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A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON LIFE STYLE MODIFICATIONS

OF PATIENTSWITH MYOCARDIAL INFARCTION

ATTENDINGCARDIOLGY O P DEPARTMENT

IN SELECTED HOSPITALS

OF BELLARY

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

Ms.G.PARVATHI

INDIAN COLLEGE OF NURSING,

CONTONMENT, TILAK ROAD,

BELLARY.

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES

KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

(Specimen copy)

  1. NAME OF THE CANDIDATE:Ms.G.PARVATHI,

&ADDRESS M.sc (N) 1st YEAR,

INDIAN COLLEGE OF NURSING

CONTONMENT,TILAKROAD

BELLARY
2. NAME OF THE INSTITUTION: INDIAN COLLEGE OF NURSING

3. COURSE OF STUDY &SUBJECT: M.SC (N) 1ST YEAR

MEDICAL SURGICAL NURSING

4. DATE OF ADMISSION TO COURSE:- 17/06/08

5. TITLE OF TOPIC: - A STUDY TO ASSES THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON LIFE

STYLE MODIFICATION OF PATIENTS WITH

MYOCARDIAL INFARCTION ATTENDING

CARDIOLGY OUT PATIENT DEPARMENT IN

SELECTED HOSPITALSOF BELLARY

6. BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION:

The heart is one of the vitalorgans. Disorders related to the heart are one of the leading causes of the death through out the world.

Myocardial infarction also known as heart attack occurs when the blood supply to the part of the heart is interrupted. This is most commonly due to occlusion of coronary artery following the rupture of vulnerable atherosclerosis plaque. Which is an unstable collection of lipids and white blood cells in the wall of the artery, the resulting ischemia and oxygen shortage if left untreated for a sufficient period.Can cause damage and/or death of heart muscle tissue. One of the major goals of care of client with acute myocardial infarction is rehabilitation and change life style of the patient through education.

6.1 NEED FOR THE STUDY: -

Myocardial infarction is a common presentation of ischemic heart disease The WHO estimated in 2002, 12.6% of deaths worldwide were from ischemic heart disease. Ischemic heart disease is the leading cause of death in developed countries.

In the United States, diseases of the heart are the leading cause of death, causing a higher mortality than Cancer. Coronary heart disease is responsible for 1 in 5 deaths in the U.S. Some 7,200,000 peoples suffer a coronary attack every year, and about 40% of them die as a result of the attack. This means that roughly every 65 seconds an American dies of a coronary event.

In India, cardiovascular disease is the leading cause of death. The deaths due to CVD in India were 32% of all deaths in 2007 & are expected to rise from 1.17 million in 1990 and 1.59 million in 2000 to 2.03 million in 2010. Although a relatively new epidemic in India, it has quickly become a major health issue with deaths due to CVD expected to double during 1985 – 2015. Mortality estimates due to CVD vary widely by state, ranging from 10% in Meghalaya to 49% in Punjab. Punjab (49%), Goa (42%) Tamil Nadu (36%) & Andrapradesh (31%) have the highest CVD related mortality estimates. State wise differences are correlated with prevalence of specific dietary risk factors in the states. Moderate physical exercise is associated with reduced incidence of CVD also effects Indians at a younger age man is typical in other countries.

The investigator in her clinical experience found more cases admitted with recurrent myocardial infarction due to lack of knowledge upon life style modification & rehabilitation. Hence the investigator found the necessity to create awareness on lifestyle modification to improve the quality of life.

6.2 REVIEW OF LITERATURE:

1. Review of literature is an important step in developing research project. It helps the investigator to develop a deeper insight into problem & gain information about what has been done before.

2. Yuval. R., Halon da, Lewis B.S, (2007) did a study on “Perceived disability and life style modification following hospitalization for non-ST elevation versus ST elevation acute coronary syndromes: in the patient’s point of view founded hospitalization for ACS & a major negative impact on patient lifestyle and return to work, irrespective of the underlying cardiac diagnoses. The experience of hospitalization for an acute heart condition was uniformly traumatic with in many instances a prolonged adverse effect on patient function.

3.Alexander K.P., M.D, Gore J.M, Armhole H.M, Oman E.M, etc(2007 may 15th) founded although a few recent trials have described treatment effects in older patients, others continue to exclude patients on the basis of age, going forward, prospective trails should enroll elderly subjects proportionate to their prevalence among the treated population to define risk and benefit. Findings from age subgroup analyses should be reported in a consistent manner across trails, including absolute & relative risks for efficacy and safety. Out comes of particular relevance to the elderly such as quality of life, physical function and independence should also be considered.

4. Condon C, McCarthy G,(2006) did a study on “lifestyle changes following acute myocardial infarction, patients perspectives” the study found that the lifestyle warning signs taking responsibility for lifestyle changes, professional support and looking forward to the future. The findings offer insight into the everyday realities which patients experience regarding lifestyle changes particularly in relation to smoking cessation and stress management. The study highlight the need for the development to support patient’s as well as providing information to families to reduce anxiety and fear.

