6. BRIEF RESUME OF THE WORK INTENDED STUDY

6.1. INTRODUCTION

The eyes are the amulets of the mind

-William R Alger

There are lakhs of children and adults in India who are blind. They know only one color that is black. If people donate their eyes, they are giving vision to two blind people and making their life self dependent and joyful. 1

Blindness is the condition of lacking visual perception due to physiological or neurological factors. Blindness is the inability to see, the leading cause cataract, glaucoma, age-related macular degeneration, corneal opacities, diabetic retinopathy, trachoma and eye conditions in children example: vitamin A deficiency. 2

Today according to WHO estimation 40 to 45 million people world wide are blind. Out of this nearly 60% reside in Africa, China and India. Despite a half century of efforts, the global burden of blindness is growing largely because of the population growth and aging. If additional resources are not urgently mobilized and efforts are not made to curb this trend by 2020. The burden can double. The developing countries will bear the brunt.3

The cornea is the clear window covering the front of the eyes. It is the main focusing element of the eyes. Vision will be dramatically reduced if the cornea becomes cloudy from disease. Corneal blindness means that one’s cornea, which is transparent and thin outer layer of the eye, becomes clouded due to injuries, infections, chemical burns and nutritional deficiency especially in childhood. A surgical procedure which replaces damaged or injured cornea with a similarly shaped piece of a healthy cornea from a donor is called corneal transplantation.4

In the aspect of eye donation, only cornea can be transplanted. The entire eye may be used for research and education. The eyes are donated because there is no substitute for human tissue. The transplantation process depends upon the priceless gift of corneal donation from one human to the next. Donated and corneal tissues are used for research, education and transplantation.5

The eyes must be donated because to begin with for a selfish reason, our eyes can live even after our death. Secondly, more importantly, we can light the life of two blind people by donating our eyes after our death. Thirdly not to mention, eye donation is the noblest of all causes.6

Practically any body from the age of one can be an eye donor. There is no maximum age limit. Poor eye sight and age make no difference. Those who wear spectacles, those who have had cataract surgery, diabetes and those who are hypertensive can donate eyes. Even a person who is blind from retinal or optic nerve disease can donate eyes, provided the cornea is clear. Those who have died of unknown causes or due to infectious rabies, syphilis, infectious hepatitis, septicemia, and AIDS can not be donors. One can bequeath eyes by taking a pledge, resolving to donate them after death. But it requires the help of relatives or friends to carry out the pledge and desire. The next of kin can give consent for a donation even if the diseased family member has not signed a pledged form.5

The eyes need to be collected within six hours of death, so the eye bank has to be called as early as possible. After making the call, both eyes will need to be closed and covered with moist cotton. The removal will leave no visible signs that would interfere with common funeral arrangements and practices. Entire procedure takes 5-20 minutes only. There is no religious conflict involved. The donation actually gives a gift of life or sight to others. As such, it is consistent with the belief and attitudes of all major religious and ethical traditions.5

A living person cannot donate eyes. A recipient is not told who donate the eye. The gift of sight is made anonymously. An eye bank obtains, medically evaluates and distributes eyes donated by caring individuals for use in corneal transplantation, research and education. Eye banks are non-profit organizations. The donated eyes and the donor’s medical history are evaluated by the eye bank in accordance with the eye bank association of America’s strict medical standards. This association provides standards for eye banks to use in training personnel to evaluate donor eyes.5

Amongst all the primary human rights one of the important right is “Right to Sight”. It is very important that no person should unnecessarily become blind or remain blind. So if it is possible for one to help the blind to gain the vision by means of man power or money power, than one should actively spent his power for a worthy charitable cause i.e.. Blindness control and eradication.7

A study was conducted in Department of Community Medicine Maulana Azad Medical College, New Delhi to asses the perception and willingness of 180 first year medical students towards eye donation. By administering a pre-tested semi-structured questionnaire. The result shown that 41.1% of students knew that the ideal time of donation was within six hours of death and less number of students were willing to pledge their eyes for the donation. The study suggests that mass media such as television, news papers, magazines and posters were important sources of information on eye donation.8

6.2. NEED FOR THE STUDY

India has the largest burden of global blindness. A considerable number Indians also suffer from significant impairment of vision that threatens their ability to be physically or financially self sufficient. The cumulative loss country’s gross national product consequent to this is estimated to be 11.1 billion. While the problem is formidable, need to take up the challenge of curtailing is compelling.5

In India there are approximately 120 lakh blind in both eyes and 80 lakh blind in one eye, which is about 1/4th of the total blind population of the world. This means 14.9out of every 1000 people in India are blind compared to just 3 per 1000 in the developed countries. Blindness in most cases is avoidable i.e... Either preventable or curable. Out of 120 lakh blind, approximately 103 lakh are curable by relatively simple operations, unfortunately yet they remain uncured. About 96 lakh persons suffer from cataract which can be cured by a simple operation. Severe lakh of Indian population suffering from corneal blindness, mostly children in their early childhood, can be cured by Eye donation.4

