RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

SUBMITTED BY

Mrs. MARINA NINAN

MSc Nursing 1 Year

2010-2012Batch

Harsha College of Nursing

Bangalore

Sl.No.TitlesPage No.

1-5Self Introduction2

6Brief Resume of intended work3

6.1Need for the study4

6.2Review of Literature4

6.3Statement of the problem8

6.4Objectives of the study8

6.5Operational Definitions8

6.6Hypothesis9

6.7Assumption9

6.8Delimitation9

6.9Variables9

7Sources of Data10

7.1Research Design and approach10

7.1.2Setting of the study10

7.1.3Population10

7.2Method of data collection10

7.2.1Sampling Procedures10

7.2.2Sample size10

7.2.3Inclusion criteria10

7.2.4Exclusion criteria10

7.2.5Tools for data collection11

7.2.6Plan for analysis11

7.3Ethical Clearance11

8List of references

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 / Name of the candidate and address / Mrs. MARINA NINAN
1ST YEAR M.SC. NURSING
HARSHACOLLEGE OF NURSING NELAMANGALA BANGALORE.
2 / Name of the Institution / HARSHACOLLEGE OF NURSING NELAMANGALA BANGALORE.
3 / Course of the study and subject / 1ST YEAR M.SC NURSING COMMUNITY HEALTH NURSING
4 / Date of Admission
5 / Title / A study to find the effectiveness of planned health teaching programme on knowledge of hypertension
among hypertensive patients (30- 50 years)
in a selected area at Nelamangala in
Bangalore district.
  1. BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

Hypertension is defined as consistent elevation of systolic blood pressure, diastolic blood pressure or both.

Hypertension is one of the leading cause of death and disability among adults. Hypertension is a debilitating condition associated with life style. Life style changes can cause, determine the severity and even control the negative impacts of Hypertension.

In most of the industrialized countries the prevalence of Hypertension in adult population has been reported to vary from 10-20% with 70% of this being mild Hypertension.

Diet has a major role in the incidence of Hypertension. Easily digestible carbohydrate diet is of great help in the dietary management of Hypertension. Dependingon the survey method used, it has been estimated that 12% to 25% of the adult population has hypertension. The specific number of individual with this condition is between 10 and 23 million1.

In addition to its wide prevalent the complications of uncontrolled hypertension such as cardiac, renal and cerebrovascular disease and the fact that only 10% to 15% of those afflicted are adequately treated contribute to the magnitude of the health problem presented by this condition12.

Hypertension is rare in persons of allraces younger than 20 years of age (1.25%) but is present in nearly halfof those over 70 years (42.5%). Development of essentialhypertension is most common between 30 and 50 years of age. Men are more likely to develop complication of Hypertension than women11.

Prevention of Hypertensive heart disease requires either control or prevention of Hypertension itself. Amultitude of research studies have indicated that certainrisk factors are related to the development of Hypertension. Highsodium diets, obesity and physical inactivity seem to be highly related to this disease.

Hypertension is a serious condition. It is mostly seen inelderly population. It is also called “silent killer” because the person who has it is often symptom free12.

6.1NEED FOR THE STUDY

World health organization in 1978 stated that the incidence of Hypertension was higher among male than the female. Systolic and diastolic pressure was found to be increased with advancing age. Hence the patient must be treated as a whole and in an integrated manner, taking into account and the severity of the Hypertension, its effect on the target organs as well as the associated conditions and aggregating factors. This is enhanced by patients understanding of their disease condition and treatment. In the drive towards Health for all it is the responsibility of the health care which will give each individual in society an opportunity to achieve optimum health23.

In most parts of the world 10-20 percent of adults have high blood pressure of course, not everybody with the condition becomes seriously ill, but the higher the pressure and the longer it is elevated the more likely it is that disease will occur. Consequently, treatment aimed at reducing high blood pressure is very important24.

About 40% of the adult population in the world develop Hypertension , more than 90% of these have essential as primary hypertension which has no identifiable and the incidence rate in Tamilnadu is 49.This is more common in females26.

6.2REVIEW OF LITERTURE

Review of related literature is an integral component of any study of research project. It enhances the depth of knowledge and inspires a clear insight a clear insight into the cure of problem. It is helpful in organizing investigation such as research approach technique and tools.

Review of literature provides basis for future investigations, justifies the need for replication, throws light up on feasibility of the study, and indicates constraints of data collection and help to relate findings of one another.

Review of literature is an integral component of any study or research project. It enhanced the depth of knowledge and inspires a clear insight into the crux of the problems. Literature review throws light on the study and their finding reported about the problems under study8.

This chapter deals with the the review of some related studies in India and other countries, which are related to this study9.

The review of literature was done from published articles, research report and other thesis on Hypertension and its various aspects. The content of the literature was divided into the following heading.

