Effectiveness of self instructional module on knowledge regardingmyocardial infarction and its management among staff nurses

INTRODUCTION

Cardiovascular diseases are the class of diseases that involve the heart or blood vessels. These remain the biggest cause of deaths and hospitalization worldwide and the second cause of death in adults less than age 85. It remains the leading cause of death in adults greater than age 85. Most of the cardiovascular disorders experience an irregular rate and rhythm, without a regular rate and rhythm, the heart may not perform efficiently as a pump to circulate oxygenated blood and other lifesustaining nutrients to all the body organs and tissues. With an irregular or erratic rhythm, the heart is considered to be dysrhythmic.

Myocardial infarction is a disturbance in regular heart rate and/or rhythm due to change in electrical conduction or automaticity. Some arrhythmias can be described as minor arrhythmias which do not usually need treatment, while other major arrhythmias which should be treated as soon as possible and life threatening arrhythmias which require immediate and emergency treatment. Cardiac arrhythmias are conduction disturbances that disrupt normal functioning of the heart, and are named according to the site of origin as sinus arrhythmias, aerial arrhythmias, atrioventricular block, or ventricular arrhythmias. Disturbances are due to three major mechanisms: 1-automaticity, 2-conduction, and 3-problems with re-entry of impulses. Common causes of arrhythmias are acidosis, electrolyte imbalance, early cardiac failure, pain and anxiety.^3,4

Myocardial infarction are common problems encountered in the coronary care unit and represent a major source of morbidity. Arrhythmias are dangerous conditions because they may lead to sudden death or heart failure, so that the importance of accurate and early identification and interpretation of arrhythmia was observed to be important to begin life saving measures. This depends on knowledge of the conduction system, electro cardio-physiologic principles, and process of analyzing electrocardiogram, also action done by the nurses during their interference based on good training and experience. So, updating knowledge regarding arrhythmias and its management by staffs is very essential to ensure effective and safe care.⁵

The ability to recognize normal and abnormal cardiac rhythms is an essential skill for the nurse. Cardiac monitoring is now used in a wide range of hospital, clinic, and home setting. Prompt assessment of Dysrhythmias and its management is very essential to prevent complications.

OBJECTIVES

(i) To assess the existing knowledge regarding myocardial infarction and its management among staff nurses.

(ii) To evaluate the effectiveness of self instructional module on knowledge regarding myocardial infarction and its management among staff nurses.

(iii) To evaluate the effectiveness of self instructional module on knowledge regarding myocardial infarction and its management among staff nurses

(iv) To find association between selected socio demographic variables and pre-test and post-test knowledge score regarding myocardial infarction and its management. 

MATERIALS AND METHODS

Methodology involves the systematic procedure by the researcher, which starts from initial identification of the problem to its final conclusion. The methodology of research indicates the general pattern of organizing the procedure for gathering valid and reliable data for the purpose of investigation. The study conducted was to evaluate the effectiveness of Self Instructional Module on knowledge of staff nurses regarding Myocardial infarction and its management.

The steps undertaken for gathering and organizing the data collected were;

Source of Data: Staff Nurses working at Sir Jayadeva institute of cardiology; Bengaluru, Karnataka.

Research design: Pre experimental one group pre-test post-test design.

Setting: The study was conducted in the Sir Jayadeva institute of cardiology, Bengaluru. Patients with cardiac problems are admitted and treated here.

Population: Staff Nurses working at Sir Jayadeva institute of cardiology; Bengaluru, Karnataka.

Sampling procedure: Purposive sampling.

Sample size: 50 samples.

Inclusion criteria for sampling:

 -Staff nurses who are willing to participate in the study and who consented to participate in the study.

-Staff nurses who were available at the time of data collection.

Exclusion criteria for sampling: 

-Staff nurses not willing to participate in the study

-Staff nurses with Diploma in cardiology nursing.

Instruments intended to be used: 

-Baseline Performa.

-Structured Interview schedule

-Practical scale.

RESULTS:

I. Descriptive statistics: 

-Frequencies and percentage distribution were used for analysis of socio demographic characteristics and level of knowledge.

-Mean, Mean percentage and standard deviation were used for analysing pre-test and post-test scores.

II. Inferential statistics:  

-Application of paired t’ test to ascertain whether there is significant difference in the mean knowledge score of pre-test and posttest values.

-Application of chi-square to find the association between socio demographi variables with knowledge scores.

Table 1 and figure 1 depicts that 16 (32 %) of Staff Nurses had inadequate knowledge and 68 % ( 34) of them had moderate knowledge on myocardial infarction and its management. 

Table 2 and figure 2 depicts the classification of respondents on post test knowledge level on myocardial infarction and its management. 30% (15) of Staff Nurses had moderate knowledge and 70% ( 35) of them had adequate knowledge in post test.

Table 2 and figure 2 depicts the classification of respondents on post test knowledge level on myocardial infarction and its management. 30% (15) of Staff Nurses had moderate knowledge and 70% ( 35) of them had adequate knowledge in post test.

Table 3 depicts the aspect wise pre-test, posttest and enhancement of Knowledge scores on myocardial infarction and its management.

The findings reveals that in the aspect of general information related to general information on myocardial infarction pretest mean percentage knowledge score was 70.8 percentages and 90.4% in post-test with an enhancement in the knowledge by 19.6%, Whereas, in the aspect of myocardial infarction the pre-test mean percentage knowledge score was 56.4 percentage and 87.6% in post-test with 31.2% of enhancement in the knowledge.

Further in the aspect of management of myocardial infarction, the pre-test mean percentage knowledge score was 58.1% and 82.3% in post-test with an enhancement in the knowledge by 24.1%.

The overall mean percentage knowledge score in pre-test was 60.8 percentages and 84.4% in post-test with an enhancement of 23.6%. The statistical paired‘t’ test indicates the enhancement in the mean percentage knowledge scores found to be significant at 5% level for all the aspects under the study.

RESULT: The staff nurses gained knowledge and skill regarding myocardial infarction and its management. 

DISCUSSION:

This chapter deals with the discussion with objectives of the study and hypothesis. The statement of the problem is “a study to assess the effectiveness of instructional on knowledge regarding myocardial infarction and its management among staff nurses at selected cardiac hospital Bengaluru.”

A structured Knowledge questioned was used to cullet the data a pre-experimental one-group pre-test post-test design was used to evaluate the knowledge of 50 staff nurses regarding identification Myocardial infarction and its management. The pretest was followed by implementation of structured teaching programme and post- test was conducted after 7 days to evaluate the effectiveness of teaching programme.

The findings of the study are discussed under the following headings: 

-Demographic characteristics.

-Assessment of knowledge of staff nurses regarding Myocardial infarction and its management.

-Evaluating the effectiveness of structured teaching programme.

- Association between demographic variables and knowledge scores.

LIMITATION: 

-A similar study can be done on a large sample to generalize the findings.

-An experimental study can be undertaken with a control group for effective comparison of the result.

-A study can be conducted by including additional demographic variables.

-A comparative study can be conducted between Nurses working in general and private hospital settings.

CONCLUSION: The finding of this study showed that the self instruction module was effective as evidenced by the result of pre-test and post-test knowledge score. This study has proved that it helps to increase the knowledge regarding the management of myocardial infarction.

The knowledge base for nursing can be developed through nursing education which can be done by integrating the techniques and knowledge into all levels of curricula in nursing education.

More stuadies can be conducted in an experimental methodology and in large scale basis.