A Study to Evaluate the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention of Deep Vein Thrombosis among Post-Operative Orthopedic Patients in Selected Hospital at Rajkot

Mital Jagatiya, Suneesh P.M, Jeenath Justin Doss K.

Shri Anand Institute of Nursing Opp. Ghanteshwar park, B/h Shainik Society, Jamnagar Road, Rajkot-360006.

*Corresponding Author E-mail: mitaldjagatiya@gmail.com

ABSTRACT:

A study to evaluate the effectiveness of structured teaching programme on knowledge regarding prevention of deep vein thrombosis among post-operative orthopedic patients in selected hospital, at Rajkot. The objectives of the study was (a) To assess the level of knowledge regarding prevention of deep vein thrombosis among post-operative orthopedic patients. (b) To evaluate the effectiveness of STP on prevention of deep vein thrombosis In terms of knowledge among post-operative orthopedic patients. (c) To find out the association between selected demographic variables and Pre-test level of knowledge on prevention of deep vein thrombosis among post-operative orthopedic patients. The research design adopted was One Group Pre-test and Post-test design. The study had been conducted in selected hospital at Rajkot. Non probability sampling technique had been adopted to select the desired samples. The sample size was 40. As a part of intervention, a STP on knowledge regarding prevention of DVT was provided to each post-operative orthopedic patients for 30 minutes and the data was collected by structured interview with set of questionnaires that is administered to assess the level of knowledge regarding prevention of DVT among post-operative orthopedic patients. The data were analyzed by using both descriptive and inferential statistical method paired “t” test was used to evaluating the effectiveness of STP on knowledge regarding prevention of DVT. The obtained value 10.05, which shows highly significant at the level of p<0.05. There is significant association between demographic variables such as age, religion with pretest level of knowledge on prevention of DVT. The study concluded that the STP was effectiveness in improving of knowledge regarding prevention of DVT.

KEYWORDS: Effectiveness, Prevention of DVT, Post-operative orthopedic patients.

BACKGROUND OF THE STUDY:

The vascular system is a vast network of vessels through which blood circulates in the body. Arteries, arterioles, veins, venules, capillaries and lymphatic constitute the structural elements of vascular system. Approximately 75% of total blood volume is contained in the veins. Venous disorders are characterized by stasis, hyper coagulability of the blood and vessel wall injury.¹

Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein, occurs most commonly in the legs or pelvis. Symptoms can include pain, swelling, redness, and enlarged veins in the affected area, but some DVTs might not have symptoms. The most common life-threatening concern with DVT is the potential for a clot (or multiple clots) to detach from the veins (embolize), travel through the right side of the heart, and become stuck in arteries that supply blood to the lungs. This is called pulmonary embolism (PE). Both DVT and PE are considered as part of the same overall disease process, which is called venous thromboembolism (VTE). VTE can occur as DVT only, as PE with DVT, or PE without DVT. The most frequent long term complication is post-thrombotic syndrome, which can cause pain, swelling, a sensation of heaviness, itching, and in severe cases, ulcers. Also, recurrent VTE occurs in about 30% of those in the ten years following an initial VTE.³

NEED FOR THE STUDY

World statistics revealed that 25% to 40% of patients over the age of 40yrs, operated for 1 or more hours develop DVT in 2018 by US agency. Therefore practice of preventive measures is needed.⁴

In worldwide, the precise number of people affected by DVT is unknown, although many as 900000 people could be affected (1 to 2 per 10000) each year. Estimates suggests that 60000 to 100000 Americans die due to DVT in 2020⁴.

Annual incidence of DVT is 80 cases per 100000 with a prevalence of lower limb DVT of one case per 1000 population. In US more than 200000 people develop DVT among it 50000 cases are complicated⁵.

Estimated incidence of DVT range from 79 per 100000 to 269 per 100000 population in 2021, it states that the DVT incidence is estimated higher among black population and lower among the Asian ,Asian American population⁵.

