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PROFORMA FOR REGISTRATION OF

SUBJECTS FOR DISSERTATION

A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED TEACHING


PROGRAMME ON KNOWLEDGE AND PRACTICE OF ORAL HYGIENE
AMONG

PRIMARY

SCHOOL

CHILDREN

IN

SELECTED

URBAN

GOVERNMENT SCHOOL AT TUMKUR

SUBMITTED BY:
MR. MALLIKARJUNA.P
1 ST YEAR M.Sc. NURSING
SHRIDEVI COLLEGE OF NURSING
TUMKUR-572106.
2008-09
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCESES


BANGALORE, KARNATAKA.
ANNEXURE - II
SYNOPSIS PROFORMA FOR REGISTRATION OF
SUBJECTS FOR DISSERTATION
1. NAME OF THE CANDIDATE

MR. MALLIKARJUNA.P
1 YEAR M.Sc NURSING,
SHRIDEVI COLLEGE OF
NURSING, LINGAPPA,
SIRA ROAD, TUMKUR.

2. NAME OF THE INSTITUTION

SHRIDEVI COLLEGE OF NURSING

1 YEAR M.Sc NURSING

3. COURSE OF STUDY AND


SUBJECT

COMMUNITY HEALTH NURSING


4. DATE OF A ADMISSION TO
COURSE
5. TITLE OF THE TOPIC

14.06.2008

A STUDY TO ASSESS THE


EFFECTIVENESS

OF

PLANNED

TEACHING

PROGRAMME

ON

KNOWLEDGE

AND

OF

PRACTICE

ORAL HYGIENE AMONG PRIMARY


SCHOOL CHILDREN IN SELECTED
URBAN GOVERNMENT SCHOOL AT
TUMKUR.

6. BRIEF RESUME OF INTENDED WORK


INTRODUCTION :
Cleanliness is next to Godliness.
Is a common saying mere teaching of cleanliness of body and surrounding is not
enough unless it is effectively demonstrated, essential and obligatory Cleans to be
observed by all children include clean environment, clean hands, clean food, clean water,
clean mouth and clean teeth. It is said that Mouth is the gateway to the inside of the
body, and it also houses one of the most important sense organ, the tongue. Therefore,
the mouth has to be kept clean and healthy.
School age is a period of overall development. During this period learns to become
productive member of the peer group. If proper oral hygiene habits are cultivated during
this period, it will go a long way in maintaining the oral health of a child throughout his/her
life.1
The goal of WHO, Health for all by the year 2025, includes oral health as one among
the health life. So WHO has selected the theme oral health for healthy life in 1994. The
purpose behind this was to make the people aware about various diseases of oral cavity and
to educate them in relation to prevention of these diseases [World Health Magazine,
1994].2
The children frequently suffer from dental diseases and defects. Dental caries and
periodontal diseases are two common diseases in India. Further they emphasize that a
school health programme should have provision for dental examination atleast once a year
and the success of the school health programme depends largely on the community health
nurse. An educator, she plans the health education in the school she provides guidance to
the teachers and parents in the matters of oral health.3
Todays children are tomorrows leaders. They form 38%-40% of our general
population. One of the major health care concept faced by these promises of future are oral
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health problems, more commonly dental caries. The higher concentration of health care
facilities in urban areas of India prevents the rural population from receiving proper health
care service in developing countries including India.
Adding to this, illiteracy, poverty and overgrowing population made it difficult to
render better health care services to all. Hence prevention seems to be the only solution in
promoting the oral health and thereby the overall health.4
Health habits if thought early would last throughout the life. Oral health helps to
maintain the health state of all the structures like lips, teeth, gum, tongue and palate, good
oral hygiene emphasis on cleanliness and moisturizing of mouth structures. It gives a sense
of well-being and also stimulates appetite. Brushing and flossing and rinsing mouth could
maintain good oral hygiene. Brushing clears the teeth of food particles. Plaque & bacteria.5

