RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
SYNOPSIS ON
THE M.SC.(N) DISSERTATION
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING HEALTH PROBLEMS RELATED TO ALCOHOLISM AMONG MALE LABOURERS IN SELECTED CONSTRUCTION SITES IN MANGALORE
Submitted By:
Mr. Arun. S
1st year M.Sc. Nursing student,
Srinivas Institute of Nursing Sciences,
Valachil Padavu, Arkula,
Mangalore – 574 143.
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / NAME OF THE CANDIDATE
AND ADDRESS
(IN BLOCK LETTERS) / MR. ARUN. S
1st YEAR M. Sc. (NURSING)
MEDICAL SURGICAL NURSING
SRINIVAS INSTITUTE OF NURSING SCIENCES,
VALACHIL PADAVU, ARKULA,
MANGALORE – 574 143.
2. / NAME OF THE INSTITUTION / SRINIVAS INSTITUTE OF NURSING SCIENCES,
VALACHIL PADAVU, ARKULA,
MANGALORE – 574 143.
3. / COURSE OF STUDY SUBJECT / M.Sc. NURSING
MEDICAL SURGICAL NURSING
4. / DATE OF ADMISSION / 01-06-2011
5. / TITLE OF THE TOPIC.
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING HEALTH PROBLEMS RELATED TO ALCOHOLISM AMONG MALE LABOURERS IN SELECTED CONSTRUCTION SITES IN MANGALORE
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20. / BRIEF RESUME OF INTENDED WORK
Introduction
“First you take a drink, then the drink takes a drink, then the drink takes you.” - Francis Scott Key Fitzgerald
Ethyl alcohol (ethanol) is a central nervous system depressant. The ingested alcohol is absorbed directly into the blood stream from the stomach and proximal part of the small intestine. Because alcohol is water soluble, it circulates easily throughout the body and readily passes through the blood- brain barrier. Approximately 95% of alcohol is metabolized in the liver, with the remaining 5% being excreted through lung, kidney and skin1. Ethanol is a straight chain alcohol, and its molecular formula is C2H5OH.2

Alcoholism refers to the use of alcoholic beverages that cause damage to the individual, society or both. Alcoholism is one of the major health and social problems all over the world.3
According to the World Health Organization, every year about 2.5 million people die from alcohol-related diseases all over the world, accounting for 3.8 per cent of total deaths. Alcohol-related heart disease, cancer, accidents and suicides contribute to these deaths. Alcohol abuse is more or less a universal problem. There is hardly any effort to discourage the consumption all over the world. Neither are there any statutory warnings.4
India is a dominant producer of alcohol in South-East Asia, with 65 per cent of the total share, and contributes to around 7 per cent of the total alcohol beverage imports into the region. Production doubled from 887.2 million liters in 1992-93 to 1,654 million liters in 1999-2000. It was expected to treble to 2,300 million liters by 2009-2010.5 In Karnataka state, availability of beverage alcohol has risen from 2.96 liters to 6.35 liters. Prevalence rate in an urban slum at Bangalore shows that 27% of males and 2% of females consume alcohol.6
According to current concepts, alcoholism is considered a disease and alcohol a “disease agent” which causes acute and chronic intoxication, cirrhosis of liver, toxic psychosis, gastritis, pancreatitis, cardiomyopathy, peripheral neuropathy and gastro intestinal cancers. In addition to that it’s a leading cause of suicide, automobile accidents, injuries and deaths due to violence. The health problems for which alcohol is responsible are only part of the total social damage which includes family disorganization, Crime and loss of productivity.7
Need For The Study
Construction workers build, repair, maintain, renovate, modify and demolish houses, office buildings, temples, factories, hospitals, roads, bridges, tunnels, stadiums, docks, airports and more. Construction workers include about 5 to 10% of the workforce in industrialized countries. Throughout the world, over 90% of construction workers are male.8
According to the International Labor Organizations 3% to 5% of the working population are alcohol dependent and 25% are risk drinkers. In the past 10 years several international studies have been conducted on alcohol use prevalence and accidents in the workplace & it is found that between 15% and 30% of fatal accidents occurring in the workplace are due to drug use; 20% to 25% of work accidents involve people who are intoxicated; alcohol users are involved in between two and four times more accidents and are absent from work two to three times more often than other employees. Overall, the percentage of workers who abuse alcohol is between 40% and 70 %.8
