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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS

FOR DISSERTATION

MRS. K. R. RAJANI
1ST YEAR M Sc NURSING
1. NAME OF THE CANDIDATE SRI VENKATESHWARA INSTITUTE
AND ADDRESS OF NURSING SCIENCES,
BOMMANAHALLI, HOSUR ROAD,
BANGALORE – 560068.

2. NAME OF THE INSTITUTION SRI VENKATESHWARA INSTITUTE


OF NURSING SCIENCES

3. COURSE OF STUDY AND MASTER OF SCIENCE IN NURSING


SUBJECT MEDICAL SURGICAL NURSING

4. DATE OF ADMISSION TO 15.03.2013


COURSE

5. TITLE OF THE TOPIC EFFECTIVENESS OF STRUCTURED


TEACHING PROGRAMME ON
KNOWLEDGE REGARDING DISASTER
PREPAREDNESS AND MITIGATION
AMONG PU COLLEGE STUDENTS AT
SELECTED COLLEGES, BANGALORE.
6. BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

“A great calamity is as old as the trilobites an hour after it has happened.”


Oliver Wendell Holmes

"Disaster is a natural or man-made event that negatively affects life, property,

livelihood or industry often resulting in permanent changes to human societies,

ecosystems and environment.” Disasters are highly events that cause suffering,

deprivation, hardship and even death, as a result of direct injury, disease, interruption of

commerce and business, and the partial or total destruction of critical infrastructure such

as homes, hospitals, and other buildings, roads, bridges, power lines, etc. 1

The term disaster owes its origin to the French word DESASTRE, where DES

means bad or evil and ASTRE means star – combined it implies “Bad or Evil Star”.

Generally, disasters are of two types – Natural and Manmade. Natural disasters are

flood, cyclone, drought, earth quake, cold wave, thunderstorms, heat waves, mud slides,

volcanoes, Tsunamis and storm. Man-made disaster includes epidemic, deforestation,

pollution due to prawn cultivation, chemical pollution, wars, road /train accidents, riots,

food poisoning, industrial disaster/ crisis and environmental pollution.2

Disaster is a sudden, calamitous event bringing great damage, loss, destruction

and devastation to life and property. The damage caused by disasters is immeasurable

and varies with the geographical location, climate and the type of the earth

surface/degree of vulnerability. This influences the mental, socio-economic, political

and cultural state of the affected area. It completely disrupts the normal day to day life,

like food, shelter, health, etc.3


According to statistics released by the National Crime Records Bureau (NCRB),

28 states together accounted for 1,36,771 deaths and the seven union territories for the

remaining. Tamil Nadu tops the list of with 16,175 deaths in 67,757 accidents, followed

by Uttar Pradesh with 15,109 deaths in 24,478 accidents. Andhra Pradesh is third with

14,966 deaths in 39,344 accidents and Maharashtra fourth with 13,936 deaths in 45,247

accidents. The capital city of Delhi accounts for 1,866 deaths in 6,937 accidents .4

Almost 85% of the country is vulnerable to single or multiple disasters. Of the

35 states and union territories in the country, 27 are disaster prone. The multi hazard

map of India depicts that 229 districts of India are prone to multiple hazards, West

Bengal for example is prone to four types of hazards. Floods, droughts, earthquakes,

cyclones, landslides and avalanches have taken a heavy toll of lives and have caused

enormous damage to property. Tsunami is the latest addition to India’s woes of natural

disasters.5

An ‘emergency’ is an unplanned event that can cause deaths or significant

injuries to employees, customers or the public; or that can shut down your business,

disrupt operations, cause physical or environmental damage, or threaten the facility’s

financial standing or public image. Disaster management (or emergency management)

is the discipline of dealing with and avoiding both natural and manmade disasters. It

involves preparedness training by private citizens response and recovery in order to

lessen the impact of disasters. 6

Government of India, ministry of home affairs and United Nations development

programme has signed an agreement on august 2002 for implementation of “disaster

risk management” programme to reduce the vulnerability of the communities to natural

disasters, in identified multi hazard disaster prone areas. The programme has been

divided in to two phases over a period of six years. Phase-1 [2002-2004] would provide
support to carry out the activities in 28 selected districts in the states of Bihar, Gujarat

and Orissa. In Phase-2 [2003-2007], the programme would cover 141 districts such as

Assam, Meghalaya, Sikkim, West Bengal, Uttaranchal, U.P, Delhi, Maharashtra,

Tamilnadu, Manipur, Mizoram, Tripura, Arunachal Pradesh and Nagaland.7

Emergency planning is the systematic and ongoing process which should evolve

as lessons are learnt and circumstances change. Its aim is to prevent emergencies

occurring and when they do occur, good planning should reduce, control or mitigate the

effects of the emergency. Professional emergency managers can focus on government

and community preparedness (Continuity of Operations/Continuity of Government

Planning), or private business preparedness (Business Continuity Management

Planning). Training is provided by local, state, federal and private organizations and

ranges from public information and media relations to high-level incident command and

tactical skills such as studying a terrorist bombing site or controlling an emergency

scene.8

Mitigation activities actually eliminate or reduce the probability of disaster

occurrence, or reduce the effects of unavoidable disasters. Mitigation measures include

building codes; vulnerability analyses updates; zoning and land use management;

building use regulations and safety codes; preventive health care; and public education.

