1.

INTRODUCTION
He who has health, has hope, and he who has hope, has everything.
[An Arabian Proverb]

BACKGROUND OF STUDY
Hypertension is one of mankinds most common diseases affecting 15-20% of
all adults. Abnormally increased blood pressure is called hypertension. Essential (or
primary) hypertension (HTN) is a disorder of the circulatory regulation. It is currently
among the leading causes of morbidity and mortality in the world and is expected to
have even greater impact on the health of the people specially in the developing world.
Hypertension is a major cardiovascular problem world over. Its prevalence
ranges from 100 to 200 per 1000 population. Most of the cases are of primary
hypertension and many 2% could be accounted for as secondary hypertension Most of
the cases of secondary hypertension are considered to be due to some and
cardiovascular diseases. Hypertension is the most common disorder encountered in
outdoor patients. The seventh report of the Joint National Committee or prevention,
detection, evaluation and treatment of High Blood Pressure (JNC VII report) has
recommended a new classification for adult 18 years or older.
Normal 120/80 mm Hg, Pre Hypertension 120 139/90 mm Hg, Hypertension
Stage 1 140 159/90 99 mm Hg., Hypertension Stage 2 > 160/ > 100 mm Hg,
Hypertension Stage 3 > 180 / > 110 mm Hg. (JS Sandhu 2004)
Hypertension can be defined as persistent levels of blood pressure in which the
systolic pressure is above 140 mm Hg and the diastolic pressure is above 90 mm Hg. In
elderly population hypertension is above 160/90 mm Hg. (Brunner & Suddarths 1998)
Arterial hypertension is an important modifiable risk factor for cardiovascular,
cerebrovascular and renal morbidity and mortality. Accurate and reliable information
about prevalence of arterial hypertension and its risk factors is a prerequisite for
designing strategies for its control and prevention. Coronary events such as a heart
attack are still the most common result of hypertension. Increased blood pressure level
is related to increased severity of atherosclerosis, stroke, nephropathy, peripheral
vascular disease, aortic aneurysms and heart failure. If hypertension is left untreated,
1

nearly half of hypertensive clients will die of heart disease, a third will die of stroke and
the remaining 10% to 15% will die of renal failure. Hypertension is highly prevalent in
India. The Indian Heart Journal give an idea about its increasing prevalence attributable
to rapid alteration of life style in developing countries like India and Nepal. Health
Planners, physicians, community leaders and public health practitioners should
formulate region specific guidelines based on local health care priorities and economic
realities. These regional guidelines should identify reality goals, such as the thresholds
for treatment, the desirable level of blood pressure control, the affordable degree of
hypertension control, the acceptable extent of hypertension control and the possible
strategies for achieving these targets. Life style modification needs to be emphasized at
all levels and there is no threshold of acceptability and affordability as it does not
concern money but attitude, policies related to tobacco, alcohol, salt and education may
be in the domain of the state, but individuals have a greater responsibility that needs to
be constantly reminded at all levels. It is also time for the citizens to wake up and redefine priorities in life. (J. C. Mohan 2005).
The high knowledge deficit among clients with hypertension indicates a low
awareness regarding their disease. It implies that patient teaching is inadequate or
ineffective and that the self-care potential of clients is not being fully used. Health
teaching is an integral component of nursing practice.
Hence, apart from the incidental teaching, nursing personnel should conduct planned
teaching programmes for patients in order to enhance their self-care ability. Nursing
personnel working in various health care settings should be given in service education
to update their abilities in identifying learning needs of clients and in planning
conducting

and

evaluating

teaching

for

different

categories

of

patients.

(M. Prakasamma 1997)

1.2

NEED OF THE STUDY

Hypertension is a common disease in world. The Prevalence of Hypertension in

the world till year 2002 was estimated to be about 972 Millions form which 634 million
patients belonged to the economically developing countries. It is also developed by a
result of anxiety, tension, dietary pattern and life style. Now a days living
2

standard is also changing. Hypertension affects vital organs like heart, lungs and
kidneys.
During the clinical experience the investigator had noticed that majority of
patient who mainly belonged to urban areas did not know much about hypertension and
its causes and prevention. They were not taking prescribed treatment, neglecting the
dos and donts of diet and did not know the importance of exercise which lead to
complications. The investigator observed that a number of hypertension patients were
hospitalized because of uncontrolled blood pressure, nephropathy and arteriosclerosis,
Hypertension complications are preventable and long and healthy life is possible
despite hypertension. Education is the process of motivating self-care so that they can
look after themselves without being dependent on trained health professionals and
thereby reducing the complications and burden on the family, and society. Hence, the
investigator felt the need to conduct this study.
Niji J. Solomon (2000) conducted a study for the prevalence of selected
modifiable risk factors of hypertension among adults at Balam village, Terunelveli.
Descriptive design was used and samples of the study were 100 adults. Structured
interview schedule was used to assess the prevalence of selected modifiable risk factors.
Findings of the study revealed that the overall mean for modifiable risk factors were
57.16 with a moderate level risk of 90%. Conclusion of the study revealed that practice
of preventive steps through healthy life style can prevent a major catastrophe in future.
Joshi Clara (1997) conducted a study to assess the effectiveness of structured
teaching on self-care of pregnancy induced hypertension among pregnant women in
hospital. A structured teaching on the self- care of pregnancy in induced hypertension
mothers. The samples comprise of pregnant women with pregnancy induced
hypertension distributed.

1.3

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured teaching programme on knowledge

regarding hypertension among hypertensive patients at Peoples Hospital of Bhopal
city.
3

1.4
1.
2.
3.
4.

OBJECTIVES

To assess the pretest knowledge score regarding hypertension.

To impart structured teaching program.
To assessed post- test knowledge score regarding hypertension.
To find out association between pre- test knowledge score and
Socio-demographic variable

1.5

HYPOTHISIS
H1 There will be some knowledge regarding hypertension among hypertensive
patient.
H2 There will be significance difference between pre and post test scores.

1.6

OPERATIONAL DEFINITION
1. Knowledge - In this study it refers to the information with regard to
hypertension obtained from hypertensive patient in term of correct responses to
the items on pamplet.
2. Effectiveness Refers to improvement is post test score of knowledge among
hypertensive patients after administration of teaching programme compared to
the pre-test knowledge score.
3. Hypertensive Patients Persons of 20 to 80 years who are diagnosed as having
hypertension by a physician and he/she is on treatment for the same.
4. Structured Teaching Programme One to one individual health education with
the help of structured teaching plan given to hypertensive patients.

1.5

ASSUMPTION
There is high prevalence of hypertension among the adult population in the
Peoples Hospital at Bhopal city.

1.8

DELIMITATIONS
The study is delimited to adult patient with hypertension, living in Peoples
Hospital in Bhopal.

1.9

CONCEPTUAL FRAMEWORK (SYSTEM THEORY)

A conceptual framework is a theoretical approach to the study of problems that

are scientifically based and emphasizes the selection, arrangement and clarification of
its concept.
-Polit and Hungler (1999)

Discussion of the relationship of concepts that underline the study

problem and support the rational ( reasons) for conducting the study.
-BT Basavanthappa (2007)
A framework for a research study helps to organize the study an provides a
context for the interpretation of the study findings. Conceptual framework provides a
background or foundation for a study and it helps to explain the relationship between
concepts. Since, this study is intended to evaluate the effectiveness of structured
teaching programme in terms of improving knowledge of the hypertensive patient, the
conceptual framework taken for the present study is based on general systems theory
given by Ludwig Von Bertalanffly in 1968.
According to this theory, a system is a group of elements that interact with one
another in order to achieve the goal. An individual is an open system because he/she
receives input from the environment. This input when processed provides an output. All
living systems are open. There is a continual exchange of matter, energy and
information. The system is cyclical in nature and continues to be so, as along as the four
parts inputs, process, output and feedback keep interacting with each other. If there
are changes in any of the parts, there will be alteration in all other parts. Feedback from
within the system or from the environment provides information, which helps the
system to determine its effectiveness.

