A STUDY TO EVALUATE THE EFFECTIVENESS OF

SELF INSTRUCTION MODULE ON KNOWLEDGE

REGARDING FIRST AID MANAGEMENT OF
BURN INJURIES AMONG HOUSEWIVES
RESIDING IN A SELECTED AREA
OF RAICHUR





PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION













ANITHA POLAMURI




NAVODAYA COLLEGE OF NURSING, RAICHUR


MAY-2012




RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA


PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION



1. Name of the candidate : Ms.Anitha Polamuri
M.Sc Nursing 1
st
year
Navodaya college Of Nursing
Manthralayam Road,
Raichur-584103


2. Name of the institution : Navodaya College of Nursing,
Raichur


3. Course of the study : M.Sc. Nursing 1
st
year,
and subject Medical and Surgical Nursing


4. Date of admission to
the Course : 20-10-2011



5. Title of the Topic :

A STUDY TO EVALUATE THE EFFECTIVENESS OF
SELF INSTRUCTION MODULE ON KNOWLEDGE
REGARDING FIRST AID MANAGEMENT OF
BURN INJURIES AMONG HOUSEWIVES
RESIDING IN A SELECTED AREA
OF RAICHUR





6. BRIEF RESUME OF THE STUDY

Injuries are part of the game, but
Sometimes we can avoid them by
Just practicing our techniques.
---- TROY VINCENT

6.1 NEED FOR THE STUDY

Home should be the safest place on the earth for a person and his family. But
unfortunately a number of hazards, particularly fire start in somebodys home and spreads
to the neighbourhood results in burn injuries. Sheer negligence and lack of attention to
leads to such a situation.

Burn injuries represent one of the most severe traumas the body can sustain. Globally,
burns are a serious public health problem. It is the leading cause of death in developing
world. Approximately 1.25 million people suffer a burn injury in the US each year. About
5,500 people die from burns & related inhalation injuries annually. One million work days
are lost each year due to burn injury.

Most burn injuries occur in the home, usually in the kitchen while cooking & in the
bathroom by means of scalds & by improper use of electrical appliances around water
resources.

Burns are the only type of unintentional injury where females have a higher rate of injury
than males. The fire related death for girls is 4.9 per 1, 00,000 population.

Burn injuries are type of injury to the flesh caused by heat, electricity, chemicals, light,
radiation or friction. Most burns affect only the skin (epidermis & dermis).



These are frequently the result of fires, automobile accidents, playing with matches,
improperly stored gasoline, space heaters and electrical malfunctions.
2
Other causes
include unsafe handling of fire crackers and kitchen accidents among housewives.

Burns can be caused by inhaling smoke, steam, superheated air, or toxic fumes often in a
poorly ventilated space.
10
Burns are one of the most common causes of injury to
housewives or females working in kitchen.

Burns are classified according to how seriously tissue has been damaged. The following
system is used:
A first degree burn causes redness and swelling in the outermost layers of
the skin.
A second degree burn involves redness, swelling, and blistering. The
damage may extend to deeper layers of the skin.
A third degree burn destroys the entire depth of the skin. It can also damage
fat, muscle, organs, or bone beneath the skin. Significant scarring is
common, and death can occur in the most severe cases.
11

Fourth degree burns are those that external down to muscle and or bone. Fortunately, these
burns are rare. Based on these, first aid management is given to burn injuries. It is
estimated that India has 0.4 million burn cases every year. Among those suffering from
burn injuries, women are more than the men (1.6:1)
10
.The overall mortality due to burn
injuries is 3.5 per 1, 00,000 population.

The risk factors associated with burns include cooking on open fire, explosion of pressure
stoves, instability of small stoves, use of open fires to keep warm during winter, use of
inflammable materials on housing & furnishing. The home is often a hot bed of fire
accidents.