Professional certifications such as Certified Emergency Manager (CEM) and Certified

Business Continuity Professional (CBCP) are becoming more common as the need for

high professional standards is recognized by the emergency management community.

Professional emergency management organizations allow for professional networking

by professionals in this field and sharing of information related to emergency

management.9
The goal of emergency preparedness programs is to achieve a satisfactory level

of readiness to respond to any emergency situation through programs that strengthen the

technical and managerial capacity of governments, organizations, and communities.

These measures can be described as logistical readiness to deal with disasters and can

be enhanced by having response mechanisms and procedures, rehearsals, developing

long-term and short-term strategies, public education and building early warning

systems. Preparedness can also take the form of ensuring the strategic reserves of food,

equipment, water, medicines and other essentials maintained in cases of national or

local catastrophes.10

The role of emergency management in India falls to National Disaster

Management Authority of India, a government agency subordinate to the Ministry of

Home Affairs. In recent years there has been a shift in emphasis from response and

recovery to strategic risk management and reduction and from a government-centered

approach to decentralized community participation. The Ministry of Science and

Technology supports an internal agency that facilitates research by bringing the

academic knowledge and expertise of earth scientists to emergency management.11

The recovery phase starts after the immediate threat to human life has subsided.

The immediate goal of the recovery phase is to bring the affected area back to some

degree of normalcy. The most extreme home confinement scenarios include

war, famine and severe epidemics and may last a year or more. Then recovery will take

place inside the home. Planners for these events usually buy bulk foods and appropriate

storage and preparation equipment and eat the food as part of normal life.12
6.1. NEED FOR THE STUDY

“Disaster mitigation... increases the self reliance of people who are at risk - in other
words, it is empowering."
Ian Davis

Disaster is a human made or a natural event that causes destruction and

devastation that cannot be relieved without assistance. Disasters of different types such

as earthquakes, cyclones, floods, tidal waves, landslides, volcanic eruptions, tornadoes,

fires, hurricanes, snow storms, severe air pollution, heat waves, famines, toxicologic

accidents, nuclear accidents and warfare etc. Emergency preparedness is a programme

of long term development activities whose goals are to strengthen the overall capacity

and capability of a country to manage efficiently all types of emergency.13

The world today is exposed to new and various kinds of dangers due to complex

changes in climates and social structures. In recent years, we have witnessed some of

the worst calamities, such as the 9.11 terrorist attack of the US World Trade Centre in

2001, huge typhoon disasters in Korea in 2002 and 2003, the tsunami that swept across

Southeast Asia in 2004, Hurricane Katrina that wreaked havoc in the United States in

2005, the new type of influenza in 2009 and Hurricane Sandy hitting the US east coast

in late October 2012.14

In 2011, 332 natural disasters were registered, less than the average annual

disaster frequency observed from 2001 to 2010 (384). However, the human and

economic impacts of the disasters in 2011 were massive. Natural disasters killed a total

of 30,773 people and caused 244.7 million victims worldwide. Economic damages from

natural disasters were the highest ever registered, with an estimated US$ 366.1 billion.15
The disaster that made most victims in 2011 was the flood that affected China in

June, causing 67.9 million victims. Furthermore, China was affected by a drought from

January to May (35.0 million victims), a storm in April (22.0 million victims) and

another flood in September (20.0 million victims), further contributing to a total of

159.3 million victims in China in 2011, a figure representing 65.1% of global reported

disaster victims. Droughts and consecutive famines made many victims in Ethiopia (4.8

million), Kenya (4.3 million) and Somalia (4.0 million). When considering the

population size of the country, 42.9% of Somalia’s population was made victim of

natural disasters in 2011, mostly due to drought.16

In 2011, 36 geophysical disasters (earthquakes/tsunamis, volcanoes and dry

mass movements) were registered, representing a share of 10.8% of total disaster

occurrence. Geophysical disasters accounted for 68.1% of total reported deaths from

natural disasters in 2011, compared to a share of 45.5% per year on average for 2001-

2010. They caused 1.8 million victims, less than the annual average number of victims

from 2001 to 2010 (8.9 million). Geophysical disasters took a share of 62.9% of total

damages caused by natural disasters in 2011, compared to a share of 20.0% per year on

average from 2001 to 2010. In absolute terms, damages increased from an annual

average of US$ 24.1 billion for 2001-2010 to US$ 230.3 billion in 2011.17

Climatological disasters (extreme temperatures, droughts and wildfires) took in

2011 an 11.7% share of total disaster occurrence, comparable with a share of 12.9% per

year on average for 2001-2010. Out of the 39 climatological disasters, 17 were

droughts, 15 extreme temperatures and 7 wildfires. Climatological disasters took the

second-largest share of total disaster victims in 2011 (64.6 million or 26.4% of total

disaster victims), as was also the case for the period 2001-2010. The reported damages

in 2011 increased by 56.3% compared to the 2001-2010 annual average damages from
these disasters. Droughts affecting the United States and Mexico from January to

December caused US$ 8.0 billion damages, while droughts in China from January to

May contributed another US$ 2.4 billion to the total reported damages from

climatological disasters of US$ 14.2 billion. It should be noted that reported damages

from climatological disasters are often underestimated due to a lack of standardized

methods for quantifying and reporting losses. 18

The Brahmanbaria tornado 2013 was a deadly tornado that took place in the

Brahmanbaria District of Bangladesh on March 22, 2013. The tornado struck 20

villages with a diameter of 8 km travelling at a speed of 70 km per hour; killed 31

people and injured approximately 500 when the tornado moved through the villages of

