Effectiveness of Video-assisted teaching on knowledge and skill regarding prevention of breast cancer among nuns
Betcy George
Assistant Professor, Department of Medical Surgical Nursing, MOSC College of Nursing,
Kolenchery, Ernakulam, Kerala.
*Corresponding Author E-mail: betccy@gmail.com
ABSTRACT:
Cancer is a group of more than 200 diseases characterized by uncontrolled and unregulated growth of cells. Breast cancer is probably the most feared among women, due to its high incidence, and above all, to the psychological effects that affect their perception of sexuality and their self image. An early diagnosis is the best guarantee of success in the treatment of breast cancer and the woman gives a relevant contribution in the early detection when she systematically does the self-examination. The objectives of this study were to assess the effectiveness of video-assisted teaching programme on knowledge and skill regarding prevention of breast cancer among the nuns and to find the association between the pre-test knowledge level and pre-test skill with selected demographic variables. A quantitative one group pre-test post-test design (quasi experimental) was adopted for the study. The conceptual framework of this study was based on the Health Belief Model (HBM) presented by Rosenstoch’s (1974) and Becker and Maiman’s (1975). Thirty nuns were selected by non probability purposive sampling technique. Video-assisted teaching was administered to the samples after the pre-testing of both knowledge and skill. Data was collected by using demographic proforma, structured knowledge questionnaire and observational checklist. The data was analyzed using descriptive and inferential statistics. The data concerning the effectiveness of video-assisted teaching was established by analyzing the pre-test and post-test knowledge score and skill of the respondents. In order to find out the effectiveness of video-assisted teaching on prevention of breast cancer of experimental group, paired ‘t’ was computed. The computed ‘t’ value of knowledge score and skill (11.0 and 15.5) was greater than the table value (t29=2.05; p<0.05). This represented that video-assisted teaching was effective in improving the level of knowledge and skill of nuns on prevention of breast cancer. Chi-square test was used to test the significant association between pre-test knowledge scores and skill in performing BSE with selected demographic variables. The test revealed that there was no significant association between pre-test knowledge scores and selected demographic variables at 0.05 level of significance. On the other hand, it showed a significant association between the pre-test skill and the demographic variables namely, educational qualification and awareness of samples with relatives, friends or colleagues with breast cancer. The study concluded that the video-assisted teaching programme for nuns significantly improved their understanding and skill on prevention of breast cancer.
KEYWORDS: Effectiveness, video-assisted teaching programme, knowledge, skill, nuns.
INTRODUCTION:
Breast cancer has ranked number one cancer among Indian females with age adjusted rate as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women.1 Lifelong nuns, comparable to all women who have not in actively reproductive, are at an increased risk of breast cancer, along with ovarian and uterine cancers, compared with women who have given birth.2 Substantial support for breast cancer awareness and research funding has helped create advances in the diagnosis and treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining, largely due to factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.3
NEED FOR THE STUDY:
Breast cancer is the most common cancer among women and the second most cancer in the world.
Figure 1: Bar diagram indicating statistics of breast cancer in the year 2020
A cross-sectional study was conducted among 420 female students of Debre Berhan University in Ethiopia. The aim of this study was to assess the practice and associated factors of breast self-examination (BSE). Multistage sampling technique was used to select the study participants. Bivariate and multivariate logistic regression analysis were done. Two hundred fifty-six (64%) of the participants had heard about BSE and 50.75% did not had knowledge about BSE. The study revealed that most of the participants had low knowledge and practice of BSE and therefore to develop health educational programs to raise awareness about BSE and breast cancer so as to practice self-breast examination.4 This throws light into the existing condition that prevail in the country and the world, as the statistics of breast cancer is at its peak which is coupled with the ignorance of early detection of breast cancer i.e, the skill in performing breast self-examination.
STATEMENT OF THE PROBLEM:
A study to assess the effectiveness of video-assisted teaching on knowledge and skill regarding prevention of breast cancer among nuns residing at selected convents of Mangalore
OBJECTIVES OF THE STUDY:
1. To determine the effectiveness of video-assisted teaching on knowledge and skill regarding prevention of breast cancer.
2. To find the association between the pre-test knowledge level and selected demographic variables.
3. To find the association between the pre-test skill and selected demographic variables.
HYPOTHESIS:
H1: There will be significant improvement in the mean post-test knowledge scores regarding prevention of breast cancer among those who receive video-assisted teaching than those who do not receive
H2: There will be significant improvement in mean post-test skill in performing breast self-examination among those who receive video-assisted teaching than those who do not receive
H3: There will be significant association between the pre-test level of knowledge and selected demographical variables.
