METHODOLOGY 1.

Research Approach: A descriptive, quantitative survey approach was used to assess the knowledge and attitude regarding prevention and management of pressure ulcers among trained nurses. 2. Research Design: A non-experimental descriptive research design was adopted to assess the knowledge and attitude among trained nurses regarding prevention and management of pressure ulcers in Shri Guru Ram Dass College of Nursing, Hoshiarpur, Punjab. Independent Variables Age Previous Academic Performance Work Experience Special Training

Dependent Variables: Knowledge of trained nurses regarding prevention and management of pressure ulcers. 3. Attitude of trained nurses regarding prevention and management of pressure ulcers.

Research Setting: The study was conducted in Shri Guru Ram Dass College of Nursing, Hoshiarpur. It is one of the reputed nursing institutes in Punjab. The courses which are running in this college are: G.N.M. B.Sc. Nursing Post Basic (B.Sc. Nursing) M. Sc. Nursing

4.

Target Population:

Target population comprises of trained nurses studying in Shri Guru Ram Dass College of Nursing, Hoshiarpur. The total number of population is 40 students. 5. Selection of Sample & Sample Size Convenient sampling was used to select size of sample of trained nurses. 6. Criteria for Sample Selection a. Trained nurses studying in Post Basic B.Sc. Nursing first year. b. Students willing in participate in study after stratification were included. 7. Development and Descriptive of Tool A self structural tool was developed to assess knowledge and attitude of trained nurses regarding prevention and management of pressure ulcers. The tool was developed after through review of literature and in consultation with experts in field of nursing. Description of Tool: Section A: It consist of items to collect demographic data of trained nurses, such as age, previous academic performance, work experience, special training. Section B: It consist of multiple choice questionnaire section-B to assess the knowledge of trained nurses regarding prevention and management of pressure ulcers. It consist of 28 items. Section B2: Section C: It consist of True/ False questionnaire 20 items. It consist of opinionnaire comprising 12 items to assess the attitude of trained nurses toward prevention and management of pressure ulcers. 8. Content Validity of Tools: Content validity of tool was established by obtaining the valuable opinion and suggestion from experts in the filed of medical, surgical, community health nursing, paediatric nursing and psychiatric nursing. The suggestion were incorporated after consultation with supervision the multiple choice questionnaire was finalized with 28 items and 20 items of True/ False for assessment of knowledge opionionnaire was finalized with 12 items for assessment of attitude among trained nurses.

9.

Pilot Study: The pilot study was conducted during the month of February to determine the reliability of tool and feasibility of study. The sample size in pilot study was trained nurses in Shri Guru Ram Dass College of Nursing, Hoshiarpur.

10.

Reliability of Tool Reliability was obtained/ calculated using split half/ test-retest method. Reliability of tools to assess both the knowledge of trained nurses regarding prevention and management of pressure ulcers was found to be 0.9.

11.

Criterion Measures Criterion measures used in study are as follows: Assessment of Knowledge (Section B1): There are 28 items to assess the knowledge regarding prevention and management of pressure ulcers among trained nurses:

S. No. a. b. c. d.

Level of Knowledge Excellent Good Average Below average

Percentage 76% 61.75% 51.60% 50% Minimum Score = 0

Maximum Score = 28

80% 70%

76%

61.75% 51.60% 50%

Percentage of Knowledge

60% 50% 40% 30% 20% 10% 0%

Percentage

Excellent

Good

Average

Below Average

Level of Knowledge

Section B2:

There are 20 items of True/ False questions to assess the knowledge regarding

prevention and management of pressure ulcers among trained nurses. S. No. Level of Knowledge a. Excellent b. Good c. Average d. Below average Maximum Score = 20 Percentage 76% 61.75% 51.60% <50% Minimum Score = 0

80%

76% 61.75% 51.60% 50%

Percentage of Knowledge

70% 60% 50% 40% 30% 20% 10% 0%

Percentage

Excellent

Good

Average

Below Average

Level of Knowledge

Assessment of Attitude: There are 12 items to assess attitude regarding prevention and management of pressure ulcers among trained nurses.

