1 / 118

FINAL THESIS OF PHD

thesis on neurological assessment<br>

Mandeep20
Download Presentation

FINAL THESIS OF PHD

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CHAPTER 1 BACKGROUND OF THE STUDY INTRODUCTION “Education is not the filling of a pail, But the lighting of a `fire” Nervous system is the major controlling, regulatory, and communicating system in the body. It is the center of all mental activity including thought, learning, and memory. Together with the endocrine system, the nervous system is responsible for regulating and maintaining homeostasis. Through its receptors, the nervous system keeps us in touch with our environment, both external and internal. Like other systems in the body, the nervous system is composed of organs, principally the brain, spinal cord, nerves, and ganglia. These, in turn, consist of various tissues, including nerve, blood, and connective tissue. Together these carry out the complex activities of the nervous system. A study reported that nurses, working in neurosurgery department have poor knowledge and practices about Glasgow coma scale (GCS) assessment of unconscious patients There is a need to conduct Page 4/9 studies to explore the nurse’s knowledge and skill about GCS assessment while working with patients in intensive care settings.1 Physicians encounter an extensive range of patients with different illnesses daily. These can range from relatively benign to life-threatening conditions. This range of potentials highlights the importance of a physician's ability to recognize red flags early on in the disease processes. These red flags are picked up in the history or during a neurological examination. A good example would be a patient who presents with chronic headaches, which can be a benign condition like migraine or life-threatening like a tumor. The presence of nausea and vomiting in the patient's history may still be present in migraines or may be a sign of increased intracranial pressure. An abnormal neurological examination can then direct the physician to the diagnosis (e.g., ataxic gait in this patient points to a 1

  2. cerebellar lesion). The physician can then refer the patient for appropriate diagnostic imaging and direct the management.2 Assessment is the first aspect in nursing process. The nurse’s skill in performing assessment has a decisive role in determining the health needs of the patient, designing nursing care plan, and implementing nursing interventions. The more accurate the assessment is, the more quality results would be obtained by the nurses caring the patient. Thus ensuring the registered nurses knowledge in each area is an important concern.3 However, nurses perform neurological assessment to determine whether patients’ neurological condition is intact or have some problem. Assess the changes in patient’s neurological status in response to treatment. And to evaluate life threatening conditions .4 In physical assessment for successful implementation and education of standardized nursing assessments, clear goals must first be communicated among healthcare staff and leaders. Identification of a need for change in this process is necessary. When change is recognized, training time for employees, understanding learning curves among staff, and clear communication must all be incorporated into the planning phase of projects for quality improvement.5 The neurological examination is an assessment tool to determine a patient's neurologic function. It is beneficial in a variety of ways as it allows the localization of neurologic diseases and helps in ruling in or ruling out differential diagnoses. Neurological diseases can present a myriad of ways, including cognitive/behavioral, visual, motor, and sensory symptoms. Certain red flags during examination allow early detection of life-threatening neurologic diseases and recognize disorders that may negatively impact the quality of life.6 The mental status examination begins during the interview. Assessment of the patient's cognitive abilities such as language usage, chronology in the recollection of events, and significance of answers will give a clinician a general feel of the patient's condition. A quick mental status exam may involve asking for 2

  3. orientation to time, place, and person. A healthy patient is recognized to be "awake," "alert" (responding appropriately), and "oriented" (aware of self, place, and time). If disorientation or memory lapses (especially in the elderly) are present, a mini-mental status examination can be done. This will assess further patient's orientation, registration, attention, recall, language, repetition, complex commands, and visuospatial function. Any abnormality in a specific function may warrant further investigation that is not covered by this article. Abnormalities in these areas can point to lesions in specific areas of the cortex . Mood and affect also require assessment.7 The neurologic examination is useful in both ambulatory and emergency settings. It provides the physician a tool to recognize neurologic involvement in certain disease states, and thereby allow proper work-up and treatment for these patients. It is also beneficial in intensive care units, particularly in monitoring neurologic sequelae of diseases like strokes, intracranial tumors, and traumatic brain injury.8 A need for standardization of nursing assessments education exits with focus on comprehensive and focused assessments for improved clinical competencies. Nurses’ decision making in clinical practice is based on patient situations, observations, experience, critical thinking, and academic background.9 The nursing assessment is an integral part of the nursing process that will affect patient outcomes. Furthermore, neurological assessments often identify potentially life threatening conditions which may have profound effects on patient outcomes.10 There was inconsistency between the health care providers in assessing the level of consciousness. Therefore, one of the major goals for developing the GCS was to standardize the way to assess LOC. GCS is defined as a neurological scale which gives a reliable, objective way of recording the conscious state of a person, for initial as well as subsequent assessment.11 Over the past forty years health care professionals are using the Glasgow coma scale (GCS) to examine the level of consciousness of patients. This scale is used 3

  4. to assess the neurological status of patients with different medical and surgical conditions like stroke or traumatic brain injuries or stroke. The GCS assessments also evaluate the progression of injury which is main point for decision making in neurosciences. GCS is also fundamental scale for research studies .12 Neurology is a branch of medicine dealing with disorders of the nervous system. Neurology deals with the diagnosis and treatment of all categories of conditions and disease involving the central and peripheral nervous system. Practical skills are the base of a challenging case in nursing education.13 Critical components of the nursing neurological assessment include patient’s level of consciousness (LOC), mental status and cognition, cranial nerves, motor response, reflexes, sensation, and gait. It has been documented that nurses who do not routinely perform a neurological assessment that include these critical components often require skills review and education pertinent to these exams. It is also important to note that in many hospital organizations the requirement for nursing neurological 15 assessment is not confined to the neurological intensive care units (ICU) or the emergency department but is in place on medical-surgical units.14 Nursing assessment approaches are from head-to-toe and focus on all body systems. The neurological system is one body system that is complex, requiring attention to detail and mastery of complex skills by bedside nurses. These skills can be acquired through educational experiences, clinical experience, and demonstration by experienced clinical providers. Neurological assessments require bedside nurses to use clinical reasoning, critical thinking, and holistic care approaches when planning, implementing, and evaluating care in this population.15 An impairment in the nervous system can manifest from subtle weakness to drastic loss of mobility and an impairment in the consciousness to death. Therefore, it is vital for the nurses to accurately perform a thorough neurological assessment and understand the implication of any change in the assessment findings, in order to initiate life saving measures.16 4

  5. Neurological assessment is a method of obtaining specific information related to the function of a patient’s nervous system. Neurologic observations allow monitoring and evaluation of changes in the nervous system that later on aid in the diagnosis and treatment, which impact patient prognosis and rehabilitation..17 The Neurological Examination is a systemic process that includes a variety of clinical tests, observations, and assessments designed to evaluate a complex system. It divided into five components: Cerebral function, Cranial nerves, Motor system, Sensory system, and Reflexes to determine whether the Nervous System is Impaired. It is the foundational database for the nursing staffs to use in making nursing diagnosis, planning care implementing interventions and evaluating care for the patient.18 The neurological system is an extremely dedicated system which regulates and integrates the body actions. Conducting neurological assessment depends on the professional’s knowledge regarding structure of nervous system and its function and very specifically the skills required to recognize and interpret abnormalities.19 Neurological examination is not as similar as physical examination. It is a critical evaluation of the functioning of the nervous system thereby assessing the functioning of certain parts of the body which are operated through nervous system. Neurological examination provides us the critical report about function of Brain.20 During a neurological examination “test” The functioning of the nervous system. The nervous system is the very complex and control many parts of the body. The nervous system consist of the brain, spinal cord, 12 cranial nerves that come from the brain and the nervous that come from the spinal cord. A neurological examination for stroke evaluates level of awareness and brain function. Different parts of the brain control different functions like language, speech, vision, eye movements, muscle control and sense of touch. Each section of the exam tests a different function of the brain.21 5

