KNOWLEDGE ON PRACTICE OF HIV/AIDS –A STUDY AMONG NURSES USING STRUCTURED TEACHING PROGRAMME

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International Journal in Management and Social Science (Impact Factor- 5.276)

KNOWLEDGE ON PRACTICE OF HIV/AIDS –A STUDY AMONG NURSES USING STRUCTURED TEACHING PROGRAMME

M.Jeyarathnama, a*A.Karpagam,a**Kamalaveni a

Retired Professor, Department of Women’s Studies Bharathiar University

a**_{Corresponding Author : Assistant Professor, Department of Women’s Studies, Bharathiar}

University, Coimbatore-641046. Tamil Nadu

Abstract

The adequate knowledge and positive attitude to HIV infection is an important factor in taking care of patients with HIV/AIDS. It will certainly influence HIV/AIDS patients to access quality care they require. Nurses with a positive attitude towards patients with HIV/AIDS will be a great asset for India. Knowledge on practice in this study refers to information or correct responses obtained from the nurses on items such as the nursing care of HIV/AIDS patients, prevention of transmission of HIV/AIDS, care of injury while taking care of HIV/AIDS patients, precautions while taking care of HIV/AIDS patients as measured by the questionnaire. The results of pre-test and post-test scores on knowledge on practice of HIV/AIDS demonstrate that the sample nurses have gained adequate knowledge on practice after undergoing the teaching programme.

Key Words: Knowledge, HIV/AIDS, Practice, Nurses, Teaching Programme Introduction

According to W.H.O. (1948), “Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity” Alteration in any aspect of the above-mentioned is said to be a disease. Disease is a state of discomfort in which the normal functioning of the body is disturbed. There are many types of diseases such as communicable and non-communicable, curable and incurable1. A disease is said to be non-communicable if it does not spread from one person to another and communicable diseases are also known as infectious diseases and which will spread from one person to another. AIDS, tuberculosis, malaria, hepatitis, chickenpox measles, mumps, typhoid, polio, influenza are communicable diseases. Among the various types of diseases AIDS is fatal which does not have a cure but it is preventable2. The Human Immuno Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is a global health problem with a rising number of cases and associated deaths.

The Government of India estimates that about 2.40 million Indians live with HIV, many have died from the effects of the virus, and many others still live with HIV/AIDS. “AIDS, is difficult to get, impossible to cure but, easy to prevent”3. The Worldwide HIV & AIDS statistics commentary points out that, according to UNAIDS, WHO and UNICEF Report, 2012, more than 35 million people live with HIV/AIDS and about 3.3 million were below the age of 15. An estimated 2.3 million people are newly infected with HIV and 260,000 are under the age of 15. Every day nearly 6,300 people contract HIV and nearly 262 every hour. In 2012, 1.6 million people died of AIDS, 210,000 out of them were under the age of 15. Since the beginning of the epidemic, more than 70 million people have contracted HIV and 2 nearly 36 million have died of HIV/AIDS related causes. Since 1995, 2.5 million AIDS-related deaths have been slightly delayed in low and middle income countries like India, Bangladesh, Africa, South Africa and Indonesia4.

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before the workshop. Knowledge score improved about 61.4% among nurses after workshop. The attitude towards caring for HIV/AIDS patients was significantly promoted after conducting workshops. The researchers concluded that education/training programmes is necessary in improving nurses’ knowledge level and more positive attitudes. The study by Nyamathi et al. in 2005 among nurses showed that HIV knowledge was improved significantly from pre-test to post-test7. Turner et al. (1988) in his study held five-hour seminar about HIV/AIDS among hospital nurses for improving their HIV/AIDS knowledge and infection control methods and also their attitudes in care of HIV/AIDS patients. The results showed significant change in AIDS knowledge, infection control, and attitude towards caring for HIV/AIDS patients for those who attended the seminar. The results of the study showed that AIDS training programmes can decrease fear of contagion and negative attitude towards care of HIV/AIDS patients (O'Donnell et al. 1987).

The study of Pisal et al. (2007)8 among nurses reinforced the same results. Nurses provide life-saving and life-enriching care throughout the world. They are primary care providers for HIV/AIDS patients. They need to have a sound and solid foundation of knowledge and a positive attitude towards HIV/AIDS patients. The nurses are the source of information for the patients and the relatives. Once the knowledge improves, skill will also improve. Improvement in knowledge and skill will help in developing self-confidence in caring for HIV infected patients. The adequate knowledge and positive attitude to HIV infection is an important factor in taking care of patients with HIV/AIDS. It will certainly influence HIV/AIDS patients to access quality care they require. Nurses with a positive attitude towards patients with HIV/AIDS will be a great asset for India.

