“A STUDY TO EVALUATE THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE

REGARDING IMMUNIZATION AMONG MOTHERS OF
UNDER FIVE CHILDREN IN SELECTED HOSPITAL AT
BANGALORE”

By

Ms. SINDHU PAUL

Dissertation submitted to

Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka.

In partial fulfillment

of the requirement for the degree of

MASTER OF SCIENCE IN NURSING

IN

CHILD HEALTH NURSING

Under the guidance of

Prof. Mr. JINSLIN OLIVER, M.Sc (N)

Department of Child Health Nursing

Noor College Of Nursing

Bangalore - 560 094

2013

i
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation/thesis entitled, “A study to evaluate the

effectiveness of structured teaching programme on knowledge regarding
immunization among mothers of under five children in selected hospital at
Bangalore” is a bonafide and genuine research work carried out by me under the
guidance of Prof. Mr. Jinslin Oliver,M.Sc(N), H. O. D.and Associate Professor of
Child Health Nursing Department, Noor College Of Nursing, Bangalore.

The dissertation has not formed the basis for the award of any degree to me
previously by any other University.

Date Signature of the Candidate

Place: Bangalore

(MS.SINDHU PAUL)

ii
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled “A study to evaluate the

effectiveness of structured teaching programme on knowledge regarding
immunization among mothers of under five children in selected hospital at
Bangalore” is a bonafide research work done by Ms.Sindhu Paul in partial
fulfillment of the requirement for the degree of Master Of Science In Nursing
(Child Health Nursing).

Date: Signature of the Guide

Place: Bangalore

Prof. Mr. Jinslin Oliver, M.Sc(N)

Associate Professor and H.O. D.,

Child Health Nursing,

Noor College of Nursing,

Bangalore.

iii
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ENDORSEMENT BY THE H.O.D., PRINCIPAL /HEAD OF THE

INSTITUTION

This is to certify that dissertation entitled “A study to evaluate the

effectiveness of structured teaching programme on knowledge regarding
immunization among mothers of under five children in selected hospital
Bangalore” is a bonafide research work done by Ms Sindhu Paul under the
guidance of Mr. Jinslin Oliver,M.Sc(N), Associate Professor and Head of the
Department of Child Health Nursing, Noor College of Nursing,Bangalore.

Seal and Signature of the H.O. D. Seal and Signature of the Principal

Prof. Mr. Jinslin Oliver, M.Sc(N) Prof.Ms.karpagam, M.sc(N)

Asso.Professor Principal cum asso.Professor

Child Health Nursing OBG Department

Noor College Of Nursing Noor College Of Nursing

Date: Date:
Place: Bangalore Place: Bangalore
iv
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

COPY RIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Sciences,

Karnataka shall have the rights to preserve, use and disseminate this dissertation /
thesis in print or electronic format for academic / research purpose.

Date: Signature of the Candidate

Place: Bangalore (Ms Sindhu Paul)

© Rajiv Gandhi University of Health Sciences, Bangalore Karnataka.

v
 ACKNOWLEDGEMENT
Gratitude can never be expressed in words but this is only the deep
appreciation which makes the words to flow from one’s inner heart.

Firstly, I praise and thank Lord almighty for his abundant grace and blessing
showered on me by keeping me in good health and helping me to complete this study
successfully.

I express my sincere words of gratitude to Mr. Md. Ayazkhan, Chairman,

Noor College of Nursing for giving me the opportunity and providing all the facilities
in my M.Sc. Nursing Programme at Noor College of Nursing. I also thank him for
offering the opportunity to pursue my studies in this esteemed institution.

I express my sincere thanks to administrator Mr. Bhagavan Sahay Mangal,

Noor college of Nursing for his valuable suggestions and motivation throughout my
study period.

I express my sincere gratitude to resourceful and respectful Asst.professor

Miss.karpagam,Msc (N), principal, HOD (obstetrics and gynaecology), and class
co-ordinator, Noor college of Nursing for guidance, suggestions and blessing that
enable me to complete this study.

My deep sense of gratitude and faithful thanks to my guide Mr.Jinslin

Oliver Vice Principal, Associate Professor, HOD in child health nursing, for his
expert guidance, suggestions and for his encouragement through out this studies.

It is a sense of honor and pride for me to express my deep sense of gratitude

to my co- guide Mrs.BabitaYumnam, M.Sc.(N), Asst.Prof.,Department of Child
Health Nursing,Noor College of Nursing for the constant effort she expanded which
helped in turning of ideas in to practical techniques. I am really grateful for her
guidance, enticing recommendations, constructive corrections, and cogent lessons in
influence. I’m very thankful to Madam for moulding me not only for the present study
but also preparing me for my future.

My deep sense of gratitude and faithful thanks to Mr.Govind Narayan

Sharma.Msc Department Of Mental Health, Noor College Of Nursing, for his
efforts, interest and constant support to mould this study in a successful way and who

vi
has also given inspiration, encouragement to complete this dissertation in a
successful way.

It gives me pleasure to express my gratitude to all Msc faculties for

their valuable suggestions and timely assistance and encouragement.

I express my thanks to the experts who have validated the research tool
and guided me with valuable suggestions.

I wish to convey my immense expression to Mrs.Sucharita Suresh for

her support in statistical analysis of data.

I offer my heart-felt thanks to Mrs.Kavitha, Librarian for the assistance

in finding necessary books and journals, extending library facilities and also helping
me in computers.

I would like to express my sincere appreciation to all the participants for

extended their co-operation without which it would have been impossible to complete
the study.

I convey my special thanks to all my friends for their constant help and
encouragement.

I have no words to pen to express my thanks to my loveable husband

Mr.Nisam, who had rendered immense support in all my endeavours and helped me
in my study.

I am deeply in debted to my Parents, In-laws, and all other family members,

for their perpetual support and encouragement without which this could never have
been completed.

Last but not least, I would like to express my sincere gratitude to all the
persons and colleagues who had directly and indirectly maintained my optimal
inspiration through out this research study.

Place: Signature of the candidate

Date: Sindhu Paul

vii
 ABSTRACT

"If you can imagine it, you can achieve it. If you can dream it, you can become it."
- William Arthur Ward

BACKGROUND OF THE STUDY

Communicable disease are a major health problem in India which lead to

death and disability of children under five years of age. Immunization is vital; it
protects nearly 3/4th of children against major child hood illness. There are several
diseases which can be easily prevented by proper vaccination at appropriate time
starting from birth. Mothers are the managers of Indian homes, their awareness about
the disease and its prevention will help in the control of many diseases.

TITLE OF THE STUDY

“A STUDY TO EVALUATE THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE
REGARDING IMMUNIZATION AMONG MOTHERS OF UNDER FIVE
CHILDREN IN SELECTED HOSPITAL BANGALORE”.

OBJECTIVES OF THE STUDY

1. To assess the level of knowledge of mothers of under five children regarding

immunization.

2. To evaluate the effectiveness of structured teaching programme on knowledge

regarding immunization among mothers of under fives.

3. To find the association between pre-test knowledge scores with selected

demographic variables.

RESEARCH HYPOTHESIS

The mean post-test knowledge score of subject exposed to structure

teaching programme will be significantly greater than the mean pre-test knowledge
scores.

viii
CONCEPTUAL FRAMEWORK

The framework of the study was adopted from the General Systems Theory
with input, throughput, output and feedback, first introduced by Ludwig Von
Bertalanffy (1968) as explained by Newby (1996)

METHODOLOGY

An evaluative research approach was utilized in the study, as the study aimed
at evaluating the effectiveness of structured teaching programme regarding
immunization among mothers of under fives. Thirty mothers were selected by using
purposive sampling technique. The study was conducted in Yelahanka government
hospital.

A structured knowledge questionnaire was utilized to obtain the data from

mothers, followed by a structured teaching programme. The data obtained were
analyzed in terms of objectives of the study. Descriptive and inferential statistics were
used for data analysis.

RESULTS

The major findings of the study were as follows

The data on sample characteristics:

Findings revealed that the percentage distributions of the mothers of under

five’s regarding immunization according to age majority 13(43%) of mother were
below 25 year, majority 15(50%) of mother belongs to Hindu religion. Majority
14(47%) of mothers belongs to primary class. Majority 11(37%) mothers are house
wife. Majority12(40%) of mothers belongs to nuclear family. Majority 11 (37%) of
them had family income between 50001-10000.majority 9(30%) of mothers have
source of health information from friends. Majority 11(37%) of mothers receiving
health services from P H C. Majority 13(43%)f have 1 child below 5 years. majority
11(37%) of mothers have children between 0-1 year of age.

ix
Data analysis on knowledge of mothers of under fives regarding
immunization

During the pre test most of the sample having not adequate level of knowledge scores
regarding immunization. After administration of structured teaching programme,
there was marked improvement in the knowledge of the sample with majority
27(90%) gained adequate knowledge score and 3(10%) of the sample had moderate
knowledge regarding immunization.

Effectiveness of structured teaching programme regarding immunization

by comparing pre test and post test knowledge scores.

The overall mean and standard deviation of post-test knowledge score regarding
immunization in mothers of under five’s were34 with a standard deviation 2.94.In the
present study, the mean post-test knowledge score was 34 which are apparently higher
the mean pre-test knowledge scores17.70 and the mean difference was 16.30.The
calculated paired test value(t cal =13.67,p=0.00) is greater than the table value (t
tab=1.7) which represents significant gain knowledge through the structured teaching
programme.

Association between the pre-tests knowledge score and selected

demographic variables.

The result shows that, there is no significant association between pre-test and
demographic variables.

Recommendations

 The study can be replicated in large sample for better generalization.

 A similar study can be done in knowledge and attitude regarding
immunization among mothers.
 This study will be reference for research scores.
 Evidence based nursing practice must take higher profile in order to increase
awareness among mothers of under fives
 A comparative study between urban and rural knowledge and attitude on
immunization can be conducted.

x
 LIST OF ABBREVIATIONS
Sl.no Abbreviations Expansions

1. WHO World Health organization

2. Df Degree of freedom
3. S.D Standard deviation
4. < Less than
5. > Greater than

xi
 LIST OF THE CONTENT

CHAPTER CONTENT PAGE NO

NO

I INTRODUCTION 1-6

II OBJECTIVES 7-11

III REVIEW OF LITERATURE 12-19

IV METHODOLOGY 20-27

V RESULTS 28-44

VI DISCUSSION 45-47

VII CONCLUSION 48-49

VIII SUMMARY 50-52

IX BIBLIOGRAPHY 53-55

X ANNEXURES 56-104

xii
 LIST OF TABLES

SL. TITLE OF THE TABLE PAGE

NO
No

1. Systematic representation of pre-experimental design 21

Frequency and percentage distribution of mothers of

2. 30
under fives according to their demographic variables

Frequency and percentage distribution of pre- test and

3. 39
post-test knowledge score regarding immunization
among mothers of under fives.
Overall mean, Standard Deviation, Paired ‘t’ value of
4. 41
Pre- test and Post-test score.

5. Association between demographic variables and Post-

42
test level of knowledge of mothers of under fives
regarding immunization.

xiii
 LIST OF FIGURES

FIGURE PAGE
NO. FIGURES NO.
Conceptual Frame Work Based On Modified General System Theory
1. 11
Proposed By Ludwig von Bertalanffy(1968)

2. Schematic Representation Of Research Study Design 27

3. Pie diagram presents percentage distribution of age mothers. 34

4. Pie diagram represents percentage distribution of religion 34

Bar diagram represents percentage distribution of educational status of

5. 35
mothers

Pie diagram represents percentage distribution of occupation of

35
6. mothers.
The Bar diagram represent percentage distribution of type of family
36
7.
Pie diagram represents percentage distribution of family income per
36
8. month.
9. Cylindrical diagram represents percentage distribution of source of
37
health information.
10. Cone diagram represents percentage distribution of health services
37
availed.
11. Pie diagram represents percentage distribution of no.of under five
38
children.
12. Bar diagram represents percentage distribution of age of the child.
38

13. Bar diagram represents distribution of pre-test and post-test

40
level of knowledge regarding immunization among mothers of under
fives.

xiv
 TABLE OF ANNEXURES

Annexure particulars Page no.

Permission letter to conduct pilot study 56

1.
Permission letter to conduct main study 57
2.
Certificate for kannada editing 58
3.
Certificate for English editing 59
4.
Letter seeking expert opinion to establish the 60
5. content validity of the tool
Certificate of tool validation 61
6.
List of experts consulted for content validity 62-63
7.
Blue print 64
8.
Structured questionnaire 65-74
9.
Score key 75
10.
Lesson plan on immunization 76-85
11.
Structured questionnaire and lesson plan in 86-103
12. kannada.

xv
 CHAPTER 1

INTRODUCTION
“what a child doesn‟t receive he can seldom later”

Child development refers to the changes that occur as a child grows

and develops in relation to being physically healthy, mentally alert, emotionally
sound, socially competent and ready to learn. The first five years of a child's life
are fundamentally important. They are the foundation that shapes children's
future health, happiness, growth, development and learning achievement at
school, in the family and community, and in life in general.1

Immunization helps protect you and your children from disease. They
also help reduce the spread of disease to others and prevent epidemics. Most
immunization given by shots, they are called vaccines. Immunization describes
the whole process of delivery of vaccine and the immunity it generates in an
individual and population. A vaccine is a special form of disease Causing agent
(e.g.: virus or bacteria) that has been developed to protect against that disease.1

The term “immune” means to be safe from or protected. The term

“Immunity” relates to the resistance of the body to the deleterious effect of
agents (pathogenic) such as bacteria, virus etc. Immunization has played a
significant role in the reduction of morbidity and mortality from bacterial and
viral infection in many countries.2

The body`s immune system responds to a vaccine by producing

substance(such as antibodies and white blood cells ) that recognize and attack
the specific bacteria or virus contained in the vaccine. Whenever the person is
exposed to the specific bacteria or virus, the body automatically produces these
antibodies and other substances. The process of giving a vaccine is called
vaccination. Although use the more general term “Immunization”.
Immunization is a act of creating immunity by artificial or inoculation a method
of stimulating resistance in the human body to specific diseases using organism
bacteria or virus that have been modified or killed.3

1
 The goal of immunizing children against chief diseases responsible for
child mortality and morbidity is indeed a noble one. However, it is not an easy
task to achieve. In a developing country like India, the sheer logistics of the
numbers of the target population that stretches across geographically diverse
regions make universal immunization of children a Herculean task. However,
the health sector of this country is making admirable achievements in that
several millions of potential life years have been saved from getting lost to
vaccine preventable diseases through the universal immunization program .4
`There are several reasons to aim for universal coverage. The factors that
should be helpful are many. The Indian culture promotes safe nurturing of
children. Hardly do we find parents who risk their children to life-threatening
diseases, unless they being unaware or misinformed. All vaccines under the
routine immunization programme are provided free-of-charge. However, the
figures for the coverage of routine immunization (RI) are lagging. The current
level of coverage of „fully-immunized‟ children under the national
immunization programme is quite low, as pointed out by several studies.5
The child needs to be protected from 11 infectious and vaccine
preventable diseases. These diseases include tuberculosis, tetanus, diphtheria,
whooping cough and poliomyelitis. The under five children can be saved from
deaths by immunizing them at the right age and right time and by completing
the full course of immunization.5
According to UNICEF immunization is currently preventing an estimated
two million deaths among children under five every year.
India has one of the highest under five mortality rates in the world with an
estimate of 64/1000 live births in 2010, the under five mortality rate in the
Karnataka state was 56/1000 live births in 2010. One of the factors contributing
to under five mortality is the ignorance of child care.6
Global immunization coverage has greatly increased since WHO‟s
expanded programme on immunization began in 1974. In India expanded
programme on immunization was launched in January 1978. UNICEF renamed
the expanded programme on immunization as Universal Immunization
Programme (UIP) and it was launched in India in November, 1985.7

