RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 / NAME & ADDRESS OF THE CANDIDATE / MS. HARSHA THOMAS
ACHARYA COLLEGE OF
NURSING
HEBBAL, BANGALORE
2 / NAME OF THE INSTITUTION / ACHARYA COLLEGE OF
NURSING, CHOLANAGAR
HEBBAL, BANGALORE
3 / COURSE OF THE STUDY AND SUBJECT / M .Sc NURSING 1st YEAR
PEDIATRIC NURSING
4 / DATE OF ADMISSION
TO COURSE / 30-06-2008
5 / STATEMENT OF THE PROBLEM / A STUDY TO ASSES THE
EFFECTIVENESS
OF SELF INSTRUCTIONAL MODULE
REGARDING KNOWLEDGE AND PRACTICE ON PREVENTION OF ROAD TRAFFIC ACCIDENTS AMONG ADOLESCENCE IN SELECTED SCHOOLS AND COLLEGES
IN BANGALORE CITY

BRIEF RESUME OF INTENDED WORK

“Life of a man is more precious than wealth, honor, and victory”

Hence, each human being has the responsibility to safeguard their valuable life in this earth.

6. INTRODUCTION

From early times, the automobile has been considered as a dangerous object, hazardous to both life and property.1

Road traffic accident is a sudden unexpected event or injury occurring without any forewarning or it is a sudden cause of death or an emergency of the victim.2

In 2005, road traffic injuries resulted in the death of an estimated 110,000 persons, 2.5 million hospitalizations, 8-9 million minor injuries and economic loses to the tune of 3% of the gross domestic product (GDP) in India. A majority of victims of road traffic injuries are men in the age group of 15-44 years and belong to the poorer sections of society. Also, a vast majority of those killed and injured are pedestrians, motorcyclists, and bicyclists3. Prevalence was found to be significantly associated with lower age and males who are more prone to accidents involving motorcyclists and bike riders. Adolescent males are more likely to enjoy with their friends and prove their individuality and freedom by breaking traffic rules and regulations. So the adolescence has been shown to be significantly correlated to risky driving.4

Moreover, road traffic accidents are more common among young drivers who use alcohol, marijuana, or other drugs while driving. Many young adults are injured every year in road traffic accidents because of reckless driving, poor road facilities, and sporty driving.5

A clearly defined road safety policy, a central coordinating agency, allocation of adequate resources, strict implementation of proven and effective interventions and reliable information systems are urgently required. Greater participation from health and other sectors based on an integrated, inter-sectoral, and coordinated approach is essential. Health professionals can contribute in numerous ways and should take a lead role in reducing the burden of road traffic injuries in India and can provide educational and training programs for the adolescence.3

6.1 NEED FOR THE STUDY

A road traffic accident is defined as any vehicle accident occurring on a public highway ( ie originating on, terminating on, and involving a vehicle partially on the highway). These accidents therefore include collisions between vehicles and animals, vehicles and pedestrians, or vehicles and fixed obstacles. Single vehicle accidents, in which one vehicle alone (and no other road user) was involved, are included.6

Driving or riding a vehicle in India is by large becoming a dangerous experience. And Indian roads like those of other Asian countries are becoming virtual death traps .The over increasing and alarming rate of road accidents is a matter of serious concern for all of us. Of the Worldwide annual average of 700,000 road accidents, 10% occur in India. The latest annual statistics indicate that over 80,000 people are killed on Indian roads. These figures do not reflect the human suffering and social problems by accidents. Nearly three lakh people per year sustain injuries.1

Road traffic accidents are the main cause of death of young men worldwide. 195,000 adolescence are killed each year in traffic accidents. More than 60% of death in adolescence by traffic accidents. Another 10% are severely disabled for life. Accidents were a major cause of total mortality, with the male female ratio being 3.4: 1. 7

The injury and death rates due to road traffic accidents in the year of 2003 in Great Britain was 33,707 and 3,508. That averages to over a hundred people killed or seriously injured on the road every day in 2003.In 2003, the serious injury due to road accidents in Northern Ireland was 1,288 and the number of deaths was 150. That averages to almost four people killed or seriously injured every day in the same year.8

