3. research methodology


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3. research methodology

  3. 3.  Hypertension is the commonest cardiovascular disorder and now regarded as major public health problem .  It is a precursor to major diseases like Myocardial Infraction , Stroke and kidney disease.  Hypertension is a chronic medical condition in which the blood pressure in the arteries is elevated.  High blood pressure is defined as if blood pressure is persistently at or above 140/90 mmHg.
  4. 4.    According to global health observatory the overall prevalence of raised blood pressure is 40% in adults aged 25years and over in 2008 globally. In United State adults the prevalence of hypertension of aged 18 and over was 28.6% in 2009–2010. In Nepal the prevalence of hypertension is 26.6% in aged ≥ 25yrs according to world health statistics 2012.
  5. 5.  A study done by Adri B. on knowledge of the hypertensive person regarding prevention strategies for coronary heart disease in South Africa Shows only16 out of 46 respondents achieved a percentage on or above the competency indicator of 50%. The majority of the respondents’ level of knowledge regarding hypertension and cardiovascular risk factors is below the competency indicator.
  6. 6.  To assess the Knowledge regarding prevention of complication of hypertension provide a basis to educate and aware the public regarding preventing measures of complications. This play a significant role to reduce the death caused by complications of hypertension.
  7. 7.   Hypertension is one of the most crucial health problem and the most common chronic disease in developed and underdeveloped countries. Hypertension is a preventable and treatable condition but with out treatment it leads to serious and life threatening complications such as heart, kidney , and brain disorders which in most cases results in patients disability.
  8. 8.  Prevention of complication plays significant role in controlling this disease which by increasing the knowledge and awareness of the public regarding hypertension.
  9. 9.   These diseases are potentially the cause of a patient to admit in a critical care unit. This study find out the gap of knowledge regarding the subject which helps in the modification of prevention strategies to aware their risk factor.
  10. 10.  B. Oluranti Familoni; S. Abayomi Ogun, and A. Olutoyin Aina, conducted a study on knowledge and awareness of hypertension among patients with systemic hypertension the. There were 254 hypertensive patients were included in the study. The result shows that 52.4% of the participants were aware that hypertension was the commonest non communicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure.
  11. 11.  Line A., Pascal B, Jean P. G., Anne R., Bernard W. and Fred P. conducted study on knowledge, attitudes, and practices on hypertension in a country in epidemiological transition. The study was done in total 1067 sample aged 25 to 64 years from the Seychelles Islands. The result shows the age-standardized prevalence of hypertension was 36% in men and 25% in women aged 25 to 64 years. Among hypertensive persons, 50% were aware of the condition, 34% were treated, and 10% had controlled BP (ie, BP ,160/95 mm Hg).
  12. 12.  To assess the knowledge regarding prevention of complications of hypertension among hypertensive clients attending medical out patient department in Eastern region of Nepal.  To assess the association between knowledge regarding prevention of complications of hypertension with selected demographic variables.
  13. 13.  There is no relationship between knowledge regarding prevention of complications of hypertension with selected demographic variables.
  14. 14.   Knowledge: Knowledge is defined as knowing what is known of a person, thing, fact or subject. It is a person’s range of information and includes specific knowledge about a subject. Complications: Any disorders resulting from high blood pressure ie: coronary heart disease, renal disease, Stroke, congestive heart failure, Myocardial Infarction, Aneurism, Dementia.
  15. 15.  Hypertension: High blood pressure is defined as if blood pressure is persistently at or above 140/90 mmHg.  Hypertensive client: Client who is already diagnosed and currently on the treatment of the disease.
  16. 16. Dependent variable :  Knowledge Independent variables:  Education  Occupation  Socio-economic status  Gender  Family history of hypertension  Accessibility to information  Age
  17. 17. Knowledge Knowledge will be scored according to the correct response of the respondents. The correct response will be computed into percentage. It will be ordered in four categories: Low level<25%,Below average25-50%,Average 50-75%, High Level 75-100% Level of measurement: Ordinal   Education: Primary, secondary, Higher secondary, Bachlors, Master, None Measurements: Ordinal  Occupation: Professional (Technicals, Managerials, Service) Non professional( skilled and Non skilled workers), Business. Measurement: Nominal
  18. 18.      Socio-economic status: Per capita income (Ratio scale) Gender:(Nominal) Previous experience: Person who have a family with hypertension ( Nominal) Accessibility to information: Urban areas (Nominal) Age: Completed years from last birthday. (Ratio)
  19. 19. Occupati on Gender Family hystory of hypertension Accessibility to information Education Knowledg e High level of knowledge Low level of knowledge
  20. 20. Research design A descriptive cross sectional study will be used to find-out the knowledge regarding preventions of complications on hypertension among hypertensive patients in eastern region of Nepal.
