A STUDY TO ASSESS THE EFFECTIVENESS OF EXERCISE REGIMEN ON

ACTIVITISE OF DAILY LIVING IN TERMS OF KNOWLEDGE AND PRACTICE

AMONG CHRONIC KIDNEY DISEASE PATIENTS IN SELECTED HOSPITALS AT
JABALPUR ,MADHYA PRADESH.

SUMMARY

SUBMITTED TO
THE
SHRI JAGDISHPRASAD JHABARMAL TIBREWAL
UNIVERSITY FOR THE DEGREE
OF
DOCTOR OF PHILOSOPHY

IN
NURSING

BY
SHWETA GRIGSON
REGISTRATION NO:
191221034

UNDER THE GUIDANCE OF

DR. RAJESH G KONNUR
JJT/2K9/SC/2562
.
DEPARTMENT OF NURSING

SHRI JAGISHPRASAD JHABARMAL TIBREWAL

UNIVERSITY VIDYANAGARI, JHUNJHUNU, RAJSTHAN-
1
 333001
YEAR- 2024

2
 INFORMATION PAGE

TITLE OF THE RESEARCH WORK A STUDY TO ASSESS THE EFFECTIVENESS

OF EXERCISE REGIMENON ACTIVITES OF
DAILY LIVING IN TERMS OF KNOWLEDGE
AND PRACTICE AMONG CHRONIC KIDNEY
DISEASE PATIENTS IN SELECTE HOSPITALS
AT JABALPUR, MADHYA PRADESH.

NAME OF THE SCHOLAR SHWETA GRIGSON

SUBJECT NURSING

REGISTRATION NO. 191221034

NAME OF THE GUIDE DR. RAJESH G. KONNUR

DESIGNATION PROFESSOR

GUIDE’S REGISTRATION NO. JJT/2K9/SC/2562

GUIDE’S WORKING PLACE PATNA, BIHAR

Signature of the Guide Signature of Scholar

with seal

3
 INDEX

S No. CONTENT PAGE NO.

1. Title Page 1

2. Information Page 2

3. Index 3

4. Introduction 4-6

5. Need of the study 6-8

6. Problem Statement and Objectives 8-9

7 Hypothesis 9

8. Research Methodology 10

9. Result 10-19

10. Limitation 19-20

11 Conclusion 20

12. References 21-22

4
INTRODUCTION
The kidneys are bean shaped organs which process blood to filter out waste product and excess
water. In an average adult Kidney filters around170 liters of blood in 24 hours. The kidneys
process most of the soluble, on irritant solid substances and water, more specifically they
excrete nitrogenous and sulphur containing end products of protein metabolism. The kidneys
are also responsible for maintaining blood pressure, water, volume of blood content and
eliminate drugs and other toxins in the body.
Renal failure is the partial or complete impairment of kidney function resulting in an ability to
excrete metabolic waste products and water, as well as causing functional disturbance of all
body system. Renal Failure is classified as Acute and Chronic. Acute renal failure is potentially
reversible, the mortality rate for intra renal acute renal failure remains at about fifty percentage,
despite advances in the treatment over the last 30 years. Chronic Renal Failure or End stage
Renal Disease usually develop slowly over months to year and necessitates the initiation of
dialysis and transplantation for long term survival.
Carla Santos-Araújo,et al (2023) stated that CKD represents a major global public health
problem affecting nearly 700 million persons and contributing to the development of related
disorders, including hypertension, obesity and type 2 diabetes mellitus. Fortunately, the
development of CKD comorbidities can be delayed or prevented if rapidly detected at early
stages.
CKD patients often also have to deal with several other chronic co-morbidities, especially
Diabetes, Hypertension and Cardiovascular Diseases. These patients also face the challenge and
burden of the intrusive and irreversible consequences of kidney failure on their physical and
mental health as well as on their quality of life including the impact on their family, lifestyle,
and relationship.
“Care of individuals with CKD includes multidisciplinary team interventions to delay the onset
of dialysis, encourage self- management and prepare and support patients for dialysis and/or
transplantation. The NKF/KDOQI Clinical Practice Guidelines (National Kidney Foundation,
2002b) and the Canadian Society of Nephrology clinical practice guidelines (Levin et.al, 2008)
recommend that each centre has an established multidisciplinary team for care of patients with
CKD. To deliver adequate medical and psychosocial preparation, patients should be assessed in
such a clinic as soon as possible or at least 12 months prior to the initiation of dialysis.

