1 NAME OF THE

CANDIDATE AND

ADDRESS

MS. CHINNU THOMAS

Ist YEAR MSc. NURSING STUDENT,

N.D.R.K. COLLEGE OF NURSING

B.M. ROAD HASSAN, KARNATAKA.

2 NAME OF THE

INSTITUTION

N.D.R.K. COLLEGE OF NURSING, B.M. ROAD, HASSAN,

KARNATAKA.

3 COURSE OF STUDY AND

SUBJECT

MASTER OF SCIENCE IN NURSING

(MEDICAL AND SURGICAL NURSING)

4 DATE OF ADMISSION TO

THE COURSE

11.07.2011

5 TITLE OF THE TOPIC “EVALUATE THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE REGARDING

PRIMARY PREVENTION OF OSTEOPOROSIS AMONG

HIGH SCHOOL TEACHERS IN SELECTED SCHOOLS,

HASSAN, AND KARNATAKA”.

5.1 STATEMENT OF THE

PROBLEM

“A STUDY TO EVALUATE THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON

KNOWLEDGE REGARDING PRIMARY PREVENTION OF

OSTEOPOROSIS AMONG HIGH SCHOOL TEACHERS IN

SELECTED SCHOOLS, HASSAN, KARNATAKA”.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE.

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

“An ounce of prevention is worth a pound of cure”.

William Clark

National osteoporosis awareness and prevention month is celebrated each May, and becomes a chance

for our Nation to become more familiar with the effects of this disease, and about the preventable steps that we

can to deal with it.

Osteoporosis is a common musculoskeletal disorder, referred as silent diseases that often remains

asymptomatic until bone fracture occur. Because of the high morbidity associated with fracture, prevention is a

clinical priority. Osteoporosis is one of the metabolic bone disorder and remains and increasingly significant

problem, affecting 200 million individuals worldwide. It affects men as well as women. One out of every two

women and out of every four men over 50 is prone to develop osteoporosis – related fracture of the hip,

vertebrae or wrist in their life time.1

Osteoporosis means porous bone. It is derived from Greek word osteon meaning “bone”, and poros

meaning “pore”. It is a disease of bones that leads to an increased risk of fractures. In osteoporosis, the bone

mineral density (BMD) is reduced, bone micro -architecture is deteriorating, and the amount and the variety of

proteins in bone is altered. Osteoporosis is defined by World Health Organization (WHO) as a bone mineral

density that is 2.5 standard deviations or more below the mean peak bone mass (average of young, healthy

adults); the term “established osteoporosis” includes the presence of a fragility fracture. The disease may be

classified as primary type 1, primary type 2 or secondary. The form of osteoporosis is common in women after

menopause.2

Despite the high prevalence and serious medical consequences of osteoporosis, many at risk patient are

inadequately screened and diagnosed before symptoms occur. Despite the prevalence and deleterious

consequence of bone loss and fracture, patient with osteoporosis continue to be under diagnosed and under

treatment. It is important for physicians to identify individuals at high risk of osteoporosis and to implement

preventive strategies. Osteopathic physicians are in a unique position to improve diagnosis and management of

this clinical condition when they implement a holistic and multi factorial approach.3

2

“To prevent “literally means “to keep something from happened”. The term “prevention” is reserved for

those interventions that occur before the initial onset of disorder. Nursing care oriented to health promotion,

wellness, and illness. Prevention can be understood is terms of health activities on primary, secondary, tertiary

levels. Primary prevention programme address area such as adequate and proper nutrition, weight control,

exercise and stress reduction among the healthy individuals. Secondary promote early detection or screening

and treatment of a diseases and limitation of disability. Tertiary prevention directed towards recover or

rehabilitation of a diseases or condition after the diseases have been developed osteoporosis can be treated and

prevented and early screening.4

A study was conducted by scientific Advisory Board of osteoporosis society of Canada regarding

prevention and management of osteoporosis. It was a controlled, randomized trials and prospective studies

conducted among Canadians. The purpose of the study was to recommend appropriate levels of calcium intake

in their dietary pattern. It was found that current recommended intakes of calcium are too low among