Some 27 million Indians have moderate sight impairment. 9 million are classified as bilateral blind. 2, 60,000 children are blind. The number of corneal blind people in India is 4.6 million of these 90% are below 45. They include 60% who are below 12 years of age. Looking at the root causes, 66% of the cases are preventable or curable. Out of the 4.6 million people, at least 3 million can benefit from Eye donation.5

Out of the 9,500,000 deaths that occurred in the country of year 2007, only a mere 10,000 had opted for Eye donation. This is in contrast to the demand of about one million Eyes per annum. Well, some experts like to believe that such a callous attitude on part of society is due to a lack of a concerted effort on a national scale by every one who needs to involve namely, professionals, the media, government, voluntary organizations and civil society at large.6

There is a severe lack of donor eyes in India and only 5,000 operations are being performed every year, while more than 30,000 new victims are added each year to the total list of 7 lakhs patients to be cured. In spite of having professional surgeons, corneal transplantation can not be carried out due to lack of donor corneas. In India there are more than 80 lakh deaths every year but sadly the corneal donations do not exceed a few thousand. The reason for this may be

  • Lack of awareness in general public.
  • Improper development of infrastructure in villages.
  • Absence of motivation even among the trained personnel.
  • Social & religious taboos.1

There are superstitions and strange beliefs to contend with, especially in rural areas.

  • The belief that one will be born disfigured or blind in the next birth if eyes are removed before cremation or burial.
  • The misconception that the process of eye donation involves hassles like taking the dead person to the hospital and waiting for procedures.
  • Finally, if consent and cooperation of family members or survivors is not there, then even an eye pledge form from the donor is useless.6

So, it is the time that people and corporators start making difference. It’s time people all opened their eyes to eye donations. Here’s peoples get chance to gift a life. Become an eye donor today.6

Over 90% of all corneal transplant operations performed each year successfully restores vision to people suffering from corneal blindness. Donated human eyes and corneal tissue are also used for research and education. More than 35,000 eyes are used annually for research and education. Research in to glaucoma, retinal disease, complications of diabetes and other sight disorders benefit from donations because many eye problems can not be simulated and only human eyes can be used. These studies advance the discovery of the causes and effects of specific eye conditions and lead to new treatments and cures.6

Other than these, there are a few more compelling reasons why the people need to donate their eyes and these includes,

  • 1.5% of the population is unnecessarily blind.
  • 2.5% of the population lives below the poverty line.
  • 2.5 million Children are suffering, including those who don’t have the correct spectacles.
  • 32% people are under 15.
  • 60% of blind children will not make it to adulthood. A cumulative economic loss of India’s GNP of US $11.1 Billion
  • 75% of people live in rural areas.
  • There are 12,000 ophthalmologists in the country but the majorities of them live and work in the urban areas.
  • 40% of people live in central and north India where there is little access to quality eye care services.6

A study was conducted in Madurai, India to determine the awareness of eye donation and corneal transplantation in an adult population of southern India. This study was conducted on 507 participants by using systemic random sampling and interviewed using a structured questionnaire. The result reveals that 50.69% were aware of eye donation and only 4.34% participants were aware that eye donation had to be done within 6 hours of death and 79.50%were not aware of corneal transplantation. So the study conclude that multiple strategies are currently followed to increase awareness of eye donation and corneal transplants, more innovative strategies have to be developed.9

Investigator being impressed by the need for donating the eyes to light the life of blind over leading the life in the agony determined to device the strategy to promote eye donation behavior among people. Since the investigator realized the truth that the nurses can influence on the mass, and they are always with the people and meant for good health educator can improve the knowledge and modify the attitude of general public towards eye donation. So if they are well informed about need and importance of eye donation they communicate the knowledge and motivating peoples for eye donation.

6.3. STATEMENT OF THE PROBLEM

“ A study to assess the effectiveness of structured teaching programme on knowledge and attitude regarding eye donation among the Final year B.Sc Nursing students of N.D.R.K. College of Nursing at Hassan District, Karnataka.”

6.4. OBJECTIVES

1. To assess the knowledge and attitude of Final YearB.Sc Nursing studentsregarding the eye donation before administration of structured teaching programme.

2.To develop and administer structured teaching programme regarding eye donation.

3. To assess the knowledge and attitude of Final YearB.Sc Nursing students regarding the eye donation after administration of structured teaching programme.

4.To evaluate the effectiveness of structured teaching programme by comparing pre and post test knowledge and attitude scores regarding eye donation among the Final YearB.Sc Nursing students.

5. To assess the association between the selected demographic variable and the post test knowledge and attitude scores regarding eye donation among theFinal YearB.Sc Nursing students

6.5. HYPOTHESIS

H1:- There will be a significant difference between the pre and post test knowledge and attitude score regarding eye donation among the Final YearB.Sc Nursing students.

H2:- There will be a significant association between selected demographic variable with the post test knowledge & attitude scores regarding eye donation among Final YearB.Sc Nursing students.

6.6. ASSUMPTION

1. The Final YearB.Sc Nursing studentswill be having less than adequate knowledge regarding eye donation prior to the administration of structured teaching programme.