6.1. NEED FOR THE STUDY:


Promotion of health as a level of prevention is most apt for formative years of life ;
pre-school and school going children, value based learning begins in life cycle at early
years of life and, there after continuous throughout the life cycle with varied degree of
acquisition. Health is not valued unless it is lost. Organized value based learning can be
achieved much more effectively in school, homes and families. It would be a real
investment in health and development of future citizens parents and teachers are best
suited to lay foundations and nurture the values of staying healthy. A new push and
enthusiasm is called for in the present system directing efforts at community levels.6
Health and hygiene as a subject cant be thought but it can be learnt as a way of life.
The primary school imparts a broad set of values that transceand specific knowledge
acquired during the time at school will determine what kind of a person that child will
become. Community health centers, Primary health centers and subcenters make some
efforts through school health services to promote personal hygiene practices and
inculcation of sound practices in school children .6
The prevalence of dental caries was highest in the age group of 8-10 years in urban
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areas, where as rural children the caries were significant in the age of 8, 10,and 12 years . 7
The dental health education is a cost effective method for promoting oral health and
ultimately the general health is only the best place for the promotion of oral health, where
all children irrespective of their socio-economic status or ethnicity can be reached.8
Approximately 35% of pediatric population visits the dentist yearly among them most
after the occurrence of some dental problems.9
Dental check-up of more 2000 school children in Vadodara city shows that abnormally
larger number of children from Vadodara suffered from various serious dental ailments
mostly due to lack of knowledge and lack of personal hygiene. 10
A study conducted on school children in Amrithsar city. It was observed that 49.9%
male & 45.9% female children were suffering with dental caries hence awareness must be
brought among the children, regarding their dietary habits and bad effects of sticky diet
must be brought to their notice11
India being a developing country, poor oral hygiene is a common problem of rural and
urban areas and is all due to low socio-economic background, Poverty ignorance and
negligence or poor knowledge of oral hygiene. Investigators own observation during his
experience in community posting was revealed poor oral hygiene among the school
children.
Hence the investigator felt that by doing this kind of study, will focus on prevailing
problems of oral health and findings help to develop effective teaching programme in order
to modify the practices and behaviour of school children; So that the general health related
complications among the future adults may be prevented leading to healthy generations.

6.2. REVIEW OF LITERATURE


The purpose of review of literature is to obtain comprehensive knowledge
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base and in department of information from previous studies.


1. Macnab AJ, et al (2008) Conducted a study to improve oral health and knowledge
among school children ,26 children were assessed prior to the intervention,
representing 45% of the 58 children in the community. All 40 children in the
community were assessed following the intervention consisted of a school based
program with daily brushing instructions, fluoride application, educational
presentations, and a recognition/incentive scheme. Prior to the intervention 8% of
children were cavity free. Among the 13 children assessed both pre and postintervention, DMFT score improved significantly (P<0.005).The visiting hygienist
noted increased knowledge about oral health and the university supported, school
based, collaborative oral health program improved oral health knowledge among
children in a Remote First Nations Community. 12
2. Shidara, et al (2007) :- Conducted a study on oral health status and the risk factors
contributing to dental caries and gum disease of school children aged between 616 years in Cambodia. Total 332 children are represented in this study, An oral
examination and self reported questionnaire were used to evaluate oral health status
of school children. The prevalence of dental caries in permanent dentition was
53.5% and gum disease was present in 46.2%. The study revealed that lack of
personal toothbrush leads to plaque build up, which may increase the incidence of
dental caries, which has been linked to tooth pain and disease, ultimately, this poor
oral health care impacts an individuals quality of life and can lead to more serious
health issues in later.13
3. Cerulli Mariani et al (2006) :- Conducted a study on oral hygiene habits and
attitudes of a school population in LAquila (Italy). The Questionnaire provided to
understand their awareness of a caries prevention method by using fluoride, 4 th and
5th grade students of elementary school in LAquila were submitted to a
questionnaires to the 1205 students, age ranging from, 8 to 12, 1094 were
questioned; 7 children 8 years old, 282 of 9, 555 of 10, 243 of 11, 8 of 12, and 2 of
13 respectively. The study has revealed that, among the Italian population with a
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low incidence of dental decay, a relatively limited group, called high risk decay
group; a higher incidence of the pathology than the standard one. The study
concluded that, in a multiracial society, as ours, it is important to carry out an
effective screening in order to recognize different categories of patients through
simple questions inserted in the patients case history. 14
4. Grimoud AM et al, (2005) Conducted the study along with multidisciplinary team
members from hospital, national education and local council sector and led a cariefree smile education campaign in Toulouse. The main aim of this study was two
fold, (1). To teach children how to manage their rontine oral hygiene while giving a
positive image to health care hence the carie-free smile theme chosen by the team.
(2) To promote an awareness campaign targeting professionals in the education,
12,000 children in the age groups of 5-10 years from 76 public and private school,
36 kindergarten and primary school leisure centers, 6 holiday centers participated in
the study. The team product back-up material in the form of posters, booklets and
stickers. The study revealed disparities in oral hygiene practices according to
residential area and appreciated the importance of early provision in the school
curriculum as well as the value of accomplishing this health education task in the
daily exercise of their profession.15
5. Farsi JM, et al (2004) :- conducted a study to assess the knowledge, attitude and
practice regarding oral health among Saudi school students in Jeddah city, revealed
that 87.7% knew the tooth brush helps prevent periodontal diseases. Only 33.1%
knew that using dental floss helps in preventing periodontal disease. Females used
brushing and flossing more than males. He conclude that knowledge, attitude, and
behaviour concerning periodontal health among young sandi school students living
in Jeddah city are in need of improvement.16
6. Simon C, et al (2003) Conducted the study on assessment of the oral health status
of school children in Addis Ababa; The oral health status of school children who
are 12 years and above, A total of 1736 study subject were selected through a multi7