Input
Consists of information material or energy that enters the system. In this study
investigator is a system with input from the environment. The input includes
hypertension background age, sex, education, occupation, income/month (in rupees),
marital status, dietary habits, and previous knowledge.

Process
After the input is absorbed by the system, it is processed in a way useful to the
system. Here it refers to the administration of pamplet to hypertensive patient. In order
to achieve the desired output, i.e. increase the knowledge of Hypertensive patient are
following process is adopted. Using a structured knowledge questionnaire knowledge of
hypertensive patient will be assessed and this will be followed by preparation and
administration of pamplet. H.T. following this knowledge will be tested again.

Output
It refers to energy, matter or information disposed of by the system as a result of
its process. In the present study, it refers to the improvement of knowledge of
Hypertension. This is assessed through a comparison between the pre-test and post-test
knowledge score of the Hypertension patient.

Feedback
It is the process that enables a system to regulate it save and provides
information about the systems output and is feedback as input. It higher knowledge
scores obtained by the hypertension patient in the post-test indicate that the structured
teaching programme was effective in increasing the knowledge of Hypertension patient.
A low score in post-test indicates that the Structured Teaching Programme was not
effective an alternative measures may be needed to improve knowledge.

1.10 SUMMARY
This chapter dealt with the introduction, background, need of the study. It
mentioned about the statement problem, objectives, operational definitions,
assumption, hypothesis and delimitation of the study and plan of writing report.

2. REVIEW OF LITERATURE
Man can learn nothing except by going from the known to unknown.
(Claude Bernard)
Review of literature is an important step in the development of a research
project. It is a complication of resources that provides the groundwork for the study.
The investigator carried out an extensive review of literature on the research
topic in order to gain deeper insight into the problem and to collect maximum relevant
information for building up the study in a scientific manner so as to achieve the desired
results.
The literature review that was undertaken for the purpose of the conducting this
study has been presented under the following headings
Section 1: Literature related to incidence of Hypertension.
Section 2: Literature related to Structured Teaching Programme on knowledge.
Section 3: Literature related to other intervention.

2.1

Literature related to incidence at hypertension

Lee Young (2006) conducted a study on the physical activity in older adults

with border line 2hypertension. Data were collected from a multiethnic non probability
samples of 267 men and women 60-75 years of age. The final model explained 44% of
the variance in physical activity. Variable that indirectly predicted physical activity were
perceived health status, barriers to physical activity, self-efficacy for physical activity
intrinsic motivation for health and environmental influence. The significant associations
between the cognitive appraisal and motivation concepts extend previous research and
add to the understanding of the complex factors that influence regular physical activity.
Soya K, Kumar Geetha V.P. (2003) conducted a quasi-experimental study to
assess the self-care activities of pregnancy induced hypertension and maternal outcome.
Based on sample criteria 70 primigravida with pregnancy induced hypertension (PIH)
were selected by non-probability purposive sampling, 30 A pre-test post-test on

equivalent Data was After selection pre-test was done using structured interview
schedule.
The bio-physiological markers such as blood pressure, weight gain, proteinuria
and oedema of all the clients were also assessed at the time of selection. They were
advised to contact the investigator during each of their subsequent antenatal visit up to
delivery. On the same day of selection the experimental group were exposed to
structured teaching programme; after the pre-test in one session of 45 minutes either
individual or in group. A hand out was provided to them for further reference. The post
test on both experimental and control group were done after two weeks, using the same
structured interview schedule. All the clients were monitored during each follow up
record.
The findings concluded that before structured teaching programme the
knowledge of primi gravida women with pregnancy induced hypertension was less. The
structured teaching programme on selected self-care activity (SSCA) considerably
enhanced the knowledge of primi gravida with pregnancy induced hypertension. The
structured teaching programme helped the primi gravida women with pregnancy
induced hypertension to practice selected self-care activity. The practice of selected
self-care activity by primi gravid women with pregnancy induced hypertension helped
to attain favourable self-care. There was an association between PIH and variables such
as age and occupation i.e. PIH was prevalent more among the age group 21 to 25 years
and most of the women pregnancy induced hypertension had no occupation. There was
no relationship with pregnancy induced hypertension and variables such as religion
educational status and family history of pregnancy induced hypertension.
Henriksson KM (2002) conducted a prospective longitudinal study to explore
the development of hypertension in a cohort of young middle-aged men. Using a
hospital setting in Sweden, data were collected from a birth cohort study of men
surveyed over 6 years. The sample included a total of 628 men born in 1953 to 1954, all
of whom were surveyed at 37, 40 and 43 years of age at the same time of the year. The
result indicated that at 37 years of age, 243 men (39%) had reference or normal blood
pressure, 167 (26%) had high normal blood pressure and 218 (35%) were hypertensive.
The individuals with high normal blood pressure at baseline were statistically

10

associated with the development of hypertension both at 40 and 43 years of age,

independent of other cardiovascular disease risk factors and ethnicity.
Niji J. Solomon (2000) conducted a study for the prevalence of selected
modifiable risk factors of hypertension among adults at Balam village, Terunelveli.
Descriptive design was used and samples of the study were 100 adults. Structured
interview schedule was used to assess the prevalence of selected modifiable risk factors.
Findings of the study revealed that the overall mean for modifiable risk factors were
57.16 with a moderate level risk of 90%. Conclusion of the study revealed that practice
of preventive steps through healthy life style can prevent a major catastrophe in future.
Jasmine J. (1998) conducted a study to assess the effectiveness of structured
teaching on knowledge and life style adopted by hypertensive patients at community
health centre. Mannadipet, Pondicherry. Research design was non-equivalent control
group pre-test and post-test design. Data was collected with the help of questionnaire on
knowledge of patients on hypertension and their life style and structured teaching
module on knowledge of hypertension and life style. The samples are 30 newly
diagnosed male and female hypertensive patients belonging to Findings of study
revealed that patients who were exposed to structured teaching have gained more
knowledge and favorable attitude towards life style practices than those who did not
have exposure to the structured teaching health teaching to an essential aspect of health
care to individuals with hypertension.
Singh R.B. (1990) conducted a study to assess the effect of diet and weight redu
and magnesium than did groups B and D. Dietary compliance and drug intake was
checked weekly. Weight loss was associated with a significant fall in systolic and
diastolic pressures in both group A (22/18 mm Hg) and Group B (16/13 mm Hg)
compared with Group D at the end of the study. Group C patients also showed a
significant fall in pressure (13/10 mm Hg) compared with Group D.

2.2 Literature Related to Structured Teaching Programme on

knowledge
Grusser, Monika (2003) conducted a study to assess the effect of structured
outpatient education and treatment programme for patients with diabetes mellitus and
11

hypertension. Four different programmes have been implemented into the German
health care system. Over 80% of the physicians rated the training courses as Very
good or good and rated the teaching material and very good or good. Data
collection

on patients with diabetes mellitus or hypertension demonstrate the

effectiveness of these programmes at the treatment level. The results also demonstrate
the practicability an effectiveness of the implementation of programmes as an integral
part of disease management in routine health care for patients with diabetes mellitus or
hypertension.
Zernike (1998) conducted a study for evaluating the effectiveness of two
teaching strategies for patients diagnosed with hypertension. Experimental research
design was adopted. Samples were drawn from 30 hypertensive patients. A pre-test was
performed shortly after admission to hospital are collect information.
Comparison of the pre and post-tests of the group revealed a significant increase in
knowledge level at the time of discharge from hospital.
Joshi Clara (1997) conducted a study to assess the effectiveness of structured
teaching on self-care of pregnancy induced hypertension among primi para mother
antennal clinic.