Canadians. The study suggested Canadians should attempt to meet their calcium requirements principally

through food sources. Revised intake guidelines designed to reduce bone loss and protected against osteoporotic

fracture. Further research is necessary before recommending the general use of calcium supplements by

adolescents. The study revealed that calcium supplementation cannot substitute for hormone therapy in the

prevention of post- menopausal bone loss and fracture. Adequate amounts of vitamin-D are necessary for

optimal calcium absorption and bone health.5

Although calcium and vitamin-D have been the primary focus of nutritional prevention of osteoporosis,

recent research has clarified the importance of several additional nutrients and food constituents. Osteoporosis is

a disease in which bones become weak and are more likely to break for fracture. Without prevention or

treatment, osteoporosis can progress without pain or a symptom until a fracture occurs. Osteoporosis is not just

an “old woman’s disease”. Although it is more common in white or Asian women older than 50 years,

osteoporosis can occur in almost any person at any age. In fact, more than 2 million American men have

osteoporosis, and in women, bone loss can begin as early as age of 25 years.6

Building strong bones and reaching peak bone density (maximum strength and solidness) can be the best

defense against developing osteoporosis. After reaching the peak, which usually occurs by the age of 30, a

healthy lifestyle can help keep bones strong. Osteoporosis is more or less preventable for most people.

Prevention is very important because, while treatments are available for osteoporosis, no cure currently exists.

6.2 NEED FOR THE STUDY

3

“Primary prevention includes all health promotion efforts as well as wellness education activities that focus on maintaining or improving the general health of individuals, families and communities”

Edelmen and Mandle.

In the united states approximately 30 million women and 10 million men aged 50 year or older have

osteoporosis, low bone mineral density, or both, placing them at risk for disabling fracture. Life style related

diseases such as diabetes mellitus, hypertension, and dyslipidemias, are often accompanied by osteoporosis. It is

a group of disorders in which there is a reduction of total bone mass without changes in the mineral

composition. There is an imbalance in the normal homeostatic bone turnover; the rate of bone resorption is

greater than the rate of bone formation, resulting in a reduced total bone mass. The bones become progressively

more porous, brittle and fragile. They fracture easily under stress that would not break normal bone. Treatment

of osteoporosis is essentially the same as that for primary osteoporosis, but it is important to be aware of the

interference between osteoporosis treatment and the drug used for the life style related diseases.7

According to the India’s National newspaper 20th October 2004, over 30 million case of osteoporosis in

India. The condition remains largely under diagnosis. This is because most doctors attribute to old age fracture

in those over 50, according to osteoporosis society in India. National largest study of osteoporosis, National

osteoporosis Risk Assessment [NORA] found that almost half of the more than 200000 postmenopausal women

assess in the study had low bone mass, putting them at risk of a breaking bone seven present of women in study

were found to osteoporosis and twice as high for women with low bone mass compared to women with normal

bone density. Osteoporosis is a major public health problem, and it prevalence may be increasing, unfortunately,

once spinal fracture occur, the treatment of osteoporosis is less than satisfactory. Prevention is the preferred

approach. Since the aetiologyof osteoporosis is multifactorial and the diagnosis usually delayed, treatment

becomes difficult. There are no set treatment methods as yet. Treatment can be divided in to medical and

orthopedic. Medical treatment consists of high protein diet, calcium supplementation, androgens, estrogen,

vitamin D and fluoride. Orthopedic treatment includes weight bearing exercise and prophylactic bracing of the

spine by using an ASH brace or Taylor brace.8

According to public health, there are three steps to prevention: primary, secondary, and tertiary. The

prevention of osteoporosis is made up of general life style preferences and other more specific treatments. 4

Keeping strong bone is the key to primary prevention and calcium build strong and health bones. Others include

vitamin D, weight bearing exercise and hormonal therapy. During the growing year of adolescence and teen

years, attention must be paid to dietary calcium if peak bone mass is to be achieved. Specific attention to dietary

calcium intake may also be warranted beyond age 60 which may come in the form of increased food calcium or

form specific calcium and vitamin D supplements. The main dietary sources of calcium include milk and other

daily products such as cottage cheese, yogurt or hard cheese and green vegetable. Milk is the primary source of

vitamin D. Exercise can help to prevent and treat thinning bones and should be done for at least 30 minutes

three times per week. Any weight bearing exercise is recommended since it is most beneficial to increase the

bone density, which is the primary factor in the prevention of osteoporosis. Smoking cigarettes can cause bones

to become thinner and weaker. Stopping smoking can reduce the risk. Some medications like glucocorticoid

medications, heparin, vitamin A and certain synthetic retinoid and antiepileptic drugs can lead bone thinning.

