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Go Back       Himalayan Journal of Nursing and Midwifery | Volume:1 Issue:1 | Feb. 18, 2022
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A Pre- Experimental Study to Assess the Knowledge and Effectiveness of Structured Teaching Programme Regarding Telemedicine among B.Sc. Nursing 3rd and 4th Year Students of S.N.G.N.C., I.G.M.C, Shimla (H.P.)”


Sushmita*1, Mrs. Ranjana Thakur2 and Mrs. Indira Marjara3

1M.Sc. Nursing, Community Health Nursing, Sister Nivedita Govt. Nursing College, IGMC, Shimla, Himachal Pradesh, India

2Clinical Instructor cum Sister Tutor, Community Health Nursing, Sister Nivedita Govt. Nursing College, IGMC, Shimla, Himachal Pradesh, India

3Clinical Instructor cum Sister Tutor, Child health Nursing, Sister Nivedita Govt. Nursing College, IGMC, Shimla, Himachal Pradesh, India

Article History

Received: 06.01.2022

Accepted: 15.02.2022

Published: 18.02.2022


Abstract: Background: Telemedicine is the use of advanced telecommunications technologies for the purposes of making diagnoses, conducting research, transferring patient data, and/or improving disease management and treatment in remote areas. In the right circumstances, Telemedicine offers a cost-effective alternative to the traditional methods of health care delivery. Objectives: The main objectives of the study was to assess the level of knowledge regarding Telemedicine, to develop and administer a Structured Teaching Programme on knowledge regarding Telemedicine, to assess the effectiveness of Structured Teaching Programme and to determine the association of post test knowledge with selected socio-demographic variables regarding Telemedicine. Methods and material: A pre-experimental (one group pre-test post-test) design was used for the study. Total 60 students of B.Sc. Nursing 3rd year and 4th year of Sister Nivedita Government Nursing College, IGMC, Shimla (H.P.) were selected by using convenience sampling technique. A self structured knowledge questionnaire was used to assess the knowledge regarding Telemedicine. After conducting pre-test, structured teaching program was provided. The knowledge score of pre-test and post-test was compared. The gathered data was analyzed by using descriptive and inferential statistics. Results: The study finding shows that the mean post-test knowledge score (21.70%) was higher than the mean pre-test knowledge score (15.10%). which was statistically significant. Conclusion: It was concluded that the structured teaching program was effective in increasing the knowledge of students of B.Sc. Nursing 3rd year and 4th year regarding Telemedicine.


Keywords: B.Sc. Nursing 3rd year and 4th year, Telemedicine, Structured Teaching Programme.

Copyright @ 2022: This is an open-access article distributed under the terms of the Creative Commons Attribution license which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use (Noncommercial, or CC-BY-NC) provided the original author and source are credited.

INTRODUCTION

Telemedicine is the use of medical information exchanged from one site to another through electronic communications to improve a patient’s clinical health status. Tele is a Greek word meaning “distance and mederi is a Latin word meaning “to heal”. Time magazine called Telemedicine “healing by wire”. Hence Telemedicine refers to the use of communications and information technologies for the delivery of care. Telemedicine is an open and constantly evolving science, as it incorporates new advancements in technology and responds and adapts to the changing health needs and contexts of societies.


The state of Himachal Pradesh is a mountain State with hilly and treacherous terrain. Health care needs in mountainous, remote and isolated areas with rugged terrain face a lot of challenges. The Government had envisaged overcoming these challenges using Telemedicine as a tool to enable quality health care service delivery to the population. The government has launched eSanjeevani app for allowing Telemedicine in the country to digitally connect patients with doctors.


Telemedicine can lower healthcare costs, drive up efficiency and revenue, provide better access to healthcare services to patients, and ultimately get happier, healthier patients who stay in your organization. Telemedicine can open up many treatment doors, but it is not the same as a brick and mortar doctor office. If someone prefer a more personal or face-to-face relationship, Telemedicine might not be the option for them.


OBJECTIVES

  • To assess the level of knowledge regarding Telemedicine among students of B.Sc. Nursing 3rd and 4th year of S.N.G.N.C, I.G.M.C, Shimla (H.P.).

  • To develop and administer a Structured Teaching Programme on knowledge regarding Telemedicine among students of B.Sc. Nursing 3rd and 4th year of S.N.G.N.C, I.G.M.C, Shimla (H.P.).

  • To assess the effectiveness of Structured Teaching Programme on knowledge regarding Telemedicine among the students of B.Sc. Nursing 3rd and 4th year of S.N.G.N.C., I.G.M.C, Shimla.

  • To determine the association of posttest knowledge with selected socio-demographic variables regarding Telemedicine among B.Sc. Nursing 3rd year and 4th year students.


MATERIAL AND METHODS

Research approach- Quantitative approach

Research design-Pre-experimental (one group pre-test post test) design

Setting of the study- Sister Nivedita Government Nursing College, Indira Gandhi Medical College, Shimla (H.P)

Study population- Students of B.Sc. Nursing 3rd and 4th year

Sample size- 60 students of B.Sc. Nursing 3rd and 4th year

Sampling technique- Convenient sampling technique

Informed consent was taken from the students and confidentiality was maintained.


