ABSTRACT

Background: Corona Virus Disease 2019(COVID-19) is a

contagious disease caused by severe acute respiratory syndrome
corona virus 2(SARS-COV-2). The first case was identified in
Wuhan, China, in December 2019. It has since spread
worldwide, leading to an ongoing pandemic.Small droplets and
aerosols containing the virus can spread from an infected
person’s nose and mouth as they breathe, cough, sneeze, sing or
speak. The virus may also spread via contaminated surfaces,
although this is not thought to be the main route of
transmission. It can spread as early as two days before infected
persons shows show symptoms and from individuals who never
experience symptoms. People remain infectious for up to 10
days in moderate cases, and two weeks in severe cases.
Symptoms of COVID-19 are variable, but often include fever,
cough, fatigue, breathing difficulties, loss of smell and taste.
Symptoms begin one to fourteen days after exposure to the
virus. Various testing methods have been developed to diagnose
the disease. The standard diagnosis method is by real- time
reverse transcription poly rRT-PCR) from the nasopharyngeal
swab. Several vaccine erase chain reaction (new have been
developed and various countries have initiated mass vaccination
campaigns. Although work is underway to develop drugs that
inhibit the virus, the primary treatment is currently
symptomatic. Management involves the treatment of the
symptoms, supportive care, isolation and experimental
measures. Preventive measures include physical or social
distancing, quarantining, and ventilation of indoor spaces,
covering while coughs and sneezes, hand washing and keeping
unwashed hands away from the face. The use of masks or
covering has been recommended in the public setting to
minimize the risk of transmission.
Title of the study:
A study to assess the impact of Structured Teaching Program
(STP) on the knowledge regarding the Corona Virus Disease
(COVID-19) among General Nursing Midwifery(GNM)
students of Ancillary Medical Training(AMT) School,
Sheerinbagh, Srinagar, Kashmir.

Objectives of the study:

I. To assess the pre-test knowledge scores regarding the
Corona Virus Disease (COVID-19) among the General
Nursing Midwifery (GNM) students.
II. To assess the post-test knowledge scores regarding the
Corona Virus Disease (COVID-19) among the General
Nursing Midwifery (GNM) students.
III. To compare the pre-test and post-test knowledge scores
regarding the Corona Virus Disease (COVID-19) among
the General Nursing Midwifery (GNM) students.
IV. To find the association between the pre-test knowledge
scores regarding the Corona Virus Disease (COVID-19)
among the General Nursing Midwifery (GNM) students
with selected Demographic variables (age, source of
information, residence).

Methodology:
 Thirty (30) GNM students were selected to conduct this study at
the Ancillary Medical Training School, Shireenbagh, Srinagar,
Kashmir. Quantitative approach was adopted. A pre-
experimental one group pre-test post-test design was used in the
present study to accomplish the objectives. Simple random
sampling technique was used for the selection of 30 GNM
students from the accessible population. The prepared tool
(structured knowledge questionnaire and interview) and the
intervention (structured teaching program) was validated by a
panel of experts. Pre-testing of the tool and intervention was
done to check for the clarity and feasibility. Pilot study was
conducted to assess the feasibility of the study. The main study
was conducted from. Data was collected by the administering
structured knowledge questionnaire and interview. After
collecting data, structured teaching program to the subjects on
the 7th post-test was conducted by using same structured
knowledge questionnaire and interview. The collected data was
analyzed by using descriptive and inferential statistics.
Results:
Conclusion:
Key words: Impact, Structured Teaching Program,
Knowledge, Corona Virus disease (COVID-19), GNM Students.

CONTENTS
Chapter Title Page No.
I Introduction 01-18
Background of the study
Need for the study
 Statement of the problem
Objectives of the study
Hypothesis
Operational definitions
Assumptions
Delimitations
Conceptual frame work
Summary
II Review of literature 19-30
Incidence and prevalence of Corona Virus Disease
(COVID-19)
Clinical manifestation of Corona Virus Disease
(COVID-19)
Transmission of Corona Virus Disease (COVID-19)
Preventive measures and treatment of Corona Virus
Disease (COVID-19)
Vaccines for Corona Virus Disease (COVID-19)
Impact of structured teaching program
Summary
III Methodology
Research approach
Research design
Setting of the study
Variables
Population
Sample and sampling techniques
Criteria for sample selection
Data collection instrument
Development of the tool (structured questionnaire
and interview)
Description of the tool
Scoring pattern/ criteria measure for the knowledge
Preparation of the Blueprint
Content validity of the tool and intervention
Reliability of the tool
 Tool try out
Development of final draft of the tool
Development of the intervention
Pilot study
Ethical consideration
Method of data collection
Plan for data analysis
 Summary
IV Analysis and interpretation