A structured teaching on the self-care of pregnancy in induced

hypertension mothers. The samples comprise of 30 primi para mothers with pregnancy
induced hypertension distributed. Findings and of study revealed that the incidence of
pregnancy induced hypertension was high among young primipara below 20 years and
gravida mothers. The age factors and family size exhibited its relationship with
knowledge gain. The pregnancy induced hypertension primipara mothers who received
teaching gained highly significant knowledge. The structured teaching on self-care
pregnancy induced hypertension primi para mothers was effective in increasing the
knowledge and in prevention of complications.
Gruesser M. (1997) conducted a study to assess the effect of structured patient
education for out patients with hypertension in general practice. A one group pre-test,
post-test approach was used. The project was carried out in co-operation with the
German hypertension league and designed to evaluate the practicability and efficacy of
the implementation in routine primary health care. A total of 466 patients were trained.
Data was collected from 272 patients. Data collected 22 weeks after the intervention
demonstrated the efficacy of the programme at treatment level : reduction of body
12

weight (2 kg, p < 0.001) and blood pressure (from systolic 158 <18 to 148 < 17 mm hg,
p < 0.001, diastolic 91 < 9 to 86 < 9, p < 0.001) 65% patients learned for the first time
how to perform blood pressure self-monitoring during the programme.
Sawicki PT (1993) conducted a study to assess the improvement of
hypertension care by a structured treatment and teaching programme. This programme
aims at improving of patients compliance to antihypertensive therapy and is based on
four groups sessions mainly conducted by paramedical personnel. This programme was
evaluated in three different settings in patients with hypertension, diabetes mellitus and
poor compliance to anti-hypertensive drug therapy. In all three studies a significant
improvement in compliance to anti-hypertensive therapy were found.

2.3

Literature Related to other intervention

Allan J. Zillich (2005) conducted a study to assess the hypertension outcomes

through blood pressure monitoring evaluation by pharmacists. A high intensity (HI)

verses low intensity (LI) intervention randomized group was there. The HI intervention
comprised 4 face-to-face visits with a trained pharmacist. Pharmacists provided patient
specific education about hypertension. The study enrolled 125 patients, 64 in the HI and
61 in the LI group. At the final visit the SBP/DBP change between the H1 and LI group
was 4.5 / 3.2 mm Hg p = 12 for DBP.
Perry M. (1999) conducted a study to assess the evaluation of drug treatment in
mild hypertension. A feasibility trail to investigate the practicality of determining the
advantage and disadvantage hypertension. It demonstrated that the required relatively
young asymptomatic population could be persuaded to adhere to the protocol for 2
years, men and women were 21-50 years old, had diastolic pressures from 85-100 of
cardiovascular renal abnormalities. They were randomized in double blind fashion into
active care therapy involved 50 mg chlorthalidone (step 1) 100 mg cholorthalidone
(step 2). Side effects were carefully tabulated in both active drug. Findings revealed an
average drop in diastolic pressure of almost 12 mm Hg for active drug group less than
half in 6 months after randomization the new pressure levels persisted almost without
change though not designed to answer the primary question regarding the benefits of
treatment.

13

Henderson A (1998) conducted a study for evaluating the effectiveness of two

teaching strategies for patients diagnosed with hypertension. Setting Australia hospital.
Sample was collected from 40 patients, Comparison of the pre and post-tests of the test
group revealed a significant increase in knowledge level at the time of discharge from
hospital. This study showed that a structured approach to health education is more
effective in improving patients knowledge.

2.4

SUMMARY
This chapter deals with the review of literature. There are 15 review of literature

which are categorized into 3 section:

Section :1 Literature related to incidence at hypertension.
Section :2 Literature related to Structured Teaching Programme on knowledge.
Section :3 Literature related to other intervention.

14

3. RESEARCH METHODOLOGY
This chapter deals with the methodology selected by the investigator to study
the research problem.
Research methodology is the systematic way of doing a research to solve a
problem. It contains statement of the problem, objectives of the study, assumptions
which have been formulated, methods used for data collection and the statistical method
used for analyzing, he data and the logic behind it (Kothari, 1998)

3.1

Research Approach
The study aims at determining the effectiveness of structured teaching

programme on hypertension for hypertensive patients. The research approach adopted

for the study is an evaluative approach. The purpose of evaluative approach is to
measure the effect of intervention which will be used for achieving the selection of
problem.

3.2

RESEARCH DESIGN

Pre-test post-test research design will be adopted for the studyPre- test

Treatment

O1

Post- Test
O2

The investigator introduced a base measure before and after a structured

teaching programme through pamplet which is depicted as a O1 and O2 respectively. In
the present study the measure was knowledge of hypertensive patients regarding
hypertension. The intervention was the structured teaching programme through pamplet
which is depicted as X.

15

SCHEMATIC REPRESENTATION OF THE RESEARCH DESIGN.

16

3.3

VARIABLES

Two types of variables were identified in these study

Independent variable Age, Sex, Education, Occupation, Income, Marital Status

and Dietary habits, previous knowledge.

Dependent variable Knowledge.

3.4

SETTING
Settings are the more specific places where data collection will occur. The

setting for the present study is conduct in Peoples Hospital in Bhopal city

3.5

POPULATION
Population is a group whose members possess specific attributes the researcher

is interested in studying. The target population consist of the total membership of a

defined set of patients from whom the study patients are selected and to whom the data
will be generalized. In this study population consist of all the patients with hypertension
at Peoples Hospital Bhopal.

3.6

SAMPLING PROCESS

Sample
A sample is a subject of a population selection to participate in a research study.
(Polit and Hungler, 1999). In this study the sample consisted of 30 subjects who were
diagnosed with hypertension and were present at peoples hospital and who fulfilled the
inclusion criteria.
Sampling Technique
In the present study purposive sampling technique was used to select the
sample. Purposive sampling is a type of non-probability sampling method in which the
researcher selects, participants for the study on the basis of personal judgement about
those who will be more representative or productive also referred to as judgement
sampling, patient were identified till the investigator found a client with hypertension
who met the inclusion criteria.

17

Sample size
In this study, the sample comprised of 30 hypertensive patients in peoples
hospital fulfilling the inclusion criteria.

3.7

SAMPLE SELECTION CRITERA

Inclusion Criteria
1.

Hypertensive patients in age group of 20-80 years.

2.

Male and female hypertensive patients.

3.

Patients who are willing to participate in this study.

4.

Patients who are able to understand and respond in Hindi.

3.8

DEVELOPMENT AND DESCRIPTION OF THE TOOL

Data collection tools are the instrument, structured questionnaire, structured

teaching pamphlet used by the research to measure the variables and knowledge in the
research problem.
Selection of Tools
The data collection technique was questioner schedule. It is considered to be
appropriate the elicit the response from adults.
The researcher included the following criteria.
Development of Tools
The tools used in this study is a structured questionnaire with
Section A
Section B

Socio-Demographic Data.
Assessing the knowledge about hypertension

Review of literature provided adequate content for the tool preparation. Personal
experience of the investigator was an added benefit in the tool construction. Prior to the
development of the tool the investigator consulted the experts in Peoples Hospital.

18

Based on the valuable suggestions of the experts and the review of literature the
investigator , prepared and organized the items of the tool under the respective areas.
Section A Socio Demographic Data
Section A consist of 8 items of the sample structured interview schedule to
collect baseline data, which consisted of socio demographic data for obtaining
formation about selected factors such as Age, Sex, education,

Occupation,

Income/month marital status and dietary habits; the previous knowledge of

hypertensive patients.
Section B consist of 24 questioner related to knowledge regarding hypertension.

3.9

CONTENT VALIDITY & RELIABILITY

Validity of the tool

Content validity refers to the degree to which an instrument measures what it is
supposed to measure ( Polit and Hungler 1999). The prepared tool along statement
objectives , hypothesis, operational definitions and criteria checklist.
Section A - Socio demographic data consisted 8 item . There was 100% agreement
of 8 items.