5
Global Scenario –
Chronic kidney disease is a worldwide health crisis. For example, in the year 2005, there were
approximately 58 million deaths worldwide, with 35 million attributed to chronic disease,
according to the World Health Organization. 10% of the population worldwide is affected by
chronic kidney disease (CKD), and millions die each year because they do not have access to
affordable treatment. According the 2010 Global Burden of Disease study, chronic kidney
disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but
rose to 18th in 2010. This degree of movement up the list was second only to that for HIV and
AIDs. Over 2 million people worldwide currently receive treatment with dialysis or a kidney
transplant to stay alive, yet this number may only represent 10% of people who actually need
treatment to live.
In people aged 65 through 74 worldwide, it is estimated that one in five men, and one in four
women, have CKD. Chronic kidney disease can be treated. With early diagnosis and treatment,
it's possible to slow or stop the progression of kidney disease.
Southeast Asia Scenario -
Chronic kidney disease (CKD) is a global public health issue, with Asia accounting for one of
the highest CKD prevalence worldwide. The estimates of age, sex and year wise burden of
CKD for 49 countries in Asia for 1990 to 2019 were procured from the Global Burden of
Disease 2019 study. In 2019, there were 9.8 million [9.0–10.6 million] new cases and 763 024
[696 050–823 829] deaths due to CKD in Asia.
Indian Scenario -
CKD, with its high prevalence, morbidity and mortality, is an important public health problem.
With <3% of land mass, India hosts 17% of the Earth’s population. The etiology of CKD varies
considerably throughout India. Parts of the states of Andhra Pradesh, Odisha, and Goa have
high levels of CKD of unknown etiology (CKDu), which is a chronic interstitial nephropathy
with insidious onset and slow progression. Even today, over 90% of patients requiring RRT in
India die because of inability to afford care, and even in those who do start RRT, 60% stop for
financial reasons. Hemodialysis (HD) was introduced in India in 1962, transplantation was
introduced in 1971, and peritoneal dialysis (PD) was introduced in 1991.
Situation in Madhya Pradesh state –
Madhya Pradesh is the 2nd largest state in India for a geographical spread of 3,08,245 km2 ,
and with a population of over 7.26 crore .The state has expanded from 45 districts in 2001 to 52
6
districts as of 2020 with a projected increase in population to 8.45 crores by 2021 .In a
population based survey of approximately 570,000 individuals in the Central Indian city of
Bhopal, the crude and age-adjusted ESRD incidence rates were determined at 151 and 232 pmp,
respectively. Studies on prevalence of CKD suffer from the use of divergent methodologies. In
a survey of about 4,000 healthy adults, the prevalence of microalbuminuria and reduced
glomerular filtration rate was 10% and 13% respectively .In another study 2.5% of 5300
subjects had dipstick positive proteinuria and 4.8% had GFR < 60 ml/min.

Chronic kidney disease can lead to serious health complications, including end-stage renal
disease, a life-threatening condition that requires dialysis or a kidney transplant to
survive.People with CKD often experience a decline in their overall health and quality of life.
They may have difficulty completing everyday tasks and may be at risk for other health
problems, such as heart disease and stroke.CKD patients are more likely to be hospitalized for
cardiovascular disease than other medical conditions. (The American Journal of Managed
Care, 2021.According to data, 554,038 Americans received dialysis to replace kidney function
in 2018 alone. (National Kidney Foundation, 2021).Around 20,000 kidney transplants are
performed each year in the United States. (Penn Medicine, 2020).There are around 93,000
Americans on the kidney transplant waiting list. (United Network for Organ Sharing, 2022).An
estimated 96 per 1,000 CKD patients older than 65 years die each year. (National Institute of
Diabetes and Digestive and Kidney Diseases, 2021).In the United States, Mississippi had the
highest mortality rate for CKD in 2020. (CDC, 2021). Those who are on dialysis for chronic
kidney disease have a five-year survival rate of less than 50% after one year of treatment.
(University of California San Francisco, 2019).

