2. RESEARCH STATEMENT
“AN EXPERIMENTAL STUDY TO ASSESS THE
EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME ON KNOWLEDGE REGARDING
MUCORMYCOSIS AMONG NURSING STUDENTS
OF SAAII COLLEGE OF MEDICAL SCIENCE AND
TECHNOLOGY KANPUR, UTTAR PRADESH”
3. INTRODUCTION
• Mucormycosis, a rare, potentially deadly infection, is caused by the fungus of
the order Mucorales. But when it does occur, it is well remembered by those
who have cared for the afflicted patient because of the speed with which it can
progress.
• It has certainly earned the designation of the most acutely fatal fungal
infection known to man. Mucormycosis is best known for its rhino-cerebral
presentation even though it can infect the lungs, central nervous system,
gastrointestinal tract, skin etc.
• Progressing through the stages of rhino maxillary, rhino-orbital and rhino-
orbit-cerebral Mucormycosis, it is rapidly fatal in 50 to 80%. It primarily
affects immune compromised patients, more commonly diabetics but seldom
infects a healthy host.
4. • During the second wave of covid in India there was a rapid rise in mucormycosis
cases in patients infected with covid. This rise was attributed to many factors which
Include steroid intake, diabetes mellitus, and oxygen therapy and ventilator/ICU
management. There were many reports suggesting the role of industrial oxygen and
even use of excessive zinc in etiology of mucor.
• The clinical hallmark of invasive mucormycosis is tissue necrosis resulting from
angioinvasion and subsequent thrombosis. In most cases, the infection is rapidly
progressive and results in death unless underlying risk factors (i.e., metabolic
acidosis) Are corrected and2aggressive treatment with antifungal agents and surgical
excision is instituted
• Patients with acute proptosis, an increased intraocular pressure, rapid visual loss,
ophthalmoplegia, fixed dilated pupil, or afferent pupillary defect should be suspected
of an undiagnosed mucormycosis .Mucormycosis carries a high mortality Rate,
making early diagnosis and prompt treatment a sine-qua-non to prevent catastrophic
outcomes
5. NEED OF THE STUDY
• An upsurge of mucormycosis is being reported throughout the world over the
past two decades, however, the rise in developing countries including India has
been phenomenal.17-18-19 Three consecutive case series on mucormycosis have
been reported from a single tertiary-care center in India: 129 cases over 10 years
(1990-1999), 178 cases during the subsequent 5 years (2000-2004) and then 75
cases in an 18 month period during 2006-2007
• According to studies, 1.7 people per million were affected by black fungus
Though the infection rate was eighty times higher in India during the COVID-
19 .In India reported 14,872 cases up to 28 May 2021. The Indian authorities
already stated that mucormycosis should be declared an epidemic due to the
higher mortality rate. However, adequate knowledge of health care workers and
its’ implementation consider effective measures to win in the battle of disease
outbreaks
6. • On 24 may 2021, Medical professionals at Lucknow’s King George Medical
University informed that at least 7 such cases have been diagnosed at the centre
over the past three months. Of these, 4 individuals are still receiving treatment in
the ICU. While 2 patients aged 35 and 60 are diabetic, the other two aged 70 and
45, have taken steroids for a long time. The 42 year old deceased had
complained of fever about 10 days back. He was admitted to Kanpur’s Lala
Lajpat Rai Hospital (Hallett Hospital). A resident of Bidhuna town in Auraiya,
he succumbed to the infection on Monday morning. Uttar Pradesh recently
declared black fungus a notifiable disease under the Epidemic Diseases Act.
• Hence , as a researcher I felt the need to conduct a quasi-experimental study on
nursing students of SAAII College of medical science and technology as
B.Sc.Nursing students,as they are getting exposure in clinical area, and they
should have adequate knowledge regarding the disease condition to provide
good nursing care whenever they get exposure with Mucormycosis patients.
7. OBJECTIVES OF THE STUDY
The objectives of the study were:
1.To determine the association between pre-test levels of
knowledge score regarding Mucormycosis with selected
socio-demographic variables of Nursing Students.
2.To determine the association between the pre and post-test
level of knowledge on Mucormycosis among Nursing
Students.
3.To assess the effectiveness of the planned structured
teaching programme.
8. HYPOTHESES
H1: There will be significant association between pre-test level of
knowledge score regarding Mucormycosis with selected socio-
demographic variables Among Nursing Students at 0.05 level of
significance.
H2: There will be significant association between knowledge scores
and selected demographic variables such as religion, age, sex,
educational qualification, previously attended any training or CNE
regarding Mucormycosis, previous knowledge regarding
Mucormycosis, Observed any patient of Mucormycosis with level
of knowledge.
9. OPERATIONAL DEFINITION
1. Effectiveness: Effectiveness refers to the increase the knowledge level of
nursing students regarding Mucormycosis after planned teaching programme.
2. Assess: In this study assess refers to evaluate the effectiveness of Structured
Teaching Programme on level of knowledge regarding Mucormycosis among
Nursing Students.