Ramrail, Basudeb, Chinair, Sultanpur union of Sadar Upazila and North Akhaura union

of Akhaura upazila in Brahmanbaria district.19

The 2011 earthquake off the Pacific coast of Tohoku known as the 2011 Tohoku

earthquake, the Great East Japan Earthquake. Earthquake, a magnitude 9.03 undersea

mega thrust earthquake off the coast of Japan that occurred on 11 March 2011,

approximately 70 kilometres east of the Oshika Peninsula of Tohoku. It was the most

powerful known earthquake ever to have hit Japan and one of the five most powerful

earthquakes in the world since modern record-keeping began in 1900. The earthquake

triggered powerful tsunami waves that reached heights of up to 40.5 metres (133 ft) in

Miyako in Japan travelled up to 10 km (6 mi) in Inland. On 12 September 2012, a

Japanese National Police Agency report confirmed 15,878 deaths, 6,126 injured, and

2,713 people missing across twenty areas well as 129,225 buildings totally collapsed,

with a further 254,204 buildings 'half collapsed', and another 691,766 buildings partially

damaged. 20
In early May 2008, Cyclone Nargis (CN) tore across the southern coastal regions

of Myanmar, pushing a tidal surge through villages and rice paddies. Almost 12 foot

wall of Water and wind speed of over 200 km/hr killed tens of thousands of people and

left hundreds of thousands homeless and vulnerable to injury and disease. Out of 7.35

million living in the affected townships of Labutta, Bogale, Pyinsalu, Yangon, and

many more, approximately 2.4 million were affected. Overall, >50 townships were

affected by this most devastating cyclone. The low-lying villages were submerged in

water. There was a widespread destruction of homes, critical infrastructure of the

villages, roads, ferries, water, fuel, and electricity supplies. 21

Disasters are unstoppable natural and anthropogenic impacts which can be

mitigated by suitable management options. India is seventh largest country in the world

and is highly prone to natural and anthropogenic disasters. Role of youth on disaster

management are ‘Change the self that talk more than work.’ Make people aware on the

cause and result of natural disaster and explain the tips that how can we save our

environment from disaster. Start campaign from schools and include disaster

management in the school curriculum, give rescue training for youth, conduct Media

program to aware people, maintain Youth unity for many programs related to disaster

management.22

The investigator identified that the PU College students are the ideal group to

work on disaster management because they are young and energetic to save the

environment from disasters. By creating awareness among them by a structured

teaching programme on disaster preparedness and mitigation, we can prepare as rescue

team members to safeguard the life of people.


6.2. REVIEW OF LITERATURE

“Where ever disaster calls there I shall go. I ask not for whom, but only where I am

needed.” American Red Cross

One of the most important steps in research project is literature review. A

literature review is an account of what has been published on a topic by accredited

scholars and researches. Review of literature for the study has been organized under the

following headings. As Garrand (2004) advises we must strive to own the literature on a

topic to be confident of preparing a comprehensive, state of the art review. 23 The review

of literature was done under the following aspects:

6.2.1. Studies related to general information regarding disaster preparedness and


mitigation.

6.2.2. Studies related to knowledge regarding disaster preparedness and


mitigation.

6.2.3. Studies related to effectiveness of structured teaching programme.

6.2.1. Studies related to General Information regarding disaster preparedness and


mitigation:

A study was conducted to characterize emergency preparedness in vulnerable

population and to ascertain the role of the personal assistant (PA) and the potential

impact of prior emergency experience on preparedness efforts. Among 253 community

residents with cognitive and / or physical disabilities, 62.8 % of the participants had

previously experienced one or more large scale emergencies, only 47.4% of the entire

sample and 53.3% of those with actual emergency experience reported preparing an

emergency plan. 63 % of those reported a plan had involved their PA in its

development. Participants who reported such involvement were significantly more

likely to have higher scores on the emergency preparedness scale (p< 0.001).
Participants who had experienced a prior emergency were also more likely to score

higher on the emergency preparedness scale (p<0.001). These findings highlight the

need for additional study on emergency preparedness barriers in people living with

disabilities so that effective strategies to reduce vulnerabilities can be identified.24

A study was conducted to recognize and compare almost all the components of

disaster preparedness between teaching and private hospitals in Shiraz, Iran, focusing on

incident command systems (ICS), communications, surge capacity, human resources,

supply management, logistic service, case management, surveillance, laboratory and

operating room management. 24 out of 31 hospitals were responded for this study. The

scores for preparedness of ICS, communication, surge capacity and human resources

was 73.9 %, 67.3%, 49%, and 52.6 % respectively. The preparedness scores for supply

management and logistic services were 68.5 % and 61.8%. While the levels of

preparedness of laboratory and operating room management were low, preparedness of

the surveillance system and case management were 66.7% and 70.8%, respectively. The

average total preparedness of all hospitals was 59.5%, with scores of 62.2% in teaching

hospitals and 55 % in private hospitals. At the time of study, the total preparedness

among hospitals was at the intermediate level, but in some key components such as

operating room management, surge capacity and human resources, the total

preparedness was very limited and at an early stage of development, therefore, requiring

urgent attention and improvement.25

A study was conducted among 639 Italian medical students to identify the

perceptions of mass casualty incidents and disasters. The results of the study shows that

38.7 % had never heard about disaster medicine; 90.9 % had never attended elective

academic courses on disaster medicine; 87.6% had never attended non-academic

courses on disaster medicine; 91.4 % would welcome the introduction of a course on


disaster medicine in their core curriculum; and 94.1% considered a knowledge of

disaster medicine important for their future career. Most of the students surveyed had

never attended courses on disaster medicine during their medical school program.

