“A Descriptive study to Asses the knowledge regarding control of Asthma

symptoms among allergic Asthma patients Admitted at selected hospitals in

Bangalore with a view to Develop information guide sheet.”

PROFORMA FOR REGISTRATION

OF

SUBJECT FOR DISSERTATION

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA.

HARSHA COLLEGE OF NURSING.

NELAMANGALA.

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1. NAME OF THE CANDIDATE AND ADRESS: Mrs. VANDANA.
I year MSc.NURSING STUDENT.
HARSHA COLLEGE OF NURSING.
NH-4, SONDEKOPPA
CIRCLE, NELAMANGALA.

2. NAME OF THE INSTITUTION: HARSHA COLLEGE OF NURSING.

3. COURSE OF THE STUDY AND SUBJECT: I year MSc.NURSING.

MEDICAL-SURGICAL NURSING.

4. DATE OF ADMISSION TO COURSE: 8-5-2010.

5. TITLE OF THE TOPIC: A Descriptive study to Asses the knowledge regarding

control of Asthma symptoms among allergic Asthma patients Admitted at selected

hospitals in Bangalore with a view to Develop information guide sheet.

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 6. BRIEF RESUME OF INTENDED WORK

INTRODUCTION

Asthma is considered to be one of the most disabling disease of all times the reason being
that it is a lifelong condition for which there is no definitive treatment and the symptoms of
the Asthma especially Allergic Asthma are very severe which make difficult for the patients
to cope with their day to day activities.
Allergic asthma is the most common form of asthma it accounts for 50% of all adult forms of
Asthma for the patients with Allergic asthma coming contact with specific substances called
Allergens will trigger a Asthmatic symptom or attack with in a short time.1

Asthma is a seriously growing health problem, especially in the developing country like
India. Among many forms of Asthma allergic asthma is the most frequent one Allergic
Asthma includes those caused by the Allergens that is found in and around the patients
environment.

There is currently no cure for asthma and no single exact cause has been identified therefore,
understanding the changes that occur in asthma. How it makes you feel. And how it can
behave over time is essential. This knowledge can empower people with asthma to take an
active role in their own health.2

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 6.1. NEED FOR THE STUDY

Asthma is one of the major causes for discomfort and death due to its chronic

characteristics it is one of the major concern now a days. The incidence of allergies in India

is approximately 25% and now probably have risen to 26% of the Indian Population out of

this Allergic asthma is 13 to 14% i.e. 130-140 million Indians are Allergic asthma patients. In

the west on the other hand 50% of the population suffers from allergies.3

It is very important today to control asthma factors in India because 80% sufferers of

allergy in India are below 40 years of age and another 19% between 40-60 years and this is

the productive age of an individual’s life, thus asthma may interfere with economic stability,

life style and comfort of a person. 2000 peoples in UK die every year of Asthma, 5 peoples a

day in average 80-90% of these could be preventable with improved management and patient

education, patients with poorly controlled asthma have more absence from work and have

more difficulty in leading a normal life then those whose condition is well controlled,

patients education aims to equip the patient with the necessary knowledge and skills to

prevent and treat his asthma symptoms. People with asthma should learn to live with their

condition rather than suffering from it.4

In Bangalore approximately 7.1% of the population is suffering from allergic rhinitis, It is

probably, one of the highest incidence of allergic rhinitis /Asthma in the world.14

Incidence of Asthma had doubled with in last 15 years and chest physicians are

looking for more and more cases of it in its severe form, the reason for this spurt in the

Allergic asthma incidence are thought to be increase in pollution, and lack of knowledge

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 among common man towards avoidance measures of dust to protect themselves from

the predisposition and severity of asthma symptoms.5

The lessons learned in asthma may be extrapolated to the development of educational

programs on allergic diseases in general there is an urgent need to continue to develop

education for specific allergic conditions. Interventions by nurses, medical professionals in

the terms of providing education about allergic diseases like asthma in need of the hour, role

of patient education is very important in helping to prevent and ameliorate the symptoms of

this Ig E-mediated disease.6

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 6.2. REVIEW OF LITERATURE

This part deals with the literature reviewed in the areas related to allergic asthma and it’s

control modalities.

1. Literature related to General aspects of Allergic asthma.

2. Literature related to Control of asthma.

Literature related to General aspects of Allergic asthma.

Kanceljack, Macan B (2004), reported that Allergic diseases are an increasing health

problem in the industrialized and developed countries especially in young adult persons.

They are considered diseases of modern civilization. The reported cumulative prevalence of

allergic diseases consists of 25-30% includes allergic asthma and dermatitis the reasons for

this increasing allergen exposure, environmental pollutants, and lifestyle. Allergic diseases

have a fatal outcome, 7

Chris Griffiths, Gurmit Kaur, et al (2001), conducted a study to explore the reasons

for increased risk of Hospital admissions among South Asian patients with asthma, 58 South

Asian Asthma patients, 49 admitted in Hospital and 9 not admitted, participated in the study

results showed that, South Asian patients admitted to hospital coped differently with asthma,

South Asians described less confidence in controlling their Asthma.8

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 Gelber LE, Seltzer LH, et al (1993), investigated through a case control study on

114 patients of Asthma in a emergency room, along with 114 controls, their research showed

that sensitization and exposure to indoor allergens like dust mites, cat dander, cockroach,

grass pollen, and ragweed pollen, are high risk factors for asthma among patients presenting

to hospital.9

Literature related to Control of asthma.

