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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA,
PROFORMA FOR REGISTRATION OF
SUBJECTS FOR DISSERTATION
MR. SHANTAPPA HEBBALATTI
1ST YEAR M.SC NURSING
MEDICAL SURGICAL NURSING
YEAR 2011-2013
CAUVERY COLLEGE OF NURSING,
TERISIAN COLLEGE CIRCLE,
SIDHARTHANAGAR,
MYSORE.
[1]
1
NAME OF THE
MR. SHANTAPPA HEBBALATTI
CANDIDATE
1st YEAR M.Sc NURSING,
AND ADDRESS
CAUVERY COLLEGE OF NURSING, MYSORE.
2
NAME OF THE
CAUVERY COLLEGE OF NURSING, MYSORE-570007
INSTITUTION
3
COURSE OF STUDY
MASTER OF NURSING -
AND SUBJECT
4
DATE OF
ADMISSION TO
COURSE
5.1
TITLE OF THE
STUDY
TO
EVALUATE
THE
EFFECTIVENESS
OF
SELF
INSTRUCTIONAL MODULE ON KNOWLEDGE REGARDING
EARLY
DETECTION
AND
PREVENTION
OF
PROSTATE
CANCER AMONG BUS DRIVERS IN MYSORE.
5.2
STATEMENT OF
A STUDY TO EVALUATE THE EFFECTIVENESS OF SELF
THE
INSTRUCTIONAL MODULE ON KNOWLEDGE REGARDING
PROBLEM
EARLY
DETECTION
AND
PREVENTION
CANCER AMONG BUS DRIVERS IN MYSORE.
[2]
OF
PROSTATE
6. BRIEF RESUME OF THE INTENTED STUDY
“Look to your health; and if you have it, praise God and value it
next to conscience; for health is the second blessing that we
mortals are capable of, a blessing money can't buy. “
-
Izaak Walton
6.1 INTRODUCTION:The prostate is a gland of men located in middle of the bladder and rectum. As men
have only prostate, so prostate cancer is the disease of the man. The main function of
Prostate gland is to produce and store fluid which comes out from a man’s penis during
ejaculation. The urethra tube that carries urine from the bladder to penis is fully encircled by
Prostate gland. The enlargement of Prostate causes urination problem of men. Prostate
cancer means cells in the Prostate grow uncontrollably and invade the nearby tissues and
other parts of the body. The abnormally grown tissues are called tumors. The benign tumors
are those tumors which are not life threatening.
Only malignant tumors can spread to
other parts of the body. Though usually Prostate cancer is slow growing, it has the
possibility of quick growth and expansion. 1
Prostate cancer is the most common cancer in men and the second most common
cause of cancer death in American men older than 55year age. In 1999, African American
men prostate cancer is the most prevelent cancer, overall its incidence is twice. Let us speak,
general population of men and death rate is about 3times greater about 1:5men in the united
states develop prostate cancer, and esteemated 1,80,000 new cases of prostate cancer are
diagnosed each year, and 37,000men who already have it, die from it each year. 2
Risk factors include, increase in age and possibly high fat diet. The genetic
association of prostate cancer, as the increased incidence within family is still being
investigated. The growth of prostate gland depends
on the presence of androgenic
harmones, such as testosterone, because Dihydrotestesterone is the important pramoter of
prostate cancer. 2
[3]
According to WHO report, in developing countries, about one-third of cancers can be
prevented, one-third can be detected early and and can be cured, and the remaining third
needs supportive care. For various reasons, over two third of cancers in India present with
advanced incurable stage. Due to the advanced stage of disease at presentation, increasing
cancer treatments will have very little impact in the outcome. The most cost effective means
to impact cancer outcome in the community is to channel resources in prevention of
preventable cancers, and early detection and down staging of cancer and provide
standardized protocol based treatment of diagnosed patients. Those patients who are
diagnosed with cancer needs to be treated based on a standardized treatment protocol, which
needs to be carried out with the support of multy-disciplinery sub-site based tumour board
in partener with comprehensive cancer centres . By tying up peripheral cancer care facilities
with tumour boards of
comprehensive cancer centres will ensure standardized cancer
management of a high standard in the community, potential for research to improve
outcomes and educational opportunities at both basic and advanced levels, preferential
channels for reference and management of patients reffered from the peripheral centres
would be commitment of the comprehensive cancer centres. After completion of treatment
the patient needs long tem surveillance, which is best carried out in the community in
partnership with cancer centres 3
6.2 NEED FOR THE STUDY
Working as bus drivers has several health risks. A large proportion of these health
risks are attributable to stress related disorders. This will result in loss of productivity and
early loss of highly skilled drivers. The impact of sick events occurring in public transport
bus drivers will be enormous on the society at large. This would result in risk to life of
passengers, other road users and pedestrians as well as damage to property and vehicles.
