INTRODUCTION:

“Our hands do so much for us. They are capable of a wide variety of functions like touching, grasping, feeling, holding, manipulating, caressing, and performing daily activities and more. They are a vitally important part of who we are and how we see ourselves”¹.

Hand hygiene is a milestone of infectious disease control, and promotion of improved hand hygiene has been recognized as an important public health measure². It has long been recognized to be a convenient, effective, and also cost-effective means of preventing communicable diseases³. According to the definition of World Health Organization, hand hygiene is a general term referring to any action of hand cleansing, i.e., it is the act of cleaning one’s hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms⁴. A causal link between hand hygiene and rates of infectious disease illness has also been established earlier⁵.

For maintaining health, Hand Washing with Soap (HWWS) is effective. Investing in HWWS is easy and minimal. For school children the practice is significant, who might suffer from more severe hygiene related diseases as compared to adults⁶. In the home and everyday life setting hand hygiene is central to prevent the spread of infectious diseases⁷.

Good hand hygiene is one of the most critical control strategies in outbreak management. Hand hygiene is defined as any method that removes or destroys microorganisms on hands. It is well-documented that the most important measure for preventing the spread of pathogens is effective hand washing⁸.

School going children are spending more time in school and they are in close contact with each other, sharing school materials everything from chairs to the desk, to crayons, to germs, and touching their faces. On surfaces, up to eight hours germs from sneeze and cough droplets can survive. So hand washing is an effective way to prevent the spread of common school illnesses like cold, pinkeye and flu and much more⁷.

BACKGROUND OF THE STUDY

Germs are found everywhere. Germs are so small that cannot be seen. Germs can make person sick. They can get rid of germs by washing their hands. Generally the person touches 15 objects in one minute. So easily they can get the infection which increases the mortality and morbidity thereby the cost of health care.

India has made steady progress in reducing deaths in children younger than 5 years, with total deaths declining from 2.5million in 2010 to 1.5million in 2013. This remarkable reduction was possible due to the inception and success of many universal programs like expanded program on immunization, program for the control of diarrheal diseases and acute respiratory infection. Even though the deaths among children under-5 years have declined, the proportional mortality accounted by diarrheal diseases still remains high. Diarrhea is the third most common cause of death in under-five children, responsible for 13% deaths in this age-group, killing an estimated 300,000 children in India each year⁹.

Hand washing is a simple, convenient, and cost-effective means to limit the transmission of communicable diseases. Improving the practice of hand washing is vital to decrease hygiene-related morbidity and mortality, particularly in developing countries. As such, this study is aimed to assess knowledge, and practices of hand washing among school children¹⁰.

STATEMENT OF THE PROBLEM:

Effectiveness of Teach Back method on Knowledge and Practice regarding Hand Washing among students of selected school.

OBJECTIVES:

Primary objectives:

1. To assess the pre-test knowledge and practice regarding hand washing among school children of selected school.

Secondary objectives:

2. To assess the effectiveness of teach back method regarding hand washing among students of selected school.

3. To find out the association between pre-test and post-test knowledge and practice regarding hand washing among school children with selected socio demographic variables.

OPERATIONAL DEFINITIONS:

EFFECTIVENESS:

In this study it refers to the extent to which the teach back method on hand washing yield the desired outcome in improving the level of knowledge and practice among school children as evidenced by gain of knowledge and practice measured by structured knowledge questionnaire and observation checklist.

TEACH BACK METHOD:

In this study it refers to the communication regarding hand washing techniques between researcher and student and their explanation back in simple words, who are studying in V to VII standard.

KNOWLEDGE:

In this study it refers to the estimation of level of understanding of school children regarding hand washing as measured by structured knowledge questionnaire.

PRACTICE:

In this study it refers to the observation of practice of steps of hand washing by school children and measured precisely by observational checklist in pre and post-test.

HAND WASHING:

In this study hand washing refers to, cleaning of hands with soap and water.

STUDENTS: It refers to children aged between 10-12 years and studying V to VII standard at a selected school.

HYPOTHESIS:

H₀There will be no significant difference between pre-test and post-test knowledge and practice score of hand washing technique.

H₁ There will be significant difference between pre-test and post-test knowledge and practice regarding hand washing technique.

H₀₁ There will be no significant difference between teach back method on knowledge and practice regarding hand washing technique.

H₂ There will be significant difference between teach back method on knowledge and practice regarding hand washing technique.

H₀₂ There will be no significant association between pretest and posttest knowledge and practice regarding hand washing technique with selected socio demographic variable.

H₃ There will be significant association between pretest and posttest knowledge and practice regarding hand washing technique with selected socio demographic variable.

SCOPE OF THE STUDY:

· The findings of the study will reveal the existing knowledge related to hand washing.

· The study would enhance the knowledge and practice of the school children related to hand washing, thus eradicating the risk of many communicable diseases.