3. Knowledge: In this study knowledge refers to comprehending the
information about Mucormycosis that is gained through the Structured
Teaching Programme and by giving the correct response of the self-
structured knowledge Questionnaire.
10. 4.Mucormycosis: In this study Mucormycosis sometimes called
zygomycosis is a serious but rare fungal infection caused by a group
of molds called mucormycetes.
5.Nursing Students: In this study Nursing Students are the Second
year and Third year B.Sc. Nursing who are gaining training to be a
nurse in the college; and are the sample selected for the study.
6.Structured Teaching Programme: this means the structured
training schedule to provide knowledge regarding mucormycosis
using various AV-Aids and power-point presentation.
13. REVIEW OF LITERATURE
• Source of Literature: Online articles and journals.
• The review of literature relevant to this study has been arranged in the
following categories:
CATEGORIES NO. OF STUDIES
1.Studies related to Mucormycosis.
2.Studies related to treatment of Mucormycosis
07
05
3.Studies related to knowledge of Mucormycosis
among nursing students.
04
4. Studies related to structured teaching programme 07
14. RESEARCH METHODOLOGY
RESEARCH APPROACH Quantitative Research Approach
RESEARCH DESIGN Quasi Experimental Research Design (0ne-group
Pre-test post-test design)
RESEARCH VARIABLES:
• Dependent Variables:
• Independent Variables:
• Demographic Variables:
Knowledge of Mucormycosis among B.Sc.Nursing student
Structured teaching programme
Religion, Age, Sex, Educational qualification, Previously
attended any training or CNE regarding Mucormycosis,
Previous knowledge regarding Mucormycosis, Observed
any patient of Mucormycosis .
RESEARCH SETTING SAAII COLLEGE OF MEDICAL SCIENCE AND
TECHNOLOGY KANPUR, UTTAR PRADESH
17. POPULATION
B.Sc.Nursing student of SAAII College of Medical Science and
Technology, Kanpur.
TARGET
POPULATION
Nursing Students studying in SAAII College of Medical Science and
Technology, Kanpur.
ACCESSIBLE
POPULATION
Second and Third Year B.Sc.Nursing student of SAAII College of Medical
Science and Technology, Kanpur
SAMPLE
Nursing Students who had met the inclusion criteria were the sample of the
study.
SAMPLING
TECHNIQUE
Simple Random Sampling and Non-probability sampling
SAMPLE SIZE
60 Second and Third Year B.Sc.Nursing student of SAAII College of
Medical Science and Technology, Kanpur
18. SAMPLING CRITERIA
Inclusion Criteria
Inclusion criteria are used to
determine whether a person can
participate in a research study or
not
In this study :
1. Who are willing to participate in the study.
2. Second and Third Year B.Sc.Nursing students.
Exclusion Criteria
Exclusion criteria helps to
identify suitable participants.
In this study:
1.Students not willing to participate in study.
2. Who were absent at the time of study.
19. DESCRIPTION OF
THE TOOL
SCORING OF
TOOL
< 13- Average= <50%
14-19- Good =51-70%
20-25 -Excellent =76-
100%
Section 1: Socio-demographic Data
Religion, age, sex, educational qualification, previously attended any
training or CNE regarding Mucormycosis, previous knowledge
regarding Mucormycosis, Observed any patient of Mucormycosis with
level of knowledge.
Section 2:Self structured knowledge questionnaire
It consisted of total 25 multiple choice questions regarding
Mucormycosis.
• It consisted of questions for general aspects (05),
• risk factors and causes (04),
• transmission(05),
• sign and symptoms (03),
• diagnosis(02)
• prevention and treatment (04),
• complication (02)
20. CONTENT
VALIDITY OF
THE TOOL
The prepared tool along with the objectives, criteria
checklist and the blueprint was submitted to 4 Nursing
experts from the department of different Nursing.
Minor modifications made on the basis of suggestions
and comments were given by the experts.There was
100 % agreement among the experts regarding the
items of the tool.
PRETESTING
OF THE TOOL
The reliability of the tool was established by
administrating the tool to 20 Nursing Students of
SAAII College of medical sciences and technology,
Kanpur.
21. ETHICAL
CONSIDERATIONS
• Ethical Permission was obtained from Chairman and
Principal of SAAII College of Medical Science and
Technology, Kanpur
• Informed written consent was obtained from the
participants.
PLAN FOR DATA
ANALYSIS
• Descriptive statistics: (frequency, percentage, mean,
standard deviation, mean difference etc.)
• Inferential statistics: paired ‘t’ test determine
association between pretest and post test data analysis;
and
• Chi-square test for association between the knowledge
and Socio-demographic variables.
22. DATA COLLECTION PROCESS
Obtained ethical and administrative permission
•Selected the target population and planned for STP
1.Researcher introduced herself to the participants
The purpose and objective of the study and information about the study was
explained.
1.The consent was obtained
1.Cleared the doubts of the participants
23. Pre- test was conducted after giving appropriate instructions
•Administered STP on Mucormycosis for 30 minutes using PPT and AV-
aids
1.Informed participants about post –test to be conducted after 7 days.
