RAJIVGANDHIUNIVERSITY OF HEALTH SCEINCES BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
VIVEKANANDA COLLEGE OF NURSING
CHITRADURGA, KARNATAKA.
SUBMITTED BY:
Ms. Solanki Priti Jayantilal.
1. / NAME OF THE CANDIDATEAND ADDRESS
/ Ms. Solanki Priti Jayantilal1ST YEAR, M.Sc. NURSING
VIVEKANANDA COLLEGE OF NURSING,
BASAPPAHOSPITAL, 5TH BLOCK,
B.L. GOWDA LAYOUT, TURUVANUR ROAD,
CHITRADURGA-577501, KARNATAKA.
2. / NAME OF THE INSTITUTION / VIVEKANANDA COLLEGE OF NURSING,
BASAPPAHOSPITAL, 5TH BLOCK,
B.L. GOWDA LAYOUT, TURUVANUR ROAD,
CHITRADURGA-577501, KARNATAKA.
3. / COURSE OF STUDY AND SUBJECT / DEGREE OF MASTER OF SCIENCE IN NURSING.
PAEDIATRIC NURSING
4. / DATE OF ADMISSION TO COURSE / 10TH JUNE 2009
5. / TITLE OF THE TOPIC / “ A STUDY TO ASSESS IMPACT OF HEALTH EDUCATION REGARDING SWINE FLUE (H1N1) AMONG HIGH SCHOOL CHILDREN IN SELECTED RURAL HIGH SCHOOL AROUND CHITRADURGA”
6 BRIEF INTRODUCTION OF INTENDED WORKS.
6.1INTRODUCTION.
Paediatrics, unlike the other subjects include a wide spectrum of age groups, each of this age groups have their own physiological, pharmacological, pathological and therapeutic characteristics which need to be remembered while handling respective age group in clinical situation.
Most of the developing countries suffer from the twin scourges of large population, with vast numbers living in poverty and subhuman living conditions more than half of the population lives below the breadline, which leads to nutritional deficits. Frequent episodes of infectious diseases further sap away, the already poor nutrition status, and swine flu is one of the current influenza A type virus which affects on children’s health immediately. 1
Influenza A is a viral respiratory infection often distinguishable from common cold or other respiratory diseases. Transmission is air born and through direct contact of with infected droplets.2
Swine flu is an infection caused by a virus. It's named for a virus that pigs can affect pigs. People usually do not get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, bodyaches, headache, chills and fatigue.
Swine flu also known as swine influenza, hog flu and pig flu. In 2009 the media labeled as "swine flu" the flu caused by 2009's new strain of swine-origin A/H1N1 pandemic virus just as it had earlier dubbed as "avian flu" flu caused by the recent Asian-linage HPAI (High Pathogenic Avian Influenza) H5N1 strain that is still endemic in many wild bird species in several countries.
Swine flu is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.9
It spreads from one person to another through mainly through coughing or sneezing of people infected with the influenza virus. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.
Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160°F/70°C, corresponding to the general guidance for the preparation of pork and other meat.
Generally clinical symptoms are similar to seasonal influenza but reported clinical presentation ranges broadly from asymptomatic infection to severe pneumonia resulting in death.
Patients present with symptoms of acute respiratory illness, including at least 2 of the following:
Fever, Cough, Sore throat, Body aches, Headache, Sudden onset with Chills and fatigue, Air hunger, Diarrhea and vomiting (possible)Persons with these symptoms should call their health care provider promptly. The duration of illness is typically 4-6 days.3
Human cases of swine influenza A (H1N1) have been reported worldwide. In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. A swine H1N1 flu virus was detected. Four days before getting sick, the patient visited a county fair swine exhibition where there was widespread influenza-like illness among the swine. In follow-up studies, 76% of swine exhibitors tested had antibody evidence of swine flu infection but no serious illnesses were detected among this group. Additional studies suggest that one to three health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.