Most of the deaths occur in poorer regions of the world among the WHO regions of Africa
& South East Asia & the low income & middle income countries of the Eastern
Mediterranean region.
15


The fire related mortality in the SEAR accounts for more than half of the global burden of
fire related burns. About two thirds of the global burden of fire related burns among
females was estimated to have occurred in South East Asian Region (SEAR). About two
thirds of the global burden of fire related burns among females was estimated to have
occurred in SEAR.
15





In India, 20,772 persons lost their lives in burn injuries & 2,793 were seriously injured. In
Karnataka, 1587 deaths & 30 serious burn injuries were reported.
2

In a longitudinal prospective design, all burn patients that were admitted to Ghotb-eddin
shirazi hospital were evaluated. Data in regard to patients social demographics, burn
injury & outcome measures were collected. Suicide attempts by burns accounted for
231(24.8%) of all burn patients admitted to hospital. Suicidal burns occurred
predominantly in the age group 15-24 years (49.1%).

First aid is the first assistance or treatment given to an injured person (casualty) for any
injury or sudden illness before the arrival of qualified medical care by using facilities and
material available at that time. Giving of first aid is an art which is acquired by getting
interested in the field and by training.
17

The overall aim must be to cool the burn, prevent ongoing burning & prevent
contamination. Education on the effect of immediate application of cool water to burns
should be promoted widely as an effective first-aid treatment.

A survey in India found that only 22.8% of patients had received appropriate first aid for
their burns. The remainder had either received no first aid or else inappropriate treatment
such as raw eggs, toothpaste, mashed potato or oil being rubbed into the burn.
3

The researcher was thus motivated to conduct a study to assess the knowledge of
housewives regarding first aid management of burn injuries.


6.2 REVIEW OF LITERATURE

The review of literature is a key step in research process. Review of literature refers to an
extensive, exhaustive and systematic examination of publications relevant to the research
project. The Review of related literature is valuable guide to define the problem,
recognizing its significance, suggesting promoting data gathering devices, appropriate
study design and source of data.

The review of literature can be brought under following headings-

A) Studies related to prevalence, incidence & epidemiology of burn injuries.
B) Studies related to effectiveness of self instructional module and other educational
Programs on burn injuries.



C) Studies related to knowledge of mothers, women and general public regarding first
aid management of burn injuries.
A) Studies related to prevalence, incidence & epidemiology of burn injuries.

A retrospective study was conducted on epidemiology of burn injuries among patients
admitted in specialist teaching hospital, Irrua, Nigeria. Data was collected from case notes
& operation registers. A total of 72 patients with burn injuries were identified. Of these
23(31.9%) were females. The commonest etiological agent was flame burn from kerosene
explosion. This accounted for 44(61.1%) patients. Another commonest cause was scald
burns in 17(23.6%) patients. Majority of burn injuries i.e 40(55.5%) occurred at home. Due
to the lack of Intensive care facility during this period, wound dressings were performed
with honey impregnated gauze over sofratulle & wrapped with gamgee as a first aid
treatment. The study concluded that there is a need for health education for the prevention
of burn injuries.
4


A prospective study was conducted on the epidemiology of burns among patients admitted
to a burns unit of a large government hospital, Madurai, Tamilnadu. Data collection was
done by personal interview with the patients. A total of 150 burn patients were treated;
among them 88 were females (58.7%) aged 15-70 years. Married women aged 15-24 years
suffered from burns significantly more than other age groups. A total of 83(55%) patients
were brought directly to hospital for first aid treatment. Among them, 33(49%) received IV
fluids, analgesics in 27(40%) patients & ointments in 11(17%) patients. The study
concluded that there is necessity of health education on prevention of burn injuries among
women.
5


A cross sectional study was conducted on epidemiology of burn injuries among patients
admitted in two tertiary care hospitals of Belgaum, Karnataka. Data was collected from
face-to-face interview with patients & relatives. The study included 316 burn patients;
among them 54.7 percent were females. Majority (69.60%) of burn cases were between 15-
44 years of age. 68 percent were from rural areas & out of total domestic burns 77.5
percent occurred in the kitchen. The study concluded that overall mortality was 41.6



percent; among the total deaths, 77 percent were females. The study concludes that a need
exists for creating awareness on burn injuries among women.
6