Patient should ask their health care provider about the possibility that these medications should be replaced or

the dose lowered. Hormone therapy is recommended for young women whose ovaries do not make estrogen

normally.9

A study was conducted by NIH consensus development panel on osteoporosis prevention, diagnosis;

therapy and objective were to clarify the factors associated with prevention and treatment of osteoporosis. The

participants were a nonfederal, nonadvocate, 13 members a panel was convened, representing the fields of

internal medicine, family and community medicine. Thirty two experts from these fields presented to the panel

and audience of 699. The panel answering predefines question, developed conclusions based on evidence

presented in one form and literature. They concluded the study that, through prevent in white post menopausal

women, osteoporosis occurs in all population and at all ages. Adequate calcium and vitamin D intake is crucial

to develop optimal peak bone mass and to preserve bone mass throughout life. Regular exercises, especially

resistance and high impact activities, contributes to development of high peak bone mass and may reduce risk of

falls is older person. Fracture prevention is the primary treatment goal for patient with osteoporosis.10

A study was conducted by Sri Sathya Sai General Hospital and Institute of Higher Medical Science,

Bangalore, India on deformities consequent to disorders of nutrition; bone and mineral metabolism constitute a

5

serious national health problem. They surveyed 337.68 million populations residing in 0.39 million villages is

22states of India during the period o f 1963 – 2005. Here 4, 11,744 patient identified with the disorder of bone

and mineral metabolism 2, 13,760 had nutritional bone diseases and 20, 784 had metabolic bone diseases.

Vitamin D deficiency, osteomalacia and rickets caused by inadequate exposure to sun light, dietary calcium

deficiency and fluoride interaction syndromes. The result showed the syndrome of bone diseases and

deformities are largely responsible for the morbidity and mortality in the young and promising individuals, with

economic consequences. Hence, the study recommended the health education on preventive aspect of

osteoporosis among perimenopausal group to achieve health aging.11

Primary prevention is a true prevention; it precedes diseases or dysfunction and is applied to clients

considered physically and emotionally healthy. Primary prevention aimed at health promotion includes health

education programmes, physical and nutritional fitness activities. It can be provided to an individual or to a

general population.12

Osteoporosis is often known as “The silent thief” because bone loss occurs without symptoms and

progressive loss and tinning of bone tissue happens over many years. This disease affects millions of people

throughout the world. Women are four time more likely than men to develop this disease. According to the

National osteoporosis foundation (NOF), primary defense is important before the age of 30. It is evident in most

of the cases that between the age of 30 and 40, one should start taking care to avoid osteoporosis. In current

situation, working women especially school teachers won’t give much attention to their health due to lack of

time and other overload activities in their daily life. Most often, they rely on junk or processed food instead of

regular balanced diet which has calcium, vitamin D and other minerals. Hence forth, the researcher felt the need

to shed light regarding the prevention of osteoporosis by providing adequate knowledge regarding the

importance of good nutrition, following healthy life style and regular exercise which can increase the bone

density is a primary factor in prevention of osteoporosis. With the aging of population, the incidence of fracture

associated with osteoporosis is rising. Therefore, the early detection and timely treatment of osteoporosis can

substantially decrease the risk of future, it is difficult to completely rebuild bone that has been weakened by

osteoporosis. Hence, the prevention of osteoporosis is as important as treatment.

It is expected to affect 36 million Indians by 2013 but osteoporosis – a disease associated with brittle bones,

fracture and painful recovery remains one of the most undermined diseases in the country.

6.3 STATEMENT OF PROBLEM

6

“A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME

ON KNOWLEDGE REGARDING PRIMARY PREVENTION OF OSTEOPOROSIS AMONG HIGH

SCHOOL TEACHERS IN SELECTED SCHOOLS, HASSAN, KARNATAKA”.

6.4 OBJECTIEVES OF THE STUDY

1. To assess the knowledge of high school teachers in selected schools at Hassan, regarding “the primary

prevention of osteoporosis” before the administration of the structured teaching programme.

2. To develop and administer structured teaching programme regarding “the primary prevention of

osteoporosis” among high school teachers in selected schools at Hassan.