H4: There will be significant association between the pre-test skill and selected demographical variables.
ASSUMPTIONS:
The study assumes that:
· The nuns are having some knowledge about breast cancer and breast self examination
· The nuns being nulliparous are at risk for breast cancer.
· Knowledge and skill helps in practicing breast self-examination.
MATERIALS AND METHODS:
· Setting of the study: The study was conducted in selected convents in Mangalore.
· Research approach: A quantitative one group pre-test post-test design was adopted for the study.
· Sample: Thirty nuns.
· Sampling Technique: Non-probability convenient sampling technique.
· Inclusion criteria: Nuns who were in the age group of 20-60 years.
· Exclusion criteria:
Nuns who were:
1) in the field of health profession.
2) diagnosed to have breast cancer.
3) having sensory-perceptual impairment.
4) previously exposed to such types of teaching programme
· Data collection instruments:
Section A: Socio demographic variables of general population which contains 10 items.
Section B: structured knowledge questionnaire
Section C: observational checklist
Validity and Reliability of the tool:
Content validity was obtained from experts in the field of nursing. The investigator obtained permission from the Mother Superior prior to the data collection period. The pre-testing and reliability of the tool were carried out among 10 nuns in Nazareth Convent, Mangalore. Split- half method was used to measure the co-efficient of internal consistency. The reliability co-efficient of the tool was determined using Spearman- Brown prophecy formula. The reliability co-efficient, r = 0.81 rendered the tool highly effective and reliable. The reliability of the checklist for skill assessment was done by using the inter-rater inter-observer method and the reliability was r = 0.95.
RESULTS:
Data were analysed by descriptive and inferential statistics using Microsoft excel and R software.
Section A: Distribution of socio demographic variables of general population
Table 1: Frequency and Percentage distribution of samples according to the sample characteristics n=30
Demographic characteristics |
f |
% |
1. Age (in years) a. <30 b. >=30 |
25 05 |
83.33 16.66 |
2. Educational qualification a. High school and PUC b. Diploma OR Graduate c. Post Graduate and above |
26 03 01 |
86.66 10 03.33 |
3. Occupation a. Student b. Teacher c. any other |
28 02 04 |
93.33 06.66 6.66 |
4. Are you aware of any of your relatives, friends or colleagues affected by breast cancer? a. Yes b. No |
02 28 |
06.66 93.33 |
5. Source of health information a. Books b. Periodicals c. Media d. Health personnel |
10 06 06 08 |
33.33 20 20 26.66 |
The table 1 shows that most of the samples (83.33%) were less than 30 years of age and 86.66% of them had high school education.
Section B: Comparison of pre test and post test knowledge and skill level
Table 2-Mean pre-test and post-test knowledge scores, mean difference and ‘t’ value n=30
|
Mean (SD) |
Mean difference |
‘t’ value |
‘p’ value |
|
Pre-test |
Post-test |
6.20 |
11.07 |
0.001 |
|
Knowledge |
11.9(2.4) |
18.1(2.2) |
The table 2 shows that there is a significant difference in the average knowledge before and after the intervention (p=0.01), hence the intervention is effective.
Figure 2: Exploded 3-D pie diagram showing mean distribution of samples according to post-test level of knowledge
Table 3- Mean pre-test and post-test skill, mean difference and ‘t’ value n=30
|
Mean (SD) |
Mean difference |
‘t’ value |
‘p’ value |
|
Pre-test |
Post-test |
4.2 |
15.50 |
0.001 |
|
Skill |
3.4 (0.89) |
7.6(1.35) |
The table 3 shows that there is a significant difference in the average skill before and after the intervention (p=0.01), hence the intervention is effective.