A Randomized study conducted by Stefan Mustata et.al on effects of exercise training on

physical impairment arterial stiffness and health related quality of life in patients with chronic
kidney disease in United States in 2010.Patients with Chronic Kidney Disease have impaired
performance in physical tasks, lower health related quality of life and high cardiovascular
morbidity and mortality. Moderate intensity exercise has been shown to provide cardiovascular
and metabolic benefits in healthy individuals and patients without CKD.Long term exercise
training is recommended as a vital component in the management of a number of chronic

7
diseases.
This study proved that long term exercise training improves physical impairment, arterial
stiffness and health related quality of life in patients with predialysis CKD to examine the
impact of exercise on markers of cardiovascular risk and quality of life in predialysis CKD
patients.

NEED OF THE STUDY

A healthy body and a healthy mind are required for a peaceful, productive and happy life. The
quality of life is often altered by chronic disease including Chronic Kidney Disease Chronic
Kidney Disease is a worldwide health problem. It is a condition that puts not only a patient but
the entire family through untold misery.
If the kidney functions are not proper most people suffer with chronic kidney disease (CKD)
Chronic Kidney Disease is a long and usually slow process where the kidney slowly loss
function. When the kidneys function at 15% or less, this is called kidney failure or end stage
renal disease (ESRD). When the kidneys fail, harmful wastes build up in the body. When this
happens, further management is necessary.
According to National Kidney Foundation (NKF) kidney disease patients can choose
continuous activities such as walking, swimming, bicycling, aerobic dancing or low level
resistance exercises NKF recommends that exercise should be carried out for 30 minutes in
non-consecutive three days a week to improve physical function, muscle strength, blood
pressure control, and good sleep and for general well-being.

Luke A. Baker,et. al (2022) conducted a study on Clinical practice guideline exercise and
lifestyle in chronic kidney disease. The statement that ‘if exercise were a pill it would be one of
the most widely prescribed and cost-effective drugs ever invented’ has been used many times,
with many slightly different iterations and with good reason; because the evidence is
compelling, and the message is clear that being active provides a foundation for a longer,
healthier and happier life. The scope of these guidelines was agreed by a multi-professional
group of healthcare experts, experienced in this field. The objective of this study was to
perform a search for randomized control clinical trials (RCTs), systematic reviews and meta-
analyses that will subsequently inform the writing of the new Renal Association Guidelines for
8
physical activity and lifestyle in the CKD stages 1–5 (non-dialysis) population.
Because of this all problem and above new Renal Association Guidelines recommendation as a
research scholar I have selected this topic to assess the effectiveness of exercise regimen on
activities of daily living in terms of knowledge and practice among chronic kidney disease
patients.
Many studies revealed that exercise regimen helped to improve the physical health and daily
living activities of patients with Chronic Kidney Disease, hence the study was undertaken to
assess the effectiveness of exercise regimen on activities of daily living in terms of knowledge
and practice among chronic kidney disease patients in selected hospitals at Jabalpur, Madhya
Pradesh.
SIGNIFICANCE OF THE STUDY
The Exercise Regimen on activities of daily living can be effectively implemented in the
health care setting for the improvement of activities of daily living among Chronic Kidney
Disease Patients. It is safe for the assessment of functional status of chronic illness, the ability
to perform tasks necessary to live independently in the community. The knowledge and
practice regarding exercise regimen on activities of daily living helps to improve the health of
Chronic Kidney Disease Patients. So, there is need for educating the nursing staff that helps to
improve the quality of care. As a result the exercise regimen on activities of daily living could
act as a guideline for nursing personnel to give health improvement education to patients.
Nurses could provide adequate knowledge to patients regarding exercise regimen on activities
of daily living and patients will understand the benefits of exercise regimen on activities of
daily living and participate effectively.

PROBLEM STATEMENT

A Study To Assess The Effectiveness Of Exercise Regimen On Activities Of Daily Living In

Terms Of Knowledge And Practice Among Chronic Kidney Disease Patients In Selected
Hospitals At Jabalpur, Madhya Pradesh.