V Discussion
VI Summary of the major finding, conclusion,
nursing implications and recommendations
Reverences
Annexures
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BACKGROUND OF THE STUDY

Corona virus disease 2019 (COVID-19) is a contagious disease
caused by severe acute respiratory syndrome corona virus
2(SARS-COV-2).The outbreak of Novel Corona virus disease
(COVID-19), the first known human infection was in Wuhan
Hubei, China. A study of the first 41 cases of confirmed
COVID-19, published in January2020. [1]

There are about 40 different varieties; they mainly infect the

humans and non-human mammals and birds. In humans and
birds, they cause respiratory tract infections that can range from
mild to lethal. Mild illnesses in humans include some cases of
the common cold (which is also caused by other viruses,
predominantly rhinoviruses), while more lethal varieties can
cause SARS, MERS, and COVID-19. In cows and pigs they
cause diarrhea, while in mice they
cause hepatitis and encephalomyelitis. [02]

The name "corona virus" is derived from Latin corona,

meaning "crown" or "wreath". The name was coined
by June Almeida and David Tyrrell who first observed and
studied human corona viruses. The word was first used in
print in 1968 by an informal group of virologists in the
journal Nature to designate the new family of viruses. The
name refers to the characteristic appearance of virions (the
infective form of the virus) by electron microscopy, which
has a fringe of large, bulbous surface projections creating
an image reminiscent of the solar corona or halo.
This morphology is created by the viral spike peplomers,
which are proteins on the surface of the virus. The
scientific name Corona virus was accepted as a genus name
by the International Committee for the Nomenclature of
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Viruses (later renamed International Committee on
Taxonomy of Viruses) in 1971.The common name corona
virus is used to refer to any member of the
subfamily Orthocoronavirinae.[03]

Corona viruses are a group of large sized (100-160 nm),

spherical, positively sense, non-segmented, single-stranded
RNA with genome sized 26-32 kb (the largest among
known RNA viruses), and known to infect both animals
and humans. Corona virus has been classified into four
genera (a-alpha, b-beta, c-gamma and d-Delta), out of
which only two genera-alpha which contains CoV-NL63 &
CoV-229E, and -beta contains CoV-OC43, CoV-HKU1,
Middle East respiratory syndrome corona virus (MERS-
CoV) and SARS-CoV, found to be infectious for
human .The genome of COVID-19 virus constitutes 29,903
nucleotides which upon fresh reannotation and mapping of
the RNA-sequences obtained, presented the reads
assembly, and was very similar to SL-CoVZC45-an already
known bat strain and SARS-CoV. [04]

There are four common human corona viruses: 229E,

NL63, OC43, HKU1
Other human corona viruses:
SARS-CoV causes Severe Acute Respiratory Syndrome
(SARS). According to the World Health Organization
(WHO) Trusted Source, the first human cases appeared in
southern China in November 2002.SARS-CoV may have
originated in bats and were transmitted to other animals
before infecting humans.
MERS-CoV causes Middle East Respiratory Syndrome
(MERS).Humans contract MERS-CoV through contact
with camels that have contracted the infection. The virus is
also transmitted by coming into very close contact with a
person who has the infection.
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SARS-CoV-2 causes COVID-19. This new corona virus
appeared in Wuhan, China, in late December 2019 after
health officials noticed an increase in pneumonia cases with
no known cause.SARS-CoV-2 causes the illness known
as COVID-19. It’s dangerous because it’s transmitted
easily from person-to-person, whether or not the person is
exhibiting symptoms. [05]

The persons infected by Novel Corona virus are main

source of infection. The major route of transmission of
COVID-19 is from person-to-person via respiratory
droplets and direct personal and physical contact within the
community setting as indicated by currently available
evidences. This Person-to-person transmission route can be
through respiratory droplets which can be enhanced by
physical body contact through handshake, hugging, kissing
and sex due to close physical contact. Similarly, corona
virus can be released in respiratory droplets through
sneezing and coughing. When the respiratory droplets
released come in contact with mucous membrane of the
eyes, nose and mouth of an individual directly or indirectly
through contaminated agents and surfaces (such as
Automated Teller Machines and note currencies, electronic
gadgets including phones and laptops, door handles and
handrails, lift or elevator buttons and fomites including
cloths, utensils and furniture), infection may likely
occur. Transmission can also be airborne as it was recently
proven under laboratory condition that respiratory droplets
of smaller size which is also called aerosols can remain in
air for approximately three hours. The incubation period for
the novel corona virus is somewhere between 2 to 14 days
after exposure. [06]