Driving as a profession puts strain on healthy life style practices of an individual. The health
of bus drivers is an important issue in public health, occupational health, transport policy and
employment conditions. There has not been a concerted effort to target those factors that
cause poor health and this is an area of neglect that needs urgent attention especially in a
developing country like ours. Measures to protect and improve the health status of bus
drivers should be pursued in a way that maximises gains to all sectors of society at large and
[4]
individual and family in particular.There has been a deterioration in work conditions of bus
drivers over the last 20 years. 24
Risk indicators related to the work environment evaluated among male professional
drivers in Sweden showed that significantly more drivers than controls had a work situation
characterized by high demands, low decision making abilities, low social support at work,
and shift work. It also showed that significantly more drivers than controls were sedentary in
their leisure time, smokers, overweight, and consumed a significantly higher proportion of
milk fat per day.25 Low physical activity in leisure time,26high incidence of smokers,27 and
obesity were also found among professional drivers in other studies. The excess proportion
of overweight drivers could be a consequence of their eating habits and their low physical
activity both at work and during their leisure time. These results indicate the importance of
trying to change the lifestyle of the drivers to decrease the risk of prostate cancer.
Cancer of the prostate ranks as the fourth most common in men globally, with an
estimated 396.100 new cases a year in 1990, which is almost a 100% increase over the 1975
estimate. Incidence rates are low in Asian and North African populations, ranging from 1 to
9 per 100,000. Studies carried out in India indicate a low incidence of the disease (3.9 per
100,000) A majority of the prostate malignancies detected in North Africa are at the T1.C
Stage. This is attributed to the presence of comprehensive screening programme with the
prostate specific Antigen (PSA) as its screening Tool. There is a lack of clinical data
pertaining to levels of prostate specific Antigen (PSA) in the Indian population. No study
targeting the Indian population exist which aims to stratify the incidence of prostate
carcinoma based on prostate specific Antigen (PSA) measurements. An effort therefore
needs to be made to create awareness
of early detection and prevention of prostate
carcinoma. 4
Dr.k ramachandra reddy maintains population based registry it says, in world, it is
estimated that about 9 million new cancer cases are diagnosed every year and over 4.5
million people die from cancer each year in the world. In india, the estimated number of new
cancers per year is about 7 lakhs and over 3.5 lakhs people die of cancer each year. And in
karnataka would be about 1.5 lakhs cancer cases at any given time in karnataka and about
35,000 new cancer cases are added to this pool each year. Cumulative risks are the absence
of other causes of death, the risk of developing cancer by an individual among bangaloreans
[5]
would be 15.1% in males and 16.8% in females (cumulative risk). In other words, one in six
persons in either sex has the risk of developing cancer during their life time.5
Prostate cancer is the most common non-skin cancer among men in most western
populations, and it is the second leading cause of cancer death among U.S. men. Despite its
high morbidity, the etiology of prostate cancer remains largely unknown. Advancing age,
race, and a family history of prostate cancer are the only established risk factors. Many
possible
risk factors, including androgens, diet, physical activity, sexual factors,
inflammation, and obesity, have been implicated, but their roles in prostate cancer etiology
remain unclear. It is estimated that as much as 42% of the risk of prostate cancer may be
accounted for by genetic influences, including individual and combined effects of rare,
highly penetrant genes, more common weakly penetrant genes, and genes acting in concert
with each other. Numerous genetic variants in the androgen biosynthesis/metabolism,
Results of these studies may lead to better detection, treatment, and, ultimately, prevention
of prostate cancer. 6
Mortality is only one in six American men diagnosed with prostate cancer will
eventually die from it. Nevertheless, 30,350 prostate cancer deaths are expected in the U.S.
in 2005, making prostate cancer the second leading cause of cancer death among U.S. men,
after lung cancer (1). Age adjusted prostate cancer mortality rates from 38 countries in 1998.