  6. Nurses form the first line of primary care for patients. They are responsible to assess patients systemically and as a whole. One of the major challenges that nurses face during assessment is the neurological dysfunctions, especially for patients with coma. The most important assessment in the neurological examination is to assess the level of consciousness (LOC), which is considered as the first step in neurological examination.22 Assessment is the first aspect in nursing process. The nurse’s skill in performing assessment has a decisive role in determining the health needs of the patient, designing nursing care plan, and implementing nursing interventions. The more accurate the assessment is, the more quality results would be obtained by the nurses caring the patient. Thus ensuring the registered nurses knowledge in each area is an important concern.23 The neurological assessment is a key compound in the care of the neurological patient. It can help to detect the presence of neurological disease or injury and monitor its progress to determine the type of care and gauge the patients response to intervention. Nurses come across various casualties in their everyday work and their main goal is to save life. In these critical situations nurse need to be vigilant and take prompt action in meeting the need of patients with altered sensorium and seriously ill.24 A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient’s medical history, but not deeper investigation such as neuro imaging. The neurological examination is one of the corenursing data base for identifying nursing intervention. The accuracy of the initial assessment and to identify the change, interpret its significance using critical thinking skill and take appropriate action from foundation of neuroscience nursing practice.25 6

  7. NEED OF THE STUDY The five leading causes of death from neurological disorders were from AD and other dementias (258,600 deaths), stroke (172,000 deaths), Parkinson’s disease (30,000 deaths), motor neuron disease (8,400 deaths) and MS (4,000 deaths). The highest incidence was of new-onset tension-type headache (44.5 million cases per year), followed by migraine (5 million cases per year), traumatic brain injury (0.96 million cases per year), stroke (0.60 million cases per year) and AD and other dementias (0.48 million cases per year).26 The Article highlights the increasing contribution of non-communicable and injury-related neurological disorders, and the decreasing contribution of communicable neurological disorders, to total DALYs in India. The contribution of non-communicable neurological disorders was 4·0% (95% UI 3·2–5·0) in 1990, doubling to 8·2% (6·6–10·2) in 2019; injury-related neurological disorders contributed 0·2% (0·2–0·3) in 1990 and 0·6% (0·5–0·7) in 2019; and communicable neurological disorders contributed to 4·1% (3·5–4·8) in 1990 and 1·1% (0·9–1·5) in 2019.In the past three decades, most studies in India have shown a high disease burden for specific diseases including stroke, epilepsy, headache, Parkinson's disease, and dementia, mostly reported for the urban Indian population.27 Nursing is a science that simultaneously depends on knowledge and practice. In many studies, nursing has been viewed as a practice-centered profession. One of the most important components of comprehensive nursing care is the basic nursing process of examination. In fact, examination is the first stage of the nursing process and physical examination is a key component of this process. Examinations conducted by nurses are an essential component of nursing healthcare services. Without its proper mastery and correct implementation, the nurses would fail in the first stage of the nursing process, and would not be able to appropriately achieve the next stage, diagnosis.28 Growth and development of neuro epidemiology in India during the last four decades has been documented highlighting the historical milestones. The 7

  8. prevalence rates of the spectrum of neurological disorders from different regions of the country ranged from 967-4,070 with a mean of 2394 per 100,000 population, providing a rough estimate of over 30 million people with neurological disorders (excluding neuro infections and traumatic injuries). Prevalence and incidence rates of common disorders including epilepsy, stroke, Parkinson's disease and tremors determined through population-based surveys show considerable variation across different regions of the country. Higher rates of prevalence of neurological disorders in rural areas, 6-8 million people with epilepsy and high case fatality rates of stroke (27-42%) call for urgent strategies to establish outreach neurology services to cater to remote and rural areas, develop National Epilepsy Control Program and establish stroke units at different levels of health care pyramid.29 In Mukono district, east of Kampala city of Uganda, central region. Over a period of six months, a cross sectional survey was conducted and screening was performed using a standardized questionnaire.Of the 3000 study subjects, 50.3% (1510/3000) were from the rural setting. Out of the participants screened, 67.4% were female, with a median age of 33 years. Among the 98 subjects with confirmed neurological disorders, the frequency of diseases was as follows; peripheral neuropathy (46.2%), chronic headaches (26.4%), and epilepsy (8.5%), followed by pain syndromes (7.5%), stroke (6.6%) and tremors/Parkinson disease (3.8%). The crude prevalence rates of these disorders (95% CI) were 14.3% (8.5– 24.1); 13.3% (7.7–22.8); 33.7% (23.9–47.4) for stroke, epilepsy and peripheral neuropathy respectively. Peripheral neuropathy followed by chronic headaches had the highest estimated incidence/1000 years. Stroke had an estimated incidence of 3.6 new cases with 95% CI of (2.1–6.1)/1000 years.30 Physical examination provides some information regarding the patient’s health status and nursing interventions based on the outcomes, which also evaluates the consequences of healthcare. Physical examination skills identified by the American nurses association were set as a practical standard for nursing staff, as one of the most important nursing skills that assists nurses identify abnormal cases.31 8

  9. A careful, timely, and accurate examination of patients by the nurses provides grounds for maintaining and improving patients’ safety in hospitals. In recent decades, the emphasis has been on preparing nurses for advanced physical examination skills due to the fact that better and more accurate examinations would result in better consequences for patients, and consequently, nurses’ professional status would be improved in the society.32 This is the first neurological disorders survey done in Uganda. The overall point prevalence of neurological diseases was 3.3%. The crude prevalence of stroke was 14.3%; (95% CI:8.5–24.1). This is within the worldwide prevalence of stroke which varies between 4 and 20 per 1000 population. The estimated incidence (95% CI) for stroke was 360 (210–610) per 100,000 years. This is higher than figures reported from Nigeria, 134/100,000 , 461/100,000 in Cotonou, Benin , and 620/100,000 in China . Our observed trend of increasing stroke prevalence among women differs from earlier studies. Plausible reasons for this observation include the fact that more women seek health care compared to men . Reports from hospital-based studies still show that more than half of stroke subjects admitted are female.33 Neurological diseases contribute significantly to morbidity and mortality worldwide. Globally, stroke is the second leading cause of death after ischemic heart disease . The burden of neurological conditions in sub-Saharan Africa has been increasing over the years. Neurological disorders contributed to 92 million disability-adjusted life-years (DALY) in 2005 and were projected to 103 million in 2030 worldwide.34 Nurses regularly face complex situations requiring sophisticated skills in examinations, decision making, planning, specialized care, and referral to other services , making health assessment skills one of the most critical clinical skills for nurses and an essential part of the nursing curriculum.35 The crude prevalence of epilepsy in our survey was 13.3% (95% CI of 7.7–22.8) with an incidence rate of 320/100,000 years (95% CI of 180–540) in Mukono district. This is lower than rates reported in Egypt (550/100,000), UK 9