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Patho-physiology [07]

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COVID-19 affects different people in different ways. Most
infected people will develop mild to moderate illness and
recover without hospitalization. Most common symptoms:
fever, dry cough, tiredness. Less common symptoms: aches
and pains, sore throat, diarrhea, conjunctivitis, headache,
loss of taste or smell, a rash on skin, or discoloration of
fingers or toes. Serious symptoms: difficulty breathing or
shortness of breath, chest pain or pressure, loss of speech or
movement.
According to researchers in China, these were the most
common symptoms among people who had COVID-19:
Fever (99%), fatigue (70%), cough (59%), lack of appetite
(40%), body aches (35%), shortness of breath (31%), and
mucus/phlegm (27%).
Some people who are hospitalized for COVID-19 have also
had dangerous blood clots, including in their legs, lungs,
and arteries. [08]

Though infection is usually due to exposure to the virus

either directly or indirectly, there are some factors that are
responsible. These factors may include;
Human factor: such as age, sex, blood group, immunity,
personal hygiene, underline pre-existing diseases and travel
history to a COVID-19 endemic.
Environmental factor: such as temperature and humidity,
and Occupations factor: that may predispose some
frontline health professional workers to the virus.
Though all age groups including infants, children, grown-
ups and elderly exposed to the virus are susceptible,
patients with lower immune system such as the elderly and

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those with other underline diseases (immune-compromised)
are more prone to developing infections and complications
and this may lead to fatality particularly in older ones.
Furthermore, it has been proven that while those who have
blood group O may be protected against severe COVID-19,
individuals having blood group A are more susceptible to
severe COVID-19 infection. This is as a result of low ACE
present on blood group O that can be used by SARS-CoV-2
as a receptor for entry. Underline health conditions;
Hypertension, diabetes, cardiovascular disease, chronic
respiratory disease, chronic kidney disease, Cancer, COPD,
asthma, smoking, obesity, pre existing medical conditions
have also been suggested as a risk for COVID -19
complication, health care workers are at high risk of
COVID -19 infection because of more frequent exposure to
covid-19 cases. [09]
COVID-19 diagnostic testing is done to find out if someone
is currently infected with SARS-COV-2, the virus that
causes Corona Virus Disease (COVID-19). There are
different types of diagnostic tests available. Some
diagnostic tests used to detect infection and others detect an
immune response. Testing plays an important role in public
health response to COVID-19.The various diagnostic tests
for covid-19 include: Molecular testing (NAAT/RT-PCR),
serology testing [detect antibodies against COVID-19
antigen; IgM, IgG, IgA], laboratory examination, Imaging
[chest x-ray examination, chest computed tomography,
lung ultrasound]. [10]
Some people -- about 1 in 6 -- will have complications,
including some that are life-threatening. Many of these
complications may be caused by a condition known as
cytokine release syndrome or a cytokine storm. This is
when an infection triggers your immune system to flood the

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bloodstream with inflammatory proteins called cytokines.
They can kill tissue and damage your organs, including the
lungs, heart, and kidneys. COVID-19 complications may
include the following: Acute respiratory failure,
pneumonia, acute respiratory distress syndrome (ARDS),
acute liver injury, acute cardiac injury, secondary infection,
acute kidney injury, septic shock, disseminated
intravascular coagulation, multisystem inflammatory
syndrome in children, chronic fatigue, rhabdomyolysis. [11]
There is currently no for an infection with the new corona
virus. However, many treatments and vaccines are
currently under study. On October 22, 2020, the Food and
Drug Administration (FDA) approved its first COVID-19
treatment, the medication Remdesivir (veklury). It is
available by prescription for people age 12 years and older
who have been hospitalized. It is administered as an
intravenous infusion. In November 2020, the FDA also
grotal the Emergency Use Authorization (EUAs) to
monoclonal antibody medications. Monoclonal antibodies
are human-made proteins that help to fight off foreign
made substances such as viruses. These medications are:
Bamlanivimab, Casirivimab and Imdevimab, which must
be administered together.
Like Remdesivir, they are also administered by IV infusion
and intended for people ages 12 years & older. These
medications are used for outpatient therapy. [12]
The world is in the midst of a Covid-19 pandemic.
Vaccines save millions of lives each year. Vaccines work
by training and preparing the body’s natural defenses - the
immune system to recognize and fight off the viruses and
bacteria they target. If the body is exposed to those disease-
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causing germs later, the body is immediately ready to
destroy them thereby preventing illness. (2021). [13]
Russia as the first country to grant regulatory approval to
Covid-19 vaccine named “SPUTNIK-V”.The Phase 1
human trials started in 17th June. Phase 2 trials were started
on July 13 in Gamaleya Institute announced it complete
clinical trial on August 2. (August 12-2020). [14]
The OXFORD-ASTRAZENECA vaccine known as Covi-
Shield in India is being produced locally by the Serum
Institute of India, the World’s largest vaccine manufacturer
(Cova-Vaxin). (Jan 3 2021). [15]
The UK is the first country in world to start using the Pfizer
vaccine. Name: BNT162b2. Manufacturer: PFIZER, Inc
and BioNTech. Type of vaccine: mRNA. Number of shots:
2 shots, 21 days apart and is given in the muscle of upper
arm. (8 December 2020). [16]
As of November 2020, the moderns COVID-19 candidate
mRNA 1273, has shown preliminary evidence of 94%
efficacy of preventing COVID-19 disease. It was
authorized for use In Canada on December 23 2020 as well
as in European Union on January 6, 2021 subsequently the
mRNA 1273 was authorized in the United Kingdom on 8
January 2021. .it is developed by the National Institute
of Allergy and infectious Disease. (2021 Jan 8). [17]
Novavax is a Maryland based Bio-Technology firm that is
taking a traditional approach to a developing a vaccine
against the corona virus disease (NVX COV 2373). The
Novavax vaccine uses a custom made Spike Protein. The
protein is combined with Novavaxe’s matrix adjuvant
which is important enhancing the immune responses
elicited by the protein antigen. (2020). [18]