As with the seasonal flu, certain symptoms may require emergency medical attention. In children, signs of respiratory distress include blue lips and skin, dehydrationa lack of desire to be held. Although "too early" to tell for certain, Dr. Frieden has noted that so far the swine flu "seems to be taking a heavier toll among chronically ill children than the seasonal flu usually does." Of the children who have died so far, nearly two-thirds had pre-existing nervous system disorders, such as cerebral palsy, muscular dystrophy, or developmental delays. "Children with nerve and muscle problems may be at especially high risk for complications," the CDC report stated. In children without chronic health problems, it is a warning sign if they seem to recover from the flu but then relapse with a high fever, Dr. Frieden added. The relapse may be bacterial pneumonia, which must be treated with antibiotics. 10
Any other condition of respiratory system or any system may leed to swine flu in children, so need to study regarding swine flu in present situation is so much necessary.
6.2NEED FOR THE STUDY:
1. This virus H1N1 carries some unique qualities that could be cause for concern down the line. “The scary thing for me as a paediatrician is that we are beginning to see flu mutate at a different time of year than is normal, as well as affecting an age group that is not normally at risk,” namely, teens and adults, as opposed to the normally vulnerable populations of young children and the elderly. This, and the fact that this flu appeared in the springtime, at the normal conclusion of flu season, shares discomfiting similarities with the 1918 Spanish flu pandemic which killed tens of millions of mostly healthy young adults.
2Aug. 27 (Bloomberg) -- Children were 14 times more likely to be sickened by swine flu than adults 60 and older, the age group that is typically the most at risk for influenza, according to a U.S. study of the disease.
Children ages 5 to 14 became ill with swine flu, also known as H1N1, at a rate of 147 per 100,000 people, according to the study of 1,557 confirmed illnesses, including seven deaths, in Chicago from April to July, months when the flu virus usually doesn’t spread. The findings were reported today by the U.S. Centers for Disease Control and Prevention in Atlanta.
3. In India cases may vary according to state.
In Maharashtra, which tops the chart for the maximum number of deaths and cases in the country, as many as 112 people have succumbed to the contagious virus and 2,574 have been affected.
Karnataka's toll has reached 85 - the second highest in the country.
The senior wing of Delhi Public School (DPS) at Indirapuram, Ghaziabad, was closed two days after two students tested positive for the influenza. Two days back, the school had closed its junior wing following two children being detected with the virus.
'Four students have been reported infected. We have closed down as a precautionary measure. All infected students are from the primary section. All these students are under treatment and belong to Mayur Vihar, Preet Vihar, Vikas Marg and Vishwas Nagar area of Shahdara,' school principal Meeta Rai said.'We have undertaken every possible measure to deal with the situation,' she added. The school has around 5,300 students from Delhi, Noida and Ghaziabad.
The national capital Thursday reported 113 fresh cases of swine flu with the majority of them being children, Delhi Health Minister Kiran Walia said. 'Of the 113 swine flu cases, 65 are children and all of them have been quarantined.
Fresh cases were also reported from Andhra Pradesh (43), Karnataka (22),Tamil Nadu (34), Maharashtra (35), Haryana (25) and Gujarat (2).8
4. In Karnataka Five swine flu deaths, including three, were reported on 22nd September 2009, taking India's total toll due to the contagious influenza A (H1N1) virus to 262, health authorities said here.According to health ministry officials, the three deaths in Karnataka were reported between Sep 18-19. 'The laboratory confirmation (received Tuesday) showed that all the deaths were due to swine flu,' an official said here. With this, Karnataka's toll has reached 82.
As Karnataka is seeing a surge in swine flu deaths, authorities are nowplanning clinical audits. 'The purpose behind the clinical audit is to find the actual causes behind the death of 80 people due to H1N1 influenza in the state,' Usha Vasunkar, director of Karnataka's Health and Family Services, told IANS.
During their survey, they found that 40 percent of the swine flu victims had co-morbid factors (pre-existing illness) and many died due to late admission. However, the audit will give a clear picture of the actual cause for deaths.
