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CHAPTER – III
Methodology
Methodology
The methodology of research indicates the general pattern of organizing the procedure of gathering valid and reliable data for an investigation ( Polit, Hungler 2004).
This chapter provides brief description of methods adopted for study. It includes research approach, research design, study setting, sample and sampling technique, development and description of tool, content validity, reliability, pilot study, data collection procedure and plan for data analysis.
RESEARCH APPROACH
According to Treece and Treece (1996) research approach is the umbrella that covers the basic procedures for conducting research.
A research approach tells the researcher from whom to collect the data, how to collect the data and how to analyze them. It also suggests possible conclusion and helps the researcher in answering specific research questions in the most accurate and efficient way possible. The research approach adopted for this study was quasi-experimental research approach.
RESEARCH DESIGN
The term research design refers to the plan of a scientific investigation. It helps the researcher in the selection of subject, identification of variables, their manipulation and control, observation to be made, type of statistical analysis to interpret the data. The overall
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plan for addressing a research question, including specifications for enhancing the integrity of the study (Polit and Hungler 2004).
The research design selected for this study was one group pretest, posttest design. The design adopted can be represented as
01 x 02
01 – pretest
x – Intervention
02 – Post test
SCHEMATIC REPRESENTATION OF THE RESEARCH DESIGN
GROUP PRETEST INTERVENTION POSTTEST
Patients with Myocardial infarction
Assessment of knowledge
[ 01 ] Structured Teaching programme on myocardial infarction
[ x ] Effectiveness of structured teaching programme
[ 02 ]
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FIGURE – 2
SCHEMATIC OUTLINE OF RESEARCH DESIGN
DESIGN
quasi experimental research design
STUDY SETTING
Pranav Hospital, Salem
SAMPLING
convenient sampling
STUDY SAMPLE
sample of 40 subjects with
myocardial infarction
INSTRUMENT
semi-structured interview schedule
VARIABLES
DEPENDENT INDEPENDENT ATTIRBUTED
knowledge of M.I.patient structured teaching programme on myocardial infarction
age, sex, education, occupation etc.
ANALYSIS
frequency and percentage to socio demographic variables.
Mean, SD, Chi-Square test, Meanscore percentage to assess the knowledge of patients
Paired ‘t’ test to compare the pre and post test score
SUMMARY, FINDINGS AND CONCLUSION
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DESCRIPTION OF VARIABLES
A concept which can take on different qualitative value is called a variable ( Kothari C.R. 2002). The variables under this study are the following:
INDEPENDENT VARIABLE:
According to Polit and Hungler (1999), the independent variable is the variable that is believed to influence the dependent variable. In this study, structured teaching programme on myocardial infarction is the independent variable.
DEPENDENT VARIABLE
A dependent variable is the response behaviour or outcome that the researcher wants to predict or explain.
In this study, the dependent variable refers to the knowledge of myocardial infarction patients.
ATTRIBUTED VARIABLES:
Attributed or demographic variables are the characteristics of the subjects that are collected to describe the samples. Age, Sex, educational status, family monthly income and type of work are the attributed variables in the present study.
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STUDY SETTING
Setting is the general location and condition in which data collection takes place in the study (Polit and Hungler 2003).
Selection of the area of study is one of the essential steps in research process. The selection of hospital for the present study was on the basis of
‘ availability of subjects
‘ feasibility of conducting the study
‘ economy of time and money.
The study is conducted in Pranav Hospital located in the area of Salem city at Tamil Nadu. It provides speciality for cardiac care. There is a separate coronary care unit to accommodate 10 patients. Nearly about 50 ‘ 60 cardiac patients attend out patient department per day. Among them, 3 to 7 patients admitted with first heart attack per day.
TARGET POPULATION
The entire set of individuals or objects having the same common characteristics (Polit and Hungler 1999).
Target population comprised of patients with myocardial infarction. All the patients fulfilling inclusion criteria were selected for the study.
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SAMPLE AND SAMPLING TECHNIQUE:
Sample is a subset of the population selected to participate in research study to generalize population characteristics sampling technique is the process of selecting a portion of the population to represent the entire population (Polit and Beck 2004).
The sample of the study comprised of 40 patients with myocardial infarction receiving treatment at Pranav Hospital, Salem. The samples were selected through convenient sampling.
CRITERIA FOR THE SELECTION OF SAMPLE
INCLUSION CRITERIA
1. Patients who are between the age group of 35 to 70 years.
2. Those who are receiving treatment for myocardial infarction in Pranav Hospital, Salem.
3. Both male and female sexes.
4. Patients who are willing to participate in the study.
EXCLUSION CRITERIA
1. Patients whose age below 35 years and above 70 years.
2. Patients admitted in emergency and intensive care unit department.
3. Patients who were seriously ill.
4. Patients who were not willing to participate in the study.
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ETHICAL CONSIDERATION:
Written consent were received from the subjects after explaining the purposes of the study.