Overall the pattern of mortality worldwide reflects that of incidence, although the mortality
rates show less variation between countries. 6
Prostate cancer is now the most commonly diagnosed male cancer in many western
countries. Currently there are 37,000 new cases a year in the UK; 218,000 in the USA;
25,000 in Canada and 17,000 new cases a year in Australia. The number of recorded cases
has increased a lot in recent years. This is partly due to the increased use of the PSA test,
which has resulted in more cases being detected, and partly due to the fact that men are
living longer. Like most cancers, prostate cancer is more common in those over 60years. 7
In an unpublished study, Dr.Chaitrathara surgical oncologist funded by the Kerala
State Council for Science, Technology and Environment, has found that the risk of prostate
cancer is very high in men above 60 years of age.The raising incidence of prostate cancer
could become a major health problem, warns ,experts working in the area It is time to plan
[6]
some large-scale population screening studies to look into the matter. Regular screening
might increase the detection rate of early cancers, said Dr Chithrathara, who along with Dr
Riju R Menon and Dr Vaidhyanathan had found this trend of increasing prostate cancer in
men. In the study centered around Ernakulam, healthy men older than 50 years of age were
screened. “Many of them had come to hospitals for executive or comprehensive checkups. From the screening of nearly 1,500 men in the ages 50-80 years, the researchers
concluded that the rate of incidence is as high as 275 per one lakh persons. The test for
Prostate Specific Antigen (PSA) showed a value of 1.19 in men aged between 50-59 which
went up to 1.99 in men aged between 60-69 and further up to 2.38 in the age group of 70-75.
While the study team attempted to get a co-relation between the dietary habits, smoking and
obesity with the incidence of prostate cancer, they could not get clear-cut pictures on
smoking and obesity. However, they found that vegetarians were at a lower risk than nonvegetarians. Obesity can however delay the diagnosis of prostate cancer in two ways. One is
that it makes digital rectal examination, a major screening tool more difficult and the second
is that the hormone changes makes the chances of detection remote using the Prostate
Specific Antigen test. Those persons who showed abnormalities in digital rectal examination
in the study were subjected to transrectal ultrasound and CT/MRI scans. Biopsies were also
done to confirm the cases. Early detection is feasible in our state. Conducting urology
camps with the help of social organisations can really help, Screening impact on population
depends on the successful diagnosis and treatment of detected cases. Probably the state also
needs to think of financial assistance for diagnosis and treatment. 8
It is evident that most cancers are largely preventable. Despite this facilities for
screening and proper management of patients are grossly limited in india. More than two
third cancer patients are already in an advanced stage at the time of diagnosis. Appropriate
strategies have been developed, including creating public awareness about cancer control
and application of self or assisted cancer screening techniques. In India, under district
cancer control programme project, in selected
districts medical and paramedical staff of
the district hospital and anganwadi workers have been trained on the examination and
reffering the suspected cases to the district hospital for the further evaluation. However,
modified district cancer control programme need to be extended to more states and
peripheral areas of the country. 9
[7]
C.S. Ratkal professor and head of the Department of Nephro-urology of Victoria
hospital, Addressing a press conference stated that prostate cancer was the most common
disease among men in the 40 and above age group. And the incidence of prostate cancer in
India was more than 20 million. Of every 20 men, nine die due to cancer owing to lack of
awareness, he said. About one in six men will be diagnosed with prostate cancer during his
life time. Persons who were over 40 and are overweight will have a higher risk of
developing this disease. Surgery was the main mode of treatment for prostate cancer. The
common technique was “Radical Prostatectomy” which involves removing the prostate
gland, seminal vesicles and lymph nodes. The possible side effects of the procedure include
some urinary incontinence, infertility and erectile dysfunction. 10
Only certain types of skin cancer affect more men. Prostate Cancer Is the Second
Leading Cause of Cancer Death in Men Among American men, prostate cancer is the second
leading cause of cancer deaths. Only lung cancer claims more lives each year. Almost
30,000 men per year succumb to prostate cancer. Prostate Cancer Rates Have Remained
Steady Over the Last Decade Prostate cancer rates have remained roughly the same over the
past decade. During the first few years after the PSA test was put into widespread use, the
rate seemed to increase dramatically. This was likely not due to more men actually having
the disease, however. With a better screening method in place . more men with prostate
cancer were actually being diagnosed for the first time. Now, the PSA test has been in place
for a number of years and the number of men being diagnosed each year has levelled off. 11
As National cancer institute says that, In 1975, the annual prostate cancer incidence
rate among U.S. males was 94 new cases diagnosed per 100,000 men; the mortality rate was
31 deaths per 100,000 men. The incidence rates among white men and African American
men were 92 and 141 new cases, respectively, per 100,000 men; the mortality rates for white
men and African American men were 29 and 56 deaths, respectively, per 100,000 men. But
today i,e in 2007, the latest year for which we have updated statistics, the U.S. incidence rate
for prostate cancer was approximately 166 new cases diagnosed per 100,000 men; the
mortality rate was approximately 24 deaths per 100,000 men. 12
The work conditions are known to be worse in a developing country like India. This
deterioration is largely the result of traffic congestion and its associated air and noise
pollution but also with the pressures of maintaining a demanding schedule in circumstances
[8]
that make that task almost impossible. These circumstances damage the health of bus drivers
in a way that is unacceptable.