3.10 RELIABILITY OF THE TOOL

Reliability of the research instrument is defined as the extent to which the
instrument yields the same result on repeated measures. The tool was tested for
reliability on 12 respondents i.e. hypertensive patients.
The reliability was confirmed by using Karl Pearson coefficient that obtained r
= 0.85 which showed that the tool was reliable.
The correlation between the tool halves was obtained by using Karl Pearsons Coefficient correlation formula as follows:-

19

Where , X=odd items

Y=even items
n=no. of sample
Formula Karl Pearsons co-efficient correlation formula.
Spearman Brown Prophecy Formula was used to find-out the reliability of full test as
follow
Reliability = 2r/l+r
Where, r= correlation co-efficient
Formula-Spearman Brown Prophecy Formula.
The reliability of the tool was found to be (r=0.85) which indicated tool was reliable.

3.11 PILOT STUDY

Pilot study is a small scale dress rehearsal that precedes the actual study, except
for the fact, that subjects who will participate in the actual study are not used (B.T.
Basavanthappa 2003).
The pilot study was conducted in Peoples Hospital Bhopal. The written permission to
conduct the study was obtained from Medical Superintendent of Peoples was Hospital
Bhopal.
The Structured Interview was taken from 5 respondents who fulfilled the
sampling criteria. An informed consent was obtained from the respondents prior to the
interview. The average time taken for interviewing each subject was 20 to 30 minutes.

20

The analysis of the pilot study revealed that objectives of the study would be
fulfilled. Based on this information, the investigator proceeded with the actual data
collection for the main study.

3.12 DATA COLLECTION PROCEDURES FOR METHOD

Written permission was obtained from the Medical Superintendent of the
Peoples Hospital Bhopal prior the data collection. The study was carried out in the
same way as that of the pilot study. A total of 30 samples were selected for the study
who were in Peoples Hospital Bhopal.
The actual data collection period was from 14th April - 26th April 2014. The
investigator collected data from 30 hypertensive patients.
The purpose of the study was explained to the respondents and informed content
was obtained. Confidentiality was assured to all the subjects to get their cooperation. A
pre-test with the socio demographic data, modification questionnaire was given to a
total of 30 subjects following which a copy of the questionnaire was given to each
respondent with the instruction to read the structured pamplet thoroughly and come
prepared for the post-test.
Post-test was administered on the 8th day by using the same questionnaire.

3.13 PLAN FOR DATA ANALYSIS

Data analysis is the systematic organization and synthesis of research data and the
testing of research hypothesis using those data. The data obtained from 30 hypertensive
patient would be analysed using both descriptive and inferential statistics on the basis of
objectives and hypothesis of the study.
1. Socio-demographic data containing sample characteristics would be analyzed
using frequency and percentage.
2. The knowledge regarding hypertension among hypertensive patients before and
after the administration of the structured pamplet would be calculated using
frequency, mean, and standard deviation.
3. The association between knowledge and selected demographic factors. Would
be determined by the chi square test.

21

4. The significant difference between the mean pre-test and post-test knowledge
scores.
5. The data would be represented in the form of tables, bar diagram and pie
diagram.

3.14 SUMMARY
Research Methodology revealed the overall plan of research in a systematic and
scientific manner. This chapter dealt with description of the research design ,variables ,
settings , population ,sample & sample size sampling technique , sampling selection
,criteria, development and description of the tool , pilot study , procedure for data
collection and plan for data analysis . The analysis and interpretation of the same
method presente in

22

4. DATA ANALYSIS AND INTERPRETATION OF DATA

This chapter deals with the description of the samples characteristics, analysis
and interpretation of the data collected from the hypertensive patients of selected
Peoples Hospital in Bhopal city using an interview schedule. The analysis is the
categorizing, ordering, manipulating and summarizing of the data obtained regarding
answers to research questions.
The data were analyzed according to the objectives of the study using
descriptive and inferential statistics.
Objectives of The Study
1.

To assess the pre-test knowledge score regarding hypertension.

2.

To impart structured teaching programed.

3.

To assess post-test knowledge score regarding hypertensive patient.

4.

To find out association between pre-test knowledge score and selected

Socio-demographic variable

Hypothesis
H1.

There will be some knowledge regarding hypertension among hypertensive

patient

H2.

There will be significance difference between pre & post test score

4.1

INTERPRETATION OF FINDINGS

The data collected was organized and presented under the following sections.
Section I

Socio-demographic variables of the hypertensive patients.

Section II

Assessing the knowledge regarding hypertension among

hypertensive patient

23

Table No.1
Frequency and percentage distribution of subjects according to
Demo-graphic variables
N=30
Demographic Variables

Freque
ncy

Percentage

6
11
10
3

20%
36.66%
33.33%
10%

13
17

43.33%
56.66%

15
3
6
4
2

50%
10%
20%
13.33%
6.66%

28
0
2
0

93.33%
0%
6.66%
0%

5
4
8
5
8

16.66%
13.33%
26.66%
16.66%
26.66%

8
9
12
1

26.66%
30%
40%
3.33%

13
17
1
8
14
7

43.33%
56.66%
3.33%
26.66%
46.66%
23.33%

Age

20-35
36-50
51-65
66-80

Years
Years
Years
Years

Sex
Male

Female
Education

Illiterate
Primary
Secondary
Graduate
Post graduate

Marital status
Married
Unmarried
Divorced
Widow

Occupation
Farmer
Government job
Private job
Business
Unemployment

Income/month

< 5000
5001 10,000
10001 15000
> 15001

Dietary habit
Vegetarian
Non vegetarian
Previous knowledge
Mass media
Friend and Relatives
Health professional
Other

24

In this study 13 (43.33%) of the subjects were female and only 17 (56.66%) of
subjects were male because most of the male went for work and they were not available
during the data collection period.
Regarding education most of the subjects 15 (50%) subject were illiterate, 03
(10%) subjects were primary education, 6 (20%) subject were secondary,4 (13.33%)
subject were,2 (6.66%) post graduate.
Regarding marital status most of the subject 28 (93.33%) subject were married,0
(0%) subject were unmarried,2(6.66%) subject were divorced,0 (0%) widow
Regarding occupation 5 (16.66%) subjects were farmer, 4 (13.33%) subjects
were government job, 8 (26.66%) subjects were private job, 5 (16.66%) subject were
business, 8 (26.66%) subject were unemployed.
Most of the subject were 8 (26.66%) monthly income less than Rs.5000/-, 9
(30%) subjects had Rs.5001-10,000/- and 12 (40%) subjects had income Rs.1000115000 per month 1 (3.33%) subject had income above> Rs15000.
Regarding dietary habit, 13(43.33%) were vegetarian and subjects 17 (56.66%)
were non vegetarian. Regarding most of the previous knowledge 1(3.33%) subject
were mass media, 8 (26.66%) subject were friends and relatives, 14 (46.66%) subject
were health professionals ,7 (23.33%) subject were other were.

25

SECTION I
DISCRIPTION OF SOCIODEMOGRAPHIC DATA
Frequency and percentage distribution of age
N=30

Figure 3 Pie diagram showing sample distribution according to age

26

Frequency and percentage distribution of according to sex

N=30

PETRSENTAGE (%)
60
50
40
PETRSENTAGE (%)
30
20
10
0
Female

Male

Figure 4 Bar diagram showing sample distribution according to sex

27

28

Frequency And Percentage Distribution Of According To Education

N=30

PERCENTAGE ( % )

LITTIRATE
PRIMARY EDUCATION
SECONDARY EDUCATION
GRADUARTE
POST GRADUATE

Figure 5 Pie diagram showing sample distribution according to education.

29

Frequency And Percentage Distribution Of According To Marital Status

N=30

PERSENTAGE ( % )

Married
unmarried
Divorced
Widow

Figure 6 - Pie Diagram Showing Of Simple Distribution According To Marital Status

30

Frequency And Percentage Distribution Of According To Occupation

N=30

PERSENTAGE ( % )

Farmer
Government job
Privet job
Business
Unemployment

Figure 7 - Pie diagrame showing sample distribution according to occupation.