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Ad 26.Cov2.S also known as Johnson and Johnson
COVID-19 Vaccines and Janssen COVID-19 Vaccine is a
vaccine candidate developed by Janssen pharmaceuticals
(Johnson, Johnson) and Beth Isract Deacons Medical
Centre (BIDMC). (13 Jan 2021). [19]
Clinical management of COVID-19 disease includes
infection prevention and control measures and supportive
care (including supplemental oxygen and mechanical
ventilator support).
Mild case management includes isolation, symptomatic
management, supportive care, adequate nutrition and
appropriate rehydration. Tab Hydroxychloroquine for those
patients have high risk features and antipyretics for fever
and -pain.
Moderate case management includes oxygen support
(target spo2 92-96%), daily 12 leads ECG, clinical
investigation (CBC, KFT, CRP, D-dimer), Tab
Hydroxychloroquine 400mg (BD) on Ist day followed by
200 mg for next four days, Methylprednisolone, low
molecular weight heparin and control of comorbid
conditions.
Severe case management includes early supportive therapy
and monitoring, supplemental oxygen therapy (5ltr/min),
management of hypoxemic respiratory failure and ARSD,
management of septic shock. [20]
Preventive measures are the current strategy to limit the
spread of cases. Preventive strategies are focused on the
isolation of patients and careful Infection Control,
including appropriate measures to be adopted during the
diagnosis & the provision of clinical care to an infected
patient. For instance, droplet, Contact, & airborne

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precautions should be adopted during specimen collection
and sputum induction should be avoided.
The WHO & other organizations have issued the following
general recommendations:
I. Avoid close contact with subjects suffering from acute
respiratory infections.
II. Wash your hands frequently, especially after contact with
infected people or their environment.
III. Avoid unprotected contact with farm or wild animals.
IV. People with symptoms of acute airway infection should
keep their distance, cover coughs or sneezes with disposal
tissues or clothes and wash their hands.
V. Individuals that are immune-compromised should avoid
public gatherings.
VI. The most important strategy is to frequently wash the hands
and use portable hand sanitizer and avoid contact with their
face & mouth after interacting with a possibly
contaminated environment.
VII. Health Care workers caring for infected individuals should
utilize contact & airborne precautions to include PPE such
as N95 or FFP3 masks, eye protection, gowns & gloves to
prevent transmission of pathogens. [21]
The corona virus disease (COVID-19) has been identified as the
cause of an outbreak of respiratory illness in Wuhan, Hubei
Province, China beginning in December 2019. As of 31 January
2020, this epidemic had spread to 19 countries with 11791
confirmed cases, including 213 deaths. A study of the first 41
cases of confirmed COVID-19, published in January 2020 in
The Lancet, reported the earliest date of onset of symptoms as 1
December 2019.Official publications from the WHO reported

