Download a study to assess the effectiveness of structed teaching programme

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA
BANGALORE,
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
.
SHYNEY VARGHESE
FIRST YEAR MSc NURSING
MEDICAL SURGICAL NURSING
2011 – 2012
CHRISTIAN COLLEGE OF NURSING,
KALYAN NAGAR
BANGALORE.
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
ANNEXURE-II
SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1
NAME OF THE
COLLEGE AND
ADDRESS
2
NAME OF THE
INSTITUTION
3
SHYNEY VARGHESE
1st YEAR M.SC.NURSING
CHRISTIAN COLLEGE OF NURSING,
KALYAN NAGAR
BANGALORE.
CHRISTIAN COLLEGE OF NURSING,
KALYAN NAGAR
BANGALORE
COURSE OF STUDY
MASTER OF SCIENCE IN NURSING
AND SUBJECT
4
(MEDICAL SURGICAL NURSING)
10/10/2011
DATE OF ADMISSION
TO THE COURSE
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TITLE OF THE TOPIC
A STUDY TO ASSESS THE
EFFECTIVENESS OF STRUCTED
TEACHING PROGRAMME ON
PREVENTION OF ORAL CANCER AMONG
THE ADULTS IN SELECTED RURAL
AREAS AT BANGALORE .
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6. A BRIEF RESUME OF THE INTENDED WORK:6.1INTRODUCTION:”Prevention is one of the few known ways to reduce demand for health and
aged care services”
Oral cancer is a subtype of head and neck cancer, is any cancerous tissue
growth located in the oral cavity.[1] It may arise as a primary lesion originating in any of
the oral tissues, by metastasis from a distant site of origin, or by extension from a
neighboring anatomic structure, such as the nasal cavity or the Oral cancers may originate
in any of the tissues of the mouth, and may be of varied histologic types: teratoma,
adenocarcinoma derived from a major or minor salivary gland, lymphoma from tonsillar
or other lymphoid tissue, or melanoma from the pigment-producing cells of the oral
mucosa. There are several types of oral cancers, but around 90% are squamous cell
carcinomas, originating in the tissues that line the mouth and lips. Oral or mouth cancer
most commonly involves the tongue. It may also occur on the floor of the mouth, cheek
lining, gingiva (gums), lips, or palate (roof of the mouth). Most oral cancers look very
similar under the microscope and are called squamous cell carcinoma.
Oral cancer is a heterogeneous group of cancers arising from different parts of the
oral cavity, with different predisposing factors, prevalence, and treatment outcomes. It is
the sixth most common cancer reported globally with an annual incidence of over
300,000 cases, of which 62% arise in developing countries. There is a significant
difference in the incidence of oral cancer in different regions of the world. The ageadjusted rates of oral cancer vary from over 20 per 100,000 population in India, to 10 per
100,000 in the U.S., and less than 2 per 100,000 in the Middle East (1).In comparison
with the U.S. population, where oral cavity cancer represents only about 3% of
malignancies, it accounts for over 30% of all cancers in India. The variation in incidence
and pattern of oral cancer is due to regional differences in the prevalence of risk factors.
But as oral cancer has well-defined risk factors, these may be modified – giving real hope
for primary prevention.
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The main symptoms of oral cancer is white and Red Patches in the Mouth or Lips, A
Sore or Blister in Your Mouth, Difficulty Swallowing, Earaches: Change in the Way
Teeth Fit Together and Bleeding from the Mouth.Oral cancer is part of a group of cancers
called head and neck cancers. Oral cancer can develop in any part of the oral cavity or
oropharynx. Most oral cancers begin in the tongue and in the floor of the mouth. Almost
all oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the
mouth, tongue, and lips. These cancers are called squamous cell carcinomas.When oral
cancer spreads (metastasizes), it usually travels through the lymphatic system. Cancer
cells that enter the lymphatic system are carried along by lymph, a clear, watery fluid.
The cancer cells often appear first in nearby lymph nodes in the neck.Cancer cells can
also spread to other parts of the neck, the lungs, and other parts of the body. When this
happens, the new tumor has the same kind of abnormal cells as the primary tumor. For
example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral
cancer cells. The disease is metastatic oral cancer, not lung cancer. It is treated as oral
cancer, not lung cancer. Doctors sometimes call the new tumor "distant" or metastatic
disease
6.2NEED FOR THE STUDY:Oral cancer appears to be increasing in incidence, and mortality has hardly
improved over the past 25 years. Better understanding of the etiopathogenesis should lead
to more accurate and earlier diagnosis and more effective treatments with fewer adverse
effects. Diagnosis is increasingly aided by detection of cellular and now molecular
changes. Treatment is increasingly looking towards chemotherapy and now gene therapy.
However, there is no doubt that prevention is the most important aspect, particularly
patient education and the reduction of lifestyle risk habits and environmental factors.
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Oral cancer is the sixth most common cancer worldwide and shows marked
geographic variation in occurrence (Warnakulasuriya, 2008). Oral cancer is of paramount
importance to Dental professionals and constitutes a major public health problem in India
as common cancer site observed by Indian cancer registries (ICMR, 1992).
Epidemiological studies have shown that incidence of oral cancer varies significantly in
different continents, and also between developed and developing countries, high
incidence rates were reported in Asia region (India, Sri Lanka, Pakistan and Taiwan),
parts of Europe (France, Hungary, Slovakia, and Slovenia), parts of Latin America and
the Caribbean (Brazil, Uruguay and Puerto Rico), and in the Pacific region (Melanesia
and Papua New Guinea) largely attributed to exposure to specific risk factors for oral
cancer (Warnakulasuriya)
A study was conducted about tobacco use and awareness among
marginalized children by Cancer Patient Aid Association, Mumbai, India. The cross
sectional study was the tool of the study. The result of the study showed that the
percentage of tobacco users in urban Mumbai was quite low at 4.8% compared with rural
Kasara (36%) and Assam (76%); and 74.6% of the children were aware that tobacco use
was dangerous and harmful to health. The average age of initiation was 9 years. Out of
the 1004 children surveyed, 253 were tobacco users and 79% were males. Of the 1700
children screened, 23.5% presented with precancerous oral lesion. The study conclude