OBJECTIVES OF THE STUDY

1) Assess the pretest knowledge score regarding Exercise Regimen on activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
9
 Pradesh.
2) Assess the pretest practice score regarding Exercise Regimen on activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.
3) Administer Exercise Regimen on activities of daily living among Chronic Kidney
Disease Patients in selected hospitals at Jabalpur, Madhya Pradesh.
4) Assess the effectiveness of Exercise Regimen on knowledge regarding activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.
5) Assess the effectiveness of Exercise Regimen on practice regarding activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.
6) Determine the correlation between post test knowledge and practice scores regarding
Exercise Regimen on activities of daily living among Chronic Kidney Disease Patients
in selected hospitals at Jabalpur, Madhya Pradesh.
7) Find the association with pretest knowledge score of Exercise Regimen on activities of
daily living and selected demographic variables among Chronic Kidney Disease
Patients.
8) Find the association with pretest practice score of Exercise Regimen on activities of
daily living and selected demographic variables among Chronic Kidney Disease
Patients.

HYPOTHESIS
H0- There is no increase in post- test knowledge and practice score regarding Exercise
Regimen on activities of daily living among Chronic Kidney Disease Patients as assessed by
Semi structured Knowledge Questionnaire at 0.05 level of significance
H1- There is increase in post- test knowledge score regarding Exercise Regimen on activities
of daily living among Chronic Kidney Disease Patients as assessed by Semi structured
Knowledge Questionnaire at 0.05 level of significance.
H2- There is increase in post- test practice score regarding Exercise Regimen on activities of
daily living among Chronic Kidney Disease Patients as assessed by Semi structured
10
Knowledge Questionnaire at 0.05 level of significance.
H3 - There is correlation between post test knowledge and practice scores regarding Exercise
Regimen on activities of daily living among Chronic Kidney Disease Patients at 0.05 level of
significance.
H4 – There is association with pre-test knowledge score regarding Exercise Regimen on
activities of daily living and selected socio demographic variables among Chronic Kidney
Disease Patients at 0.05 level of significance.
H5- There is association with pre-test practice score regarding Exercise Regimen on activities
of daily living and selected socio demographic variables among Chronic Kidney Disease
Patients at 0.05 level of significance.

RESEARCH METHODOLOGY
Research methodology is a way to systematically solve the research problem. The
research approach adopted for this study was quantitative approach. The research design for the
present study was Pre-experimental one group pretest-post- test. The present study was
conducted at Jabalpur Hospital and Research Centre Jabalpur, Madhya Pradesh. In the present
study, the sample size consisted of 300 patients with Chronic Kidney Disease. Simple Random
Sampling Technique was used to select the sample. The tools used in the study were Semi-
Structured Knowledge Questionnaire and Semi Structured Observational Checklist. After due
simplifications and suggested modifications, a Pilot Study was conducted on the research topic
and the interpretations were drawn for feasibility and validity of the study. Required permission
from authorities was taken before study. A total of 30 (10% of total population of main study)
samples were selected as per sampling criteria. Written consent was taken from the samples
then structured knowledge questionnaire was administered. Planned teaching programme
regarding Exercise Regimen on activities of daily living among Chronic Kidney Disease
Patients was administered to all 40 samples on the next day of pretest. Post test was conducted
by using same tool after seven days using same tools. By conducting pilot study tools and study
design were found to be feasible. Based on the outcomes of the pilot study, the tool was further
redefined. The final study was conducted on a sample size of 300 Chronic Kidney Disease
Patients in the same manner. Planned Teaching programme was prepared by reviewing research
and non-research articles and also consulting experts in the area. The data was analyzed by
using descriptive and inferential statistics on the basis of objectives and hypothesis to be tested.
11
RESULT
Section 1: Frequency and Percentage Distribution of subjects according to socio-
demographic variables.
The data was collected from 300 samples of Chronic Kidney Disease Patients in Jabalpur
Hospital and Research Centre, Jabalpur, Madhya Pradesh. The demographic variables were Age
in years, Gender, Educational status, Occupation, Type of dietary intake. Other Family
members affected with chronic kidney disease, If yes, relationship with the family member.
Any previous knowledge regarding exercise regimen, If yes, source of formation regarding
exercise regimen, Other related disease conditions, Duration of chronic kidney disease,
Duration of treatment, Able to perform activities of daily living and Currently following any
exercises.