Statement of the Problem

Employing universal precautions means taking precaution with everybody. If precautions are taken by every health care worker they do not have the risk of infection. Precautions include washing hands with soap and water before and after procedures. The six steps of hand washing technique, using protective barriers such as gloves, gowns, aprons, masks for direct contact with blood and other body fluids, wearing of personal protective equipments with disinfecting instruments and other contaminated equipment should be adhered. Soiled linen should be handled as little as possible, and disposable syringe should be discarded immediately without recapping in puncture-proof container. After use needles should be placed in puncture-resistant container filled with freshly prepared one percentage hypochlorite solution and while disposing syringe it should be incinerated.

In case of Needle Stick Injury let the wound bleed freely without pressing it, and the wound may be washed thoroughly under running water with soap for about two minutes. The hand may be dipped in undiluted savlon for 15 second. The injury may be reported to appropriate hospital authorities. Soiled linen should be placed in impervious laundry bag in the patients’ room. The bag should be labelled ‘Biohazard’ and should follow double bag technique. Soiled linen should be handled with gloved hand and soak it in one percentage hypochlorite solution for ½ hour and washed with detergent. In case there is a splash on the skin / gloves are torn, hands should be washed thoroughly with soap and water for 2 minutes after the removal of gloves under running water.

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otherwise called as “SLIM” disease. Because of its wide ranging health implications, AIDS touches all aspects of primary health care. It is important that AIDS education has to be enforced to the public. Diagnostic testing with counseling may be useful in gauging the magnitude and course of epidemic. As nurses take a major role in health care system nurses attitude and knowledge has to be enhanced well.

Nurses have an important role in prevention, treatment and care of people living with HIV/AIDS. However, research studies have shown that stigmatizing attitudes against HIV/AIDS is still prevalent among health care personnel and nurses and that there is lack of knowledge about HIV/AIDS among nurses. The need for educating them is frequently highlighted in many studies. There is an imperative need to assess the nurses’ knowledge on practice of HIV/AIDS and provide them suitable training to educate them. The result of the study will help to develop right type of educational programme to deal with HIV patients effectively. Hence the study assumes paramount importance.

Objectives

To study the profile of the respondents

To assess the levels of knowledge of HIV/AIDS, and knowledge on practice of HIV/AIDS, before and after the structured teaching programme.

Scope of the Study

The present study is undertaken to assess the current knowledge of staff nurses working in PSG Hospitals, Coimbatore and their level of knowledge after undergoing the teaching programme. It covers the respondents’ knowledge on practice of HIV/AIDS before and after the teaching programme. The study is made from the point of view of nurses only.

Operational Definition

Knowledge on Practice of HIV/AIDS

Knowledge on practice in this study refers to information or correct responses obtained from the nurses on items such as the nursing care of HIV/AIDS patients, prevention of transmission of HIV/AIDS, care of injury while taking care of HIV/AIDS patients, precautions while taking care of HIV/AIDS patients as measured by the questionnaire.

Sampling Design

The population for the study consists of nurses who have been working in all departments in PSG Hospitals. There were 600 staff nurses on the roll of the hospital. A total of 400 nurses, 2/3 of the total population was selected from all the departments through random sampling method. Lottery method has been adopted for this purpose.

Null Hypotheses

1. There is no significant difference between the pre-test and post-test scores with regard to knowledge on practice of HIV/AIDS

Framework of Analysis

Respondents’ levels of knowledge on practice of HIV/AIDS were assessed by using nominal scale. For this purpose a questionnaire containing 20 questions was given to the respondents who were asked to express their opinion on knowledge on Practice of HIV/AIDS. Score one is given for right answers and score zero is given for wrong answers. On the basis of the scores obtained, the respondents are categorized into three distinct groups such as adequate level of knowledge on practice, moderate level of knowledge on practice and inadequate level of knowledge on practice.

Levels of Knowledge on Practice of HIV/AIDS

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nurses with inadequate level of knowledge on practice, moderate level of knowledge on practice and adequate level of knowledge on practice. Arithmetic mean and standard deviation of the total scores of 400 respondents have been computed.

