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Table of Contents
ARTICLE
Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 75-80

Effectiveness of structured teaching programme on knowledge and attitude regarding disaster preparedness among nursing students


1 3rd Year B. Sc (N) Student, College of Nursing, CIHSR, Dimapur, India
2 Assoc.Professor, College of Nursing, CIHSR, Dimapur, India

Date of Web Publication5-Jun-2020

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Source of Support: None, Conflict of Interest: None


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  Abstract 


Disasters cause serious disruption of the normal functioning of a community or society, resulting in widespread devastating human, property or environmental effects,the recovery from which requires assistance from outside the affected community. In disaster prone areas, disaster preparedness can minimize injuries, loss of life, and damage to property. Health care professionals and students are great resources in times of disaster and their knowledge on disaster management enables optimal and timely services during a disastrous event. Apre-experimental research study was undertaken with the objective to assess the knowledge and attitude of nursing students regarding disaster preparedness for earthquakes and fires and to determine the effectiveness of a structured teaching programme on knowledge and attitude. Proportionate stratified random sampling was done to obtain a sample of 52 first year and second year B.Sc (N) and G.N.M students and data was collected using a self-administered knowledge questionnaire and an attitude scale. The study findings showed that 8% nursing students had adequate knowledge about disaster preparedness. Majority (62%) of the nursing students had positive/favorable attitude regarding disaster preparedness. Effectiveness of the structured teaching programme, was assessed using paired t- test, and was found to be statistically significant at ρ < 0.05. Study findings support the promotion of routine assessment of knowledge and attitude and regular trainings on disaster preparedness using structured teaching programmes to ensure adequate disaster preparedness among nursing students.

Keywords: knowledge, attitude, nursing students, disaster preparedness, structured teaching programme


How to cite this article:
Pongen TB, Kiho T, Pongen >, Venyo U, Singson V, Vungzahoih, Humtsoe LE. Effectiveness of structured teaching programme on knowledge and attitude regarding disaster preparedness among nursing students. Indian J Cont Nsg Edn 2018;19:75-80

How to cite this URL:
Pongen TB, Kiho T, Pongen >, Venyo U, Singson V, Vungzahoih, Humtsoe LE. Effectiveness of structured teaching programme on knowledge and attitude regarding disaster preparedness among nursing students. Indian J Cont Nsg Edn [serial online] 2018 [cited 2022 Oct 6];19:75-80. Available from: https://www.ijcne.org/text.asp?2018/19/2/75/286093






  Introduction Top


Disasters are events that occur suddenly, often without any warning, leaving behind a trail of devastation, loss, and suffering. According to the National Disaster Management Authority (2017), India is vulnerable, in varying degrees to floods, cyclones, droughts, tsunamis, earthquakes, urban flooding, landslides, avalanches, and forest fires. Added to these are fire accidents, industrial accidents and other manmade disasters involving chemical, biological, and radioactive materials. These have accentuated the need for strengthening mitigation, preparedness, and response measures. In the recent months, there had been an increasing trend in the occurrence of natural and manmade disasters such as fires, floods, and landslides in India which have led to the deaths of hundreds and rendered thousands homeless, to the extent that the affected states had to rely on outside assistance to recover from the devastating impacts.

Disaster has been defined as “a sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources”. Though often caused by nature, disasters can have human origins (International Federation of Red Cross and Red Crescent Societies [IFRCRCS], 2017). Disaster preparedness refers to the measures taken to predict and where ever possible, prevent disasters and reduce their effects on vulnerable populations, respond to disasters and effectively cope with their consequences (IFRCRCS, 2017).

Disasters can pose serious threats to any nation. The ability of the health care professionals to quickly assess, effectively communicate and manage a disastrous event can contribute significantly to a nation’s capacity to respond to disasters successfully. Nurses, forming the major workforce in the healthcare setting, being well prepared and equipped with the required knowledge and skills, can be valuable assets during disasters. Health services involved in disaster response would also greatly benefit from nursing students being educationally prepared for disasters, as this would reduce the requirements for increased manpower and organizational efforts for trainings on disaster response (Jennings- Sanders, Frisch, & Wing, 2005).

Given the increasing focus on disaster preparedness of nurses in the literature in recent years (Ibrahim, 2014; Labrague et al., 2018) and the important roles nurses are required to play during disasters, local and international initiatives have been undertaken to adequately prepare nurses and other healthcare workers to respond effectively to disasters through extensive disaster trainings, disaster drills and exercises, and the provision of disaster management courses. It has been reported that disaster related content has also been included in the nursing curriculum (Labrague et al., 2018). It is commendable that the Indian Nursing Council has also included Disaster Nursing, as a part of the undergraduate and diploma nursing curriculum. However, its inclusion only in the 2nd and 3rd year of their training and the time allotment of five hours of theory seems inadequate to prepare nursing students to make significant contributions during disasters. And again, in spite of all the initiatives, local and international, available evidence has shown that nurses remain inadequately prepared to respond to disasters (Back & Alfred, 2013 ; Duong, 2009; Fung, Loke, & Lai, 2008).