Some of the reasons workers offer as justification for drug and alcohol use are to relieve tension, stress, frustration, monotony and absence of intellectual stimuli that can occasionally occur at work. Environmental factors include: availability of alcohol or drugs; social pressure to drink; frequent travel that keeps workers away from the stabilizing influence of home; and lack of supervision. Significantly alcoholism affects the worker, his co-workers, employer, and family, as well as society in general. It can mean the loss of a job or income for the worker, worries and harm for their partners, accidents and loss of productivity for employers, instability, disruption of relationships, and internal strife for the family; and, for society as a whole.8
Chronic drinking has major effects on all body systems, causes progressive liver and kidney damage, damages to the stomach and related organs, and slows mental responses frequently leading to accidents and death.9 Alcohol is a direct multisystem toxin and CNS depressant that causes drowsiness, in coordination, slurring of speech, sudden mood changes, aggression, belligerence, grandiosity, and uninhibited behavior. In excess it also causes stupor, coma and death.10
A descriptive study was conducted on alcoholism and construction workers. The objective of the study was to study the alcohol consumption and consequence of alcohol on health, working ability and accidents in construction workers. The Sample consisted of 142 workers from Italy, whose alcohol concentration measured during periodic health surveillance examination. Result had shown that alcohol related disease as a cause of work limitation, work disability and accidents in work sites. This study concluded that there was a correlation between frequency and seriousness of accidents and alcohol consumption in construction workers.11
A study was conducted to find out association between alcohol Consumption and risk of 6 types of concerns (oral cavity, esophagus, colorectal, liver, larynx and breast).
Sample consisted of 390 persons were reviewed and of this 200 were selected for meta analysis. Result had shown that alcohol most strongly increased the risks for cancers of the oral cavity and pharynx 5.7% for the highest alcohol consumption level, esophagus 4.2% and larynx 3.2. Study concluded that Cirrhosis of liver, neoplasm of upper respiratory and digestive tract, haemorrhage stroke, injuries and adverse effect were highly associated with alcoholic consumption.12
Workplace programmes to prevent and reduce alcohol-related problems among employees have considerable potential, because employees spend a lot of time at work, co workers and supervisors may have the opportunity to notice a developing alcohol problem. In addition, employers can use their influence to motivate employees to get help for an alcohol problem.13
The investigator has had personal experiences of seeing many construction workers working under the influence of alcohol. This in turn has led to accidents at the working places, sometimes even loss of life. Nevertheless, these construction workers are unaware of the ill effects of alcohol consumption on their health. Thus the investigator felt the desire to spread the awareness regarding alcohol abuse among construction workers so that steps can be taken to prevent the problems related to alcoholism and to promote health.
Review of Literature
A prospective cohort study was conducted on alcohol attributable burden of incidence of cancer in European countries. The objective of the study was to compare the burden of cancer attributable to current and former alcohol consumption. Data were collected from 10, 9118 men and 25, 4870 women aged 37-70 years from Western Europe. The result had shown that 44% affected with upper aero gastric tract, 33% for liver, 17% colorectal area respectively. This study concluded that an important proportion of causes of cancer can be attributable to alcohol consumption.14
A longitudinal study was conducted to assess the alcohol consumption, binge drinking and coronary calcification. The objective of the study was to assess the association between higher level alcohol consumption and coronary calcification. The sample consisted of 3,037 white and black men and women aged between 18-30 years from US. The result had shown that the prevalence of coronary calcification was 8% in consumption of drinks/week, 9% for 1-6 drinks/week,13% for 7-13% drinks/week and 19% for>14 drink/week, calcification was common among binge drinkers. The study concluded that a direct association between higher alcohol consumption and coronary calcification.15
A clinical study was conducted on effects of chronic alcoholism on male fertility hormones and semen quality. The objective of the study was to evaluate the effects of chronic alcoholism on male fertility hormones and quality of semen. Data were collected from 66 alcoholics free from smoking and drug abuse from addiction treatment center America, by checking complete blood count, biochemical parameters, levels of male fertility hormones FSH, LH, testosterone, progesterone. Result had shown that in alcoholics FSH & LH levels were significantly increased. Testosterone and progesterone levels significantly decreased. This study concluded that chronic alcohol consumption has a detrimental effect on male reproductive hormones and sperm quality.16