  10. (400/100,000) and India (883/100,000). However, this is higher than an earlier study conducted in Uganda which reported an overall crude incidence rate of 215 per 100000 person-years, (age-adjusted: 156 per 100000 person-years). People with epilepsy in our survey were not routinely attending and receiving anti- epileptic therapy for their seizure control. The treatment gap in our setting appears due to problems with medication access, lack of follow-up, and epilepsy stigma. The overall prevalence of chronic primary headaches was 18.4% (95% CI), this is slightly lower than earlier studies in similar regions in Africa. A higher prevalence was recorded in Zambia (72%) (gender- and habitation- adjusted 61.6%) whereas, lower prevalence was reported in Ethiopia (21.6%) .36 Among the other benefits of proper health examination are improved relations between nurses and patients, accurate nursing diagnosis, and representation of nursing as a science-based profession. Hence, obtaining the history and performing a physical examination are a part of the health-related examination.37 In recent years, emphasis has been placed on the self-assessment of the skills adopted by nurses and nursing students. However, many nurses criticize the duplicity of such assessments, and experience discomfort and conflict while performing examinations. In addition, nurses do not consider obtaining physical examination skills as essential. Furthermore, some nurses use these skills only based on the needs of a particular group of patients. Moreover, in reality, some of these examinations may not be carried out due to nurses’ lack of self- confidence.38 STATEMENT OF PROBLEM To evaluate the effectiveness of computer assisted teaching on knowledge and practice regarding neurological assessment, an experimental study on nursing students in selected colleges. SCOPE The scope of present study is to focus on the effectiveness of computer assisted teaching on knowledge and practices regarding neurological assessment among 10

  11. nursing students with view to improve their existing knowledge and to develop practices by giving pamphlets regarding neurological assessment. AIM OF THE STUDY The aim of the study is to explore the knowledge and practices on the nursing students regarding neurological assessment with a view to improve their existing knowledge and practices by computer assisted program and provide pamphlets. GAP IN RESEARCH From 2012 to 2021 .Total 9 year gaps in a study to evaluate the effectiveness of computer assisted teaching on knowledge regarding neurological assessment on nursing students in selected nursing colleges. OBJECTIVES OF THE STUDY The objectives of the study are to:- 1. To assess the pre-test knowledge and practices regarding neurological assessment among nursing students. 2. To assess the post-test knowledge and practices regarding neurological assessment among nursing students. 3. To find out the correlation between pre-test knowledge and practices regarding neurological assessment among nursing students. 4. To find out the correlation between post-test knowledge and practices regarding neurological assessment among nursing students. 5. To find out the relationship of pretest knowledge with selected demographic variables such age ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and Neuro unit, proficiency control for procedure during training ,source of information regarding neurological assessment. 6. To find out the relationship of pretest practice with selected demographic variables such as age ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and Neuro unit, proficiency control for procedure during training ,source of information regarding neurological assessment. 11

  12. 7. To prepare pamphlets regarding neurological assessment among nursing students. OPERATIONAL DEFINITIONS Effectiveness:-Effectiveness is the capability of producing a desired result or ability to produce desired output Computer assisted teaching:-Any learning that is mediated by a computer Knowledge:-It is an understanding or information about a subject that you get by experience or study. Practice :-Practice means something that is usually or regularly done, often as a habit, tradition or custom. Neurological assessment:-It is a series of questions and tests to check brain, spinal cord and nerve function. Nursing students:-Those students who are studying in nursing college. ResearchHypothesis H0 There will be no significant difference between mean pretest and posttest knowledge score after computer assisted teaching programme regarding neurological assessment H1There will be significant increase in posttest knowledge and practice score as compare to pretest knowledge and practice score after computer assisted teaching programme regarding neurological assessment H2There will be positive correlation between posttest knowledge and practice score after computer assisted teaching programme regarding neurological assessment H3There will be significant association between the pretest knowledge of nursing students regarding neurological assessment with selected demographic variables. H4There will be significant association between the pretest practices of nursing students regarding neurological assessment with selected demographic variables. Rational (Guillen VG 2015)39The meanpost testknowledge score of nursing students after computer assisted teaching programme on neurological assessment was 12

  13. significantly higher than the pre test knowledge as evident from structured questionnaire at p>0.05 level of significance. DELIMITATIONS This study is delimited to: 1. Nursing students who were not be interested in study. 2. Nursing students who were not willing to participate. 3. Nursing students were not present at the time of study CONCEPTUAL FRAMEWORK A conceptual framework broadly presents an understanding of the phenomenon of interest and reflects the assumptions and philosophic views of the model’s designer. Conceptual models can serve as spring boards for generalizing research hypotheses. Theory is the basis of all scientific work. Theorizing is a central process in all scientific endeavors. The critical thinking is essential to all profession understanding. In the current study, King’s theory of Goal Attainment was applied to investigate the phenomenon of interest. APPLICATION OF THEORY OF GOAL ATTAINMENT TOTHE CURRENT STUDY King (2002)40 stated that communication is the interchange of thoughts and opinions among individuals. Communication is the main key for facilitating mutability and trust between the nurse educator and the nurse. “To evaluate the effectiveness of computer assisted teaching on knowledge and practice regarding neurological assessment, an experimental study on nursing students in selected colleges.” King’s concept of nursing is applied to this study as follows; “Nursing is anointer personal process of action, reaction, interaction and transaction, whereby the nurse educator and the nursing student share information about their perceptions in the nursing situation”. King added, “Nursing is a process of human interaction, 13

  14. between the nursing students and the nurse educator where by each perceives the other and the situation, and through communications, they set goals, explore means and agree on means to achieve goals”. Kings (1996) King put particular emphasis on the nursing student’s ability for critical thinking, observation of behavior, and the collection of specific information essential for decision- making, to meet the needs of individuals at a particular point of time. Computer assisted teaching on neurological assessment serves this purpose, by explaining about the importance of “Alert and Action lines”. The delivery of nursing care to patients therefore becomes a process of thinking as well as doing, as nursing students continuously maintain neurological assessment and makes decision based on it to prevent complications. This can be measured by monitoring patient outcomes. Kings (1996) King’s perspective of the process of nursing reflects the science of nursing, which enables critical thinking to discover the rationale for actions taken. Computer assisted teaching on neurological assessment provides such qualities. Goal attainment needs ongoing evaluation. According to king goal attainment leads to effective nursing care. In this study, “Enhancing the knowledge and linked it with the practices of the nursing students on neurological assessment” is the goal established by the nurse educator and the nursing students. If this goal is attained, it ensures effective neurological assessment. If goals are not attained, the nurse educator and the nursing students need to re-examine the process of educating, critical thinking and transaction. Perceptions Perceptions refer to each person’s representation of reality. Perceptions are related to experiences, concept of self, socioeconomic group, biological inheritance, and educational background. In this study, the nurse educator perceives the inadequacies of the situation and analyzes the maternal mortality and morbidity rates. The 14