that addresses the tobacco habits of a typical sample of marginalized children in India
and the need for effective interventions aiming at reducing the burden of tobacco-related
cancers by controlling at the point of initiation.
A study was conducted to find out the knowledge about oral cancer and
effect of an education in Babol. The questionnaire was the study tool.The result of the
study showed that community sample of 400 people,76.0% had no knowledge of oral
cancer. Mean knowledge score before the education intervention was 1.47 (standard
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deviation 3.40) out of 10. Knowledge about oral cancer was not associated with age, sex
or education level but urban residents had better knowledge than rural residents. Mean
knowledge score improved significantly by 5.92 (SD 3.30) at 1 month after the
intervention among the 226 respondents who had read the brochure.
The researcher felt that since the incidence oral cancer is increasing and interest for
prevention and treatment are arises by the early detection of oral cancer in adolescence .
The researcher can help the children to cope up with the problems .All these instance
prompted the researcher to conduct the study.
6.3. REVIEW OF LITERATURE
Review of literature is a systematic identification, location,scrutiny and summary of written
material that contains information on research problem . The research reviews are organized
under the following headings .
6.3.1 Study related to awareness regarding oral cancer.
6.3.2 Study related to effectiveness of structured teaching programme .
6.3.1 Study related to awareness regarding oral cancer.
A study was conducted to find out Factors affecting oral cancer awareness in a highrisk population in India by Amrita Institute of Medical Sciences and Research Center,
Cochin, India.The questionnaire was the too used in the study.The result of the study
showed that out of 1885 persons 86% had heard about oral cancer and 32% knew
someone with oral cancer. Sixty-two percent of the subjects correctly identified the
causes; this included 77% of the subjects who identifying smoking, 64% alcohol and 79%
pan chewing as a cause of oral cancer. More than 42% believed that poor oral health
could lead to oral cancer and 53% thought that oral cancer is an incurable disease.
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Eighty-two percent of the smokers,75% of the tobacco chewers and 66% of those who
consumed alcohol were aware that their habits could lead to oral cancer.
6.3.2 Studies related to effectiveness of structured teaching programme.
A study was conducted to assess the knowledge of high schoolchildren on oral
cancer risk factors in southern Texas by University of Texas Health Sciences Center U S
A.The tool of the study was questionnaire. The result of the study showed that the
effective response rate was 67%. Ninety-five percent of the students were Hispanic
American, 55% had not heard about oral cancer, and 60% failed to identify the most
common early signs of oral cancer. Lack of awareness of oral cancer risk factors indicate
the need for improved health education directed towards minority population, especially
in underprivileged areas.
A study was conducted about Tobacco consumption and awareness of their health
hazards amongst lower income group school children in National Capital Territory of
Delhi by Department of Human Nutrition, All India Institute of Medical Sciences New
Delhi. The result of study showed that 9.8%of the study children had at least once
experimented with any form of tobacco in their lifetime. The proportion of children who
were "current users" of tobacco products was 5.4% (boys: 4.6%, Girls: 0.8%). Nearly
eighty percent of the study subjects knew that, tobacco consumption is injurious to
health. The parents of 59% of the children discussed the harmful effects of tobacco
consumption with their children.
A study was conducted to determine the need for health promotion in oral
cancer prevention and early detection by National Institute of Dental Research, National
Institutes of Health, Bethesda.The result of the study showed that Overall, the public is
ill-informed about risk factors for and signs and symptoms of oral cancers and relatively
few US adults have had an oral cancer examination. Further, health care providers are
remiss in providing oral cancer examinations and detecting early oral cancers. To achieve
the oral cancer objectives contained in "Healthy People 2000," health care providers and
the public must know the risk factors for these cancers as well as their signs and
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symptoms. Further, health care providers need to provide oral cancer examinations
routinely and competently. Equally important, the public needs to know that an
examination for oral cancer is available and that they can request one routinely. Thus, a
vigorous agenda that includes education, policy, and research initiatives is needed to
enhance oral cancer prevention and early detection.
A study was conducted to understand the picture of premature death from oral
cancer, they estimated years of life lost (YLL) and average years of life lost (AYLL) of
this cancer for the years 1995 and 2005 in Japan. The result showed that both men and
women combined, 4099 and 5679 deaths due to oral cancer were recorded for the years
1995 and 2005. Study showed that cancer of pharynx, tongue, and gum were the most
frequent oral cancers in both sexes and responsible for a remarkable number of years of
life expectancy lost. Deaths due to those cancer sites occurred about 16-21 years earlier
than expected in men, and 14-22 years in women.
6.4.STATEMENT OF THE PROBLEM:“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTED TEACHING
PROGRAMME ON PREVENTION OF ORAL CANCER AMONG THE ADULTS
IN THE SELECTED RURAL AREAS AT BANGALORE” .
6.5.OBJECTIVES OF THE STUDY:1. To assess the knowledge regarding prevention of oral cancer among adults population in terms
of pretest score.
2. To assess the knowledge regarding prevention of oral cancer in terms of post-test score after
administering structured teaching program me.
3 To compare the effectiveness of structured teaching programme in pre-test and post test
knowledge score.
4 To associate the level of knowledge on selected demographic variables .
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6.6. OPERATIONAL DEFINITIONS:
Effectiveness: It refers to the extent to which structured teaching programme on
oral cancer achieve the desired effect in improving knowledge regarding
prevention of oral cancer as evidenced by gain in post test knowledge score.