Figure 3: Clustered cylinder diagram showing mean distribution of samples according to post-test skill level
SECTION C: Association of knowledge /skill with demographic variables
Table 4: Chi-square test for association between pre-test knowledge scores and selected demographic variables. n=30
Demographic Variables |
Pre-test knowledge score |
df |
c2 |
‘p’ value |
||
≤median |
≥median |
|||||
Age |
20-30 |
28 |
15 |
3 |
3.60 |
0.3 |
31-40 |
6 |
8 |
||||
41-50 |
0 |
1 |
||||
51-60 |
1 |
1 |
||||
Educational qualification |
High school |
4 |
1 |
3 |
2.01 |
0.5 |
PUC |
23 |
15 |
||||
Diploma/Graduate |
5 |
5 |
||||
PG and above |
3 |
4 |
||||
Occupation |
Student |
28 |
18 |
2 |
0.50 |
0.7 |
Teacher |
5 |
5 |
||||
Any other |
2 |
2 |
||||
Family history |
Yes |
0 |
1 |
1 |
1.40 |
0.2 |
No |
35 |
24 |
||||
Awareness of relatives, friends or colleagues with breast cancer |
Yes |
2 |
8 |
1 |
7.20 |
0.007 |
No |
33 |
17 |
||||
Source of health information |
Books |
10 |
6 |
3 |
2.90 |
0.39 |
Periodicals |
6 |
4 |
||||
Media |
6 |
9 |
||||
Health personnel |
13 |
6 |
Table 5: Chi-square test for association between pre-test knowledge scores and selected demographic variables n=30
Demographic Variables |
Pre-test knowledge score |
df |
c2 |
‘p’ value |
||
≤median |
≥median |
|||||
Age |
20-30 |
37 |
6 |
3 |
3.09 |
0.3 |
31-40 |
10 |
4 |
||||
41-50 |
1 |
0 |
||||
51-60 |
1 |
1 |
||||
Educational qualification |
High school |
1 |
4 |
3 |
16.4* |
0.0 |
PUC |
35 |
3 |
||||
Diploma/Graduate |
7 |
3 |
||||
PG and above |
6 |
1 |
||||
Occupation |
Student |
38 |
8 |
2 |
0.16 |
0.9 |
Teacher |
8 |
2 |
||||
Any other |
3 |
1 |
||||
Family history |
Yes |
1 |
0 |
1 |
0.22 |
0.6 |
No |
48 |
11 |
||||
Awareness of relatives, friends or colleagues with breast cancer |
Yes |
6 |
4 |
1 |
4.70* |
0.05 |
No |
44 |
6 |
||||
Source of health information |
Books |
11 |
5 |
3 |
6.9 |
0.07 |
Periodicals |
7 |
3 |
||||
Media |
12 |
3 |
||||
Health personnel |
19 |
0 |
Table 4 shows that the computed chi-square values have no association with any of the demographic variables. Therefore, null hypothesis H03 is accepted and research hypothesis H3 is rejected. Hence, there is no association between level of knowledge and demographic variables of the samples.
Table 5 shows that the computed chi-square values have the highest degree of association between the pre-test skill in performing BSE and educational qualification and the awareness of relatives, friends or colleagues with breast cancer. Therefore, null hypothesis H04 is partially accepted.
DISCUSSIONS:
To summarize the video-assisted teaching was effective in improving the knowledge and skill of the nuns on prevention of breast cancer and this finding is supported by the following study conducted to assess the effectiveness of planned teaching programme on knowledge regarding breast cancer and breast self-examination on 64 GNM students in Calcutta. The samples were selected by simple random sampling technique and a structured knowledge questionnaire and an observational checklist was administered. The study showed that the pre-test and post-test gain scores were 43 and 47 respectively and the modified Gain Score as 0.74 and standard deviation 8.69. The findings show that the computed mean post-test knowledge score (73.6) mean ability post-test score (21.5), sum of the square of deviation score of knowledge (969), sum of the square of deviation score of ability (31.5), sum of the square of difference score of knowledge and ability (741.7), and r (0.74) is significant at 0.05 level. Thus, the findings revealed that the pre-test knowledge scores were lower than post-test knowledge scores. This implies that the student nurses had lack of knowledge regarding breast cancer. The planned teaching programme was effective as it increased their knowledge about breast cancer, breast self-examination and the ability to perform breast self-examination.
CONCLUSION:
The study concluded that
· The video-assisted teaching was effective in improving the knowledge of the nuns.
· The video-assisted teaching was an effective mode of teaching programme in increasing the skill of nuns.
· There was significant association between pre-test skill in performing BSE with selected demographic variables like educational qualification and awareness of relatives, friends or colleagues with breast cancer.
ACKNOWLEDGEMENT:
Here we extend our sincere thanks to all nuns who participated in the study.
REFERENCE:
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Received on 13.09.2021 Modified on 14.01.2022
Accepted on 09.03.2022 © A&V Publications all right reserved
Int. J. Nur. Edu. and Research. 2022; 10(2):160-164.
DOI: 10.52711/2454-2660.2022.00038