  15. nurse educator also perceives the need to educate the nursing students on neurological assessment. The nursing student perceives the need to update their knowledge and link it with the practices on neurological assessment. Judgement Judgement is defined as “a dynamic and systematic process by which goal- directed choice of perceived alternatives is made and acted upon by individuals or groups to answer a question and attain a goal”. In this study, judgement by the nurse educator is deciding to teach about neurological assessment and judgement by the nursing students is deciding to learn about neurological. Action Communication between the nurse educator and the nursing students occurs, thus creating action. In this study, action by the nurse educator refers to the pretest conducted by the nurse educator to assess the knowledge by self- administered questionnaire and practices by check list of nursing students. Reaction Reaction occurs as a result of action. In this study, reaction is that the nursing students lack knowledge and unsatisfactory practices on neurological assessment. Disturbance Inadequate knowledge and unsatisfactory practices of the nursing students, are the disturbance felt in this study. Mutual Goal Setting The nurse educator and the nursing students mutually decide to enhance the knowledge and development of practices on neurological assessment, and to attain this goal, the nurse educator prepares the computer assisted teaching on neurological assessment. Interaction Interaction is “a process of perception and communication between person and environment, between person and person, represented by verbal or non- verbal 15

  16. behaviors that are goal- directed. In this study, interaction is the computer assisted teaching on neurological assessment by the nurse educator to the nursing students. 16

  17. CONCEPTUALFRAMEWORK Fig: 1 Modified King’s Goal attainment theory for save and effective using neurological assessment Inadequate Knowledge & Poor Practices Perception: - Promoting safe neurological assessment, it preventing further complication in future Reaction Mutual goal setting: -The nurse educator & the nursing students mutually decide to enhance the knowledge & practices on neurological assessment Interaction Transaction - Conducting Post test to find out increase the knowledge and satisfactory practices Nursing students In nursing college Implementation of Computer assisted teaching on neurological assessment by the nurse educator to the nursing students. Nursing students lack knowledge on neurological assessment Judgment :Deciding to update knowledge& link it with practices of nursing students -To evaluating outcome Action: Conducting pretest to assess the knowledgeand practices of nursing students Action:Co-operating and filling the knowledge questionnaire and check list on Neurological assessment given in the pre test Nursing students in nursing college Judgement:Deciding to learn about neurological assesssement Perception:Need to update knowledge and satisfactory practices neurological assessment Promotes effective neuroAssessment Adequate or Moderately adequate knowledge& Good or Average Practice 17

  18. CHAPTER 11 REVIEW OF LITERATURE K.Chitra, Pooja Godiyal (2022)41 A pre-experimental study was conducted on Neurological Examination with 54 nursing students of Basic Bsc 3rd year in State college of nursing, 107 Chander nagar Dehradun.. The Pre test data was collected by using self-administered questionnaire and mean was of (12.2.). The obtained data was analyzed using descriptive statistics. (Teaching was given regarding anatomy and physiology of nervous system as well as OSPE conducted for neurological examination. After 7 days of intervention post test was conducted for the same group of students and mean score was (16.8).SD of the pre and post test score was (2.9&1.91) and t test was done to find out the difference between pre and post test score. Calculated’ T ‘value is (5.9) and tabulated value is 2.66. So Findings are suggesting that calculated value is higher than tabulated value. It shows that the effectiveness of structured teaching on Neurological Assessment. Further there was association of knowledge of neurological examination with their demographic variables and it was statistically significant at p< o.o5 level. The study Findings conclude that the student nurses had good knowledge after structured teaching programme regarding neurological examination. Usha Rani Kandula, Eshete Teklewold, et all (2022)42 Quasi-experimental research work was carried out at Asella teaching referral hospitals in the Oromia Region of Ethiopia to assess the effect of implementing an educational program regarding neurological examination on nurses. To hand pick up 56 study samples, a convenient sampling technique was asserted. At first, a comprehension set of questions on neurological examination has been used to undertake a pre-measurement evaluation, which was accompanied by a two-week self-administered intervention in an educational program regarding the neurological examination. Followed that, the same comprehension set of questions on neurological examination was used for post-measurement evaluation among nursing professionals.. The investigation 18

  19. outcomes showed that the pre-measurement mean and SD were 13.02± 2.62, while the post-measurement mean and SD were 22.63± 3.21. The paired-t- test resulted in t=26.24 (p=0.00, df-55, S*) for the effect of implementing an educational program regarding neurological examination among nurses. Whereas, linear multiple regression was explained with no statistically significant association between pre-measurement knowledge and the study’s demographic factors. The study strongly indicates that there is a significant effect of implementing an educational program regarding neurological examination among nurses. Dr. Snehal Patil , Ms. Mayuri Dhoke et all (2022)43 A descriptive study has been conducted by focusing on objective to assess effectiveness of lecture cum demonstration method on knowledge of nursing students regarding neurological assessment. Material &method :A descriptive evaluative approach and one group pre-test and post-test design was used . The sample size for the present study was 40 undergraduate nursing students.The knowledge of samples assessed by administering structured questionnaire developed on neurological assessment followed with administration of lecture cum demonstration method. Post test conducted on 7th day after implementation of lecture cum demonstration. The ‘t’ test was computed to find out the effectiveness of lecture cum demonstration method.Result :Maximum of samples 27 (67.5%) were with average knowledge in pre-test and followed by maximum samples 31 (77.5%) were with good knowledge and 7 (17.5%) found with excellent knowledge score in post test. As ‘t’ value was found to be 14.95 for overall knowledge regarding topic. Conclusion:This revealed that the lecture cum demonstration method is an effective method for improving knowledge regarding neurological assessment among the undergraduate nursing students. Ms. Sheetal Barde1, Dr. Sheela Upendra (2021)44 A descriptive study to Assess the Knowledge Regarding Neurological Assessment among Nurses 19

  20. working in Selected Hospitals of Pune City. Aims: The present work targets to assess the knowledge in performing Neurological Assessment among staff nurses working in the selected hospitals. Methodology: Quantitative descriptive design is used. Sampling method used is Convenience sampling. Data analysis was completed using the (SPSS) version 20. Result: Findings showed that(52.7%) were staff nurses, almost half of the participants (56.7%) were diploma nurses. Maximum nurses were in their 30s. Almost more than half (62 %) nurses were having more than 5 years of experience. 64.3% of participants were female nurses. Results showed that the nurse’s knowledge on Neurological Assessment is poor regarding Neurological Assessment Amita Patel (2021)45 Pre-experimental approach was used with one group pre test post test design. The investigator used convenient sampling technique for selecting 40 samples. A structured knowledge questionnaire to assess the knowledge of the samples. The reliability of the structured knowledge questionnaire was determined by 'test-retest method' and using 'Karl pearson’s correlation coefficient formula'. Descriptive and inferential statistics was used to analyze the data. Results Majority of the samples 24 (60%) belong to the age group of 20 to 30 years, majority 34 (85.0%) of samples were female, majority of the samples 30 (75%) belong to GNM, majority of the samples 15 (37.5%) had 0 to 2 years of experience and majority of the samples 38 (95%) had not attended any training/workshop/seminar/In service education regarding neurological assessment. The mean pre-test knowledge score of samples regarding neurological assessment was 15.08, whereas mean post-test knowledge score was 24.55 with a mean difference of 9.47 and SD pretest was 2.84 and post test was 2.83 The calculated 't' value 39.453 was greater than tabulated 't'= 2.02 which was statistically proved at 0.05 level of significance. It revealed that the Planned Teaching Programme was effective in increasing knowledge among the Samples. The association between the pre test score and demographic variables was tested using the chi-square test. There was 20