2. Administration of structured teaching programme will promote the knowledge and develops the positive attitude towards eye donation among the Final YearB.Sc Nursing students

6.7. OPERATIONAL DEFINITIONS

  • ASSESS: - It refers to an activity to estimate the outcome of the structured teaching programme on knowledge and attitude regarding eye donation as revealed by suitable knowledge questionnaire and attitude rating scale.
  • EFFECTIVENESS: - It refers to significant increase in the level of knowledge and attitude ofFinal YearB.Sc Nursing students regarding eye donation which is measure from the response of pre test, structured teaching program and post test.
  • STRUCTURED TEACHING PROGRAMME: -It refers to systematically organized instruction on knowledge and attitude regarding eye donation forThe Final YearB.Sc Nursing students of N.D.R.KCollege of Nursing..
  • KNOWLEDGE: - It refers to the understanding and awareness of Final YearB.Sc Nursing studentsregarding eye donation.
  • ATTITUDE: - It refers to the expressed belief and feeling ofFinal YearB.Sc Nursing students regarding eye donation.
  • EYE DONATION: - Eye donation is a process where eye is removed from the body of a deceased person after obtaining consent of the relative(s) closest to him/her. The cornea of such eye is transplanted in the eyes of patients blinded by corneal diseases.
  • FINAL YEAR B.Sc NURSING STUDENTS: - The students who are studying

in Final Year Bachelor of Science in Nursing at N.D.R.K. College of Nursing,

Hassan.

6.8. CRITERIA FOR SELECTION OF SAMPLE

Inclusion criteria:

1. Students who are studying in Final Year B.Sc Nursing at N.D.R.K. College of Nursing,HassanDistrict.

2. The Study will include the Final Year B.Sc Nursing Students who are present at the time data collection.

Exclusion criteria:

1. Students those who are studying I, II, III year of B.Sc Nursing.

2. Students who are not present at the time of data collection.

6.9. DELIMITATION OF THE STUDY

  1. The study is limited to the N.D.R.K.College of Nursing students those who are

Studying Final Year B.Sc Nursing

  1. Study period is limited to 4-6 weeks of duration.

3. Sample size is limited to 60Final Year B.Sc Nursing Students.

4. The study design is limited toQuasi experimental study with randomization, manipulation without control group.

6.10. SIGNIFICANCE OF THE STUDY

The study signifies the importance of structured teaching program on eye donation and it will enhance the knowledge of Final Year B.Sc Nursing Studentsregarding eye donation and it will motivateFinal Year B.Sc Nursing Students to donate the eyes and they may change the attitude of general people and make them to donate eyes in future where they work.The students themselves will be a role model for the society because as per the Statistics 120 lakh blind people needed of eyes in India. Hence we can reach theVISION 2020 effectively i.e.. THE RIGHT TO SIGHT.

6.11. CONCEPTUAL FRAME WORK

Conceptual frame work is based on the General System Theory

6.12. REVIEW OF LITERATURE

Literature review is standard requisition of scientific research. It means reading and writing the pertinent information of the attempt in research topic. It also support and explained why the proposed topic is taken for research and avoids unnecessary duplication explore the feasibility and illuminate the way of new researcher.

A study was conducted by P.Jena, et al (2007) at Department of community medicine and Ophthalmology, M.K.C.G.MedicalCollege, Brahamapura on 1st year medical students. The aim of the study is to assess the knowledge of 1st year medical students on eye donation. By using cross sectional study on 107 students. The result reveals that all were aware of eye donation. However some of them ignore about the aspects of eye donation. More emphasis should be given on eye donation and eye banking in under graduate courses.10

A study was conducted by Espindola RF, et al (2007) at Department of Ophthalmology, Brazil to compare the knowledge of medical students about the corneal donation. A questionnaire containing multiple choice questions about the subject was applied to 402 medical students in that 140 were of group A and 262 of group B. The result shows that knowledge between the two groups was different but not statistically significant (P=0.8328). Is concluding that knowledge about the corneal donation process among the interviewed seemed to be in sufficient, even those who had studied Ophthalmology? Information and education about transplants in medical schools should be improved.11

A study was conducted by Farias RJ, et al (2008) in Portuguese to enumerate the marketing role of corneal donation and donor’s socio-economic profile. Retrospective study was conducted on 93 donor families. The result revealed that 82.9% of the corneal grafts were donated through the efforts of the procurement coordination team. This concludes that the role of the media and Institutional creditability are mandatory for public commitment to eye donation.12

A study was conducted by Omer Ashraf, et al (2005) at MedicalCollege, Aga KhanUniversity, Karachi, Pakistan to assess the knowledge, attitude and practices of the people of Pakistan regarding eye donation. Systematic sampling was used and interviewed on 357 medical and surgical patients. The result shows that 59.9% of the populations were willing to donate their eyes. Knowledge of eye donation was significantly associated with education and socio economic statistics. Willing to donate had a significant association with gender. This study conclude that awareness of eye donation and the knowledge that eye donation can give lives was also significantly associated with willingness to donate.13