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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.

"A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING VARICOSE VEIN AND IT’S MANAGEMENT AMONG TEACHERS IN SELECTED SCHOOLS AT BANGALORE".

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

SUBMITTED BY:
Mrs. ROSHIN .M .J

I YEAR M.Sc. NURSING

MEDICAL SURGICAL NURSING

SRI SHARADA COLLEGE OF NURSING

BANGALORE- 560061.



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,


BANGALORE, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION


1.


NAME OF THE CANDIDATE

AND ADDRESS

Mrs. ROSHIN .M .J

I YEAR M.Sc NURSING,

SRI SHARADA COLLEGE OF NURSING,

BANGALORE-560061.



2


NAME OF THE INSTITUTION

SRI SHARADA COLLEGE OF NURSING,

UTTARAHALLI MAIN ROAD,

BANGALORE-560061.




3


COURSE OF STUDY AND SUBJECT

MASTERS DEGREE IN NURSING

MEDICAL SURGICAL NURSING



4

DATE OF ADMISSION TO COURSE

13.06.2012





5


TITLE OF THE STUDY


A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING VARICOSE VEIN AND IT’S MANAGEMENT AMONG TEACHERS IN SELECTED SCHOOLS AT BANGALORE.




6. BRIEF RESUME OF THE INTENDED WORK:

INTRODUCTION:

The work environment constitutes an important part of man’s total environment. Health to a large extend is affected by work conditions. Occupational environment too place a major role on the health of the exposed. The health hazards get more severe when the duration of exposure increases. 1

Millions of workers spend majority of the working day on their feet and many hours in static positions. Prolonged standing can lead to tiredness, loss of concentration and increased health risks such as the swelling of feet and legs, feet and joint damage, varicose veins, heart and circulatory disorders, lower back problems. Severe varicose veins can have an impact on the lives of the people who work on their feet especially the teachers, nursing staffs, flight attendants, dental staff, traffic and bar workers, postal workers, construction workers and bank staff. 2

The teachers are the main pillars of a sound and progressive society. They bear the weight and responsibility of the teaching and apart from parents, are the main source of knowledge and values for children. There are a lot of problems faced by the teachers standing most of the working day and it has a great effect on the lower limbs that is it can damage the joints, make muscles ache and major condition affecting is ‘varicose veins’.3 It is estimated that 10-20% of the general population has varicose veins. 4

As blood rushes through our legs the veins send it back to the heart. A case of prolonged standing, do to force of gravity, the veins lose their ability push the blood upwards, causing the blood to settle down in certain areas of the veins. 5

Varicose veins are tortuous, distended and bulging veins (varicosities) beneath the skin of the legs. They are most often swollen, gnarled veins that most frequently occur in the legs, ankles and feet. 3 Even though the exact cause of varicose veins is unknown, there are some risk factors which contribute to development of this problem. Some of the risk factors are, low physical activity, smoking, family heredity of varicose veins, Congenital valve or vein wall defects, Valve damage from trauma, obstruction, deep vein thrombosis (DVT), or inflammation, Chronic venous distention associated with occupation requiring prolonged standing, obesity, or pregnancy , Systemic conditions that interfere with venous return and Loss of vein wall elasticity with aging. 6, 36

The recent statistics shows that about 25% of the women and 18% of men suffer from varicose veins. 7 60% of the leg ulcers are due to varicose veins. Almost 2, 00,000 reports lower limb symptoms caused or made worse by job. The Health and Safety Executive’s (HSE) latest estimates of the extent of occupational ill- health in the teachers in UK show musculoskeletal disorders are the most common causes of teacher’s related ill-health and that 17 percent of these disorders affected lower limbs. It is been estimated that not only the teachers nearly 1,92,000 people in UK are suffering occupational lower limb disorders caused or made worse by their work. 8

According to the World Health Organization statistical information system nearly 177 deaths per year occurred in US, 152 deaths per year in Germany due to varicose veins. If left untreated, 50% of the patients will eventually experience complications such as chronic venous insufficiency, thrombophlebitis and cellulitis. 9

Varicose veins tend to get worse over time. You can ease discomfort and slow varicose veins from getting worse by taking care of them. 10, 11 Complications of varicose veins, although rare, can include Ulcers and blood clots. 12