  21. significant association found between pre-test knowledge score and demographic variables such as professional qualification and years of experience. Thus it was concluded that there was significant association between pre test knowledge score and the selected demographic variables and also between pre test practice score and the selected demographic variables. Mahesh Bamani (2021)46 A study was conducted to assess the effectiveness of planned teaching programme on Knowledge and Skills Regarding Use of Glasgow Coma Scale in Neurological Assessment. A total of 55 staff nurses working in Critical Care Units of KLES Hospital and MRC, Belgaum were selected for the study. The findings of the study revealed that during pre-test, 41(74.55%) of the staff nurses had average knowledge and 14(25.45%) had poor knowledge. After the administration of PTP in post-test 38 (69.09%) of staff nurses had good knowledge and 17(30.91%) had average knowledge. The study also revealed that during the pre test all the staff nurses 46(83.64%) had average skill. After the administration of the PTP in post-test 35(63.64%) of staff nurses had average skill and 20(36.36%) had good skill. Thus the study concluded that, PTP was useful in including the knowledge & skill in using glasgow coma scale in neurological assessment of patients by the nursing staff. Poje (2020)47 A survey study wrote of a similar experience when discussing a patient’s exam findings with a student. The student had been taught many exam techniques but had difficulty determining the importance of each finding. Just teaching assessment skills alone does not teach a nurse how to analyze the exam findings. This lack of clinical judgement application can increase the risk of missing the signs of patient deterioration. To graduate students who can apply clinical judgement to provide safe, effective care, faculty must discern the “need to know” from the “nice to know”. Sherin PK(2019)48 A cross-sectional study was conducted to assess the knowledge regarding the Glasgow coma scale among Nurses of Bharatpur 21

  22. Hospital, and College of medical sciences in the ICU, Neuro ward, post- operative ward and Emergency ward from July to August 2018. Sample size was calculated based on study conducted by P. K. Sherin in Lucknow showed that 10.01% had good (74.0%) of the nurses worked less than or equals to one year in critical care unit, 57.8% of nurses have not participated in in-service education regarding GCS. Likewise, most of the nurses (81.8%) reported that they had a protocol regarding GCS in their working area and 88.3% of the nurses had habit of self- directed learning. Prashik Baburao Chavhan (2019)49 A study was conducted to assess the effectiveness planned teaching programme on Knowledge Regarding Care of Head Injury Patients among Staff Nurses Working in Selected Hospitals, Punjab. Quantitative evaluative research approach and Pre-experimental one group pre-test post-test design was adopted. Sample size comprised of 50 staff nurses, nonprobability convenience sampling technique was used for sample selection. Structured questionnaire was used to assess the knowledge of staff nurses regarding care of head injury patients. The study findings revealed that mean pre-test knowledge score was 13.16 with SD 2.333 and mean posttest knowledge score was 24.04 with SD 2.657 with calculated t- value 29.151 which indicates that there was statistically significant increase in the post knowledge score (p<0.001). Findings of the study also indicated that there was no statistical significant relationship between post-test knowledge score of staff nurses with selected socio-demographic variables (p<0.05). Hence, it was concluded that PTP was effective in the enhancement of knowledge regarding care of head injury patients among staff nurses. Divya K Y (2018)50A study was aimed to assess the effectiveness of a structured training program on comprehensive neuro system assessment among registered nurses. Materials& Methods: This pre testpost test research design was carried out among a convenient sample of 83. Data was collected before and after the training program, using a semi structured questionnaire prepared by the researcher assessing knowledge on various aspects of neuro 22

  23. assessment like consciousness, orientation, memory, cognition, mental status, motor, sensory and reflex assessment. The training program was developed and validated by the researcher before it is being implemented. Data analysis was done by using descriptive and inferential statistics. Results: The study has shown the structured training program was effective in improving the knowledge of graduate nurses. The entire pretest knowledge mean score out of 20 was 12.7 with a standard deviation of 2.56. The posttest knowledge mean score was 17.41 with a standard deviation of 1.97 Conclusion: The study has shown that structured training program was effective in improving the knowledge of graduate nurses. There should be provision of in-service education for nursing personnel to update their knowledge so that they can enhance their assessment skills for quality care. Pandey A (2018)51 A quasi experimental study The aim of this research was to identify the efficacy of lecture cum demonstration on the knowledge and skills of the nursing students regarding cranial nerve assessment. The pre- experimental research design approach was considered appropriate for conducting this study. About 200 nursing students getting education in hand- picked nursing colleges of Lucknow were considered appropriate for this study. The relevant fact was gathered using self-prepared multiple choice knowledge questionnaires and an observation check list to assess the clinical expertise of the students. The lecture cum demonstration was effectual in upgrading the knowledge and clinical expertise of the student nurses. Ji Yeon Shina , S. Barry Issenbergb et all (2017)52 A Quasi experimental study The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. Design: This study used a non-equivalent control group pretest- posttest design. Settings: Nurses working in the neurology and neurosurgery wards, Republic of Korea Participants: A convenience sample of 50 nurses was assigned to either the experimental group (n = 24) or the control group (n = 26). Methods: The experimental group participated in the self-directed e- 23

  24. learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and selfconfidence were measured at pretest and posttest. Results: There were no significant differences in knowledge (U = 270, p = 0.399) and self-confidence (U = 241.5, p = 0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U = 199, p = 0.028). Conclusions: Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment. Kohtz, et al.(2017)53published a study which replicated Giddens’ original 2007 study by surveying fourth semester students. The results determined the frequency of physical exam skills used in the students’ clinical care. Of the 126 physical assessment skills surveyed, only 21 skills were used each time the student was in clinical practice. An additional nine physical exam skills were performed two to five times per week. In another study evaluating final semester nursing students, researchers found that of 126 skills taught, 53 skills were never performed during the students’ clinical practice. Douglas et al.(2015)54 at an Australian University found that students routinely used only five out of Giddens 126 assessment skills. The students performed evaluation of breathing, assessment of capillary refill, palpation of temperature in the extremities, and assessment of mental status/level of consciousness using the Glasgow Coma Scale at every assessment. Another 10 skills were regularly or frequently used. Levelling of nursing programs and access to technology may vary across countries, further adding to differences in curricula and nursing practice patterns. World Health Orgnization (2015)55Using a cross sectional community based survey, we randomly selected 3000 adults, aiming at interviewing at least one adult per household selected. About 1500 subjects from two sub- 24

