X. Plan for data analysis
The data collected will be analyzed by means descriptive statistics and inferential
statistics.
Descriptive statistics frequency, percentage distribution of demographic variables
and mean, standard deviation will be used for level of knowledge.
Inferential statistics chi-square test will be used to associate the level of knowledge
and selected demographic variables.
XI. Projected outcomes
The structured teaching program will improve the knowledge regarding warning
signs of cancer among adult group (30-65 age in year).
7.3 Does the study require any investigation or interventions to be
conducted on the patient or other human beings or animals?
Yes, structured teaching program on knowledge regarding warning signs of cancer
among adult group (30-65 age in year).
7.4 Has ethical clearance obtained from your institution?
Yes, permission will be obtained from ethical committee of the Sri Venkateshwara
College of Nursing.
14
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9. Signature of the candidate
:
10. Remarks of the guide
:
11. Name and Designation
:
11.1 Guide
:
11.2 Signature
:
11.3 Co-guide (if any)
:
11.4 Signature
:
11.5 Head of the department
:
11.6 Signature
:
12.1 Remarks of the principal
:
12.2 Signature
:
17