I the researcher seen in clinical duties and as well my neighbour uncle suffering from
prostate cancer but he didn’t knew the diagnosis, when he was approached me to solve his
problem. I discussed with my consultant doctor. He said its, prostate cancer. I was unable
to see that, he is finding problems in his even Daily living activities. I my relatives alone
there are three members are Drivers only. So this motivated to work on this study to evaluate
the effectiveness of self instructional module on knowledge regarding early detection and
prevention of prostate cancer among bus drivers.
Karnataka State Road Transport Corporation (KSRTC) being a large, economically
successful state government enterprise is expected to lead other transport organizations in
providing preventive and promotive health care services to their employees according to
job specific health hazards and risks.
Hence this study has been planned to review the evidence on the health problems of
bus drivers and to make recommendations for a significant improvement in the health status
of this group of professionals.
6.8 REVIEW OF LITERATURE
Review of literature is defined as broad, comprehensive in depth systematic and
critical review of scholarly publication, unpublished scholarly print materials, audiovisual
materials and personal communication. Review of literature is a key step in research process.
Review of literature refers to an extensive, exhaustive and systemic examination of
publication relevant to research project. One of the most satisfying aspects of the literature
review is the contribution it makes to the new knowledge, insight and general scholarship of
the researchers.13
Solenova LG, Smulevich VB, Dymova EG, Beresneva AD. Conducted study on
general and cancer morbidity among municipal transport drivers in Moscow, they took,the
mortality and cancer morbidity in 1969 to 1988 were followed up among 2528 men. In the
first decade, prostatic cancer mortality was statistically significantly higher in bus drivers
with length of service of over 20 years. 14
[9]
Lüngen M, Rath T, Schwartze D, Büscher G, Bokern E. conducted study in
‘convergence tendencies in inpatient oncological care after implementation of diagnosisrelated groups in germany.’ Claims data of about 23,600,000 insured within the inclusive
period 2004-2007. All cases with the main diagnosis of prostate cancer, in the study.
Broken down by entities and years, graphical and statistical concentration measures as well
as the percentages of different hospital size classes were calculated. Increasing case numbers
could be observed for all entities within the period prostate cancer: +12.5%; The
concentration measures showed hardly any changes in the course of time. The absolute
increase of case numbers seems to affect those hospitals with case numbers higher than 50
per year above average [prostate cancer cases in a hospital group including hospitals with
more than 50 cases 2004 and 2007: 81.6%; prostate cancer: 67.4% whereas case numbers of
hospital groups including hospitals with case numbers less than 50 per year remain
unchanged or grow more slowly. 15
Jack A. Clark, Thomas S. Inui, Rebecca A. Silliman, Barbara G. Bokhour,
Steven H. Krasnow, Richard A. Robinson, et.al, conducted study on Patients’ Perceptions
of Quality of Life After Treatment for Early Prostate Cancer.’ Using survey method Patients
with previously treated prostate cancer and a reference group of men with a normal prostatespecific antigen (PSA) level and no history of prostate cancer completed questionnaires.