Inclusion criteria- Students of B.Sc. Nursing 3rd and 4th year, who are studying in S.N.G.N.C, I.G.M.C, Shimla, H.P, students who are willing to participate and students who are present at the time of study.


Exclusion criteria: Students who are not willing to participate in the study and students who are not present at the time of study.


Development of Tool-A self structured knowledge questionnaire was constructed to assess the knowledge related to Telemedicine among students of B.Sc. Nursing 3rd and 4th year. The tool was developed after extensive review of literature, expert’s opinion and researchers own experience to increase the knowledge students regarding Telemedicine. The self structured knowledge questionnaire was divided into two parts:


Part I: It deals with demographic variables such as age, academic year, educational qualification, previous knowledge, source of information, workshop/ seminar attended, existence of Telemedicine unit nearby and session attended in Telemedicine department regarding Telemedicine.


Part II: It consists of self-structured knowledge questionnaire regarding Telemedicine.


Validity of tool- by the experts in this field


Permission – obtained from the concerned authorities.


Ethical consideration-Approval from the ethical and research committee of Sister Nivedita Govt. Nursing College Shimla and ethical committee of IGMC was taken to conduct the research study. Permission for data collection was obtained from the Principal of Sister Nivedita Govt. Nursing College, IGMC, Shimla.


DATA ANALYSIS & RESULTS

The collected data is tabulated, analyzed, organized and presented under the following headings:

  • Section I: Findings related to classification of socio-demographic variables in terms of frequency and percentage.

  • Section II: Findings related to pre-test knowledge score of B.Sc. Nursing 3rd year and 4th year students regarding Telemedicine.

  • Section III: Findings related to post-test knowledge score of B.Sc. Nursing 3rd year and 4th year students regarding Telemedicine.

  • Section IV: Findings related to the effectiveness of Structured Teaching Programme regarding Telemedicine.

  • Section V: Findings related to association of post-test knowledge regarding Telemedicine among students of B.Sc. Nursing 3rd year and 4th year with selected socio- demographic variables.


Section I: Findings Related to Classification of Socio-Demographic Variables in Terms of Frequency and Percentage

Table 1: Frequency and Percentage Distribution of Characteristics of Selected Socio-Demographic Variables

Socio-Demographic Variables

Frequency(F)

Percentage (%)

Age



18-20 Years

10

16.7

>20-23 Years

48

80.0

> 23 Years

2

3.3

Academic year



4th Year

30

50.0

3rd Year

30

50.0

Educational qualification



10+2

59

98.3

Graduate

1

1.7

Others

-

-

Family income



Less than Rs 5000

1

1.7

Rs 5001-10,000

5

8.3

Rs 10,001-20,000

20

33.3

More than Rs 20,000

34

56.7

Do you have any previous knowledge regarding Telemedicine?



Yes

23

38.3

No

37

61.7

If yes, then what is the source of information?



Journal

2

3.3

Magazines

-

-

Internet

11

18.3

TV

2

3.3

Newspaper

-

-

Clinical experience in hospital

7

11.7

Other

1

1.7

Have you attended any seminar/ workshop regarding Telemedicine?



Yes

1

1.7

No

59

98.3

Is there any Telemedicine unit nearby?



Yes

22

36.7

No

38

63.3

Have you attended any session in Telemedicine department?



Yes

1

1.7

No

59

98.3


The data represented in the table 1 revealed that maximum number of students 48(80.0%) were in the age group of >20-23 years followed by 10 (16.7%) were in the age group of 18-20 years and 2(3.3%) study subjects were from age group of >23.As per academic year, equal study subjects were taken from B.Sc. Nursing 3rd year and 4th year i.e. 30 (50%). With regard to educational status, majority 59 (98.3%) of the students were 10+2 and only 1(1.7 %) student was graduate and none of them under “others” i.e.0 (0%). As per monthly income, 34(56.7%) students having family income more than 20,000, 20(33.3%) were having income RS 10001-20,000, 5 (8.3%) were having income RS 5001-10,000 and only 1(1.7%) were having income less than 5000. Maximum number of the students 37(61.7%) had no previous knowledge regarding Telemedicine whereas 23(38.3%) had some previous knowledge regarding Telemedicine. As per source of information, 11(18.3%) students had information form internet, 7 (11.7 %) students had information from clinical experience in hospital, equal study subjects had information from journal and TV respectively i.e. 2(3.3%), 1(1.7%) had information from other sources and none of the student had information from magazines and newspaper. Out of 60 students, 59(98.3%) students had not attended any seminar/workshop regarding Telemedicine whereas 1(1.7%) student had attended seminar/workshop regarding Telemedicine. Majority of the students 38(63.3%) knows that there is Telemedicine unit nearby them whereas 22 (36.7%) does not have any knowledge about any Telemedicine unit near them. Majority of the students 59(98.3%) had not attended any session in Telemedicine department whereas 1(1.7%) student has attended session in Telemedicine department.