31

Frequency and Percentage Distribution Of According To Dietary Habits

PERSEN

N=30

32

Figure 8 -Pie diagram showing showing sample distribution according to dietary habit

Frequency And Percentage Distribution Of According To Income

N=30

33

PERCENTAGE (%)
27%
3%
40%
<50000

5001-10000

10001-15000

>15001

Figure 9 - Pie Diagram Showing sample distribution according to Income

34

Frequency and Percentage Distribution Of According To Previous Knowledge

N=30

PERCENTAGE( % )
3%
23%
27%

massmedia
health personal
frinds
other

47%

35

Figure 10 - Pie Diagram Showing sample distribution according Previous

Knowledge

36

Section II : Association between knowledge and selected demographic variables.

This section deals with the details of the analysis and interpretation done to find out the
association between knowledge and selected demographic variables of the patients.
Table No. 2
The association between knowledge and selected demographic variables of the
patients.
N=30
Sl. No.
1
2
3
4
5
6
7
8

Demographic
variable
Age
Sex
Education
Marital status
Occupation
Income
Dietary habit
Previous
knowledge

D
F
6
2
8
2
8
6
2

Chi square
value
5.80%
2.05%
3.13%
4.36%
8.80%
5.36%
0.17%

4.15%

probability

inference

0.46%
0.36%
0.93%
0.11%
0.36%
0.50%
0.92%

NS.
NS.
NS.
NS.
NS.
NS.
NS.

0.657

NS.

Table -2 reveals that the computed chi- square value shows significant association
between pretest knowledge regarding hypertension with hypertensive patient at the
level of > 0.05 and not found any significant association between pre-test knowledge
with other demographical variable like age , sex, education, status, occupation,
income ,dietary habit and previous knowledge2
NS = Not Significant Table t value p < 0.05 12.59 significant
No significant association was found between knowledge and selected demographic
factors/variables.

Section III
37

Assessing the knowledge regarding hypertension among hypertensive patients.

Table No. 3
Frequency and percentage , mean score, SD distribution of pre-test knowledge score
regarding of hypertension among hypertensive patients.

N=30
Pre- test Knowledge

Frequency

Percentage

Poor

14

46.66%

Average
Good

13
3

43.33%
10

Mean
Score

X= 9.33

SD
SD
=5.577

percentage
50.00%
45.00%
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%

percentage

poor

average

good

Figure 11 Bar diagram showing sample distribution according to Pre - test

38

39

Frequency and percentage , mean score, SD distribution of post- test knowledge

score regarding of hypertension among hypertensive patients.

N=30
Post- test
Knowledge
Poor

Mean
Frequency

Percentage

SD
Score

Average

10

33.33%

Good

20

66.66%

X=

SD=

17.83

3.410

Chart Title
25%
20%
15%
10%
5%
0%
poor

average

good

Figure 12 Bar diagram showing sample distribution according to Post - test

40

4.2

SUMMARY
Research Methodology revealed the oven of the research in a systematic and

scientific manner. This chapter dealt with description of the research design , variables
, settings , population , sample and sample size , sampling technique sampling
selection , criteria, development and description of tool , pilot study procedure for data
collection , and plan for data analysis .The analysis and interpretation of the same
method presented in the following chapter.

41

5. DISCUSSION
Discovery consists of seeing what everybody has seen and thinking what nobody
has thought.
(Albert Szent)
In this chapter findings of the study are discussed in line with objectives ,
review of literature and of other studies. Discussion of findings is based on the sample
characteristics, clinical information, knowledge of patients about hypertension,
effectiveness of individual planned teaching programme, association of knowledge and
selected variables.

I - Socio-demographic variables of the hypertensive patients

The finding of the study revealed that :
The findings of the study revealed the 06 ( 20% ) were in the age group of 20-35
years, subjects 11 ( 36.66% ) were in the age group of 36-50 years, 10 ( 33.33% ) were
in the age 51-65 years,03 ( 10% )were in the age group above 66-80 years.
In this study 13 ( 43.33% ) of the subjects were female 17 ( 56.66% ) of subjects were
male because most of the male went for work and they were not available during the
data collection period.
Regarding education most of the subjects 15 ( 50% ) were illiterate 3 (10%)
subjects were primary education, and 06 ( 20% ) subjects were secondary education 4
(13.33%) subject were graduate,2 ( 6.66% ) subject were post graduate.
Regarding marital status 28 ( 93.33% ) subject were married,0 ( 0% ) subject
were unmarried,02 ( 6.66% ) subject were divorced 0 ( 0% ) subject were widow.

42

Regarding occupation 05 ( 16.66% ) subjects were farmer 04 (13.33%) subjects were

govt.job 8 (26.66%) subjects were private job,5 (16.66%) subject were business 08
(26.66%) subject were unemployed.
Most of the subject were 08 (26.66%) monthly income less than Rs. 5000/-, 9
(30%) subjects had Rs. 5001-10,000/- and 12 (40%) subjects had income Rs.1000115000/- only 1 (3.33%) subject had> Rs.15,000
Most of the subjects 13 (43.33%) were vegetarian and only subjects 17
(56.66%) were non vegetarian.
Most

of

the

subject

previous

knowledge,

(3.33%)mass

media,8

(26.66%),subject were friendship and relatives 14 (46.66%), subject were health

professional 7 (23.33%) subject were others.
The above findings were supported by study done by Henrikson K.M. (2002) in
which he reported that the total of 628 men born in 1953 to 1954, all of whom were
surveyed at 20, 36 and 51,80 years of age at the same time of the year. The result
indicated that at 20, years of age, 243 men (39%) had normal blood pressure 167 (26%)
had high blood pressure and 218 (35%) were hypotensive.
To find out association between pre-test knowledge score and selected demographic factors/ variables.
Association between knowledge and demographic variables
The study shows that there is no significant relationship between age, sex, education
occupation, income, marital status, dietary habits and previous knowledge.
Thus the hypothesis formulated by investigator
RH1 - That there will be significant relationship between knowledge and demographic
factors/variables is rejected.
RH2 - That there will be knowledge regarding hypertension among hypertensive
patients has been retained.
II - Assessing the knowledge regarding hypertension among hypertensive patients.
The findings of the study revealed that majority of 13 (43.33%) patients had
average .knowledge, 3 patients (10%) had good knowledge and 14 patients (46.33%)
had poor knowledge.
The above findings is supported by Henderson A. (1998) conducting for
evaluating the effectiveness of two teaching strategies for patients diagnosed with
43

hypertension, samples was collected from 10 patient, 20 patients in the test group
received a structured education programme and received the usual information.
Comparison of the pre-test and post-test of the test group revealed a significant
increased in knowledge level at the time of discharge from hospital. The study showed
that a structured approach to health education is more effective in improving patients
knowledge.
The above findings is supported by Jasmine J. (1998) conducted a study to
assess the effectiveness of structured teaching on knowledge and life style adopted by
hypertensive patients. The samples were 30 male and female hypertensive patients
belonging to the age group 20-80 years.30 patients in Peoples Hospital Bhopal.
Findings of study revealed that patients who were exposed to structured teaching have
gained more knowledge and favorable
III - Evaluate effect of structured teaching among hypertensive patients.
Evaluate the effectiveness of Structured teaching among hypertensive patient
The findings of study revealed that high knowledge scores mean (9.33) in post-test
when compared to their pre-test scores mean (17.83). The mean difference (5.577) SD
(23.410) and shows a highly significant improvement in the knowledge scores, thus the
structured teaching pamplet was effective.

5.1

IMPLICATIONS
The findings of the present study have several implications in the field of

nursing education, nursing administration and nursing research.