.Structure teaching: - It refers to systematically develop instructional method
and visual aid design and used for adult population which include causes, signs
and symptoms, diagnosis, treatment and prevention.
 Oral cancer; : Any malignant tumor including carcinoma and sarcoma which
may occur on the lips or anywhere within the mouth.

Adult; The stage of development between childhood and adult hood.
6.7.ASSUMPTIONS:1. The adult population may have inadequate knowledge about oral cancer.
.
2. Structure teaching is an effective way to improve the knowledge of
adolescence to prevent oral cancer
6.8. RESEARCH HYPOTHESIS:
H1- There will be a significant difference between the pretest and post test
knowledge scores of adult.

H2- There will be significant association between the knowledge scores and selected
demographical variables.
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6.9.DELIMITATIONS:1, The study is limited to only adult in selected area
2, Data collection period is limited to 30 days.
7.0. MATERIALS AND METHODS:7.1. SOURCE OF DATA
Data will be collected from the adult in selected rural areas at Bangalore.
7.2. METHODS OF COLLECTION OF DATA
Data will be collected by using structured interview technique.
7.2.1. RESERCH DESIGN
Pre- experimental design one group pre-test and post test design will be used to
achieve the objectives of the study.
7.2.2..RESEARCH APPROACH
Evaluative survey approach will be used to carry out the study
7.2.3.SETTING OF THE STUDY
The setting of the study is adult population in selected rural areas at Bangalore.
7.2.4.POPULATION
The population of the present study consists of adult (30-70 years)
7.2.5. SAMPLE SIZE
The sample size of the study consists of 40 adults.
7.2.6.SAMPLING TECHNIQUE
The convenient sampling technique will be adopted to select the sample.
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7.2.7.SAMPLING CRITERIA
INCLUSION CRITERIA
1. Adults who are willing to participate in the study.
2.
Adults who are available at the time of study.
EXCLUSION CRITERIA
1.
Adults who are available and not willing to participate in the study.
2. Adults who are not available during study period.
7.2.8. TOOLS FOR DATA COLLECTION:
Data will be collected from adults by using structured interview questionnaire .
It consist of two sections.

Section A- items on demographic variables about age,sex,education,occupation
,income and source of information.