LIMITATION:

1. School children who were aged 10-12 years at a selected school.

2. The school children studying V to VII standard at a selected school.

3. Available during the period of study.

4. Students who understand and speak Marathi, Hindi and English language.

5. Willing to participate in the study.

REVIEW OF LITERATURE:

1. Review of literature related to health risks of children of not washing hands.

2. Review of literature related to knowledge of hand washing among school children.

3. Review of literature related to effectiveness of teach-back method.

RESEARCH METHODOLOGY:

In view of the nature of problem selected for the study and the objectives to be accomplished, an explanatory quantitative approach was used for the present study. This approach was considered to be the most suitable one to conduct the study because it would help the researcher to use one group and observe the difference in the knowledge and practice scores before and after imparting of teach back method and evaluate the effect of teach back method with regards to school children related hand washing technique in selected school. One group pre-test post- test pre- experimental research design was used to evaluate the effectiveness of teach back method on school students related to hand washing in selected school.

The data collected were from 60 school children’s between the age group of 10 – 12 years, who was selected through probability simple random sampling technique. The structured questionaries’ was used to collect data, and data were analyzed by using descriptive and inferential statistics. The result was presented in the form of tables, figures in chapter IV.

A self-prepared and validated structured questioner was used to collect data, which comprised of section A consist of Socio Demographic data, Section B consisted of three part, Part A: Structured knowledge questionnaire related to general information about spread of infection. Part B: Structured knowledge questionnaire based on concept of hand washing. Part C: Structured knowledge questionnaire based on prevention of infection. And section C It consists of Observation checklist to assess the practice of hand washing techniques.

FINDINGS OF THE STUDY:

Section B:

Table:-1 Area wise comparison of mean, SD of pretest and posttest knowledge score on hand washing.

Sr. No.	Knowledge area	Max. Score	Pretest score		Post test score
Sr. No.	Knowledge area	Max. Score	Mean	SD	Mean	SD
1	General information about spread of infection	5	2.06	0.60	3.98	0.86
2	Concept of hand washing	13	5.12	1.16	9.81	2.22
3	Prevention of infection	2	0.68	0.58	1.18	0.76
4	Overall	20	7.86	2.34	14.97	3.84

Comparison of the pretest and posttest mean score shows that the effectiveness of teach back method by (14.97±3.84) as posttest where as in pretest the score was (3.48±2.23) it indicates the school students had a good knowledge which is higher than pretest shows that teach back method is effective in improving the knowledge level of school students.

Table:-2 Area wise comparison of mean, SD of pretest and posttest practice score on hand washing.

Sr. No.

Practice Area

Max.

Score

Pretest score

Post test score

Mean

Observational checklist

4.76

0.84

9.13

1.77

Comparison of the pretest and posttest mean score shows that the effectiveness of teach back method by (9.13±1.77) as the posttest where in pretest the score was (4.76±0.84). It indicates the school’s students able to perform hand washing procedure, shows that of teach back method is effective in improving practice level regarding hand washing.

Section C:

Table No. 3 Area wise comparison of mean, SD of pretest and posttest knowledge score on hand washing.

Sr. No.	Knowledge area	Max. Score	Pretest score		Post test score
Sr. No.	Knowledge area	Max. Score	Mean	SD	Mean	SD
1	General information about spread of infection	5	2.06	0.60	3.98	0.86
2	Concept of hand washing	13	5.12	1.16	9.81	2.22
3	Prevention of infection	2	0.68	0.58	1.18	0.76
	Overall	20	7.86	2.34	14.97	3.84

Table No. 4 Area wise comparison of mean, SD of pretest and posttest practice score on hand washing.

Sr. No.

Practice Area

Max.

Score

Pretest score

Post test score

Mean

Observational checklist

4.76

0.84

9.13

1.77

Section E:

Hypothesis testing:

H₀There will be no significant difference between pre-test and post-test knowledge and practice score of hand washing technique.

Table No. 5 Paired ‘t’ value of pre and post-test knowledge on hand washing

Sr. No.	Knowledge area	‘t’ value	Level of significance
1	General information about spread of Infection	3.18	Significant
2	Concept of hand washing	3.39	Significant
3	Prevention of infection	2.98	Significant

Df = 60, table value = 1.96, p ≤ 0.05

Paired t value was calculated to analyze the difference in pre-test and post-test knowledge score of hand washing on different aspects of hand washing. Highly significant difference was found between the knowledge score on hand washing among school students (‘t’ value =1.96).

Hence the stated null hypothesis (H₀₁) was rejected as it is interpreted that there was significant difference between pre-test and post-test knowledge scores. Thus the difference observed in mean knowledge score was true difference not by chance.

H₀₁– There will be no significant difference between teach back method on knowledge and practice regarding hand washing technique.