Innovative scales assessed behavioral consequences of urinary dysfunction, sexuality, health
worry, PSA concern, perceived cancer control, treatment decision making, decision regret,
and cancer-related outlook. Urinary, bowel, and sexual dysfunction were assessed with
symptom indexes; health status was assessed by the Physical and Mental Summaries of the
Short Form. The study results were, reported greater urinary, bowel, and sexual dysfunction,
but similar health status. They reported worse problems of urinary control, sexual intimacy
and confidence, and masculinity, and greater PSA concern. Perceptions of cancer control
and treatment decisions were positive, but varied by treatment: prostatectomy patients
indicated the highest and observation patients indicated the lowest cancer control. Bowel and
sexual dysfunction were associated with poorer sexual intimacy, masculinity, and perceived
cancer control; masculinity and PSA concern were associated with greater confidence in
treatment choice; and diminished sexual intimacy and less interest in PSA were associated
with greater regret. And the study Conclusion was, the lack of change in global measures of
health status after treatment for early prostate cancer obscures important influences in men’s
[10]
lives; cancer diagnosis and treatment complications may result in complex outcomes.
Aggressive treatment may confer confidence in cancer control, yet be countered by
diminished intimate relationships and masculinity, which accompany sexual dysfunction. 16
Sunny L, Yeole BB, Kurkure AP, Hakama M, Shiri R, Mathews S, Shastri NG,
Advani SH. Conucted the study in ‘cumulative risk and trends in incidence of prostate
cancer in Mumbai, India,’ using data collected by the Bombay Population-based Cancer
Registry from the year 1986 to 2000.During the 15 year period, a total of 2864 prostate
cancer cases (4.7% of all male cancers and 2.4% of all cancers) were registered by the
Bombay Population-based Cancer Registry. For evaluation of the trend, they applied a linear
regression model based on the logarithm of the observed incidence rates. The annual
percentage changes were also computed for the evaluation. Cumulative incidence rates
percentages were calculated by adding up the age specific incidence rates at single ages and
then expressed as a percentage. Analysis of the trends in age-adjusted incidence rates of
prostate cancer during the period 1986 to 2000 showed the probability estimates indicated
that one out of every 59 men will contract a prostate cancer at some time in his whole life
and 99% of the chance is after he reaches the age of 50. 17
Carol L. Hanchette M.A. Gary G. Schwartz Ph.D., M.P.H conducted study on
‘Geographic patterns of prostate cancer mortality. Evidence for a protective effect of
ultraviolet radiation.’ In 1992. Recently it was hypothesized that low levels of vitamin D, a
hormone with potent antitumor properties, may increase the risk for clinical prostate cancer.
Because the major source of vitamin D is casual exposure to ultraviolet (UV) radiation, the
authors examined the geographic distributions of UV radiation and prostate cancer mortality
in 3073 counties of the contiguous United States using linear regression and trend surface
analyses.These data lend support to the hypothesis that UV radiation may protect against
clinical prostate cancer. Viewed in conjunction with other recent data, including those
demonstrating a differentiating effect of vitamin D on human prostate cancer cells, these
findings suggest that vitamin D may have an important role in the natural history of prostate
cancer. 18
Seidler A, Heiskel H, Bickeböller R, Elsner G were studied on ‘Association
between diesel exposure at work and prostate cancer..’The possible etiologic relevance of
occupational factors such as cadmium, cutting oils, diesel fuel and fumes, herbicides,
[11]
polycyclic aromatic hydrocarbons (PAH), polychlorinated biphenyls, soot, tar, mineral oil,
and solvents to prostate cancer was studied. A case-referent study design was used to recruit
192 subjects with histologically confirmed prostate cancer and 210 referents who had
prostate cancer Data were gathered with a self-administered questionnaire and analyzed
using logistic regression to control for age, region, and cigarette smoking. The analysis of
dose-years yielded a statistically significant association between occupational exposure to
diesel fuel or fumes and prostate cancer only exposure to PAH was significantly associated
with prostate cancer.19
Nilsson S, Norlén BJ, Widmark A. conducted study on ‘Self learning materials and
modules for health workers for the development utilisation and education’ using meta
analysis and retrospective method A systematic review of radiation therapy trials in prostate
cancer has been performed by according to principles adopted by the Swedish Council of
Technology Assessment in Health Care (SBU). This synthesis of the literature is based on
data from one meta-analysis, 30 randomized trials, many dealing with hormonal therapy, 55
prospective trials, and 210 retrospective studies. Totally the studies included 152,614
patients. There is fairly strong evidence that patients with localized, intermediate risk, and
high risk . There is some evidence that 3D conformal radiotherapy results in reduced late
rectal toxicity and acute anal toxicity compared with radiotherapy administered with nonconformal treatment volumes. There is some evidence that postoperative external beam
radiotherapy after radical prostatectomy in patients There is fairly strong evidence that shortterm endocrine therapy prior to and during radiotherapy results in increased disease-free
survival, increased local control, reduced incidence of distant metastases, and reduced causespecific mortality in patients with locally advanced disease. There is some evidence that
short-term endocrine therapy prior to and during radiotherapy results in increased There is
strong evidence that adjuvant endocrine treatment after curative radiotherapy results in
improved local control, increased freedom from distant metastases, and increased diseasefree survival in patients with loco-regionally advanced and/or high-risk disease. There is
moderately strong evidence that adjuvant endocrine treatment after radiotherapy results in
longer overall survival compared with radiotherapy alone in patients with loco-regionally
advanced disease. 20
Held JL, Osborne DM, Volpe H, Waldman AR.conducted study on ‘Cancer of the
prostate: treatment and nursing implications. Using observational study, to review the
[12]
clinical manifestations, current treatment, and nursing management of prostate cancer.
