Effectiveness of Education Intervention on Knowledge Regarding Hepatitis-B among Secondary Level Students of Carmel Secondary School in Dharan Municipality Investigator GuideAsmita Lama Syangtan Mr. Ram Sharan MehtaB.Sc Nursing 4th year Additional ProfessorBatch 2007 Department of medical- surgicalRoll no.-4166 nursing College of nursing,BPKIHS
Background of the studyHepatitis-B is an infectious illness caused by hepatitisB virus (HBV) which infects the liver and causes aninflammation called hepatitis. Transmission of HBVresults from exposure to infectious blood or bodyfluids.About a third of the worlds population, more than 2billion people, have been infected with the hepatitisB virus.
The disease has caused epidemics in parts of Asiaand Africa, and it is endemic in China.In Nepal, there are about 315,000 people infectedwith chronic Hepatitis-B.HBV is about 100 times more infectious than HIV.
Need of the studyA study conducted by Liver Foundation Nepal showsthat drug abuse and hepatitis B and C start togetheramong children in our schools.The problem continues to smolder inside without theknowledge of the infected persons or thecommunity. And in 20 years time when it willexplode, it will add to a costly and tragic conditionwith a large number of patients with cirrhosis andliver cancer.
Contd...The first step in this direction is the spread ofawareness about drug abuse and hepatitis amongschool children as it is the problem of our youth.The best way to beat it is being aware of it and bysharing concern with people.
Significance of the study• This study had assessed the effectiveness of education intervention on knowledge regarding Hepatitis-B among the secondary level students of Carmel Secondary School. The school can use the findings of this study to uplift the knowledge of the students regarding Hepatitis- B and take preventive measures to prevent from Hepatitis-B.
ObjectivesTo assess the knowledge regarding Hepatitis-B amongthe Secondary level students of Carmel Secondary Schoolin Dharan Municipality.To prepare the teaching module and provide educationintervention regarding Hepatitis-B.To evaluate the effectiveness of planned educationalintervention regarding knowledge of Hepatitis-B.
Null Hypothesis• There will be no difference on knowledge regarding Hepatitis-B before and after educational intervention among the students.
Operational Definitions• EFFECTIVENESS: The outcome of the educational intervention that causes differences in the knowledge of Hepatitis B among the secondary level students of Carmel Secondary school in Dharan, measured by pre- test and post-test questionnaire.• KNOWLEDGE: It refers to the students ability to recall the facts and information regarding Hepatitis-B, its causes, signs and symptoms , management ,preventive measures and Hepatitis-B vaccination, according to the given tool.
Contd...• EDUCATION INTERVENTION: It is a structured teaching program which is designed to provide information regarding Hepatitis-B among the students based on educational package developed.• EDUCATIONAL PACKAGE: A set of educational materials which consists of information regarding Hepatitis B which includes: Definition, Causes ,
Contd... Signs and symptoms Management Preventive measures Hepatitis B vaccination• SECONDARY LEVEL STUDENTS: It refers to the students studying in class 8,9 and 10 of Carmel Secondary school in Dharan.
Study variablesDependent Variables:Knowledge on Hepatitis B.Independent Variables:Educational intervention.
INPUT THROUGHPUT OUTPUTLevel of students Education intervention Affect on on Hepatitis- knowledge B Other source of information Fig I. Conceptual framework based on General system theory approach.
Research methodology1.RESEARCH DESIGN: Pre-experimental, one group pre-test and post-test research design was used to conduct the study.2.RESEARCH SETTING: The study was conducted in Carmel Secondary School in Dharan Municipality, ward no. 18.
3. STUDY POPULATION: All the students studying in secondary level (class 8, 9 and 10) of Carmel Secondary School constituted the study population (N=156).4. SAMPLE: The students meeting the eligibility criteria was study sample.5. SAMPLE SIZE: The sample size of the study was 39 (25% of the target population).
SAMPLE TECHNIQUE: Population proportionate stratified simple random technique was adopted.
Table 1 Details of Sampling TechniqueDescription Class 8 Class 9 Class 10 TotalTotal no. of 60 52 44 156studentsPercentage 38.5% 33.3% 28.2% 100%of thestudentstakenNo. of the 15 13 11 39studentstaken
Eligibility CriteriaInclusion criteria• Only the students from class 8, 9 and 10 of Carmel Secondary School and who were willing to participate were included in this study.Exclusion criteria• Students who were not able to participate due to absenteeism or other problems were excluded from this study.
RESEARCH INSTRUMENTSData was collected using a semi-structuredquestionnaire based on the objective of thestudy which consist of 2 parts:1. Socio-demographic data.2. Knowledge of Hepatitis-B.
Validity of the tool• The content validity was established by review of literature, consulting with the research guide and experts on the subject, faculties of nursing college and modification was done accordingly.