12
Table-1 Frequency and percentage distribution of subjects according to socio
demographic variables.
N= 300

13
S Socio Demographic Variables Sample Percentage
Frequency
No. Characteristics (%)
(f)

1 Age in years 31- 40 9 3.0

41-50 55 18.3

51-60 138 46.0

61 and above 98 32.7

2 Male 121 40.3

Gender Female 179 59.7

3 Educational Status Illiterate 23 7.7

Primary 114 38.0

High School 154 51.3

Graduate or above 9 3.0

4 Occupation Service 33 11

Labourer 21 7

Business 84 28

Household 162 54

5 Type of Dietary Intake Vegetarian 103 34.3

Non- Vegetarian 197 65.7

6 Other family members affected Yes 0 0

with chronic kidney disease No 300 100

7 Previous knowledge regarding Yes 98 32.7

exercise regimen
No 202 67.3

8 If yes, source of information Printed Literature 8 2.6

14
 regarding exercise regimen Media 20 6.7

Family and friends 46 15.3

Health workers 24 8

9 Other related Disease conditions Myocardial Infarction 49 16.3

Hypertension 64 21.3

Diabetes Mellitus 178 59.3

Other 9 3

10 Duration of Chronic kidney 1-6 months 17 5.7

disease
7-12 months 13 4.3

13-18 months 258 86

19 months and above 12 4

11 Able to perform activities of Yes 168 56

daily living
No 132 44

12 Currently following any Yes 48 16

exercises
No 252 84

Table 1-shows the frequency and percentage distribution of the demographic variables.

15
 Out of the total. 46% of the subjects were in age group 51-60, 32.7% were 61 and
above. 18.3% 41-50 and 3 % were between 31-40 years of age.

 Out of the total samples, 40.3% were males and 59.7 % were females.

 Majority of the subjects, 51.3% had high school education, 38.0% had primary, 3%
were graduates or above and 7.7% were illiterate.

 Out of the total, 54% of the subjects had household occupation, 28% had business, 11%
had service and 7% had labor occupation.

 Majority of the subjects, 65.7% were non-vegetarian and 34.3% were vegetarian.

 None of the subjects had other family members affected with chronic kidney disease.

 Out of the total, 67.3% had no previous knowledge regarding exercise regimen and
32.7% had previous knowledge.

 Majority of the subjects15.3% had source of information regarding exercise regimen

from family and friends, 8% from Health workers, 6.7% from Media and 2.6% had
source of information regarding exercise regimen from printed literature.

 Out of the total subjects, 59.3% had history of Diabetes Mellitus, 21.3% had
Hypertension, 16.3% had Myocardial Infarction and 3% had other disease conditions.

 Most of the subjects, 86% had duration of the chronic kidney disease and duration of
treatment for 13-18 months, 5.7% had 1-6 months, 4.3% had 7-12 months durations
and4% had 19 months and above duration of the chronic kidney disease and duration of
treatment .

 Out of the total, 56 % of the subjects showed ability to perform activities of daily living
and 44 % of the subjects were not able to perform activities of daily living .

 Majority of the subjects, 84% did not follow any exercises while 16% followed
exercises.

16
Section-2
Assess the pretest knowledge score regarding Exercise Regimen on activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.

Table 2: Frequency and percentage of pretest knowledge scores regarding exercise

regimen on activities of daily living among Chronic Kidney Disease Patients.

Pretest Knowledge Score Frequency(f) Percentage(%)

Excellent (76-100%) 01 0.3

Good (51-75%) 151 50.3

Average (26-50%) 148 49.3

Total 300 100.0

In the above table no. 16 Pre- test knowledge scores has been categorized with Below Average
category(0-9 scores), Average (10 to 15 scores), Good (16 to 21 scores) and Excellent category
(22 to 30 scores) .148(49%) patients lies in Average category, 151(50%) patients lies in Good
and only one(3%) lies in Excellent category.

Section-3
Assess the pretest practice score regarding Exercise Regimen on activities of daily living
among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.