Nursing Research
There is a need for extended and intensive nursing research in the area of physiological
areas of hypertensive patient. Specially in India only a few studies were reported
regarding hypertension. Extensive research is needed in this area so that nurses can
detect the hypertension that may lead to improve means of reduction of morbidity
mortality and prevent more severe complications and health problems.
Nursing Education

44

Prevention is better than cure. The health care personnel should be given an
opportunity to update their knowledge regarding hypertension, which is influenced by
hypertensive patients emotional make up, sociological, dietary habits and cultural
background and even his/her willingness to accept or reject of disease. Nurse educators
need to know about causes of hypertension, signs and symptoms, complications,
treatment and prevention of the hypertension. The effectiveness of structured teaching
programme through pamplet was informational aid to hypertensive patients for
prevention of complications.
Nursing Administration
The study helps to raise awareness among nurses and nurse educator to acquire
knowledge and to understand the importance of care of hypertensive patient.
Nursing Administration
The nursing administrators may use the structure teaching pamphlet to improve
their knowledge in order to ensure that the nurses may assume responsibility and
accountability of hypertensive patients under their care. A copy of the structured
teaching pamphlet may be provided to health worker and nurses planning to work in
any

peoples

hospital

during orientation programme. This shall ensure better

professional standard of nursing. Health administrator should make the education

department aware about the prevailing hypertensive patients care and should assign the
health workers or nurse to conduct health teaching in the Peoples Hospital Bhopal

5.3

LIMITATIONS
1. Purposive sampling was done which restricts the generalization of the study.
2. The size of the sample was only 30 patients hence
3. it is difficult to make a broad generalization.
4. A structured questionnaire schedule was used for data collection which
restricted the amount of information that could not be obtained from the patient.
5. No attempt was made to measure the retention of knowledge after the pre-test
and post-test i.e. feed-back due to time short.

5.3

RECOMMENDATIONS

On the basis of the findings of the study following recommendations have been
made further study.
1. A similar study may be replicated on a larger scale.
45

2. A comparative study may be conducted to find out the effectiveness of using

different teaching strategies and structured teaching programme regarding
the same topic.
3. The study can be replicated with a pre test
4. A study can be conducted to assess the knowledge and practices of other
chronic diseases like diabetic, Tuberculosis, Arthritis, Asthma e

5.4

SUMMARY
The findings of the present study were analysed and discussed with the findings

of the similar studies. This helped the investigator to proved that the findings were true
and the structured teaching pamplet was effective in improving knowledge.
It includes statement, objective, hypothesis, tool used for the study and the findings.
A study to evaluate effectiveness of structured teaching regarding hypertension
among hypertensive patients at selected Peoples Hospital Bhopal. The study made us
approach with one group pre-test post-test design. The population of the study consisted
of hypertensive patients at selected peoples hospital. Purposive sampling technique
was utilized to selected 30 hypertensive patients based on certain predetermine criteria.
Pre-test knowledge score and selected demographic factors/variables .
1.
2.
3.
4.

To assess the pre -test knowledge score regarding hypertension

To impart structured teaching programme
To asses post- test knowledge score regarding hypertension
To find out association between pre- test knowledge score and selected socio
demographic variable

HYPOTHESIS
H1. There will be same knowledge regarding hypertension among hypertensive
patient.
H2.

There will be significance difference between pre and post test scores.
The present study attempted to assess the knowledge regarding hypertension

among care hospital in hypertensive patient peoples hospital . The study made to use of
evaluator y approach with descriptive pre- test and post - test probability stratified
random sampling technique was 30 sample form peoples hospital Bhopal knowledge

46

assessment by using structured pamphlet and questionnaire. The collected data

analyzed by using descriptive and inferential statistics.
The result revealed that 33.33% have average 66.66% good knowledge and 0.0
% regarding hypertensive patient on the carrying out of study .The constant
encouragement guide , co-operation and inert of the respondents to participate to the
study ,contributed to the completion of the study.
Review literature was divided into three parts i.e., literature related to
hypertension, literature related to structured teaching programme and literature related
to evaluative study.
In research methodology pre experimental research approach using one group
pre- test and post- test design was adopted. The setting was Peoples Hospital Bhopal.
Populations were 30 hypertensive patients were selected by purposive sampling
technique, structured knowledge questionnaire was used to collect data. Pre-test was
given and planned teaching was given through pamlet on first day and after seventh day
post test was conducted.
The analysis and findings of this study shows that educating the hypertensive
patient will help them to improve their knowledge regarding hypertension. that there
was a highly significant difference between pre-test and post-test knowledge scores.

5.5

CONCLUSION

After the detailed analysis, this study leads to the following conclusions
Pre test mean knowledge score of hypertensive patient was 43.33(9.33) and
post- test mean knowledge score was 33.33 (17.83%).
Structured teaching through pamplet was an effective method of improving
knowledge of hypertensive patients.
There was no significance association was found between knowledge and
demographic factors/variables like age, sex, education, occupation, income,
marital status dietary habits and previous knowledge.

47

6. REFERENCES
1.

Bare B. Smltezer C. Suzanne. (2004), Text Book of Brunners Medical Surgical

2.
3.

Nursing 10th ed. London, Lippincott Williams & Wilkins.

Basavanthappa B.T. (2004), Medical Surgical Nursing, Delhi Jaypee brothers.
Basavanthappa, B.T. (2003), Nursing Research, 2nd ed., Jaypee Brothers

4.

Medical Publishers (P) Ltd.

Billings D. Gooem M.C. & Strokes (1782), Medical Surgical Nursing 7th ed.

5.

London, Mosby Co.

Black Joyce M. (2005); Medical Surgical Nursing, Volume 2, 7th ed.

6.

Singapore, W.B. Saunders Company.

Bloom Arnold, (1981), Tooheys Medicine for Nurses, 13th ed., The English

7.

Language Book Society and Churchill Livingstone.

Brunner and Suddarths (1999), Medical Surgical Nursing 7th ed; J.B.

8.

Lippincott Company, Philadelphia. New York London Hagerstown.

Calfee, R.C. and Valencia, R.R. (1999) APA guide sto preparing manuscripts for

9.
10.

journal publication. Washington, DC : American Psychological association.

Chapman Christine M. (1983), Medical Nursing 9th ed. N.R. Brothers India.
Clara, J. (2004), Effectiveness of Structured teaching on self care of pregnancy
induced hypertension among primipara mothers, Communicating Research

11.

Omayal Achi College of Nursing. 39-40.

Donvan, F. & Neighbors, M. (1998), Medical Surgical Nursing, 2nd ed.

12.

Philadelphia: W.B. Saunders Company.

Elhart Dorothy, (1984), Scientific Principles in Nursing, 8th ed. The C.V. Mosby

13.

Co. N.R. Brothers India.

Karch Amy M. (1997), Lippincotts Nursing Drugs Guide, Lippincotts

14.

Philadelphia, New York.

Kothari, C.R. (2006), Research Methodology. 2nd ed., New Delhi, New Age

15.

International (P) Limited, Publishers.

Lewis S.M. & Colli M. (1987); Medical Surgical Nursing 2nd ed. New York

16.

M.C. Ground Hill Co.

Luckman & Sorensen (1987), Medical Surgical Nursing 3rd ed. Philadelphia :
W.B. Saunders Company. Luckman, (1997), Sauders Manual of Nursing Care,
Philadelphia; W.B. Saunders Company.
48

17.

Luckmans (1890), Medical Surgical Nursing 2nd ed; Philadelphia W.B.

18.

Saunders Co.
Macleod John, (1974), Principles and Practice of Medicine. 11th ed, The

19.

English Language Book Society and Churchill Livingstone.

Mahajan B.K. (2002); Methods in Priostatisties, for medical students and

20.
21.

Research Workers, 6th ed, Jaypee Brothers Medical Publishers.

Mehta P.J. (1997), Practical Medicine. The National Book Depot, Mumbai.
Mosbys Medical Surgical Nursing & Allied health Dictionary (1994), 4th ed.

22.

New York, Mosbey.

Nalson R.M. (1997), Nurses Notes Medical Surigical Lippincott, Philadelphia.

23.

New York.
Parker; Marilyn E; Nursing Theories and Nursing Practice; Philadelphia; F.A.

24.

Davis Company.
Philip Wilma & Shafers J. (1980), Medical Surgical Nursing, 7th ed. St. Lewis,

25.

e.v. Mosby & Co.