3. To assess the knowledge of high school teachers in selected schools at Hassan, regarding “the primary

prevention of osteoporosis” after the administration of structured teaching programme.

4. To evaluate the effectiveness of structured teaching programme by comparing pre and post test

knowledge regarding primary prevention of osteoporosis among high school teachers in selected schools

at Hassan.

5. To associate post test knowledge with the selected socio- demographic variables regarding primary

prevention of osteoporosis among high school teachers in selected schools at Hassan.

6.5 HYPOTHESIS

RESEARCH HYPOTHESIS

H1.There will be significant difference between pre-test and post-test knowledge, scores of high school teachers

who received the structured teaching programme regarding primary prevention of osteoporosis.

H2.There will be significant association between the selected demographic variables and post-test knowledge of

high school teachers regarding primary prevention of osteoporosis.

6.6 ASSUMPTIONS

7

The study will improves the knowledge of high school teachers regarding primary prevention of

osteoporosis in selected schools at Hassan, Karnataka.

The study will improve the knowledge of high school teachers regarding the primary aspects of

preventing osteoporosis such as early detection, nutritional management, physical exercise, life style

modifications and hormonal replacement therapy.

6.7 OPERATIONAL DEFINITIONS

EVALUATE;

It refers to the assessment of effective structured teaching programme on “primary prevention of

osteoporosis”.

EFFECTIVENESS;

It refers to the extent to which structured teaching programme has achieved the desired effect as

measured by the subjects gain in knowledge scores.

STRUCTURED TEACHING PROGRAMME;

Refers to the systematically arranged facts regarding osteoporosis which includes definitions, meaning,

signs and symptoms, prevention and management.

KNOWLEDGE;

It refers to the level of understanding of high school teachers regarding primary prevention of osteoporosis.

PRIMARY PREVENTION;

Primary prevention is true prevention; it precedes diseases or dysfunction and is applied to clients

considered physically and emotionally healthy.

8

OSTEOPOROSIS;

A disorder characterized by abnormal loss of bone density and deterioration of bone tissue with an

increased fracture risk.

HIGH SCHOOL TEACHERS;

A teacher who certifies in teaching 8th, 9th, and 10th grade students working in a reputed school.

SELECTED SCHOOLS;

C.K.S. English Medium School, United Academy, C.M.I. C.B.S.E School.

6.8 CRITERIA FOR SELECTION OF SAMPLE

INCLUSION CRITERIA;

High school teachers those who are,

Female with the age group of 25 – 45 years.

Present during the time of the study.

EXCLUSION CRITERIA

High school teachers those who are,

Male.

Females with age group below 25 and above 45 years.

Females absent during the time of the study.

6.9 SIGNIFICANCE OF THE STUDY

9

(a) Increases the knowledge of high school teachers regarding the primary prevention of osteoporosis.

(b) Helps the high school teachers to gain knowledge regarding the primary aspects of preventing osteoporosis

such as early detection, nutritional management, physical exercise, life style modifications and hormonal

replacement therapy.

6.10 CONCEPTUAL FRAME WORK

Based on- “Betty Neumann model of prevention”

6.11 REVIEW OF LITERATURE

A literature review is a body of text that aims to review the critical points of current knowledge including substantive findings as well as theoretical and methodological contributions to a particular topic. It is an important step in research. It can help with the orientation to what is known about an area of enquiry to ascertain what research can best make a contribution to the existing base evidence. Review of literature is therefore, an essential process in the development of the research projects.

The results of studies conducted in various aspects of structured teaching programme on osteoporosis are presented below.

Review of literature is divided into two parts; they are literature related to,

1) Osteoporosis and its prevalence.

2) Primary prevention of osteoporosis.

1. Review of Literature Related To Osteoporosis and Its Prevalence.

10

A study was conducted to assess the prevalence of osteoporosis in Saudi women. 110 radio graphs of

calcaneum were reviewed for post-menopausal osteoporosis. The patients had come with unrelated complaints.

The age of this patient group was in the range of 45-80 years. Of these 76 percent patient had osteoporosis, of

these 42 had mild osteoporosis, 31 had frank osteoporosis and 11 were diagnosed to have severe osteoporosis.