S. No. Level a. Highly positive attitude b. Positive attitude c. Negative attitude Maximum Score = 60

Percentage > 80% 70-80% <70 Minimum Score = 12

60%

60%

50%

Percentage of Knowledge

40.00%

40%

30%

20%

Percentage

10%
0%

0%

Highly +ve attitude

Moderately +ve attitude

-ve attitude

Level of Knowledge

12.

Ethical Consideration: A formal written permission to conduct the study was taken from Principal, Shri Guru Ram Dass College of Nursing, Hoshiarpur. The purpose of study was explained to respondents and verbal constent was taken from them.

13.

Data Collection Procedure: Data collection procedure was carried out from 27.02.2012 to 28.02.2012 before data collection formal permission was obtained from Principal, Shri Guru Ram Dass College of Nursing, Hoshiarpur from for conduction of the study in the college, convenient sampling was used to collect the sample of 40 trained nurses. On 27 Feb, 2012, the researcher meets the students and explained them the purpose of their selection. Thereafter, the tools was administered to all students. It took 45 minutes for students to complete the tool.

14.

Analysis of Data: The analysis of data was done in accordance with the objective of the study. The data was analyzed by using discipline and inferential statistics by calculating the frequency, percentage, mean percentage, standard deviation, t-test

SECTION-I DEMOGRAPHIC VARIABLE TABLE-I Percentage distribution of sample characteristics demographic variable
DEMOGRAPHIC VERIABLES 1) a) b) a) b) c) a) b) a) b) AGE IN YEARS 20-25 26-30 <60% 61-70% 71-80% WORK EXPERIENCE < 2 years > 2 years SPECIAL TRAINING No Yes 20 20 50 50 28 30 70 30 N 36 4 2 10 28 % AGE 90 10 5 25 70

PREVIOUS ACADEMIC PERFORMANCE

Age:- Majority of trained nurses i.e. 90% belong lotus age group of 20-25 years, 10% of Trained nurses belong to the 26-30 years.

Previous Academic Performance:- Maximum trained nurses 70% have their academic performance between 71-80% and 25% of trained nurses have their academic performance between 61-70% and 5% of trained nurses have their academic performance between <60%.

Work Experience:- Maximum trained nurses 70% have their work experience of < 2 years and 30% of trained nurses have their work experience of > 2 years.

Special Training:- 50% of trained nurses have attended special training and 50% of trained nurses have not special training regarding prevention & management of pressure ulcers.

10% 20-25 years 26-30 years

90%

(a) Percentage distribution of sample characteristics according to age.

5% 25%

<60% 61-70% 71-80%

70%

(b) Percentage distribution of sample characteristics according to previous academic performance.

30% < 2 years > 2 years

70%

(c) Percentage distribution of sample characteristics according to work experience.

No Yes 50% 50%

(d) Percentage distribution of sample characteristics according to special training.

Section-II (B-I) Objective:- To assess the knowledge regarding prevention & management of pressure ulcers among trained nurses. Table- 2-(I) Percentage distribution of trained nurses according to level of knowledge regarding prevention & management of pressure ulcers. Level of Knowledge
a) b) c) d) Excellence Good Average Below Average

Criterion Measure
>76% 61-75% 51-60% <50%

N
2 13 18 7

% age
5% 32% 45% 17.5%

Maximum Score=28

Minimum Score=0

45 45 40 35 30 25 20 15 10 5 0 32 17.5 Percentage 5% Excellent Good Average Below Average

Percentage of Knowledge

Level of Know ledge

Table 2-(I) shows to percentage distribution of the knowledge score according to criterion measure and it shows that 45% of trained nurses had average knowledge and 32% have good knowledge and 5% of trained nurses had excellent knowledge and 75% of trained nurses had below average knowledge regarding prevention & management of pressure ulcers. So our assumption trained nurses have average knowledge regarding prevention & management of pressure ulcers is proved.

