INTRODUCTION:

Hypertension is one of the most poorly controlled chronic diseases in all over the world. It is also known as the “silent killer” as hypertension is asymptomatic during its early stages and it shows its devastating consequences after progression. As reported by the World Health Organization, more than 1.28 billion individuals worldwide currently live with hypertension¹. Many of them remain either undiagnosed or inadequately managed due to the late arrival of sign and symptoms. In India, hypertension accounts for nearly 10.8% of all mortality cases, making it a leading health concern. Thus, it is the most significant modifiable risk factor for cardiovascular morbidity and mortality. Although multiple pharmacologic classes have been developed to manage blood pressure like ACE inhibitors, beta-blockers, and calcium channel blockers but still the disease burden remains alarmingly high. This gap in knowledge about other available treatments calls for a deeper exploration of genetic contributors to hypertension.

A variety of epidemiological research studies and genome-wide association studies (GWAS) have confirmed that hypertension is a polygenic disorder. Hypertension develops due to the combined influence of multiple genetic variations working in a complex and interconnected manner. More than 100 independent genetic loci have been discovered so far which are associated with systolic and diastolic blood pressure regulation. Several of these genes influence essential physiological processes, including blood vessel tension, sodium balance, and hormone regulation mechanisms². Genes such as AGT, eNOS, ACE, and SLC4A5 have been identified as critical players in the mechanisms controlling blood pressure. They have been influencing the vascular tone, renal sodium handling, and hormonal pathways like the renin-angiotensin-aldosterone system (RAAS). The identification of these loci has not only improved our understanding of hypertension's etiology but has also led to the gene therapy as a potential solution to maintain these mechanisms properly. The aim is not only to control blood pressure but also correct the blood pressure from genetic roots.

Gene therapy has now begun extending its reach to common complex diseases like hypertension. Early-stage research and animal studies on gene therapy have yielded encouraging results, suggesting potential for future clinical use. As for example, recent studies on animals have shown results by lowering blood pressure. CRISPR-Cas9 has been used to reduce angiotensin II receptors especially AT1R to lower blood pressure. Gene editing works by disabling specific gene segments that trigger blood vessel constriction and fluid retention. As a result, blood vessels stay relaxed and less fluid builds up which leads to lower pressure. These results suggest that CRISPR-based gene therapy could be a useful way to treat high blood pressure in the future³. Similarly, adeno-associated virus (AAV) vectors have been used to carry eNOS gene directly into blood vessel tissues. It enhances nitric oxide production which improves endothelial function by relaxing blood vessels. Though this technique is still in nascent stages, these interventions reflect a shift in how we treat diseases from symptomatic management toward genomic correction. Instead of just managing symptoms, these methods try to fix problem at the genetic level.

Despite these advancements, there is one critical dimension that still remains under-addressed. That is the readiness of healthcare professionals particularly nurses to engage with these innovations. Nurses should involve themselves to educate patients on advanced therapies, participate in genetic counseling, and support informed decision-making. Yet, studies have shown that nursing curriculum often lag behind in integrating genomic content in the Indian context⁴. This knowledge gap affects professional competency and also limit the effective implementation of gene therapies at the clinical practice.

Educational interventions are the only ways to tailor the knowledge of emerging therapies among nursing students. However, very few studies have focused on gene therapy as a thematic area. Even fewer have specifically targeted its application in common diseases like hypertension. This represents a critical gap in nursing education and practice about genomic medicine.

Therefore, this study was undertaken to evaluate how well a structured teaching module on gene therapy improves knowledge in final-year BSc Nursing students. The rationale is to equip future nurses with foundational knowledge of gene-based interventions. By doing so, this research not only aims to improve knowledge outcomes but also to advocate for a forward-thinking approach to nursing education in India. This will align the demands of 21st-century precision medicine.

METHODOLOGY:

Research Design:

A one-group pre-test post-test approach, commonly used in educational research, was adopted for this study. It was used to evaluate the effectiveness of a structured teaching programme on the knowledge about gene therapy to treat hypertension among B.Sc. nursing students.