Common surgical technique for treating superficial varicose veins is “vein stripping” - where the affected vein is completely removed. At the completion of surgery, the incisions in the skin are closed with small stitches to minimize scarring. Bandages or elasticized stockings are then applied for up to six weeks to gently compress and support the leg and to reduce swelling. Other surgical treatments for varicose veins are Mini-stab avulsion, Endoscopic vein surgery, Trans illuminated Powered Phlebectomy, Catheter assisted procedures, Laser surgeries and Ambulatory phlebectomy. 12, 36

As varicose veins cannot be cured, the best course of action is prevention. some self-care measures that can help in the prevention of varicose veins are Avoiding crossing the legs when sitting, Exercising regularly, Maintaining a healthy body weight, Avoiding tight clothing that constricts the legs, groin or waist eg: knee high pantyhose, Avoiding constipation, When standing for long periods, shifting weight from one leg to the other every few minutes, elevating legs, Eating a high-fiber, low-salt diet, Avoiding high heels and tight hosiery, Changing your sitting or standing position regularly and avoiding long periods of standing or sitting can ease pain and prevent varicose veins from getting worse .12, 13,14

Non-medical treatments are more effective for milder cases of varicose veins. Some of these treatments are acupuncture and acupressure, aromatherapy, compression stockings, massage, healthy diet, vitamins and so on. Alternating between hot and cold baths (hydrotherapy) can help with the blood circulation.15



6.1. NEED FOR THE STUDY:

A study from Southern California, venous problems were present in 33 percent of women and 17 percent of men. Varicose veins occur almost as often in women as in men, however, spider veins were more frequent in women. A large U.S. survey, the Framingham study, reported that 27 percent of the American adult population had some form of venous disease in their legs. It is estimated that at least 20 to 25 million Americans have varicose veins.16 Interesting statistics show that over the age of 50, 1 of 2 people is affected by veins. 17



It is estimated that 10 to 20% of the general population of India eventually develop this disorder in the course of life. It is much more common in the age groups over 50, in which the incidence may reach a figure of 50% of individuals. Over the age of 30, females are affected four times more commonly than males, a reflection of the venous stasis in the lower legs caused by pregnancy. Many women develop varicose veins during pregnancy. In fact, it has been estimated that as many as 40% of all pregnant women suffer from varicose veins. 18

Current statistics reveal that nearly 2.7 million people worldwide, suffer from varicosites and the toll is ever increasing. According to Dr Ravinder Singh Ranger, Consultant Vascular, Endovascular and General Surgeon, Great Western Hospital, UK, says that the recurrence rate of varicose vein now gone up to 25 per cent . 19

Indian experts are witnessing a growing prevalence of varicosites especially among women. Nearly, 20-15 per cent of women and 10-15 per cent of men suffer from varicose veins in India. Dr Rajiv Parekh, Chairman, Maulana Azad Medical College, Delhi, explaining the causes of varicose veins says, "Varicose veins these days are very common in the younger population, especially among young pregnant women and women who have just delivery babies. This is an effect of long standing or sitting hours. 19

The prevalence of varicose veins increases with age. A study result shown that, 40-year-olds had a prevalence of 22%, 50-year-olds a prevalence of 35%, and 60-year-olds a prevalence of 41%. A genetic link exists, and the risk of varicose veins developing if both parents are affected is 90%; 62% risk if 1 parent is affected and female offspring; 25% risk if 1 parent is affected and male offspring; and if no parent is affected, the risk is 20%.20

A cohort study was done to assess the prevalence and extent of treatment of varicose veins by using mailed questionnaires to every resident that is 3284 men and 3590 women living in Tampere, Finland. The result found was the life time prevalence of varicose veins was 18% for men and 32% for women. 25% of men and 41% of women who reported varicose vein had received treatment. Thus the researcher concluded that prevalence of varicose veins was high in the studied population and that preventive measures also were required because treatment alone seems to be inadequate in control of varicose veins. 21

Dr Alaap Shah of Mission Health said they were prompted to do the study on prevalence of varicose veins in teachers when they noticed more numbers from this fraternity frequenting their vein clinic, the first non-surgical centre to treat varicose veins. Usha Nambidi, 40, a teacher in Asia School, was the first who kick started the study. Nambidi came with the complaint that the legs were killing her as she stood non-stop for seven to eight hours daily at school. After school, she would invariably also spend more time standing at home in the kitchen. Treating Nambidi opened a Pandora’s box as more teachers approached the clinic with similar problems. This led to a wider study covering more teachers. Dr Shah says the disease is more prevalent among women and preventable if treated in the initialstages.22 