The 1999 World Health Organization “Injury: A Leading Cause of the Global Burden of Disease, “reports that the leading injury – related cause of death among people aged 15-44 years is traffic injuries. Of the 5.8 million people who died of injuries in 1998, 1,170,694 died as a direct result of injuries sustained in a motor vehicle accident. Worldwide, the WHO reports that 38,848,625 injuries were received by the people involved in motor vehicle accidents in 1998.6

This study was conducted on pattern of fatal head injuries due to vehicular accidents in Mangalore. Head injury is an important cause of mortality worldwide as a head is the most vulnerable part of the body involved in fatal road traffic accidents. The present study was undertaken on 682 victims of road traffic accidents who died due to injuries sustained to the head, which were autopsied at District Wenlock Hospital, Mangalore over a period of 5 years between January 1999 and December 2003.The most vulnerable age group was found to be the adolescence. Two wheelers occupants were most commonly involved.9

The health care provider is supposed to help to prevent accidents of youth by educating them to manage the equipments properly by using bike paths, by wearing helmets etc….5

These adolescents are getting into more road traffic accidents compared to the other age groups. So many families loose their adolescents due to these accidents. Some poor families are in pathetic condition because of the loss of their dear and near ones. The modern adolescent population is not very keen on following the rules and regulations of road traffic. So the researcher was motivated to take up this study.

6.2 REVIEW OF LITERATURE

The present study is undertaken to asses the information expected and the information received by adolescent population who are subjected to road traffic accidents. The investigator did an extensive search of the existing literature.

Studies related to road traffic accidents.

Studies related to knowledge and practice on road traffic accidents.

Studies regarding the effectiveness of self instructional module.

STUDIES SHOW THAT THERE ARE INCREASED RISK OF ROAD TRAFFIC ACCIDENTS AMONG ADOLESCENCE

A qualitative study was conducted on young people’s perceptions, in Barcelona, Spain, about the evolution, magnitude, causes and determinants of traffic crashes, to describe their opinions on road safety regulations, and to explore their suggestions and proposals. Interviews were conducted with 43 key informants and 12 focus groups involving 98 participants. The result of the study was that young people admit that fitness, speed cameras, and alcohol breath testing reduce risky driving. They demand information on traffic regulations, and politicians’ decisions and a considerable increase in weekend and night time public transport.10

This multivariate analysis was conducted on road traffic injuries among young car drivers by country of origin and socioeconomic position. The study examines the relationship between country of origin, socioeconomic position and the risk of being injured as a young car driver. It consists of a nationwide follow up of young people in Sweden in which individual census records on country of origin and household socioeconomic position were linked to the Hospital discharge register so as to identify subject’s road traffic injuries as car drivers. The study results do not support the idea that the type of country of origin constitutes a significant mark of risk level for road traffic injuries among car drivers. The results reconfirm that, in Sweden, the risk of road traffic injuries among young drivers from different socio-economic background varies.11

A quasi experimental study was conducted on road traffic injuries among youth: measuring the impact of an educational intervention. It was administered among students from 16 to 19 years old in colleges and universities in the City of Cuernavaca. The educative intervention included radio spots, banners, pamphlets, posters and cards. The measure of impact was established as changes in knowledge about speed, alcohol and the use of seat belts using factors analysis methodologies. The study offers an appropriate methodology to measure short- term changes in knowledge about risk factors associated with a significant problem affecting Mexican youth.12

A qualitative analysis was conducted on understanding high traffic injury risks for children in low socioeconomic areas: Focus groups were conducted in 10 low socioeconomic English districts that also have high rates of child pedestrian injury. The study concluded that, multi- agency partnerships involving the community are increasingly needed to implement traditional road safety approaches, such as education, engineering and enforcement, and provide safety and accessible public space, affordable activities for children, and greater support for parents.13