Table No. 6 Paired ‘t’ value of pre and post-test practice on hand washing

Sr. No.	Practice area	‘t’ value	Level of Significance
1	Rating scale	5.26	Significant

Paired t value was calculated to analyze the difference in pre-test and post-test practice score of hand washing on different aspects of hand washing steps. Highly significant difference was found between the practice score on hand washing among school students (‘t’ value =1.96).

Hence the stated null hypothesis (H₀₁) was rejected as it is interpreted that there was significant difference between pre-test and post-test practice scores. Thus the difference observed in mean score was true difference not by chance.

H₀₂– There will be no significant association between pretest and posttest knowledge and practice regarding hand washing technique with selected socio demographic variable.

Table No. 7 Association between the post-test knowledge score on hand washing with demographic variables

Sr. No.	Variables	_X2	Level of significance
1	Age	4.08	Significant
2	Gender	1.53	Not Significant
3	Type of family	1.67	Not Significant
4	Education of father	3.88	Significant
5	Education of mother	3.11	Not Significant
6	Income	1.35	Not Significant

Df =1, table – 3.84, p ≤ 0.05

Chi square values were calculated to find out the association between post-test knowledge score with demographic variables of school students.

The findings revealed that there was significant association between knowledge score and socio demographic variables like age, Education of father. Whereas there was no significant association was found between practice score and socio demographic variables like gender, Type of family, Education of mother, Income. Hence the stated null hypothesis (H_O2) was accepted as there was no significant association between knowledge score and their selected socio demographic variables.

Table No. 8 Association between the post-test practice score on hand washing with demographic variables

Sr. No.	Variables	_X2	Level of significance
1	Age	4.03	Significant
2	Gender	1.67	Not Significant
3	Type of family	2.59	Not Significant
4	Education of father	2.48	Not Significant
5	Education of mother	1.17	Not Significant
6	Income	1.24	Not Significant

Df =1, table – 3.84, p ≤ 0.05

Chi square values were calculated to find out the association between post -test practice score with demographic variables of school student. the findings revealed that there Was significant association between practice score and socio demographic variables like age, where as there was no significant association was found between practice score and socio demographic variables like, gender, type of family, education of father, Education of mother, Income hence the stated null hypothesis (H_O2) Was accepted as there was no significant association between practice score and their selected socio demographic variables.

DISCUSSION:

1. The assessment of practice regarding hand washing technique among school students.

Distribution of mean, SD and of pretest practice score on hand washing technique in student studying in selected school shows that the overall mean score was (4.76±0.84); it seems that school student have average level performance on hand washing procedure.

2. The assessment of effectiveness of teach back method on knowledge and practice regarding hand washing technique among school students.

· In this study overall Comparison of the pretest and post test mean score shows that the effectiveness of teach back method by (14.97±3.84) as post test where as in pretest the score was (3.48±2.23) it indicates the school students had a good knowledge which is higher than pretest shows that teach back method is effective in improving the knowledge level of school students.

· Comparison of the pretest and post test mean score shows that the effectiveness of teach back method by (9.13±1.77) as the post test where in pretest the score was (4.76±0.84). It indicates the school students able to perform hand washing procedure shows that teach back method is effective in improving practice level regarding hand washing.

3. The find out the association with pre-test knowledge and practice score and selected socio-demographic variables among school students.

· Paired t value was calculated to analyze the difference in pre test and post test knowledge score of hand washing on different aspects of hand washing. Highly significant difference was found between the knowledge score on hand washing among school students (‘t’ value =1.96).

· Paired t value was calculated to analyze the difference in pre test and post test practice score of hand washing on different aspects of hand washing steps. Highly significant difference was found between the practice score on hand washing among school students (‘t’ value =1.96).

· Chi square values were calculated to find out the association between post test knowledge score with demographic variables of school students. The findings revealed that there was significant association between knowledge score and socio demographic variables like age, Education of father. Whereas there was no significant association was found between practice score and socio demographic variables like gender, Type of family, Occupation of father, Income. Hence the stated null hypothesis (H_O2) was accepted as there was no significant association between knowledge score and their selected socio demographic variables.

· Chi square values were calculated to find out the association between post test practice score with demographic variables of school student. the findings revealed that there Was significant association between practice score and socio demographic variables like age, where is there was no significant association was found between practice score and socio demographic variables like, gender, type of family, education of father, Occupation of father, Income hence the stated null hypothesis (H_O2) Was accepted as there was no significant association between practice score and their selected socio demographic variables.

CONCLUSION:

The findings of the present study indicated regarding teach back method among high school students, shows that the knowledge on hand washing is good among high school students of selected school it an indicates the high school student had a good knowledge which is higher than pretest and shows that teach back method is effective in improving the knowledge level of high school student of selected school. It should be emphasis that having teach back method session with school students on hand washing technique improves their knowledge and practice.

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Received on 07.12.2022 Modified on 09.02.2023

Int. J. Nur. Edu. and Research. 2023; 11(2):137-142.

DOI: 10.52711/2454-2660.2023.00030