A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON POLIO VACCINE AMONG MOTHER IN A SELECTED PHC IN

NELAMANGALA AT BANGALORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

SUBMITTED BY

MONISHA VARGHESE

1st YEAR MSc NURSING

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 Name of the candidate and address MONISHA VARGHESE

1ST YEAR M.SC NURSING

HARSHA COLLEGE OF NURSING

BANGALORE

2 Name of the institution HARSHA COLLEGE OF NURSING

BANGALORE

3 Course of the study and subject 1st YEAR M.Sc NURSING

COMMUNITY HEALTH NURSING

4 Date of Admission 06-06-2009

5 Title of the topic A study to evaluate the effectiveness of structured teaching programme on polio vaccine among mother in a selected PHC in Nelamangala at Bangalore.

6. BRIEF RESUME FOR INTENDED WORK

6.1 INTRODUCTION

Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease

spread from person to person, primarily via the fecal-oral route.1 The term derives from the Greek

poliós (πολιός), meaning "grey", myelós (µυελός), referring to the "spinal cord", and the suffix -

itis, which denotes inflammation.2 Although around 90% of polio infections cause no symptoms at

all, affected individuals can exhibit a range of symptoms if the virus enters the blood stream.3

In about 1% of cases the virus enters the central nervous system, preferentially infecting

and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis. Different

types of paralysis may occur, depending on the nerves involved. Spinal polio is the most common

form, characterized by asymmetric paralysis that most often involves the legs. Bulbar polio leads

to weakness of muscles innervated by cranial nerves. Bulbospinal polio is a combination of bulbar

and spinal paralysis.4

Poliomyelitis was first recognized as a distinct condition by Jakob Heine in 1840.[5] Its

causative agent, poliovirus, was identified in 1908 by Karl Landsteiner.5 Although major polio

epidemics were unknown before the late 19th century, polio was one of the most dreaded

childhood diseases of the 20th century. Polio epidemics have crippled thousands of people, mostly

young children; the disease has caused paralysis and death for much of human history. Polio had

existed for thousands of years quietly as an endemic pathogen until the 1880s, when major

epidemics began to occur in Europe; soon after, widespread epidemics appeared in the United

States.6

By 1910, much of the world experienced a dramatic increase in polio cases and

frequent epidemics became regular events, primarily in cities during the summer months. These

epidemics which left thousands of children and adults paralyzed provided the impetus for a "Great

Race" towards the development of a vaccine. The polio vaccines developed by Jonas Salk in 1952

and Albert Sabin in 1962 are credited with reducing the global number of polio cases per year

from many hundreds of thousands to around a thousand.7 Enhanced vaccination efforts led by

theWorld Health Organization, UNICEF and Rotary International could result in global

eradication of the disease.8

Two polio vaccines are used throughout the world to combat poliomyelitis (or polio). The

first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on

April 12, 1955, it consists of an injected dose of inactivated (dead) poliovirus. An oral vaccine

was developed by Albert Sabin using attenuated poliovirus that he had received from Hilary

Koprowski. Human trials of Sabin's vaccine began in 1957 and it was licensed in 1962.9 Because

there is no long term carrier state for poliovirus in immunocompetent individuals, polioviruses

have no non-primate reservoir in nature, and survival of the virus in the environment for an

extended period of time appears to be remote. Therefore, interruption of person-to person

transmission of the virus by vaccination is the critical step in global polio eradication.10 The two

vaccines have eradicated polio from most countries in the world, and reduced the worldwide

incidence from an estimated 350,000 cases in 1988 to 1652 cases in 2007.11

Two vaccines are used throughout the world to combat polio. Both vaccines induce

immunity to polio, efficiently blocking person-to-person transmission of wild poliovirus, thereby

protecting both individual vaccine recipients and the wider community (so-called herd immunity).