A retrospective study was conducted on prevalence of burns among patients admitted in
Burns unit of a tertiary care hospital, Nigeria. The study included 138 patients with acute
burns. The results shown that 66.7% were males & 46% were females with age range of 2-
80 years. Flame was the most common cause of burns. Out of 106 patients with known
cause of burns, 70 (66%), 12 (11.3%), 10 (9.4%), 7 (6.6%), 6 (5.6%) & 1 (0.9%) patients
had flame burns, scalds, and electricity, friction, chemical & chemo thermal injuries
respectively. The study concluded that the overall mortality rate was 45.8 percent & 55
percent of the burn injuries occurred indoor. So, there is a need for promotion of health
education among women on burns & its prevention.
1


B) Studies related to effectiveness of self instructional module and other educational
Programs on burn injuries.

An experimental study was conducted to evaluate the effectiveness of self
Instruction module on burns and fire prevention among elementary schoolStudents and
parents in USA. A 60 page prevention curriculum for grades 1
through 6 was Presented with two 32 page, picture story books regarding
scald prevention and family fire safety. Parent materials were provided in
Spanish and Somalia. Students were assessed by a pretest on knowledge regarding
fire safety and burn prevention. A post test was administered at the completion
of the grade appropriate curriculum and again at 6 months post instruction. The
study concludes that students and parents, after receiving materials and curriculum
showed significant improvement in knowledge from pre to post test. Such programs helps
sustain learning and effects knowledge retain well beyondInitial classroom instruction.
6


A continuing education programme was conducted in Kansas and pre-post survey
design was used to assess changes in participants knowledge and self-faced
ability, confidence and competence to perform in a burn disaster before and after
training. Participants (N = 383) were predominantly female (71.1%), 40 years or



older (57.7%), nurses (52.2%), were employed in a pre-hospital care setting (38%),
and had worked in healthcare for 10 years or fewer (53.6%). The percentage of
correct responses pre- v/s post-test increased between 30% and 65% on two-thirds
of the knowledge items. Most participants (64%) felt competent or highly
competent to manage multiple burn causalities after the training programme, and
most participants (58%) indicated that they intended to incorporate the newly
acquired knowledge into their daily practice within two weeks. The curriculum and
teaching methods achieved desired goals for improved knowledge, which appeared
to have been translated to enhanced abilities, confidence and competence in burn
assessment and treatment modalities
.1

A quasi-experimental study was conducted to evaluate the effectiveness of self
instruction module on care of patients with burns in the burns unit of Main
university, emergency hospital in El-Mansoura,Iraq.100 burn patients were
selected through convenient sampling method; who were divided randomly into
two equal groups; a study group for application of intervention and a control group
to receive the routine management of the hospital. Data was collected using
interview questionnaire and the Brief Burn Specific Health Scale. A rehabilitation
program with a self instruction module was provided to the study group patients,
while the control group received routine hospitals nursing management. The
programme effectiveness was evaluated through a post test done for both groups.
After implementation of self instruction module , the knowledge scores improved
in both groups; the magnitude of change was much lower in the control group
compared to those in the study group. The study concludes that the information
given through self instruction module proved beneficial in improving the
knowledge on burns.
8


C) Studies related to knowledge of mothers, women and general public
regarding first aid management of burn injuries.

A qualitative study was conducted in Mugalur village, Bangalore, South
India. The study population comprised all women residing in Mugalur village. A
total of 140 women were interviewed. A Training program on First Aid on burns



was designed and administered to the study group following pretest and the post
training change in knowledge was assessed. 75.5% of the study population who
experienced injury administered some form of First Aid immediately at the time of
injury. However the practices of first aid were not satisfactory. The study thus
shows that domestic injuries are a common occurrence in rural areas. Knowledge
Attitude and Practice regarding First Aid for injuries among women in the study
area was poor. Training on First Aid can improve knowledge on First Aid on burn
injuries among women in a rural area.
14