Section II: Findings Related to Pre-Test Knowledge Score of B.Sc. Nursing 3rd Year and 4th Year Students Regarding Telemedicine

Table 2: Frequency and Percentage Distribution of Pre-Test Knowledge Score of Students of B.Sc. Nursing 3rd Year and 4th Year according to their Level of Knowledge Regarding Telemedicine

Level Of Knowledge

Score Level

Frequency (F)

Percentage (%)

POOR

0-10

4

6.7

AVERAGE

11-20

55

91.7

GOOD

21-30

1

1.7

Minimum score: 0

Maximum score: 30


Table 2 depicts that in pre-test score, 4 (6.7%) of students had poor knowledge, 55(91.7%) students had average knowledge, and only 1(1.7%) student had good knowledge regarding Telemedicine.


Section III: Findings Related to Post-Test Knowledge Score of B.Sc. Nursing 3rd Year and 4th Year Students Regarding Telemedicine

Table 3: Frequency and Percentage Distribution of Post-Test Knowledge Score of Students of B.Sc. Nursing 3rd Year and 4th Year according to their Level of Knowledge Regarding Telemedicine

Level Of Knowledge

Score Level

Frequency (F)

Percentage (%)

POOR

0-10

-

-

AVERAGE

11-20

15

25

GOOD

21-30

45

75


Table 3 shows post test knowledge score, none of sample falls in poor category. 15 (25%) were having average knowledge and 45(75%) of the sample having good knowledge regarding Telemedicine.


Section IV: Findings Related to the Effectiveness of Structured Teaching Programme Regarding Telemedicine

Table 4: Frequency and Percentage Distribution of Pre-Test and Post Test Knowledge Scores of the Students of B.Sc. Nursing 3rd Year and 4th Year Regarding Telemedicine.

Level Of Knowledge

Score Level

Pre-Test

Post Test

Frequency (f)

Percentage (%)

Frequency (f)

Percentage (%)

POOR

0-10

4

6.7

0

0

AVERAGE

11-20

55

91.7

15

25

GOOD

21-30

1

1.7

45

75

Table 4 shows that in pre-test score, 4 (6.7%) students had poor knowledge, 55(91.7%) students had average knowledge, and only 1(1.7%) had good knowledge regarding Telemedicine.


Post test knowledge score, none of sample falls in poor category. 15 (25%) were having average knowledge and 45(75%) of the sample having good knowledge regarding Telemedicine. Hence after the introduction of Structured Teaching Programme, knowledge score increased.


Table 5: Descriptive Statistics Findings on Effectiveness of Structured Teaching Programme Regarding Telemedicine

Paired T Test

Mean±S.D.

Mean%

Range

Mean Diff.

Paired T Test

Table Value at 0.05

P value

Pre-test knowledge

15.1±3.007

50.30

7-22

6.600

20.404 *

2.00

<0.001

Post-test knowledge

21.7±2.702

72.30

15-27

*Significance Level 0.05


Table 5 shows that by using paired t-test, it was found that there is a significant change in post-test knowledge score of samples. The pre-test and post test mean score for knowledge regarding Telemedicine were 15.1 and 21.7 respectively. Standard deviation for pre-test and post test was 3.007 and 2.702 respectively. Range for pre-test was 7-22 and for post-test it was 15-27. Mean difference was 6.600. Paired t-test value was 20.404 and table value was 2.00 at a level of significance level 0.05. The calculated t-test value was more than table value which shows significance. Hence it was revealed that Structured Teaching Programme was effective in increasing the knowledge of students. Hence H1 was accepted.


Section V: Findings Related to Association of Post-Test Knowledge Regarding Telemedicine among Students of B.Sc. Nursing 3rd Year and 4th Year with Selected Socio- Demographic Variables

Findings shows that there is no significance association between the score level and demographic variables (age, academic year, educational qualification, previous knowledge, source of information, workshop/ seminar attended and existence of Telemedicine unit nearby and session attended in Telemedicine department. The calculated chi-square values were more than the table value at the 0.05 level of significance. Hence H2 was rejected.


CONCLUSION OF THE PRESENT STUDY

On the basis of findings of present study, the following conclusion was drawn:


The pre-test knowledge score of students was 50.30% and post-test knowledge score of students was 72.30%. There was significant difference (6.600) in pre-test and post-test knowledge of B.Sc. Nursing 3rd year and 4th students after giving structured teaching program.


The knowledge of students was not appropriate before administration of structured teaching program but after the administration of structured teaching program the knowledge of students increased gradually which means that the intervention given to the students was effective. Therefore, it was concluded that a brief structured teaching programme is an effective intervention for improving knowledge regarding Telemedicine.


Recommendations for the Future Studies

A similar study can be conducted in different setting at a large scale. A study can be done to assess the attitude and perception of nursing students towards Telemedicine. A quasi-experimental study can be conducted to assess the knowledge of students. A similar study can be replicated on large sample to draw more definite conclusions. A similar study can be conducted on nursing staff and also among rural population.


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