The first inactivated virus vaccine was developed in 1952 by Jonas Salk, and announced to the

world on April 12, 1955. The Salk vaccine, or inactivated poliovirus vaccine (IPV), is based on

poliovirus grown in a type of monkey kidney tissue culture (Vero cell line), which is chemically

inactivated with formalin. After two doses of IPV (given by injection), 90% or more of

individuals develop protective antibody to all three serotypes of poliovirus, and at least 99% are

immune to poliovirus following three doses.

Subsequently, Albert Sabin developed an oral polio vaccine (OPV) using live but

weakened (attenuated) virus, produced by the repeated passage of the virus through non-human

cells at sub-physiological temperatures. Human trials of Sabin's vaccine began in 1957 and it was

licensed in 1962. The attenuated poliovirus in the Sabin vaccine replicates very efficiently in the

gut, the primary site of wild poliovirus infection and replication, but the vaccine strain is unable to

replicate efficiently within nervous system tissue. A single dose of oral polio vaccine produces

immunity to all three poliovirus serotypes in approximately 50% of recipients. Three doses of

live-attenuated OPV produce protective antibody to all three poliovirus types in more than 95% of

recipients.

Because OPV is inexpensive, easy to administer, and produces excellent immunity in the

intestine (which helps prevent infection with wild virus in areas where it is endemic), it has been

the vaccine of choice for controlling poliomyelitis in many countries. On very rare occasions

(about 1 case per 750,000 vaccine recipients) the attenuated virus in OPV reverts into a form that

can paralyze. Most industrialized countries have switched to IPV, which cannot revert, either as

the sole vaccine against poliomyelitis or in combination with oral polio vaccine.12

While now rare in the Western world, polio is still found principally in Asia and Northern

Africa. Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of

poliomyelitis declined dramatically in many industrialized countries. A global effort to eradicate

polio began in 1988, led by the World Health Organization, UNICEF, and The Rotary Foundation.[68] These efforts have reduced the number of annual diagnosed cases by 99%; from an estimated

350,000 cases in 1988 to 1,310 cases in 2007.[69][70] Should eradication be successful it will

represent only the second time mankind has ever completely eliminated a disease. The first such

disease was smallpox, which was officially eradicated in 1979.[71] A number of eradication

milestones have already been reached, and several regions of the world have been certified polio-

free. The Americas were declared polio-free in 1994.[72] In 2000 polio was officially eradicated in

36 Western Pacific countries, including China and Australia.[73][74] Europe was declared polio-free

in 2002.[75] As of 2006, polio remains endemic in only four countries: Nigeria, India (specifically

Uttar Pradesh and Bihar), Pakistan, and Afghanistan.13

6.2 NEED FOR THE STUDY

Global eradication programmes, since 1988, which have employed poliovirus

vaccines in many parts of the world has significantly reduced the worldwide occurrence of polio

by 99%. The western regions can today boast of a complete polio- free environment. According to

the latest figures, there is a significant reduction of 58% in polio cases as compared to 2006. Only

613 cases have been reported globally in 2007. Nevertheless, it is not time to rest on laurels, yet.

Afghanistan, Pakistan, certain areas in India and Africa are not completely free from the virus.

India had reported 676 cases of polio in 2006. This year, 2007, the number has reduced to 281.

Most of the victims belong to parts of Uttar Pradesh

and Bihar, from regions that lack hygiene and proper sanitation. Recently, two cases, one in Delhi

and the other in Orissa have been reported14.

India has reported 236 cases of polio in the last eight months and the country is moving

towards wiping out the disease as 99 percent of the job is almost over, an official said Monday

According to statistics released by the health ministry, the World Health Organization (WHO) and

other partner organizations like Rotary, Uttar Pradesh has topped the table with 181 cases so far

this year. 'India has achieved a lot of success in the polio eradication drive. I can say that 99

percent of the job is done,' Deepak Kapur, chairman of Rotary India Polio Committee, told IANS.

'The country is on the verge of wiping out P1 cases (the most virulent strain) by the end of this

year. We have just 34 P1 cases this year as against 75 last year. Perhaps we are in the best position

ever to wipe out P1,' Kapur added. Of the 236 cases reported in India, 181 were detected in Uttar

Pradesh, 49 in Bihar, four in Delhi and one each in Rajasthan and Uttarakhand, said Anil Kumar

Singh, a health official in Patna. In 2008, India had reported 559 cases of polio, including 75 of

P1.