A cross sectional study was done to assess the prevalence of varicose veins, risk factors and the complications of varicose veins among 100 school teachers in Thiruvananthapuram. The study showed the prevalence of varicose vein was 19% among the school teachers. Among those affected with varicose veins, 89.5% had history of standing for long duration and 26.3% had complications from this disease. Thus conclusion was made that standing for long hours was a major risk factor as compared to other known risk factors. Health Education and cutting down of working hours maybe recommended to bring down the prevalence of Varicose veins. 23

Bass A. (2007) conducted a study on the effect of standing in the workplace will lead to the development of chronic venous insufficiency of the superficial venous system in legs. Mechanical hydrostatic pressure generated by long periods of standing at the work place is a major etiological factor for this condition. Varicose veins on working while standing are very common, so it is not surprising to find a high percentage of varicose veins amongst those who work standing up. This, however does not mean they are directly related .Ambulatory venous pressure while sitting is about 60-80mm of water, as opposed to 20mm while walking, and the number is only slightly higher (about 100) while standing. Recent work by J.Bergan and his group demonstrated (in laboratory animals) that increased venous pressures will leads to the disappearance of the valve leaflets. This can explain the high frequency of venous reflux amongst young people (13%) and the even higher frequency (35%) found amongst the elderly population. Standing as an important and significant factor in the development of this complex disease process so the persons should be aware of the conditions and its prevention. 24

6.2. REVIEW OF LITERATURE:

a) Review of literature related to varicose vein:

Standing is a daily activity for us but standing for hours on a daily basis can cause several body complaints. Security guards, sales persons, teachers, traffic enforcers, nurses are people who have jobs that require prolonged standing in the performance of their duties. Prolonged standing causes muscles strain at the same time blood remains in the legs and feet and cannot properly circulate. This results in inflammation of the veins and over time, this can progress to varicose veins. The veins become dilated and this will prevent further circulation of the blood going to the heart.25

A twelve year prospective study was conducted in 9653 working age adults standing or walking at least 75% of their time at work to assess the risk of hospitalization due to varicose veins in the lower extremities .The samples was drawn from the Central Population Register of Denmark in 1991. Of these, 8664 interviewed by telephone (response rate 90%). 2939 men and 2708 women 20–59 years old and employed in 1990 were responded. During 12 year follow up, 40 hospitalizations due to varicose veins were observed among men and 71 among women. This prospective study confirms that prolonged standing at work constitutes an excess risk of varicose veins and that it accounts for more than one fifth of all cases of working age.26

A cross sectional study was conducted among 138 teachers in 12 schools at Ahmadabad revealed that 77% of them were suffered from varicosity or enlargement of the veins of legs , 84 people suffered from spider webs, the first stage of varicose veins and 23 had severely established varicose veins suffered from severe aches, swelling and heaviness in the legs. This study concluded that varicose veins is a condition that makes walking and standing extremely difficult and painful and if treated early at the stage of spider veins they are preventable.22

A retrospective cohort design study conducted among 58 patients who were diagnosed with varicose veins in Bapuji hospital and CG hospital Davangere during January 2009 to april 2010 to identify the incidence of Varicose veins in relation to occupation and working hours. The study result shown that 70.69% cases involved in mainly standing occupations while only 29.31% patients belonged to mainly sitting occupations. The male female ratio among the varicose vein patients was found to be 4:1.On an average, the patients who got the disease had worked standing or walking for 9.33 hours/day. The maximum incidence was seen in the age group of 30-39 years with as many as 17 cases out of 58 cases studied. The study concluded that a definite co relation between varicose veins and standing occupations, and taking care of the factors responsible for the disease will go a long way in increasing the productivity and efficiency of workers. People who work more than 9.33 hours per day standing or walking are more likely to develop the disease.27

A study was conducted in Harley street vein clinic shown that the people who spend most of their working day in a standing or sedentary position (ex: police officers, teachers, sales assistance) are considered to be at a high risk for varicose vein development. The incidence of varicose veins in adults varies from 7% to 40% men and from 14 % to 51 % in women. If the condition can’t be prevented or treated in a timely manner, varicose vein can lead to more serious morbidities and medical complications .28