The profile of each victim, which includes name, age, sex, symptoms and cause of death, will be studied by a panel of experts during the clinical audit.
According to investigator experience and review of literature that CHITRADURGA is a backward district and people are unaware about swine flue and also rural high school children are more prone to get swine flu infection due to lack of knowledge regarding the causes, symptoms, and preventive strategies. The knowledge of swine flu should be imparted through health education, as their level of understanding is quite good, so the investigator felt that rural high school children should have awareness regarding cause, symptoms, and preventive strategies through health education.
6.3REVIEW OF THE RELATED LITERATURE.
6.3.1 REVIEW OF LITERATURE RELATED TO SWINE FLU AMONG CHILDREN.
6.3.2 REVIEW OF LITERATURE RELATED TO PREVENTIVE STRATEGIES OF SWINE FLU.
6.3.1 REVIEW OF LITERATURE RELATED TO SWINE FLU
AMONG CHILDREN:
A study was conducted by Kelly H, Grant K. Williams S, and Smith Doninfection with seasonal influenza A (H1N1) virus in patients recruited through sentinel general practices in Victoria and Western Australia in 2007 and 2008 were compared with early publications on infection with swine origin influenza.A (H1N1) virus in the United States and Europe. They found that Influenza A (H1N1) virus infection was predominantly a disease of younger people, regardless of whether the virus was of swine or human origin. The median age of infection with swine origin virus was 20 years in the United States and 22 years in Spain, while the median age of infection with human origin virus was 18 years in Western Australia and 23 years in Victoria. Finally The median age of infection with influenza A (H1N1) virus was around 20 +/- 3 years, independent of the origin of the H1N1 virus but a higher proportion of swine origin influenza infections occurred in children aged 10-18 years. This is at least partially explained by biased sampling among surveillance patients, although it may also reflect a different infection pattern.6
A literature from internet by Yankus, on Children and Swine Flu. He said that Although new mutations of the influenza virus are alarming, there isn't a lot of evidence that shows children in the U.S. are currently at high risk. “Parents shouldn't be particularly worried, ”noting that in the U.S. cases of swine fluhave been relatively mild.
“Most everybody so far has gotten better fairly quickly.” For parents, following normal behaviour, with extra focus on hygiene, is the best bet: “Wash hands, bathe kids, and if you see flu symptoms such as sore throat, headache, fever, or body aches and pains, go see your doctor.”8
6.3.2 REVIEW OF LITERATURE RELATED TO PREVENTIVE
STRATEGIES OF SWINE FLU.
A study conducted by Quinn SC, Kumar S, Freimuth VS, and Musa D on public willingness to take a vaccine or drug under emergency use authorization during the 2009 H1N1 pandemic. They examined that the willingness to accept an EUA drug or an H1N1 vaccine, the extent of worry associated with taking either, the conditions under which respondents would accept an EUA drug or vaccine, and the impact of language from the EUA fact sheet on people’s willingness to accept drug for themselves or their children. We also examined the association among these variables and race/ethnicity, education level, trust in government, previous vaccine acceptance, and perceived personal consequences from H1N1influenza. These results provide critical insights into the challenges of communicating about EUA drugs and vaccine in our current pandemic.10
W.H.O ( world Health Organization ) reported (2009) about Influenza H1N1 and prevention. W.H.O phasing of pandemic influenza H1N1 which now become epidemic. The detection and verification of this human to human transmission is a pivotal point in the evolution of a epidemic and requires several urgent actions on the part of W.H.O. The first and most pressing decision is whether or not to attempt a rapid containment of a virus at a source. Many factors will play a role in this decision including time since detection geographic location of the initial clusters, population, density, urban versus rural environment and other factors. Another decision that must be made by WHO is that of advising the governments and vaccine manufacturers to limit production of seasonal influenza vaccine and rapidlybegin development and production of a vaccine against emerging epidemic virus H1N1. All of these decision have wide ranging impacts on the measures that countries must take in response.5
6.4. STATEMENT OF THE PROBLEM:
“ A STUDY TO ASSESS IMPACT OF HEALTH EDUCATION REGARDING SWINE FLU (H1N1) AMONG HIGH SCHOOL CHILDREN IN SELECTED RURAL HIGH SCHOOL AROUND CHITRADURGA”
6.5. OBJECTIVES OF THE STUDY:
- To assess the knowledge about swine flue among high school children.