SELECTION AND DEVELOPMENT OF INSTRUMENT:
SELECTION OF THE INSTRUMENT:
According to Carol.L.Macne, the study methods used to collect data are intended to allow the researcher to construct a description of
the meaning of the variables under study. Semi structured interview schedule was used to assess the knowledge of patient since it is considered to be the most appropriate instrument to elicit the responses from illiterate subjects.
DEVELOPMENT OF THE INSTRUMENT
In the process of developing the tool, the investigator used the following steps.
‘ Literature review
‘ Experts opinion.
Literature review:
Literature related to the topic available from books, journals, periodicals published and unpublished research studies and articles were reviewed to develop the tool.
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EXPERTS OPINION.
The investigator discussed the topic with experts in the fields of nursing, cardiology, biostatistics and Coronary Care Unit staff and incorporated their valuable suggestion.
DESCRIPTION OF THE INSTRUMENT:
The instrument consisted of semi-structured interview schedule with two sections.
SECTION ‘ I
Section-I consists of 16 questions dealing with Socio-demographic variable of myocardial infarction clients, including age, sec, religion, educational status, type of work, dietary pattern, family history of heart attack etc.
SECTION-II
The knowledge aspects consist of 30 items regarding structure and function of heart, meaning, definition, causes, signs and symptoms, management, prevention and complication of myocardial infarction. The maximum score of this section was 54; each correct answer is given a score one.
CONTENT VALIDITY:
Validity is the most important simple methodological criteria for evaluating any measuring instrument. Validity reflects how accurately the measure yields information about the true or real variable being studied (Carol Macnee 2004).
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The experts from the fields of nursing and cardiology examined the relevancy and accuracy of the tool. Based on the experts opinion the tool was modified.
The final tool comprised of
‘ Socio demographic variables with 16 items
‘ Knowledge section with 30 items.
RELIABILITY OF THE INSTRUMENT:
The tool was administered to 8 patients admitted in Medical Trust Hospital, Kochi, Kerala. The reliability was established by using spearman brown split half technique and co-efficient correlation of knowledge test was found to r = 0.95, which indicates high reliability.
DEVELOPMENT OF THE STRUCTURED TEACHING PROGRAMME
A structured teaching programme was developed to educate the patients regarding myocardial infarction.
Keeping in mind, the objectives, literature review and the opinion of the experts, the researcher developed a first draft of structured teaching programme. The main factors considered while preparing structured teaching programme included, the method of teaching adopted, simplicity of language, literacy level of the samples and the areas covered in the knowledge assessment and the relevance of teaching aid.
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The Structured Teaching Programme was prepared to enhance the knowledge of patient regarding myocardial infarction and was given to experts for their comment.
PILOT STUDY
Polit and Hungler (2004) states that, Pilot study is a small scale version or trial run for the major study. The function of this Pilot study is to obtain information for improving the project or for assessing its feasibility.
The Pilot study was conducted in the month of October 2007. Eight patients admitted with myocardial infarction were selected from Medical Trust Hospital, Kochi, Kerala.
The purpose of the Pilot study was
‘ To evaluate the effectives of structured teaching programme on knowledge regarding myocardial infarction.
‘ To find out the feasibility of conducting the final study and
‘ To determine the method of statistical analysis.
Eight patients with myocardial infarction were selected by convenient sampling. A semi-structured interview schedule was used to assess the knowledge. Structured teaching programme was administered and then effectiveness of Structured Teaching Programme was evaluated after 6 -12 hours using the same tool.
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PROCEDURE FOR DATA COLLECTION:
The investigator got permission from hospital authority to conduct the study. Data was collected from 05.11.2207 to 19.11.2007. 40 patients with myocardial infarction were selected by using convenient sampling technique. The investigator established good rapport with the patients and obtained information regarding demographic data. The knowledge regarding myocardial infarction was assessed first and structured teaching programme was given soon after pre-test.
Charts, models and Flash cards were used as visual aids and the subjects were very much interested during study period and took active participation in asking question and seeking clarification.
Post test was done on the next day morning with the same semi structured interview schedule.
PLAN FOR DATA ANALYSIS:
The data obtained were analyzed in terms of objectives of the study by using descriptive and inferential statistics. The plan for data analysis is as follows.
‘ Data were organized in master sheet.
‘ The frequencies and percentage will be used for the analysis of socio demographic variables like age, sex, education etc.
‘ Mean, mean score percentage and standard deviation of pre and post test scores.
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‘ Paired ‘t’ test to find out the effectiveness of structured teaching programme in terms of gain in knowledge.
Inferential statistics especially chi-square tests to assess the relationship between knowledge and selected demographic variables.
Summary
This chapter deals with research approach, research design, study setting, sample selection, development of instrument, content validity, reliability, development of structured teaching programme, pilot study procedure for data collection and plan for data analysis.
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