Table-2 (II)

Percentage distribution of trained nurses according to level of Knowledge regarding prevention & management of pressure ulcers. Level of Knowledge
a) b) c) d) Excellence Good Average Below Average

Criterion Measure
>76% 61-75% 51-60% <50%

N
6 18 14 2

% age
15% 45% 35% 5%

45 45 40 35 30 25 20 15 10 5 0 35

Percentage of Knowledge

15 5 Percentage

Excellent

Good

Average

Below Average

Level of Know ledge

Table 2- (II) shows the percentage distribution of the knowledge score according to criterion measure and it shows that 45% of trained nurses had good knowledge, 35% of trained nurses had average knowledge, 15% of trained nurses had excellent knowledge and 5% of trained nurses had below average knowledge regarding prevention & management of pressure ulcers. So our assumption trained nurses have good knowledge regarding prevention and management of pressure ulcers is proved.

Section III, (C) Objective 2:- To asses the attitude regarding prevention and management of pressure ulcers among trained nurses. Table 3 Percentage distribution of trained nurses according to attitude scores regarding prevention and management of pressure ulcers. Level of Knowledge
a) b) c) Highly Positive Moderately Positive Negative attitude

Criterion Measure
>80% 70-80% <70%

N
8 25 7

% age
20% 62.5% 17.5%

Maximum score=60 Minimum Attitude score=12

70 60 Percentage of Knowledge 50 40 30 20 10 0 Highly Positive 20

62.5

17.5 Percentage

Moderately Postive

Nagative Attitude

Level of Know ledge

Table 3 shows that 25 trained nurses (2.5%) have moderately the attitude toward prevention and management of pressure ulcers and 8 trained nurses (20%) have highly positive attitude and 7 trained nurses (17.5%) had negative attitude toward the prevention and management of pressure ulcers. So our assumptions trained nurses have positive attitude regarding prevention and management of pressure ulcers is proved.

Level of attitude Fig 4, percentage distribution of trained nurses according to attitude scores regarding prevention and management of pressure ulcers Objective 3:- To find out the relationship of knowledge (Section-B) regarding prevention and management of pressure ulcers among trained nurses with selected variable such as age, previous academic performance, work experience, special training. Table-4(a) Section B1 Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to age.
Mean Knowledge score Age (Years) a) b) 20-25 26-30 n 36(90)% 4(10)% df(b,a) 38 Mean 15.8 17.25 S.D. 3.2 0.829 t 5.18***

Maximum score=28 Minimum score=0 Significance at .100, .050, .005

90 90 80 70 60 50 40 30 20 10 0

Percentage of Knowledge

Percentage 10

20-25 years

26-30 Year

Level of Know ledge

Table (a) show that the trained nurses in the age group of 26-30 had higher mean knowledge score is 17.25. But the difference in the mean score of both the age group is statistically significant. Hence it can be inferred that age had an impact of knowledge among trained nurses regarding prevention and management of pressure ulcers.

Table 4 (b) Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to previous academic performance. Previous academic performance mean knowledge score:N=40
Mean Knowledge score n a) b) c) <60% 61-70% 71-80% 2(5%) 10(25%) 28(70%) df(b,a) 10(a,b) 36(b,c) 28a,c df 38 Mean 17 18.1 16.57 t ab=2.25 ac=1.10 bc=7.28 S.D. 0 2.02 2.92 t 2.25 7.28 1.10

Maximum score = 28

Minimum score = 0

70 70 Percentage of Knowledge 60 50 40 30 20 10 0 5 25 Percentage

<60%

61-70%
Level of Know ledge

71-80%

Table 4(b) shows that trained nurses of 61-70% had higher mean knowledge score (18.1) that <60% and 71-80% (16.57%) or than trained nurses with their academic performance between <60%(17) and 71-80% (16.57). The difference between mean score of knowledge of as is significant at the level of .010 & not significant at the level of .0058.050. The knowledge score of i.e. is significant knowledge score of ac is not significant.