2
 In 2010, global DPT3 (three doses of the diphtheria, pertussis, tetanus
combination vaccine) coverage was 68% up from 50% in 2005. However, 27
million children world wide were not reached by DPT3 in 2010, including
9.9million on south Asia and 9.6 million in sub-Saharan Africa.8
In 1978, Expanded programme on Immunization was started by the
Government of India to reduce mortality and morbidity and also to achieve self-
sufficiency in the production of vaccines. Communicable diseases are still
number one killer ailments of mankind with 16.5 million deaths every year.
Measles killed 2 per 100 cases in the developing world and this can be high as
10 per 100 or even more in the areas inhabited by the poorest of the poor having
combined misfortune virtually all the children would catch measles. In world
every year 5 million children‟s are die because of Tuberculosis, Diphtheria,
Tetanus, Pertussis and Poliomyelitis.9

Initially, the programme was focused on children under 5 years but later
children under 2 years were targeted. Eventually in 1985 with a view to energize
and universalize the immunization coverage, EPI programme was redesignated
as “Universal Immunization Programme” (UIP) in India and the target age for
children was further reduced to infancy. In due course, as the UIP activity
expanded and covered the entire country, the immunization coverage in respect
of oral polio vaccine increased to more than 90%.10

In consideration of the fact that vaccine preventable diseases namely

diphtheria, pertussis, tetanus, poliomyelitis, measles and tuberculosis were
responsible for considerable morbidity and mortality all over the world, WHO
in 1974 introduced a global immunization program me against there diseases
known as expanded program me of immunization. This program me was
launched in India in 1978 and a steady increase in the immunization level of
preschool children.11

According to WHO report (1997) there has been 19 percent of under five
mortality in the developing world due to diarrheal diseases and about 18 percent
due to vaccine preventable diseases. The recent study (2006) conducted in India
revealed that 71.7% of children were fully immunized, 9.8% were partially
immunized and 8.5% had not been immunized. Coverage of each individual

3
vaccine shows that BCG (85.6%), DPT-1(90.3%), DPT-2(88.7%), DPT-
3(80.2%), OPV-1(92.0%), OPV-2(90.3%), OPV-3(82.2%) and measles 73.6%
and also they have found that not being aware of the immunization schedule
was cited as the main reason (41.2%) and non availability of the immunization
service was another reason (45.5%).12

Without immunization, an averse of three out of every hundred children

born will die from measles. Another two will die from whooping cough. One
more will die from tetanus. And out of every two hundred children, one will be
disabled by polio. Children can be protected against these diseases by vaccines.
It is therefore essential that all parents and child welfare workers know why,
when, where, and how many times their infants should be immunized.
Immunization protects against several dangerous diseases. A child who is not
immunized is more likely to become sick, permanently disabled or
undernourished, and could possibly die. It is safe to immunize a child who has a
minor illness or a disability or is malnourish.13

Each child has basic human needs like adults to fulfill the essentials of life
and to promote growth and development. Immunization is one of the needs of
the children. The responsibilities of the nursing personnel is to help the parents
to emphasize on promotion of health, prevention of illness, maintenance of
health and restoration of health.14

Health teaching an important means bringing about health behavior

among mothers. It emphasizes a significant attitude towards health which
enables mother to take the vaccines to their children‟s.

4
 NEED FOR THE STUDY

“He who cures a disease may be the „skill fullest‟

But he that prevents it is the safest physician”

-Thomas fuller

The physical health of a child is important because it is associated with

the mental and social development of a children. Mothers are the first care
providers of their children, is needed to reduce the under five mortality rate.
One of the ways to achieve reduction of under five mortality is to educate the
mothers on matters pertaining to child care.15

A descriptive study was conducted to determine the relationship between

the literacy status and immunization coverage among 100 mothers of under five
children in Kolar district in Bangalore. The analysis revealed a fairly low
immunization coverage (<33%) for all vaccines and it was found that literacy
status of mothers had a significant influence on the immunization level. Lack of
awareness and motivation was cited as the main reason for non-immunization.
The study recommended to give awareness by health care personnel among
mothers to improve their knowledge which in turn changes their attitude.16

Each year since 1990, immunization with routine vaccines has reached
more than 70 %of children world wide. At the UN General Assembly special
session in 2007 the international community adopted the specific target of
immunizing by 2010 at least 90 percent of children‟s in each country.17

World wide approximately 130 million children are born every year in
which 91 million are from developing countries. America and Europe maintains
over 90% of immunization and western pacific maintains 92% of immunization
while eastern Mediterranean maintains 86% of immunization.114 countries has
reached 90% of immunization where 150 countries has reached 80% of
immunization.18
The child mortality rate or under-5 mortality rate is the number of
children who die by the age of five, per thousand live births. In 2007, the world

5
average was 68 (6.8%) In 2006, the average in developing countries was 79
(down from 103 in 1990), whereas the average in industrialized countries was 6
(down from 10 in 1990). The world's child mortality rate has dropped by over
60% since 1960.19
Around 10 million children die under the age of five every year and over 27
million infants in the world do not get full routine immunization. The predicted world‟s
infant mortality rate during the year 2005 to 2010 is 47 per 1000 birth where the actual
infant mortality rate is 57 per 1000 births.20
In India over all statistics says that 80% immunization has been covered.
In 1985, the Universal Immunization Programme was started in India with the
aim of achieving at least 85% coverage of primary immunization of infants. 93
percent of all under-5 deaths occur in Africa and Asia. Half of these deaths
occur in five countries: India, Nigeria, Democratic Republic of Congo, Pakistan,
and China.21
According to NFHS-3(National family heath survey.) report, the
percentage of children who received all basic vaccinations in Karnataka was
only 55% and 6.9% receives no vaccinations. These indicates that India still
lags far behind the goal of universal immunization coverage of children. All
these reveals that targeted education and vaccination campaigns are essential to
achieve the elimination of childhood infections.22
This area of study has been selected because even today the mortality of
under five children is high and it is mainly due to diseases that can be prevented.
Hence, the need was felt to identify the learning needs of mothers and educate
them regarding immunization by introducing structured teaching programme
and promoting health of under five children which in turn reduces mortality
among under five children.

6
 CHAPTER-II
OBJECTIVES

STATEMENT OF THE PROBLEM

“A study to evaluate the effectiveness of structured teaching programme on

knowledge regarding immunization among mothers of under five children
in selected Hospitals at Bangalore.”

OBJECTIVES

1. To assess the level of knowledge of mothers of under five children regarding

immunization.

2. To evaluate the effectiveness of structured teaching programme on

knowledge regarding immunization among mothers of under fives.

3. To find the association between pre-test knowledge scores with selected

demographic variables.

HYPOTHESIS

H: The mean post-test knowledge score of subject exposed to structure teaching

programme will be significantly greater than the mean pre-test knowledge
scores.

OPERATIONAL DEFINITION

1.Assess:-In the present study assess refers to the organized systematic and
continuous process gathering information on knowledge of immunization from
mother of under five children.

2.Effectiveness:-In this study effectiveness means “Improving the knowledge

regarding immunization for mothers of under five by structured teaching
programme which may result differences between pre and post test knowledge
core.”

7
 3.Structured teaching programme:-In the present study it refers to
systematically planned teaching programme designed to provide information
regarding immunization among mothers of under five children.

4.knowledge:-It refers to ability of the mothers of under five children in giving

correct responses to the questions asked as measured by structured knowledge
questionnaire.

5.immunization:-it refers to the process of protecting under five children

against diseases like diphtheria, polio, tetanus, whooping cough, tuberculosis,
and measles by following the schedule prescribed by national immunization
schedule.

6.Mothers Of Under Five Children:-In the present study it refers to the

mothers who has children below 5 years admitted in paediatric ward, of
Yelahanka Government Hospital.

Assumption

1) It is assumed that mothers knowledge regarding immunization in under fives

should improve after attending the structured teaching programme.
2) It is assumed that mother‟s knowledge is influenced by variables such as
education and source of information.

DELIMITATIONS OF THE STUDY

The study is delimited to

 The mothers of under fives admitted in paediatric ward of yelahanka

Government Hospitals
 The duration of study was only to four weeks.
 The sample size was limited to 30

8
CONCEPTUAL FRAME WORK

Good research usually integrates research findings into an orderly

coherent system. Such integration typically involves linking research and
existing knowledge through review of prior research on a topic and by
identifying or developing an appropriate conceptual frame work.43

Conceptual frame work provides the investigator the guide lines to

proceed in attending the objectives of the study based on theory. It is a scientific
representation of the steps, activities, and out come of the study.44

The present study aims at developing and assesses the effectiveness of

structured teaching programme on knowledge regarding immunization among
under five children.

The conceptual frame work selected for this study is based upon the
general system theory developed by Ludwig von Bertalanffy, According to
general system theory, a system consist of a set of interacting components, all
contributing to the over all goal of the system. Any system consists of input,
through process and out put. This study aims at developing and evaluating
structured teaching programme on knowledge of mothers regarding
immunization.

The process of development of structured teaching programme includes

preparatory phase as input, the implementory phase, as through process and
evaluation and feed back of the system as the output.

Input: Input is considered as assessment of knowledge regarding

immunization.

Through process: Through process is the process of charge in the knowledge

and understanding about immunization. Here the investigator implements
structured teaching programme to the mothers of under fives about

9
immunization including knowledge on general information, purpose,
importance, immunization schedule, and purpose of giving each vaccine.

Output: Output from a system is energy, matter or information given out by

the system as a result of its processes. In this study output refers the result either
gains in knowledge among mothers of under five regarding immunization. the
gains knowledge was measures through post-test.

Feed back: The feed back is the environment responses to the system. Feed
back may be positive, negative, or neutral. In this study input was assessing the
knowledge of mothers regarding immunization. Through process was the
activity phase where structured teaching programme was regarding
immunization. output refers to change in level of knowledge regarding
immunization after the structured which was measured by using post-test. Feed
back strengthen the input and through process .

10
 INPUT THROUGH PUT OUTPUT

POST TEST
Assessment of demographic data
of mothers
1.Age of the mother
Define immunity define vaccine
2. Religion INCREASED IN
KNOWLEDGE
3. Educational status
Purpose of
4. Occupation Structured each

Immunization teaching vaccine

5. Types of family
programme
6. Family income schedule MODERATE
IMPROVEMENT
7. Source of health information IN
8. Health services availed Purpose importance KNOWLEDGE

9. no.of under five children Of immunization of immunization

10. Age of children

LESS
Assessment of knowledge(by KNOWLEDGE
administering structured knowledge
questionnaire)
Conceptual Frame Work Based On Ludwig Von Bertalantt’s General System Theory(1968) Adopted For Educating
Mothers On Immunization

11
 CHAPTER-III
REVIEW OF LITERATURE

“ nursing personnel efficiency developed only by updating knowledge

and sills.”
It refers to an integral component of any study or research projects.
It enhances the depth of the knowledge and inspires a clean insight into course
of the problem. Literature review throws light on the studies and their reports
about the problem under the studies.23

Review of literature has been divided in to the following headings:

 Literature related to General information on Immunization.

 Literature related to knowledge regarding immunization among mothers of

under five children.

 Literature related to effectiveness of structured teaching programme on

immunization.

Literature related to General information on immunization

A cross sectional study was conducted on National Immunization survey

(NIS) which was designed to measure vaccination coverage estimates for the 10
states of United State. The NIS includes a random-digit-dialled telephone
survey and a provider record check study. Data are weighted to account for the
sample design and to reduce non response and non coverage biases in order to
improve vaccination coverage estimates. The survey reports communicated that
92% of the children in 10 state of United State has been covered by vaccination
and prevented from all vaccine preventable diseases.24

12
 An exploratory study was conducted to assess immunization coverage
among 500 mothers of children under the age of 5 years belonging to a low
income group. All were attending the paediatrics out patient department of a
large teaching hospital in New Delhi, India. Only 25% were found to have
received complete primary immunization as per the National Immunization
schedule (bacilli calamite – Guerin at birth, 3 doses of diphtheria, pertussis and
tetanus and oral poliovirus vaccine at 6,10 and 14 weeks and measles at 9
months). The major reasons for non-immunization of the children were
migration to a native village (26.4%), domestic problems (9.6%). The
immunization centre was located too far from their home (9.6%) and for child
was unwell when the vaccination was due (9%). The lack of awareness and fear
of side effects constituted a small minority of reasons for non-immunization.25
A comparative study was conducted to estimate the vaccination coverage
level of children‟s living in rural and urban areas to identify statistically
significant differences. Children‟s aged between 19-35 months residing in Kolar
District of Bangalore participating on the 2008 National Immunization Survey
were included in the study. Statistically significant differences in vaccination
coverage levels between the rural population and their urban counterparts were
determined for individual vaccines and vaccine series as evidenced by 28% of
the children were covered by immunization residing in rural areas whereas 46%
were covered in Urban area. The study recommended that health care personnel
need to execute the awareness among the needy population of the Kolar
District.26
A cross-sectional study was conducted to determine the coverage of the
expanded programme of Immunization (EPI) of the ministry of Health and the
coverage of private vaccines in Yelanhanka Health District in order to establish
approaches for improving vaccination services. Thirty streets were selected at
random from each health care region, utilization of vaccination services and
vaccination status of children under the age of 5 years were determined by face
to face interviews. The findings of the study was as follows: Hepatitis B third
dose, 84.6%; BCG, 94.8%; DPT third dose, 90.1%; Oral polio virus (OPV)
third dose, 90.0%; Measles, mumps, rubella (MMR), 13.3%;, The full
vaccination rates for children under 5 years were 68.3%.27

13
 A comparative study was conducted between two slums in Tamil Nadu to
evaluate the reason being not immunized in the two slums. The study revealed
that group A was 69.7% immunized and group B was 79.8% immunized. The
conclusion of the study was that there is no adequate information to the crowd
about immunization.28
A cross- sectional study was conducted t o assess the knowledge
about immunization among six hundred and eighty-two caretakers
accompanying children under 5 years in Pulse polio immunization centres in
East Delhi. The data was collected by using Pre-tested semi-open-ended
questionnaire. The collected data was analyzed by using Proportions, Chi-
square test. The study results shows that the proportions of respondents who had
awareness about different aspects of immunization, such as weekday of
immunization (37.0%), age group for immunization (49.1%), number of visits
required in the first year of life (27.0%), were all low. When asked to name the
four diseases covered under the immunization programme in Delhi, only 268
(39.3%) could name at least three. The study concluded that the need of the hour
is to make Immunization a „felt need‟ of the community. Making caretakers
more aware about immunization is a vital step in achieving the health goal of
the country.29

A study to assess the immunization status of children in the states

of Bihar, Madhya Pradesh, Rajasthan and UP the evaluation covered BCG,
DPT, OPV, Measles, Pulse Polio and Vitamin A. WHO 30 cluster survey
methodology with certain modifications incorporating information on sex of the
child, literacy of parents and distance of the village was used. Study covered 30
districts, 900 villages and 6,300 children. About 48 per cent of children received
all the vaccines (BCG, DPT, OPV, and Measles) in these states as compared to
63 per cent at all India level. These states accounted for about 70% of non-
immunised children. The coverage levels were lower for children of illiterate
mothers and in small, inaccessible and triple villages30