Öztekin, Larson, Akahoshi, and Öztekin (2016) also observed that the concept of disaster preparedness and response has not been adequately explored among nursing students. The few studies exploring nursing students’ level of preparedness for disaster response have demonstrated that nursing students generally have inadequate knowledge and are inadequately prepared for disasters (Kumar & Karsayal, 2016; Schmidt et al., 2011 ). Nursing educators have also been recommended to develop strategies to prepare their students for disaster management (Schmidt et al., 2011). Studies on effectiveness of disaster preparedness training for nursing students have also been infrequent (Alim, Kawabata, & Nakazawa, 2015) and even more so in India as well as the North Eastern state of Nagaland, which are highly vulnerable to natural and manmade disasters. The state of Nagaland in the North Eastern region of India is multi-hazard prone, vulnerable to disasters such as fires, earthquakes, and landslides brought on by incessant rains. It comes under the seismic zone IV/V and hence is vulnerable to high intensity earthquakes (Nagaland State Disaster Management Authority [NSDMA], 2012).

Hence, a need was felt to conduct a study to assess whether the development and utilization of a Structured Teaching Programme (STP) will be effective in enhancing the knowledge and attitude of nursing students regarding disaster preparedness for earthquakes and fires.

Objectives

  • To assess the knowledge of the nursing students regarding preparedness on selected disasters before and after STP
  • To assess the attitude of the nursing students regarding preparedness on selected disasters before and after STP
  • To determine the effectiveness of STP regarding disaster preparedness among the nursing students



  Methods Top


A pre-experimental study was conducted among 52 nursing students in a College of Nursing, in the North Eastern state of India, with the aim to determine the effectiveness of a STP. Ludwig Von Bertalanfiy’s General Systems Model was used as the Conceptual Framework for the study. The total number of nursing students undergoing 1st and 2nd year of both G.N.M and B.Sc. (N) courses were 114, from which a sample of 52 students were obtained using proportionate stratified random sampling. The sample size was estimated based on the pilot study findings. These groups of students who had not yet studied the disaster related contents as part of their curriculum were selected to maintain homogeneity of the sample. Considering each class of 30-40 students as a stratum, a proportion of 40% of the class strength was selected using simple random sampling from each of these strata. A structured questionnaire and a five-point Likert Scale prepared by the investigator and validated by four experts were used to assess the knowledge and attitude of the study subjects. The research instrument with a content validity index of 1, consisted of 23 knowledge questions in multiple choice formats with only one correct response and 8 attitude statements on disaster preparedness. Ethical approval was obtained from the Research Committee of the College of Nursing. Written informed consent was obtained from the study subjects. Confidentiality and anonymity were maintained.

Data Collection

The subjects were all gathered in one classroom on a designated date and after explaining and obtaining informed consent, the researchers conducted the pretest using the self- administered knowledge questionnaire and Likert scale. This was followed by 1 hour 15 minutes teaching session on disaster preparedness in earth quake and fire using the prepared teaching module. The content for the teaching module was prepared by the investigator utilizing content from sources such as World Health Organization (WHO) manual and disaster nursing books. The teaching was a one- time group teaching for all the 52 study participants. Teaching methods used were lecture with powerpoint presentation, video clip, and mock drills. The post test was conducted for a period of one week after the structured teaching programme.


  Results Top


[Table 1] shows the description of demographic variables of 1st and 2nd year GNM and B.Sc nursing students. Out of 52 study participants, 44 (85%) were females of which majority i.e., 38 (73%) of them belonged to the age group of 18-20 years. The majority of the students 50 (96%) were Christians.
Table 1: Distribution of Nursing Students Based on Selected Demographic Variables

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Overall, in pretest, 22 (42%) of nursing students had inadequate knowledge, 26 (50%) had moderate knowledge and only 4 (8%) had adequate knowledge about disaster preparedness. After STP, however, only 2 (4%) had inadequate knowledge, 18 (35%) had moderate knowledge and majority of the study subjects i.e., 31 (61%) had adequate knowledge regarding disaster preparedness see [Figure 1].
Figure 1: Distribution of Nursing Students Based on Pre-test and Post-test of Knowledge

