RJNS Vol No: 14 Issue No: 2 eISSN: pISSN:
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M Raghavendran1 , S Andal2
1 Professor, Faculty of Nursing, Rama University, Kanpur.
2 MSc student, Faculty of Nursing, Rama University, Kanpur.
*Corresponding author: Raghavendran M, 1 Professor & HOD, Department of Medical Surgical Nursing, Rama College of Nursing, Rama University, Mandhana, Kanpur, UP, India. Email: ragharev@gmail.com
Received date: June 3, 2021; Accepted date: June 17, 2021; Published date: June 30, 2021
Abstract
The incidence of myocardial infarction (MI) in the world varies greatly. A Spanish study reported crude coronary heart disease (CHD) incidence rate as 300.6 per one lakh per year for men and 47.9 per one lakh per year for women. Education about lifestyle modifications for myocardial infarction patients helps to improve the quality of life. The objectives of the present investigation were to assess the knowledge and attitude regarding lifestyle modifications, to assess the effectiveness of structured teaching program, to associate the level of knowledge and attitude with selected demographic variables and to correlate the level of knowledge with attitude. An evaluatory approach with one group pre-test post-test design was used. Thirty myocardial infarction patients selected by purposive sampling technique were included in the study. The result showed that in pretest, among 30 MI patients, 19 (63.3%) had inadequate knowledge and 11 (36.7%) had moderately adequate knowledge on lifestyle modifications. In post-test, among 30 MI patients, two (6.7%) had inadequate knowledge, 16 (53.3%) had moderately adequate knowledge and 12 (40%) had adequate knowledge on lifestyle modifications. Regarding the attitude of 30 subjects included in the study, six (20%) demonstrated positive attitude and 24 (80%) demonstrated negative attitude for life style modifications in pre-test. In posttest, 19 (63.3%) demonstrated positive attitude and 11 (36.7%) demonstrated negative attitude regarding life style modifications among MI patients. There was highly significant difference in the mean score of knowledge and attitude on lifestyle modifications between pre-test and post-test groups after structured teaching program among myocardial infarction patients. The study concluded that STP was effective in improving the level of knowledge.
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Introduction
The incidence of myocardial infarction (MI) in the world varies greatly. A Spanish study reported crude coronary heart disease (CHD) incidence rate as 300.6 per one lakh per year for men and 47.9 per one lakh per year for women.1 The incidence of MI in India was reported as 64.37/1000 people in men aged 29-69 years. Alcohol intake led to 30% lower CHD incidence. Smoking is known to cause arterial thrombosis and MI, and is known to cause endothelial dysfunction.2 More than 80% of the cases of cardiovascular disease are in developing countries. However, studies on risk factors were mostly conducted in developed countries.3 Hence, it is important to carry out relevant studies in a developing country such as ours, in order to study the risk factors and their influence. One in four deaths in India are because of CVDs, with ischemic heart disease and stroke responsible for >80% of this burden. These diseases tend to affect patients in the most productive years of their lives and result in catastrophic social and economic consequences.4
Education about lifestyle modifications for myocardial infarction patients helps to improve quality of life. The National Heart Attack Alert Program (NHAAP) was established to reduce the risk of acute myocardial infarction. The major goal of this program was to increase public awareness on signs and symptoms of acute myocardial infarction. Nurses can play a major role in educating patients, families and communities about the importance of early recognition and treatment of cardiac symptoms. Lifestyle modifications, acute intervention and various well documented pharmacological treatment options beneficially affect prognosis and survival of patients with ischemic heart disease and myocardial infarction.
Statement of the Problem
A study to assess the effectiveness of structured teaching program on the knowledge and attitude regarding lifestyle modifications among myocardial infarction patients admitted in selected Hospitals, Kanpur.
Objectives
- To assess the knowledge and attitude regarding lifestyle modifications among myocardial infarction patients.
- To assess the effectiveness of structured teaching program on the knowledge and attitude regarding lifestyle modifications among myocardial infarction patients.
- To associate the pretest knowledge and attitude of lifestyle modifications among myocardial infarction patients with certain demographic variables.
- To correlate the level of knowledge with attitude of lifestyle modifications among myocardial infarction patients.
Hypothesis
There is a significant difference between pre-test and the post-test knowledge on lifestyle modifications among patients with myocardial infarction after structured teaching program.
There is a significant difference between pre-test and the post-test attitude on lifestyle modifications among patients with myocardial infarction after structured teaching program.
Research Methodology
Research Design: Pre-experimental One Group Pre-test and Post-test Design
Variables
Independent variable - Structured teaching program on lifestyle modifications of myocardial infarction patients.
Dependent variable - Knowledge and attitude on lifestyle modifications of myocardial infarction patients.
Setting of the Study: This study was conducted in medical and cardiology wards of selected hospitals, kanpur
Sampling Technique: Purposive sampling technique was adopted to select the patients for the study.
Sample Size: Thirty patients with myocardial infarction who met the inclusion criteria were selected.
Description of Tools: The tool was developed through extensive review of books. The structured questionnaire comprised of three sections - Section 1 consisted of demographic data of the subjects such as age, gender, educational Status, occupation, monthly Income, previous knowledge regarding MI.