Ramirez NC, Lodford DK (2002), reported from Florida that specific allergen

immunotherapy is an effective treatment of allergic asthma. Double blind studies provide

proof of benefit, although seasonal or intermittent asthma consistently responds better than

perennial asthma. Advantages of immunotherapy compared with most pharmacotherapies

include modification of natural history of allergic disease, reduction of need for chronic

medication, and treatment of both upper and lower airway disease simultaneously.

Improvements in immunotherapy occurred in the later portion of the twentieth century

because of enhanced understanding of immunotherapy’s mechanism of action, recognition of

the dose effect, and improved quality and consistence of allergen vaccines. Purified inhibitors

of specific mediators of the allergic response, the future of immunotherapy and other

immunomodulation of allergic asthma are promising.10

Cypcar D, Lemanske RF (1994), reported that physical training, exercise should be

part of the asthmatic patient’s over all plan of management. When properly treated, asthmatic

individuals should be able to participate or compete in the majority of sports. At the same

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 time it should be kept in mind that unplanned, over intensity Exercise can trigger

acute exacerbations in virtually all individuals with allergic asthma.11

Luczynska C, Tredwell E, Smeeton N, Burney P (2003), conducted a randomized

control study about benefit of asthma avoidance measure in improving symptoms among

allergic asthma clients. By using various modalities like using allergen impermeable bed

covers, good house keeping etc., patients are randomizing to a placebo controlled trial of use

of allergen proof bed linens for 12 months, without any other form of dust reduction

measures. Adults with asthma were selected from general practices and asthma clinics in

London. Their serum Ig E to mite allergens and allergen content of mattress dust samples

were measured, those with 0.70 KU/L mite specific a and Ig E and >2micro gms/g were

randomized in to active or placebo treatments, information was collected on allergic

symptoms and medication use and quarterly peak flow diaries were kept throughout trial. The

mean decrease in micro gms/g was 25.7 (95%) in the active group and 4.5 in the placebo

group. It was concluded that mite allergen avoidance in bedding alone cannot be

recommended as an effective way of relieving allergic asthma symptoms.12

6.3. OBJECTIVES OF THE STUDY

STATEMENT OF THE PROBLEM

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For the present study the after discussing with the experts and guide ,after referring literature
reviews and also with the personal clinical experience of the student researcher following
research problem was selected.
“A Descriptive study to Asses the knowledge regarding control of Asthma symptoms among
allergic Asthma patients Admitted at selected hospitals in Bangalore with a view to Develop
information guide sheet”
OBJECTIVES:
The present study is intended to fulfill the following objectives
 To Asses the knowledge of Allergic asthma patients regarding control of Asthma
symptoms.
 To find out Association between Demographic variables and knowledge scores.
 To develop an information guide sheet on control of Asthma symptoms.

OPERATIONAL DEFINITIONS
 Asses: It refers to the critical analysis and valuation or judgment of the status
of a particular condition.
 Knowledge: it refers to the facts, information and skills acquired through
experience or education.
 Patient: it refers to individuals suffering with one or the other ailments and
receiving therapeutic, diagnostic and preventive procedures.
 Control of Asthma: The ability of patients to reduce the severity of asthma

symptoms, by adopting certain measures, lifestyle and environment

modifications.

 Asthma: It is a respiratory condition marked by attacks of spasms in the

bronchi of the lungs, causing difficulty in breathing and usually associated

with a allergic reaction.

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  Allergic Asthma: Allergic asthma is a chronic inflammatory disorder of the

airways. Its symptoms are made worse by exposure to an allergen.

ASSUMPTIONS

 Allergic asthma patients visiting hospitals for treatment have limited

Knowledge about controlling Asthma.

 The knowledge can be improved by using information guide sheet.

HYPOTHESIS
For the present study following hypothesis may be applicable
H2 :( Research alternative hypothesis) There is a significant Association between
Demographic variables and knowledge scores.

CONCEPTUAL FRAME WORK

The present study will be conceptually based on a conceptual frame work named ‘HEALTH
BELIEF MODEL’ by IRWIN.M.ROSENSTOCK (1988).

7. MATERIALS AND METHODS

Data collection method is a systematic way of resolving a research problem

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This part provides a brief description of different steps taken to conduct the study population,
criteria for sample selection, research data collection tool and plan for data analysis

7.1. SOURCE OF DATA.

TARGET POPULATION: It is a large population related to the problem of the research. For
the present study target population are the Allergic asthma patients. there for the source of
data will be those Allergic asthma patients with symptoms of Asthma Admitted at various
selected hospitals in Bangalore.

