A Study to Assess the Effectiveness of Self Instructional Module on Knowledge Regarding Stress Management among the Relatives of Patient who got Admitted in Selected ICUs in Mehsana City

Nandi Hirak Harshendrukumar

Ass. Professor, Joitiba College of Nursing, Bhandu, Tal- Visnagar, Dist- Mehsana (Gujarat)

*Corresponding Author Email: hirak.nandi@googlemail.com

ABSTRACT:

Background- Although patients in intensive care units (ICUs) receive care for a large variety of disease states, the leading causes of death in the ICU are multi organ failure, cardiovascular failure, and sepsis. Multi organ failure has a mortality rate of 11% to 18%. Sepsis, the second leading cause of death in non coronary ICUs, carries a mortality rate of 25% to 30%. Of patients who are diagnosed with sepsis, up to 51% will develop acute renal failure, up to 18% will have acute respiratory failure, and up to 80% will develop a myopathy or polyneuropathy. Overall mortality rates in patients admitted to adult ICUs average 10% to 29%.⁵ Recent studies have shown that the pediatric mortality rate associated with sepsis is 13.5%, whereas the overall mortality rate for pediatric ICU patients ranges from 2% to 6%. A mortality rate of 6.04% has been reported in ICUs with intensivist staffing compared with 14.4% when a non-intensivist attending provides care.⁷Aims and Objective- To assess the existing knowledge regarding stress management among the patient who got admitted in ICUs. To assess the effectiveness of self instructional module. To associate the post test knowledge score with selected demographic variables.Material and Methods: Non probability purposive sampling. Data collection is the gathering of information from the sampling unit that is Deep ICU, Mehsana. The investigator collected the data from the 30 relatives of ICU patient. A structured questionnaire (closed ended) was used as a method of data collection. A quasi experimental study was undertaken to assess the effectiveness of SIM on knowledge regarding Stress management among relatives of ICUs patient. Data were collected from 30 relatives by purposive sampling technique and close ended structured questionnaire used to collect data; the data were analyzed by descriptive and inferential statistics. Result: Finding revealed that the highest percentage (33.33%) were in the age group of 26-33 years ,(73.33%)relatives were Hindu,(36.66%) of the relatives had secondary education level,(73.33%) were married,(26.66%) relationship with patient had their father,(56.66%)relatives belongs to nuclear family,(56.66%)of the relatives has family income 5000-10000Rs.,(93.33%)relatives were not performed exercises daily,(76.66%) relatives had not previous knowledge about stress management. Findings revealed that the pre test level of knowledge score was (9.42.31) which is 47%whereas in the post test score was (14.5±1.9) which is (72.5%).The effectiveness was found (25.5%). The paired test value shows the significant difference between the pre test and post test level of knowledge score and chi square value were calculate to find out the association between the post test level of knowledge and selected demographic variables of the relatives. Finding reveals that there was significant association between the types of family with post test knowledge score. Hence the stated hypothesis was accepted.

KEYWORDS:. Adolescents, Adjustment, Interventions, Parental Substance Use.

INTRODUCTION:

The intensive care unit (ICU) can be a challenging place for patients’ family members, especially if their loved one is at an increased risk for dying.¹ Such patients are acutely ill, are sedated, and have multiple complex interventions, often leaving the patients unable to participate in their own care. The expectation that patients’ family members will be surrogate decision makers and patient advocates, all the while preparing for the potential loss of a loved one, puts much of the burden on the family³. Consequently, many family members experience psychological symptoms during the ICU experience; the most frequently reported are traumatic stress, anxiety, and depression.² Stress is the word commonly used in both common places and professional literature to refer to problematic biophysical, chemical, psychosocial and cultural situations.⁶ The nurse, usually involved with care and fulfilling the patients' needs, may fail to notice the angst, fear and suffering undergone by the family members.⁹ The lack of information and uncertainty can cause apprehension and anxiety. In a nationwide study, whose purpose was the identification of the necessities of the relatives of patients admitted into intensive care units (ICUs), the authors concluded that the necessities reported more frequently were: being sure that the patient is receiving the best treatment (89.7%), knowing concrete facts about the progress of the patient (84.6%) and knowing exactly what is being done for their relative (82.1%).⁸

Assessment of the effectiveness of self instructional modules.

SN	Areas	Max score	Pre test			Post test			Difference In mean%
SN	Areas	Max score	Mean	SD	Mean %	Mean	SD	Mean %	Difference In mean%
1	Introduction of stress	5	1.8	0.9	36%	3.66	0.6	72%	36%
2	Causes and Types of stress	6	3.2	1.3	53.33%	4.26	1.2	70%	16.67%
3	Clinical manifestation of stress	3	0.9	0.3	30%	2	0.2	66.66%	36.66%
4	Stress management techniques	6	3.5	1.0	58.33%	4.6	0.7	76.66%	18.33%
Over all		20	9.4	2.31	47%	14.5	1.9	72.5%	25.5%

Above table shows comparison of pre test and post test knowledge score shows the effectiveness of SIM by (25.5%) as the post test mean score (14.5±1.9)which is (72.5%) indicates that relatives had good knowledge which is higher than pre test mean score (9.4±2.3)which is (47%). Sub area wise comparison of mean, SD, mean% of pre test and post test knowledge score of relatives regarding stress shows that the post test highest mean score of (4.6±0.7) which is the 76.66% of the total score obtained in the area of “Stress management techniques“ indicates good knowledge and had effectiveness (18.33%)and lowest post test mean score (2±0.2)which is 66.66% was obtained in the area of “Clinical manifestation of stress “indicates good knowledge and had the effectiveness (16.67%),however the following other area about stress “Introduction and causes of stress” had post test mean% more than 50% which indicates the relatives had good knowledge on these area also.

CONCLUSION:

The major conclusion drawn from this study was that SIM found to be effective in improving the knowledge of relatives with stress management. So it should be emphasized that having education sessions with the relatives regarding stress management with educating materials would there by improve their knowledge, which leads to better care for the symptoms, compliance with the treatment, early recognition and prevention of complication. Thus reduces the lack of awareness, negative attitude and less chance of health problems there by leading an effectiveness comprehensive care, cure and longer survival and reduces health care cost.

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