  25. counties of Mukono Town Council and Kojja over a 6 months period from June 2014 – December 2014 were enrolled for this study. Mukono Town Council and Kojja sub-counties represented urban and rural populations respectively. This classification was based on information from the Mukono district administration and the current level of urbanization. During this community survey, 3000 adults were screened from the list of households randomly generated from a census database at each sub – county. The stepwise approach was followed as shown below; Administration of a questionnaire, physical measurements such as weight, height, waist hip ratio, blood pressure and neurological examination and laboratory measurements; including fasting blood glucose and lipid parameters. Anderson, et al. (2014)56 conducted a survey study surveyed 900 nurses using Gidden’s 126 skills and asked the nurses to report the frequency of use. Based on survey, only 37 competencies were felt to be essential components of the physical assessment. As new prelicensure nursing health assessment faculty and experienced nurse practitioners, course faculty wondered why we were teaching advanced practice physical assessment skills to first semester nursing students. These skills are rarely, if ever, used in general practice by a registered nurse. Examples of rarely used physical assessment skills included: diaphragmatic excursion, liver span, chest percussion and assessment of cardiac borders. In addition, course faculty were hearing from second semester medical/surgical clinical faculty that students lacked confident in the basic patient physical assessment skills. Clinical faculty noted that students were struggling to apply physical exam findings in a meaningful way. 25

  26. CHAPTER 111 METHODOLOGY Research methodology is a way to solve the problem systematically. It is a procedure in which the researcher starts from initial identification of the problem to final conclusion. Methodology of research organizes all the component of the study in a way that is most likely to lead to valid answer to the problems that have been posed. Research Design Research Setting Target Population Sample and Sampling Technique Inclusion criteria Exclusion criteria Demographic Variable Independent variable Dependent Variable Selection and Development of tool Description of the tool Criteria measure Content validity of tool Ethical consideration Pilot study Reliability of tool Data collection procedure Difficulty faced by an investigator Plan of data analysis Testing hypothesis Expected outcome Relevance of Expected Results Summary 26

  27. Research Design The term research design refers to the plan or organization of a scientific investigation. The selection of research design is the most important step as it provides the framework for the study. It helps the investigator in the selection of subjects, manipulation of independent variable, observations to be made, and the statistical analysis to be used to interpret the data. For the present study a pre experimental one group pre-test and post-test research design and quantitative research approach will be used to assess the knowledge regarding neurological assessment and their relationship with selected variables. The research design will utilize for the present study to achieve the stated objectives. Schematic –Representation:- Pre test Intervention Post test 01 X 02 The Symbol used are :- 01:-Pre test score to assess the level of knowledge among nursing students regarding neurological assessment X computer assisted teaching programme was given to nursing students regarding neurological assessment 02 :-Post test score to assess the level of knowledge among nursing students regarding neurological assessment 27

  28. Independent Variables Criterion Measures Population and Sample Dependent Variables Knowledge Score (Questionnaire)  age ( in years)  professional Maximum Score=32 Minimum Score = 0 Knowledge course %age  gender Knowledge Nursing (Score)  type of stay and Students of INADEQUATE KNOWLEDGE (0-10) MODERATE KNOWLEDGE (11-21) ADEQUATE KNOWLEDGE (22-32) Practice Score (Check list)  occupation of practices of 30-35 Nursing mother nursing  occupation of Colleges of 36-70 students father Moga regarding  training institute 71- 100 neurological  training institute have u ever been assessment to ICU and Neuro Maximum Score=20 Minimum Score = 0 Practice Score unit N = 500  %age proficiency control for 30-35 POOR PRACTICE (0-7) procedure during 36-70 AVERAGE PRACTICE (8-14) training 71-100 GOOD PRACTICE (15-20)  source of information FIGURE 2: RESEARCH DESIGN 28

  29. Research Setting It is the physical location and condition in which data collection take place in a study. The selection of an appropriate setting is important because the setting can influence the way the people behave, feel and how they response. The study was conducted in Dr Shyam Lal Thapar College Of Nursing in moga which is located at distance of 5 kilometers from main city. The total students strength of college was 800. The reason for selecting this college was investigator’s expected cooperation from authorities in getting permission for conducting the study. Target Population A population is the entire aggregation of cases that meets a designated set of criteria for researcher. The target population of the study was GNM Nursing, B.Sc Nursing, Post Basic Nursing from Dr Shyam Lal Thapar College Of Nursing , Moga Sample size and sample technique The researcher has selected a sample of 500 nursing students (for one group pre-test and post-test) by using Purposive sampling method of non- probability sampling technique. Inclusion and Exclusion criteria Inclusion criteria Nursing students were studying in GNM, BSC Nursing and Post Basic B.SC Nursing in selected nursing college, Punjab Nursing students who were willing to participate. Nursing students who were available at the time of data collection. Exclusion criteria The Nursing students who were absent on the day of data collection excluded from study. Nursing students who were not willing to partici 29

  30. Demographic Variables In this study the demographic variable wereage ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and Neuro unit, proficiency control for procedure during training ,source of information. Independent Variables In this study, independent variable was computer assisted teaching programme regarding neurological assessment Dependent variable In this study, dependent variable were knowledge and practices of nursing students regarding neurological assessment Selection and development of tool As the study wasto evaluate the effectiveness of computer assisted teaching on knowledge and practice, an experimental study regarding neurological assessment on nursing students in selected colleges.. Therefore a Self Structured questionnaire and Check list was preparedto assessthe knowledge of nursing students regarding neurological assessment. Preliminary drafting of multiple choice questionnaire and check list (tool) and computer assisted teaching programme was prepared after extensive review of literature and after consulting with various experts. Description of tool The tool consists of following parts:- Section A :-Demographic Variables (Sample characteristics) This part consists of items for obtaining personal information about subjects such as age ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and 30

  31. Neuro unit, proficiency control for procedure during training ,source of information. Section B :- Structured questionnaire to assess the knowledge of nursing students regarding neurological assessment This part consists of self structured multiple choice question regarding neurological assessment. The test consists of 32 questions which have one correct answer. Criterion Measure:- Part- 1 It was related to sample characteristics which were not included in scoring system. Part -11 A structured questionnaire regarding neurological assessment. Correct response remarks 1 mark Incorrect response remarks 0 marks. Maximum score was 32 Minimum score was 0 Level of Knowledge Score % Inadequate Knowledge 0-10 0-31 Moderate Knowledge 11-21 32-67 Adequate Knowledge 22-32 68 -100 Section C: - Check list to assess the Practice of nursing students regarding neurological assessment The part consists of 20 questions regarding neurological assessment A total of 20 questions were included. Correct response remarks 1 mark Incorrect response remarks 0 marks Maximum score was 20 31