Section 2 consisted of structured questionnaire with 25 multiple choice items to assess the knowledge regarding life style modifications among MI patients. Each correct answer was scored (1) mark and each wrong answer scored (0) marks. Maximum score was 25 marks.
Section 3 consisted of attitude scale containing 20 questions related to attitude on lifestyle modifications. Responses for each question were recorded as a fivepoint scale from Strongly agree to Strongly Disagree, with a maximum score of 5 point and a minimum of 1 point according to the statement.
Results
The study results are described in the following sections:
Section A: Analyzing the level of knowledge regarding lifestyle modifications
Section B: Analyzing the level of attitude regarding lifestyle modifications
Section C: Analyzing the effectiveness of structured teaching program on knowledge and attitude regarding lifestyle modifications
Section D: Association between the level of knowledge and attitude with the selected demographic variables
Section E: Correlation between the level of knowledge and attitude
Section A: Analyzing the level of knowledge regarding lifestyle modifications
Table 1 shows the frequency and percentage distribution of level of knowledge on lifestyle modifications among MI Patients. In pre-test, among 30 MI patients, 19 (63.3%) had inadequate knowledge and 11 (36.7%) had moderately adequate knowledge on lifestyle modifications. In post-test, among 30 MI patients, two (6.7%) had inadequate knowledge, 16 (53.3%) had moderately adequate knowledge and 12 (40%) had adequate knowledge on lifestyle modifications.
Table 2 depicts mean and standard deviation of knowledge regarding lifestyle modifications in pretest and post-test among MI patients. Regarding the knowledge on lifestyle modifications, the pre-test mean score recorded was 39.08, with standard deviation 11.29 and the post-test mean score was 79.08 with standard deviation 7.28.
Section B: Analyzing the level of attitude regarding lifestyle modifications
Table 3 shows that out of 30 samples, six (20%) demonstrated positive attitude and 24 (80%) demonstrated negative attitude towards lifestyle modifications in pre-test. With post-test, 19 (63.3%) exhibited positive attitude and 11 (36.7%) exhibited negative attitude towards lifestyle modifications among MI patients.
Table 2 depicts the mean and standard deviation of attitude regarding lifestyle modifications in pre-test and post-test among MI patients. Regarding the attitude towards lifestyle modifications, the pre-test mean score recorded was 5.6 with standard deviation 2.3 and in post-test, a mean score of 13.4 with standard deviation 3.6 was recorded.
Section C: Analyzing the effectiveness of structured teaching program on knowledge and attitude regarding lifestyle modifications
There was a highly significant difference in the mean score of knowledge and attitude on lifestyle modifications between pre-test and post-test groups after the structured teaching program was conducted among myocardial patients. Hence, hypothesis H1 was accepted.
Section D: Association between the level of knowledge and attitude with the selected demographic variables
The association between the level of knowledge and attitude with selected demographic variables of MI patients was non-significant.
Section E: Correlation between the level of knowledge and attitude
The r values for pre-test and post-test overall knowledge and overall attitude on lifestyle modifications in myocardial infarction patients were 0.141 and 0.315. There was a positive correlation between the level of knowledge and attitude on lifestyle modifications in myocardial infarction patients. Hence, hypothesis H2 was accepted.
Nursing Implication
Its a challenge for continuing nursing education to keep up with the new scientific and technology developments. Educational programme plays a major role in shaping the future of the profession of nursing service.
Nursing Education
Nursing may be defined as a therapeutic and educative process in meeting health needs of the society. The present study emphasizes the effectiveness of planned teaching program on knowledge regarding lifestyle modifications in myocardial infarction patients. In order to educate the patient, it is essential that nurses are competent and have sound knowledge to improve the level of understanding about the effects of lifestyle modifications in myocardial infarction patients.
Nursing Research
Research is a systematic attempt to obtain meaningful answers to a phenomenon or an event through the application of scientific procedure. It is an objective, impartial, empirical and logical analysis and recovering of controlling observation that may lead to the development of generalisation, principal of theories, resulting to some extent in prediction and control of events that may be the consequence or cause of specific phenomena.
The findings of the present study can be utilised by nurse researchers to contribute to the profession to accumulate new knowledge regarding lifestyle modifications in myocardial infarction patients. Publication and presentation often inhibit rather than support researchbased practice. Clearly delineate practice implication of result.
Conclusion
The present study concluded that structured teaching program showed effectiveness in gaining knowledge and improving attitude on lifestyle modifications among myocardial infarction patients.
Supporting File
References
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- Newby DE, Wright RA, Labinjoh C, Ludlam CA, Fox KA, Boon NA, et al. Endothelial dysfunction, impaired endogenous fibrinolysis, and cigarette smoking: A mechanism for arterial thrombosis and myocardial infarction. Circulation 1999;99:1411-5.
- Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004;364:937-52.
- India State-Level Disease Burden Initiative CVD Collaborators. The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990–2016. Lancet Glob Health 2018;6:e1339– e1351. Available from: doi: 10.1016/S2214- 109X(18)30407-8.