Because no definitive method for identifying clinically important lesions exists, much
controversy surrounds prostate cancer treatment. Issues significant to the diagnosis and
treatment of all stages of prostate cancer are identified, and nursing care concerns focusing
on treatment and disease related problems are presented. Nursing care focuses on providing
patients with accurate information to make informed decisions regarding treatment for early
stage disease, on promoting comfort, and on preventing and managing treatment and
disease-related complications. Nursing diagnoses include knowledge deficit; altered sexual
patterns, body image disturbance, altered urinary elimination, diarrhea, impaired skin
integrity, and pain, fatigue, bleeding, and infection, all of which are related to surgery,
pathologic fractures, spinal cord compression, and edema of the scrotum/lower extremities.21
LITERATURE ON SELF INSTRUCTION MODULE.
To develop a self instructional module, the related literature is reviewed. The
technical report of world health organisation (WHO) in 1985, suggests the following phases
be involved in developing self instructional material.
i)
Preparatory phase; This includes collection of data, that serves as baseline
information for planning aself learning material, its implementation and
evaluation.
ii)
Implementation phase; Includes preparation, production, dessimenation,
assessment, and monitoring activities concerned with the module.
iii)
Evaluation phase; This phase includes evaluation of input process,
product and impact on health status of population. 22
Torney and Thompson (1982) profess that, the learning module is a strategy for
individualising instruction in a self contained Instructional unit that focuses on a single
concept or topic and has a few well defined objectives. Individual study is a process. The
elements of learning module according to Torney and Thompson are,
[13]
-
Table of content.
-
Introduction; including purpose, terminal objectives and general
objectives.
-
List of pre-requisites and suggested resources.
-
Pre-test
-
Activities
-
Self check for progress.
-
Post test and
-
Feedback on module
The review of literature has helped the Investigator to become aware of the various
methodologies, used in various studies. It has helped in every step of the study from the
statement of problem to the conclusion of the study. 23
6.3 STATEMENT OF THE PROBLEM
A study to evaluate the effectiveness of self instructional module on knowledge regarding
early detection and prevention of prostate cancer among bus drivers in Mysore.
6.4 OBJECTIVES
1. To assess the pre test level of knowledge on regarding early detection and prevention of
prostate cancer among bus driver
2. To assess the post test level knowledge on regarding early detection and prevention of
prostate cancer among bus driver
3. To assess the effectiveness of self instructional module on of knowledge on regarding
early detection and prevention of prostate cancer among bus driver
4. To associate the level of knowledge on regarding early detection and prevention of
prostate cancer among bus driver with their selected demographic variables
[14]
6.5 OPERATIONAL DEFINITIONS
1. Effectiveness
It refers to the efficiency of self instructional module in improving the level of knowledge
of bus drivers in early detection and prevention of prostate cancer.
2. Self instructional module
Simplified and understandable information material for self education. Or refers to the
systematically developed health educational design
3. Knowledge
It
refers to the level in knowledge on regarding early detection and prevention of
prostate cancer among bus driver
4. Early detection .
It refers to prevent overt disease or disablement or complications from prostate cancer
5. Prevention
Prevention refers to promote health, to preserve health to restore health from the
prostate cancer
6. Prostate cancer
Its a cancerous disease, in which the prostate grows uncontrollably and invade the near
by tissues and other parts of the body. The abnormally grown tissues are called tumors.