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Regarding attitude, nursing students had overall positive attitude about disaster preparedness (see [Figure 2]). It was seen that, in the pre-test, 20 (38%) had neutral attitude regarding disaster preparedness and 32 (62%) had positive/favorable attitude. However, after SIP, 18 (35%) had neutral attitude and 33 (65%) had positive/favorable attitude. This could be attributed to the reason that the socioculturel background may also have had an influence, as students from this part of the region are not found to be expressive about their opinions and views. Although the attitude score increased considerably after the teaching in the posttest, since the range for positive attitude was set high, the change could not be appreciated. This however is only hypothetical. In the pre-test, 37 (73%) students strongly agreed that they need to know about disaster plan, 23 (45%) students strongly agreed that potential hazards likely to cause disaster should be identified and dealt with, 29 (57%) students agreed that disaster simulation exercises should be conducted regularly and a large number, i.e., 21 (41%) disagreed to the statement that drills need not be conducted in the hospitals.
Figure 2: Distribution of Nursing Students Based on Pre-test and Post-test Level of Attitude

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As is evident from the data presented in [Table 2], the mean post test score (16.78) is more than the mean pretest score (12.26) after the STP with a mean difference of 4.47, which is found to be statistically significant (p < 0.001). The obtained mean difference is a true difference and not by chance, leading to the conclusion that the STP was effective in enhancing the knowledge of the participants. [Table 3] represents the difference between the pre and post-test altitude scores. It shows that the mean post test score 32.64 is more than the mean pretest score 31.5 after STP with a mean difference of 1.19, which is found to be statistically significant (p < 0.05). Therefore, it is inferred that the obtained mean difference is a true difference and not by chance. This indicates that the STP was effective in improving the attitude of the participants.
Table 2: Effectiveness of Structured Teaching Programme regarding Knowledge on Disaster Preparedness

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Table 3: Effectiveness of Structured Teaching Programme regarding Attitude on Disaster Preparedness

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[Table 3] represents the difference between the pre and post-test altitude scores. It shows that the mean post test score 32.64 is more than the mean pretest score 31.5 after STP with a mean difference of 1.19, which is found to be statistically significant (p < 0.05). Therefore, it is inferred that the obtained mean difference is a true difference and not by chance. This indicates that the STP was effective in improving the attitude of the participants.


  Discussion Top


The study findings revealed that pre and post-test mean knowledge scores of the nursing students were 12.26 and 16.78 respectively out of a total score of 23. The majority of the nursing students had inadequate (42%) to moderate knowledge (50%), while 8% had adequate knowledge about disaster preparedness for earthquakes and fires during the pretest. Out of them, 2% were aware that disaster is a serious disruption of functioning of community where as the majority (98%) were not aware. Regarding earthquakes, 38% students knew that “Duck, Cover and Hold” are the steps to be followed during an earthquake, and 38% of the nursing students were aware that ‘after an earthquake tremor we should not rush out to an empty space’. Regarding fire disasters, 33% were aware that loose wiring is the most common cause of fire accidents and 12% were aware that there were 5 types of fire extinguishers in the hospital. From these data, it is seen that nursing students do not have adequate knowledge about disaster preparedness. This study is consistent with studies done by Ibrahim (2014) and Jothi (2015) that there was inadequate knowledge among nursing students regarding disaster preparedness. Therefore, regular and timely educational programme on disaster preparedness needs to be conducted to enhance the knowledge of not only the healthcare workers but also the nursing students so that students are also prepared early to face disasters and assist in mitigating the effects of disasters.

Regarding attitude on disaster preparedness, the current study findings revealed that nursing students have favorable attitude about disaster preparedness with a mean attitude score of 31.5 in the pretest and 32.64 in the post test out of a total score of 40. Ismail and Saiboon (2012) also reported that nurses had positive attitude towards disaster management. The current study also found that 37 (73%) nursing students agreed that they need to know about disaster plan. This is consistent with the findings reported by Ibrahim (2014) where 69.8% of the study subjects agreed that they need to know about disaster plan. It is interesting to note that in this study, only 8(16%) of nursing students agreed that disaster plans need to be regularly updated. However, in the study reported by Ibrahim (2014), 73.4% of the study participants agreed that disaster plans needs to be regularly updated. Further teaching is needed for the present group of students. Our study findings add to the existing literature reporting a positive/favorable attitude among healthcare workers and nursing students regarding disaster preparedness.

The effectiveness of the STP was assessed using paired t- test on mean knowledge and attitude scores which was found statistically significant. This indicated that the STP was effective in improving the knowledge and attitude of the participants regarding disaster preparedness. Jothi (2015) and Alim et al. (2015) also reported improved knowledge of disaster preparedness among nursing students following STP and mock drills. Diab and Mabrouk (2015) reported statistically significant improvements in nurses’ attitude towards disaster management plan after implementation of a guidance booklet. These observations support that implementation of regular teaching sessions using structured teaching programmes or modules can significantly improve the knowledge and attitude of nurses and nursing students regarding disaster preparedness.