Coducted post-test after 7 days of STP sith the same structured tool
1. Thanked the participants for their active participation and cooperation
1.Query or questions raised by them were clarified by the researcher
32. OBJECTIVE 2: ANALYSIS OF PRE-TEST AND POST TEST KNOWLEDGE
SCORE OF NURSING STUDENT REGARDING MUCORMYCOSIS
Group Test Mean SD
Mean
Difference
“t”
value
p- value
Nursing students Pre-test 12.93 0.84
10.77 15.102
P<0.001
(HS)
Nursing students Post-test 24.3 2.99
*p<0.05significant,**p<0.01&***p<0.001highlysignificant
33. SECTION-3: ASSOCIATION BETWEEN PRE-TEST
KNOWELDEGE AND DEMOGRAPHIC VARIABLE
• The association test obtain a pre-test level of knowledge with age (x2=0.227
,p=o.o173*), Religion (x2=0.421 ,p=0.0209*), Previous knowledge regarding
Mucormycosis 19(x2=0.187, p=0.0189*), observed any patient of
Mucormycosis (x2= 3.32,p=0.0189*) and Previously attented training
(x2=3.491,p=0.0188*)shows significant association has the significant
association.
• Thus the stated research hypothesis there will be significant association
between pre-test knowledge score among undergraduate nursing students
regarding Mucormycosis and their selected demographic variables at0.05
level of significant is accepted
36. SECTION 1: DISCRIPTION OF DEMOGRAPHIC DATA OF
THE NURSING STUDENTS ON MUCORMYCOSIS
In this study majority undergraduate nursing students 28 (49.12%) belonged to 20 years of
age,47 (84.21%) were Hindu by religion, 54(95%)were having previous knowledge
regarding mucomucormycos53(93%) have not undergone any training for Mucormycosis
and 50 (91.22%) have not observed any Patients of Mucormycosis.
A similar study showed that Rita Oladele,1,&AkaninyeneAsuquoOtu, conducted study on
Evaluation of knowledge and awareness of invasive fungal infections amongst resident
doctors in Nigeria834(79.7%) of the 1046 participants had some knowledge of IFIS,
338(32.3%) from undergraduate medical training and 191(18.3%) during post-graduate
(specialty) residency training. Number of years spent in clinical practice was positively
related to knowledge of management of IFIS, which was statistically significant (p
37. SECTION 2: ANALYSIS OF THE KNOWLEDGE SCORE AMONG
NURSING STUDENTS BEFORE AND AFTER ADMINSTRATION OF
STRUCTURED TEACHING PROGRAMME
The analysis of study revealed that majority of the student were in age group >22 years. 60
B.Sc.Nursing students did not previously attended the CNE and had no knowledge on
Mucormycosis, majority of students did not attended any patient of
Mucormycosis.53(88.33%) had average knowledge, 7(11.77%) had good knowledge, 0%
had excellent knowledge in pretest which increased to 50(83.33%)gained excellent
knowledge score; 10(16.66%) had good knowledge score in post test after intervention.
A similar study conducted on Black fungus by HumayunKabirl, *, Md. KamrulHasanlet.al
on Mucormycosis: a cross-sectional knowledge assessment among the Bangladeshi health
care workers during COVID-19 pandemic results showed that 422 responses from the
health care workers of Bangladesh. Among The respondents, nearly half of them (45.26%)
were doctors (n= 191); where the nurses (n=161) Were 38.15%, and other health care
workers (n=70) were 16.59%.
38. • Evaluation of effectiveness was done by inferential statistic. A paired t-test
was computed and the Result is shown below.The study findings revealed that
there is a significant difference between pre-test and post- test knowledge
Score among undergraduate nursing students, the mean pre- test score was
12.93 with the standard deviation Of 0.84 and post- test mean score was 24.3
with the standard deviation of 2.99 the mean difference 10.77.the obtained’
value 15.102 was statistically significant at p <0.005level.
• A Similar study focuses on the utilization of explicated STP modules training
of all health-care personnel of The institute and assessment of the
effectiveness of STP training for IPC practices during COVID-19 Pandemic.
The STP for revision. Structure teaching program training modules similar to
this study may be Utilized to enhance the knowledge of various cadres of
health-care staff regarding IPC practice.
SECTION 3: EFFECTIVNESS OF STRUCTURED TEACHING PROGRAMME
39. CONCLUSION
The study concluded there was significant Increase in knowledge among
undergraduate nursing students on MUCORMYCOSIS after Structured
Teaching Programme in SAAII College of Medical Science and Technology
Kanpur, Uttar Pradesh.”From the study it was concluded that the most majority
of samples improved knowledge regarding Mucormycosis after structured
teaching programme.The pre-test statistics of the study revealed that there was
average knowledge about Mucormycosis among B.Sc.Nursing students, which
indicated the need for structured teaching programme which increased the
knowledge regarding Mucormycosis , which is justified with increase in
knowledge score in post-test.