Bihar health authorities are a little worried as 16 of the 49 cases detected are of the virulent

P1 strain. The rest are the less virulent P3 strain. The state has been recording the second highest

incidence of the disease in India for the last few years. 'Sixteen cases of P1 in Bihar as against

only three last year is certainly a cause for concern. But we believe that things will be under

control soon,' Kapur added.

WHO authorities in New Delhi said that though there are some implementations problems at the

ground level, India are on the right track. Bihar recorded over 300 new polio cases in 2008 but in

last eight months there are just 49 cases. The state recorded 61 polio cases in 2006 and 193 cases

in 2007. After a recent Cabinet Committee on Economic Affairs meeting, Home Minister P.

Chidambaram said that the main objective is to achieve the 'goal of zero transmission of polio and

obtaining international polio free certification for accomplishment of this goal'15.

The team from Kasturba Medical College (KMC), Mangalore, led by U.V. Shenoy,

Professor and Head of the Department of Paediatrics at KMC, and comprising paediatricians and

physiotherapists, conducted a screening and interviewed villagers on June 16 and 17. They found

that of the 3,600 people living in Adagallu and the 4,501 in Mathagere, as many as 110 people had

some form of disability. In Adagallu, 28 had post-polio residual paralysis while 18 people were

afflicted with this ailment in Mathagere. The paralysis is caused by the polio virus and the disease

is called `Provocative Poliomyelitis.' Almost every fifth person in two remote villages of north

Karnataka seems to have some disability. Moreover, the most common disability among the

villagers is post-polio residual paralysis16.

For the first time ever, India has confirmed two separate cases of vaccine-derived

poliovirus (VDPV). The cases have been reported in a four-year-old boy in Assam’s Dibrugarh

district and a two-year-old in Bihar’s Champaran district at 12 june 2009. VDPVs are strains of

the virus contained in the oral polio vaccine which have changed and reverted to a form that can

cause paralysis in humans with the capacity for sustained circulation17.

Eradicating polio from Bihar continues to be a big challenge with at least 100 new cases of

polio recorded in the state this year, despite multi-million rupee campaigns by the state and central

governments as well as WHO and Unicef, officials said Saturday. After Uttar Pradesh, Bihar has

been recording the second highest incidence of the disease in India for the last few years18.

For effective herd immunity, at least 80% of all eligible, children must get routine doses of OPV.

Non-registration of home deliveries, lack of education and non-availability and incorrect

administration of potent vaccine interferes with effective immunization. During 2002,

approximately 68% infants received more than 3 doses of oral poliovirus vaccine (OPV3) in India.

Substantial variation was found between states in routine coverage with OPV3, ranging from 21%

in Bihar to 99% in Madhya Pradesh. OPV3 coverage in Uttar Pradesh was 41%[6]. Even those

administered OPV were not protected and sero- conversion with 3 doses of OPV varied from 70-

90%, which rose to 88-96% with 5 doses19

On 15 January 2004, ministers of health from the six polio-endemic countries – Nigeria,

India, Pakistan, Niger, Afghanistan and Egypt – publicly pledged an all-out effort to end a disease

that in recent memory crippled more than a thousand children every day. Ministers gathered at

WHO Headquarters to sign the Geneva Declaration for the Eradication of Poliomyelitis, marking

a historic step toward stopping poliovirus transmission in their countries by the end of 200420.

India has reached the final stage of polio eradication. The polio partnership in India, under

the leadership of the Government of India, mounted tremendous response to the outbreak. The

progress since 2003 is the most significant in the history of polio eradication in India. Surveillance

sensitivity was increased to reach the goal for polio eradication. Since nearly all polio cases now

occurring in India are caused by type 1 poliovirus in children, monovalent oral polio vaccine type

1 (mOPV1) was introduced in select high-risk districts of UP, Bihar and Mumbai-Thane during

the April and May 2005 National Immunization Days and the June and August 2005 in 6 sub-

national immunization rounds. Strategies were also being implemented to improve the impact of

supplementary immunization activities in the high-risk areas. As a result of supplementary

immunization activities targeted using surveillance data, India has made striking progress towards

polio eradication21.