5. Paivi Kleemola, eta.al., (2000) did a study on coffee consumption & the riskof coronary heart disease & death. The findings are coffee drinking does not increase the risk of CHD and all causes in heavy coffee drinkers is largely explained by the effects of smoking & a high serum cholesterol level.

6.Hollander JE (1992) did a study on cocaineinduced Myocardial infarction an analysis & review of the literature. The findings of the study is , cocaine induced Myocardial Infarction identifies a group of young individuals who may be prone to recurrent complications after initial presentations.

PROBLEM STATEMENT

A study to assess the effectiveness of structured teaching programme on life style modifications of patients with Myocardial Infarction attending Cardiology out patient department in selected hospitals of Bellary.

6.3.OBJECTIVES

  1. To assess the knowledge on life style modification of patients with Myocardial Infarction.
  1. To develop and impart a structured teaching programme onlife style modification of patients with Myocardial Infarction.
  1. To develop and implement an instructional module on life style modification of patients with Myocardial Infarction.
  1. To assess the effectiveness of structured teaching programme on life style modification of patients with Myocardial Infarction.
  1. To associate pre and post test knowledge of Myocardial Infarction patients with demographical variables.

OPERATIONAL DEFINITIONS:

1. Assess:To determine or to evaluate the knowledgeon life style modification of patients with Myocardial Infarction.

2. Structured teaching:a teaching programme on

programmelifestyle modifications in Myocardial infarction clients.

3. Life style Modification:the change in habits includes alcohol Consumption smoking physical activity and food habits which have an impact on Myocardial infarction.

4.Myocardial Infarction:The myocardial layer of the heartis gets insufficient oxygen & blood supply due to blockage of coronary artery. it leads to myocardial cell death.

7. MATERIAL AND METHODS:

7.1 SOURCES OF DATA:-

Research approach: Quasi experimental

Research Design:One group,Pre test- Post test design

Setting of the study:out patient department ofcardiology

In Selectedhospitals of bellary

Sampling technique:Simple random technique by lottery

method.

Sample size: 50

Selected variables: Variables include in the present study are

demographic variables - such as age, sex,occupation,education,

Dependent variables: smoking,cocaine,coffee,Stress, exercise.

Samplingcriteria

Inclusion criteria:-

AllMI clients.

Those who are willing to participate in the study.

Those who are able to read and write English, kannada, Telugu.

Exclusive criteria: -

  • Those who are not available during the period of study.
  • Those who are not willing to participate in the study.

7.2 METHODS OF DATA COLLECTION:-

Tool for data collection: Structured questionnaire.

Method of data analysis& the data analyze byMean,Chi-squares

Interpretation: - and data interpreted by Graph, Table,

and Pie diagrams.

Duration of the study: - 4-5 weeks.

7.3. Does the study require any investigation or interventions to be conducted on patients or other humans or animals? If so please describe briefly.

NO

7.4 Has ethical clearance been obtained?

NOT NECESSARY

8.LIST OF REFERENCES:

  1. Brunner and Suddharth S. (2004).Medical and Surgical Nursing, (10th Edition). Philadelphia: Lippincott, 2057.
  1. Lewis. Et al., (2003) Medical and Surgical Nursing, (6th Edition)

Philadelphia: Mosby, 828-830.

  1. Luckman’s et al., (1996). Core principles and practice ofMedical and Surgical Nursing,Philadelphia:W.B.Saunders Company,629.
  1. YUVAL R, Halon DA, Lewis BS, “Percieved disability and life style modification following hospitalization for non ST elevation versus ST elevation acute coronary syndromes”,(2007), Dec;6(4) 287-292.
  1. Candon C, MC Carthy G, “Life style changes following acute Myocadial Infarction: Patients perspectives” (2006), March:5(1);37-44.
  1. Alexander Kp.et al.,”Acute coronary care in the elderly” (2007), May 15;115(19);2549-2569
  1. Paivi Klemola et al.,”coffee consumption and the risk of coronary Heart Disease and Death” (2000);160:3393-3400.
  1. JE Hollander, RS Hoffman - Journal of Emergency Medicine, 1992 - csa.com10:22, 169-177, 1992.
  1. Kosuge, M; Kimura K, Ishikawa T et al. (March 2006). "Differences between men and women in terms of clinical features of ST-segment elevation acute myocardial infarction". Circulation Journal70 (3): 222–226.. Retrieved on 31 May 2008.
  1. Pearte CA, Furberg CD, O'Meara ES, et al (2006). "Characteristics and baseline clinical predictors of future fatal versus nonfatal coronary heart disease events in older adults: the Cardiovascular Health Study". Circulation113 (18): 2177–2185.

9. Signature of the candidate :
10. Remarks of the Guide : The study is feasible and I forward
it for acceptance.
11. Name and Designation of : Y. ANURADHA
11.1 Guide H.O.D DEPARTMENT OF
MEDICAL SURGICAL
NURSING,
INDIANCOLLEGE OF
NURSING, BELLARY.
11.2 Signature :
11.3 Co-Guide (if any) : MANJULA
11.4 Signature :
11.5 Head of the Department : Y.ANURADHA
11.6 Signature :
12. 12.1 Remarks of the Chairman
And Principal : I discussed with the research
committee i felt that research
problem is good and feasible
12.2 Signature :