Adequate Level of Knowledge on Practice

Nurses whose total scores are more than the arithmetic mean plus standard deviation have been classified as nurses with adequate level of knowledge on practice.

Adequate level of knowledge on practice ≥ Arithmetic mean + Standard Deviation ≥ 18.74 + 1.17 = 19.91 ≥ 20

Inadequate Level of Knowledge on Practice

Nurses whose total scores are less than arithmetic mean minus standard deviation have been grouped as nurses with inadequate level of knowledge on practice. Inadequate level of knowledge on practice ≤ Arithmetic mean - Standard Deviation

≤ 18.74 - 1.17 = 17.57 ≤ 18 Moderate Level of Knowledge on Practice

Nurses whose total scores fall between the two extremes have been considered to be respondents with medium level of knowledge on practice.

Moderate level of Knowledge on practice = 18 to 20

In the pre-test the mean score is 9.60 and the standard deviation is 1.88. In the post-test the mean score is 18.74 and the standard deviation is 1.17. Nurses who have obtained scores more than 11 for pre-test and 20 for post-test are grouped as having adequate level of knowledge on practice. Nurses who have obtained scores less than 8 for pre-test and less than 18 for post-test have been classified as having inadequate level of knowledge on practice. Nurses who have obtained scores between 8 to 11 for pre-test and 18 to 20 for post-test have been classified as having moderate level of knowledge on practice.

Table 1

Presents pre-test and post-test scores of Level of knowledge on practice of HIV/AIDS

Sl. No. Level of Knowledge on Practice

Pre-test Scores

% Post-test

Scores

%

1 Inadequate 17 4 0 0

2 Moderate 380 95 24 6

3 Adequate 3 1 376 94

Total 400 100 400 100

It is observed from the table that a nurse with moderate level of knowledge on practice is more in number (380) in the pre-test. The post-test score reveals that there is an upswing in the number of nurses (376) with adequate knowledge on practice

Table 2

Knowledge on Practice of HIV/AIDS –‘t’ Test

Test Pre-test Post-test ‘t' Value

Mean 9.60 18.74 2.26

SD 1.88 1.17

P<0.05=1.645

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nurses had enhanced their knowledge on practice of HIV/AIDS after undergoing the teaching programme. Education is found to be effective.

The knowledge on practice of HIV/AIDS is studied in terms of four dimensions such as 1. Nursing care of patients

2. Prevention of transmission of HIV/AIDS 3. Care of injury while taking care of HIV/AIDS 4. Precautions while taking care of HIV/AIDS

In the pre-test the respondents’ knowledge on practice of HIV/AIDS is abysmal with regard to the fact that a patient needs emergency blood transfusion blood is screened for HIV/AIDS which is an aspect of the dimension ‘Nursing care of HIV/AIDS patients’. Their knowledge is not adequate with regard to the aspect “A client diagnosed to be HIV positive has to be admitted and given care in general ward” as the score is 168.

The higher post-test scores for all aspects of the dimensions, the mean value (6.69) and the higher t-value (53.82) show that there is a significant improvement in the respondents’ knowledge on practice of HIV/AIDS. Knowledge on practice of HIV/AIDS with regard to “Put bleaching powder on the blood to prevent the transmission of HIV infection if blood spilled on the floor” (145) is low which is an aspect in the dimension ‘Prevention of transmission of HIV/AIDS’. The post-test score reveals that there is an improvement in all aspects of this dimension, particularly with regard to “Gowns are worn to protect the skin of personnel from blood and body fluid exposures”. The higher post-test mean value (4.67) and the t-value (45.11) show that there is a significant improvement in all aspects of this dimension.

In the dimension ‘Care of injury while taking care of HIV/AIDS Patients’ all the aspects have shown higher post-test score. The low pre-test score of the respondents shows that the nurses have little knowledge on practice of HIV/AIDS. Regarding the aspect “All health care workers should take precautions when cleaning used instruments and during disposal of used needles to prevent injuries caused”. The higher post-test mean value (2.73) and the t-value (33.38) prove that there is a significant improvement regarding care of injury of patients after undergoing the teaching programme. There is an increase in all the aspects of the dimension ‘Precautions while taking care of HIV/AIDS patients’ in the post-test. The higher post-test mean value (4.67) and the t-value (36.83) prove that there is a significant improvement regarding precautions while taking care of HIV/AIDS patients after the teaching programme.

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