Participants:

Participants consisted of third and fourth-year B.Sc. Nursing students enrolled at NIMS, Bhubaneswar. Total 80 students (40 from each year) were selected using purposive sampling. Only the students, who were present during the study period and provided written informed consent, were included in the study. The students having prior exposure to gene therapy were excluded from the study.

Data Collection Tool:

A structured knowledge questionnaire was developed with 25 multiple-choice questions (MCQs) for this study. The questionnaire includes the basics of hypertension, fundamentals of gene therapy, role of genes in regulation of blood pressure and the applications of gene therapy like CRISPR and viral vectors.

Intervention Procedure:

Following the initial assessment, a one-hour structured educational session was conducted. The teaching was done through power point presentations, charts and illustrations and interactive discussion sessions.

The topic was focused on gene therapy, its mechanisms, its role in managing hypertension, and recent developments like gene editing. After seven days, the same questionnaire was re-administered as a post-test to evaluate knowledge improvement.

Data Analysis:

Data were coded and analyzed using SPSS version 25. Descriptive statistics were applied to summarize participant demographics and their knowledge test results. To determine the impact of the intervention, a paired t-test was used to compare mean scores before and after teaching.

FINDINGS:

The findings are presented in structured sections for clarity and ease of interpretation.

SECTION A:

Frequency and Distribution of Demographic Variables of 3rd and 4th Year B.Sc. Nursing Students:

This part of the report presents an overview of the participants’ demographic details. Total 80 students were included in the study. The collected demographic data covered the students’ year of study and gender. These characteristics help investigate the findings and explore whether educational background or gender may influence basic knowledge or learning outcomes.

Table 1. Demographic Breakdown of Third- and Fourth-Year B.Sc. Nursing Students

S. No	Demographic variable	Frequency (n)	Percentage (%)
1	Academic year
	3^rd year	40	50%
	4^th year	40	50%
2	Gender
	Male	18	22.5%
	Female	62	77.5%

The data shows that the number of students from the third and fourth year was equal. This helped ensure a fair comparison between the two academic levels. In terms of gender, most of the participants were female, which is commonly seen in nursing education across India. The balanced sample from both years and the overall participant profile helped make the results more meaningful and relevant.

SECTION B:

Percentage Distribution of Pre-Test Level of Knowledge Regarding Gene Therapy among B.Sc. Nursing Students:

Before the intervention, students were assessed on their knowledge of gene therapy using a structured questionnaire. Their scores were categorized into three levels: Good, Average and Below Average.

Table 2. Pre-Test Knowledge Level Distribution

S. No	Level of Knowledge	Scoring Range	Frequency (n)	Percentage (%)
1	Good	18-25	6	7.5%
2	Average	10-17	29	36.2%
3	Below Average	0-9	45	56.3%

The majority of students (56.3%) were in the 'below average' category, which indicates that many had limited basic knowledge about gene therapy. Only a small number of students scored in the 'good' range. These findings highlight the importance of providing educational support to improve their understanding of this advanced topic. It clearly shows that the teaching programme was necessary and timely.

SECTION C:

Analysis of Effectiveness of Educational Intervention on Knowledge Levels Regarding Gene Therapy:

· Comparison between pre-test and post-test level of knowledge scores.

· Area wise pre-test & post-test level of knowledge scores.

Following the structured teaching programme, post-test scores were collected and compared to pre-test scores using a paired t-test. The results demonstrated a significant increase in knowledge scores. It confirms the effectiveness of the intervention.

Table 3. Comparison of Overall Pre- and Post-Test Knowledge Scores

S. No	Assessment	Mean Score	SD	t- value	p- value
1	Pre- Test	11.8	3.2	16.42	<0.001
2	Post- Test	20.6	2.7	16.42	<0.001

The mean knowledge score improved by 8.8 points after the intervention, showing a clear gain in understanding among the students. With a t-value of 16.42 and p< 0.001, the analysis confirms the improvement in scores was statistically significant and unlikely due to chance. This strongly confirms positive impact of structured teaching programme on the students’ learning. It helped them better understand complex biomedical topics like gene therapy Comparable outcomes have been observed in earlier research, where structured educational interventions led to significant knowledge gains among nursing students⁵.

