Study to evaluate the effectiveness of Self Instructional Module

“A man too busy to take care of his health

is like a mechanic too busy to take care of his tools.”

Seizure is a neurological disorder characterised by unprovoked electrical discharges that disrupt the nervous system and can cause abnormalities such as abnormal blood levels of calcium, magnesium, glucose which can trigger one or more seizure conditions that irritate the brain. (Christensen and Vestergaard, 2007)

Most people with seizure lead outwardly normal lives. Approximately 80% can be aided by modern therapies, and some may take months or years between each seizure attack. However, this condition can affect daily life of people with seizure, their family and their friends. People with seizures who ignore treatment have, a shorter life expectancy and increased risk of cognitive impairment. People with seizure have an higher risk of poor self -esteem, depression and suicide tendency. These problems may by a reaction that may result in cruelty and avoidance by other people. (httpwww.nih.gov)

Based on the total projected population of India, the estimated number of people with seizure would be 5.5 million. Based on a single study on the incidence of seizure, the number of new cases of seizure in each year would be close to half a million (Epilepsy status 2009) .The average incidence rate was higher than many developed countries, but lower than the developing countries. (Shankar Saha, and Shyamal Das, 2008)

Seizure becomes a medical emergency, when seizure lasts longer than 5 minutes or when a person has many seizures and does not wake up between them. Good healthy habits may help to control seizure such as good sleep habits, stress reduction, proper exercise, good nutrition, regular intake of medicine etc. (Rubin and Kornblau, 2009)

NEED FOR THE STUDY

Many people with seizure also live with ever present fear of getting another attack. The risk of seizure acts as a barrier for their independence; In USA people with seizure or other handicaps cannot be denied employment or access to many educational, recreational or other activities due to their seizure. However one survey in India showed that about 56% of people with seizure finish high school education and only 15% finish college education. These rates are found lower than those of the general population. These numbers indicate that some important barriers still exist for people with seizure.

The risk of seizures becomes a barrier for people’s recreational choices; sports is a positive factor in life which is best for the person to participate. Women with seizure are often concerned about whether they can become pregnant and have a healthy child. This is usually a possible situation. Probably 90% women with seizure have the chance of bearing a normal healthy baby and the risk of birth defects is only associated with pregnancy and delivery.

The researcher personally felt that seizure episodes are common and often recurrent if the patient does not maintain good health habits. The knowledge level regarding safety measures on management of seizure is essential for people. So the researcher got interested to prepare a Self Instructional Module regarding promotion of safety measures among patients with seizure.

STATEMENT OF THE PROBLEM

The study to evaluate the effectiveness of Self Instructional Module (SIM) on knowledge regarding promotion of safety measures among patients with seizure and primary care givers in selected Hospitals at Salem.

OBJECTIVES

To develop and validate Self Instructional Module regarding promotion of safety measures for patients with seizure and primary care givers.

To assess the knowledge score on Safety measures regarding seizure management before and after exposed to SIM among patients with seizure and primary care givers.

To find out the association between pre-test level of knowledge with selected demographic variables (Age in years, Educational status)

RESEARCH HYPOTHESES: (Level of significance p

H1: The mean post-test knowledge score after exposed to SIM will be higher than the mean pre-test knowledge score among patients with seizure.

H2: The mean post-test knowledge score after exposed to SIM will be higher than mean pre-test knowledge score among primary care givers of patients with seizure.

H3: There will be significant association between the pre-test knowledge level on promotion of safety measures among seizure patients with their selected demographic variables.

H3(a): There will be significant association between the pre-test knowledge level on promotion of safety measures among seizure patients with their age.

H3(b): There will be significant association between the pre-test knowledge level on promotion of safety measures among seizure patients with their educational status.

OPERATIONAL DEFINITIONS

1. Effectiveness:

In this study Effectiveness refers to the significant difference in mean pre test and post test knowledge score regarding promotion of safety measures on management of seizure among the samples.

a). Knowledge of patients with seizure :

In this study , it refers to the level of information which is known by the patients with seizure regarding promotion of safety measures which includes drug regimen; marriage and pregnancy ; relaxation therapy and safety measures on management of seizure which will be assessed by using a structured questionnaire, with Multiple choice questions . The scores will be interpreted as below 50% – Inadequate knowledge; 50% – 75% moderate knowledge and above 75% – adequate knowledge.

b). Knowledge of primary care givers of patients with seizure:

In this study; it refers to the level of information regarding promotion of safety measures which includes care of patient during and after seizure by the primary care giver which is assessed by structured questionnaire that contains multiple choice questions. The scores will be interpreted as below 50% – Inadequate knowledge; 50% – 75% – moderate knowledge; above 75% – adequate knowledge.

2. Primary Caregiver:

In this study; it refers to a person who is being with the patient and giving care before, during and after a seizure attack.

3. Self Instructional Module:

Section-1: For patients with seizure:

In this study; it refers to a self explanatory guide regarding the promotion of safety measures on management of seizure. It gives information regarding meaning of seizure, its causes, signs and symptoms, diagnosis, complications, and management of seizure.

Section – 2: For primary care givers of patients with seizure:

In this study; it refers to set of guidelines regarding promotion on care of patients with seizure for the primary care givers. It gives information regarding the care of patient during after seizure.

4. Patients with Seizure:

In this study, it refers to individuals who are diagnosed as patients with seizure for the past one year and who attend the out- patient department for regular treatment in selected Hospitals at Salem.

5. Safety Measures on Management of Seizure:

In this study it refers to the information regarding safety measures on drug regimen; relaxation therapy; care during and after seizure which should be followed by the patient to avoid physical as well as mental harm.

6. Demographic Variables:

a) Age in years:

In this study the age group from 20 to 60 years was included.

b) Gender:

It refers to the sex of the patient with seizure and primary care giver (male and female).

c) Educational status:

In this study primary school to post graduate level were included.

d) Family member in health profession:

In this study; it refers to the individual in the family who is working as doctor, nurse, physiotherapist or other health personnel.

ASSUMPTION

The knowledge on seizure and care during seizure is essential for people to lead a healthy life and to promote psychosocial well being.

The improved knowledge will help in preventing the further attack of seizure.

ETHICAL CONSIDERATION

Formal permission will be obtained from the concern authority from the Neuro Hospital OPD where the study is conducted.

Written informed consent will be obtained from the samples after explaining the usefulness of study.

DELIMITATIONS

Sample size is delimited to 30 patients on regular treatment and their primary care givers who attend OPD.

Patients with seizure who are accompanied by primary care giver.

Study is delimited to those who will be available for post test.

SUMMARY

This chapter dealt with the introduction, need for the study; statement of the problem; objectives; hypotheses; operational definitions; assumption; ethical consideration and delimitations.