stage sampling produce from three different categories of schools ( Private, public
and government). The prevalence of dental caries was determined to be 21.1% and
it was found to increase significantly with increasing age, high consumption of
sweets, and in those who do not clean their teeth regularly. Periodontal disease
affected more than half (53.4%) of the study subject was significantly higher in
males, and those with poor oral hygiene. The study revealed that health education
programmes, about health and practices of adequate oral hygiene should be
promoted in school through integration into the school curriculum and services.17
7. Hartono (2002) : - performed a study among primary school children regarding the
effectiveness of oral health education programme at primary school level. The
result indicated that the time spent and effectiveness of brushing were significantly
increased among children who had undergone the training.18
8. Bal C.S(2001) :- Performed a study on school going children of Amrithsar
city.1050 children in the age group of 3-14 Years were examined. It was observed
that 49.9% male and 45.9% female children were suffering from dental caries. In
this study, the relation of occurrence of dental caries with vegetarian and nonvegetarian foods socio-economic conditions of the children, maintenance of oral
hygiene, method of oral hygiene, frequency of taking sweets and habit of mouth
wash were observed and recorded.11
9. Al-Banyan R,A et al(2000) : Surveyed oral health of 5-12 year old school children
of National Guard Employees in Riyadh, Saudi Arabia, to assess the oral health and
preventive practice among children on sample of 272.An examination was assessed
using the debris index and gingival index. The study revealed that a high level of
oral disease and poor oral hygiene in the study population and a need for
therapeutic preventive intervention .19

STATEMENT OF THE PROBLEM:A study to assess the effectiveness of planned teaching programme on
knowledge and practice of oral hygiene among primary school children in selected
urban Government school at Tumkur.
8

6.3. OBJECTIVES OF THE STUDY:The Objectives of the study are:1. To assess the level of knowledge regarding oral hygiene among urban primary
school children.
2. To observe the performance of brushing technique among urban primary school
children.
3. To find out the association between the knowledge and practice of oral hygiene
with selected Socio-Demographic variables.
4.

To evaluate the effectiveness of imparted health education on oral hygiene before


and after teaching.

6.4. OPERATIONAL DEFINATION: ASSESSMENT:It is the organized, Systematic and continuous process of collecting data
about pretest and post test knowledge from primary school children regarding oral
hygiene.
EFFECTIVENESS:Refers to gain in knowledge as determined by significant difference in pre
test and post-test knowledge scores.
PLANNED TEACHING PROGRAMME:Refers to the systematic organized instruction and discussion. Which are
prepared to educate a group of subjects.
KNOWLEDGE:Refers to information about the functions of the teeth, healthy and unhealthy
practices related to cleaning and care of the teeth oral care as measured by correct
responses given by respondents to questions.
PRACTICE:9

In this study practices refer to those actions which predisposes or


contributes to the occurrence of dental health problem which are observable.
ORAL HYGIENE:Cleanliness observed in mouth and related areas.
PRIMARY SCHOOL CHILDERN:Refers to children studying in 5th , 6th and 7th standards, who are in the age
group between 09-12 years.

6.5 RESEARCH HYPOTHESES:H1: There is a significant difference between the pre and post test knowledge scores and
practice of urban primary school children regarding oral hygiene.

6.6 ASSUMPTIONS:The study assumes that


1. Most of the primary school children may not have enough knowledge regarding the
oral hygiene.
2. lack of oral hygiene knowledge leads to improper practices of brushing technique
3. Planned Teaching Programme on oral hygiene will help the primary school
children to improve their knowledge.
4. The practice of children related to oral hygiene may differ depending on their
knowledge.

6.7. DELIMITATIONS:
The study is limited to children studying in 5th 6th and 7th standard in
selected Government Urban primary school at Tumkur.

6.8. PILOT STUDY


Pilot study will be conducted with 10 samples; The purpose of the pilot
study is to find out the feasibility of conducting study and design on plan of
statistical analysis. The findings of the pilot study samples will not be included in main
study.

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6.9. VARIABLES:Research variables are the concepts at various levels of abstraction that are
entered manipulated and collected in a study.
Independent variable : Planned Teaching Programme
Dependent variable: Knowledge and performance of the bruching technique as
measured by an Observation checklist.

7. MATERIALS AND METHOD


In this study one group pre and post-test design will be used. The study is
designed to evaluate the effectiveness of Planned Teaching Programme on
knowledge and practice of oral hygiene among primary school children of selected
urban Government primary school at Tumkur.