A population based survey was conducted to assess the knowledge of first aid on
burn injury among general population of New South Wales. People aged 16 years
or older were interviewed. In total, 7320 respondents were asked questions related
to burn injuries & first aid. Of the surveyed population, 82% reported that they
would cool a burn with water and 9% reported that they would cool the burn for
the recommended 20mins. Few respondents reported that they would remove
patients clothing and keep the injured person warm. The population reported there
was effective first aid by cooling a burn with cold water provides pain relief and
limits the severity of injury.
7



A descriptive study was conducted on 312 teachers to evaluate the knowledge and
attitudes of teachers in primary schools about first aid on burns. Data were
obtained using a questionnaire. It included 30 questions that help identify the
teachers and determine their knowledge and attitudes about first aid on burns. Data
were analyzed by chi-square test. In this study, it was determined that most of the
teachers do not have correct knowledge and attitudes about first aid on burns.
13

A survey regarding knowledge on burn prevention and first-aid treatment for
burn injuries was carried out on 420 students in Cambodia. 36% of students
indicated they had received information about burn prevention and first aid, only
13% mentioned application of cool water as initial treatment, only 7% knew to roll
on the ground if their clothes caught fire, and nearly 50% would pour water on a
burning pot of oil. This survey identified significant inadequacies in Cambodian



children's knowledge about burn prevention and first aid and suggested that a
televised burn prevention campaign could be an effective method to improve their
knowledge, especially if it was endorsed by an authority figure.
12
6.3 STATEMENT OF THE PROBLEM


A STUDY TO EVALUATE THE EFFECTIVENESS OF
SELF INSTRUCTION MODULE ON KNOWLEDGE
REGARDING FIRST AID MANAGEMENT OF
BURN INJURIES AMONG HOUSEWIVES
RESIDING IN A SELECTED AREA
OF RAICHUR


6.4 OBJECTIVES OF THE STUDY:

To assess the knowledge of housewives regarding first aid management of
burn injuries.

To develop and implement self instruction module regarding first aid
Management of burn injuries.

To evaluate the effectiveness of self instruction module on first aid
Management of burn injuries.

To identify the association between post test knowledge regarding
First aid management of burn injuries among housewives with selected
demographic variables.


6.5 HYPOTHESES:





On the basis of the objectives of the study, the following hypotheses
have been formulated

H
1
-There will be a significant difference between the pre & post test knowledge
scores of housewives regarding first aid management of burn injuries.

H
2
-There will be significant association between the post test knowledge scores of
housewives regarding first aid management of burn injuries with the
selected demographic variables.

6.6 OPERATIONAL DEFINITIONS:

1. Effectiveness: It refers to the extent to which the self instruction module has
achieved the desired effect in improving the knowledge of housewives regarding
first aid management of burn injuries.

2. Self Instruction Module : It refers to the systematically organised instructions
designed for the housewives to provide information on first aid management
of burn injuries.

3. Knowledge: It refers to the level of understanding of housewives regarding
first aid management of burn injuries.

4. First aid management: It refers to the immediate treatment given to a person
who is injured or suddenly becomes ill by using available facilities or materials at
that time before medical help is imparted.

5. Burn injuries : It refers to the type of skin injury that result from dry heat like
hot flame or fire contact with a hot object or hot liquid, hot oil spillage and
contact with wire carrying high tension electric current. In this study,
the following causes of burn injuries are considered.

- Electrical accidents




- Household fires

- fume ignitions

- Gas explosions

- Hot liquid scalding

- Water heater fires.

6. Housewives: a Married woman, whose main occupation is caring for her
family, managing household affairs and doing housework.

7. MATERIALS AND METHODS:

7.1 SOURCE OF DATA

Design:

One group pre test and post test Pre experimental design is adopted for the
present study.
O
1
X O
2

O
1
-Pre test on knowledge regarding first aid management of burn injuries
X - Self instruction module on first aid management of burn injuries
O
2
-Post test on knowledge regarding first aid management of burn injuries

Setting of the study:

Raichur is one of the backward districts situated in Northern Karnataka. It has an
area of 60 sq.km and it consists of 5 towns and 300 villages. The total Population
of Raichur is 19,22,773 with 32 revenue wards and 8 election wards. It consists of
50 wards, among which ward no.13 i.e. Zaheerabad area is selected for the present
study.