14
Literature related to knowledge regarding immunization among
mothers of under five children.
A logistic study was conducted to find out: (a) the immunization status of
children admitted to a paediatric ward of tertiary-care hospital in
Delhi, India and (b) reasons for partial immunization and non-immunization.
Parents of 325 consecutively-admitted children aged 12-60 months were
interviewed using a semi-structured questionnaire. A child who had missed any
of the vaccines given under the national immunization programme till one year
of age was classified as partially-immunized while those who had not received
any vaccine up to 12 months of age or received only pulse polio vaccine were
classified as non-immunized. Reasons for partial/non-immunization were
recorded using open-ended questions. Of the 325 children (148 males, 177
females), 58 (17.84%) were completely immunized, 156 (48%) were partially
immunized, and 111 (34.15%) were non-immunized. Mothers were the primary
respondents in 84% of the cases The most common reasons for partial or non-
immunization were inadequate knowledge about immunization or belief that
vaccine has side-effects, lack of faith in immunization. The immunization status
needs to be improved by educating mothers and caregivers regarding
immunizations.31
A health survey regarding immunization status among one hundred and
thirty mothers in the age group (15-44) years and 142 children aged (12-59)
months were selected in Warta district. Out of this 100 mothers and 122
children could be contacted for evaluation of immunization coverage and
assessing maternal knowledge and practice regarding immunization 52.5%
children were fully immunized and 45.1% were partially immunized. Vaccine
coverage for B.C.G. and primary doses of DPT/OPV was 95.9% and above 85%
respectively. It was 57.4% for measles and 63.04% for booster dose was
36.96%. mothers had a knowledge regarding need for immunization but a poor
knowledge regarding the diseases prevented and doses of the vaccines. The
study recommended that mothers need to improve their knowledge regarding
immunization thereby preventing disease which can be prevented by vaccine.32

15
 A case control study was conducted to assess the level of knowledge
among 800 parents in Tumkur, regarding support for immunization registries
laws, authorizing registries and mandating provider reporting and financial
worth and responsibility of registry development and implementation methods.
Surveys administered to the parents, asked about views on registries and
perceived utility and safety of vaccines. The findings shows that surveys were
completed by 56.1% of respondents, fewer than 10% of parents were aware of
immunization registries on their communities. The study recommended that
health care personnel need to create awareness regarding importance of
immunization registries laws to improve the heath indices of the state thereby
can take the intervention to improve child mortality and morbidity rate.33
A study was conducted in 2009 in northern California with the objective
of mother‟s poor knowledge about immunization. 50 women were taken as
samples. Teaching and counselling were taken up as a part of evaluation of their
knowledge. The study revealed many barriers which inhibits the knowledge of
the mother so to improve it the mothers were given the checklist of
immunization for children.34
A community based study was conducted to evaluate the factors affecting
the immunization coverage of children in Assam, India, in the first year of life
of the children. About 62.2% of the children were fully immunized. Lack of
information among the parents was one of the major causes of drop out of
vaccinations. The children from urban areas and mother's education level
showed significant role in immunization coverage. Improvement in female
literacy coupled with the reduction in the drop out rate would add to achieve a
higher target of immunization among children in the study area.35
A cross sectional study on immunization in the town of Pilani was
conducted and a total of 166 mothers were interviewed using a pre-tested
interview schedule/questionnaire on Knowledge. The results showed that among
the 12-24 month old children 50% fully, 31.3% partially and 18.7% not at all
immunized. Many mothers (87%) were aware of the importance
of vaccination in general, specific information about importance of completing
the schedule and knowledge about vaccine preventable diseases other than
poliomyelitis was very limited. Obstacles, misconceptions/beliefs among

16
the mothers of partially immunized children and lack of information among not
at all immunized group were the main reasons of non-immunization. The
implications of the study are to enhance the maternal knowledge about the
vaccine preventable diseases and importance of completing
the immunization schedule through interpersonal mode and to overcome
obstacles to immunization such as accessibility and lack of family support.36
A case control study was conducted to assess Immunization coverage and
the knowledge and practice among one hundred and thirty mothers in the age
group (15-44) years and 142 children aged (12-59) months which were selected
by cluster sampling method from nine villages in Wardha district. Out of this
100 mothers and 122 children could be contacted for evaluation
of immunization coverage and assessing maternal knowledge and practice
regarding immunization. 52.5% children were fully immunized and 45.1% were
partially immunized. Vaccine coverage for B.C.G. and primary doses of
DPT/OPV was 95.9% and above 85% respectively. It was 57.4% for measles
and 63.04% for booster dose of DPT/OPV. Drop-out rate from second to third
dose of DPT/OPV was 5.3% and from third to booster dose was
36.96%. Mothers had a fair knowledge regarding need for immunization but a
poor knowledge regarding the diseases prevented and doses of the vaccines.
Commonest side reactions reported were fever (36%) and pain at injection site
(33%). Contraindications listed by mothers were mild cold (41%), mild fever
(24%) or loose stools (14%). Health workers were the major source of
information and 76% knew the use and maintenance of immunization cards.37

A cross sectional survey was performed to assess the knowledge, attitude

and practice of mother regarding expanded program me of immunization. The
study revealed that 88% of patients had knowledge about EPI programme 92%
of parents had positive attitude towards EPI. The most common reason for not
vaccinating their children was laziness and wrong concepts about vaccination.
This study concludes that there is need for more clear and appropriate health
education messages regarding vaccination of children.20 surveys carried out
between 1991-2001 to obtain information on mother‟s knowledge and attitude
towards immunization, in England. More than 15,000 interviews were

17
conducted as part of routine programme of research. These surveys show that
public wants clarity, consistency factual information and openers from those
delivering immunization services.38

Literature related to effectiveness of structure teaching

programme on immunization.

A pre-experimental study was conducted in The Children's Hospital at

Saint Peter's University Hospital, New Brunswick, NJ, USA, 2008, for the
implementation of pertusis immunization program among the employees of the
hospital with a 3 phase publicity and educational model and 3 phase vaccination
delivery approach. As the infection transmission rate was high from patients to
employee implementation of pertussis vaccine came into action. After the
teaching program every employee in the hospital was immunized which has
reduced one third of the cases reported annually in hospital.39
An evaluative study was conducted in Udupi District, Karnataka to
determine the knowledge of mothers on immunization of children and to the
effectiveness of structured teaching programme(STP) in selected paediatric
wards. One group pre test post test design and non probability convenience
sampling was used. Data were collected from 50 samples by structured
knowledge questionnaire and STP was administered. Data were analyzed by
descriptive and inferential statistics. The t – test showed that post test
knowledge means score (29.74%) were significantly higher than that of pre –
test mean score. (16.16%) t (49) = 27.77 p<0.01. This indicated that the STP was
effective in improving the knowledge level of mothers regarding immunization.
Majority of the mothers (87.7%) strongly agreed that STP was highly effective
to a great extent.40
A study was conducted to assess effectiveness of planned teaching
programme on immunization among mothers of under five children staff in
selected hospital of Udupi. The sample consisted of 35 mothers. Study has
conducted in two phases. In the first phase learning needs were identified and in
the second phase, planned teaching programme was developed based on
identified learning needs. To evaluate the planned teaching programme one

18
group pre-test and post-test design was used. The findings revealed that the
post-test knowledge score (26.53%) was higher than the pre-test knowledge
score (13.5%). Therefore, planned teaching programme was found to be an
effective media for educating mothers regarding importance of immunization.41
An evaluative study was conducted among 50 mothers of under five
children in selected paediatric hospital, Pondicherry. The aim of the study was
to evaluate the effectiveness of structured teaching programme(STP) regarding
immunization. A closed ended questionnaire with 30 items related to
immunization was used to collect the data followed by intervention of STP. The
study finding shows that the post-test knowledge score (22.73) was higher than
the pre-test knowledge score (12.78). The study claimed that STP is effective to
enhance mothers mother knowledge regarding the importance of immunization.
The study recommended that nursing personnel should continue in health
teaching approach especially to the health problems which can be prevented.42

19
 CHAPTER IV

METHODOLOGY

Research methodology is the systematic way to solve a research problem.

The research methodology refers to the principles and ideas on which
researchers bases their procedures and strategies. Methodology is the most
important part of any research study which enables the researcher to form the
blue print for the systemic proceeding by which the researcher starts from the
time of initial identification of the problem to it final conclusion.

This chapter deals under the following headings: Research approach,

Research design, Setting, Population, Sample, and Sampling technique,
development and description of tool, development of teaching plan, pilot study,
procedure for data collection and data analysis.

Research approach

The research approach is an over all planned or blue print chosen to

carryout the study. The selection of the research approach is the basic procedure
for conduct of research enquiry. An evaluative research is an applied form of
research that involves finding out how well a programme, practice, procedure,
or policy is working.45

The research approach adopted in this study was evaluative research

approach method, as the study is aimed at evaluating the effectiveness of
structured teaching programme regarding immunization among mothers of
under fives.

Research design

The research design refers to the plan or organization of specific

investigation. Research design refers to the over all plan for obtaining answers
to the research problem. Pre experimental design was used for the study with
ingle group pre-test, pos -test design .the schematic representation of research
study deign used by the research investigation is given below.

20
 Pre- Treatment Post
test test

One Day- X Day-

group 1,O1 3, O2

Table-1:Sytematic representation of pre-experimental design

Key:

O1 : Pre test knowledge score before structured teaching programme.

X : Treatment variable (structured teaching programme)

O2 : post test knowledge after 4 days of administering structured teaching

programme.

Setting

Setting will be conducted in Yelahanka Government Hospital, Bangalore,

which is a distance of 10 km from Noor college of Nursing.

Variables

The concepts that can take on different quantitative values are called
variables. Variables are the measurable characteristics of a concept of logical of
attributes.

Variables for the present study were;

Independent variable

Independent variable is the presumed causes for the resulting effects on

the dependent variable.

21
 In this present study the independent variable was structured teaching
programme on immunization.

Dependent variable

Dependent variable is the variable, the researcher is interested in

understanding, explaining or predicting. In this present study the dependent
variable was the level of knowledge of mothers regarding immunization.

population

The target population of the present study was mothers of under five
children.

Sample

Sample refers to a subset of population that is selected to participate in a

particular study. The sample for the present study was mothers of under fives
presented in Yelahanka Government Hospital.

Sample size

Sampling size refers to the number of sampling units included in the

study. The sample comprises 30 mothers of under fives who met the inclusion
criteria and admitted during October to November (2012) in Yelahanka General
hospital, Bangalore.

Sampling technique

The sampling technique used for the study was purposive sampling
technique, which is a type of non-probability sampling.

Criteria for sample selection

Inclusion criteria:

 Mothers of under fives.

22
 Mothers who are available at the time of data collection.
 Mothers who can read and understand kannada or English.

Exclusion criteria;

 Mothers who cannot understand either English or kannada.

 Mothers who were not willing to participate.

Development and description of tool

On modifying the tool as per the experts suggestion the final tool consist
of two sections.

Section 1:-demographic data

It consist of selected demographic variables like the age of the mother,

education, occupation, income, source of health information, health service, age
of children, no. of children.

Section II :

It was self structured knowledge questionnaire and contained 40 items.

Section III

Development of structured teaching programme regarding immunization.

Lesson plan is a title given to a statement of the achievement to be realized and
the specific means, by the activities engaged during the period of 45 mts.

In order to educate the mothers regarding immunization, the lesson plan

was designed after reviewing material from books, journals, magazine,
bulletins, and the electronic media. Experts opinion aided to refine the
structured teaching programme to the comprehensive focused and objective
oriented.

23
 The tool was translated into regional language. Medical terminologies
were translated into kannada according to the level of under standing of the
samples.

Validity of the tool

The content validity of the instrument was assessed by obtaining opinion

from 9 expert in the field of paediatric nursing and paediatrician. The suggestion
of experts were incorporated in the tool and was modified and finalized.

Pilot study

A pilot study is a small scale version or trail run for the major study
conducted to refine the methodology. After obtaining a formal permission from
medical officer, Yelahanka government hospital at Bangalore. The pilot study
was conducted from 15.9.2012 to 28.9.2012 among 10 antenatal mothers were
selected by purposive sampling and those who met sampling criteria.

A structured pre-test, post-test questionnaire was used to collect data from

the mothers during pilot study. The samples taken for the pilot study were
excluded from the main study. The collected data were analyzed and interpreted
to conduct main study. Hence no change was made after the pilot study. The
researcher the proceed for the final study.

Reliability

The reliability of the tool was established by using split-half method. The
reliability (r =0.92) was found to be significant.

Data collection procedure

The main study was conducted from7.10.2012 to 8.11.2012 after obtained

permission from the medical officer, Yelahanka Government Hospital at
Bangalore.

24
 The steps used for data collection were a follows:-

1. The investigator introduce self and explained the purpose of the study.
2. The investigator introduces fixed days for conducting study.
3. Written consent of all mothers of under fives was taken to confirm willingness
to participate in the study.
4. Pre test was administered.
5. Structured teaching programme was administered on the day of pre-test.
6. Post-test was conducted by using the same tool on the 3rd day from the day of
pre test.
7. Data collected was tabulated and analyzed.

Plan for data analysis

Experts in the field of nursing and statistics directed the development of

data analysis plan which was as follows:-

a) Organization of data on a master sheet.

b) Tabulation of the data in terms of frequencies percentage, mean, standard
deviation, and range to describe the data.
c) Classification of knowledge by using the following formula.

Obtained score/ maximum score X 100

In adequate -50% and below

Moderate -51-75%

Adequate -76-100%

Structured knowledge questionnaire

A score of “1” was awarded to a correct response while a score of “0” was
awarded to incorrect response of structured knowledge questionnaire.

1. Frequency and percentage for the analysis of demographic variables.

25
2. Frequency, percentage, mean, and standard deviation for the analysis of
knowledge.

3. Paired„t‟ test for testing the effectiveness of structured teaching from pre test
and pot test knowledge.

4. Chi-square test to find association between post-test knowledge and selected

demographic variables.

26
 Target Sample Sampling Variables Instrument Method Analysis
Setting
population
Target technique of data
population collectio
n

Paediatric ward MOTHERS OF 30 Purposive Independent Pre test Section I: Descriptive

of yelahanka UNDER FIVES samples sampling Variable:
Demographic Analysis:
Government technique structured
hospital teaching Administrat Frequency,
Data
programme on ion of
Section II: Percentage,
knowledge structured
regarding Structured Mean, standard
immunization teaching
Knowledge Deviation, and
among mother of
programme
under fives. Questionnaire range
Dependent followed by Inferential
variable
Knowledge of after D3 Statistics:
mothers of under
Paired ‘t’ test
fives regarding
immunization. Chi-square test

Fig 2: Schematic Representation of research process

27
 CHAPTER V
RESULTS

Analysis is the process of organizing and synthesizing data in such a way that
research questions can be answered and hypothesis tested.

This chapter deals with the analysis and interpretation of the data collected to
assess the structured teaching programme on knowledge regarding immunization among
mothers of under fives in selected hospital at Bangalore.

The purpose of this analysis is to reduce the data to in manageable and

interpretable form so that the research problem can be studied and tested. The analysis and
interpretation of data of this study are based on data are collected through structured teaching
programme on knowledge regarding immunization among mothers of under fives in selected
hospital at Bangalore. The collected data were coded, organized, tabulated, analyzed and
interpreted using descriptive and inferential statistics, based on the objectives and hypothesis
of the study.