A study conducted on “Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among 2165 workers from various occupations (55.6% female). The source of data from a department of occupational and environmental health, the graduate school of public health, Seoul National University, Seoul , Korea. Multiple logistic regression analyses were conducted to reveal factors related to symptoms of varicose veins and nocturnal leg cramps. The prevalence of VV and nocturnal leg cramps was higher among women than men. Prolonged standing at work may be a more important risk factor for VV and nocturnal leg cramps than biological differences between women and men. Therefore, effective interventions to interrupt or reduce prolonged standing at work should be implemented for the prevention of VV and nocturnal leg cramps.29

b) Review of literature related to effectiveness of structured teaching programme:

An experimental study with pretest - posttest control group design was carried out 200 Adolescent school students in four selected schools at Dharan town of Nepal. Structured teaching program consisting of information on human reproductive system was used as a tool of investigation for the experimental group, whereas conventional teaching method was used for the control group. The mean (+/-SD) pretest score on knowledge of reproductive health in experimental group was 39.83 (+/- 16.89) and in the control group 39.47(+/- 0.08). The same of experimental group after administration of the structured teaching program on knowledge was (84.60+/-10.60) and in the control group with conventional teaching method was (43.93+/-10.08). Similarly, the post-test scores of knowledge of the groups on responsible sexual behaviour and their attitude towards reproductive health were better in the experimental group than in the control group .So the use of structured teaching program is effective in improving knowledge and attitude of the adolescents on reproductive health.30

A quasi experimental one group pretest posttest design was used to assess the effectiveness of structured teaching programme on knowledge regarding bronchial asthma and its management among 60 mothers of asthmatic children by using a structured knowledge questionnaire. The findings reveals that, in the pretest 36(60%) had moderate knowledge and 24(40%) had inadequate knowledge regarding Bronchial Asthma and its Management. In the post test majority of them 56(93.33%) had adequate knowledge, 4(6.67%) had moderate knowledge and none of them had inadequate knowledge. This study shows that the developed STP was effective in improving the knowledge of mothers on bronchial asthma and its management. 31

An experimental study was conducted for 4 months period to determine the effectiveness of a structured preoperative teaching programme among 40 adult surgical patients in a surgical ward of general hospital. The first twenty subjects were assigned to the control group, and received the unstructured, pre-existing preoperative instruction from the staff nurses. The second twenty subjects made up the experimental group and received structured preoperative teaching in small groups conducted by the investigator, with the aid of a slide-taped programme. Prior to discharge, each subject was given two questionnaires to complete, and data were collected by means of a patient profile sheet. It was revealed that experimental group was more effective in detecting the post operative complications and better treatment compliances. A Statistical significance was found for the patient's ability to recall knowledge explained preoperatively. 32

A quasi experimental study was carried out to determine the effectiveness of Structured Teaching Programme on Knowledge, Attitude and Practices regarding Tobacco Consumption among 60 subjects who were attending the South Pitchavaram rural health centre in Tamil Nadu by using a structured tool for data collection .study result shown that there was a significant reduction in the practice of the subjects between pretest and post-test and there was a positive relationship between knowledge and attitude level of the subjects and the demographic variables. There was a significant increase in the level of knowledge and attitude after one month of Structured Teaching Programme .33

A pre experimental evaluative study was conducted by using one group pretest – post test research design to evaluate the effectiveness of planned teaching programme on knowledge regarding first aid in selected conditions among 30 primary school teachers working in schools at B.K. Nagar, Bangalore. The result reveals that the overall score was 38% in the pre test and 70% in the post test, 100% of primary school teachers had inadequate knowledge in the pre test, after planned teaching programme, 24 (80%) had moderately adequate knowledge and 6 (20%) had adequate knowledge regarding selected conditions of first aid. The study findings reveal that planned teaching programme on selected conditions of first aid is effective in improving knowledge of primary school teachers. 34

Since the teachers spend most of the time standing, they are prone to get lower limb symptoms like itchiness, cramps, burning sensation, pain, and results in superficial swollen veins, which later develop to varicose veins. So there is a need to educate the teachers regarding this condition. 35 This urged the investigator to take up the present study with an intention to provide Structured Teaching Programme regarding varicose veins and it’s management.