Table 4 (c) N=40

Work experience Years a) b) <2 years > 2 years n 28(70%) 12(30%) df(ba) 38 Mean Knowledge score Mean 16.5 12.5 S.D. 2.51 4.9 t 13.33***

Maximum score = 28

Minimum score = 0 Significant at .010. .005, and .050.

70 70 Mean Knowledge Score 60 50 40 30 20 10 0 30 Percentage

< 2 Years

> 2 Years

Level of Experience

Table 4(c) shows that trained nurses of work experience <2years had highest mean knowledge score (16.5) than the trained nurses of work experience >2 years (12.5). The difference between the mean score of both the work experience is statistically significant. Hence it can be inferred that work experience had an impact on knowledge of trained nurses.

Table 4(d) Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to special training.
Special training n a) b) No Yes 20(50%) 20(50%) df(ba) 38 Mean Knowledge score Mean 17.2 16.75 S.D. 2.90 2.47 t 2.36

Maximum score=28

Minimum score=0 Significant at the level of .010

50 50 45 40 35 30 25 20 15 10 5 0

50

Mean Knowledge score

Percentage

NO

YES

Level of special training

Table 4(d) shows that trained nurses have their special training of No had highest mean knowledge score (17.2) than the trained nurses have their special training of yes (16.75). The difference between the mean score of both special training is statistically significant at the level of .010, Hence it can be inferred that special training had an impact on knowledge of trained nurses. Section B (II) To find out the relationship of knowledge II (Section-B-II) regarding prevention and management of pressure ulcers among trained nurses with selected variable such as age, previous academic performance, work experience and special training.

Table-5(a) Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to age. N=40
Mean Knowledge score Age (Years) a) b) 20-25 yrs 29-30 yrs n 36(90%) 4(10%) (b,a) df(ba) 38 Mean 13.19 13.25 S.D. 1.82 1.63 t 0.3

Maximum score=20

Minimum score=0 NS =not significant.

90 90 80 Mean Knowledge score 70 60 50 40 30 20 10 0 10 Percentage

20-25

25-30

Table 5(a) shows that trained nurses in the age of group of 26-30 yrs had higher mean knowledge score than 20-25 yrs. But in the difference in the mean score of both the age group is not statically significant. Table 5(b) mean knowledge score of trained nurses regarding prevention and management of pressure ulcers.
Previous academic performance n a) b) c) <60% 61-70% 71-80% 2(5%) 10(25%) 28(70%) df(ba) 10(ab) 36(bc) 28(ac) Mean Knowledge score Mean 11.5 13.2 13.32 S.D. 0.5 1.88 1.79 % age 4.25 (ab) 0.4 (bc) 7.28 (ac)

Maximum score=20

Minimum score=0

70 70 Mean Knowledge score 60 50 40 30 20 10 0 5 25 Percentage

<60%

61-70%

71-80%

Previous academ ic performance

Table 5(b) shows that trained nurses have their academic performance between 71-80% had highest mean knowledge score (13.32) than the trained nurses with their academic performance between 61-70% (13.2) and <60%(11.5). The knowledge score of ab and ac is significant. The knowledge score if bc is not significant.

Table 5(c) Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to work experience. N=40
Work experience n a) b) <2 years >2 years 28(70%) 12(30%) df 38 Mean 13.3 12.5 S.D. 1.65 4.958 Significant at the level of .010 t 2.35*

Maximum score = 20 Minimum Score=0

70 70 Mean Knowledge score 60 50 40 30 20 10 0 30 Percentage

<2 years

>2 years
Work Experience

Table 5(c) shows that trained nurses of work experience <2 years had highest mean knowledge score (13.3) than the trained nurses of work experience >2 years (13.3). The difference between the mean score of both the work experience is statistically significant at the level of .010. Hence it can be inferred that work experience had and impact on knowledge of trained nurses.