  21. 21.  Setting The study will be conducted In clients attending medical OPDs in selected hospitals. Study population All diagnosed cases of hypertension attending medical OPDs in selected hospitals. 
  22. 22.  Sample: Diagnosed cases of hypertension fulfilling the illegibility criteria at the time of data collection.  Sample size: 285 Sample size is calculated according to statistical analysis. Based on power analysis using prevalence(26%) at 0.05% significant level, power of 80%. Sampling technique: Stratified population proportionate random sampling technique will be used. Selects all hospitals of Eastern Region of Hospital. Dividing them into strata, taken equal proportion from each strata. 
  23. 23.  Inclusion criteria: Diagnosed case of hypertension under antihypertensive medications.
  24. 24.    Tool for data collection Semi-structured questionnaire will be used to conduct the study. Data collection techniques Semi structured interview will be used by the researcher own self. Validity of the tool: Content validity will be established by the review of literature, consulting with experts on the subjects including consultant clinicians and guides and co-guides.
  25. 25.  Plan for data analysis: After collection of data it will be checked for completeness. Coding will be done. Coded data will be intered in EXCEL and transfer in SPSS PC 16 version. Data will be presented by descriptive statistics such as mean, median, mode, percentage and standard deviation to describe demographic variables and other variables of knowledge. Chi square test will be used to find out the association between knowledge and selected demographic variables.
  26. 26.       Reliability of the tool: Cronbach alpha coefficient test will be done for the reliability of test instrument. Ethical considerations: Permission will be obtained from concerned authorities from concerned hospitals. Informed verbal consent will be taken from each respondents prior data collection. Participation will be completely voluntary Confidentiality will be maintained.
  27. 27. S N Activities 1. Literature review 2. Problem identification 3. Proposal writing 4. Proposal presentation 5 Tool Development 6 Tool Finalization 7 Data collection 8 Data Analysis 9 Report Writing 10 Report Presentation 11 Report Submission Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb
  28. 28. Personal cost  Transportation  Communication  Refreshment  Material cost  Stationary  Literature review i) Photocopy ii) Printing iii) iii) Internet  10,000 5,000 15,000 15,000 10,000 10,000 10,000
  29. 29.  Report preparation cost  Expert cost  Statistician  Translator  Editor  Principle investigator  Co-investigator  Miscellaneous total budget 10,000 10,000 5,000 5,000 20,000 15,000 10,000 1,50,000/-
  30. 30. Dear Respondent, Research Topic: Knowledge Regarding Prevention of Complication of Hypertension among Hypertensive Clients in Eastern region of Nepal : A Hospital Based Study. I am in the process of completing the Master of science and nursing. I therefore invite you to participate in my research study. All that is expected from you is to answer the asked question. The contents of the questionnaire are about high blood pressure. The aim of the research is to determine the knowledge regarding prevention of complications of hypertension.
  31. 31. It would be appreciated if you could participate in the study. All information obtained from you will be treated as confidential at all time. To maintain the anonymity your name will not be written in the questionnaire. Permission for conducting this study has been granted by the relevant authorities. Participation in this study is voluntary and you are free to refuse to participate or withdraw your consent and discontinue participation at any time. Findings from the research study will not include any data that could identify you or any other participants in the study. The information given by you will not be traceable and you will therefore not be able to recall your consent. Thank You
  32. 32.   Oluranti Familoni; S. Abayomi Ogun, and A. Olutoyin Aina. (2004). knowledge and awareness of hypertension among patients with systemic hypertension Journal of the National Medical Association VOL.96,NO.5, Adri, B. (2009). knowledge of the hypertensive person regarding prevention strategies for coronary heart disease 0861 670 411(South Africa+27 11 670 9000 (International) Available from: uir.unisa.ac.za/handle/10500/2608  Global Health Observatory (2013). Raised blood pressure Situation and trends Available From: www.who.int/gho/ncd/risk_factors/blood...prevalence.../i ndex.htm