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the earliest onset of symptoms as 8 December 2019.Human-to-
human transmission was confirmed by the WHO and Chinese
authorities by 20 January 2020.In May 2020, George Gao, the
director of the Chinese Centre for Disease control and
prevention (CDC), said animal samples collected from the
seafood market had tested negative for the virus, indicating that
the market was the site of an early super spreading event, but it
was not the site of the initial outbreak.
By December 2019, the spread of infection was almost
entirely driven by human-to-human transmission. The
number of corona virus cases in Hubei gradually increased,
reaching 60 by 20 December and at least 266 by 31
December. The Wuhan Municipal Health Commission
made the first public announcement of a pneumonia
outbreak of unknown cause on 31 December, confirming
27 cases enough to trigger an investigation. A report in The
Lancet on 24 January indicated human transmission,
strongly recommended personal protective equipment for
health workers, and said testing for the virus was essential
due to its "pandemic potential". On 30 January, the WHO
declared the corona virus a “Public Health Emergency of
International Concern”. By this time, the outbreak spread
by a factor of 100 to 200 times.
On 31 January 2020, Italy had its first confirmed cases, two
tourists from China. As of 13 March 2020, the WHO
considered Europe the active centre of the pandemic. On 19
March 2020, Italy overtook China as the country with the most
deaths. By 26 March, the United States had overtaken China
and Italy with the highest number of confirmed cases in the
world. On 11 June 2020, after 55 days without a locally
transmitted case, Beijing reported the first COVID-19 case,
followed by two more cases on 12 June. By 15 June, 79 cases
were officially confirmed. Most of these patients went to
Xinfadi Wholesale Market. As per WHO: 17-12-2021;
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Prevalence of Corona Virus Disease (COVID-19) in the world
are 271,963,258 cases, deaths are 5,331,019. On 18-12-2021;
incidence was 18993. On 16-12-2021; 8,337,664,456 vaccine
doses have been administered. [22]
The COVID-19 pandemic in India is part of the worldwide
pandemic of corona virus disease 2019 (COVID-19) caused
by severe acute respiratory syndrome corona virus 2
(SARS-CoV-2) with a rise of 127 million reported case,
71.7 million recoveries and 2.78 million deaths globally as
in March 28, 2021. The first case of COVID-19 in India,
which originated from China, was reported on 30 January
2020. India currently has more than 11.9 million reported
cases of COVID-19 infection and more than 161k deaths as
of March 28, 2021.The new COVID-19 cases in India are
over 60,000 cases reported per day as in mid-March, 2021.
On 18-12-2021 prevalence was 34,733,194 cases. On 6-12-
2021 1,294,608,045 vaccine doses have been administered.
[23]
In union territory of Jammu and Kashmir, two suspected
cases with high virus load were detected and isolated on 4
March in Government Medical College, Jammu. One of
them became the first confirmed positive case on 9 March
2020. Both individuals had a travel history to Iran. As of 28
March 2021; total numbers of positive cases in Jammu and
Kashmir were 129k. This includes, 126k successful
recoveries/discharges and 1984 deaths. With a testing rate
over 10,000 per million, Jammu & Kashmir is now leading
all the states in the country in testing. 13 June 2021, total
no. Of active cases was 16284, successful recoveries/
discharges was 286180 and deaths was 4174. Total vaccine
doses administered are 36, 46,922. On 16-12-2021;
Confirmed cases was 3, 23499, Active cases was 1229,
Recovered case was 3, 17,872 and Deaths was 4398. On 25
August 202, nearly 16.5 lakh people received 2 doses of
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vaccine. On 20 September 2021, 1 crore vaccine doses was
administered. On 14 October 2021 1.4 crore doses of
Vaccine have been administered so far in J and K. [24]

NEED OF THE STUDY

A Novel Corona Virus, 2019-nCoV, has been
identified as the cause of an outbreak of respiratory
illness that originated in the Wuhan, China and which
has spread to several other countries around the
world.
Public health emergencies during outbreak of the
communicable diseases may cause fear and anxiety
leading to prejudices against people and
communities, social isolation and stigma. Such
behavior may culminate into increased hostility,
chaos and unnecessary social disruptions. Cases have
been reported of people affected with Corona Virus
Disease (COVID-19) as well as healthcare workers,
sanitary workers and police, who are in the frontline
for the management of the outbreak, facing
discrimination on account of heightened fear and
misinformation about the infection. Even those who
have been recovered from Corona Virus Disease
(COVID-19) face such discrimination. Further,
certain communities and areas are being labeled
purely based on the false reports floating in the social
media and elsewhere. There is an urgent need to
counter such prejudices and to rise as a community
that is empowered with health literacy and responds
appropriately in the face of this adversity. [25]