Table-5(d) Mean knowledge score of trained nurses regarding prevention and management of pressure ulcers according to special training. N=40
Special training n a) b) No Yes 20(50%) 20(50%) df(ba) 38 Mean 13.6 S.D. 1.95 t 6.15***

Maximum Score=20 Minimum score=0

12.8 1.69 Significant at the level of .010,.100,.005

50

50

Mean Knowledge score

50 45 40 35 30 25 20 15 10 5 0

Percentage

NO

YES

Level of special training

Table 5(d) shows that trained nurses have their special training of NO had highest mean knowledge score (13.6) than trained nurses have their special training of YES (12.8). The difference between the mean score of both special training is statistically significant. Hence, it can be inferred that special training had impact on knowledge of trained nurses. Objective-4:- To find out the relationship of the attitude regarding prevention and management of pressure ulcers with selected variables such as age, previous academic performance, work experience and special training. Table-6 (a) Mean attitude score of trained nurses regarding prevention and management of pressure ulcers according to age.
Mean Attitude score Age (Years) a) b) 20-25 yrs 26-30 yrs N 36(90)% 4(10)% df(ba) 38 Mean 46.25 42.75 S.D. 3.26 1.20 t 17.5**

Maximum score =60 Minimum Score=12

100 Mean Knowledge score 80 60 40 20 0 20-25 26-30 Level of special training
10 90

Significant at level .100,.010,.005

Percentage

Table 6 (a) shows that mean attitude score was highest among age group of 20-25 years (46.25) as compared to age group of 26-30 (42.75) respectively. The difference between their groups was statistically significant. Hence, the age had impact on the knowledge of the students. Table-5 (6) Mean attitude score of trained nurses regarding prevention and management of pressure

ulcers according the previous years academic performance.

Previous Academic performance N a) b) c) <60% 61-70% 71-80% 2(5%) 10(25%) 28(70%) df(ba) 10(ab) 36(bc) 28(ac) Mean attitude score Mean 45 42.1 47.32 S.D. 4 2.38 2.25 2.54(ab ) 27.47(bc) 3.68(ac) t

t =2.54,ac=3.68. bc=27.47

Maximum score=60

Minimum score = 12

70 70 Mean Knowledge score 60 50 40 30 20 10 0 5 25 Percentage

<60%

61-70%

71-80%

Previous academ ic performance

Table 5(6) shows that trained nurses having academic performance between 71-80% had higher mean attitude score 47.32 than trained nurses having academicp erformance <60% (45) and 6170% (42.1). The mean attitude score of ab is at significant at .010. The mean attitude score of bc and ac is significant.

Table 5 (c) Mean attitude score of trained nurses regarding prevention and management of pressure ulcers according to work experience.
Work experience N a) b) <2 years >2 years 28(70%) 12(30%) 38 Mean Knowledge score df(ba) Mean 45.8 45.9 . S.D. 3.6 2.17 NS= not significant 0.5 t

Maximum score=60 Minimum score=12

70 70 Mean Knowledge score 60 50 40 30 20 10 0 30 Percentage

<2 years

>2years

Previous academ ic performance

Table 5 (c) shows that trained nurses of work experience >2Years had highest mean attitude score (45.8). The difference between the mean attitude score of both the work experience is not statistically significant. Hence it can be inferred that work experience had no impact on attitude of trained nurses.

Table 6 (d) Mean attitude score of trained nurses regarding prevention and management of pressure ulcers according to special training.
Special training N a) b) No Yes 20(50%) 20(50%) df(ba) 38 Mean 45.45 46.35 Mean Knowledge score S.D. 2.08 4.11 Significant .100, .010, .005 12.85*** t

Maximum score= 60 Minimum score=12

50 50 45 40 35 30 25 20 15 10 5 0

50

Mean Knowledge score

Percentage

NO

YES
Special Training

Table 6(d) shows that trained nurses have their special training of Yes had highest mean attitude score (46.35) than trained nurses have their special training of NO (45.45). The difference between the mean score of both special training is statistically significant. Hence, it can be inferred that special training had an impact on attitude of trained nurses.