Polit, D.F. & Hungler B.P. (1999); Nursing research principles and methods; 6th

26.

ed, Philadelphia, New York, Baltimore Lippinlott.

Raman A.V. (2004), Communicating Nursing Research, Omayalachi College of

27.

Nursing Avadi.
Smeltzer Suzanne, C. Medical Surgical Nursing, 10th edi.; Lippincott Williams

28.

Wilkings.
Swaminathan M. (2001), Food and Nutrition Volume II; The Banglore printing

29.

and Publishers Co. Ltd. N 88, Mysure Road, Banglore 560018.

Tgnataveius Donna, S. (1995), Medical Surgical Nursing, 2nd ed. Philadelphia;

30.

W.B. Saunders Company.

Watson Jeannettee. (1979), Medical Surgical and Related Physiology, 2nd ed.

31.

Philadelphia, W.B. Saunders Company.

Williams & Wilkins (2001) Menual of Nursing Practice, 7th ed. Lipincott.

49

JOURNALS
1. Biswas Tamal Kumars (2003). Managing Hypertension A real Challenge in the
New Millennium, J. Indian Med ASSOC Vol. 101, No. 4 pp 250-252.
2. Linnethe, Jutiana (2002). Conducted a study to evaluation of a problem based
Learning Package on Pregnancy Induced Hypertension for B.Sc. Nursing
Students, The Nursing Journal of India, Volume No. 11, pp 261-262.
3. Jaya Kumar R.V., (2004) Hypertension and Diabetes Mellitus, Health Action,
Volume No. 101, pp. 254-256.
4. Lee Young Shin, Laffery Shirley Clourier, (2006), conducted of study of
Physical Activity in older. Adults with Borderline Hypertension. Nursing
Research. March-April 2006 Vol. 55, No. 2 pp 110-112.
5. M. Prakasamma, (1997). Conducted a study to assess the knowledge and
learning needs of clients with hypertension; The Nursing Journal of India.
Volume No. 4, pp 74-76.
6. Soya, K. (2003). Conducted Study to Self care Activities of pregnancy induced
Hypertension and maternal outcome. The nursing Journal of India. Volume No.
3, pp. 58-60.
7. Yadav Rohtas K. (2002). A profile of Renal/Renovascular Abnormalities in
patients of Hypertension, J. Indian Med. Assoc Vol. 100, No. 6 pp 363-364.
ONLINE PERIODICALS
1. Eoin O Brien; Neil Atkins; Jan Staessen. (1995). A Review of Ambulatory
Blood Pressure monitoring Devices. Retrieved on 2nd Feb. 2007, from
http://www.ncbi.ncm.nih.gov/entrez/guery.
2. Singh R.B. (1990), Effect of diet and weight reduction in hypertension, 6 (4);
297-302,

Retrived

on

2nd

2007,

from

http://www.medscap.com/medline/abstract.
3. Vasam R.S. (1966), The progression from hypertension to congestive heart
failure,

Retrived

on

3rd

Feb.

2007,

from

http://www.medscap.com/

medline/abstract.
4. Zernike W. (1998), conducted a study to evaluating the effectiveness of two
teaching strategies for patients diagnosed with hypertension, 7 (1) : 37-44.
Retrived on 2nd Feb. 2007, from http://www.medscape.com/medline/abstract.

ANNEXURE - I
LETTER SEEKING PERMISSION FOR CONDUCT THE STUDY
50

To,

Subject - Request permission to conduct the pilot study and main study.
Respected mam,
We Bs.C (N) IVth year student of Peoples College Of Nursing And Research
Centre, Bhopal selected the following topic for research project to be submitted to
Barkatullah University ,Bhopal in partial fulfilment of the university of the university
requirement for the award of the Bachelor of Science in Nursing Degree.
Topic- A study to assess the effectiveness of Structured Teaching Programme
regarding hypertension among hypertensive patients

at Peoples Hospital Of

Bhopal City
Kindly grant permission to conduct the pilot study and main study on adults at
your area.

Thanking you
Yours Sincerely
Prof. (Mrs.) Karesh Prasad
Principal
PCN & RC, BHOPAL

ANNEXUR-II

51

LETTER REQUESTING FOR CONTENT VALIDATION OF THE TOOL .

Subject - Request for the content validation of the tool.

We the students of Bachelor of Science (Nursing),4th year and members of the
IInd group

of research(Medical Surgical Nursing Group) of Peoples College Of

Nursing And Research Centre, Bhanpur, Bhopal have taken a research project on A
study to assess effectiveness of

structured teaching programme on knowledge

regarding hypertension among hypertensive patients at peoples hospital of Bhopal

city. Which is to be submitted in Barkatullah University for the partial fulfilment of
university requirement for the award of Bachelor of Science (Nursing) degree.
We request you to kindly go through the content

and give your expert and valuable

opinion and suggestion for any modification and improvement. We also request your to
kindly sig the certificate that you have validated the tool. Your kind co-operation and
expert opinion will be very much appreciated.
Thanking you
Yours Sincerely
Principal
Group members -II
Prasad

Signature Of
Lt. col. (Mrs. ) Karesh
Principal, PCN&RC

Date:
Place: Bhopal

52

ANNEXURE-III

CERTIFICATE OF VALIDITY

This is to certify that the tool and Self Structured Teaching Programme by
group II, B.sc. Nursing 4th year student of Peoples College Of Nursing And Research
Centre, Bhopal (M.P.) to be

used in her research titled A study to assess the

effectiveness of structured teaching programme on knowledge regarding hypertension

among hypertensive patients at peoples hospital of Bhopal city. Has been validated by
me.

This tool is up to the mark and can be used for the above mentioned study.

Signature:
Name:
Designation:
Date:

53

ANNEXURE-IV

CERTIFICATE OF LANGUAGE TRANSLASTION

This is to certify that the tool used by the Research Group-II nd Medical Surgical
Nursing of B.Sc. Nursing 4th year of Peoples College of Nursing and Research
Centre ,A study to assess the effectiveness of structured teaching programme on
knowledge regarding hypertension among hypertensive patient at peoples hospital of
Bhopal city.
Bhopal for their data collection on the research study titled has been seen and
translated by us in Hindi. It yields the same meaning as in English.

SignatureNameQualification-

54

ANNEXURE-V
CONSENT FORM
I, Named.. agree to participate in the study, on A study to assess the
effectiveness of structured teaching programme on knowledge hypertension among
hypertensive patients at peoples hospital of Bhopal city. I have been explained and
made understood the purpose of the study. My participation in this study is entirely
voluntary and can withdraw from the study at any time as I wish .Researcher assured
that data will be kept confidential. However this information will be used in nursing
publication and presentations.

Place: Bhopal

Signature of the participant

Date:

Signature of Researcher

55

56

57

PEOPLES COLLEGE OF NURISNG AND RESEARCH

CENTER, BHANPUR, BHOPAL
QUESTIONNARIES
SECTION-A
Code No.

Date:

This questionnaire consists of two section

Section A Questionnaire related to Socio-Demographic variables
Section B Questionnaire regarding the knowledge of hypertensive patients

INSTRUCTIONS
1. Select only one alternative, which suits you, and tick mark ( ) against it.
2. Please do not leave any question unanswered.
3. Your answer will remain strictly confidential.

SOCIO DEMOGRAPHIC VARIABLES

1) Age (in Year)
a) 20-35
b) 36-50
c) 51-65
d) 66-80
2) Sexa) Male
b) Female
3) Educationa) Primary
b) Secondary
c) Graduate
d) Post graduate
4) Marital status
a) Married
b) Unmarried
c) Separat
d) Divorced
e) Widow
5) Occupationa) Farmer
b) Govt. job
c) Private job
d) Business
e) Unemployed
6) Monthly income (in rupees)-

58

(
(
(
(

)
)
)
)

)
(

(
(
(
(

)
)
)
)

(
(
(
(
(

)
)
)
)
)

(
(
(
(
(

)
)
)
)
)

a) <5000
(
b) 5001-10000
(
c) 10001-15000
(
d) >15001
(
7) Dietary habitsa) Vegetarian
(
b) Non vegetarian
(
8) Previous knowledge about hypertension is obtained through
a) Mass media (T.V. Newspaper)
(
b) Health professionals
(
c) Friends & relatives
(
d) Others
(

59

)
)
)
)
)
)
)
)
)
)

PEOPLES COLLEGE OF NURISNG AND RESEARCH

CENTER, BHANPUR, BHOPAL
QUESTIONNARIES
SECTION-B
Code No.