The population of the area is 10,203 out of which 5,102 are females. Among them
1,532 are housewives.

The boundaries of Zaheerabad area includes;

East: KSRTC Divisional Control Office

West: Ashok Depot roads and Kurumgadda

North: Pentecostal church

South: Hillocks

Population:

The population included in the study is housewives (20- 50yrs); who are residing
in the Zaheerabad area of Raichur.

Sample size:

The sample size of the present study comprises of 40 housewives aged between
20-50 years

Sampling technique:

Sampling refers to the process of selecting a portion of the population to represent
the entire population. In this study, the purposive sampling technique will be used to
select the area and Simple random sampling technique will be used for the selection
of the subjects.

Inclusion criteria:

The study includes housewives, who are
between the age group of 20-50 years.
available and willing to participate in the study.



available at the time of data collection
able to read and write Kannada and English
residing in Zaheerabad area.

Exclusion criteria:

The study excludes housewives, who are not
between the age group of 20-50 years.
available and willing to participate in the study
available at the time of data collection
able to read and write Kannada and English
residing in Zaheerabad area

SELECTED VARIABLES

Variables included in the present study are :

Dependent Variable: Knowledge of housewives regarding first aid management
of burn injuries.

Independent variable: Self Instruction module on first aid management
of burn injuries.

EXTRANEOUS VARIABLES

1) Age: Age of the sample is categorized as

(a) 20-30 years
(b) 30-40 years
(c) 40-50 years

2) Religion: Religion of the sample is categorized as

(a) Hindu
(b) Muslim
(c) Christian







3) Educational qualification: It refers to the previous education of the subjects.
It is categorized as

(a) Primary education
(b) Secondary education
(c) Higher secondary education
(d) Graduation and above

4) Source of information: Source of information is categorized as

(a) Mass media
(b) Colleagues
(c) Health personnel
(d) Friends
(e) Others

5) Family history of burn injuries: Any history of burn injuries in
their family members.

(a) Yes
(b) No
If yes specify


6) Personal history of burn injuries: Any history of burn injuries
to the participant of the study.

(a) Yes
(b) No
If yes specify.







7.2 METHODS OF DATA COLLECTION:

Data collection instrument

Data collection is the gathering of information from sample. The researcher will develop a
structured questionnaire to collect the data. It consists of two parts

Part I: deals with sample characteristics or socio demographic data.

Part II: represents the knowledge related items on first aid management of
Burn injuries among housewives.

Data collection method

After obtaining the permission from the significant authorities & consent
from the subjects, the investigator will assess the knowledge of
housewives regarding first aid management of burn injuries by using
structured questionnaire & then administers self instruction module on
first aid management of burn injuries. The investigator will assess the
effectiveness of self instruction module by post test after a gap of 7 days
depending on time convenience of the sample.


7.3 PLAN FOR DATA ANALYSIS:

Data analysis is the systematic organization and synthesis of research data, the
testing of the research data, and the testing of research hypothesis by using the
Obtained data. The following methods are used to analyze the data.

Descriptive statistics like percentage and frequency distribution will be used to



describe sample characteristics.

Mean and standard deviation for pre and post test knowledge on first aid
management of burn injuries.

Paired t test will be used to evaluate the effectiveness of
Self instruction module.

Chi-square test will be used to identify the relationship between knowledge of
housewives regarding first aid management of burn injuries & selected
demographic variables.


7.4 PROJECTED OUTCOME:

The result of the study throws light on effectiveness of self instruction module
on Knowledge regarding first aid management of burn injuries among housewives.
Thereby, helps the future researchers to adopt modified strategies to enhance the
Knowledge of housewives in preventing burn injuries.

7.5 DOES THE STUDY REQUIRE ANY INVESTIGATION
OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR
OTHER HUMAN OR ANIMALS? IF SO,DESCRIBE BRIEFLY.