This study showed high prevalence of post-menopausal osteoporosis.13

A study was conducted in china to assess the prevalence of osteoporosis and to find low bone mass of

healthy adult and its risk factors among 881 participants. Among these, 498 were women and 383 were men

aged 50 and above were analyzed in this study. A self administered questionnaire was used to assess their

demographic characteristics, diet, life styles and medical history. The prevalence of osteoporosis was high in

women (47 percent) compared to men (15.5 percent).14

Osteoporosis is the thinning and weakening of the bones that leads to the break, even with minimum

force. It is also in general higher among women and older people. According to a recent estimation, there are

about 300 million people with osteoporosis in India. The study also indicates that there may be a 50 per cent

increase in the number of people with osteoporosis in India in the next 10 years. This reveals that Indian women

are at high risk of osteoporosis.15

2 Review of Literature Related To Primary Prevention of Osteoporosis.

A study was conducted by the scientific advisory board of osteoporosis society of Canada in physical activity

as therapy for osteoporosis. Relevant epidemiological studies, clinical trials and reviews were examined,

including the large scale FICSIT trial in the United States, a prospective 4 year study of women enrolled in an

exercise programme in Toronto and the large scale study of osteoporotic fractures. The study revealed that

immobilization should be avoided in any one with osteoporosis. Regular, moderate physical activity is

recommended for those with osteoporosis. Younger people with osteoporosis need exercise that will preserve or

improve bone mass, muscular strength, endurance and cardiovascular fitness. Weight loss as a result of physical

activity should be avoided and adequate intake of protein, vitamins and minerals assured. Because the benefits

of physical activity are independent of the effect of other therapies, physical activity is an essential adjunct to

appropriate nutrition and other therapies.16

11

A study was conducted by Scottish Centre for evidence based care of older people, Scotland, UK

regarding the effectiveness of exercises interventions in preventing bone loss and fracture in postmenopausal

women. Selection was based on randomized controlled trials (RCTs). 43 RCTs with 4320 participants met the

inclusion criteria. the most effective type of exercise intervention on bone mineral density (BMD) for the neck

of femur appears to be non-weight bearing high force exercise for the lower limbs (MD 1.03; 95% confidence

interval 0.24 to 1.82). The most effective intervention for BMD at the spine was combination exercise

programmers (MD 3.22; 95% CI 1.80 to 4.64) compared with control groups. The result suggested a relatively

small statistically significant, but possibly important, effect of exercise on bone density compared with control

groups. Exercise has the potential to be a safe and effective way to avert bone loss.17

A study was performed by a meeting held in Funchal, Madeira, based on hormone replacement therapy

in the post- women’s health initiative era. It is important to note that randomized controlled trials such as the

WHI are really scientific tools for a group of research participants, not a form of individualized medical

management the WHI targeted a group of women who were much older than those normally treated and who

had numerous other risk factors. It is clear that hormone therapy is effective for post menopausal symptoms and

osteoporosis prevention. Timing is critical for the initiation of therapy and length of treatment. Additionally,

presenters explored the possibility of class effect against the potential risk factors associated with particular

estrogen and progestogen types. Evidence from preclinical and clinical studies support the conclusion that, HRT

should be given to women with menopausal complaints to meet their individual needs, taking in to account their

individual risk profile and the overall therapeutic objectives.18

A study was conducted to review, the effect of dietary intakes and the effect of vitamin D on bone

mineral density, and fracture or fall risk. To minimize bias, study design was limited to randomized controlled

trials. Data were abstracted in duplicate and study quality assessed. If clinically relevant and statistically

feasible, meta-analyses of RCTs on vitamin D supplementation and bone health outcomes were conducted, with

exploration of heterogeneity. Result shown that, largest body of evidence on vitamin D status and bone health

was in older adults with a lack of studies in premenopausal women and infants, children and adolescents. The

quality of RCTs was highest in the vitamin D efficacy trials for prevention of falls and or fractures in older

adults. In older adults, there was fair evidence that serum 25(OH) D is inversely associated with falls. There was

good evidence that intakes from vitamin D foods consistently increased serum 25(OH) D in both young and

older adults. The results highlight the need for additional high quality studies in infants, children and

premenopausal women. Vitamin D with calcium supplementation has a small beneficial effect on BMD, and

reduces the risk of fractures and falls. Vitamin D intake above current dietary reference in take was not reported

to be associated with an increased risk of adverse events. However, most trials of higher doses of vitamin D