Studies related to knowledge and practice on road traffic accidents

A study was conducted on knowledge and attitude towards road traffic codes among commercial motorcycle riders in Anambra state. Road traffic accidents (rates) represent a major epidemic of non-communicable disease in the country and has since escalated with the introduction of the new phenomenon of commercial motor cycle transportation such as is found in the two urban towns of Nnewi and Awka of Anambra state, Nigeria

Pre tested semi structured questionnaire method was used. The study was tested on socio demographic and motorcycle characteristics collected from a sample of commercial motor cyclist selected by systemic sampling technique. The findings have shown that the younger motorcyclist possessed statistical significant better knowledge of traffic codes and safety.14

A study was conducted on National young-driver survey: teen perspective and experience with factors that affect driving safety. The goal of the study was to explore the adolescent perspective on driving safety to provide a better understanding of factors that influence safety and teenager’s exposure to driving hazards. It was conducted among 68 high school students in 2006 that included teen-generated items. The result of the study was that adolescence generally understands the danger of intoxicated driving. However, some groups need to better recognize this hazard. Although inexperience is the key factor that interacts with other conditions to cause crashes, adolescence do not recognize what merits experience.15

A questionnaire method was conducted on self reported motorcycle riding behavior among school children in India. It attempts to find out the behavioral and non behavioral factors leading to motorcycle use and the ore-disposition to accidents among male school children aged between 10 and 16 years. The finding has explained how these children behaviorally take up adult roles and seek adult risk taking attitudes. The implications of child motorcycle riders upon children themselves and on the society are discussed for a greater discourse on road safety motorcycle riding policy and to highlight the behavioral and non behavioral factors that are associated with traffic accidents.16

There was a study conducted on young driver risk in relation to parent’s retrospective driving record and it is observed that parents are an important potential influence on the driving safety of their children. It examined the relationship of parental driving record on male and female offspring’s at-fault collision risk. Drivers aged 16 to 21 on the date of full licensure were selected from driver record and a matching process were used to identify putative parents in to-parent households. Results: a) parents of young children should be aware of their role in influencing their children’s future driving risk. b) Risk factors that could be of interest to licensing authorities and the insurance industry.17

Studies regarding the effectiveness of self instructional module

A questionnaire survey was conducted on Japanese high school student’s usage of mobile phones while cycling. The objective of the study is to investigate the perception and actual use of mobile phones among Japaneese high school students while riding their bicycles, and their experience of bicycle crash / near crash. The result of the study was, since mobile phone use while riding a bicycle potentially increases crash risk among cyclists, student bicycle commuters should be informed that cyclists phone usage while riding is prohibited according to the road traffic law.18

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A multi-disciplinary health and development study was conducted on personality factors as predictors of persistent risky driving behavior and crash involvement among young adults. The study population was 1037 young people and the duration was 12 months (from 1 April 1972 to 31 March 1973). The result of the study was that road safety investigations seeking to deter young adult males from persistent risky driving behavior need to be directed at those who do not endorse traditional views, are aggressive and feel alienated from the rest of the society.19

A cross-sectional study was conducted about risk perception, road behavior and pedestrian injury among adolescent students in Katmandu, Nepal. The objective is to examine the relationship between the perceived safety of specified road behaviors, self described road behaviors and pedestrian injury among adolescents. The final conclusion was, adolescents, road behaviors except for compliance with green signals were not significantly associated with pedestrian injury. This suggests that a behavioral approach without modification of the traffic environment might not effectively prevent the occurrence of pedestrian injury in developing countries with poor traffic conditions.20

This data collection was conducted on road traffic mortality in Estonia: Alcohol as the main contributing factor. Traffic fatalities are the leading cause of death among the young and middle aged population in Estonia. The objective of the study was to reveal the pattern of traffic fatalities among the population aged 15-64 years and to determine the role of alcohol in their fatalities. The result of the study was that, the mean blood alcohol concentration (BAC) and percentage of alcohol- related deaths was significantly higher in pedestrian than in driver fatalities. Alcohol intoxication was identified as the most powerful contributing factor to traffic fatalities. The result provides more evidence for politicians to tackle alcohol abuse and unsafe traffic environments.21