However, respondents would like to increase their knowledge in this area and would

welcome the introduction of specific courses into the standard medical curriculum.26

A study was conducted to assess and evaluate the disaster management among

325 residents by using a structured interview questionnaire. The result of the survey

indicates that, more than 90% of residents lacked tsunami knowledge. 10% of residents

have tsunami knowledge. The school surveys reveal that; about 30 % of school children

do not yet understand what causes a tsunami; 90% of school children have a keen

interest in studying natural disasters; comprehensive disaster education has not been

provided; and audio-visual means are thought to be the most effective tool for disaster

education. The survey of officials shows that; seminars and drills on natural disaster

have not been conducted among general officials other than the military and police;

measures need to be developed to safeguard the interests of tourists; and sirens, TV, and

radio broadcasts are effective tools for disseminating disaster warnings to residents.27

A study was conducted to assess the disaster preparedness at selected public

schools in Luzon, Philippines. The school profile and data on each schools disaster

preparedness were collected through an interview of 37 schools, 35 (95%) schools

reported to have formed disaster committees and 2 (5%) schools have not formed
rd (
disaster committees. However, less than 1/3 30%) of the respondent schools had

disaster preparedness plans. The majority 35(95%) of the public schools conducted

drills once a year. Fire and earthquake drills were the most common type of drill

conducted in these schools. 51% were not used as centres of evacuation during the

disasters that occurred in last five years. Majority 35 (95%) of the public school key
personnel were aware of the national local disaster management programs. This study

provided a glimpse of the efforts that teachers and students are preparing in times of

emergencies and disasters such as "chemical spills" food poisoning and infectious

disease outbreaks. These may also be considered the preparation of the school's

preparedness plans.28

A study was conducted to assess the important role of social, capital and public

policy in disaster recovery among 100 participants. Random and purposeful sampling

was used to select participants for the study. Sumatra tsunami in the Indian Ocean killed

more than 14,000 people and left 50,000 people homeless. This research included a

questionnaire survey administered to people in two tsunami affected districts and

compared the types of social capital that can be associated with disaster recovery. Thus

study concluded that importance of role of social, capital and public policy in disaster

recovery has an effect on tsunami.29

A historical review was conducted to describe the impact of tsunamis on human

populations in terms of mortality, injury, displacement and, to the extent possible. The

Findings were 2, 55,195 deaths (range 252,619-275,784) and 48,462 injuries (range

45,466-51,457) as a result of tsunamis. The majority of deaths (89%) and injuries

reported during this time period were attributed to a single event, the Indian Ocean

tsunami. Findings from the systematic literature review indicate that the primary cause

of tsunami-related mortality is drowning, and that of females, children and the elderly

are at increased mortality risk. The few studies reported on tsunami-related injury

suggest that males and young adults are at increased injury-risk. The Conclusion of the

study states that Early warning systems may help to mitigate tsunami-related loss of

life.30
A cross sectional cluster survey was conducted to describe the impact of floods

among 1769 households conducted in 29 most affected districts of Pakistan. 20 million

people were affected due to flood. The flood destroyed 54.8% of homes and caused

86.8% households to move to other places. Lack of electricity increased from 18.8% to

32.9% , lack of toilet facilities from 29% to 40.4% .Access to protected water remain

unchanged(96.8%), however the resources changed . 88% reported loss of income with

rural households. Immediate deaths and injuries were uncommon. But 77.0% reported

flood related illnesses. Significant differences were noted between urban and rural as

well as gender and education of the head of household.31

A study was conducted to assess the impact of earth quakes in Japan. Result of

the study shows that 1.87 million deaths with an average of 2,052 fatalities per event

affecting humans. Overall 74.1% of events in the database were reported. The average

magnitude was 6.2 and focal depth 27.1km.A rapid increase in earthquake affected

populations was observed after 2000.Earhquake impact was greatest in the western

pacific, which accounted for 44% of deaths, and Americans which accounted for 60%

of the affected population. Of the 738 identified events, the databases recorded

687(96.9%) deaths, 420(50.9%) injuries and 359(51.4%) leading to homelessness.32

A study was conducted to identify the level of disaster preparedness and

management in reducing human sufferings in the earthquake in Gujarat, India. Nearly

20000 people were killed, 1, 70,000 were injured and 6, 00,000 were render homeless.