A study conducted on Polio Eradication in India Poliomyelitis has been eradicated from

large parts of the world. In South East Asian Region, India and Pakistan the eradication measures

have been reviewed. The corrective measures appear to be succeeding. Various facets of

eradication and their impact are evaluated. Conclusion of the study was Poliomyelitis is controlled

but the ultimate target of eradication may still be elusive, keeping in mind operational lacunae and

vaccine virus characteristics22.

All the studies show that poliomyelitis is one of the health problems in India. Polio

vaccine immunization schedule is used to prevent the poliomyelitis. So Gov. of India launched

pulse polio programmes and carried out every year in December to January. The campaign proved

to be successful, and the incidence of poliomyelitis in India has decreased dramatically: India

recorded 4,791 cases of polio in 1994; 2,489 in 1997; 1,600 in 2002; 225 in 2003; and 135 in 2004

Nevertheless, critics charge that the campaign has seriously encroached on other essential public

health services at times when health care resources were minimal. People will get knowledge

through the health education regarding prevention of poliomyelitis by polio vaccine, motivated the

researcher to do this study

6.3 REVIEW OF LITERATURE

Review of literature provides basis for future investigations, justifies the need for

replication, throws light up on feasibility of the study, and indicates constraints of data collection

and help to relate findings of one another

A study conducted on an overview of parents perception on pulse polio programme in

India.The present study was carried out with the objective to assess the knowledge of the parents

regarding pulse polio and their perception towards pulse polio and other immunization.The study

revealed that children of all age groups participated in PPI though the coverage was low in 37-48

and 49-60 month age group. In all 30.5% children of respondents could not get OPV in the

previous year and they came for the first time to the PPI centre. A significant finding of the study

was the status of children regarding other immunization, as 59.5% of the respondents were not

immunizing their children for other vaccines. In the present study, 30% of the respondents could

not tell correctly about pulse polio. Predominant source of information about pulse polio was

found to be electronic media (55.8%) followed by health workers (20.9%). Only 8.4%

respondents opined that distance of PPI centre was far away from their residence23

Qualitative research presented on Polio eradication--a success in sight in New Delhi. The

paper is a presentation of findings from 15 states, carrying the data as of Aug. 31, 2000. The

modified cluster sampling has been used in this study. Data reveals that out of 15, 10 states have

more than 95% coverage for at least 3 doses, MP and Gujarat at the top with 99% coverage.

Despite this high coverage level, huge number of children is still unreached. Nearly 5 lakh

children are left out in UP alone. Ironically, higher proportions of urban clusters have zero dose

children. Apart from lack of awareness about date and need of additional doses, lacks of positive

attitude among parents are major cause of not getting any of the doses. Qualitative research

pinpointed some more reasons for non-compliance--apprehension about side effect, knowledge

and traditional barriers. According to the service providers and influencers, lack of proper training

and monetary compensation are major demotivating factors24

This paper presents findings of a study that was conducted in the National Capital

Territory of Delhi to examine mothers' knowledge regarding PPI and routine Oral Polio Vaccine

(OPV) immunization schedule and their practice regarding the availing of its services. A total of

481 mothers participated in the study. Findings showed that 97.7% of mothers were aware of this

special poliomyelitis vaccination program, while 2.3% were unaware of it. 75% of mothers

correctly reported the age group of children receiving OPV to be less than 3 years, while 11%

reported that it was being given to all age groups. Moreover, awareness of mothers regarding

some aspects of routine OPV immunization was very low. 43% of mothers had incorrect

knowledge regarding age of initiation of OPV, and 68% had incorrect knowledge regarding the

number of primary doses of OPV. Given the consistently high coverage of the three primary doses

of OPV in Delhi, these findings could be explained on the basis of poor emphasis of information,

education, and communication activities in routine functioning by health professionals and

paramedical workers25

A cross sectional study on immunization coverage in the town of Pilani was conducted and

a total of 166 mothers were interviewed using a pre-tested interview schedule/questionnaire on