The pre-test score was average which confirms students had very limited basic understanding about the topic. On the other hand, the post-test score has significantly increased following the teaching session. This improvement suggests that the intervention was effective. It enhances students' knowledge about gene therapy and its application in management of hypertension.

Figure 1. Comparison of mean knowledge scores before and after intervention among third- and fourth-year nursing students on gene therapy topic

CONCLUSION:

The present study demonstrated that a structured teaching programme significantly enhanced the knowledge of B.Sc. Nursing students' understanding of gene therapy as an approach to treat hypertension. The notable improvement in post-test scores highlights the effectiveness of focused educational interventions in bridging knowledge gaps on advanced biomedical topics. Given the growing importance of genetic and precision-based medicine in modern healthcare, it is crucial that nursing education incorporates such content into its curriculum. Equipping nursing students with current scientific knowledge will enhance their capacity to participate in collaborative healthcare, educate patients effectively, and apply evidence-based practices in clinical settings. The study also reinforces the potential of targeted teaching methods in improving the preparedness of nursing students to meet evolving clinical demands.

IMPLICATIONS OF THE STUDY:

· The results indicate the need to integrate genetic topics into undergraduate nursing curriculum.

· Similar to earlier research, this study highlights how structured genetic education can improve knowledge and awareness among nursing students⁶.

LIMITATIONS:

· The study was conducted at a single institution, which limits generalizability.

· Only short-term knowledge gain was measured. Long-term retention was not assessed in this study.

· It is difficult to confirm that the improvement happened only due to the teaching programme because there was no control group.

ETHICAL CONSIDERATIONS:

Ethical clearance has taken from the Ethics Committee of Neelachal Institute of Medical Sciences. Each participant provided written informed consent prior to their involvement in the study. The study was completely confidential and anonymous. Participants were involved voluntarily in the study. They have their right to withdraw at any point.

CONFLICT OF INTEREST:

The author declares that there is no conflict of interest associated with this research.

INFORMED CONSENT:

Before the study began, written consent was clearly explained and obtained from all participants.

ACKNOWLEDGMENTS:

The author sincerely expresses gratitude to the principal and faculty members of Neelachal Institute of Medical Sciences, Bhubaneswar, for their continuous support and encouragement throughout the research process. Special thanks are extended to the BSc Nursing students who willingly participated in the study and contributed valuable time and responses. The author also acknowledges the guidance of ethical committee members for granting permission to conduct the study.

REFERENCES:

1. World Health Organization. Hypertension. [Internet]. 2023 [cited 2025 Jun 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension

2. Evangelou E, et al. Genetic analysis of over one million people identifies 535 new loci associated with blood pressure traits. Nat Genet. 2018 Oct; 50(10): 1412–25. doi: 10.1038/s41588-018-0205-x

3. Li C, et al. CRISPR-Cas9 gene editing reduces angiotensin II receptor expression and lowers blood pressure in hypertensive rats. Hypertension. 2020; 76(6): e34–e42. doi: 10.1161/HYPERTENSIONAHA.120.15412

4. Kumar A, Das S. Awareness and Attitude of Nursing Students Towards Genomic Medicine: A Cross-sectional Study. Int J Nurs Educ Res. 2021; 9(2): 220–5. doi: 10.5958/2454-2660.2021.00050.8

5. Sharma R, Rao S. Evaluating the impact of structured teaching programs on nursing students’ understanding of modern genetic therapies. Asian J Nurs Educ Res. 2021; 11(1): 45–9. doi: 10.5958/2349-2996.2021.00009.5

6. Patel V, et al. Enhancing genetics literacy through targeted learning in undergraduate nursing. J Contemp Med Educ. 2022; 10(4): 195–201. doi: 10.7759/cureus.28492

Received on 09.07.2025 Revised on 14.08.2025

Accepted on 13.09.2025 Published on 27.10.2025

Available online from November 08, 2025

Int. J. Nursing Education and Research. 2025;13(4):263-266.

DOI: 10.52711/2454-2660.2025.00052

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.