17
Table 3: Frequency and percentage of pretest practice score regarding Exercise Regimen
on activities of daily living among Chronic Kidney Disease Patients

Pretest Practice Score Frequency (f) Percentage (%)

Excellent(76-100%) 0 0

Good(51-75%) 109 36.3

Average(26-50%) 191 63.7

Total 300 100.0

Pre-test Practice scores has been categorized with Below Average category with 0-9 scores,
Average with 10 to 15 scores, Good with 16 to 21 scores and Excellent category with 22 to 39
scores. In the above table 191(63%) patients’ lies in Average category 109(36%) lies in good
but no one lies in Excellent and Below Average Category.
Section 4
To assess the effectiveness of Exercise Regimen on knowledge regarding activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.
Table 4: Frequency and percentage distribution of post knowledge rating scores
regarding Exercise Regimen on activities of daily living among Chronic Kidney Disease
Patients.

Post-knowledge scores Frequency Percent

Average (10-15) 8 2.7

Good (16-21) 70 23.3
Excellent (22-30) 222 74.0
Total 300 100.0

In the above table shows the post knowledge scores regarding Exercise Regimen on activities of
daily living among Chronic Kidney Disease Patients. Among 300, 8(2.7%) patients lies in
average category, 70(23%) patients lies in good and 222(74%) lies in excellent category after
the 7 days program.

18
Section 5
Evaluation of effectiveness of exercise regimen on practice regarding activities of daily
living among Chronic Kidney Disease Patients.
Table 5: Frequency and percentage distribution of post practice rating scores regarding
Exercise Regimen on activities of daily living among Chronic Kidney Disease Patients.
Post-practice scores Frequency Percent

Average 160 53.3

Good 131 43.7
Excellent 09 0.3
Total 300 100.0

In the above table post practice scores has been categorized with below average category(0-9
scores), average (10 to 15 scores), good (16 to 21 scores) and Excellent category (22 to 39
scores) Among 300, 160(53%) patients lies in average category, 131(43%) patients lies in good
and only 9(3%) lies in excellent category after 7 days program.
Figure 1: Comparison between pre and post knowledge score regarding activities of daily

living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya

Pradesh.

Comparison between pre and post knowledge

score
74
80
70 49.3 50.3
60
50
40 23.3
30
20 2.7 0.3
10
0
Average Good Excellent

Pre % Post %

Figure 2: Comparison between pre and post practice scores regarding activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.

19
 70
Comparison between pre and post practice score.
63.7
60 53.3
50 43.7
40 36.3
30
20
10 3
0 0 0
0
Excellent Good Average Below Average

Pretest % Post test %

Section 6
Table 6: Paired Samples Correlations of teaching program regarding activities of daily
living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.

N Correlation Sig.

Pre knowledge scores & Post knowledge scores 300 .262 .010

At .262 the correlation between the baseline and 7 days according to teaching program
regarding activities of daily living among Chronic Kidney Disease Patients. P-value is (.010)
i.e. statistically significant and change was consistent after training across all subjects. We can
see the positive correlation (.262) between base line and after 7 days training program
according to all outcome measures.

Table 7: Paired Samples Correlations of teaching program regarding activities of daily

living among Chronic Kidney Disease Patients in selected hospitals at Jabalpur, Madhya
Pradesh.

N Correlation Sig.
Pre-Test Practice scores & Post Test
300 .775 .001
Practice Scores

20
 At .775 the correlation between the baseline and 7 days according to practice teaching program
regarding activities of daily living among Chronic Kidney Disease Patients. P-value is (.001)
i.e. statistically significant and change was consistent after training across all subjects. We can
see the positive correlation (.775) between base line and after 7 days training program
according to all outcome measures.

Section 7

Table 8: Chi-Square test statistics of association between pretest knowledge score of

Exercise Regimen on activities of daily living and selected demographic variables among
Chronic Kidney Disease Patient.
Demographic variables Chi-Square Inference
value

1. 1.Age .015*
15.843
2. 2.Gender 27.325 .002*
3. 3.Education status 2.604 .857

4. 4.Occupation 3.275 .774

5. 5.Types of dietary intake 2.018 .365

6.Other related disease condition .012*

16.299
7.Duration of chronic kidney disease .001*
30.243
8.D 8.Duration of treatment .030*
33.823