The disaster relief evaluation revealed that relief provided to disaster victims had

reduced quality by the following proper public health indicators had not yet been

developed: inefficient coordination was lacking, delayed relief actions and policies on

delivery of disaster relief not yet been developed. The study concluded that a successful
disaster response will depend on accurate and relevant medical intelligence and

planning in advance of during and after disaster.33

6.2.2. Studies related to knowledge on disaster preparedness and mitigation among


students:

A cross-sectional study was conducted to evaluate the factors associated with

preparedness against an earth quake in Tehran city among 1195 people aged 15 years or

older. The analysis shows that 1076 (90.0%), 1160 (97.1%), and 490 (41.0%) of the

participants achieved half of the possible scores for the knowledge, attitude, and

practice components, respectively. Furthermore, in multivariate analysis low knowledge

(p<0.001), having a high-school (p=0.033) or lower education (p<0.001) and living in

Northern high-risk regions (p<0.001) of the Tehran were identified as risk factors for

taking precautionary measures against earthquake. For low knowledge, lack of previous

experience and working as labour, businessman, employee (p=0.001) or being

housewife (p=0.002) were related risk factors. In addition, people in the Southern high

risk regions were significantly more knowledgeable (OR=0.618 compared to people in

low risk regions). It is suggested that preparedness programs should target people with

lower educational level and people in high risk regions especially the Northern districts

of the city and aim at increasing public knowledge about earthquakes.34

A cross-sectional study was conducted to evaluate the knowledge, attitudes and

practices (KAP) among 630 students (359 female, 266 male, 5 not identified) in 32

elementary schools toward fire prevention in Thailand. The mean of age of the studied

subjects was 11.09±1.07 and ranged from 6 to 13 years. The results indicated that no

gender differences were with the level of knowledge, attitudes and practices (p=0.072,

0.149 and 0.235 respectively) and the Pearson chi-square showed that the level of

knowledge, attitudes was not associated with practices (p=0.256 and 0.572
respectively). The finding also revealed that the students who had not been trained in

fire evacuation had more inappropriate behaviour or practice and poorer attitude toward

fire than those had the experience. Strategy planning to improve attitudes and practices

through proper training for fire evacuation among students are needed.35

A study was conducted to design a questionnaire by using a new approach

(systemic networks) to investigate the existing knowledge of earthquakes among 823

students from 5th to 8th grades. Participants in the sample were chosen from two separate

locations: Aydin, Turkey, which is in a high-risk earthquake zone; and Columbus OH,

which is in a low-risk zone. The majority of students in the United States had received

formal instruction about earthquakes, whereas the majority of students in Turkey had

not. Comprehensive Exploratory Factor Analysis (CEFA version 1.03 for MS

Windows) was used to examine student’s patterns of thinking. Ten factors were found

for the common thinking pattern, 10 factors represented separate themes framed around

the features of systemic networks. The research showed similarities as well as

differences between the responses. The US students’ scientific knowledge about

earthquakes was significantly higher than Turkish students’ and they held fewer naive

beliefs than Turkish students about the definition of earthquakes and about how

earthquakes happen. Less than half of the students in both countries know about

earthquake safety. Also, students who had experienced an earthquake did not have

better knowledge about them. The success of this study suggests that the network design

of the questionnaire might have broader application to different subject matter and

concepts.36

A study was conducted to assess the knowledge, attitude, and behaviour

regarding disaster management among 135 postgraduate (PG) students in a private

dental institution in Dharwad, India. A cross sectional design was used. The results of
the study show that PG students 125(92.59%) participants responded in the study. Mean

knowledge (58.74), attitude (85.78), and behaviour (31.60) scores were identified.

Significant correlations were observed between knowledge and year of study (α2 =

45.301, p = 0.000), and behaviour and place of residence of respondents (α2= 4.112, p =

0.043).The study concluded that the participants had low knowledge and behaviour

scores, but high attitude scores regarding disaster management. The year of study and

the place of residence were associated with knowledge and behaviour. This study

suggests the need for curriculum changes in dental education and has policy

implications for disaster management in India.37

A study was conducted to assess the objective knowledge, attitude, behaviour

and perceived knowledge regarding disaster management among 86 Indian dental

graduates, Manipal College of dental sciences, Mangalore by using a questionnaire

method. The result shows that a majority (98.8%) of respondents were willing to

participate in disaster management. Mean objective knowledge (48.65%), attitude

(80.26%), behaviour (29.85%) and perceived knowledge scores were (60.80%). Males

reported higher perceived knowledge than females (P = .008), and respondents residing

in hostels reported higher perceived knowledge than those not residing in hostels (P =

.02). Gender showed significant correlations with attitude (r = 4.076, P = .044) and

behaviour (r = 3.722, P = .054), and residence with behaviour of respondents (r = 5.690,

P = .017).The study concluded that high degree of willingness to provide assistance

during disasters was observed among undergraduate dental students. 38

6.2.3. Studies related to effectiveness of structured teaching programme:

A quasi-experimental study was conducted to evaluate the effectiveness of

Hospital Disaster Life Support training (HDLS) among 84 convenience samples.11

physicians, 40 nurses, 23 administrators and 10 other personnel (n = 84) attended


a two-days, 16 hours course. The primary goal of teaching hospital personnel was

focused on how to manage the disaster. The average score on pre-test was 69.1+/-6.7

and the post-test score was 89.5+/-6.7 there was an improvement of 20.4 points

(P<0.0001; 17.2 – 23.5). Results revealed that Hospital Disaster Life Support

training (HDLS) was effective in case of teaching hospital employees. The study

was concluded that Hospital Disaster Life Support training (HDLS) was an

effective way to train hospital-based employees.39

A study was conducted to evaluate the effectiveness of planned teaching

programmed on knowledge of disaster management among 50 N.C.C. students of

selected schools of Belgaum city by using purposive sampling technique. The results

shows that the mean percentage of knowledge in the pre-test was 21.31% with mean

and SD of 3.18%, and mean percentage in the post-test was 36.41% with mean and SD