A prospective cohort study was conducted to assess the effect of body mass index (BMI) and alcohol consumption on liver disease. The main objective of the study was to investigate whether alcohol consumption and raised BMI act to increase risk of liver disease. The sample consisted of labours from workplaces across central belt of Scotland. The result had shown that BMI and alcohol consumption were strongly associated with liver disease (P=0.001 and P<0.0001). The study suggested that raised alcohol consumption and BMI were significantly associated with liver diseases.17
A descriptive study was conducted to assess the incidence of alcohol use in road traffic accidents (RTA) in South Delhi. The objective of the study was to assess the involvement of alcohol use in RTA. The sample consisted of 500 cases whose blood samples were screened for alcohol by cavett test and then quantified by gas liquid chromatography. The result had shown that, totally 170 cases (34%) were positive for alcohol. The maximum cases (38.2%) belonged to the age group of 20-30 years. The study concluded that there is a significant effect of alcohol consumption to road traffic accidents in South Delhi.18
A cross sectional study was conducted on health problem among migrant construction workers. The objective of the study was to assess the sociodemographic profile and morbidity pattern of construction workers. Data were collected from 1337 workers from Vidyavihar (West) Mumbai. Result had shown that regular consumers of alcohol and tobacco were 50.48 and 14.65%. This study concluded that the morbidity status of construction workers is also associated with tobacco use and alcoholism.19
A descriptive study was conducted on alcohol use, and HIV related risk behaviours among adult men in Karnataka. The objective of the study was to examine the association between alcohol use and HIV risk-related behaviors. Data were collected from 1137 men aged 16-49 years in Karnataka. Results shown that overall 9.5% of all men reported HIV risk-related behaviors, 38.1% consumed alcohol, and about half of all current drinkers met criteria for hazardous alcohol use. The study concluded that alcohol use remained significantly associated with HIV risk related behaviour.20
Statement of the Problem
A study to assess the effectiveness of structured teaching programme on knowledge regarding health problems related to alcoholism among male labourers in selected construction sites in Mangalore.
Objectives of the Study
Objectives of the study are to
Ø  Assess the knowledge of male laborers regarding health problems related to alcoholism.
Ø  Develop and administer STP on health problems related to alcoholism.
Ø  Evaluate the effectiveness of STP by comparing the pre test and post test knowledge scores.
Ø  Find out the association between pre test knowledge scores and selected demographic variables.
Operational Definitions
·  Effectiveness:
Effectiveness refers to improvement in the post test scores after administration of STP on health problems related to alcoholism, which is measured and expressed in terms of knowledge scores.
·  Structured teaching programme:
It refers to structured teaching strategies to improve the knowledge of alcoholism regarding its meaning, major causes, symptoms, and effect of alcoholism on body systems.
·  Knowledge:
Knowledge refers to the correct responses to the questions asked during interview by a questionnaire.
·  Alcoholism:-
Alcohol abuse is a bad habit that is characterized by the sufferer having a pattern of drinking excessively despite the negative effects of alcohol on the individual, work, medical, legal, educational and social life.
·  Health related problems:
It refers to effect of alcoholism on body systems includes nervous system, hepatic system, reproductive system, musculoskeletal system, gastro intestinal system, renal system, blood vessels and injuries.
·  Male labourers:
Male labourers refer to persons who are working in selected construction sites.
Assumptions
·  Male labourers may not have adequate knowledge regarding health problems related to alcoholism.
·  Structured teaching programme may improve the knowledge on health problems related to alcoholism.
·  The knowledge may vary according to selected demographic variables.
Delimitations
The study will be limited to:
·  Male labourers in selected construction sites, irrespective of their habit of
alcoholism.
·  Evaluate the effectiveness of STP only in gaining knowledge.
·  50 male construction workers.
Hypotheses
H1:- The post test mean scores will be significantly higher than the mean pre test knowledge scores of male labourers regarding health problems related to alcoholism.