OBJECTIVES OF THE STUDY

1. To assess the knowledge of immunization among mothers of under five children .

2. To assess the effectiveness of structured teaching program me on Knowledge regarding

immunization among mothers of under five children .

3. To determine the association between pre-test knowledge score and selected demographic
variables.

HYPOTHESIS

H: the mean post-test knowledge score of subject exposed to structured teaching

program me will be significantly greater than the mean pre-test knowledge scores.

PRESENTATION OF THE DATA

The data collected are entered in master data sheet, for tabulation and statistical processing in
order to find the relationship. The data collected were edited, tabulated, analyzed, interpreted

28
and findings obtained were in the form of tables and diagrams represent under the following
sections:-

Section I: Analysis of sample characteristics regarding demographic variables

Section II: To assess the level of knowledge on immunization among mothers of under five
by conducting pre- test and post-test.

Section III: To assess the effectiveness of the structured teaching programme on knowledge
regarding immunization among mothers of under five by comparing mean pre-test and post-
test knowledge score and by using paired „t‟ test.

Section IV: To find out the association between pre-test knowledge scores with their
selected demographic variable.

29
 SECTION- I

Analysis of sample characteristics regarding demographic variables.

Table : 2, Frequency and percentage distribution of mothers of under fives

according to their demographic variable

N=30

Sl.no Demographic variable frequency Percentage(%)

1. Age of the mother

a) 20-25 years 13 43
b) 6-30 years 10 33
c) 31-35 years 7
23
Total 30 100
2 Religion
a) Hindu 15 50
b) Muslim 10 33
c)Christian 5 17
Total 30 100

3 Educational status
a) Primary 14 48
b) Middle school 11 37
c) Secondary 4 13
d) Degree 1 3
Total 30 100

30
4 Occupation
a) House wife 11 37
b) Private 10 33
c) Business 6 20
d) Government 3 10
Total 30 100
5 Type of family
a) Nuclear 12 40
b) Joint 10 33
c) Extended 8 27

Total 30 100
6 Family income
a) Below 5000 5 17
b) 5001-10,000
11 37
c) 10,001-20,000
11 37
d) 20,001-above
3 10
Total 30 100
7 Exposure to source of health
a) Self learning 6 20
b) Mass media 8 27
c) Friends
9 30
d) Health personnel
7 23
Total 30 100
8 Health services availed from
a) P.H.C 11 37
b) Sub centre 7 23
c) Nursing home
8 27
d) Hospital
4 13
Total 30 100

31
9 No of under five child
a) 1 13 43
b) 2 10 33
c) 3
7 23
d) 4 and above

total

10 Age of children
a) 0-1 11 37
b) 1-2 5 17
c) 3-4 9 30
d) 4-5 5 17
Total 30 100

The above table no 2 shows that the frequency and percentage of mothers of under fives
according to their demographic variables

32
Age of the mother in that majority13(43%) of mother were below 25 years, 10(33%) of
mothers belongs to age group between 26-30 years,7(23%)of mothers were belongs to 31-35
years(fig-3)

Religion of mothers shows majority 15(50%) of Hindu and 10(33%) belongs to Muslim and
5(17%)belongs to Christian.(fig-4)

Educational qualification of mothers of under fives shows that majority 14(47%) belonged
to primary followed by 11(37%) belonged to middle school and 4(13%) were belonged to
secondary and 1(3%) were belonged to degree.(fig-5)

In regard to occupation of mother majority of them were in private job10(33%) followed by

business6(90%) and Government3(10%) and house wife 1(37%)

In regard to type of family the majority of them are nuclear family14(40%) followed by joint
family10(33%) and in extended family 8(27%)

In regard to family income the majority of them were11(37%) earning between 5001-10,000
followed by 11(37%)in below 5000 and in above 20,001 were belonging to 3(10%).

Exposure to source of health, shows the majority 9(30%) from friends followed by
8(27%)from mass media, and 7(23%) from health personnel and 6(20%) self learning.

Health services availed from11(37%) from PHC and 8(27%) from nursing home and
7(23%) from sub centre and 4(13%) from hospital.

No. of under five children 13(43%) are 1 year of age followed by 10(33.3%) were years
and 7(23%) are 3 years of age.

33
 23%
44%
a=below 25 years
b= 26-30 years
33% c = 31-35

Fig 3: Pie diagram represents percentage distribution of age of mothers.

17%

50%
a=hindu
b=muslim
33%
c=christian

Fig4: pie diagram presents percentage distribution of religion

34
 16
a=primary, 14
14
P
12 b=middle, 11
E
R 10
C
E 8
N
6
T c=secondary, 4
A 4
G
2 d=degree, 1
E
0
a=primary b=middle c=secondary d=degree

Fig 5: bar diagram represents percentage distribution of educational status of mothers.

10%
37%
20%
a= house wife
b=private job
c=business
33% d=government

Fig 6: pie diagram represents distribution of occupation of mothers

35
 a=nuclear, 12
P 12
E b=joint, 10
R 10
C 8
E c=extended, 8
N 6
T 4
A
2
G
E 0

a=nuclear
b=joint
c=extended

Fig 7: Bar diagram represents percentage distribution of type of family

10% 17%

a=below 5000
37% b=5001-10000
36% c=10001-20000
d=20001- above

Fig 8: Pie diagram represents percentage distribution of family income per month.

36
 9
P b=mass media, 8c=friends, 9
a=self learning,
8
E 6
7 d=health
R
6 prsonnel, 7
C
E 5
N 4
T 3
A 2
G 1
E 0

a=self
learning b=mass
media c=friends
d=health
prsonnel

Fig 9: Cylindrical diagram represents percentage distribution of exposure of source of

health.

a=PHC, 11
12
P
10
E
c=nursing home,
R 8 8
b=sub center, 7
C
E 6
N
4
T
A d=hospital, 4
2
G
E 0

a=PHC
b=sub center
c=nursing
home d=hospital

Fig 10: Cone diagram represents available health services

37
 23%

44%

a=1
b=2
c=3
33%

Fig 11: Pie diagram represents percentage distribution of no of under five children

12
a= 0-1, 11

10
P c=3-4, 9
E
R
8
C
E
N
6
T b=1-2, 5 d=4-5, 5
A
G
4
E

0
a= 0-1 b=1-2 c=3-4 d=4-5

Fig 12: Bar diagram represents percentage distribution of age of children

38
 SECTION II

To assess the level of knowledge on immunization among mothers of under fives by

conducting pre-test and post-test

Table:3, frequency and percentage distribution of pre-test and post-test knowledge

score regarding immunization among mothers of under fives.

N=30

Pre test Post test

Level of
frequency percentage frequency percentage
knowledge
In adequate 21 70 - -

Moderate 7 23 3 10

Adequate 2 7 27 90

Total 30 100 30 100

It is observed in table No.3 that pre test knowledge score of children regarding
immunization among mothers of under fives was inadequate 21(70%), moderate 7(23%),and
adequate2(7%).whereas post-test knowledge score was adequate in 27(90%) mothers,
moderate in 3(10%) mothers and none of them had inadequate knowledge after the structured
teaching programme.

39
Fig 12: Bar diagram represents percentage distribution of pre-test and post test level of
knowledge regarding immunization among mothers of under five

40
 SECTION III

To evaluate the effectiveness of the structured teaching programme on knowledge

regarding immunization among mothers of under fives by comparing mean pre-test
knowledge score and by using paired „t‟ test.

Table 4

Over all mean, standard deviation, paired „t‟ value of pre test and post test

N=30

Mean Standard Paired „t‟ test

Test deviation
Pre test 17.70 6.09 „t‟cal =13.67

df=29
Post test 34.00 2.948
„t‟ tab=1.7

P=0.00 HS
HS* highly significant, df –degree of freedom

Above data table no.4 depicted that the mean and of post-test knowledge scores among
mothers of under fives was 34, which is significantly higher than mean of pre-test knowledge
scores of 17.70.standard deviation of post-test score and pre-test score is2.948 and 6.09
respectively. The computed paired „t‟ value(13.67,df=29, at the level of p 0.00) is greater
than table value(1.7) which represents significant gain knowledge through structured teaching
program me. Hence the hypothesis is accepted.

41
 SECTION IV

To find out the association between post test knowledge scores with their selected
demographic variables.

Table-5

Association between demographic variables and pre test level of knowledge of

mothers of under fives regarding immunization.

Sl.no Demogr Categories scores total Chi

aphic Adequate Moderate Inadequate Square
variable value
s F %
F % F % F %

1 Age below-25 2 6.6 4 13.3 7 23.3 13 43.2 X2 =0.74

26-30 years 0 - 3 10 7 23.3 10 33.3 df=1
NS
31-35 years 0 - 0 - 7 23.3 7 23.3
TOTAL 2 7 21 30 100

2 Religion Hindu 1 3.3 4 13.3 10 33.3 15 50 X2 =1.22

Muslim 0 - 3 10 7 23.3 10 33.3
df=1
Christian 1 3.3 0 - 4 13.3 5 16.6
TOTAL 2 7 21 30 100 NS

3 Educatio Primary 1 3.3 3 10 10 33.3 14 46.6 X2=.475

nal Middle 0 - 2 6.6 9 30 11 36.6 df=1
status school NS
Secondary 1 3.3 1 3.3 1 3.3 4 9.9
Degree 0 - 1 3.3 0 - 1 3.3
TOTAL 2 7 21 30 100

4 Occupat House wife 0 - 3 10 8 26.6 11 36.6 X2=1.75

ion df=1
Private job 0 - 1 3.3 9 30 10 33.3 NS
Business 1 3.3 2 6.6 3 10 6 19.9
Government 1 3.3 1 3.3 1 3.3 3 9.9
TOTAL 2 7 21 30 100

42
5 Type of Nuclear 1 3.3 1 3.3 10 33.3 12 39.9 X2=.362
family Joint 0 - 3 10 7 23.3 10 33.3 df=1
NS
Extended 1 3.3 3 10 4 13.3 8 26.6
TOTAL 2 7 21 30 100

6 Family Below 5000 0 - 3 10 2 6.6 5 16.6 X2=.621

income 5001-10000 1 3.3 1 3.3 9 30 11 36.6 df=1
NS
10001-20000 1 3.3 1 3.3 8 26.6 10 33.2
20001-above 0 - 2 6.6 2 6.6 4 13.2
TOTAL 2 7 21 30 100

7 Exposur Self learning 1 3.3 2 6.6 3 10 6 100 X2=0.21

e to Mass media 1 3.3 0 - 7 23.3 8 100 df=1
source NS
of health Friends 0 2 6.6 7 23.3 9 100
Health 0 3 10 4 13.3 7 100
personnel

TOTAL 2 7 21 30 100

8 Health PHC 0 - 2 6.6 9 30 11 36.6 X2=0.88

services Sub center 2 6.6 2 6.6 3 10 7 23.2 df=1
NS
Nursing 0 - 2 6.6 6 20 8 26.6
home

Hospital 0 - 1 3.3 3 10 4 13.3

TOTAL 2 7 21 30 100
9 No.of 1 2 6.6 4 13.3 7 23.3 13 43.2 X2=0.07
under 2 0 - 1 3.3 5 16.6 6 19.9 df=1
five NS
children 3 0 - 2 6.6 5 16.6 7 23.2
4 and 0 - 0 - 4 13.3 4 13.3
above
TOTAL 2 7 21 30 100
10 Age of 0-1 2 6.6 3 10 6 20 11 36.6 X2=0.74
children 1-2 0 - 2 6.6 3 10 5 16.6 df=1
3-4 0 - 2 6.6 7 23.3 9 29.9 NS
4-5 0 - 0 - 5 16.6 5 16.6
TOTAL 2 7 21 30 100

NS=not significant

43
X2=chi-square

The above table(table no-5) shows the association of pre-test knowledge score with their
selected demographic variables by using chi-square(x2) ,it was evident that ,there was no
significant association between pre-test knowledge score with their demographic variable.

44
 CHAPTER VI

DISCUSSION

The present study is undertaken to evaluate the effectiveness of structured teaching

program me on knowledge regarding immunization among mothers of under fives in selected
hospital at Bangalore.

The objectives of the study were to:

1. To assess the level of knowledge of mothers of under fives regarding immunization.

2. To evaluate the effectiveness of structured teaching programme on knowledge regarding

immunization among mothers of under fives.

3. to find association between pre test knowledge scores with selected demographic
variables.

HYPOTHESIS

H: the mean pot-test knowledge score of subject exposed to structured teaching programme
will be significantly greater than the mean pre-test knowledge scores.

The findings of the study are discussed under the following headings:

1. Findings related to sample characteristics.

2. Findings related to knowledge of mothers of under fives regarding immunization.

3. Findings on association between pre-test knowledge scores and selected demographic

variables.

Findings related to sample characteristics

Age of the mother in that majority13(43%) of mother were below 25 years, 10(33%)
of mothers belongs to age group between 26-30 years,7(23%)of mothers were belongs to 31-
35 years

Religion of mothers shows majority 15(50%) of Hindu and 10(33%) belongs to

Muslim and 5(17%)belongs to Christian.

45
 Educational qualification of mothers of under fives shows that majority 14(47%)
belonged to primary followed by 11(37%) belonged to middle school and 4(13%) were
belonged to secondary and 1(3%) were belonged to degree.

In regard to occupation of mother majority of them were house wife1(37%) followed

by private job 10(33%) and business 690%)and government 3(10%)

In regard to type of family the majority of them are nuclear family14(40%) followed
by joint family10(33%) and in extended family 8(27%)

In regard to family income the majority of them were11(37%) earning between 5001-
10,000 followed by 11(37%)in below 5000 and in above 20,001 were belonging to 3(10%).

Exposure to source of health, shows that majority 9(30%) from friends followed by
8(27%)from mass media, and 7(23%) from health personnel and 6(20%) self learning.

Health services availed majority 11(37%) from PHC and 8(27%) from nursing
home and 7(23%) from sub centre and 4(13%) from hospital.

No. of under five children, 13(43%) are 1 year of age followed by 10(33.3%) were
years and 7(23%) are 3 years of age.

In last age of children majority shows 11(37%) were in 0-1 years of age. 9(17%)
were belonged to 1-2 years of age. 5(17%) were in between3-4 years of age, and in last
5(17%) were in between 4-5.

Findings related to knowledge of mothers of under fives regarding

immunization

Finding shows that during pre-test, most of the sample were having in adequate level
of knowledge regarding immunization. After administration of structured teaching program
me, there was marked improvement in the knowledge of the sample with majority 27(90%)
gained adequate knowledge score and3 (10%) of the sample had moderate knowledge score
regarding immunization.

This was supported by a study conducted to describe the finding of literature

review focusing on immunization among under fives. Qualitative deductive content analysis
was used to investigate what is known about mother‟s views on immunization.

46
Findings related to effectiveness of structured teaching program me on
knowledge of mothers by comparing pre-test and post-test knowledge
score.

Findings shows that the overall mean and standard deviation of post-test knowledge
scores among mothers of under fives regarding immunization was 34 with a standard
deviation of 2.94 which is significantly higher than mean and standard deviation of pre test
knowledge scores of 18.04 with a standard deviation of 4.20. The computed „t‟ value (13.67,
df= 29,at level of p=0.00)is greater than table value (1.7) which represents significant gain in
knowledge through structured teaching program me.

Therefore, the post-test knowledge score was apparently higher than that of the pre-
test knowledge score, the research hypothesis was accepted.

Findings on association between pre-test knowledge scores with selected

demographic variables.