of 2.27%. Further effectiveness was tested by using paired ‘t’ test. The difference

between pre-test and post-test knowledge score was significant (t=19.9 p<0.05). There

was a significant increase in the knowledge scores of NCC students after

administration of the planned teaching programme. Therefore, study is concluded that

the planned teaching programmed was effective in improving the knowledge of NCC

students regarding disaster management.40

A study was conducted to assess the effectiveness of structured teaching

programme on knowledge regarding bronchial asthma and its management among

mothers of asthmatic children. Samples of 60 mothers of asthmatic children were

selected by using non probability convenient sampling technique. Major findings of

the study were; the majority of mothers 34 (56.67%) were between 21-25 yrs,

38(63.3%) belonged to nuclear family ,31(51.67%) lived in rural areas, 30(50%) had
children with duration of illness less than 1 year, 49(81.67%) had no family history of

asthma and 43(68.3%) had no previous exposure to knowledge, the findings reveals

that, in the pretest 36(60%) had moderate knowledge and 24(40%) had inadequate

knowledge regarding bronchial asthma and its management , the findings reveals that,

in the post test majority of them 56(93.33%) had adequate knowledge, 4(6.67%) had

moderate knowledge and none of them had inadequate knowledge regarding bronchial

asthma and its management. The study concluded that the developed structured

teaching programme was effective in improving the knowledge of mothers on

bronchial asthma and its management. 41

A study was done to assess the awareness and impact of education on breast

self examination (BSE) among 40 female degree college going girls from Udupi

district, Mangalore. Result shows that majority (52.5%) of the samples were in the age

group of 18-19 yrs and (90%) of them were studying in basic science group. The

structured teaching programme was effective with pre test score 27 and post test score

50(t=12.46,df=39,p=0.05). The study concluded that majority of the samples acquired

good knowledge on BSE. The study recommended that education regarding Breast

cancer to young girls and the knowledge of mother and siblings thereby can reduce

the incidence of Breast cancer.42

A Quasi Experimental study was conducted to assess the effectiveness of

structured teaching programme on knowledge and practices related to hand washing

technique among 23 food handlers in Punjab. The structured questionnaire methods

used to assess the knowledge and check list was prepared for observing the hand

washing practices. The result shows that pre test mean knowledge score was 43.7%

and the post test mean knowledge score was 83.1%, pre test mean hand washing
practice score was 63% and the post test mean hand washing score was 92% . The

study revealed that the structured teaching programme had significantly effective in

increasing their knowledge and practices scores.43

A prospective study was conducted for evaluation of the effectiveness of a new

structured diabetes teaching and treatment programme (DTTP) for geriatric patients

with diabetes mellitus. A total of 155 geriatric patients were randomly admitted to

either the new DTTP (n=83) or the standard DTTP (n=72). Diabetes knowledge

increased significantly in both groups after the DTTP, a slight decrease in diabetes

knowledge in both groups was measured. Overall treatment satisfaction was equal in

both groups at the t0 and t2 visits [SGSVS, Standard t0:28(6-38) points vs .28(13-36)

points, n.s; t2:31(13-36) points vs.31 (14-36) points, n.s]. The study concluded that in

diabetes education programme is effective in improving metabolic control and in

maintaining auto efficiency in geriatric patients with diabetes mellitus.44

A study was conducted to evaluate the effectiveness of structured teaching

programme on osteoporosis among 60 middle aged women admitted in jayanagar

general hospital, Bangalore. The findings revealed that the mean post test knowledge

score was 26.3 was higher than the mean pre test knowledge score 12.97 with the ‘t’

value of 73.237 which is significant at p< 0.05 level. This supports that the structured

teaching programme was an effective method for providing information on

osteoporosis among middle aged women.45

A cluster randomized control trial was conducted in England and Scotland to

assess the effectiveness of the diabetes education and self management for ongoing

and newly diagnosed (DESMOND) programme for people with newly diagnosed type

2 diabetes mellitus. The participants were 824 adults (55% men, mean age 59.5 yrs).
Referral of patients with newly diagnosed type 2 diabetes mellitus began on 1 October

2004 and ended on 31 January 2006. The mean age was significantly higher in the

consented group (60.3yrs (12.2) vs 56.5yrs (13.0); p < 0.001). The groups showed no

statistically significant difference according to sex. Haemoglobin A1c levels at 12

months had decreased by 1.49% in the intervention group compared with 1.21% in the

contol group. The intervention group showed a greater weight loss: -2.98 kg (95%

confidence interval -3.54 to -2.41) compared with 1.86 kg (-2.44 to -1.28), p=0.027 at

12 months. The intervention group showed significantly greater changes in illness

belief scores (p=0.001): directions of change were positive indicating greater

understanding of diabetes. The study concluded that a structured group education

programme for patients with newly diagnosed type 2 diabetes resulted in greater

improvements in weight loss and positive improvements in beliefs about illness. 46

A study was conducted to assess the effectiveness of structured teaching

programme on modification of life style among 30 myocardial infarction clients

admitted with at Sri Jayadeva institute of cardiology. On statistical analysis it was

observed that myocardial infarction was more in male literates. The mean post test

score was 87.67% which was higher than the pre test score 22.40% and the

enhancement of knowledge was 59.27% with t value of 15.17% (p<0.05).47

A study was done to evaluate the effectiveness of structured teaching

programme on sex awareness among 80 adolescent girls in selected rural areas,

Chennai, India. 40 samples were allocated for experimental group and remaining 40

samples for the control group. The overall knowledge mean value in experimental

design was 48.69 with the SD of 17.41 where in the control group the mean value was