Yes, the study requires Intervention. The Investigator will assess the knowledge of
housewives on first aid Management of burn injuries and administers self instruction
module and again tests the knowledge of housewives to evaluate the effectiveness of
self instruction module.

7.6 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM
YOUR INSTITUTION IN CASE OF 7.5?




Permission will be obtained from Institutional Ethical Committee, Navodaya
Education Trust, Raichur
Permission will be obtained from the Research Committee, Navodaya
College of Nursing, Raichur
Consent will be obtained from all participants.
8. LIST OF REFERENCES

1) www.pubmed.com

2) www.medlineplus.com

3) www.wikepedia.com

4) Andrew E Dongo, Eshobo E Irekpita, Lilian O Oseghale; A Five-year
review of burn injuries in Irrua, Nigeria,2007.

5) R.Raja Shanmugakrishnan, V. Narayanan, Dept. of Medicine and Plastic
surgery, Epidemiology of burns in a teaching hospital in South India,
Madhurai, Tamilnadu, 2008.


6) Gowri Shankar, Vijaya A Naik, Rajesh Powar; Epidemiological study of
burn injuries admitted in two hospitals of North Karnataka, Belgaum,
Karnataka,2010

7) Lara A Harvey, Margo L Barr (2011), A population based survey of
knowledge of first aid for burns in New South Wales, Australia.

8) Md.Radwan, Salwa samir (2011), Mansoura university hospital, Effect of
a rehabilitation program on the knowledge, physical & psychological
functions,Mansoura,Iraq.

9) R B Rimmer, M Pressman (2011), The effectiveness of a culturally
sensitive burn and fire prevention programme designed for school
students and parents, Arizona burn centre, USA.




10) L C Gupta and Abhitabh gupta, MANUAL OF FIRST AID, Management
of general injuries and common ailments, Jaypee, pp: 294-305.

11) Lewis M.S., Heitkemper M.M., and Dirksen R.S.,(2004), Medical surgical
nursing: ASSESSMENT AND MANAGEMENT OF CLINICAL PROBLEMS,
6th edition., Mosby, pp. 515-39.

12) Hsiao M, Tsai B, Uk P, Jo H, Gomez M, Gollogly J G, et al. A survey on
420 Grade 5 students in Cambodia on their knowledge of burn prevention
and first-aid treatment on Burns. 2007 May; 33(3): 347-51.

13) Baser M, Coban S, Taci S, Sungur G, Bayat M.Evaluating First-Aid
Knowledge and Attitudes of a Sample of Turkish Primary School
Teachers. Journal of Emergency Nursing. 2007 Oct; 33(5): 428-32.

14) Dr.Rekha S Sonavane, M.D in Community Medicine, Knowledge, attitude
and practice of first aid among women in rural area; 2008.

15) Peden M, McGee K, Krug E. Injury:A Leading Cause of the Global
Burden of Disease. World Health Organization. 2002


16) Ghosh A, Bharat R., Domestic burns prevention and first aid awareness in
and around Jamshedpur, India: Strategies and impact. Burns,
Volume 26, Issue 7, 1 November 2000:605-608.

17) First aid to the injured St. Johns Ambulance association book published by
volunteers of St. Johns ambulance brigade. Pg 5-6.

18) First aid to the injured St. Johns Ambulance Association.
INTRODUCTION TO FIRST AID1
st
Edition, published by lieutenant
general R S Hoon, Pg

9-10.






9. Signature of the candidate :

10. Remarks of the Guide :

11. Name and Designation of the
Guide : Ms. ANNAPOORNA.S
Professor & HOD
Medical and Surgical Nursing
Navodaya College of Nursing
Raichur


11.1 Signature :


11.2 Co-Guide ( if any) :

11.3 Signature :


11.4 Head of the Department : Ms. ANNAPOORNA.S
Professor & HOD
Medical and Surgical Nursing
Navodaya College of Nursing
Raichur


11.5 Signature :

12. Remarks of the Chairman
and Principal




12.1 Signature :