Pre-testing of the tool• Pretesting was done by taking 10% of the sample size (n=39) with similar characteristics but not in the same setting i.e in Depot Higher Secondary School. Four students were taken, 2 students from class 8, 1 student from class 9 and 1 student from class 10.
Procedures of data collection• Permission obtained: concerned all• Pre-Test (25th of Jan, 2011)• Education intervention• Post-test (8th of Feb, 2011)• Analysis of data
Ethical consideration• Permission was taken from the concerned authority i.e. from college of nursing, principle of the Carmel Secondary School where the students were studying and informed verbal consent was taken from each student prior to data collection.• Confidentiality and anonymity of the students was maintained. The purpose of the study was revealed to the students prior to the data collection.
Table 2 Socio-demographic Characteristics of the Students n=39S.N Characteristics Categories Frequency Percentage (%)1. Age groups 13-14 20 51.3 ( In years) 15-16 19 48.7 Mean =14.41 S.D =1.16 Range =13-16
Table 2 (contd...)S.N Characteristics Categories Frequency Percentage (%)2. Sex Male 21 53.8 Female 18 46.23. Permanent Address Sunsari 37 94.9 Others 2 5.14. Religion Hindu 15 38.5 Buddhist 9 23.1 Christian 3 7.7 Kirat 12 30.8
80 69.2 70 60 50percentage (%) 40 30 20 10.3 10.3 10 5.1 5.1 0 Mongol Brahmin Newar Chhetri Others Fig II: Ethnic group of the students n=39
Table 3 Income and Main Occupation of the Family of the Students n=39S.N Characteristics Categories Frequency Percentage (%)1. Family income per 20000-29000 14 35.9 month 30000-39000 13 33.3 40000-49000 6 15.4 ≥50000 6 15.5 Mean =34358.97 S.D =15984.35 Range =20000-800002. Main occupation of Abroad 12 30.8 the family Business 11 28.2 Service 10 25.6 Army 6 15.4
Table 4 Source of Information for the Students n=39Characteristics Categories Frequency Percentage (%)Source of Teachers/Books/Class 25 64.1Information(Multiple response) TV/Radio 20 51.3 Parents 11 28.2 Friends 7 17.9
Table 11 Student’s Pre-test and Post-test Knowledge Regarding Prevention of Hepatitis-B n=39Knowledge regarding Correct response % p-valueprevention of Hepatitis-B difference Pre-test Post-test No. % No. %Use sterile syringes and needle 24 61.5 39 100.0 38.5 <0.001Do not sit next to infected person^ 25 64.1 39 100.0 35.9 <0.001Practising safer sex 19 48.7 39 100.0 51.3 <0.001Do not hug with infected person^ 28 71.8 39 100.0 28.2 0.001Take vaccination 39 100.0 39 100.0 0.0 -Avoid kissing 1 2.6 37 100.0 92.9 <0.001Vaccination available for 23 59.0 39 92.3 41.0 <0.001prevention of Hepatitis-BRegular doses of Hepatitis-B 23 59.0 39 89.7 41.0 <0.001*Binomial test Median score (IQR): 5(3-6) and 8(8-8)^ Negatively correct
120 100.0 98.0 96.2 98.4 100 94.9 89.7 83.5percentage(%) 80 55.6 58.3 60 41.0 41.0 40 31.5 33.3 32.1 20 0 Fig III: Overall Differences in Knowledge on Hepatitis-B before and after Education Intervention pre per post per
Table 12 Student’s Overall Pre-test and Post-test knowledge Regarding on Hepatitis-B n=39Knowledge Total score Pre-test Post-test p-value*regardingHepatitis-B Median Median with IQR with IQR 29 15 (11-18) 28 (28-29) <0.001 *Wilcoxon Signed Ranked test
CONCLUSIONThe findings of the study showed that the post-testmedian score on knowledge regarding Hepatitis-B wasincreased than the pre-test median score.Thus, the findings revealed that there was a significantincrement on knowledge of the students on Hepatitis-Bin the post-test after the education intervention.
RECOMMENDATIONSThe study can be conducted in the larger sample size togeneralize the results.Regular health education program can be conducted inthe school to update the knowledge of both students andteachers.Similar study can be done using control group.
LIMITATIONSThis study was conducted in one setting i.e Carmel SecondarySchool, hence findings of the study cannot be generalized toother settings.There was no control group in this study, to compare theresults.The study was conducted among the secondary level studentsonly. The other levels students were not included.Time was limited for data collection.
IMPLICATIONSThis study had positive impact in enhancing knowledgeamong the students and making aware about Hepatitis-B.The findings also emphasize on the increasing need ofawareness program on Hepatitis-B.The educational package can be used to prepare educationalmaterial like booklets, pamphlets etc on Hepatitis-B.Regular health education program on Hepatitis-B can beprovided so that students and the teachers will be updatedwith adequate knowledge.