Knowledge, Attitudes, Perceptions and Expectations (KAPE). The results showed that among the

12-24 month old children 50% fully, 31.3% partially and 18.7% not at all immunized. High levels

of initial vaccination rates and low levels of OPV3/DPT3 (62.7%) and measles (51.8%) vaccines

indicate that completing vaccination schedule needs attention. Almost all the children in the study,

165 out of 166 received two doses of polio vaccine from the Pulse Polio Immunization

programme. Majority of the mothers expressed favourable attitudes and satisfaction regarding the

programme. Though many were aware of the importance of vaccination in general, specific

information about importance of completing the schedule and knowledge about vaccine

preventable diseases other than poliomyelities was very limited. Obstacles, misconceptions/beliefs

among the mothers of partially immunized children and lack of information among not at all

immunized group were the main reasons of non-immunization. The implications of the study are:

to enhance the maternal knowledge about the vaccine preventable diseases and importance of

completing the immunization schedule through interpersonal mode and to overcome obstacles to

immunization such as accessibility and lack of family support26.

A study conducted on Evaluation of a poliomyelitis immunization campaign in Madras

city. The evaluation method was the "30-cluster" sample survey technique, designed by WHO,

where surveys were done in 30 districts of the city on 10 children in each age group. The survey

was conducted in April 1985 by 5 trained and supervised interviewers. This campaign increased

the vaccine coverage to 94%, 88% and 72% for first, second and third doses of OPV. Coverage

was higher in older children. Percent coverage decreased slightly over 1-3 doses, and from there

rapidly up to 6-7 doses. The campaign accounted for 27% of all the OPV the study children had

received. 47% of parents heard about the vaccination through word of mouth, either from health

workers, volunteers or "balwadi ayahs," women day-care workers. 17% learned through television

or radio. 3% cited mobile loudspeakers, handbills, posters or slides in cinemas. Many parents did

not avail themselves of the vaccine because they believed that 3 doses are sufficient. Actually the

WHO recommends 4 doses; the Indian Academy of Pediatrics recommends 5 doses; while criteria

from research on Indian children would suggest that 5-7 doses are required to raise strong

immunity27

A study conducted on Update on vaccine-derived polioviruses--worldwide, January 2008-

June 2009. The Global Polio Eradication Initiative of the World Health Organization (WHO)

reduced the global incidence of polio associated with wild polioviruses (WPVs) from an estimated

350,000 cases in 125 countries in 1988 to 1,651 reported cases in 2008 and reduced the number of

countries that have never interrupted WPV transmission to four (Afghanistan, India, Nigeria, and

Pakistan). However, because vaccine-derived polioviruses (VDPVs) can produce polio outbreaks

in areas with low rates of Sabin OPV coverage and can replicate for years in immunodeficient

persons, enhanced strategies are needed to limit emergence of VDPVs. This report updates

previous summaries and describes VDPVs detected worldwide during January 2008-June 2009.

During this period, 1) two new outbreaks of circulating VDPVs (cVDPVs) (accounting for 4-20

cases) were identified in the Democratic Republic of Congo and Ethiopia; 2) a previously

identified outbreak in Nigeria ultimately resulted in a cumulative total of 292 cases; 3) two newly

identified paralyzed immunodeficient persons in Argentina and the United States were found to

excrete VDPVs; and 4) isolated VDPVs were found among persons and environmental samples in

11 countries. This study highlighted all countries need to maintain high rates of polio virus

vaccination coverage to prevent VDPV spread and sensitive poliovirus surveillance to detect