The result shows that, there was no significant association between the mean pre-test
knowledge and selected demographic variables.

47
 CHAPTER-VII

CONCLUSION

The present study assessed the knowledge among mothers of under fives regarding
immunization and found that the mothers had inadequate knowledge related to immunization.
After the structured teaching program me on immunization there was significant
improvement on knowledge of mothers of under five regarding immunization. The study
concluded that the structured teaching programme was effective in improving knowledge of
mothers of under fives regarding immunization.

The nursing personnel are challenged to provide standard and quality nursing care.
Hence there is a need for the nurse to take active part to restore the life of patients to
maximize functional capacity. Despite all efforts at preventing unexpected situations, these
situations can do occur. More and more nurses are taking up pediatric specialty, gradually the
role of the pediatric nurses is expanding into liaison nursing.

The findings of this study has implication in various areas of nursing namely nursing
practice, nursing education, nursing administration and nursing research.

Nursing practice

1) The field of pediatric nursing has great responsibility to protect the health of
children‟s.
2) Nurses should be equipped with update knowledge on immunization to impart
appropriate knowledge to the community.
3) Pediatric nurses need to take up the responsibility to create awareness among mothers
of under fives regarding immunization to prevent communicable diseases.
4) Nurse working in various health care setting are key persons who play a major role in
health promotion, health maintenance, and prevention of disease.
5) Nurses and health care providers play a vital role in motivating the mothers to provide
immunization to their children at correct time according to the schedule.
6) Nurse should organize health education campaign to all health care setting about
immunization to prevent immunization.

48
 Nursing education
1) The study emphasizes the need for developing good teaching skills among
student nurses on immunization.
2) The nurse educator should emphasize health education on immunization and
to prevent diseases as a part of learning experience for the students.
3) The nurse educator should arrange for the in-service education
programme(seminars, workshops) for student nurse regarding immunization and
to prevent disease.
4)The nurse educator can provide an opportunity for students to actively
participate in immunization programme.
Nursing administration
1) Nurse administrator should guide and monitor the nurse regarding immunization
and has to plan for in services education periodically.
2) Nurse as an administrator plays an important role in educating the professional
and in policy making such as mass health education measures in the hospitals.
3) Nurse administrators should plan regarding the training programme well in
advance.
Nursing research
1) The essence of research is to build a body of knowledge in nursing.
2) Nursing research is the main source by which the nursing profession is growing.
3) The generalization of the study results can be made by replication of the study the
nurse researcher can inculcate practice by strong base research.
4) This study will serve as a valuable reference material for future investigators.
Recommendations
1) A similar study can be done on a large sample to validate and generalize the
findings.
2) This study will be reference for research scholars.
3) Evidence based nursing practice must take higher profile in order to increase
awareness among mothers of under fives.
4) A comparative study between urban and rural knowledge and attitude on
immunization can be conducted.

49
 CHAPTER VIII
SUMMARY
The primary aim of the study was to evaluate the effectiveness of structured teaching
programme on knowledge regarding immunization among mothers of under fives in
selected hospitals at Bangalore.
Objectives

1. To assess the level of knowledge of mothers of under fives regarding

immunization.

2. To evaluate the effectiveness of structured teaching programme on knowledge

regarding immunization among mothers of under fives.

3. To find association between pre test knowledge scores with selected demographic
variables.

HYPOTHESIS

H: The mean post test knowledge score of subject exposed to structure teaching
programme will be significantly greater than the mean pre- test knowledge scores.

The conceptual frame work for this study was developed by applying Ludwig Von
Bertalanffy‟s general system theory.

Pre experimental, pre-test and post-test, with an evaluate approach was used to test
the proposed hypothesis. The study sample(n=30) selected for study was mothers of
under fives admitted in pediatric ward at Yelahanka government hospital, Bangalore.
Purposive sampling technique was utilized for the selection of the study samples. In
order to collect data ,a structured knowledge questionnaire was used.

An extensive review of related literature for this present study was done by the
investigator herself which helped investigator to develop the criteria for development of
structured teaching programme and construction of tool. The literature review also
helped in determining the effectiveness of structured teaching programme and plan for
determining and analysis.

50
Findings of the study were presented under the following headings

Section I:Distribution of demographic characteristics of the mothers

a) Majority 13(43%) of mothers belongs to age group below 25 years.

b) Majority 15(50%) of mothers belongs to Hindu religion.
c) Majority 14(47%) of mothers belongs to primary class.
d) Majority 11(37%) of the mothers are house wife‟s.
e) Majority 12(40%) of the mothers belongs to nuclear family.
f) Majority 11(37%)of them had family income between 5001-10000
g) Majority 9(30%) of mothers have source of health information from friends.
h) Majority 11(37%) of them receiving health services from P.H.C
i) Majority 13(43%) of have 1 child below 5 years.
j) Majority 11(37%) of mothers have children between 0-1 year of age.

Section II: The knowledge of mothers of under fives regarding

immunization
During pre-test, most of the sample were having not adequate level of
knowledge scores regarding immunization. After administration of structured
teaching programme, there was marked improvement in the knowledge of the sample
with majority27 (90%) gained adequate knowledge score and3(10%) of the sample
had moderate knowledge regarding immunization.

Section III: Effectiveness of structured teaching programme regarding

immunization by comparing pre test and post test knowledge scores
Over all comparison of pre-test and post-test knowledge score
The overall mean and standard deviation of post-test knowledge score
regarding immunization among mothers of under five‟s were34 with a standard
deviation 2.94
In the present study, the mean post-test knowledge score was 34 which are
apparently higher the mean pre-test knowledge scores17.70 and the mean difference
was 16.30.The calculated paired test value(t cal =13.67,p=0.00) is greater than the
table value (t tab=1.7) which represents significant gain knowledge through the
structured teaching programme.

51
Section IV: association between the pre-test knowledge score and selected
demographic variables
The result shows that, there is no significant association between pre-test and
selected demographic variables.

52
 CHAPTER-IX
BIBLIOGRAPHY
1. Dorothy .R. marlow,”Text book of Paediatric Nursing” (2005),6th edition, esevier
publishers, noida,pno593-597
2. M.S Jessie M.chellappa, paediatric nursing ,1st edition, gajanana book publisher,
2000,page no: 42
3. Introduction: immunization: The merck manual medical library: the merck manual of
medical information. Home edition July 2008: available from
URL:http://www.merck.com.
4. Hockenberry MJ,Wilson D. Wong‟s nursing care of infants, 8th edition, New Delhi:
Mosby 2009
5. Ball WJ, Binder R C. Paediatric Nursing Caring For Children. 4th ed. New Delhi:
Dorling Kindersley Pvt.Ltd:2009
6. Laura Contreras, U.S. Fund for UNICEF media 212,880,9166.
7. Miles MS,Carlson j, Brunssen S Burchinal p. Journal of paediatric nursing 1999
feb;14(1):44-50
8. UNICEF, “global child mortality continues to drop” on December 8th,2009.
9. GM DHAAR,I ROBBANI, foundations of Elsevier community medicine.1st edition
.India pvt Ltd p.no:969
10. Anita khokhar,immunization status in urban community. Indian journal of preventive
and social medicine.2005 p no:82-86
11. k.k gulani, text book of community health nursing, principles and practice: New
Delhi
12. Basavantappa BT. Text book of child health nursing. New delhi:Tarun ahuja;
13. polkki T, Pietila AM, julkunen K V,laukkala H,Ryhanen p.Dertermine the
relationship between the literacy status and immunization coverage among mothers
of under five children in kolar district in Bangalore. journal of paediatric nursing
2001 aug:17(4):270-2.
14. W.H.O global forum for health research 2010.www.pubmed.com
15. CIA world fact book febryary 19th ,2010
16. World infant mortality rates in 2008,population references bureau.
17. WHO,UNICEF and World Bank, state the world‟s vaccines and immunizations, 3rd
edition, Geneva world health organization 2010.

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18. UNICEF a look at the urban child: New Delhi, UNICEF 2009.
19. Anjum Q,omair A, Inam S.N, Ahmed y, Usman y,Shaih S,” improving vaccination
status of children under five through health education”journal of paistan medical
association,2004,54(12) 610-613.
20. Singh M, c badole cm singh MP”immunization coverage and the knowledge of
practice of mothers regarding immunization in rural area, Indian jounal of public
health 1994 july 38(3) 103-107.
21. wilson FL ,Brown D L,stephens- ferris M, mothers journa of paediatric nursing2006
feb (1)4-21
22. National Family Heath Survey (NFHS-3) 2006
23. Meheja.N; “The purpose and need of research study and review of literature.”
Nursing times, April 1(12) p no:45-7
24. Bossert E, Hart D.A cross sectional study on national immunization survey (NIS)
united state American Journal Paediatric Nursing.1994::23(1) p.no 33-34
25. Melnyk BM. An exploratory study was conducted to assess immunization coverage
among. Journal of Paediatric Nursing. February 2000; 15(1):4-11.
26. Polkki T, Pietila AM, Julkunen KV, Laukkala H, Ryhanen P. A comparativestudy
to estimate the vaccination coverage level of childrens living in rural and urban
areas . Journal of Paediatric Nursing 2001 Aug;17(4):270-2.
27. Mahat G, Scoloveno MA. A cross-sectional study to determine the coverage of the
expanded programme of Immunization (EPI) of the ministry of Health . Journal of
Paediatric Nursing 2003 Oct;18(5):305-13.
28. Canella B, Mahat G, scoloveno MA Evaluate the reason being not immunized in the
to slums paediatric health care 2004 nov-Dec:18(6):3027
29. Bossert E,Hart D.Ahealth survey regarding immunizationjournal of paediatric
nursing 2009:23(1):33-49.
30. Aggarwa A K,kumar R the immunization status of children and reasons for partial
immunization and non immunization Indian journa of community medicine
200525(3)420-432
31. Vazir S, Naidu AM. To assess the level of knowledge among parents . Indian
Paediatrics 2008 Oct;35:959-65.
32. Sanofer.T.G. The objective of mother‟s poor knowledge about immunization.
American Journal of Public Health. 2009 Jul – Sep; 32(3); 103-7.

54
33. Singh MC, Badole CM, Singh MP. A community based study was conducted to
Evaluate the factors affecting the immunization coverage. Indian Journal of Public
Health. 2008 oct; 22(3); 104-8.
34. Zell ER, Ezzati, Rice TM, Battaglia MP, Wright RA. Immunization in the town of
Pilani Public Health Rep 2000 Jan. Feb; 115(1); 65-77.
35. Topuzoglu A, Ozaydin GA, Calis, Cebeci D, Kalaca S,et al; Immunization coverage
and the knowledge and practice. Journal of publHealth. 2005 Oct; 119 (10): 862-
9.Stokley S, Smith PJ, Klevens RM
36. Stokley S, Smith PJ, Klevens RM, Battaglia MP; The implementation of pertusis
immunization program Journal of Community Medicine 2008 May; 20(4); 55-60.
37. Linkins RW, Salmon DA, Omer SB, Pan WK, Stoklev S, et al: To determine the
knowledge of mothers on immunization of children. BMC public Health. 2006 sep
226;236.
38. Tada Y. Effectiveness of planned teaching programme educational on immunization.
Journal of Paediatric Nursing 2008;22(6):43-48
39. Mayurasakom K. To evaluate the effectiveness of structured teaching programmed.
Indian Journal of Community Medicine 2005;25(3):420-32.
40. BMC public health,2008 nov5:8(1)381,E pub
41. Vaccinations for infants and children Available from URL:
http://www.bolohealth.com/expertspeak/Indukhosla/healthy-skin-and-hair/82-
vaccines-recommended-for-indian-children
42. “Christian Glaud” “Centre for clinical intervention research, H:S Rigshospitalet.
Denmark.
43. Basavanthappa B.T. Nursing research.1st edition, published by jaypee brothers‟, new
Delhi 1998,p.no-93
44. Shaw.implementing conceptual frame work, journal of nursing administration
aug.1973,p no:8-11
45. Polit, F Dennis nursing research principles and methods. 4th edition.philadelpia,JB
Lippincott publications,2000.p no91-92
Net reference
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2. www.google.com
3. www.pubmed.com

55
ANNEXURE-I

56
ANNEXURE - II

57
ANNEXURE - III

58
 ANNEXURE – IV

This is to certify that content prepared by Ms. Sindhu Paul 2nd year M.Sc. nursing, of Noor

College of Nursing, Bangalore for her study stated A STUDY TO ASSESS THE EFFECTIVENESS

OF STRUCTURED TEACHING PROGRAM ME ON KNOWLEDGE REGARDING

IMMUNIZATION AMONG MOTHERS OF UNDER FIVE CHILDREN IN SELECTED

PEDIATRIC WARD IN BANGALORE.

59
 ANNEXURE-V

FORMAT OF LETTER SEEKING EXPERTS CONTENT VALIDATION

OF CONSTRUCTURED TOOL

From,
Ms. Sindhu Paul

2nd Year M.Sc Nursing

Child Health Nursing

Noor College Of Nursing

Bangalore.

Through the Principal, Noor College of Nursing

To,

……………………..

……………………..

……………………..
Subject: Requisition for expert’s opinion and suggestions for content validity of research tool.

Respected Madam/Sir,

I am 2nd year student of Masters of Nursing at the Noor college of nursing, Bangalore. As a part
of my partial fulfillment of M. Sc (N) programme, I need to construct tool and send it for
valuation and suggestions about my tools which I have enclosed. I humbly request you to certify
regarding your validation in the enclosed format. I will be grateful to your honorable work.

Thanking you. Yours faithfully

Date:

Sindhu Paul

60
 ANNEXURE-VI

CERTIFICATE OF TOOL VALIDATION

This is to certify that the tool constructed by Mrs.Sindhu Paul 2nd year M.Sc. Nursing, Noor
College of nursing to be used in her study titled, “A study to assess the effectiveness of
structured teaching program me on knowledge regarding immunization among mothers of under
five children in selected pediatric ward in Bangalore”. Has been validated by the undersigned.
The suggestion and modification given by me will be incorporated by the investigator in concern
with their respective guide. Then she can proceed to do the research.

MY COMMENTS ON THE TOOL:

SIGNATURE WITH SEAL:

NAME

DESIGNATION:

COLLEGE:

PLACE:

DATE:

61
 ANNEXURE – VII

LIST OF EXPERT CONSULTED FOR CONTENT VALIDITY

1) Mrs. Babita Yumnum

Asso. Professor

Child Health Nursing

Noor College of Nursing

Bangalore

2) Mrs. Sujatha

Lectures

Child Health Nursing

Noor College of Nursing

Bangalore

3) Mrs. Bindu Kumar

HOD

Child Health Nursing

Acharya College of Nursing

Bangalore

4) Mrs. Indira

HOD

Child Health Nursing

Varalakshmi College of Nursing

Bangalore

62
5) Mr. Jinslin Oliver

HOD

Child Health Nursing

Noor College of Nursing

Bangalore

6) Mrs. R.Anand Jyothy

Govt. College of Nursing

Bangalore

7) Dr. Sanjay patak

HOD,

Dept. of Paediatrics

Kohinoor Hospital

Mumbai.

8) Dr. Krishnappa

Dept. of Paediatric

Sri Devaraj Urs Hospital

Bangalore.

9) Dr. Santhosh Kumar

Depat. Of Paediatrics

ACME, Kannur

Kerala.

