RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE KARNATAKA
PERFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1 / NAME OF THECANDIDATE
AND ADDRESS / MR. SIBY K ABRAHAM
1st YEAR M. SC. NURSING
THE OXFORD COLLEGE OF NURSING
1st PHASE, J.P.NAGAR
BANGALORE- 560078.
2 / NAME OF THE INSTITUTION / THE OXFORD COLLEGE OF NURSING
1st PHASE, J. P. NAGAR
BANGALORE- 560078
3 / COURSE OF STUDY AND SUBJECT / DEGREE OF MASTER OF NURSING
COMMUNITY HEALTH NURSING
4 / DATE OF ADMISSION TO COURSE / 28. 05. 2007
5 / TITLE OF THE TOPIC / ASSESSMENT OF KNOWLEDGE AND PRACTICES OF TRAFFIC POLICE MEN REGARDING PREVENTION OF VARICOSE VEIN IN SELECTED TRAFFIC POLICE STATION BANGALORE.
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
“Aware of Cure is better than Beware of Prevention”
K. PARK
Diseases are more common in the world; the person will find out the cause of diseases and try to take immediate action to prevent the diseases. Immediate awareness is the best way to save the life successfully.
Varicose vein is one of the chief preventable diseases which is associated with veins. It is a serious disease, which poses threat of life of patient when effective and efficient measures are not taken.
Varicose veins are common in the superficial veins of the legs which are subject to high pressure when standing. Accumulation of more and more venous blood in the superficial venous system makes the superficial veins dilated and tortuous. This condition of dilated and tortuous veins in the leg due to damaged value between the deep and superficial venous system is called varicose vein1
Varicose vein is most common in women and in people whose occupations require prolonged standing, teachers, traffic police, bus conductors, machine workers, pregnancy and construction workers. The deep and superficial veins
1
get damaged because of prolonged standing2.Ones the vein is damaged there is a reversal of blood flow from deep to superficial vein.3
According to W H O approximately 2% of western population have primary varicose vein, women is having 3-4 times more than men. Varicose veins are less common in Eastern population, particularly Africans and Indians. The world prevalence of varicose veins usually means the estimated population of people who are managing varicose veins at a given time. Statistics by country for prevalence of varicose veins is 45 per 1000. it is approximately 1 in 22 or 12.2 million people in U S A.4
In India varicose vein affect one out of 2 people over age of 50. Varicose veins are more common in women than men. Varicose veins are painful and varicose vein can be dark purple or blue and look twisted and bulging.
In Bangalore 3-5% of the population suffer venous problems, 10% of population is having varicose veins. Prolonged standing is one of the number one causes of varicose vein in traffic police men. Other causes include hereditary, aging, obesity and injury to the leg.
6.1 NEEDS FOR THE STUDY
Varicose vein is a preventable disease and most of the people are unaware about the intensity of problem. The investigator felt the importance of
2
creating knowledge of traffic police men regarding the prevention of varicose vein. Prolonged standing is the major cause to increase the number of varicose vein in traffic police. The purpose of the study is to create awareness and improve the knowledge regarding prevention of varicose vein5
In 1981 Trendelen burg first noted that varicose veins were caused from vein valve incompetence and abnormal hydrostatic pressure in the lower extremities.6 Few individuals under the age of 25, develop varicose veins. By the age of 40 years 25% of men are affected. The incidence rate is increased, it is about more than 50% of men are affected due to prolonged standing.
According to one estimate in 2004, 15-20% of population in India is suffering from varicose vein disease.6 In our country people are quite ignorant of this disease. So the severity of disease becomes increased. Health education is one of the strategy in the prevention of varicose veins. Keeping the preventive facts in view and the fact that health education has a significant effect on knowledge of traffic police which in turn helps in the prevention of varicose veins.
Based on these literature and statistical values, Researcher felt that assessing the knowledge and practice regarding prevention of varicose veins in traffic police men. So the study is designed to determine the knowledge and practice regarding prevention of varicose vein among traffic police men.