were not adequately designed to assess long term harms.19

12

A study was conducted by Journal of the American Board of family medicine (JABFM) to determine

the frequencies of female patients aged 65 years and older having bone density measurement performed and

prescription therapy use among osteoporotic women. They completed a retrospective chart audit to assess our

adherence to Physician Quality Reporting Initiative guidelines. Women aged 65 to 75 with an office visit

between June 1 to November 30, 2007, were divided into 3 subgroups: those who had a recent preventive

general medical examination (GME), those who received one in the last 10 years, and those who had not. They

determined osteoporosis screening rates for all 3 groups. The first group then underwent electronic medical

record review to obtain patient demographics, determine bone mineral density results, and review if those with

osteoporosis were receiving prescription treatment. Result had shown that. Ninety-six percent of 305 female

patients seen for a GME during the study period had completed bone mineral density testing. This was a

screening rate significantly greater than that for patients with an earlier GME and those who never had one in

the offices (70% and 50%, respectively). The study concluded that female patients who completed a recent

GME had extraordinarily high rates of screening for osteoporosis. We believe this demonstrates the importance

of a dedicated preventive health examination as well as the increased significance that physicians and patients

currently place on this behavior. The study also highlights one thousand two hundred forty-eight female patients

between the ages of 65 and 75 were seen by DFM physicians at MCA between June and November 2007. Three

hundred five (24.4%) completed a GME during this time, as determined by billing data for a preventive service

code. Six hundred forty-five (51.7%) of patients had completed a GME during the previous 10 years but not

during our period of study. Two hundred ninety-eight patients (23.9%) had not been billed for a preventive

service code within the proceeding 10 years.20

A study was conducted to examine osteoporosis knowledge and awareness among Vietnamese women

who have accessed health care. A sample of 217 women, 13 to 76 years of age, who were attending 1 to 2 health

care facilities in Vietnam, questionnaire assessing their awareness of osteoporosis and measuring their

knowledge. Majority of women had heard of osteoporosis on average, women answered 49% 0f the knowledge

questions correctly. Mean knowledge scores were higher among those reporting a family members with

osteoporosis, nurses and women with high school education or greater. More than 90% of the women expressed

interest in a prevention and treatment programme. The study was concluded that Vietnamese women may have

heard of osteoporosis, yet they would benefit from education, targeting prevention and treatment of the

diseases.21

13

A study was conducted to assess the higher levels of knowledge regarding osteoporosis prevention. A

classic experimental design was used. Convenience samples of thirty young college women were randomly

assigned to an experimental group or to a controlled group to receive an osteoporosis prevention programme.

Both groups completed the knowledge test, the osteoporosis health belief scale and self efficacy scale. The

osteoporosis programme was effective in increasing awareness of osteoporosis prevention, in the experimental

group of young women.22

A study was conducted in Hongkong using randomized controlled design to evaluate whether a nurse

initiated education programme on four specific osteoporosis-prevention related behaviours leads to their

adoption or positive attitude changes compared with women, who did not participate in this programme. Pre-

post and follow-up education data compared attitude and conception frequency before and after the education

programme. The study found that a targeted education programme conducted on Hongkong women resulted in

significantly increasing consumption of calcium including Soya based foods, milk and vitamin D.23

A study was conducted to assess the effectiveness of workshop on Osteoporosis among Canadian

women. A semi experimental design was used to measure any changes in the participant’s knowledge about

osteoporosis and their preventions and treatment practices regarding this disease. It is found that the work shop

was effective in increasing the participant’s level of knowledge on osteoporosis.24

7. MATERIALS AND METHODS OF STUDY

7.1 SOURCE OF DATA COLLECTION

Data will be collected from high school teachers working in selected schools, Hassan, Karnataka.

7.2 METHODS OF COLLECTING DATA

1. Research Design

Quasi experimental design (one group-pre-test post test design).

14

SCHEMATIC PLAN OF THE STUDY

Group Pre-test Intervention Post-test

A group of 60

high school

teachers.

(single group)

O1 X O2

KEY

O1; Pre test knowledge of high school teachers regarding “primary prevention of osteoporosis“.

X; structured teaching program on “primary prevention of osteoporosis“.

O2; Post test knowledge of high school teachers regarding “primary prevention of osteoporosis“.