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Overworked Indian medical professionals are now

increasingly fighting on a whole new front in the
Corona Virus Disease (COVID-19) battle: stigma.
Fully under the grip of the global pandemic, the
country is reporting cases of the doctors, nurses and
other health care professionals, on the frontline of the
battle, being shunned by others for fear of being
infected.
Slum in the central Indian city of Indore when the
mob attacked. Group of public-health workers had
been tracking down a man who might have had
contact with recently confirmed cases of the Corona
Virus. When they found him, he cursed at them,
asking why they wanted his information and accusing
them of trying to take him away. Almost
immediately, at least 100 people surrounded the
team, throwing stones and other objects. [26]
In the southern city of Bengaluru (formerly known as
Bangalore), health workers were attacked as they
went door to door checking people symptoms. In the
central city of Bhopal, doctors returning from an
emergency shift were stopped by the police, accused
of spreading the virus and beaten with batons. And in
New Delhi, one doctor was assaulted by a shopper at
the local fruit market, while neighbors of one of her
colleagues attempted to force the woman from her
apartment building. [27]
In some cases, the way testing was conducted also
caused problems: one couple in the eastern state of
the Bihar said that their son was told to come out of
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their apartment building and into the street to give his

swab for testing. He was in home quarantine after
returning from Canada. Seeing so many doctors in
hazmat suits made our neighbors really scared.
People stopped saying hello-even from a safe
distance. They added that their son tested negative,
but the discrimination continues. [28]
Panic gripped Nagpur as four suspected Corona Virus
ran away from a government-run hospital. [29]
There are many examples for which people have
misconceptions and stigma about the COVID-19
disease. As seen from the recent data in India, the
stigma attached to Corona Virus Disease (COVID-
19) and the fear of the isolation may be the reasons
for people shying away from being diagnosed.
With several reports now emerging that people
suspected of Corona Virus infection are fleeing from
quarantine facilities in India owning to isolation and
social stigma fears, this can lead to unnecessary panic
and spread of the deadly disease.
The Corona Virus Disease (COVID-19) pandemic
and lockdown and social distancing mandates have
disrupted the consumer habits of buying as well as
shopping. Consumers are learning to improvise and
learn new habits. For example, consumers cannot go
to the store, so the store comes to the home. While
consumers go back to the old habits, it is likely those
they will be modified by new regulations and
procedures in the way consumers shop and buy

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products and services. New habits will also emerge

by the technology advances, changing demographics
and innovative ways consumers have learned to cope
with blurring the work leisure and education
boundaries. [30]
The Corona Virus Disease (COVID-19) outbreak is a
sharp reminder that pandemics, like other rarely
occurring catastrophes have happened in the past and
will continue to happen in the future. Even if we
cannot prevent dangerous virus from emerging, we
should prepare to dampen their effects on the society.
The current outbreak has severe economic
consequences across the globe and it does not look
like any country will be unaffected. This not only has
consequences for the economy; all of the society is
affected, which led to the dramatic changes in how
businesses act and consumers behave. This special
issue is a global effort to address some of the
pandemic related issues affecting society. In total,
there are 13 papers that covers different industry
sectors (e.g., tourism, retail, higher education),
changes in consumer’s behavior and businesses,
ethical issues and aspects related to employees and
leadership. [31]
A Web Based Survey in Northern India, to assess the
knowledge and awareness among nursing students
towards Corona Virus Disease (COVID-19)
pandemic was conducted on September 2020 [32]. A
total of 250 nursing participated in this study. Around
75.2% respondents were having moderate

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knowledge. 17.2% participants were having good

knowledge followed by 7.6% were having below
moderate knowledge. There was significant
association of knowledge and awareness score with
the age, year of study and source of health
information was found to be statistically significant at
p<0.05 level of significance. The study participants
showed moderate knowledge and awareness of
Corona Virus Disease (COVID-19). There is a strong
need to implement periodic educational interventions
and training programs on infection control practices
and other updates of Corona Virus Disease (COVID-
19) across all healthcare professions including
nursing students.
A Questionnaire Based Survey, to assess the Corona
Virus Disease (COVID-19) awareness among
Healthcare Students and Professionals in Mumbai
Metropolitan Region, was conducted on 02, April,
2020 [33]. A total of 1562 responders from the
Mumbai Metropolitan Region. The overall awareness
for all subgroups was adequate with 71.2% reporting
correct answers. The highest percentage of correct
responses were from undergraduate medical students
and the lowest was from non-clinical/ administration
staff. Less than half of the total respondents could
correctly define “close contact”. More than three-
fourths of the responders were aware of various
infection control measures like rapid triage,
respiratory hygiene and cough etiquette and having a
separate, well ventilated waiting area for suspected
Corona Virus Disease (COVID-19) patients.
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However, only 45.4% of the responders were aware

