INTRODUCTION:

The birth of a child presents us a very unique opportunity along with the happiness, the occasion delivers us that we have someone more, very important, to care about. The opportunity is nothing but something that could be derived from the umbilical cord and placenta – Cord Blood. The blood that remains in the blood vessels of the placenta and the portion of the umbilical cord that remains attached to it, after a baby is born and the umbilical cord is cut, is called cord blood or placental blood.

Cord blood banking includes the collection, processing and storage of umbilical cord blood for any future needs that are related to the family or others². During 1970’s researchers discovered that umbilical cord blood could supply the same kinds of blood forming (hematopoietic) stem cells as a bone marrow donor. And so, umbilical cord blood began to be collected and stored. The first successful stem cell transplantation was performed by Gluckman and his colleagues in 1988, when they took umbilical cord blood from a new born and gave it to a five year old sibling who had Fanconi’s anaemia, a severe type of anaemia that causes skeletal defect. They opened a way for the subsequent development of a blood bank at New York Blood Centre³. In the last sixteen years, there has been a substantial increase in the use of cord blood as an alternative stem cell source for the patients who cannot find matched bone marrow donors. As the use of cord blood transplantation has become a common practice, the number of cord blood banks continued to be increase in the world. Cord life is considered as the largest network of stem cell banks².

NEED FOR THE STUDY:

Research on stem cell therapy has shown that advanced stem cell therapy could be used to treat more than 75 life threatening diseases. Currently research in the use of stem cells to treat more than 85 diseases such as diabetes, heart attack, stroke, spinal cord injuries etc, is being undertaken⁴. In 2006, a study conducted to assess the knowledge regarding cord blood banking among mothers. This study reveals that only 1/3^rd of expectant mothers are aware of cord blood banking and 84% of patients expect health care providers to answer their questions regarding cord blood banking.¹Perlow JH et al. (2007) conducted a study to determine the patient’s knowledge of umbilical cord blood banking. The total sample size was 425 patients. The method used was survey. The data were collected by using questionnaire. This study revealed that 37% of patients had no knowledge regarding umbilical cord blood banking, 2.6% of patients had knowledge and 74% of patients were minimally informed about umbilical cord blood banking only 14% of patients were educated about umbilical cord blood banking by their nurse, although 90% of patients expected their obstetrician to answer their questions on umbilical cord blood banking. This study concluded that patients are poorly informed about umbilical cord blood banking and they are expecting information from the health care professionals.⁵These studies have proved that mothers do not have enough knowledge about cord blood banking and they expect their health professionals to give adequate information regarding cord blood banking. Therefore it’s a necessity to teach the nurses about cord blood banking.

PROBLEM STATEMENT:

“A study to assess the effectiveness of self instructional module on the knowledge regarding cord blood banking among staff nurses in selected hospitals, Tumkur.

OBJECTIVES:

Ÿ To assess the existing knowledge regarding cord blood banking among the staff nurses.

Ÿ To determine the effectiveness of self instructional module on knowledge regarding cord blood banking among staff nurses by comparing pre test and post test knowledge score.

Ÿ To find out the association between the pre test knowledge score of staff nurses with selected demographic variables.

HYPOTHESIS:

H₁: The mean post test knowledge score on cord blood banking among the staff nurses, who have learned through self instructional module, will be significantly higher than their mean pretest score at 0.05 level of significance.

H₂: There is a significant association between pre test knowledge score of staff nurses regarding cord blood banking with their selected demographic variables

METHODOLOGY:

Research approach:

quantitative evaluative approach.

Research design:

pre experimental one group pre test post test design.

Setting:

data collected from Govt. Hospital, Siddaramana hospital, Pragathi hospital, Adarsha hospital, and Shridevi Hospital, Tumkur.

Sample and sampling technique:

50 staff nurses were selected by using non probability purposive sampling technique.

Variables:

Independent variable:

Self instructional module regarding cord blood banking

Dependent variable:

knowledge regarding cord blood banking

Description of Tool:

Part I:

demographic variables

Part II:

structured knowledge questionnaire regarding cord blood banking

Validity of tool:

12 experts, comprising of 9 nurse educators from the department of Obstetrics and Gynecology, 1 nurse educator from the department of Medical Surgical Nursing, 1 Professor from department of Obstetrics and Gynecology and 1 Statistician, established content validity of the tool.

Reliability of tool:

The data of the structured knowledge questionnaire was analysed by split half method and the reliability coefficient was calculated using Spearman Brown Prophecy formula. The reliability co- efficient of the tool was found to be 0.94. Hence the tool was found to be reliable

Data collection:

A pretest was conducted by using structured knowledge questionnaire and on the same day the Self instructional module regarding CBB was administered to them. After 7 days, post test was conducted with the same questionnaire for the same group of staff Nurses to assess the effectiveness of SIM.

Analysis and interpretation of data:

The collected data were analyzed in terms of both descriptive and inferential statistics.

RESULTS:

The mean score is increased in the post test. The mean score in the post test is 31.78 and the mean score in the pretest is 14.54. The variation is decreased in post test when compared to pre test.SD in the post test is 3.55 and in the pretest is 3.89. The mean is improved by 17.24 and variation is reduced by 0.34. The calculated value of t is 72.35 which is highly significant. The results undoubtedly confirm that the SIM significantly was effective in improving the knowledge on CBB among the staff nurses.