STATEMENT OF THE PROBLEM:

“A Study to assess the Effectiveness of Structured Teaching Programme on knowledge regarding varicose vein and it’s management among teachers in selected schools at Bangalore”.


6.3. OBJECTIVES OF THE STUDY

1. To assess the level of knowledge on varicose vein and it’s management among teachers.

2. To develop and to conduct a structured Teaching Programme regarding varicose vein and it’s management.

3. To evaluate the effectiveness of Structured teaching programme on varicose vein and it’s management among teachers by comparing pre and post test knowledge scores.

4. To find out the association between pre and post test knowledge scores and selected Demographic variables.

OPERATIONAL DEFINITIONS:

Assess:

In this study it refers to measure the knowledge level of teachers by structure knowledge questionnaire regarding varicose vein and it’s management.



Effectiveness:

It refers to the extent to which the structured teaching Programme on varicose vein and it’s management has achieved the desired effect as gain in knowledge scores by teachers.


Structured teaching programme (STP):

In this study it refers to the planned and organized teaching programme by the investigator to educate teachers about varicose vein and it’s management.


Varicose vein:

Varicose Veins are abnormally dilated veins with incompetent valves occurring most commonly in the lower extremities and lower trunk, usually in the great and small saphenous veins.


Knowledge:

Responses given by the teachers for structured knowledge questionnaire regarding varicose vein and it’s management before and after the structured teaching programme.



Teachers:

It refers to the male and female participants those who are teaching

in selected schools at Bangalore.
HYPOTHESIS:

H1: There will be a significant difference between the pre and post test knowledge scores of teachers regarding varicose vein and it’s management.

H2: There will be a significant association between the pre and post test knowledge scores of teachers and their selected Demographic variables.


ASSUMPTIONS:

1. The teachers are having high risk to get varicose vein due to long hours of standing during working hours.

2. The teachers may have less knowledge regarding varicose vein and it’s management.

3. The teachers will be expressing their willingness to learn new things.

4. The teachers will teach to others in their home and in other schools.

5. Any educational programme will increase the knowledge.


RESEARCH VARIABLES:
Independent variable: Structured teaching Programme regarding varicose vein and it’s management.
Dependent variable: knowledge scores about Varicose Vein and it’s management.
Selected Demographic variables: socio demographic variables such as age, sex, educational qualification, marital status, years of experience, source of information, duration of working hours etc..,
DELIMITATIONS:

1. The study will be limited to teachers working in selected schools at Bangalore.

2. The study will measure only the knowledge of teachers about varicose vein and it’s management.



7. MATERIALS AND METHODS:
7.1. SOURCE OF DATA: Data will be collected from the teachers of selected schools at Bangalore.
7.2. METHOD OF COLLECTION OF DATA
Research Approach:

Evaluative approach.



Research Design:

Quasi experimental One group pretest posttest design.



Study Setting:

The study will be conducted in selected schools at Bangalore.



Population:

Teachers working in schools at Bangalore.


Sample:

Teachers working in selected schools at Bangalore.


Sample Size:

The sample consist of 60 teachers.


Sampling Technique:

Non-probability convenient sampling technique will be used.



SAMPLING CRITERIA:

Inclusion criteria:


  1. Teachers working in the selectedschool, at Bangalore.

  2. Teachers who are willing to participate in the study.

  3. Able to read and write Kannada or English.



Exclusion criteria:


1. Teachers are on leave or not available during data collection.

2. Teachers who attended any educational programme regarding varicose vein.

3. Teachers who have been diagnosed and undergoing treatment for varicose vein.
DATA COLLECTION TOOL AND INSTRUMENT:
Structured questionnaire consist of two sections

Part A – Selected Demographic variables of teachers.

Part B – Structured Knowledge questionnaire regarding varicose vein and it’s management.
DATA ANALYSIS METHOD
Descriptive and inferential statistics will be used to analyze the data. The findings will be presented in the form of tables, graphs and figures.
1. Demographic data and knowledge scores before and after the structured teaching programme will be analyzed in terms of frequency, percentage, mean and standard deviation.in terms of frequency and percentage.

2. The significant difference between the mean pre-test and post-test knowledge score will be determined by Paired‘t’ test.