  32. Minimum score was 0. Level of Knowledge Score % Poor Practice. 0-7 0-35 Average Practice. 8-14 36-70 Good Practice 15-20 71-100 Validity of the tool The tool was given to 15 experts from the field of psychiatric nursing, pediatric nursing, medical surgical nursing, obstetric and gynecological nursing and community health nursing. The experts were requested to give their valuable opinion and precious suggestion. As per their guidance and experience I prepared my tool and check list. Ethical consideration Written permission was obtained from authority and objectives were explained. Verbal consent was taken from nursing students for their participation in study and assured that information given by them will be kept confidential and will be purely used for research purpose. Pilot study Pilot study is small version or trail run, done in preparation for a major study. The samples consist of 50 nursing students. It was conducted to find out the reliability and feasibility of study. The pilot study was conducted in the month of sept 2021 to ensure the reliability of the tool and feasibility of the study. The pre test of nursing students was taken to assess their knowledge regarding neurological assessment. The computer assisted teaching programme was given to group on neurological assessment. The time spend for computer assisted teaching programme was 45 minutes. The post test was taken of the subjects after the gap of 48 hours to evaluate the effectiveness of computer assisted teaching programme regarding neurological assessment. Reliability of tool 32

  33. Reliability refers to the accuracy and consistency of measuring tool. The tool after validation was subjected to test for its reliability. Reliability of the tool was computed by split half method, Karl Pearson’s correlation coefficient formula and Spearman’s Brown proficiency formula. The reliability of knowledge score was r = 0.9 and statistical validity was r’= 0.94. The reliability of practice was r = 0.85 and statistical validity was 0.92 that shows tool was highly reliable. Data Collection procedure The data was collected after formal permission from Principal of Dr shyam Lal Thapar college of nursing, moga. Data was collected in the month of Jan 2022. The sample consisted of 500 nursing students. Purposive sampling method was used to select sample. Prior to fulfill the questionnaire, the researcher gave self introduction to the patients and explained the purpose of gathering information, a good rapport was established with nursing students they were assured that response would be kept confidential and should be used for research purpose. Structured questionnaire and check list was used to collect the data. The informed consent was taken from nursing students. Prior information was given to nursing students before pre test and computer assisted teaching programme. The time spend The time spend for computer assisted teaching programme was 45 minutes. The post test was taken of the subjects after the gap of 48 hours to evaluate the effectiveness of computer assisted teaching programme regarding neurological assessment. Difficulty faced by researcher Researcher found difficulty to collect sample because students went to clinical area. Plan for data analysis Analysis of the data was done in accordance with the objectives. It was done by using descriptive and inferential statistics such as reliability of tool, 33

  34. percentage, standard deviation, Karl Pearson’s correlation -coefficient etc. Pie chart and bar diagram were used to depict the findings. Testing hypothesis The mean post test knowledge score of nursing students after computer assisted teaching programme on neurological assessment will be significantly higher than the pre-test knowledge as evident from structured questionnaire, at p<0.05 level of significance. Expected outcome The mean post test knowledge score of nursing students after computer assisted teaching programme on neurological assessment will be significantly higher than the pre-test knowledge in experimental group. Relevance of Expected Results The mean post test knowledge score of nursing students after computer assisted teaching programme on neurological assessment will be significantly higher than the pre-test knowledge as evident from structured questionnaire, at p<0.05 level of significance. Summary This chapter dealt with research a Research Design, Research Setting, Target Population, Sample and Sampling Technique, Inclusion and exclusion criteria, Development and Description of Tool, Validity of tool, Ethical consideration, Pilot study, Reliability of tool, Data collection procedure, Difficulty faced by an investigator, Plan of data analysis, Testing hypothesis, Expected outcome and Relevance of Expected Results. 34

  35. ANALYSIS & INTERPRETATION OF DATA This chapter deals with the description of sample, analysis and interpretation of data collected from those nursing students of selected colleges of Moga (Punjab)." Data analysis enables the researcher to reduce, summarize, organize, evaluate, interpret and communicate numerical information. (Sharma S.K 2017)57 This chapter deal with theanalysis as the categorizing, ordering, manipulating and summarizing of data to reduce it to a tangible and interpretable from so that research problem can be studied and tested including the relationship between variables. Analysis and interpretation of the data was done in accordance with the objectives laid down for the study. The data has been analyzed by using descriptive and inferential Statistics i.e. calculating mean, mean percentage, standard deviation ‘test, ANOVA and chi square test. The results of the study were shown in the form of tables and figures. Statement of Problem To evaluate the effectiveness of computer assisted teaching on knowledge and practice regarding neurological assessment, an experimental study on nursing students in selected colleges. Objectives of the Study The objectives of the study are to:- 1. To assess the pre-test knowledge and practices regarding neurological assessment among nursing students. 2. To assess the post-test knowledge and practices regarding neurological assessment among nursing students. 3. To find out the correlation between pre-test knowledge and practices regarding neurological assessment among nursing students. 4. To find out the correlation between post-test knowledge and practices 35

  36. regarding neurological assessment among nursing students. 5. To find out the relationship of pretest knowledge with selected demographic variables such age ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and Neuro unit, proficiency control for procedure during training ,source of information regarding neurological assessment. 6. To find out the relationship of pretest practice with selected demographic variables such as age ( in years), professional course, gender, type of stay, occupation of mother, occupation of father, training institute, have u ever been to ICU and Neuro unit, proficiency control for procedure during training ,source of information regarding neurological assessment. 7. To prepare pamphlets regarding neurological assessment among nursing students. ORGANIZATION OF FINDINGS The data was organized, analyzed and presented under the followings headings. Section –1 Description of frequency and percentage distribution of the nursing students according to the selected demographic variables . Section – 11 Analysis of the percentage of pretest knowledge and practices of nursing students on different aspect on neurological assessment . Section -111 Analysis of the percentage of posttest knowledge and practices of nursing students on different aspect on neurological assessment Section -1V Correlate the pretest knowledge and practices of nursing students on different aspect on neurological assessment. 36

  37. Section –V Correlate the posttest knowledge and practices of nursing students on different aspect on neurological assessment. Section –V1 Association between pretest knowledge scores and demographic variables of nursing students 37

  38. SECTION 1 DEMOGRAPHIC VARIABLES Table - 1 Frequency and Percentage Distribution of Sample characteristics N= 500 Demographic Variables n % 19-22 years 210 42.2 23-26 years 193 38.6 Age (in years) 27-30 years 6 1.0 ≥31 years 91 18.2 GNM 127 42.2 Nursing Professional BSc 173 38.6 Course Nursing Post basic 200 1.0 BSc nursing Male 205 41.0 Gender Female 295 59.0 Home 108 21.6 Type of Hostel 89 17.8 stay PG 303 60.6 Medical 128 25.6 Occupation Non- of 174 34.8 Medical mother Other 198 39.6 Medical 100 20.0 Occupation of Non- 193 38.6 father Medical 38