According to World Health organization there was whole several factors of Hypertension includes the following. They are age, sex education, occupation, heredity, personality trait and presence of organic diseases.

Epistemology study found out the prevalence of Hypertension in females of Punjab state. The study found that the Blood pressure increases significantly with age13.

Blood pressure increased with age due to sodium intake11.

Itstudies the association of age, sex, heredity, body weight, physical activity and socio-economic status on Blood pressure levels in 1325 adults, in a rural community of Jhansi district, Uttar Pradesh. The systolic and diastolic Blood pressures were found to increase with advancing age, sex, heredity and body weight. However the socio-economic status of respondents did not significantly influence their B.P levels23.

The familiaraggregation of systolic & diastolic Blood pressure was pronounced between biologically related members of the family but negligible between unrelated household members. In their study they found that diastolic Blood pressure aggravated between all pairs of family members except between mother and adopted children3.

Obese patients are known to be at greater risk of developing hypertension as compared to the non-obese patients20.

In this study they compared the treatment of Hypertension with drugs and alternative measures showed that weight reduction in produced significant mean reduction in Blood pressure [mean 15%] and was the most effective non-pharmacological measure.

They conducted an eight week two hour diet counseling exercise sessions for 184 black and three white women. 8 were on Anti -hypertension while 99 were not on medication with a mean weight less of 61bs, the mean systolic and diastolic Blood Pressure decrease was 10/6 mm of Hg in the control group. Thus it can be inferred that weight loss and related dietary or behavioral changes from the participation in weight control program could enhance Blood Pressure control2.

It studies the influence of alcohol on Blood Pressure. Alcohol is an important but insufficiently recognized cause of Hypertension.

Itstudies the effect of alcohol in 16 men with Hypertension, who are alcoholics. It was found that the consumption of alcohol produced statistically significant use in diastolic & systolic Blood Pressure. They also demonstrated the pressure effect of alcohol in patient with Hypertension and confirmed the link between alcohol and Hypertension.

They studied over a period of 6 months studied the smoking habits of patients with malignant phase hypertension as compared with those of 92 patient with non-malignant hypertension 33 patients with malignant hypertension were found to be smokes when first diagnosed. It was found that cigarette smoking was associated with the development of adverse effects of Hypertension like retinopathy; the study suggested that smoking does have a definite role in aggravating the cause of Hypertension25.

It studies the relationship between physical activity and Blood pressure among 1577 adults comprising both sexes. Result showed that a statistically significant higher mean systolic B.P among the light physical activity group20.

A 20 minute relaxation twice a day will be beneficial regardless of whether or not the person is on drug therapy.

They demonstrated the influence of yoga a bio feedback in the management of Hypertension. 34 patients were assigned at random 6-8 weeks treatment by yoga, relaxation with bio feedback or placebo therapy. Both the groups showed a decrease in Blood Pressure and the difference was highly significant24.

Studies related to Management :

A diet high in naturally occurring potassium a low in artificial sodium is important in lowering Blood pressure increase fruits and vegetables, apples, bananas, carrots , oranges, potatoes and cereal are all excellent foods to balance potassium sodium level, limit the use of table salt and food that are high in sodium. Eat more garlic,onions,basil and ginger root. These foods all have mild Blood Pressure lowering effects1.

High blood pressure is generally the results of an imbalanced life style. Dietary corrections,stress education, herbal a nutritional supplement a holistic therapy are excellent to reverse this condition3.

Theyconducted a study on education on patient with hypertension. She collected the samples randomly. After the pretest, education was given, posttest was conducted. At last it was found out that there is a significant difference between the pre tests and post test score all through this study the peoples gained knowledge regarding the management and also the complications of Hypertension8.

They conducted a study on the role on Dietary control in Hypertension. He selected the samples, which were in particulars area. First he went and educated all the peoples regarding the dietary pattern. After that he made a visit for 2 days. At last it was found that the people who maintained the strict diet control had Blood Pressure around 120/90 mm of Hg to 130/100mm of Hg 80 from this study he concluded that diet play an vital role in the control of hypertension16.

They conducted the study on Blood Pressure a mortality in elderly people aged 85 and older. Samples included all people aged 85 yrs and over. He found that when age and sex were adjusted for a significant inverse relation between Blood Pressure and mortality was observed. Mainly due to increase in the risk of mortality among those subjects with low diastolic pressure6.

Studies Related to Health Education

It wasa study on Hypertension. He selected a samples, which were in a particular area and conducted pretest and after 2 days he gave health education.After conducting post –test he found that there was a significant difference between pretest and post –test score. So it was found out that health education plays a vital role in controlling each a every disease there by increasing the knowledge level16.

It was found that after health education, the people could answer most of the questions correct and supported the role of community participation.