3. The association between selected Demographic variables and pre-test knowledge score regarding varicose vein will be determined by Chi-square test.
Data Collection Method:

              The objectives of the study will be explained and the data will be collected after getting permission from the concerned authorities of selected schools at Bangalore. The researcher herself will collect the data by using structured knowledge questionnaire in pre test after obtained informed consent from the participants. Post test will be conducted for all the participants after the structured teaching programme intervention regarding varicose vein and it’s management.

7.3 DOES THE STUDY REQUIRE ANY INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS?

Yes, the structured teaching programme regarding varicose vein and it’s management will be used as an intervention among teachers of selected schools in Bangalore.


7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?

Yes .Ethical clearance and Permission will be obtained from,



  • The research committee of Sri Sharada College of Nursing.

  • Authorities of selected schools in Bangalore.

  • Informed consent will be obtained from study participants.


8. LIST OF REFERENCES:

  1. DM Satapathy, TR Behera, RM Tripathy. Health Staus of Traffic Police personnel in Brahmapur City. Indian Journal of Community Medicine 2009 Jan; 34(1):72.

  2. Neill R. Standing problem. Hazards Magazine . Available from: www.hazards.org.

3. Bailey H, Love NRJ. Short practice of surgery. 23rd ed. London: Hodder

Arnold; 1991:235-45.

4. Definition of varicose vein. Available from: www.google.com.

5. What are varicose veins? Available from: www.indiaparenting.com.

6. Dr. Malouf NBC. Symptoms and Prevention of Varicose Veins and Spider

Veins. Available From: www.nutralegacy.com.

7. Varicose vein statistics-2012. Available at www.the veins.ca

8. Neill R. Standing problem - Hazards Magazine. Available from:

www.hazards.org

9. Morality statistics- varicose vein of lower extremity. Available at

www.nationmaster.com.

10. Freischlag JA, Heller JA. Venous disease. In: Townsend CM, Beauchamp

RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed.

Philadelphia, Pa: Saunders Elsevier; 2012: chap 65

11. Nijsten T, van den Bos RR, Goldman MP,. Minimally invasive techniques in

the treatment of saphenous varicose veins. J Am Acad Dermatol.

2009;60:110-119.

12. Varicose vein. Available at www.mayoclinic.com.

13. Varicose veins. Available at www.southerncross.co.nz

14. Varicose veins. Available at www.ncbi.nlm.nih.gov



  1. Non medical treatments for varicose veins. Available at www.articlesbase.com

  2. Venous problems. Available at www.vasculardisease.org

  3. Advances in treating varicose veins. Available at www.blogs.webmd.com

  4. Fisher R.W. Prevalence of varicosities. Available at www.wikipedia.org

  5. Varicose veins and the problem. Indian scenario. Available at www.healthcare.financialexpress.com

  6. Epidemiology of varicose vein. British medical journal. Available at:- www.bestpractice.bmj.com

  7. Laurikka J, Sisto T, Auvinen O, Tarkka M, Hakama M. Varicose vein in Finnish population aged 40-60. J Epidemiol Community Health. 2011 Oct 26; 47(2):355-7.

22. Radha Sharma. New worry for teachers: Varicose veins. The Times Of India

Ahmedabad.2010 Nov 29: sec, page 1.



  1. Meera Shruthy, Divya Aleena Jacob, Vinitha T.V. Prevalence of varicosity among people whose work demands standing for long hours .National conference on students’ medical research 2008 april 11-12. Medical college, thiruvananthapuram.

  2. Bass A. The effect of standing in the workplace and the development of chronic venous insufficiency. Available at: www.ncbi.nlm.nih.gov

  3. Anna katharina. Job Hazard: Prolonged Standing. Available at: www.annakatharinamd.com

  4. Tuchsen F, Hannerz H, Burr H, Krause N. Prolonged standing at work and hospitalization due to varicose veins: a 12 year prospective study of the Danish population. Occup Environ Med 2011 Oct 23; 62(12):847-50.

  5. Amir Mohammad. The incidence of varicose veins in relation to occupation and working hours. Available at: www.slideshare.net

  6. The Harley street vein clinic. Compression Stockings. Available at :www.dr-bull.com

  7. Bahk JW, Kim H, Jung-choi K, Jung MC, Lee I. Relationship between prolonged

standing and symptoms of varicose veins and nocturnal leg cramps among

women and men . Available at: www.ncbi.nlm.nib.gov

  1. Dhital AD, Badhu BP, Paudel RK, Uprety DK. Effectiveness of structured teaching program in improving knowledge and attitude of school going adolescents on reproductive health. Kathmandu University Medical Journal. 2005 Oct-Dec; 3(4):380-3.