Venous thromboembolism (VTE) is a global health concern with substantial mortality and morbidity. Approximately 70% of patients with symptomatic VTE manifest as deep-vein thrombosis (DVT). Contrary to earlier belief, the incidence of VTE in India is comparable to the Western population. Earlier studies from India ascertain the incidence to be 22/10,000 admissions. The risk of VTE is especially high in the hospitalized patients, especially in the immediate postoperative period, the majority of which can be prevented by appropriate thromboprophylaxis. As very few studies on DVT are present of the Indian population, we aim to publish the results of our registry with respect to demographics, management, and clinical outcomes.⁵

DVT is a complication and major source of morbidity and mortality in healthy patients above 40yrs of age undergoing extensive elective surgery like arthroplasty and cardiac surgeries and immobility. As nurses, our duty is to prevent DVT by teaching exercises pre-operatively and applying elastic stockings after surgery⁵.

The actual incidence of pulmonary embolism – it may be the cause of death in 3 to 10 patients out of 1000 hospital deaths. All the precautions and anti-coagulation prevents at least 5 to 6 deaths out of 1000 deaths in thehospitals.⁵

In India the incidence states that pulmonary embolism and DVT were 16.5% and 14.8% respectively. DVT was present in 42.4% of patient with pulmonary embolism. Incidence of symptomatic DVT was 4.4%.patient with metabolic syndrome had an increase incidence of DVT compared to those without metabolic syndrome⁵.

In Gujarat, Among 404 patients 2.7 % were diagnosed with DVT, 304 patients 1.3% were diagnosed with DVT, 287 patients 2% were diagnosed with DVT. Among all these 85% of patient were diagnosed with DVT proximal to popliteal vein and 15% at distal vein. The incidence note that DVT was found 10.8% in Ahmedabad in 2021⁵.

OBJECTIVES OF THE STUDY:

1. To assess the level of knowledge regarding prevention of deep vein thrombosis among post-operative orthopedic patients.

2. To evaluate the effectiveness of STP on prevention of deep vein thrombosis In terms of knowledge among post-operative orthopedic patients.

3. To find out the association between selected demographic variables and Pre-test level of knowledge on prevention of deep vein thrombosis among post-operative orthopedic patients.

HYPOTHESES:

· H₁: The mean post-test knowledge scores of patients receiving STP will be significantly higher than the mean pretest knowledge scores regarding prevention of DVT.

· H₂: There will be significant association between the selected demographic variables and their pre-test level of knowledge regarding prevention of DVT.

METHODOLOGY:

RESEARCH APPROACH:

Quantitative research approach.

Research Design:

Pre experimental one group pretest posttest design

Variables Under The Study:

The variables under the study were independent variable and dependent variables.

Independent variable:

Structure teaching programme on knowledge regarding prevention of deep vein thrombosis.

Dependent variable:

Knowledge regarding prevention of deep vein thrombosis among post-operative orthopedic patients.

Setting of The Study:

Setting is the physical location and condition in which data collection takes place.

The study was conducted in Shiv orthopedic Hospital at Rajkot. Shiv hospital is well known 52 beds orthopedic hospital which is located at the Mahapuja Dham chowk, near Balaji hall, 150 feet ring road, Rajkot. The hospital is growing in full pledge with the support of all the medical staff, and nursing staff.

Population:

Target population:

Orthopedic patients admitted in selected orthopedic hospital.

Accessible population:

Post-operative orthopedic patients.

Sample:

The sample of the study comprised of orthopedic patients in Shiv orthopedic hospital.

Sample Size:

The sample size of the study comprised of 40 post-operative orthopedic patients.

Sampling Technique:

Non probability Purposive sampling technique was used to select the sample for the study.

Data Analysis and Interpretation:

The collected data was analyzed using both descriptive and inferential statistics.