3
6.2 REVIEW OF RELATED LITERATURE
1. Studies related to varicose vein.
2. Studies related to prevention of varicose vein.
3. Studies related to informational booklet.
1. Studies related to Varicose vein
Robert Beagle hole (2005) Department of Community Health and General Practice, School of Medicine, University of Auckland.The prevalence rate of varicose veins in adults varies from less than 1% in lowland New Guinea women to over 50% in women in south Wales. Within populations the prevalence increases with age, is generally greater in women, is directly related to body mass, has an inconsistent relationship with occupation, None of these factors explain the striking geographic variation in the occurrence of varicose veins. The 2 most plausible hypothesis implicate low-fiber diets and prolonged chair-sitting as the primary causal factor. Epidemiological studies are required within populations to establish the merits of these 2 competing hypothesis. Since varicose veins are potentially preventable, further research is well justified.7
Nelzen O, Berquist D, Lindhagen A (2002) Department of surgery Karnsjukhuset Skoviden conducted study on venous and non venous leg ulcers, clinical history and appearance in population study. According to this
4
study, in a defined Swedish population of 2, 70800 all patients with current chronic leg ulcers were identified and a random sample of 382 studies in detail. Ulcers of primarily venous cause comprised 54% of the total, giving a point prevalence of 0.16%. The median duration of ulcer diathesis was significantly longer in patients with venous than in those with non venous lesions.8
Langer RD, H O,E, Denenberg J O (2007)Department of family and preventive medicine university of California, conducted study on relationship between symptoms and venous disease. The association between symptoms and venous disease of the lower extremities are poorly characterized. The cross sectional study to evaluate the relationship between symptoms associated with venous disease and prevalence disease in 2408 men and women aged 21 to 91 years who were employees were randomly selected With in strata by age, sex and ethnicity. A structured interview assessed the prevalence of aching, itching, heaviness, tired legs, cramping, swelling and night time restless legs. A comprehensive standardized examination determined the prevalence of visible disease. Swelling was the most specific marker for prevalent visible and functional disease.9
Racette S. Sauvageau A (2005) Canada submitted an article on unusual sudden death: two case reports of hemorrhage by repture of varicose vein. According to this although varicose vein are frequent, they are rarely considered lethal still repture of the varicosity can result in significant and even fetal hemorrhage. External hemorrhage is an unusual complication of
5
this common venous pathology, reported here are two cases of severe external
hemorrhage resulting from the perforation of a varicose vein.10
CJ Evans, FG Fowkes, CV Ruckley and AJ Lee Wolfson(1999) conducted the study to determine the prevalence of varicose veins and chronic venous insufficiency (CVI) in the general population. Men and women aged 18-64 years selected randomly from age-sex registers of 12 general practices. In 1566 subjects examined, the age adjusted prevalence of trunk varices was 40% in men. This sex difference was mostly a result of higher prevalence of mild trunk varices in men. More than 80% of all subjects had mild hyphenweb and reticular varices. The age adjusted prevalence of CVI was 9% in men. The prevalence of all categories of varices and of CVI increased with age (p < or = 0.001). No relation was found with social class. In contrast with the findings in most previous studies, mainly conducted in the 1960s and 1970s. . No evidence of bias in the study was found to account for this sex difference. Changes in lifestyle or other factors might be contributing to an alteration in the epidemiology of venous disease.11
2.Studies related to prevention of varicose vein.