It wasa study to find out the breast feeding practices. It wassurveyed in 361 infant randomly sampled from 19 of 190 villages attached to a primary health centre near Bangalore. Findings revealed that India these were 202 male and 160 female infants, mothers were asked about prelatic feed, sugar water was given by 3, 12 and 16 mothers in social classes I, II and III, 55 and 10 mothers in social classes IV and V consisting primarily of illiterates gave castor oil % (Colostrums )was given only to a small number of infants were being breast fed supplements in addition to breast milk educated mothers were more likely to continue breast feeding their children at 7-9 and 10-12 months of age8.

6.3 STATEMENT OF THE PROBLEM

A study to find the effectiveness of planned health teaching programme regarding Hypertension amonghypertensive patients(30-50years)in a selected area at Nelamangala inBangalore district.

6.4OBJECTIVES OF THE STUDY

  • To assess the pre test knowledge among thehypertensive patients regarding Hypertension..
  • To evaluate the effectiveness of health teaching program among hypertensive patients .
  • To find out the association between pretest knowledge and past test knowledge of hypertensive patients regarding hypertension and selected demographic variable such as age, sex, educational status , marital status etc.

6.5 OPERATIONAL DEFINITIONS

  • Hypertension

It referred to thepersistent elevation in systolic pressure of above 150 mm of Hg and diastolic pressure of above 90 mm of Hg.

  • Planned Health Teaching programme

It referred to education planned for the Hypertensive patients regarding the management in hospital, community as well as in home.

  • Effectiveness of Planned Health Teaching

It referred to the gain in knowledge regarding Hypertension in post-test than that of pre-test as measured by a structured knowledge questionnaire.

  • Hypertension Patients

Hypertension patients referred to patients who are diagnosed as having Blood Pressure above 150/90 mm of Hg by a physician.

6.6 HYPOTHESIS

H1: There is a significant increase in the knowledge of hypertension in the post test knowledge score than the pretest knowledge score among hypertensive patients

H2: There is a significant association between knowledge score and demographic

Variable

6.7 ASSUMPTON

It is assumed that hypertensive patients will have some knowledge about disease condition

Hypertensive patients would willingly participate and co- operate in the study

Health education is one of the recognized methods of improving knowledge

6.8 DELIMITATION

The study was delimited to

- Community setting

- Only knowledge and practice in relation to hypertension was measured

6.9 VARIABLES

  • Dependent variable:Knowledge of hypertensive patient

Regarding hypertension.

  • Independent variable:Health teaching programme on hypertension

7 SOURCES OF DATA

Data will be collected from hypertensive patients (30-50years)in a selected area at Nelamangala inBangalore district.

7.1.1 RESEARCH DESIGN AND APPROACH

An Experimental study of one group pre test and post test design with evaluative approach.

7.1.2 SETTING OF THE STUDY

The study will be conducted in Nelamangala at Bangalore District.

7.1.3 POPULATION

The population of study comprises of all patients aged 30-50 years residing in Nelamangala at Bangalore District.

7.2 METHOD OF DATA COLLECTION

By self administered questionnaire

7.2.1 SAMPLING PROCEDURE

This samples will be selected by convenient sampling technique.

7.2.2 SAMPLING SIZE

Sample size consist of 50 hypertensive patients

SAMPLING CRITERIA

7.2.3 Inclusion criteria

  1. Who are willing to participate
  2. Who can read and understand Kannada or English

7.2.4 Exclusion criteria

  1. Patients who were not willing to participate in the study.
  2. Patients who are maintaining blood pressure lend at 120/80 mm of Hg after treatment

7.2.5. Tools for data collection

Structured questionnaire

7.2.6Plan for Analysis

The researcher will use appropriate statistics for data analysis, present in the form of tables, graphs and diagrams. The percentage analysis, frequency distribution, Standard deviation, mean and chi square will be used to analyze and interpret data.

7.3Has ethical clearance has been obtained from your institution?

Administrative permission and ethical clearance with regard to the study will be obtained from the institution and samples prior to conducting the study.