“*” Significant P<0.05

We mark a p < 0.05 significance level with one asterisk (*) and without asterisk not significant.
We can see here that χ2 = 15.843, p = .015 .This tells us that there is statistically significant
association between age of patients and pre-knowledge score of Exercise Regimen on activities
of daily living; we reject the null hypothesis. Rather, we conclude that there is enough evidence
to suggest an association between age and pre-knowledge score of Exercise Regimen on

21
activities of daily living among patients of selected hospitals at Jabalpur. But χ2 =
2.604, p = .857.This tells us that there is no statistically significant association between
educational status
and pre-knowledge score of Exercise Regimen on activities of daily living; we do not reject the
null hypothesis. Rather, we conclude that there is not enough evidence to suggest an association
between educational status and pre-knowledge score of Exercise Regimen on activities of daily
living among patients. According to above table age, gender, duration of disease and treatment
are associated. No association found in others variables.

Section 8

Table 9: Find the association with pre-test practice score of Exercise Regimen on
activities of daily living and selected demographic variables among Chronic
Kidney Disease Patients.

Demographic variables Chi-Square value Inference

Age .401
2.938

Gender .442
.800

Education status 15.915 .007*

Occupation 8.477 .020*

Types of dietary intake 11.517 .001*

Other related disease condition

16.299 .012*

Duration of chronic kidney disease

15.996 .001*

Duration of treatment 14.776 .002*

“*” Significant P<0.05
We mark a p < 0.05 significance level with one asterisk (*) and without asterisk not significant.
22
We can see here that χ2 =2.938, p = .401.This tells us that there is no statistically significant
association between age of patients and pre-practice score of Exercise Regimen on activities of
daily living; we do not reject the null hypothesis. Rather, we conclude that there is not enough
evidence to suggest an association between age and pre-practice score of Exercise Regimen on
activities of daily living among patients of selected hospitals at Jabalpur. But χ2 =
15.915, p = .007.This tells us that there is statistically significant association between
educational status and pre-practice score of Exercise Regimen on activities of daily living; we
reject the null hypothesis. Rather, we conclude that there is enough evidence to suggest an
association between educational status and pre-knowledge score of Exercise Regimen on
activities of daily living among patients. According to above table pre practice scores age,
gender, are not associated rather than association found in others variables.

LIMITATIONS

1. The study was limited to 300 Chronic Kidney Patients admitted in hospital at Jabalpur
city, Madhya Pradesh.

2. Data collection period was limited to three months.

3. Sample was selected only from selected hospital at Jabalpur city, Madhya Pradesh.

4. The study could not have a control group to allow testing for an increase in knowledge
and practice.

5. A semi structured knowledge questionnaire schedule was used for the data collection,
which restricted the amount of information that could be obtained from respondent.

CONCLUSION

On the basis of above findings of the study following conclusions were drawn-
There was 0% of the subjects had excellent knowledge at the time of pre-test among Chronic
kidney Disease Patients regarding Exercise Regimen on activities of daily living, whereas 6.6%
of the subjects had excellent knowledge score at post-test. The study revealed that 33.4% of the
subjects had good knowledge score at the time of pre- test and post-test. There was 50% of the

23
subjects had average knowledge score at the time of pre-test, whereas 45% of the subjects had
average knowledge score at the time of post-test. There was 16.6% of the subjects had below
average knowledge score at time of pre-test, whereas 15% of the subjects had below knowledge
score at the time of post-test. Therefore Semi Structured Knowledge Questionnaire had proved
beneficial for the subjects in the study.

There was 3.4% of the subjects had good practice score at the time of pre-test, whereas 20% of
the subjects had good practice score at the time of post-test. There was 80% had average
practice score at the time of pre-test, whereas 63.4% practice average practice score at the time
of post-test. There was 16.6% of the subjects had below average practice score at the time of
pre-test and post-test regarding Exercise Regimen of the subjects had average on activities of
daily living among Chronic Kidney Disease Patients. Therefore Semi Structured Observational
Checklist was effective for the subjects in this study.There was moderate degree positive
correlation between knowledge and practice scores of Exercise Regimen on activities of daily
living among Chronic Kidney Disease Patients at the time of post-test. The study also showed
significant association with pre- test knowledge score and selected socio-demographic
variables. There was significant association with pre-test practice score and selected socio-
demographic variables.

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