2. Research Setting

Selected high schools in Hassan, Karnataka

3. Population

High school teachers working in selected high schools in Hassan, Karnataka

4. Sample

High school teachers who are fulfilling inclusion criteria

5. Sample Size

60 High school teachers in selected schools in Hassan, Karnataka.

6. Sampling Technique.

Probability sampling – Simple random technique.

15

7. Collection of Data

Data will be collected from samples using a structured questionnaire.

8. Selection of Tools.

Structured questionnaire consists of two sections

Section A – Sociodemographic Variable.

Section B – Structured Questionnaire regarding primary prevention of osteoporosis.

9. Data Collection Method.

Data collection is the gathering of information needed to address a research problem. The permission

will be obtained from the authorities in respective institutions before the data collection. Pre test will be

conducted with the demographic proforma and structured knowledge questionnaire followed by

administration of structured teaching programme on primary prevention of osteoporosis. Post test will be

conducted with the same structured knowledge questionnaire after 7 days.

8. VARIABLES

INDEPENDENT VARIABLES;

Structured teaching programme regarding primary prevention of osteoporosis among high school

teachers in selected schools in Hassan, Karnataka.

DEPENDENT VARIABLES;

Knowledge of High school teachers regarding primary prevention of osteoporosis.

EXTRANEOUS VARIABLES;

Age, sex, education, experience in teaching filed, exposure to mass media etc.

16

9. PLAN FOR DATA ANALYSIS

Descriptive statistics:

It includes percentage, frequency, mean and standard deviation for High school teachers

regarding primary prevention of osteoporosis.

Inferential statistics:

It include paired ‘t’ test and chi square test and ANOVA ‘f’ test for the assessment of

knowledge and to associate the socio- demographic variables planned.

10. PILOT STUDY

10% Population is planned for pilot study.

11. ETHICAL CONSIDERATION

1. Has the consent been taken from the respondents?

Yes, informed consent will be taken from the respondents.

2. Has ethical clearance being obtained from the institution?

Yes, it will be obtained at the time of study.

17

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-134.

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introduction.

3. M.Jill.Gronholz, medical director, Bone density of North Idaho, 920 Iron wood, “prevention, diagnosis and

management of osteoporosis” – related fracture; A multifactorial osteopathic approach.

4 Potter and Perry, Fundamentals of Nursing, 7th edition, Mosby publications, Page no- 19-20.

5. Murray TM, Division of Endocrinology and Medicine, University of Toronto, “Prevention and management

of Osteoporosis, 1996 Oct 155(7), 935-940.

6. Katherine tucker, USDA Human Nutrition Research Center on Aging, Tufts university, 711 Washington

Street. Boston.

7. Suzanne C. Smelter and Brinda G Bare, Brunner & Siddhartha’s Text book of Medical Surgical nursing, 10 th

editions, Lippincott, Williams& Wilkins, 2004. Page no 2058- 2060.

8. J Maheshwar, Essential. Orthopedics, Interprint publication, volume 1, page No- 232 – 234.

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10. NIH Consensus Development Panel on osteoporosis prevention, diagnosis & therapy, 2001 February 14;

285(6): 785 – 795.

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12. Taylor Lillis, Lemone Lynne, Fundamentals of Nursing, 6 th edition, Lippincott Williams & Wilkins, Page

No 20-22.

13. Postmenopausal Osteoporosis in Saudi Women- A Pilot screening. Available from http://eprints.ktupm.edu.sa/8385/-

14k.

18

14. Prevalence and Associated factors of Low bone Mass in health check. Available from

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osteoporosis.html.

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1996, October 155(7), 940-945

17. Dawson L J, Downie F etal, Glasgow Caledonian University, Scottish Center for Evidence Based Care of Older

People, Glasgow, Scotland, UK. 2011July 6(7), 180-185.

18. Report meeting held in Funchal, Madeira on “Hormone Replacement Therapy in the post- women’s Health Initiative

era, 2003 February 24-25.

19. Cranney A, Horsley T etal, “Effectiveness and Safety of Vitamin D in relation to bone health, 2007 August (158) 1-

235.

20. Michael Grover, DO, Matthew Anderson, MD,etal, Department of Family Medicine, Mayoclinic Arizona, “Increased

Osteoporosis Screening rates Associated with the Provision of a Preventive Health Examination, 2006 July (128) 268-275.

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