of the correct sequence for the application of a mask/
respirator and only 52.5% of the responders were
aware of the preferred hand hygiene method for
visibly soiled hands. There is a need for regular
educational interventions and training programs on
infection control practices for Corona Virus Disease
(COVID-19) across all healthcare professions.
Occupational health and safety are of paramount
importance to minimize the risk of transmission to
healthcare students and professionals and provide
optimal care for patients.
There is a need for this study as the research group is
interested in this topic. When the research group
notices such incidents in the news and media, many
people were suffering from the wrong perception,
knowledge and stigma about the COVID-19 (Corona
Virus Disease). This happens because of the people
do not have sufficient information about the Corona
Virus Disease (COVID-19).
As the knowledge of Corona Virus Disease (COVID-
19) is crucial in today’s scenario to protect self and
others from its contaminations and to detect and
identify new cases in order to handle them as early as
possible, so that cross contamination can be reduced
until the vaccine is administered to each and every
individual in the country against this disease and it
get fully eradicated. The present study was conducted
on the IST year General Nursing Midwifery (GNM)
students of Ancillary Medical Training (AMT)

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School, to assess the impact of Structured Teaching

Program (STP) on the knowledge regarding Corona
Virus Disease (COVID-19).
STATEMENT OF THE STUDY:
A study to assess the impact of Structured Teaching
Program (STP) on the knowledge regarding the Corona
Virus Disease (COVID-19) among General Nursing
Midwifery(GNM) students of Ancillary Medical
Training (AMT) School, Sheerinbagh, Srinagar,
Kashmir.
OBJECTIVES OF THE STUDY:
I. To assess the pre-test knowledge scores regarding the
Corona Virus Disease (COVID-19) among the General
Nursing Midwifery (GNM) students.
II. To assess the post-test knowledge scores regarding the
Corona Virus Disease (COVID-19) among the General
Nursing Midwifery (GNM) students.
III. To compare the pre-test and post-test knowledge scores
regarding the Corona Virus Disease (COVID-19) among
the General Nursing Midwifery (GNM) students.
IV. To find the association between the pre-test knowledge
scores regarding the Corona Virus Disease (COVID-19)
among the General Nursing Midwifery (GNM) students
with selected Demographic variables (age, source of
information,residence).
HYPOTHESIS:
H1:There is significant increase in the mean post-test
knowledge score as compared to mean pre-test knowledge
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score regarding the Corona Virus Disease (COVID-19)
among the General Nursing Midwifery (GNM) students at
0.05 level of significance.
H2: There is significant association between the pre-test
knowledge regarding the Corona Virus Disease (COVID-
19) among the General Nursing Midwifery (GNM) students
with selected Demographic variables (age, source of
information, residence) at 0.05 level of significance.

OPERATIONAL DEFINITION:
Impact: In this study, it refers to the outcome of the Structured
Teaching Program (STP) in improving the knowledge of Corona
Virus Disease (COVID-19) among the GNM students under the
study.

Structured Teaching Program: In this study, it refers to the

structured learning material prepared by the investigator for the
participants under the study regarding the introduction,
definition, structure, source, mode of transmission, incubation
period, diagnosis, treatment, prevention, complications, vaccines
etc. of the Corona Virus Disease (COVID-19) and also the
procedure.
Knowledge: In this study, it refers to the correct responses to
the questions about the Corona Virus Disease (COVID-19) on
the formed structured knowledge questionnaire.
Corona Virus Disease (COVID-19): In this study, it refers to
the infectious disease of the respiratory tract caused by the
Corona Virus.
General Nursing Midwifery (GNM) students: In this study, it
refers to the first year General Nursing Midwifery (GNM)
students with the age group of 18->24 years under study.

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ASSUMPTIONS:
1. The General Nursing Midwifery (GNM) students have
significantly inadequate knowledge regarding the Corona
Virus Disease (COVID-19), because of their academic
level.
2. The Structured Teaching Program (STP) will enhance the
knowledge of the General Nursing Midwifery (GNM)
students regarding the Corona Virus Disease (COVID-
19).
3. Appropriate knowledge regarding the Corona Virus
Disease (COVID-19) can reduce the incidence of the
Corona Virus Disease (COVID-19)---new cases.