VDPVs

This review examines polio communication efforts in India and Pakistan between the

years 2000 and 2007. It shows how epidemiological, social and behavioural data guide

communication strategies that have contributed to increased levels of polio immunity, particularly

among underserved and hard-to-reach populations. It illustrates how evidence-based and planned

communication strategies - such as sustained media campaigns, intensive community and social

mobilization, interpersonal communication and political and national advocacy combined - have

contributed to reducing polio incidence in these countries. Findings show that communication

strategies have contributed on several levels by: mobilizing social networks and leaders; creating

political will; increasing knowledge; ensuring individual and community-level demand;

overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and

marginalized populations29

An article repotted on why polio has not been eradicated in India despite many

remedial interventions. Oral polio vaccine has reduced the incidence of polio in India and many

states have been polio free for a long time while occasional polio cases are occurring in some

states. On the other hand more than 96% of polio cases being reported in India are occurring in

Uttar Pradesh and Bihar. The current polio scenario indicates that oral polio vaccines cannot

eradicate polio from Uttar Pradesh and Bihar because some children from these two states show

poor response to OPV. This report highlighted urgent need for re-appraisal of polio eradication

strategy and health education30.

A paper presented on Epidemiology of poliomyelitis-options and update. Poliomyelitis is

a disease of major public health importance. Since the launch of the Global Poliomyelitis

Eradication Initiative in 1988, considerable progress has been achieved globally. At present, the

causative agent for the disease--poliovirus--remains endemic in only four countries (Afghanistan,

India, Nigeria and Pakistan). The poliovirus eradication plan, as outlined in the WHO strategic

plan for 2004--2008, incorporates priority activities for each phase of the plan: (i) polio

eradication certification for regions, (ii) oral poliovirus vaccine (OPV) cessation phase, and (iii)

post-OPV phase. The ultimate goal to eventually stop all vaccination is, however, jeopardized by

the emergence of vaccine-derived polioviruses and the risk of bioterrorism. In the post-eradication

era, individual countries will be presented with guidelines on OPV cessation and inactivated

poliovirus vaccine (IPV) usage. This paper, presented during the Asian Pacific Pediatric

Association (APPA) meeting in Pattaya, Thailand from 20 to 22 July 2006, provides an update on

the current global situation, focusing on the progress and challenges faced by different countries

in their quest for poliovirus eradication31

A study conducted on Intussusception in southern Indian children: lack of association with

diarrheal disease and oral polio vaccine immunization. Researchers studied the history, clinical

presentation, management and outcome of intussusception presenting to a tertiary care hospital in

southern India over a 10-year period, in order to assess potential association with diarrheal disease

and immunization. Results of the study were data from 137 index cases and 280 control subjects

indicated that the risk of diarrheal disease or oral polio vaccine administration in the month prior

to presentation was similar in the index cases and controls. Mean time to presentation to hospital

after developing symptoms was 1.8 days, and 77.3% of patients required surgery, with 47.4%

undergoing intestinal resection. Mortality was 0.006%. Conclusions of the study was no

association could be demonstrated between gastroenteritis or oral poliovirus vaccine

immunization and intussusception in southern Indian children. These children presented later and

required operative intervention more frequently than has been reported in other studies, but had a

good outcome with low mortality32.

STATEMENT OF THE PROBLEM

A study to evaluate the effectiveness of structured teaching programme on polio vaccine among mother in a selected PHC in Nelamangala at Bangalore.

6.4 OBJECTIVES OF THE STUDY

1. Assessing the knowledge on polio vaccine among mothers in the terms of pretest.

2. Evaluate the effectiveness of structured teaching programme regarding polio vaccine by

comparing pretest score on post test knowledge score

3. Find out the association between knowledge score on post test knowledge score and

selected demographic variables.

4. To prepare Health education package on polio Vaccine

6.5 OPERATIONAL DEFINITIONS

1) Evaluation: is an act or process that allow one to make a judgement about the

desirability or value of a measure.

2) Effectiveness: Refers to differences in the post test knowledge score with that of pre test

knowledge score.