RESULT:

Major Finding of The Study

Major study findings includes, Findings related to demographic variables of the study

1. The majority of 30 (75%) sample’s age is between 27-36 yrs.

2. The majority of 30 (75%) samples were male orthopedic patients.

3. The majority of 25 (62.5%) samples were secondary education.

4. The majority of 32 (80%) samples were belonging from Hindu religion.

5. The majority of 30 (75%) samples were married.

6. The majority of 15(37.5%) samples were farmer.

7. The majority of 25(52.5%) samples were physically active.

With regards to effectiveness of STP on knowledge regarding prevention of DVT among post-operative orthopedic patients. The obtained “t” value for the level of knowledge was 10.05 with degree of freedom 39 highly significant at 0.001 level of significance. Thus the researcher accepted H1.

With regards to association between selected demographic variables and their pre-test level of knowledge, Researcher found the following demographic variables such as age, gender, marital status, occupation found calculated chi quare value higher than the tabulated value, at 0.05 level, this indicate there is a significant association between these variables and pre-test knowledge, thus researcher accepted stated H2.

CONCLUSION:

The main conclusion of this present study was that STP to improve the level of knowledge regarding prevention of deep vein thrombosis among post-operative orthopedic patients in selected hospital.

REFERENCES:

1. Smeltzer, C. Suzzare. A text book of Medical-Surgical Nursing. 4th edition, 2003, Philadelphia, Lippincott Company,page no.1530.

2. BM. Joyce and Hawks HokansonJame. A text book of Medical- Surgical Nursing. 2003, Philadelphia, W.B. Saunder’s Company, pp1423-1425.

3. Dr. Pinjala. A Clinical Problem-DVT; I edition,1990, published by Nikhila publishers, page no. 235.

4. Russel J C. Prophlaxis of post-operative deep vein thrombosis and pulmonary embolism. Surg. Gynecol Obstet. 1993 Jul: 157(1):89-104.

5. Brady L P. A multifaceted approach to prevention of thromboembolism”: a report of 529 cases. South Med. J. 1977 May: 70(5):546.

6. Park. J.E. AText book of Preventive and Medicine. 2nd edition, 2000, Bharat Publication, Jabalpur,pp137-138.

Received on 24.01.2023 Modified on 14.02.2023

A and V Pub Int. J. of Nursing and Medical Res. 2023; 2(1):13-15.

DOI: 10.52711/ijnmr.2023.04

World statistics revealed that 25% to 40% of patients over the age of 40yrs, operated for 1 or more hours develop DVT in 2018 by US agency. Therefore practice of preventive measures is needed.4

In worldwide, the precise number of people affected by DVT is unknown, although many as 900000 people could be affected (1 to 2 per 10000) each year. Estimates suggests that 60000 to 100000 Americans die due to DVT in 20204.

Annual incidence of DVT is 80 cases per 100000 with a prevalence of lower limb DVT of one case per 1000 population. In US more than 200000 people develop DVT among it 50000 cases are complicated5.

Estimated incidence of DVT range from 79 per 100000 to 269 per 100000 population in 2021, it states that the DVT incidence is estimated higher among black population and lower among the Asian ,Asian American population5.

REFERENCES:

World statistics revealed that 25% to 40% of patients over the age of 40yrs, operated for 1 or more hours develop DVT in 2018 by US agency. Therefore practice of preventive measures is needed.⁴

In worldwide, the precise number of people affected by DVT is unknown, although many as 900000 people could be affected (1 to 2 per 10000) each year. Estimates suggests that 60000 to 100000 Americans die due to DVT in 2020⁴.

Annual incidence of DVT is 80 cases per 100000 with a prevalence of lower limb DVT of one case per 1000 population. In US more than 200000 people develop DVT among it 50000 cases are complicated⁵.

Estimated incidence of DVT range from 79 per 100000 to 269 per 100000 population in 2021, it states that the DVT incidence is estimated higher among black population and lower among the Asian ,Asian American population⁵.