Date:

This questionnaire consists of two section

Section A Questionnaire related to Socio-Demographic variables
Section B Questionnaire regarding the knowledge of hypertensive patients

INSTRUCTIONS
1. Select only one alternative, which suits you, and tick mark ( ) against it.
2. Please do not leave any question unanswered.
3. Your answer will remain strictly confidential.
KNOWLEDGE REGARDING HYPERTENSION
1)

Meaning of hypertension
1) What is average range of blood pressure
a) 140/90mmhg
b) 120/80mmhg
c) 130/100mmhg
d) 150/100mmhg
2) What do you mean by hypertensiona) High blood pressure
b) Low blood pressure
c) Normal blood pressure
d) Average blood pressure
3) Which organs is affected by hypertension
a) Bone
b) Heart
c) Skin
d) Lungs

60

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4) How many stages in hypertension

a) Primary stage
b) Secondary stage
c) Both A&B
d) None
5) Which age group is mostly affected by hypertensionA) 10-30 years
B) 31-50 years
C) 51-70 years
D) 71-90 years
6)

7)

8)

9)

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CAUSES O HYPERTENSION
What is the cause of hypertension
a) Plevritis
(
b) Diabetes mellitus
(
c) Peptic ulcer
(
d) Shock
(
Which dietary factor can lead to hypertensiona) Pickle and papad
(
b) Gulab jamun
(
c) Tea & cold drinks
(
d) Chicken.
(
which systemic disease can cause hypertensiona) Renal disease
(
b) Skin disease
(
c) Respiratory disease
(
d) Reproductive disease
(
which type of medication increases the risk of hypertension
a) Birth control pills ( mala-D, Mala M)
(
b) Antipyretic ( Paracetamol )
(
c) Analgesic ( ibugesic plus )
(
d) Antiemetic( domperidone)
(

10) Which type of life style can lead to hypertensiona) Farmer

b) Labor
c) Sedentary workers (sitting work)
d) Students.

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SYMPTOMS OF HYPERTENSION
11) What is the average range og systolic blood pressurea) 100-110mmhg
b) 110-120mmhg
c) 120-130mmhg
d) 130-140mmhg
12) What is the average range of diastolic blood pressure
a) 160-70mmhg
b) 70-80mmhg
c) 80-90mmhg
61

d) 90-100mmhg
13) What is the main symptom of hypertension
a) Severe headache & dizziness
b) Blood spot in eyes
c) Itching & rashes
d) Loss of appetite
14) Which health problem is associated hypertension
a) Arthrosclerosis
b) Renal failure
c) Stroke
d) Arthritis
15) How can you identify that you have hypertension
a) Sweating, restlessness
b) Anxiety
c) Polyuria
d) Pyros is
16) Common methods used to diagnose hypertension
a) Checking B.P. at regular interval
b) USG
c) X-RAY
d) Blood test

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TREATMENT OF HYPERTENSION17) Which dietary factors can control hypertension.

a) Low sodium diets ( low salt intake)
(
b) High fat diet (samosa)
(
c) High fluid die (juices)
(
d) Low sweet diet ( low sugar intake)
(
18) When should you can yours doctor about hypertension
a) Itching
(
b) Stomach ache
(
c) Dehydration
(
d) Sweating & luring vision
(
19) How can you control hypertension
a) Limiting alcohol consumption
(
b) Regular aerobic exercise
(
c) Quit smoking
(
d) Proper medication
(
20) How long the anti-hypertensive drugs could be continues
a) Till sign & symptoms disappear
(
b) Life long
(
c) For 5 year
(
d) According to doctors advise
(
21) Which type of activity is required for hypertension
a) Strict bed rest
(
b) Self-case activities
(
c) Unsupervised ambulating
d) Light exercise & daily routine.

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22) What are the most important long term goal for a client & hypertension62

a) Learn how to avoid stress

b) Explore a job change & early retirement
c) Make commitment to ling term therapy
d) Take balanced diet
23) What is the dash diet ( dietary approach to stop hypertension)a) Eating more fruits vegetables and low fat diary floods
b) Spicy food high fluid intake
c) Eating food more sodium
d) Eating red meat & sweets
24) Which type of exercise helps to reduce hypertension
a) Brisk walling
b) Gymming
c) Yoga
d) Aerobic exercise
25) What is the side effect of hypertensive medication
a) Hemoptysis
b) While pigmentation of skin
c) Nausea
d) Sleep apnea

63

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bu lHkh esa pkj [k.M gSa muesa ls vkidksa tks mfpr yxs ml
[k.M esa lgh dk fpUg yxkb;sA
Hkkx v
O;fDrxr tkudkjh ls lacaf/kr izu gSA
1- mez o"kZ esa
1- 20&35
2- 36&50
3- 51&65
4- 66&80
2- fyax
1- iq#"k
2- L=h

3- ;ksX;rk
1- vf'kf{kr
2- izkFkfed
3- ek/;fed
4- Lukrd
5- mPp LukdksRrj

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2- fookfgr
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4- rykd 'kqnk

64

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2- ljdkjh ukSdjh

3- vLFkkbZ ukSdjh

4- O;kikjh

5- csjkstxkj

6- ekfld vk;
1- 0&5000

2- 5001&15000

3- 10001&15000

4- 15001

7- vkgkj dh vknr
1- 'kkdkgkjh

2- Eklkgkjh

8- mPp jDr pki ds ckjs esa tkudkjh fdlds }kjk feyrh

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2- nksLr ;k fjrsnkj
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1- jDr pki dk eryc jDr pki esa tkudkjh gksrh gSA
1- 140@90 ,e-,e- ,pth

2- 120@80 ,e-,e- ,pth

3- 130@100 ,e-,e-,p th

4- 150@100 ,e-,e-,pth

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65

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2- 31&50
3- 51&70
4- 71&90

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8- mPp jDr pki fdl lkoZanSfgd jksx ds dkj.k gks ldrk

gSA
1- xqnsZa dh chekjh

2- Ropk dh chekjh

66

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4- 'olu ra= dh chekjh

9- izatuu ra= dh chekjh fdl rjg dh nokbZ;ksa ls

jDrpki c<+us dk [krjk gksrk g SA
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gSa
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2- etnwj
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1100&110

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gSA
1- 60&70
2- 70&80
3- 80&90
4- 90&100

67

68

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14-

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gksrk gSa
1- /keuh dyk dkfBU;
2- xqnsZa [kjkc gksuk

3- v|kr
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mPp jDrpki gSA

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69

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2-

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70

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2- isV esa nnZ gksus ij

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19- vki dSls mPp jDrpki dks fu;af=r dj ldrs gSA

1- lhfer efnjk lsou

2- fu;fer ,jksfod O;k;ke

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1- tc rd fd ladsr vkSj y{k.k lekIr u gks tk,

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4- fpfdRld dh lykg ds vuqlkj

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gksrh gSA
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71

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72

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gksrs gS\
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4- lksrs le; 'okl dk #dukA

73

ANSWER KEY

NO. Of
Item
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

Correct Response

Maximum Score

B
A
B
C
B
B
A
A
A
C
B
B
A
A
A
A
A
D
D
D
D
D
A
D

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

74

KNOWLEDGE ASSESSMENT CRITERIA

0-8 Poor Knowledge

9-16 Average Knowledge
17-24 Good Knowledge

75