Padmavathy Gowda. (2004) Conducted the study on Bangalore. The study is depending upon new methods for treating varicose vein. According to experts in vascular diseases, 3-5% of the population suffers from severe venous problems. 10% of these patients have varicose veins. Varicose veins
6
affect those who work standing for long hours, such as traffic policemen. The disease is not life threatening, it can be debilitating if not treated properly. Many people do not know about the treatment for varicose veins even when the disease is at an advanced stage as surgery is required in many cases. The treatment involves making a small incision in the affected part and the introduction of laser fibre. Laser is fired at regular intervals causing the varicose vein to collapse completely. The Centre for Venous Disorders at JIVAS claims to be the first in the State and third in India to acquire the ELVes Laser System used for "Endovenous Laser Ablation." "Sequential Compression Therapy" is another treatment for severe swelling caused by certain venous diseases. It involves pushing fluids from the foot, leg, and thigh into the venous system by using a multi-chambered compression device.12
Phillips L J 2nd, Sarkar R.( 2007) Department of Vascular Surgery and Pacific Vascular Research Laboratories University of California San Francisco, According to this study the post-thrombotic syndrome represents a poorly understood and significant vascular health problem. This review focuses on our current understanding of the pathogenesis of post-thrombotic syndrome. These include the initiation of deep venous thrombosis, the pathogenesis of elevated venous pressure, and the factors responsible for non healing of venous stasis ulcers.13
7
3. Studies related to Informational Booklet
Frost M H (2000) conducted the study to identify characteristics of print education materials that health care providers report as important to patients. The finding showed that appropriate reading level, clarity, credibility
of the information, whether information is current or up to date, are the important characteristics of printed educational material. In developing print education materials for patient access need to be considered.14
Joshi H B (2001) conducted a study to report a specific approach in corporating patient preference towards the development of patient information booklet about ureteric students. Result showed that of the 35 patients, out of 30 participated in the initial survey.80% of the patients reported dissatisfaction about the information they received. Patients want more information about the use adverse events and effects of stents on daily life. As
evidenced by conclusion booklet is expected to be an effective tool for patient
communication that would help the patient cope better with indwelling stents
and be useful in counseling patients.15
8
6.3 STATEMENT OF THE PROBLEM
“ A study to assess the knowledge and practices of traffic police men regarding prevention of varicose vein in selected traffic police station Bangalore with a view to develop an informational booklet”
6.4 OBJECTIVES OF THE STUDY
1. To assess the knowledge of traffic police men regarding prevention of
varicose vein.
2. To assess the practices of traffic police men regarding prevention of varicose vein.
3. To find out the correlation between knowledge and practices on prevention of varicose vein.
4. To determine the association between the knowledge and practice with selected demographic variables.
5. To develop an informational booklet regarding prevention of varicose vein.
9
6.5 HYPOTHESIS
H0 1 – There is no significant correlation between knowledge and practices of traffic police men regarding prevention of varicose vein.
H0 2- There is no significant association between knowledge and practice score with selected demographic variables of traffic police men regarding prevention of varicose vein.
6.6 RESEARCH VARIABLE
6.6.1 Independent variable
refers to demographic variable such as age, sex, education etc.
6.6.2 Dependent variable
refers to the level of knowledge and practice of traffic police men regarding prevention of varicose vein.
6.7 OPERATIONAL DEFENITIONS
KNOWLEDGE: refers to the correct response of traffic police men to the knowledge items regarding prevention of varicose veins as per elicited through structured interview schedule.
10
PRACTICE: refers to the observations such as itching, heaviness in the legs and swelling which occurs to the traffic police men to prevent varicose vein by doing proper exercises, wearing tight shoes and elastics for the legs.
VARICOSE VEIN: is a dilated tortuous veins with pooling of blood due to long standing.
INFORMATIONAL BOOKLET: refers to an educational material giving change about prevention of varicose vein.
6.8 ASSUMPTION
· Traffic police men will have some knowledge regarding prevention of varicose vein.
· Traffic police men may have interest to know more about varicose vein.
6.9 DELIMITATION
This study is delimited to the traffic police men in Bangalore.
7. MATERIAL AND METHODS
7.1 SOURCES OF DATA
Data will be collected from traffic police department in Bangalore.
11
7.2 METHODS OF DATA COLLECTION
Structured interview schedule will be used to collect the data.
7.2.1RESEARCH APPROCH
Descriptive survey approach used to conduct the study.
7.2.2 RESEARCH DESIGN
Descriptive design will be used to carry out the study.
7.2.3 RESEARCH SETTING
Study will be conducted in selected traffic police station Bangalore.
7.2.4 POPULATION
The population of the study consists of traffic police men who all are
working in selected traffic police station.
7.2.5 SAMPLE SIZE
Sample consists of 60 Traffic police men in selected traffic police station Bangalore.
7.2.6 SAMPLE TECHNIQUE
Purposive sampling technique will be used to select the sample.
12
7.2.7 SAMPLING CRITERIA
INCLUSION CRITERIA:
· Traffic police men who are willing to participate in the study.
· Traffic police men who are available during the data collection period.
EXCLUSION CRITERIA