- To enhance the knowledge through health education about causes, symptoms, and prevention about swine flue.
- To assess the impact of health education through post test.
6.6 OPERATIONAL DEFINITIONS :
1. ASSESS: An activity to estimate the outcomes of structured health education programme on the cause, symptoms and preventive strategies of swine flu.
2. IMPACT: It refers to the extent to which the structured health education programme on cause, symptoms and preventive strategies of swine flu has desired effect in improving the knowledge of rural high school children as evident from gain in knowledge scores.
3. HEALTH EDUCATION: It refers to the systematically developed instructional method designed for rural high school children that informs, motivates and maintain healthy practices and lifestyle.
4. HIGH SCHOOL: It refers to the educational institute where the 8th to 10th standard’s students are studying.
5. SWINE FLU: It is a respiratory condition caused by H1N1 virus , it’s symptoms are fever, cough, sore throat, body ache, headache, chills, and fatigue. It should be treated promptly, if not can be fatal.
6.7. INCLUSION AND EXCLUSION CRITERIA :
1. Inclusion criteria:
1. Students of rural high school,who are interested to participate in study.
2. Students belong to 8th to 10th standard of rural high school will be selected.
2. Exclusion criteria:
1. Students who are sick at the time of data collection are not included in the study.
2. Those who are not interested and not co-operative.
6.8. ASSUMPTION :
The knowledge about swine flue among high school children will be significantly less.
6.9. HYPOTHESIS :
There will be significant difference between pre-test and post-test level of knowledge about swine flue.
6.10. DELIMITATIONS :
It depends upon the numbers of students available during post test session.
7. MATERIALS AND METHODS :
7.1. Sources of Data :
8th to 10th standard students of rural high schools around Chitradurga.
7.1.2. Research design :
Quasi-experimental, Pre-test and post-test design will be used to conduct the study.
7.1.3. Setting :
Study will be conducted in the selected rural high schools around Chitradurga.
7.1.4. Population:
The population of present study comprises Rural high school children who are Studying in 8th to 10th standard.
7.2. Method of data Collection :
Structured questionnaire will be used to assess the knowledge regarding cause, symptoms and preventive strategies among the students of rural high school around Chitradurga.
7.2.1. Sampling Technique:
Stratified random sampling technique will be used to select the sample.
7.2.2. Sample size: The sample size of the present study will be 150. including boys and girls.
7.2.3 Inclusion criteria for Sampling :
1. Rural high school children around Chitradurga who are in standard 8thto 10th.
2. High school children who are interested and able to participate in study.
7.2.4. Exclusion Criteria fir Sampling :
1. Students who are sick at the time of data collection are not included in the study.
2. Those who are not interested and not co-operatev.
.
7.2.5. Method of Data Analysis and Interpretation :
Data will be analysed with the use of both descriptive and inferential statistics. Frequency, percentage and Cross Tabulation to check the association between the selected variables through interpretation of findings will be planned. Master sheet will be prepared. and data analysis will be presented with use of tables and graphs.
7.3. VARIABLES :
Independent variable : Health education on prevention of swine flue.
Dependent variable : Knowledge on cause, symptoms and preventive strategies of swine flue.
7.4. PROJECTED OUT COME :
As the investigator as planned for health education, there will be increase in knowledge on cause, symptoms and prevention of swine flue (H1N1).
REFERENCES :
TEXTBOOKS :
1.Parthasarthy A, Menon PSN, Nair MKC, “IAP Textbook of paediatrics “ 2nd edition, New Delhi: Jaypee Brothers Medical Publishers; 2003.p02.