8. LIST OF REFERENCES

TEXT BOOKS

  1. Park K (2000) Text Book of preventive and social medicine 16th edition M/s Banaridas Bhanot Publishers, 1167, Prem Nagar, Jabalpur, P. 273-277
  2. Charrbelcain, N.E and oligive, C. Symptoms and signs in clinical medicine. Great Britain, The store bridge press. P. 667-684
  3. Drug Introduction to patient Care, Philadelphia, W.B.Saurders company P. 141-144.
  4. Evars, C.D.C.C (1987). Symptoms and sign in clinical medicine.Bristol Job publishers limited. P.142 - 152
  5. Jacobs, M.E. and Black, J.E. (1997), Medical Surgical Nursing. Philadelphia, W.B.Saurders company P.1387-1390.
  6. Knowler, & Malcohn, (1970). The modern practices of adult education. New York, Associated press, P.259-263.
  7. Lewis, W.V.Lu (1989). Fundamental skills in patient care. Philiadelphia, J.B. Lippincott company. P.155-167
  8. Polit BF and Hungler, B.P. (2004) Nursing Research – Principles and methods, jb lippincot co. Philadelphia P. 30-36
  9. Basavanthappa (2006) Nursing Research Jp publishing company New Delhi. P. 116-120
  10. Morrissay B.G. (1984). Therapeutic Nutrition, Philadelphia, Lipiracatt’s quick references 91-96.
  11. Park J.E. (1988). Text book of preventive and social medicine, Jabalpur, M/s.Banarials Bharat Publishers. P. 721-735
  12. Perry and pooter(1992). Fundamentals of Nursing. (1992) Philadelphia, Moshy year book company, 1232.
  13. Smeltzer Suzanne, C.D, and Brenda G.Bare Brunner and siddarth (1992). Text book of medical and surgical nursing, Philadelphia, J.B, Lippincott company, 821-924.
  14. Swaminathan (1990). Handbook of food and nutrition. 243-244.
  15. Sancheti D.C and Kapoor V.K Statistics [Theory, Methods and Application], sultan chand and sons Educationa publishers, 23 Daryaganj, New Delhi –T8, T10.

JOURNALS

  1. Amarnath G.S (1997). Hypertension is a silent killer health action. British Medical Journal.174
  2. Andrew (1982). Hypertension is a compaign of drug and non-drug. British Medical Journal, 284 (19), 212-214.
  3. Annest A.M.Peer C.R.Gilad, J.M. and Bluma (1989) Familial treatment of blood pressure. American Journal of Medicine., 51 (5), 208-11.
  4. Blaxhass, A.C. and Christen, P.J (1980). Alcohol induced hypertension. American Journal of Medicine.,653.
  5. Chatterlies, G.(1999). Treatment of Mild hypertension.British Medical Journal.
  6. Chaudry, R (1999). Stress induced hypertension. British Medical Journal.
  7. Dhaurad, R.J (1994). Hypertension areview Health Action.
  8. Gupta S.P. (1978). Epidemiology of Hypertension on total community survey in urban population of Haryana. Indian Health Journal, 30, 315-319.
  9. Hendrick (1999). Blood pressure and mortality in elderly people. British Medical Journal.
  10. Herbert (1997). Silent killer. Health Action.
  11. Hoffman, A.A. Haze, varke (1981). A rardomised trial of sodium intake Blood Pressure in new born infants. Journal of American Medical Association, 25.
  12. Cohnson, (1997). Prevention and control of hypertension. Health Action.
  13. Keil, J.E.B. Lowman, M (1980) prevalence of hypertension families of Punjab State in rural state with age, residence, heart rate and occupation. British Medical Journal, P. 141-143.
  14. Kher, K, Kanwel, p and sudesh, P.M. (1986). Hypertension of paediatrics perspectives. Indian Journal of paediatrics, 55(6), 541-551.
  15. Sancheti D.C, Kapoor V.K. (1992) Statistics, (Theory, Methods and application).P. 115-120
  16. Marlow (1998). Role of dietary control in hypertension. British Medical Journal. P. 825-856
  17. Morgan G (1981), Hypertensive treatment by salt restriction, Dancet 1, P. 227-330.
  18. Messeli, H.F. (1982). Cardiovascular effects of obesity and hypertension. Dancet 1, P. 228-231.
  19. Moses (1983), Less severe hypertension, should it be treated American Health Journal, 101, P. 456-466.
  20. Rao, S (1984). Relationship between physical activity and blood pressure. Indian Medical Gazette, 17(4), P. 118-122.
  21. Sauder B.J. Beever, G.D. and paton A (1981) Alcohol induced hypertension. Dancet, 2, 653
  22. Skrabal, F (1981). Low sodium & high potassium diet for prevention of hypertension Dancet, 2, P. 895-900.
  23. Srivastava (1981). The influence of some correlates of blood pressure or its distribution in an Indian rural community. Journal of Epidemiology and community health, 33 (4). P. 145-156
  24. Sudarsan (1992). Comparison of hypertension with other diseases. Health Action. P. 225-250
  25. Sauder B.J. Beever, G.D. and paton A (1981) Alcohol induced hypertension. Dancet, 2, 6
  26. Suraj Dr. (2000). Complications of hypertension Health Action.

6 / Signature of candidate
7 / Remarks of the guide
8 / Name and designation of
(in block letters)
8.1Guide
8.2Signature
8.3Co-guide (if any)
8.4Signature
9 / 9.1 Head of the Department
9.2 Signature
10 / 10.1Remarks of the
Chairman or Principal
10.2Signature

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