5.36 with the SD of 11.94. After administering structured teaching programme the
paired‘t’ value was 17.69, which was highly significant at (p<0.001). It shows that

there was an improvement of knowledge on sex awareness among adolescent girls.48

A study was conducted to evaluate the effectiveness of structured teaching

programme for type 2 diabetes in general practice in a rural area of Austria. 53

patients from 7 general practices attended structured teaching programme and served

them as interventional group and 55 patients from 7 general practices without the

programme served as the control group. After 6 months, the weight reduction in the

intervention group was 2.6 kg and the difference in Hb A/ c between the groups was

0.92% at follow up. Systolic and diastolic BP, serum cholesterol were reduced

significantly in the intervention group. The number of patients with callus formation

and nail care decreased significantly after participating in the teaching programme (p

< 0.001). In the control group no reduction in body weight, metabolic control or risk

factors for diabetic foot complications were observed. The teaching programme was

efficient and helpful to increase the overall quality of diabetes care.49

A study was conducted to evaluate the effectiveness of structured teaching

programme on awareness of cataract among 30 clients with cataract in selected area of

raichur by using purposive sampling technique. The findings revealed that the mean

post test knowledge scores (60) was higher than the mean pre test knowledge score

(30). Overall pre and post test mean difference is 40 with the‘t’ value of 37.192,

which is significant at 0.01 level. It is evident that the structured teaching programme

was effective for providing information on cataract among the client with cataract.50
STATEMENT OF THE PROBLEM

“EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME

ON KNOWLEDGE REGARDING DISASTER PREPAREDNESS AND

MITIGATION AMONG PU COLLEGE STUDENTS AT SELECTED

COLLEGES, BANGALORE.”

6.3. OBJECTIVES OF THE STUDY

6.3.1. To assess the knowledge of PU college students regarding disaster

preparedness and mitigation in terms of pre test knowledge scores.

6.3.2. To develop and administer structured teaching programme on disaster

preparedness and mitigation among PU college students.

6.3.3. To assess the effectiveness of structured teaching programme by comparing

pre and post test knowledge scores.

6.3.4. To find the association between pre test knowledge scores with selected

demographic variables.

6.4. HYPOTHESIS

H1: There will be significant difference between pre-test and post-test Knowledge

scores of PU college students regarding disaster preparedness and mitigation.

H2: There will be significant association between pre test knowledge scores with

selected demographic variables.


6.5. VARIABLES UNDER THE STUDY

INDEPENDENT VARIABLE

Structured teaching programme on disaster preparedness and mitigation.

DEPENDENT VARIABLE

Knowledge of PU College students regarding disaster preparedness and mitigation.

DEMOGRAPHIC VARIABLES

Demographic variables such as age, gender, languages known, exposure of any training

or classes regarding disaster preparedness and mitigation, source of information

regarding disaster preparedness and mitigation.

6.6. OPERATIONAL DEFINITIONS

1. Effectiveness: refers to the extent to which structured teaching

programme regarding disaster preparedness and mitigation achieves the

desired effect by gain in knowledge of PU College students by significant

difference in pre-test and post-test knowledge scores.

2. Structured teaching programme: refers to a systematically

developed instructional method and teaching aid designed for PU College

students to provide information regarding disaster preparedness and

mitigation.

3. Knowledge: refers to correct response received from PU College students

regarding disaster preparedness and mitigation elicited by self-administered

structured knowledge questionnaires.


4. Disaster: An occurrence of a natural catastrophe, technological accident,

or human caused event that has resulted in severe property damage, deaths,

and/or multiple injuries.

5. Disaster preparedness: is the development and documenting of a

Comprehensive plan that will allow an organization to recover from a

catastrophic event. It should include policies and procedures that are

appropriate to the size and function of the business.

6. Disaster mitigation: Mitigation is the effort to reduce loss of life and

Property by lessening the impact of disasters. Mitigation is taking

action before the next disaster—to reduce human and financial consequences

later.

7. PU Students: It refers to the boys and girls who are studying in P.U

College between the age group of 16-18 years.

6.7. ASSUMPTIONS

1. PU College students may have the interest to know more about disaster

preparedness and mitigation.

2. Structured teaching programme may enhance the knowledge of PU college

students regarding disaster preparedness and mitigation.

6.8. DELIMITATIONS

The study is delimited to PU College students between the age group of 16-18 yrs.
7. MATERIALS AND METHODS

7.1. SOURCES OF DATA

Data will be collected from the students at selected PU colleges, Bangalore.

7.2. METHOD OF DATA COLLECTION

Self administered structured knowledge questionnaire will be used to assess the

knowledge regarding disaster preparedness and mitigation.

7.2.1. RESEARCH APPROACH

An evaluative research approach will be found to be appropriate for the study.

7.2.2. RESEARCH DESIGN

One group pre-test post-test research design [pre experimental] will be used to achieve

the objectives of the study.

7.2.3. RESEARCH SETTING

Study will be conducted at selected PU Colleges, Bangalore.

7.2.4. POPULATION

The population of the study comprises of PU College students between the age group of

16-18 yrs at selected colleges, Bangalore.