DELIMITATIONS OF THE STUDY:

The study is delimited to the following:
i.The data should be collected from the selected students of
selected institution (Ancillary Medical Training School,
Shireenbagh,Srinagar).
ii.The study should be focused on the GNM (Ist Year) students
only.
iii.Sample size should be limited to 30
iv.Duration of one week for data collection.
v.Period of study is limited to
CONCEPTUAL FRAMEWORK:
Nursing science is deeply involved in the body of the
knowledge essential to nursing research and practice.
Identification of the knowledge base requires the
development and recognition of the concepts and theories
specific to nursing.[25]
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Conceptual framework refers to the interrelated concepts or
abstractions assembled together in a rational scheme by the
virtue of their relevance to a common theme. The
development of Conceptual framework is a fundamental
process required before conducting actual research because
it guides each stage. It is a framework which provides the
investigator the guidelines to proceed in attaining the
objectives of the study based on the theory. It is a scientific
representation of the steps, activities and outcome of the
study.
In the present study the investigator adopted a modified
conceptual framework based on Ludwig Von Bertalanffy’s
(1968) General System theory or System Model(Fig.
01)developed by WHO in 1985.This model aims at
assessing the impact of impact of Structured Teaching
Program (STP) on the knowledge regarding the Corona
Virus Disease (COVID-19) among General Nursing
Midwifery (GNM) students of Ancillary Medical Training
(AMT) School, Sheerinbagh, Srinagar, Kashmir.
According to this model living systems are open because
there is an ongoing exchange of matter, energy and
information. In general system theory the systems
are composed of both structural and functional components
that interact within a boundary which filters the type and
rate of exchange with the environment. A structure refers to
the arrangements of part at a given time whereas function is
the process of continuous change in the system as matter;
energy and information that are exchanged within the
environment.
For survival, a system must achieve a balance internally
and externally. Equilibrium depends on the system’s ability
to regulate input and output to achieve a
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balanced relationship of the interactive parts. The system
uses various adaptation mechanisms to maintain
equilibrium. Adaptation may occur through accepting or
rejecting the matter, energy and information or by
accommodating the input and modifying the system
responses. Being an open system, a client is capable of
receiving information and gathering awareness from its
environment. Utilizing the capacity of the client, nurse
research takes the opportunity to provide information
regarding the knowledge of Corona Virus Disease
(COVID-19).Conceptual framework is a schematic
representation. It provides:

 A theoretical framework of the research problem statement

that has scientific base and which lays emphasis on the
selection, arrangements and classification of its concepts.

 A certain frame of the reference for clinical practice,

research and education.

 A direction to the research for the relevant question on the

phenomenon points out a solution to the practical problem.
Ludwig open system theory model focuses on three areas;
1. Input
2. Throughput (process).
3. Output.
1.Input: According to general system theory input refers to
the matter, energy or information from the environment
into the system. Here, it refers to the learner target group
with their characteristics, level of competence, learning
needs, interest etc, before dissemination of Structured
Teaching Program. Input for the current stud refers to the
GNM students in the selected nursing school of Kashmir
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with attributes like; age, Gender, Source of information,
and Residence.
2. Throughput (process): Throughput refers to the process
by which matter, energy and information is modified or
transformed within the system. Here, it refers to the
different operational aspects in the development and
implementation of the program. It includes the factors that
facilitate or block the implementation ofvarious stages of
development of the Structured Teaching Program. Process
for the current study is:

 Development of the Structured Teaching Program.

 Development of the tool i.e., structured questionnaire to

assess the knowledge among the GNM students in the
selected nursing school of Kashmir.

 Ensure content validity and reliability of the structured

knowledge questionnaire and interview.

 Try out of the study.

 Pilot study.

 Assessment of the knowledge among the GNM students

regarding the management of the Corona Virus Disease
(COVID-19) by administering the pre-test.

 Dissemination of the Structured Teaching Program.

 Assess the impact of the Structured Teaching Program by

post knowledge score.

 Data analysis and interpretation by using descriptive and

inferential statistics.
3. Output: Output in this model refers to matter, energy

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and information that are released from the system into the
environment. Here, it refers to the assessment of the
performance of the GNM students to the Structured
Teaching Program and to find out whether there is any
evidence of the desired change in the knowledge of the
GNM students.

SUMMARY
This chapter dealt with the introduction, need for the study,
and statement of problem, operational definitions,
assumptions, hypothesis, delimitations and conceptual
framework.

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 (Fig. 01) CONCEPTUAL FRAMEWORK BASED ON THE
SYSTEM MODEL

THROUGHTP OUTPUT
INPUT UT/
Knowledge
D
Development of the structured
e
knowledge questionnaire regarding
m
the knowledge of Corona Virus Disease
o
(COVID-19)
g
r Development of STP
a
Validation of the tool and intervention
p
by the experts
h Target
i Pilot study group
c
Pre-test of the knowledge

v Implementation of STP Administration of

a STP
Data analysis and interpretation

G N

FEEDBACK

KEY
Administra Administrati
on of STP is
tion of STP not effective
not in our is effective
study

Health promoting behavior

 METHODOLOGY CHAPTER

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