  2. Prashanth PV. Effectiveness of structured teaching programme on knowledge regarding bronchial asthma and its management among mothers of asthmatic children, International Journal of Nursing Education 2011. 3(1): 74-7.

  3. Ricci, Joanne Roberta, The effectiveness of a structured preoperative teaching program for the adult surgical patient. Available at www.circle.ubc.ca

  4. N. Gowri. Effective Structured Teaching Programme on Knowledge,

Attitude and Practices regarding Tobacco Consumption in Rural Health Setting. The Nursing Journal of India, 2010 February; 2:21

34. Devi,Maloti K. Effectiveness of planned teaching programme on knowledge regarding first aid in selected conditions among primary school teachers working in schools at B K Nagar Bangalore. M Sc Nursing thesis, RGUHS. Available at: www.hdl.handle.net

35. Malhotra SL. An epidemiological study of varicose veins in Indian rail road .Vein study cross sectional population survey. BMJ 1999 Jun 15; 318(6):318-53.


  1. Medical and nursing management of varicose veins . Available at: www.nursing-nurse.com.


ETHICAL COMMITTEE:



TITLE OF THE TOPIC


A Study to assess the Effectiveness of Structured Teaching Programme on varicose vein and it’s management among teachers in selected schools at Bangalore.




NAME OF THE CANDIDATE

Mrs. Roshin.M.J




COURSE AND THE SUBJECT


Master of Science in Nursing.


Medical Surgical Nursing



NAME OF THE GUIDE

Mr.J.Baskaran M.Sc(N)

Principal and Head of the Department

Department of Medical Surgical Nursing

Sri Sharada College of Nursing, Bangalore.



ETHICAL COMMITTEE


Approved



MEMBERS OF THE ETHICAL COMMITTEE:
1. Mr.J.Baskaran M.Sc(N)

Principal cum Head of the Department

Department of Medical surgical Nursing

Sri Sharada College of Nursing, Bangalore – 61.


2. Mrs. K.Padmavathi M.Sc(N)

Vice Principal

Department of Medical Surgical Nursing

Sri Sharada College of Nursing, Bangalore– 61.


3. Prof. B.Maheshwari Bai M.Sc(N)

Head of the Department

Department of Mental Health Nursing

Sri Sharada College of Nursing, Bangalore – 61.


4. Mrs. Venkatalakshmi M.Sc(N)

Asst. professor

Department of Mental Health Nursing

Sri Sharada College of Nursing, Bangalore – 61.


5. Mr.Anil kumar R.V M.Sc(N)

Head of the Department

Department of Child Health Nursing

Sri sharada College of Nursing, Bangalore – 61.


6. Dr.Ganga Boriah

Statistician

Department of community medicine

Kempe Gowda Institute of Medical Science, Bangalore.


7.Dr.K.C.Tharun M.S

Chairman, Vishwabharathi hospital Pvt Ltd,

Sri Sharada Nursing College, Bangalore-61.


9.

SIGNATURE OF THE CANDIDATE




10.

REMARKS OF THE GUIDE


11.1

NAME AND DESIGNATION OF GUIDE.

Mr. J. Baskaran M.Sc (N)

Principal and Head Of the Department

Department of Medical Surgical Nursing

Sri Sharada College of Nursing, Bangalore



11.2

SIGNATURE OF THE GUIDE.





11.3

CO – GUIDE (IF ANY)





11.4

SIGNATURE OF THE CO-GUIDE




11.5

HEAD OF THE DEPARTMENT

Mr. J. Baskaran M.Sc (N)

Head of the Department

Department of Medical Surgical Nursing

Sri Sharada College of Nursing, Uttarahalli, Bangalore



11.6

SIGNATURE OF THE HEAD OF THE DEPARTMENT


12.1

REMARKS OF THE PRINCIPAL

This study is feasible to conduct and enhance the teachers knowledge regarding varicose vein and it’s management.

12.2

SIGNATURE OF THE PRINCIPAL








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