RESEARCH APPROACH
Research approach is the basic procedure for the research of enquiry it helps the researcher
regarding what data to be collected and how to analyze it
The present study is a descriptive explorative approach and analyses patient knowledge
scores with relation to various demographic variables.
RESEARCH DESIGN
It is a plan for organization of the study, Research design for the present study is quasi
experimental Descriptive explorative study of 50 patients with Allergic asthma.
RESEARCH SETTING
It is the probable geographical are where the research study is planning to be conducted, for
the present study Research setting is the various selected hospital located in Bangalore,
Karnataka.
7.1. METHOD OF COLLECTION OF DATA.
RESEARCH SAMPLING
SAMPLE SIZE: The Research will be conducted on 50 representative samples drawn from
the target population.

SAMPLING TECHNIQUE: The sample will be selected by using probability sampling

technique and Random sampling method.

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CRITERIA FOR SAMPLE SELECTION

INCLUSION CRITERIA
Patients with Allergic Asthma
Patients who are willing to participate in the study.
Patients who can read and write kannada or English.

EXCLUSION CRITERIA
Patients who are not suffering with active Asthma symptoms
Patients who are not willing to participate
Patients who are not present during the study./sampling.
SELECTION AND DEVELOPMENT OF TOOL
The data collection tool will be developed based on expert guidance, guide reviews, literature
review and researchers own experience. And the tool will comprise of following parts
1. Demographic variables
2. Objective type questionnaire.
The tool will be a structured objective type questionnaire in both English and kannada.
BLUEPRINT AND RELIABILITY OF THE TOOL.
The blue print of the tool will be prepared after validation from subject experts and guide
with the help of expert and guide direction and advice.
The reliability of the tool will be examined by using proper statistical methods like KARL-
PEARSON’S correlation method by using spearman brown’s prophecy formula.
METHOD OF DATA COLLECTION.
The data will be collected directly from the research subjects that are patients with Allergic
asthma by using a structured questionnaire.

DURATION OF THE STUDY

The research is intended to be completed with in a time frame of 8 weeks.

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7.3. DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO
BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS?
Yes, the study required an explorative assessment of knowledge of 50 representative samples
of Allergic asthma patients.

7.4. HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?
Yes, ethical clearance has been obtained from the institution and also a prior consent will be
obtained from the patient or their relatives, and also it will be assured to the patients that their
self-esteem and privacy will be utmost respected throughout the study.

8. LIST OF REFERENCES.
1. www.choose natural.com/alternative/medicine.

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2. www.Medicine net.com/asthma/article.htm.
3. Wiqar Ahmed sheikh. ‘Evidence for increase in Asthma worldwide. Australian journal of
respiratory medicine.Canberra. 2001; 206(9): 230-54.

4. Peatite P T.Walker S. ‘Asthma; an epidemic and immunlolgy’. Stanford. 1991 Aug; 3(8):
715-20.
5. Pinn. ‘What can be done to prevent progression of Asthma’. University of Verona medical
journal. Verona. 1992 Jun; 81(7): 44-51.
6. Arshad SH et.al. ‘Association of Asthma related symptoms with sensitization to common
Allergens’. Journal of Allergy research. Californea. 2001 Jan; 58(13): 94-102.
7. Kanceljack. Macan B. ‘Current views on Allergic diseases’. Archives highrada Toksikol.
Zagreb. 2004 Jul; 61(8): 123-34.
8. Chris griffiths, Gurmit kaur, et .al. ‘Prevalence of Asthma in southeast Asian population’.
Philidelphia journal of medicine. 2001 Feb; 61(3): 312-20.
9. Gelber LE.SeltzerLH.et.al. ‘Prevalence of Asthma in Delwar’American journal of
Asthma.Delwar. 1993 May; 18(5): 135-42.
10. Ramirez T. ‘Immunotherapy for Allergic asthma’. Journal of medical clinic of North
America. Florida. 2002 Sep; 86(5): 1091-112.
11. Cypcar D.Lemanske RF. ‘Asthma and exercise’. Clinical chestmedicine. Wisconsin. 1994
Oct; 39(17): 351-68.
12. Luczynska C. Tredwell E. ‘Randomized control trial of Dust mite allergen impermeable
bedcovers in adult Asthmatics’. London. 2003 Mar; 51(18): 1648-83.

9. SIGNATURE OF THE CANDIDATE:

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10. REMARKS OF THE GUIDE:

11. NAME AND DESIGNATION:

11.1 NAME AND DESIGNATION OF THE GUIDE:

11.2. SIGNATURE OF THE GUIDE:

11.3. NAME AND DESIGNATION OF THE CO-GUIDE (If any):

11.4. SIGNATURE OF THE CO-GUIDE (If any):

11.5. HEAD OF THE DEPARTMENT:

11.6. SIGNATURE:

12. PRINCIPAL:
12.1. REMARKS OF THE PRINCIPAL:

12.2. SIGNATURE:

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