3) Structured Teaching Programme: Refers to systematic by lecture cum discussion method

designed to provide information regarding polio vaccine such as meaning, types, indication,

dose, schedule, importance, complication and prevention. The duration of teaching is 2 hours

4) Polio vaccine refers to one of the recommended childhood immunizations and vaccination

should begin during infancy to prevent the poliomyelitis.

5) Mother refers to women who have under five children..

6.6 HYPOTHESIS

H1 : There is a significant deference in the knowledge score on polio vaccination in the post

test knowledge score than the pretest knowledge score among mothers.

H2 : There is a significant association between knowledge score and demographic variable

6.7 ASSUMPTION

The mothers have inadequate knowledge regarding polio vaccination

The planned teaching programme improves the knowledge of mothers regarding polio

vaccination

6.8 DELIMITATION

The data collection period is limited to 6 weeks

Assessment of knowledge is measured by one observation only

Teaching strategy is delimited to lecture method only

6.9 VARIABLE

Dependent variables of this study are knowledge of mothers regarding polio vaccination

and Independent variable are structured teaching programme on polio vaccination

Demographic variables in this study are Age, Gender, education, occupation, religion, and

Family income, Type of family and Source of information

7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

Data will be collected from mothers having under five children in selected rural area in

Nelamangala at Bangalore.

7.1.1RESEARCH DESIGN

Research design adopted for the present study is quasi experimental, one group pre test- post

test design

7.1.2 RESEARCH APPROACH

Evaluative approach

7.1.3 SETTING OF THE STUDY

Setting of the study will be selected rural area in Nelamangala at Bangalore.

7.1.4 POPULATION

The population of present study comprises the mothers who have under five children in a

selected rural area in Nelamangala at Bangalore.

7.2 METHOD OF COLLECTION OF DATA

7.2.1 SAMPLING TECHNIQUE

Sampling technique using in this study is Simple random sampling

7.2.2 SAMPLE SIZE

The proposed sample size of the study is 60 mothers who have under five children

SAMPLING CRITERIA

7.2.3 Inclusion criteria

Mothers who are willing to participate.

Mothers who are present at the time of data collection.

7.2.4 Exclusion criteria

Mothers who are not understanding Kannada or English

Mothers who are not having under five children.

7.2.5 TOOL FOR DATA COLLECTION

Tool for data collection in the study is structured knowledge questionnaire. It consist two part,

part 1 and part 2.

Part 1 – items on demographic variable like Age, Gender, education, occupation, religion, and

Family income, Type of family and Source of information

Part 2 – structured knowledge questionnaire to elicit knowledge of mothers who have under

five children.

PROCEDURE FOR DATA COLLECTION

The data will be collected with the prescribed time period in selected community

Permission will be obtained from higher authorities

Purpose of the study will be explained to the respondents

Pre test will be conducted using structured knowledge questionnaire. Subsequently

planned teaching programme will be given on the day.

On the seventh day post test will be conducted. Proposed data collection period will be

30 days.

7.2.6 METHOD OF DATA ANALYSIS AND INTERPRETATION

The researcher will use appropriate statistical technique for data analysis and present in the

form of tables and diagrams. Knowledge will be assessed by frequency and percentage

distribution. Level of knowledge will be assessed with mean and standard deviation.

Association between demographic variables and knowledge polio vaccination will be assessed

with chi square test.

7.2.7 DURATION OF STUDY

Duration of this study is 30 days

7.2.8 PROJECTED OUT COME

The structured teaching programme will enhance mother’s knowledge regarding polio

vaccination

7.3 Does the study require any investigation to be conducted on the patient

or other human beings or animals?

NO.

7.4 Has ethical clearance has been obtained from your institution?

Yes, ethical clearance report is here with enclosed.

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9 Signature of candidate

10 Remarks of the guide

11 Name and designation of (in block letters

11.1 Guide

11.2 Signature

11.3 Co-guide (if any)

11.4 Signature

12 12.1 Head of the Department

12.2 Signature

13 13.1 Remarks of the Chairman or

Principal

13.2 Signature