Table.1: Section 1: Analysis of sample characteristics

Sl. No	Demographic characteristics	Frequency	Percentage
1.	Age(yrs)
	20-25	13	26%
	25-30	13	26%
	30-35	12	24%
	35 and above	12	24%
2.	Gender
	Female	35	70%
	Male	15	30%
3.	Professional Qualification
	GNM	32	64%
	Basic B.sc Nursing	18	36%
4.	Professional experience
	0-5 years	13	26%
	6-10 years	13	26%
	11-15 years	12	24%
	16 years and above	12	24%
5.	Current Working area
	Maternity ward	29	58%
	Pediatric ward	21	42%
6.	In service Education attended regarding CBB
	Yes	12	24%
	No	38	76%

Table 2: Section II: Evaluate the effectiveness of self instructional module by comparing pre and post test knowledge score

Parameter	Mean	S. D	SEM	Range	Mean%	t -value	Result
Pre-test	14.54	3.89	0.55	7-22	34.74	72.35	HS P<0.001
Post-test	31.78	3.55	0.50	24-38	75.67
Improvement	17.24	0.34

Table 3: Section III: association between the demographic variables and knowledge of staff nurses regarding cord blood banking in Pre-test.

S. No	Characteristics	Chi-square value	Df	Result	P-value
1	Age	5.71	3	NS	0.12, ie,p>0.05
2	Gender	2.86	1	NS	0.09, ie,p>0.05
3	Professional Qualification	7.41	1	Sig	0.006, ie,p<0.05
4	Professional Experience	10.11	3	Sig	0.01, ie,p<0.05
5	Current Working area	5.89	1	Sig	0.01, ie,p<0.05
6	In-service education	4.16	1	Sig	0.04, ie,p<0.05

v NS – Not significant at 5% level (i.e., P > 0.05)

v Sig – Significant at 5% level (i.e., P < 0.05)

From the table- Professional qualification, Professional experience, in-service education regarding cord blood banking and current working area are significant. The remaining characters are not significant.

DISCUSSION:

The first objective of the study was to assess the preexisting knowledge regarding cord blood banking among the staff nurses:

The pre-test findings of the study revealed that the overall score in the pre-test was mean14.54, standard deviation 3.89 and mean score percentage was 34.74%. This shows that the knowledge of staff nurses regarding cord blood banking was inadequate.

These findings are consistent with the findings of Fernandez C. V et al (2003). They have conducted a study to examine the pregnant women’s knowledge and attitude regarding cord blood banking. The study was conducted among 650 women attending antenatal clinic at regional women’s hospital. Data were collected by using questionnaire. In this more than half of the women reported poor knowledge about cord blood banking. This study concluded that many of the respondents wanted to receive information about cord blood banking from health care professionals and most of the women supported the donation of cord blood to the public cord blood bank for potential transplantation and research.⁶

These findings provokes for imparting adequate knowledge on cord blood banking for staff nurses.

To determine the effectiveness of self instructional module on cord blood banking among staff nurses by comparing pre test and post test knowledge score:

The investigator has assessed the effectiveness of SIM. After administering SIM the samples has showed the knowledge score in post-test as mean 31.78 Hence the overall improvement in knowledge score is 17.24. The findings of study depicted a real evidence of significance between pre-test and post-test knowledge scores. The difference was statistically proved that paired “t” test 72.35 and it is significant at p<0.05. So there is a significant difference between the pre and post-test knowledge score of staff nurses regarding cord blood banking, hence the hypothesis is accepted.

These findings are consistent with the findings of Shin.s et al (2010). They conducted a study to investigate the knowledge and attitude towards cord blood banking among well educated pregnant Koreans. The data were collected by using questionnaire from 1001 women attending a maternity education programme from April to October 2008. This study concluded that a considerable portion of educated pregnant women has more than minimal knowledge of cord blood, but the level of knowledge regarding the potency of public bank and current usefulness and limitations of cord blood are generally low and the obstetrician should play an important role in disseminating knowledge regarding cord blood banking.⁷

These findings highlighted the need for teaching programs to improve knowledge of staff nurses on CBB.

REFERENCES:

1. Human immunology. 2006; June 67(6): 398-404; E pub 2006 March30. Available from: URL:http://www.ncbi.nlm.nih.gov/pub med/ 16728260

2. Cryo banks India- Wikipedia, Available from: URL: http://www.cryobanksindia.com/what_are_stem_cells?

3. Gluck man F, Rocha V, chastang C. peripheral stem cell in bone marrow transplantation, cord blood stem cell transplantation. Baillieres Best Practice and Research Clinical Haematology 1999 March-June;12(1-2):279-92. Available from: URL: http://www.ncbi.nlm.nih.gov/pub med/11000999.

4. Wu J Y, Liao C, Xu ZP, Chen JS, Gu SL, Huang YN et al. Banking and transplantation of umbilical cord blood in Guangzhou. Cyto therapy 2006; 8(5):488-97. Available from: URL: http:// www.ncbi.nlm.nih.gov/pub med/ 17050254

5. Perlow J H. Patients knowledge of umbilical cord blood banking. Journal Of Reproductive Medicine 2006 Aug 51(8): 642-48. Available from URL:http:// www.ncbi.nlm.nih.gov/pub med/16967635.

6. Fernandez C V, Gordon K, Van Den Hof M, Taweel S, Baylis F. Knowledge and attitude of pregnant women with regard to collection, testing, and banking of cord blood stem cells. Canadian Medical Association Journal 2003 March 18; 168(6): 695-8; Available from URL:www.ncbi.nlm.nih.gov/pub med/12642424.

7. Shin S. Perspectives of potential donors on cord blood and cord blood cryopreservation: a survey of highly educated, pregnant Korean women receiving active prenatal care. Transfusion 2010 Aug 23. Available from URL:http://www. http://www.ncbi.nlm.nih.gov/pubmed/20735763.

Received on 25.02.2019 Modified on 31.03.2019

Int. J. Nur. Edu. and Research. 2019; 7(3):379-382.

DOI: 10.5958/2454-2660.2019.00085.1