63
 ANNEXURE-VIII

BLUE PRINT OF THE CONTENT OF THE

TOOL
SL. CONTENTS ITEMS NO. TOTAL NO.
NO OF ITEM
1. knowledge related to the 1,2,3,4, 4
general information
regarding immunization
2. knowledge of mothers
regarding the immunization 5,6,7,8,9,10,11,12,13,14,15,16,17,18 27
schedule 19,20,21,22,23,24,25,26,27,28,29,30,31
Knowledge of mother
3.
regarding the purpose of 32,33,34,35,36,37,38,39,40, 9
each vaccine.

64
 ANNEXURE-9

STRUCTURED QUESTIONNAIRE

INSTRUCTIONS:

This Section Contains Questions Regarding You. Please Mark( )In Appropriate Space

This Information Provides Will Be Exclusively Used For The Purpose Of Research Study And
Will Be Kept Confidential.

PART-A: SOCIODEMOGRAPHIC VARIABLE

1. Age of the mother

a. below-25 ( )
b. 26-30 ( )
c. 31-35 ( )
2. Religion
a. Hindu ( )
b. Muslim ( )
c. Christian ( )
3. Educational status
a. Primary ( )
b. Middle school ( )
c. Secondary ( )
d. Degree ( )
4. Occupation
a. Housewife ( )
b. Private Job ( )
c. Business / company ( )
d. Government ( )

65
5. Type of family
a. Nuclear ( )
b. Joint ( )
c. Extended ( )
6. Family income
a. Below 5000 ( )
b. 5001-10,000 ( )
c. 10,001-20,000 ( )
d. 20,001-above ( )

7. Exposure to source of health information

a. Self learning ( )
b. Mass media ( )
c. Friends ( )
d. Health personnel ( )

8. Health services availed from

a. P.H.C ( )
b. Sub centre ( )
c. Nursing home ( )
d.Hospital ( )

9. No.of under five children

a. 1 ( )
b. 2 ( )
c. 3 ( )
d. 4 and above ( )

10. Age of children

a. 0-1 ( )
b. 1-2 ( )

66
c. 3-4 ( )
d. 4-5 ( )

(A)GENERAL INFORMATION REGARDING IMMUNIZATION

1. What is the importance of vaccination?

(a) Induce immunity against specific Disease ( )

(b) Prevent occurr ance of a specific disease ( )

(c) Both ( )

2. What is a Vaccine?

(a) Substances that produces protection n against a disease ( )

(b) Substances used to kill a organism ( )

(c) Substances that induce death o f tissue ( )

3. What is the purpose of Immunization?

(a) To protect body ( )

(b) To prevent illness ( )

(c) To provide specific protection of diseases ( )

4. What is Immunization?

(a) Process of protecting an individual through injections ( )

(b) Process of killing an organism ( )

(c) Process of protecting an individual by vaccination ( )

67
B.KNOWLEDGE QUESTIONNAIRE.

1. Knowledge of mothers regarding the immunization schedule.

5. At what age BCG to be given

(a) 6 weeks ( )

(b) At Birth ( )
( )
(c) At 10 weeks

6. At what age OPV to be given

(a) 6 weeks ( )
( )
(b) 14 weeks
( )
(c) At Birth

7. At what age Hepatitis B1 to be given

(a) At Birth ( )
( )
(b) 10 weeks
( )
(c) 14 weeks

8. At what age OPV1 to be given

(a) 6 months ( )

(b) 6 weeks ( )
( )
(c) 14 weeks

9. At what age DTP1 to be given

(a) At Birth ( )
( )
(b) 14 weeks
( )
(c) 6 weeks

68
10. At what age Hib1 to be given

(a) 6 weeks ( )
( )
(b) 10 weeks
( )
(c) 6 months

11. At What age hepatitis B2 to be given

(a) 4 weeks ( )

(b) 6 weeks ( )
( )
(c) 10 weeks

12. Which age group children are administered pneumococcal conjugate vaccine (PCV)

(a) At birth
( )
(b) 10 weeks ( )

(c) 6 weeks ( )

13. At what age Rota virus 1 to be administered

(a) 6 weeks ( )

(b) 1 year ( )
( )
(c) 10 weeks

14. At what age OPV 2 to be administered

(a) 1 year ( )
( )
(b) 10 weeks
( )
(c) 6 months

15 .At what age Hib2 to be given?

(a) 10 weeks ( )
( )
(b) 14 weeks
( )
(c) 6 weeks

69
16. At which age group PCV2 to be given
( )
(a) 14 weeks
( )
(b) 10 weeks
( )
(c) 6 months

17. At What age Rota virus is to be given

(a) 6 months ( )
( )
(b) 14 weeks
( )
(c) 10 weeks

18. At what age OPV3 is to be given

( )
(a) 14 weeks
( )
(b) 6 weeks
( )
(c) 6 months

19. Which age group children are administered DTP3

(a) 1 year ( )
( )
(b) 14 weeks
( )
(c) 6 weeks

20. At what age group HIB3 is to be given

(a) 6 months ( )

(b) 10 weeks ( )
( )
(c) 14 weeks

21. Which age group children is administered PCV3 vaccine

( )
(a) 14 weeks
( )
(b) 2 years
( )
(c) 1 year

70
22. At which age group children is administered hepatitis B3

(a) 2 months ( )
( )
(b) 6 months
( )
(c) 10 months

23. Which vaccine to be given at the age of 9 months

(a) Typhoid ( )
(b) Cholera ( )

(c) Measles ( )

24. MMR vaccine to be given at the age of

(a) 15-18 months ( )

( )
(b) 12-14 months
( )
(c) 1 year

25. At what age OPV4+IPV4 is to be given

(a) 2 years ( )
( )
(b) 15-18 months
( )
(c) 6 months

26. At which age group PCV B Vaccine to be given

(a) 6 months ( )
( )
(b) 1 year
( )
(c) 15-18 months

27. At what age Varicella vaccine is to be given

(a) 15 months ( )
(b) 18 months ( )
( )
(c) 2 year

71
28. Which vaccine to be given at the age of 18 months

(a) Typhoid ( )

(b) Hepatitis A ( )
( )
(c) Measles

29. At what age typhoid vaccine to be given

(a) 1 year
( )
(b) 5 year ( )
(c) 2 year ( )

30. At what age OPV5 is to be given

(a) 5 year ( )

(b) 3 year ( )
( )
(c) 2 year

31. at what age group MMR2 to be given

(a) 1 year ( )

(b) 5 year ( )
( )
(c) 2 year

2. KNOWLEDGE REGARDING THE PURPOSE OF EACH VACCINE

32. What is the purpose of giving BCG?

( )
(a) Polio ( )
(b) Diarrhea ( )

(c) Tuberculosis

33. What is the vaccine administered for polio

(a) OPV

(b) MMR

(c) DPT

72
34. Which vaccine is administered for diphtheria

(a) IPV ( )
(b) DPT ( )
( )
(c) Hib

35. What is the purpose of giving rota virus vaccine

(a) Pneumonia ( )
( )
(b) Meningitis
( )
(c) Diarrhea

36. what is the purpose of giving PCV(Pneumococcal conjugate vaccine)

(a) Pneumonia ( )
(b) Typhoid ( )

(c) Meningitis ( )

37. What is the purpose of giving Hib Vaccine?

(a) Hepatitis ( )

(b) Encephalitis ( )
( )
(c) Meningitis

38. Which vaccine is giving for mumps?

(a) MMR ( )
(b) DTP ( )

(c) PCV ( )

39. Which vaccine is given for rubella?

(a) OPV ( )
(b) MMR ( )

(c) Hib ( )

73
40. What is the purpose of giving varicella vaccine?

(a) Measles
( )
(b) Chicken pox ( )

(c) Typhoid ( )

74
 ANNEXURE-X
SCORE KEY
ITEM NO SCORE KEY SCORE
1. C 1
2. A 1
3. C 1
4. B 1
5. B 1
6. A 1
7. D 1
8. C 1
9. A 1
10. A 1
11. B 1
12. B 1
13. A 1
14. C 1
15. B 1
16. C 1
17. C 1
18. A 1
19. C 1
20. C 1
21. A 1
22. B 1
23. C 1
24. A 1
25. B 1
26. C 1
27. A 1
28. B 1
29. C 1
30. A 1
31. B 1
32. C 1
33. A 1
34. B 1
35. C 1
36. A 1
37. C 1
38. A 1
39. B 1
40. A 1

75
 ANNEXURE-XI

LESSON PLAN
ON
IMMUNIZATION

76
 STRUCTURED TEACHING PROGRAMME

Name of the student teacher: Mrs. sindhu Paul

Name of the subject : Child Health Nursing

Year : 2nd year M.Sc. Nursing

Name of the topic : immunization

Class/Group/Batch : Mothers

Sample strength : 30

Venue : Hospital

Previous knowledge level : Mothers have less knowledge

Method of teaching : Lecture cum Discussion

Medium of instruction : Kannada, English

Duration of teaching : 30min

Instructional AV aids : flash card, charts

77
General objective:

On completion of Structured Teaching Program me on immunization the mother will be able to gain knowledge regarding immunization and will
develop desirable attitude and skill regarding immunization.

Specific objective
At the end of class the mothers will be able to
Define vaccine
Define immunity
Describe the purpose of immunization
Describe about importance of immunization
Enumerate immunization schedule
Enlist about each immunization

78
S.No TIME SPECIFIC CONTENT INSTRUCTER LEARNER’S
OBJECTIVE ACTIVITY ACTIVITY AV AIDS EVALUATION
Introduction:-
1. 1mt. Introduce the Babies are born
topic with some natural immunity Lecture cum Listen
which they get from their discussion attentively to Flash cards
mother and through breast method the lecture.
feeding .having a child
immunized gives extra
protection against illness.
Immunisation prepares our
bodies to fight against
2. 1mt. diseases, in case we come in
Define contact with them in future. Lecture method
vaccines Listen
attentively to Flash cards
Vaccines are substances the lecture
3. 1mt. designed to produce specific
protection against diseases.
Define
immunity
Immunity is the ability of the Lecture cum
4. 2mt body to recognize, destroy, discussion
and eliminate antigenic
Define about material. Method.
immunisation

5. 2mt. Immunisation is a process of

protecting an individual from Lecture method
Describe the a disease through Asking Listen charts

79
 purpose of introduction of a vaccine. questions carefully. and
immunisation. answering the
questions
6. 2mt. Immunisation helps to
provide specific protection
from diseases. It also helps to
List reduce the spread of diseases
importance of to others and prevent
immunisation. epidemics.

Protection from infectious

7. 5mt. diseases is one of the
importance of immunisation.
Immunisations induce Immunization card.
Enumerate immunity against specific Lecture method
the disease and prevent Listening and
immunization occurrence of specific asking doubts
schedule disease.

At birth -BCG,OPV,
Hep B1

6 Weeks -IPV 1, DTP

1, Hib 1,

PCV 1, RV
1.

10 Weeks -Hep B 2,

80
 IPV 2, Hib 2,

PCV 2, RV 2

14-18 Weeks -IPV 3, DTP

3, Hib 3,

PCV 3, RV
3.

6 months -OPV 1

9 Months -OPV 2,
Measles.

12-18 months -Hep B 3,

IPV B1, DTP B1

-Hib Booster,
PCV Booster
8. 10 mt.

-MMR 1,
Varicella 1,

Enlist the Hep A

purpose of 1,Influenza (yearly)
each vaccine.
2-3 years -HepA
2,Typhoid, Explaining
purpose of each Learners
vaccine. shows interest

81
Meningococcal,

4-6 years -OPV 3, DTP

B2, MMR 2,

Varicella 2,

BCG:- BCG vaccination is

administered at birth/ before
6 weeks of birth. Purpose of
giving this vaccine is to
prevent tuberculosis.
Tuberculosis commonly Listening
found in children of 0-14 carefully
years.
OPV (oral polio vaccine):-it
should be administered at
birth. This vaccine is giving
to prevent poliomyelitis.
Polio is a viral infection of
the alimentary tract but it
may affect the brain and
nerves, resulting in paralysis.

POLIO VACCINATION
DPT (Diphtheria, pertusis, Lecture method
tetanus):-this vaccine is and asking
administering to prevent questions.
these three diseases. It is

82
administered at the age 6
wks-14 wks.
Diphtheria is
an acute infectious disease
caused by coryne bacterium
diphtheria. It affects children
under 10 years of age.
Pertusis is
otherwise known as
whooping cough. It is an DPT
infectious disease affecting
the respiratory tract.
Tetanus is an
acute disease caused by
clostridium tetani leading to
5 to 10 percent of neonatal
deaths.

IPV (In activated polio virus Discussion Listening and

vaccine):-this is an inject able method answering
form to prevent polio. it questions.
should be administered at the
age of 6 wks.

PCV (pneumococcal
vaccine):-This is a vaccine
against streptococcus
pneumonia. Minimum age of
this vaccine is 6 wks.
POLIO CHILD
MMR vaccine:-this vaccine
is to prevent mumps,

83
measles, and rubella.

MEASLES:-This vaccine is
used to prevent measles. It
should be administered at the
age of 9 months.

HEPATITIS B
VACCINE:-this vaccine is
used for Hepatitis B virus.
First dose of this vaccine
should be given at birth. MUMBS

Hib:-this vaccine is given for

meningitis. And minimum
age group is 6 weeks.

ROTA VIRUS:-Rota virus

vaccine against infant
diarrhoea. Minimum age for
this vaccine is 6 weeks.

VARICELLA VACCINE:-
This vaccine is for varicella
virus. Minimum age is 16-24
months. Rubella

CHOLERA VACCINE:-
This vaccine is to prevent
cholera. This should be
administered at the age of
one year.

84
 Lecture method Listening
INFLUENZA:-This vaccine carefully.
should be administered
minimum age of 6 months.
And to be given yearly. It is
used for influenza.

MPSV:-Administered at the
age of 2 years. And this
vaccine for meningococcal
infection

TYPHOID VACCINE:-this
vaccine is given for typhoid
fever, and it is administered
at the age of 2-3 years.

CONCLUSION:-
Immunization is urgent. It is
vital to immunize children
early in life. Immunization
protects against several
dangerous diseases. A child
who is not immunized is
more likely to become under
nourished, to become
disabled and to die.

85
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86
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87
 (Š) ¤ÙÖÓ–Ð º¤ÙÖÓ·°Ð‘Ð ÃË‘Ù–ÐÎÐ ½–Ù—¹Ð ƒ§ÀÐÕ

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88
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89
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21. ¼ËÁ3 Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 14 ÀѤЖÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 2 ÀÐÈÐþ–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 1 ÀÐÈÐþ·Ð ÊÐÀÐԁ¦ÐÔ·ÐÅö ( )

22. ÌٻЪÙÚ«Êý-¿3 Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 2 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 6 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

90
 …) 10 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

23. 9 ´•–ÐÎÐ ÀЁ¦ÐÔËú¹ÐÅö ¦Ð¦ÑÀÐ Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) ªÙÚ»°Ñ•¦Ð¦ýç ( )
„) ‘ÑÄÙ¤Ñ ( )
…) ÁÔÓÊÐÄýú ( )

24. ŠÀЦýŠÀЦý„¤ý Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 15-18 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 12-14 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 1 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

25. ¼Á4 +Œ¼Á4 Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 2 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 15-18 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 6 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

26. ¼ËÁ¿ Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 6 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 1 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 15-18 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

27. ÀЧÊÙÃö Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 15 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 18 ´•–ÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 2 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

28. 18 ´•–ÐÎÐ ƒÀи°¦ÐÔÅö ¦Ð¦ÑÀÐ Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) ªÙÚ»°Ñ•¦Ð¦ýç ( )
„) ÌٻЪÙÚ«Êý-Š ( )
…) ÁÔÓÊÙÄýú ( )

29. ªÙÚ»°Ñ•¦Ð¦ýç Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 1 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 5 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 2 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

91
30. •¼Á 3 Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?
ƒ) 5 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 3 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 2 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

31. ŠÀЦýŠÀЦý„¤ý-2 Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÐ ÀЁ¦ÐÔËú¹ÐÅö ‘ÙÖ¯ÊоÙÓ‘ÐÔ?