Prostate cancer is the most common cancer in men over 50 years of age.
7. Bus drivers
Drivers are the one who operates the big vehicle to help the passengers to reach their
destiny it’s one of the profession where they work uncomfortable situations.
[15]
6.6 RESEARCH HYPOTHESIS
H1: There will be significant difference between mean pre test and post test knowledge
regarding early detection and prevention of prostate cancer.
H2: There will be significant association between the pre test knowledge and attitude
regarding early detection and prevention of prostate cancer with their selected demographic
variables.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
Data will be collected from bus drivers in bus depot Bannimantap Mysore.
7.2 METHODS OF DATA COLLECTION
i.
Research design
Pre-experimental design
ii.
VARIABLES
a) Dependent variables
Bus drivers knowledge regarding early detection and prevention of prostate cancer.
b) Independent variables
self-instruction module on knowledge regarding early detection and prevention of
prostate cancer.
c) Demographic variable
Demographic variables of bus drivers such as age, religion, education, occupation,
income, history of early detection and prevention of prostate cancer in family and
previous source of information.
iii.
Settings
The study will be conducted in Bus depot Bannimantap Mysore.
iv.
Population
v.
All drivers engaged in active service in bus depot Bannimantap Mysore.
[16]
vi.
Samples
vii.
The Drivers who fulfil inclusion criteria will considered as a samples and the
sample size is 60.
viii.
Criteria for sample selection.
Inclusion criteria.
The study includes;
1. Drivers between age group of 45 to 60 years.
2. Drivers engaged in active service
3. Drivers who can able to read Kannada or English.
Exclusion criteria
The study excludes;
1. Drivers, those who are already having prostate cancer
2. Drivers who are not willing to participate.
3. Drivers , who are not available during data collection.
4. Drivers , who has already sensitized with similar session before.
ix.
Sampling technique.
Non probability convenience sampling technique will be used select
samples for the study
x.
Data collection:
A questionnaire will be developed by the investigator or a standardized
method will be used, to evaluate the knowledge on early detection and prevention
of prostate cancer
Method of data collection:
a) Administrative approval will be obtained to conduct the study from the KSRTC
Management Mysore will be obtained
[17]
b) A pre-experimental design will be conducted to evaluate the early detection and
prevention of prostate cancer
Data collection steps:
1. selection of sample as per sample criteria mentioned above
2. Informed written consent will be obtained from the study subjects
3. Administration of data collection tools to the sample will be done personally by
the investigator
Data analysis plan and presentation:
Data will be analyzed using descriptive study and inferential statistics
1. Personal variation of the bus drivers knowledge will be analyzed
2. using frequency distribution and percentage
3. paired ‘t’ test will be used to compare the pre-test and post-test knowledge
4. ‘chi’ square test will be used to analyze the association between the pre-test knowledge
and socio-economic variables
7.3 Does the study require any investigation or intervention to be conducted on the
Patients or other human or animals?
-No
7.2 Has ethical clearance been obtained from your institution?
Yes, permission will be obtained from concerned authorities and informed
consent will be obtained from samples. The privacy and confidentiality of the data will be
maintained.
[18]
7.3 LIST OF REFERENCES.
1. http://men.webmd.com/picture of the prostate.
2. Brunner and Siddnarth. text book of medical surgical, 9th edition 2010.(1)1306
3. Moni Abraham Kuriakose FRC’s Prof and director. Dept of surg-oncology, Narayan
Hrudayalaya, B’lore. RGUHS Cancer Book CME series-4 may-2010-31p,
4. Dr.Ravindrakumar S Pattar.KIMS Hubli on his Dessertattion topic-2008
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[20]
9
SIGNATURE OF THE CANDIDATE
10.
REMARKS OF THE GUIDE
11.
NAME AND DESIGNATION OF THE
GUIDE (IN BLOCK LETTERS)
11.1.
11.2.
11.3.
11.4.
GUIDE
SIGNATURE
CO-GUIDE (IF ANY)
SIGNATURE
11.5.
HEAD OF THE DEPARTMENT
11.6.
SIGNATURE
12.
REMARKS OF THE CHAIRMAN AND
PRINCIPAL
12.1.
SIGNATURE
[21]