  39. Other 207 41.4 Private 205 41.0 Training Government 283 56.6 Institute Both 12 2.4 Have you ever Yes 205 41.0 been to ICU and No 295 59.0 Neuro unit Independent 0 0.0 handling Assist with health 206 41.2 personal Proficiency Observation control 173 34.6 only on procedure during training Demonstration 115 23.0 period All the 6 1.2 above None of 0 0.0 these Mass media 3 0.6 Seminars 183 36.6 Source of Work shop 218 43.6 Information Teachers 96 19.2 No any 0 0.0 Source Table 1 figure 3 (a- j) reveals that the subjects were studied by placing them into various categories according to age, Professional course, Gender, type of stay, Occupation of mother, Occupation of father, Training Institute, Have you ever been to labour room, Proficiency control on procedure during training period, Source of Information health. The findings were as follow– 39

  40. According to age, the maximum 210(42.2%) nursing students belong to age group 19-22 years, followed by 193(38.6%) of nursing students by 23-26 year, 51(26%), 91(18.2%) of nursing students were belong to age group ≥31 years and minimum 6(1%) nursing students from 27-30 years. According to Professional Course, 200 (40%) students were doing Post Basic B.Sc. Nursing course , followed by 173(34.6%) B.Sc. Nursing and 127(25.4%) were doing GNM course. According to Gender, maximum 295(59%) nursing students were female 205(41%) nursing students were male. According to type of Stay, maximum 303(60.6%) students were staying in PG, followed by 108(21.6%) nursing students stay at Home and 89(17.8%) nursing students were staying in hostel. According to mother’s occupation198(39.6%) students, mothers were working in other fields, followed by 174(34.8%) in Non- medical field and 128(25.6% were working in medical field. According to father’s occupation 207(41.4%) students mothers were working in other fields, followed by 193(38.6%) in non- medical field and 100(20%) were working in medical field. According to training Institute, maximum 283(56.6%) nursing students got training from government hospital, followed by 205(41%) students got training from private hospital and minimum 12(2.4%) nursing students got training from was both. (government and private hospital ). According to Have you ever been to ICU and Neuro unit, majority of students 295(59%) were having been to ICU and Neuro unit, 205(41%) were not having been to ICU and Neuro unit. According to Proficiency control on procedure during training period, majority of students 206(41.2%) had assisted with health personals during 40

  41. neurological assessment, followed by 173(34.6%) who only observed the procedure, 115(23%) had been demonstrated, 6(1.2%) are concerned with all the above and no one comes under independent handling and none of these. According to Source of information, maximum 218(43.6%) nursing students got information from workshops, followed by 183(36.6%) nursing students learned from seminars, 96(19.2%) nursing students from teachers and minimum 3(0.6%) nursing students got knowledge from mass media. Thus it was concluded that According to age, the maximum 210(42.2%) students were belongs to age group of 19-22 years, and minimum number 6(1%) students were belong to age group of 27-30 years. According to Professional Course,maximum 200 (40%) students were doing Post Basic B.Sc. Nursing, followed by 173(34.6%) B.Sc. Nursing and minimum 127(25.4%) nursing students were doing GNM course. According to Gender, maximum 295(59%) nursing students were female and minimum 205(41%) nursing students were male. According to type of Stay,maximum 303(60.6%) nursing students were staying in PG and minimum 89(17.8%) nursing students were staying in hostel. According to mother’s occupationmaximum 198(39.6%) nursing students, mothers were working in other fields, and minimum 128(25.6%) nursing students were working in medical field. According to father’s occupationmaximum 207 (41.4%) nursing students fathers were working in other fields and minimum 100 (20%) nursing students were working in medical field. According to training Institute, maximum 283(56.6%) nursing students got training from government hospital and minimum 41

  42. 12(2.4%) nursing students got training from both.( Private and Government hospital ) According to Have you ever been to ICU and Neuro unit majority of students 295(59%) were learn about neurological assessment to ICU and Neuro unit, 205(41%) were not having been to ICU and Neuro unit. According to Proficiency control on procedure during training period, maximum number 206(41.2%) nursing students had assisted with health personals during neurological assessment and minimum 6(1.2%) nursing students were concerned with all the above and no one comes under independent handling and none of these. According to Source of information, maximum 218(43.6%) nursing students got information from workshops and minimum 3(0.6%) nursing students got knowledge from mass media. 42

  43. Table No: 1(a). Frequency and Percentage Distribution nursing students according to Age. Demographic Variables n % 19-22 years 210 42.2 23-26 years 193 38.6 Age (in years) 27-30 years 6 1.0 ≥31 years 91 18.2 Age (in years) 27-30 years 6 1% ≥31 years 91 18% 19-22 years 210 42% 23-26 years 193 39% 19-22 years 23-26 years 27-30 years ≥31 years Figure No 3(a): Percentage distribution of nursing students according to age (in years) 43

  44. Table No: 1(b) Frequency and Percentage Distribution nursing students according to professional course. Demographic Variables n % GNM 127 42.2 Nursing Professional BSc 173 38.6 Course Nursing Post basic 200 1.0 BSc nursing Professional course Post basic BSc nursing 200 40% GNM Nursing 127 25% BSc Nursing 173 35% GNM Nursing BSc Nursing Post basic BSc nursing Figure no 3 (b) Percentage distribution of nursing students according to professional course 44

  45. Table No: 1(c) Frequency and Percentage Distribution nursing students according to gender . Demographic Variables n % Male 205 41.0 Gender Female 295 59.0 Gender Male 205 41% Female 295 59% Male Female Figure no 3 (c) Percentage distribution of nursing students according to gender 45

  46. Table No: 1(d) Frequency and Percentage Distribution nursing students according to type of stay. Demographic Variables n % Home 108 21.6 Type of Hostel 89 17.8 stay PG 303 60.6 Type of stay Home 108 21% Hostel 89 18% PG 303 61% Home Hostel PG Figure no 3 (d) Percentage distribution of nursing students according to type of stay 46

  47. Table No: 1(e) Frequency and Percentage Distribution nursing students according to occupation of mother. Demographic Variables n % Medical 128 25.6 Occupation Non- of 174 34.8 Medical mother Other 198 39.6 Occupation of mother Medical 128 25% Other 198 40% Non-Medical 174 35% Medical Non-Medical Other Figure no 3 (e) Percentage distribution of nursing students according to occupation of mother 47

  48. Table No: 1(f) Frequency and Percentage Distribution nursing students according to occupation of father Demographic Variables n % Medical 100 20.0 Occupation Non- of 193 38.6 Medical father Other 207 41.4 Occupation of father Medical 100 20% Other 207 41% Non-Medical 193 39% Medical Non-Medical Other Figure no 3 (f) Percentage distribution of nursing students according to occupation of father 48

  49. Table No: 1(g) Frequency and Percentage Distribution nursing students according to training institute. Demographic Variables n % Private 205 41.0 Training Government 283 56.6 Institute Both 12 2.4 Training institute Both 12 2% Private 205 41% Government 283 57% Private Government Both Figure no 3 (g) Percentage distribution of nursing students according to training institute 49

  50. Table No: 1(h) Frequency and Percentage Distribution nursing students according to have you ever been to ICU and neuro unit Demographic Variables n % Have you ever Yes 205 41.0 been to ICU No 295 59.0 and Neuro unit Have you ever been to ICU and neuro unit Yes 205 41% No 295 59% Yes No Figure no 3 (h) Percentage distribution of nursing students according to have you ever been to ICU and neuro unit 50

More Related