ƒ) 1 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
„) 5 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )
…) 2 ÀÐÈÐþ·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö ( )

2. »Ðõ´Ó Ãˑف¦ÐÔ¹ÐÔî ¦Ð¦ÑÀÑôÀÐ ¤ÙÖÓ–ÐÀйÐÔî ³Ð®Ù–Ð©åÃÔ ‘ÙÖ®ÐÔ³Ñê¤Ù

Š¹ÐÔîÀÐշФР½–Ù—¹Ð ƒ§ÀÐÕ

32. ¿Ë£ Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊÐÔÀÐ ‡·ÙìÓÆÐÀÙÓ¹ÐÔ?

ƒ) »ÙÖÅ•¦ÙÖ ( )
„) ƒ´ÊѤР(®Ð¦ÙÔÓ§¦ÐÔ) ( )
…) ‘Ðù¦ÐÔ ¤ÙÖÓ–Ð ( )

33. »ÙÖÅ•¦ÙÖÓ ³Ð®Ù–ЩåÃÔ ‘ÙÖ®ÐÔÀÐ ÃË‘Ð ¦Ð¦ÑÀÐÕ·ÐÔ?

ƒ) •¼Á ( )
„) ŠÀЦýŠÀЦý„¤ý ( )
…) ¯¼« ( )

34. ¯»°Ù꧁¦Ð¦Ñ ‛ÑÂÔÄÙ ³Ð®Ù–ЩåÃÔ ‘ÙÖ®ÐÔÀÐ ÃË‘Ù ¦Ð¦ÑÀÐÕ·ÐÔ?

ƒ) Œ¼Á ( )
„) ¯¼« ( )
…) ÌÙ›ýŒ¿ ( )

35. ¤ÙÖªÑÀÙÚ¤ÐÊý Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊÐÔÀÐ ‡·ÙìÓÆÐÀÙÓ¹ÐÔ?

ƒ) ¹ÐÔôÀÙÖÓº•¦ÐÔ ( )
„) ÀÙÔº¹ý–ЫÊý ( )
…) ƒ´ÊѤР(®Ð¦ÙÔÓ§¦ÐÔ) ( )

36. ¼ËÁ Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊÐÔÀÐ ‡·ÙìÓÆÐÀÙÓ¹ÐÔ?

ƒ) ¹ÐÔôÀÙÖÓº•¦ÐÔ ( )
„) ªÙÚ»°Ñ•¦Ð¦ýç ( )
…) ÀÙÔº•—«Êý ( )

92
37. ÌÙ›ýŒ¿ Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊÐÔÀÐ ‡·ÙìÓÆÐÀÙÓ¹ÐÔ?
ƒ) ÌٻЪÙÚ«Êý ( )
„) Š¹ýÊл°ÐÅ«Êý ( )
…) ÀÙÔº•—«Êý ( )

38. ÀÐÔÀЦýú ‛ÑÂÔÅ–Ù ‘ÙÖ¯ÊÐÔÀÐ ÃË‘Ù ¦Ð¦ÑÀÐÕ·ÐÔ?

ƒ) ŠÀЦýŠÀЦý„¤ý ( )
„) ¯«¼ ( )
…) ¼ËÁ ( )

39. ¤ÐÔ¾ÙÄÑö ‛ÑÂÔÄÙ–Ù ‘ÙÖ¯ÊÐÔÀÐ ÃË‘Ù ¦Ð¦ÑÀÐÕ·ÐÔ?

ƒ) •¼Á ( )
„) ŠÀЦýŠÀЦý„¤ý ( )
…) ÌÙ›ýŒ¿ ( )

40, ÀЧÊÙÃö Ãˑف¦ÐÔ¹ÐÔî ‘ÙÖ¯ÊÐÔÀÐ ‡·ÙìÓÆÐÀÙÓ¹ÐÔ?

ƒ) ÁÔÓÊÙÄýú ( )
„) œ‘йý »Ñ‘ýú ( )
…) ªÙÚ»°Ñ•¦Ð¦ýç ( )

93
 »Ñ¬Ð •¦ÙÖÓ¡¹Ù

Ç‘Ðù‘Ð ƒ¾°Ðô¶þ¦ÐÔ ÌÙÊФÐÔ : ÇõÓÀÐÔ´. Ë•·°ÐÔ »ÛÄý

ÁÈЕ¦ÐÔ : ÀÐÔ‘ÐÜÎÐ „¤ÙÖÓ–Ðô ¹ÐËþ•–ý
ÀÐÈÐþ : Š.ŠËú. ¸÷´Ó¦ÐÔ ÀÐÈÐþ
»Ñ¬Ð •¦ÙÖÓ¡¹Ù–Ù ƒ§Ë·Ð ÁÈЁ¦ÐÔ : ¤ÙÖÓ–Ð º¤ÙÖÓ·°Ð‘Ð ÃË‘Ù–ÐÎÐÔ
¾°Ñ–ÐÀÐÍË·ÐÀФÐÔ : ³Ñ•¦ÐÔ•¸¤ÐÔ
¾°Ñ–ÐÀÐÍË·Ð ³Ñ¦Ðԁ¸¤Ð ÊЁ‛Ùô : 30
ÊÐëÎÐ : „ÊÐï³Ùõ
ÁÈЕ¦ÐÔ·Ð ½–ÙÞ ¾°Ñ–ÐÀÐÍË·ÐÀЧ—¤ÐÔÀÐ »ÐÖÀÐþ ƒ§ÀÐÕ : ÁÈЕ¦ÐÔ·Ð ½–ÙÞ ‘ЯÀÙÔ ´ÎÐÔÀÐÏ‘Ù
Ç‘Ðù±·Ð Á·°Ñ¹Ð : ¾ÙÖÓ·°Ð¹Ù ÌÑ–ÐÖ ÀЦѳÐԑгÙ
Ç‘Ðù± ÀЦѷ°ÐôÀÐÔ : ‘йÐî®Ð, …—öÓÈý
ÊÐÀÐÔ•¦ÐÔ : ƒ·°Ðþ ―ЁªÙ
·ÐØÆÐô ÀЦѷ°ÐôÀÐÔ–ÐÎÐÔ : Áԁ›ÐÔ »Ð«å

94
 ‘ÐõÀÐÔ ÊÐÀÐÔ•¦ÐÔ º¸þÈÐå ÁÈЕ¦ÐÔ·Ð •®ÐÃÔ Ç‘Ðù‘ФР¾°Ñ–ÐÀÐÍË ·ÐØÆÐô ÀЦÛÃôÀЦѻйÐ
ÊЁ‛Ùô ‡·ÙìÓÆЖÐÎÐÔ ›Ð©ÔÀЫ‘Ù ·ÐÀФРÀЦѷ°ÐôÀÐÔ
–ÐÎÐÔ ›Ð©ÔÀЫ‘Ù–ÐÎÐÔ –ÐÎÐÔ
1. 1 ÁÈЕ¦ÐÔÀйÐÔî »Ð§›Ð¦ÐÔ: ¾ÙÖÓ·°Ð¹Ù „ÊÐ’êÂԁ·Ð
ºÁÔÈÐ »Ð§›ÐÂÔÊÐÔ ÀÐÔ‘ÐÜÎÐÔ ÌÐÔ©ÔåÀÑ–ÐÄÙÓ º¸þÈÐå ¤ÙÖÓ–Ð ÌÑ–ÐÖ ÁÈЕ¦ÐÔÀйÐÔî
ÀÐÕ·ÐÔ »Ðõ´¤ÙÖÓ·°Ð‘Ð ÆВꁦÐÔ¹ÐÔî »Ð®Ù·ÐÔ ÌÐÔ«å¤ÐÔ³Ñê¤Ù. ÀЦѳÐԑгف¦ÐÔ „ÅÊÐÔÁ‘Ù
…·Ð¤Ùց¸–Ù ³ÑÂԁ¦ÐÔ Š·ÙÌÑŹÐÅö ÀÐÔ‘ÐÜÏ–Ù ÀÐÔÖÑÐ
ƒÀÐÆÐô‘ÐÀѷЁ³ÐÌÐ ¤ÙÖÓ–Ð »Ðõ´¤ÙÖÓ·°Ð‘Ð ÆÐ’ê ÁÈЕ¦ÐÔÀйÐÔî
–ÐϤÐÔ³ÐêÀÙ. …·Ð¤Ð ¢ÙÖ³Ù–Ù ÀÐÔ‘ÐÜÏ–Ù ÊЧ•¦Ð¦Ñ·Ð »Ð§›ÐÂÔÊÐÔ
ÊÐÀÐԁ¦ÐÔ·ÐÅö ƒÀÐÆÐô‘ÐÀѷЁ³ÐÌÐ ¤ÙÖÓ–Ð ÀÐÕ·ÐÔ
º¤ÙÖÓ·°Ð‘Ð ÃË‘Ù–ÐÎйÐÔî ‘ÙÖ¯ÊÐÔÀÐշЧ·Ð ƒÀФÐ
¤ÙÖÓ–Ð »Ðõ´¤ÙÖÓ·°Ð‘Ð ÆÐ’ê …¹ÐÖî ÌÙ›Ñà–ÐÔ³Ðê·Ù.
¤ÙÖÓ–Ð »Ðõ´¤ÙÖÓ·°Ð‘Ð ÃË‘Ù–ÐÎÐÔ ¾°ÐÁÈÐô·ÐÅö
Š·Ñ·Ð¤ÐÖ ÀÐÔ‘ÐÜÎÐ ·ÙÓÌÐ ¤ÙÖӖзР‘б
–ÐÎÙÖ•¸–Ù ÊЁ»Ð‘Ðþ‘ÙÜ ½·Ð¤Ù ƒÀÐÕ–ÐÎÙÖ•¸–Ù
ÌÙÖӤѮÐÃÔ ÊÐÆБÐêÀÑ—¤ÐÔÀЕ³Ù Ë·Ðí»Ð¯ÊÐÔ³Ðê·Ù.

2 1 ÃË‘Ù–ÐÎÐÔ ¤ÙÖÓ–Ð »Ðõ´¤ÙÖÓ·°Ð‘Ð ÃË‘Ù–ÐÎÐÔ Š·Ð¤Ù, º¸þÈÐå ¾ÙÖÓ·°Ð¹Ñ „ÊÐ’êÂԁ·Ð

ºÁÔÈÐ Š•·Ð¤ÙÓ¹ÐÔ ‛ÑÂÔÄÙÂԁ·Ð ÀÐÔ‘ÐÜÎйÐÔî ¤Ð’ùÊÐÃÔ »Ð·Ðí´ ÁÈЕ¦ÐÔÀйÐÔî
Š•·ÐÔ ³Ð•¦Ð¦Ñ§Ë¤ÐÔÀЕ³ÐÌÐ •Èи°–ÐÎÐÔ „ÅÊÐÔÁ‘Ù
ÀÑô‛Ñô¹Ð
ºÓ®ÐÔÀÐÕ·ÐÔ

95
3. 1 ¤ÙÖÓ–Ð ¤ÙÖÓ–Ð »Ðõ´¤ÙÖÓ·°Ð‘Ð ÆÐ’ê Š·Ð¤Ù ¹ÐÀÐÔó ·ÙÓÌБÙÜ ¾ÙÖÓ·°Ð¹Ù „ÅÊÐÔÁ‘Ù
ºÁÔÈÐ »Ðõ´¤ÙÖÓ·°Ð‘Ð ·ÑÏ …®ÐÔÀÐ ÌѺ‘ѤБÐ/¤ÙÖӖБѤБРÌÑ–ÐÖ
ÆÐ’ê £ÓÀБÙÖÓÆЖÐÎйÐÔî ‘Ð®ÐÔͯ¦ÐÔÔÀÐÕ·ÐÔ, ƒÀÐÕ ÀЦѳÐԑгف¦ÐÔ
Š·Ð¤ÙÓ¹ÐÔ –ÐÎйÐÔî ¹ÑÆÐ »Ð¯ÊÐÔÀÐÕ·ÐÔ ÌÑ–ÐÖ ƒ·Ð¹ÐÔî ÀÐÔÖÑÐ
Š·ÐÔ ·ÙÓÌи·Ð ÌÙ֤РÌÑ‘ÐÔÀÐÕ·ÐÔ ÁÀЧÊÐÔ
ÀÑô‛ÑôºÊÐÔ ÀÐÕ·ÐÔ
ÀÐÕ·ÐÔ

4 2 ÃË‘Ù–ÐÎйÐÔî ÀÐÔ‘ÐÜÏ–Ù ÃË‘Ù ÌÑ‘ÐÔÀÐÕ·ÐÔ Š·Ð¤Ù ÀÐÔԁ·Ù ¾ÙÖÓ·°Ð¹Ù „ÊÐ’êÂԁ·Ð

ºÁÔÈÐ ÀÐÔ‘ÐÜÏ–Ù ·ÙÓÌБÙÜ „–нÌÐÔ·Ñ·Ð ³ÙÖ•·Ð¤Ù–ÐÎÐ ºÀѤв٠ÌÑ–ÐÖ „ÅÊÐÔÁ‘Ù
ÌÑ‘ÐÔÀÐÕ·ÐÔ –Ñ— ÀÙÖ·ÐÄÙÓ ÊÐԤБÐù³Ñ ‘ÐõÀÐÔ¸·Ð ÃË‘Ù–ÐÎÐ ÀЦѳÐԑгف¦ÐÔ
ÀÐÔÖÑР¤Ð‘Ðù²Ù ºÓ®ÐÔÀÐÕ·ÐÔ ÀÐÔÖÑÐ
ÁÀЧÊÐÔ
ÀÐÕ·ÐÔ

5 2 ÃË‘Ù ÃË‘Ù ÌÑ’ÊÐÔÀÐշЧ·Ð ÀÐÔ‘ÐÜÎÐ ·ÙÓÌÐ ‛ÑÂÔÄÙ ¾ÙÖÓ·°Ð¹Ù „ÅÊÐÔÁ‘Ù

ºÁÔÈÐ ÌÑ‘ÐÔÀÐշФР–ÐÎÙÖ•¸–Ù ÌÙÖӤѮÐÃÔ Ë·ÐíÁ¤ÐÔÀЕ³Ù ³Ð•¦Ð¦Ñ§
ÀÐÔÔ‚ô ÀЦѯ‘ÙÖÎÐÔü³Ðê·Ù …·Ð¤Ùց¸–Ù ‛ÑÂÔÄÙ
‡·ÙìÓÆÐÀйÐÔî •½ñ§•·Ð •½ñ§–Ù ÌФЯ Êс‘ÑõÁԑЖÙÖÎÐü·Ð•³Ù
´ÏÌÙÓÎÐÔ ³Ð®Ù•¦ÐÔÔ³Ðê·Ù.
ÀÐÕ·ÐÔ

96
6 2 ÃË‘Ù ¤ÙÖÓ–Ð ‘ѤБР£ÓÀБÙÖÓÆЖÐÏ•·Ð ·ÙÓÌÐÀйÐÔî
ºÁÔÈÐ ÌÑ’ÊÐÔÀÐÕ ¤Ð’ùÊÐÔÀÐÕ·ÐÔ ÃË‘Ù ÌÑ’ÊÐÔÀÐշФР½ÌÐÔ ÀÐÔÔ‚ô
·Ð¤Ð ‡·ÙìÓÆÐ ÀÐÔ³ÐÔê …·ÐÔ ·ÙÓÌБÙÜ ¤ÙÖÓ–Ð ³Ð–ÐÔ÷Е³Ù
»ÑõÀÐÔÔ‚ô³Ù ³Ð®Ù–ЩÔå³Ðê·Ù. …·ÐÔ º¸þÈÐå ‛ÑÂÔÄÙ ·ÙÓÌБÙÜ
–ÐÎйÐÔî »Ð«å ³Ð–ÐÔ÷Ё³Ù »Ðõ´¤ÙÖÓ·°Ð‘Ð ÆВꁦÐÔ¹ÐÔî
ÀЦѮÐÔÀÐÕ·ÐÔ ¾ÙÎÙË‘Ùց®ÐÔ ·ÙÓÌзÙÖÎЖ٠„ ‛ÑÂÔÄف¦ÐÔ
£ÓÀБÙÖÓÆЖÐÎÐÔ »ÐõÀÙÓÇÊзЕ³Ù ³Ð®Ù•¦ÙÖ®ÐÔç³ÐêÀÙ.