  Conclusion Top


The study adds to the existing literature that nursing students have inadequate knowledge but favorable attitude about disaster preparedness. The study also provides impetus for STP that are effective in enhancing knowledge and attitude of nursing students and should be used on a regular basis. Disaster preparedness is essential to reduce the devastating effects of disasters and nursing students need to be adequately prepared to face and manage disasters as they can be lifelines in times of disaster.

Conflicts of Interest: The authors have declared no conflicts of interest.



 
  References Top

1.
Alim, S., Kawabata, M., & Nakazawa, M. (2015). Evaluation of disaster preparedness training and disaster drill for nursing students. Nurse Education Today, J5(l), 25-31.  Back to cited text no. 1
    
2.
Baack, S., & Alfred, D. (2013). Nurses’ preparedness and perceived competence in managing disasters. Journal of Nursing Scholarship, 45(3), 281-287.  Back to cited text no. 2
    
3.
Diab, G. M., & Mabrouk, S. M. (2015). The effect of guidance booklet on knowledge and attitudes of nurses regarding disaster preparedness at hospitals. Journal of Nursing Education andPractice, 5(9), 17.  Back to cited text no. 3
    
4.
Duong, K. (2009). Disaster education and training of emergency nurses in South Australia. Australasian Emergency Nursing Journal, 12(3), 86 - 92  Back to cited text no. 4
    
5.
Fung, O. W., Loke, A. Y., & Lai, C. K. (2008). Disaster preparedness among Hong Kong nurses. Journal of Advanced Nursing, 62(6), 698-703.  Back to cited text no. 5
    
6.
Ibrahim, F. A. A. (2014). Nurses’ knowledge, attitudes, practices and familiarity regarding disaster and emergency preparedness Saudi Arabia. American Journal of Nursing Science, 3(2), 18-25.  Back to cited text no. 6
    
7.
International Federation of Red Cross and Red Crescent Societies. (2017). Disaster and crisis management. Retrieved from http://www.ifrc.org/ en/what-we-do/disaster-management/about-disasters/  Back to cited text no. 7
    
8.
Ismail, A., & Saiboon, I. M. (2012). Disaster management: A study on knowledge, attitude and practice of emergency nurse and community health nurse. BMC Public Health, 12, (A3), doi.org/10.1186/ 1471-2458-12-S2-A3  Back to cited text no. 8
    
9.
Jennings-Sanders, A., Frisch, Ν., & Wing, S. (2005). Nursing students’ perceptions about disaster nursing. Disaster Management and Response, 5(3), 80-85.  Back to cited text no. 9
    
10.
Jothi A. (2015). A study to evaluate the effectiveness of structured teaching programme on the knowledge regarding disaster management among students in selected nursing schools in Kanyakumari district, Chennai, India (Master’s Thesis). Retrieved from https://repository-tnmgrmu.ac.in/ 1300/1/ 3001216 aruniyothi.pdf.  Back to cited text no. 10
    
11.
Kumar, R, & Karsayal, R. (2016). A study to assess the knowledge regarding disaster management among B. Sc. Nursing 2nd year students at Teerthanker Mahaveer College of Nursing, Moradabad, UP. Indian Journal of Applied Research, 2(6), 1015-1017.  Back to cited text no. 11
    
12.
Labrague, L. J., Hammad, K, Gloe, D. S., McEnroe- petitte, D.M., Fronda, D. C., Obeidat, A. A & Mirafuentes,E.C. (2018). Disaster preparedness among nurses: A systematic review of literature. International Nursing Review, 65(1), 41-53.  Back to cited text no. 12
    
13.
Nagaland State Disaster Management Authority. (2012). Nagaland State Disaster Management Plan. Retrieved from http://www.nsdma.gov.in /Docs/ActsPlans/ NSDMP%202012.pdf  Back to cited text no. 13
    
14.
National Disaster Management Authority. (2017). Annual report. Retrieved from https://ndma.gov.in/ images/annreport/ENG- 2016-17-AR.pdf  Back to cited text no. 14
    
15.
Öztekin, S. D., Larson, E. E., Akahoshi, M., & Öztekin, Ý. (2016). Japanese nurses’ perception of their preparedness for disasters: Quantitative survey research on one prefecture in Japan. Japan Journal of Nursing Science, 73(3),391- 401. doi: 10.1111/jjns. 12121  Back to cited text no. 15
    
16.
Schmidt, C. K., Davis, J. M., Sanders, J. L., Chapman, L. Α., Cisco, M. C., &Hady, A. R. (2011 ). Exploring nursing students’level of preparedness for disaster response. Nursing Education Perspectives, 32(6), 380-383.  Back to cited text no. 16
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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