7.2.5. SAMPLE SIZE

The sample size for the present study consists of 50 students between the age group of

16-18 yrs at selected PU colleges, Bangalore.


7.2.6. SAMPLING TECHNIQUE

Purposive sampling technique will be used to select the samples for the present study.

7.2.7. SAMPLING CRITERIA


Inclusion criteria:

The study includes the PU college students who are

1. Belong to the age group of 16-18 years

2. Available during the time of data collection

3. Willing to participate in the study.

Exclusion criteria:

The study excludes the participants who are

1. Sick/ ill/ absent during the time of data collection .

2. Not cooperative.

3. Exposed to any education programme related to disaster.

7.2.8. TOOL FOR DATA COLLECTION

Data collection will be done by self-administered structured knowledge questionnaire.

It consists of:

Part 1: Items on demographic variables like age, gender, languages known, exposure of

any training or classes regarding disaster preparedness and mitigation, source of

information regarding disaster preparedness and mitigation.

Part 2: Knowledge regarding disaster preparedness and mitigation.

7.2.9. DATA ANALYSIS METHOD


Data analysis will be done through descriptive and inferential statistics.
Descriptive statistics:

Frequency, percentage, mean, mean percentage and standard deviation will be used to

describe demographic variables to interpret the knowledge scores.

Inferential statistics:

 Paired ‘t’ test will be used to find the difference between the pre-test and post-test

knowledge scores.

 Chi-square test will be used to find the association between the knowledge scores
with selected demographic variables.

7.3. DOES THE STUDY REQUIRE ANY INTERVENTION TO BE

CONDUCTED ON PATIENTS OR OTHER HUMANS OR

ANIMALS?

Yes, the study will be conducted on PU College students by self-administered structured

knowledge questionnaire to collect information regarding disaster preparedness and

mitigation.

7.4. HAS THE ETHICAL CLEARENCE BEEN OBTAINED FROM

THE INSTITUTION?

 Yes, Ethical clearance will be obtained from the ethical committee of Sri

Venkateshwara Institute of Nursing Sciences and is enclosed.

 Permission will be obtained from the concerned administrative authority of

selected PU Colleges, Bangalore.

 Informed consent will be obtained from students who are willing to participate

in the study.
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14(2) :32-34.

46. K. Mostafa. “A cluster randomized control trial was conducted in England and

Scotland to assess the effectiveness of the diabetes education and self management

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48. A J Padmavathy ,K N Madhavan. “Effectiveness of structured teaching programme

on sex awareness among adolescent girls in selected rural areas,” Chennai, India,

2008.June. 20-24.

49. H. Youkui, Y M Coyle. “ Effectiveness of structured teaching programme for type

2 diabetes in general practice in a rural area of Austria ,” 2008.April.42-45.

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2008. March.245-248.
9. SIGNATURE OF THE STUDENT :

10. REMARKS OF THE GUIDE : The topic which is selected by the


candidate is relevant, appropriate
and it attempts to increase the
knowledge among the PU college
students regarding disaster
preparedness and mitigation.

11. NAME & DESIGNATION OF THE GUIDE:

11.1 GUIDE’S NAME AND ADDRESS: Mrs. Merina Joseph, HOD

Sri Venkateshwara Institute of

Nursing Sciences, Bommanahalli,

Hosur Road, Bangalore-560068

11.2. SIGNATURE OF THE GUIDE :

11.3. HEAD OF THE DEPARTMENT :

Mrs. Merina Joseph

Associate Professor

Sri Venkateshwara Institute of

Nursing Sciences, Bommanahalli,

Hosur Rsoad, Bangalore-560068.


11.4. SIGNATURE OF THE H.O.D:

12. REMARKS OF THE PRINCIPAL : The study is relevant, feasible and


will help the PU college students
to empower them with the
knowledge regarding disaster
preparedness and mitigation

12.1. SIGNATURE OF THE PRINCIPAL:

Asso. Prof. Merina Joseph

The principal (I/C)

Sri Venkateshwara Institute of

Nursing sciences, Bommanahalli,

Hosur Road, Bangalore-560068.


SRI VENKATESHWARA INSTITUTE OF NURSING SCIENCES

BOMMANAHALLI, HOSUR ROAD,

BANGALORE, KARNATAKA.

ETHICAL COMMITTEE

NAME OF THE STUDENT : MRS. K. R. RAJANI

YEAR : 1ST YEAR M.Sc. NURSING (2013-2014)

SUBJECT : MEDICAL SURGICAL NURSING

TITLE OF THE TOPIC : EFFECTIVENESS OF STRUCTURED


TEACHING PROGRAMME ON KNOWLEDGE REGARDING DISASTER
PREPAREDNESS AND MITIGATION AMONG PU COLLEGE STUDENTS AT
SELECTED COLLEGES, BANGALORE.

ETHICAL COMMITTEE MEMBER APPROVAL

DESIGNATION NAME SIGNATURE

1. CHAIRMAN : MRS.MERINA JOSEPH

2. LEGAL ADVISOR : MAJOR MUDDEGOWDA

3. SOCIOLOGIST : PROF. LEELAVATHY

4. PSYCHOLOGIST : MRS. MAMATHA

5. STATISTICIAN : MR. ARUN KUMAR. M

6. FACULTY ADVISOR : MRS.MAHESHWARI.K

SIGNATURE OF THE PRINCIPAL