Section B- knowledge questionnaire regarding prevention of oral cancer.
.
7.2.9. DATA ANALYSIS AND INTERPRETATION.
DECRIPTIVE STATISTICS
It includes mean,median,standared deviation to assess demographic variables.
INFERNTIAL STATISTICS
.
Chi square test will be used to find out the association between knowledge score
and demographic variables of adult population.
.
Paired T test will be used to compare pre-test and post knowledge score.
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7.2.10. DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER
HUMANS OR ANIMALS? IF SO PLEASE DESCRIBE BRIEFLY.
Yes, structured teaching on assess the effectiveness of a structure teaching on
counseling among adult will be administered to the study participants as a part of the
research study.
7.3.HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION IN CASE OF 7.2.9?

Yes, ethical clearance will be obtained from the research committee of the
Christian college of nursing Bangalore.
 Informed consent will be obtained from the study participants who are
willing to participate in the study.

Consent will be taken from the subjects before conducting the study.

Confidentiality and anonymity of the subject will be maintained.
7.4. LIST OF REFERENCES:BOOK &JOURNALS REFERENCE
1,Southern H. Oral care in cancer nursing: nurses' knowledge and education. J
AdvNurs. 2007 Mar;57(6):631-8.
2,Walid EI, Nasir F, Naidoo S. Oral health knowledge, attitudes and behaviour
among nursing staff in Lesotho. SADJ. 2004 Aug;59(7):288, 290, 292.
3,VikramKekatpure, M.D. Oral Cancer in India: Learning from Different
Populations,News letter, NewYork-Presbyterian Hospital 2010 .Issue 14.
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4,Scully C. Oral cancer aetiopathogenesis; past, present and future aspects. Med Oral
Patol Oral Cir Bucal. 2011 May 1;16(3):e306-11.
5,AtessaPakfetrat , FarnazFalaki, HabibOllahEsmaily PHD2,Samira Shabestari DDS .
Oral Cancer Knowledge among Patients Referred to Mashhad Dental School, Iran
Archives of Iranian Medicine.Volume 13, Number 6, 2010 Nov , P:547.
6,Carter LM, Harris AT, Kavi VP, Johnson S, Kanatas A, Oral cancer awareness
amongst hospital nursing staff: a pilot study. BMC Oral Health, 2009 Jan 28.
7,Wårdh I, Paulsson G, Fridlund B, Nursing staff's understanding of oral health care
for patients with cancer diagnoses: an intervention study. J ClinNurs, Epub2008
Feb19, 2009 Mar;18(6):799-806.
8,Omolara G. Uti, B.ch.D., F.M.C.D.S.; A.A. Fashina, B.D.S.Oral Cancer Education
in Dental Schools:Knowledge and Experience of NigerianUndergraduate Students.
Journal of Dental Education Volume 70, Number 6.
9,David A Mitchell,Laura Mitchell, Dental decks2 – Dental Secrets - Oxford
Handbook of Clinical Dentistry. 4th Edition.
10,Polite F Denise, Beck T C. Nursing research principles and methods. 6th ed.
Philadelphia: Lippincott Co; 1999;Pp 88-99.
11,R. Sankaranarayanan MD, Oral Surgery, Oral Medicine, Oral Pathology
Volume 69, Issue 3, 1990 March, Pp 325-330.
12,D.I. Conwaya , D.L. Stocktonb, K.A.A.S. Warnakulasuriyac, G. Ogdend and
L.M.D. Macphersona Oral Oncology Volume 42, Issue 6, 2006 July, Pp 586-592.
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13,AhmedinJemalDVM,Freddie Bray ,Melissa M. Center MPHCA: A Cancer Journal
for Clinicians.Volume 61, Issue 2, March/April 2011,69-90
14,Bayashi H, Pham TM, Fujino Y, Kubo T, Ozasa K, Matsuda S, Yoshimura T.
Estimation of premature mortality from oral cancer in Japan, 1995 and 2005. Cancer
Epidemiol. 2011 Apr 5.
15,Kumar S. Panmasala chewing induces deterioration in oral health and its
implications in carcinogenesis. ToxicolMech Methods. 2008 Jan;18(9):665-77.
16,Fortnightly review: Oral cancer BMJ 1999;318:1051 (Published 17 April 1999).
NET REFFERANCE
17, www.indianjournals.com
18, www.pubmed.com
19, www.chocrane.net
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CANDIDATE SIGNATURE
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REMARKS OF THE GUIDE
20, Available resources from ,http://onlinelibrary.wiley.com
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NAME AND DESIGNATION
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HEAD OF THE DEPARTMENT
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SIGNATURE OF THE H.O.D
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REMARKS OF THE PRINCIPAL
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