7 5 •¦Ð¦ÑÀÐ •¦Ð¦ÑÀÐ ¾ÙÖÓ·°Ð¹Ñ „ÅÊÐÔÁ‘Ù ÃË‘Ù

ÀÐÔ–ÐÔ ÌÐÔ«å·Ð ÊÐÀÐÔ•¦ÐÔ·ÐÅö:
ºÁÔÈÐ ÀЕ¦ÐÔËú¹ÐÅö »Ð·Ðí´ ÀÐÔ³ÐÔê ÊЕÆЕ¦ÐÔ ÌÑ’ÊÐÔÀÐ
¿Ë£, •¼Á, ÌٻЪÙÚ«Êý-¿
•¦Ð¦ÑÀÐ •¦Ð¦ÑÀÐ –ÐÎйÐÔî ‘Ñ®ýþ
ÃË‘Ù–ÐÎйÐÔî ºÀѧˑÙÖÎÐÔü
‘ÙÖ¯ÊоÙÓ‘ÐÔ
6 ÀѤЖÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö: ÀÐÕ·ÐÔ
Š¹ÐÔîÀÐշйÐÔî Œ¼Á 1, ¯«¼ 1, ÌÙ›ýŒ¿ 1, ¼ËÁ 1,
´ÏË‘ÙÖ®ÐÔ „¤ýÁ 1.
ÀÐÕ·ÐÔ
10 ÀѤЖÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö:
ÌٻЪÙÚ«Êý-¿2, Œ¼Á 2, ÌÙ›ýŒ¿ 2, ¼ËÁ
2, „¤ýÁ 2.

14-18 ÀѤЖÐÎÐ ÊÐÀÐÔ•¦ÐÔ·ÐÅö:

Œ¼Á 3, ¯«¼ 3, ÌÙ›ýŒ¿ 3, ¼ËÁ 3,
„¤ýÁ 3.

97
„¤ÐÔ ´–ÐϹÐÅö:
•¼Á-1
••¾°Ð³ÐÔê ´•–ÐϹÐÅö:
•¼Á-2, ÁÔÓÊÐÄýú

ÌйÙî¤Ð®Ð§•·Ð Ìи¹Ù•©Ô ´•–ÐϹÐÅö:

ÌٻЪÙÚ«Êý-¿ 3, Œ¼Á ¿1, ¯«¼

½ÖÊýå¤ý–ÐÎÐÔ:
-- ÌÙ›ýŒ¿ ½ÖÊÐå¤ý, ¼ËÁ
-- ŠÀЦýŠÀЦý„¤ý 1, ÀЧÊÙÃö 1
-- ÌٻЪÙÚ«Êý Š 1, …¹ý»ÐÖö¦Ùԁ¡

(ÀÐÈÐþ–ÐÎÐ ÄÙ‘ÐÜ·ÐÅö)
Š¤Ð®Ð§·Ð ÀÐÔÖ¤ÐÔ ÀÐÈÐþ:
 ÌٻЪÙÚ«Êý Š 2, ªÙÚ»°Ñ¦Ð¦ýç,
ÀÙÔº¹ý–ÙÖ‘ÙÖ‘ÑÜÄý

¹ÑÃܧ·Ð „¤ÐÔ ÀÐÈÐþ:

-- ¼Á 3, ¯«¼ ¿2, ŠÀЦýŠÀЦý„¤ý 2,
ÀЧÊÙÃö 2.

98
8 10 »Ðõ´•¦ÙÖ•·ÐÔ ¿Ë£: »Ðõ´•¦ÙÖ•·ÐÔ ³Ñ•¦ÐÔ•¸¤ÐÔ
ºÁÔÈÐ ¤ÙÖÓ–Ð ¿Ë£ Ãˑف¦ÐÔ¹ÐÔî ÀÐÔ–ÐÔ ÌÐÔ«å·Ð ³Ð‘Ðù± ÌÑ‘Ð Ãˑف¦ÐÔ¹ÐÔî …·Ð¤ÐÅö ÌÙœà¹Ð
º¤ÙÖÓ·°Ð‘Ð ÄÑ–ÐÔ³Ðê·Ù ƒµÐÀÑ ÀÐÔ–ÐÔ ÌÐÔ©ÔåÀÐ „¤ÐÔ ÀѤЖÐÎÐ ÌÑ‘ÐÔÀÐշФР„ÊÐ’ê
•Èи°–ÐÎÐ ÀÙÖ·ÐÃÔ ‘ÙÖ®ÐÄÑ–ÐÔ³Ðê·Ù. ¿Ë£ Ãˑف¦ÐÔ¹ÐÔî ‡·ÙìÓÆÐÀйÐÔî ³ÙÖÓ§ÊÐÔÀФÐÔ
‡·ÙìÓÆÐÀйÐÔî ÌÑ‘ÐÔÀÐշФР‡·ÙìÓÆÐÀÙӹف·Ð¤Ù ‘Ðù¦ÐÔ ¤ÙÖÓ–ÐÀйÐÔî ´Ï
»Ð«å ³Ð®Ù–ЩÔåÀÐÕ·ÐÔ. ‘Ðù¦ÐÔ ¤ÙÖÓ–ÐÀÐÕ ÊÑÀЦѹÐôÀÑ— ÌÙÓÎÐÔÀÐÕ·ÐÔ
ÀЦѮÐÔÀÐÕ·ÐÔ ÌÐÔ«å·Ð ÀÐÔ–ÐÔÁº•·Ð 14 ÀÐÈÐþ–ÐÎÐ ƒÀи°¦ÐÔÅö
‘Ё®ÐÔ ½¤ÐÔ³Ðê·Ù.

¼Á:(¾ÑÂԁ¦ÐÔ ÀÐÔÖÑРÌÑ‘ÐÔÀÐ

»ÙÖÓŁ¦ÙÖ ÃË‘Ù)
…·Ð¹ÐÔî ÀÐÔ–ÐÔ ÌÐÔ«å·Ð ³Ð‘Ðù± ÌÑ‘ÐÄÑ–ÐÔ³Ðê·Ù.
¹Ð³Ð¤Ð ‘ÐõÀÐÔÀÑ— ¾ÙÓ¤Ù ¾ÙÓ¤Ù ÊÐÀÐԁ¦ÐÔ·ÐÅö Œ·ÐÔ
ÀÐÈÐþ–ÐÎÐÀФٖ٠ÌÑ‘ÐÄÑ–ÐÔ³Ðê·Ù.
»ÙÖÓŁ¦ÙÖ Š¹ÐÔîÀÐÕ·ÐÔ ·ÐÔ Êс‘ÑõÁÔ‘Ð
¤ÙÖÓ–Ð , …·ÐÔ ÀÙÚ¤ÐÊýº·Ð ÌФЮÐÔ³Ðê·Ù.
»ÙÖÅ•¦ÙÖ¸•·Ð ¹Ð¤Ð–ÐÏ–Ù, ÀÙÔ·ÐÔÏ–Ù
³ÙÖ•·Ð¤Ù•¦Ð¦Ñ— ·ÙÓÌзР¾°Ñ–Ð •¹ÐÀÑ–ÐÔÀÐ
ÊЁ¾°ÐÀÐÀÐÕ …¤ÐÔ³Ðê·Ù . …·Ð¤Ùց¸–Ù
»ÑÆÐ÷þÀс¦ÐÔÔ ‘Ð֮Р„–нÌÐÔ·ÐÔ.

99
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 MASTER CODING SHEET
PLANNED KNOWLEDGE QUESTIONAIRE FOR PRE TEST SCORE SCORE INTERPRETATION

Inadequate< Moderate 51- Adequate 76-

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Total score Percentage 50% 75% 100%
1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 0 1 1 0 1 0 0 0 0 1 0 1 0 1 0 0 1 0 0 1 1 1 0 1 15 37.50%
2 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 1 0 1 0 1 0 11 27.50%
3 1 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1 0 14 35%
4 0 1 0 1 0 1 0 1 0 1 1 0 1 0 1 1 1 1 0 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 0 1 0 0 0 0 20 50%
5 0 1 0 0 0 1 0 1 1 0 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 1 1 0 1 1 1 1 22 55%
6 1 1 0 1 1 0 1 1 1 1 1 1 0 0 0 1 0 0 1 0 0 0 1 0 1 0 0 1 0 0 1 1 0 1 0 1 1 0 1 0 21 52.50%
7 0 1 0 1 0 1 0 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 1 0 1 0 0 0 1 1 1 0 0 1 1 1 0 0 1 16 40%
8 0 0 0 1 1 0 0 0 1 1 0 0 0 0 1 1 0 1 1 1 1 0 1 0 1 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 18 45%
9 1 0 1 1 0 1 1 1 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 25%
10 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 9 22.50%
11 0 0 1 0 0 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 1 0 0 0 0 0 1 1 0 1 0 0 14 35%
12 1 1 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 1 0 1 0 1 1 0 1 1 1 1 0 1 1 1 0 1 29 72.50%
13 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 1 1 0 1 0 0 1 1 1 0 15 37.50%
14 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 12 25%
15 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 1 0 1 1 1 1 0 1 1 1 0 1 1 1 1 0 1 31 77.50%
16 1 0 1 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 0 0 1 0 1 1 0 0 0 0 0 1 0 0 0 17 42.50%
17 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 0 1 0 1 26 65%
18 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1 1 0 1 0 1 1 0 0 1 1 0 0 1 1 1 0 1 1 0 0 1 1 0 0 17 42.50%
19 1 1 1 0 1 1 0 1 1 1 1 1 1 1 0 1 1 0 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0 1 32 80%
20 0 0 1 0 1 0 1 0 0 1 0 0 1 0 1 0 0 1 0 0 1 1 0 1 1 0 0 1 1 0 1 1 0 0 1 1 0 0 0 1 18 45%
21 0 0 1 1 0 1 1 0 0 1 0 0 0 1 1 1 1 0 0 0 1 1 1 0 1 0 1 1 0 0 1 1 0 1 0 0 1 1 0 1 21 52.50%
22 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 1 0 0 1 0 1 0 0 1 1 0 0 0 0 1 12 30%
23 0 0 0 1 0 1 0 0 1 1 0 1 0 0 1 0 1 0 1 0 1 1 1 0 1 1 0 1 0 1 1 0 1 1 1 1 0 1 0 1 21 52.50%
24 0 0 1 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 1 0 1 0 0 0 1 1 1 0 0 17 42.50%
25 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 0 0 1 1 0 0 1 0 1 0 1 0 1 0 0 1 0 1 17 42.50%
26 0 1 0 1 0 1 1 0 1 0 1 1 1 1 1 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 1 0 1 0 1 1 1 0 0 21 52.50%
27 0 0 0 0 1 1 0 1 0 1 0 1 1 0 1 1 1 0 1 0 1 1 1 0 0 0 1 1 1 1 0 0 1 0 0 0 0 1 0 0 19 47.50%
28 0 0 0 0 1 0 0 0 1 0 0 0 1 0 1 1 0 0 1 1 1 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 13 32.50%
29 0 1 0 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 9 22.50%
30 1 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 1 12 30%
 Master coding Sheet
Planned Knowledge Questionnaire - Post Test

Sl.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 total score Percentage Inadequate <50% moderate 51-75 Adequate 76 -100

1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 1 1 0 1 0 1 0 1 1 1 1 31 77.50%

2 0 1 1 1 0 1 0 0 1 0 1 1 1 1 1 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 0 1 0 1 1 1 1 1 1 28 70%

3 1 1 1 1 0 1 1 1 1 0 1 1 1 1 0 1 1 1 0 0 1 1 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 32 80%

4 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 35 87.50%

5 1 1 1 0 1 1 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 35 88%

6 1 1 1 1 0 1 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 1 0 0 32 80.00%

7 0 1 0 1 0 0 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 0 1 1 1 0 0 1 1 1 1 1 0 0 1 1 1 0 1 27 67.50%

8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 37 93%

9 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 36 90%

10 1 1 1 0 1 1 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 35 87.50%

11 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 35 87.50%

12 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1 0 1 33 82.50%

13 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 37 92.50%

14 1 1 1 1 0 1 1 1 0 1 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 0 1 31 77.50%

15 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 11 1 0 0 1 1 35 87.50%

16 1 1 0 1 1 1 0 1 1 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 35 87.50%

17 1 1 1 1 0 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 0 1 1 33 82.50%

18 1 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 0 1 31 77.50%

19 1 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 36 90.00%

20 1 1 1 1 0 1 0 1 1 1 1 0 1 1 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 31 77.50%

21 1 0 0 1 1 0 1 0 1 0 1 1 0 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 0 1 1 1 0 29 72.50%

22 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 37 92.50%

23 1 1 0 0 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 36 90%

24 1 1 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 37 92.50%

25 1 1 0 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 33 82.50%

26 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 38 95%

27 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 37 92.50%

28 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 36 90%

29 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 38 95%

30 1 1 1 0 1 1 1 0 1 1 0 1 1 1 1 1 0 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 0 31 77.50%
 DEMOGRAPHIC VARIABLES
Sl.no Age Religion Education Status Occupation Type of Family Family Income Exposure of source of health Health services availed No of underfive Age of children Age
1 a a a b a b c d a c
2 b b b a a a d b b d
3 a c a a c b b a a a
4 c a b c a c b c b b
5 b a c b c c c a c c
6 b b d d b d d c a a
7 a c a a b c b a a a
8 c a b b c h a a b b
9 a b b b a c a c c c
10 a a a a b c c b a a
11 b b b b b b c a b a
12 a b b c c a d d b b
13 b a a a a a b c c c
14 c a a b b b b a a a
15 a c c d c c a b a a
16 a a a c c b d c b c
17 b a a a a a a a a c
18 c b b b b b c a b d
19 a a a c a b b b a a
20 b a a a a b c c c c
21 a b b c b c a b a a
22 c c c d a d a a b d
23 a a a a c b c c c b
24 b b b b a c b d a d
25 b a a b a c c a b c
26 a a a a b a d b a a
27 c b b b b c d d c b
28 a a b a b b c a a d
29 b b a a a c b c b c
30 c c c c c b d b c a