7.1. SOURCE OF DATA:


The data will be collected from the primary school children at selected
urban Government school at Tumkur.
1. Primary source: The data will be collected originally from the primary school
children by the investigators in a selected Government school at Tumkur.

2. Secondary source : The data will be collected from research articles already
carried out by other researches.
7.1.1. RESEARCH DESIGN
A pre-experimental research method was chosen for the study to assess the
effectiveness of Planned Teaching Programme on knowledge and practice regarding
oral hygiene. The research design used in this study was one group pre-test and
post-test.
7.1.2. RESEARCH APPORACH
An evaluative research approach will be used.
7.1.3. RESEARCH SETTING
The study will be conducted at selected urban Government school at
11

Tumkur.
7.1.4. POPULATION
In this study population consist of 100 primary school children at selected
urban Government school at Tumkur.

7.2. METHOD OF DATA COLLECTION


The data collection procedure will be carried out a period of 3 months. The
study will be conducting after obtaining permission from the concerned authorities.
Data collection of the study is at two levels

Self structured questionnaire oral hygiene knowledge.

Observational method for brushing technique performance.

7.2.1. SAMPLING PROCEDURE


Simple random sampling technique will be used.

7.2.2. SAMPLE SIZE


The sample size of the study consists of 100 primary school childrens in a
selected setting at Tumkur.

CRITERIA FOR SAMPLING


7.2.3 INCLUSIVE CRITERIA
1. Children aged between 9-12 years are included as a sample and who are
studying in 5th to 7th standard.
2. Both boy and girl children are included the study.
3. Children available during the period of data collection.
7.2.4. EXCLUSIVE CRITERIA:
1. Children who are below 9 years and above 12 years of age group.
2. Children not available during the period of data collection.
7.2.5. TOOLS OF DATA COLLECTION
Structured knowledge questionnaire .It consists of two parts as part I and
part II.
Part-I : Demographic variables like age sex educational qualification etc:
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Part II : It consist of two parts a and b


a) Knowledge items on oral hygiene.
b) Observational checklist for brushing technique.
PROCEDURE FOR DATA COLLECTION
The data will be collected with the prescribed time period in selected urban
primary school at Tumkur.
The objective of the study will be explained to the head of the school and
responsible persons of the school and prior permission will be obtained before
starting the data collection.

7.2.6. DATA ANALYSIS METHOD


The data analysis is through descriptive and inferential statistics.
1. Descriptive statistics : Frequency ,Mean percentage and standard deviation of
described demographic variables.
2. Inferential statistics : Paired t test to compare pre and post test knowledge
scores and chi square test will be used to find out the association between
selected variables.
7.2.7 TIME AND DURATION
Time and duration of the study will be according to the research committee.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR


INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER
HUMANS OR ANIMALS? IF SO PLEASE DESCRIBE BRIFLY.
Yes, the study will be conducted on assessment of knowledge on oral
hygiene among primary school children.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR


INSTITUTION IN CASE OF 7.3 ?
The main study will be conducted after the approval of research committee
permission will be obtained from the concerned head of the insitutuion. The
purpose and study subject and an informed consent wll be obtained from them.
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Assurance will be given to the study subjects on the confidentially of the data
collected from them.

8. LIST

OF

REFERENCES

(VANCOUVER

STYLE

FOLLOWED)
1. MC Donald ER, Avery RD, Dentistry for the Child and Adolescence. 5 th edition.
St.Louis: The CV Mos by Company 2000. P-143-145.
2. Oral health for healthy life. World Health Magazine 1994.P.47.
3. Park K : Text Book of preventive and social medicine. 17th edition, Jabalpur; M/S
Banarsidas Bhanot ; 2003 P-379.
4. Curson MEJ. Robert Kodnes pediatric operative dentistry. St louis: Lippin cott
company: 1996.P.245-49.
5. Damle SG.A Text of pediatric dentistry 2nd edition. New Delhi Arya (medical)
publishing house : 2002. P-302-306.
6. Kay E, Locker DA. Systematic Review of Effectiveness of health Promotion aimed
at improving oral health . community Dental health , 1998;15;132-144.
7. prasad K.N Dental caries and periodontal diseases among school children between
8-12 years. Indian journal of pediatrics. 1997.P.31-37
8. Erica R oliveria, Marendran, S.Williamson, D,(2000) oral health knowledge,
Attitutes and preventive practices of third grade school children American
Association of pactiatric Dentistry (3) 395-399
9. Love your Teeth. Nursing Journal of India. May 2000. p.11-13.
10. Indian Express 1998 August 6.
11. Bal C.S Incidence of dental caries in school going children of Amritsar city. Journal
of conservative dentistry. 2001.p.22-24.
12. Macnab Aj, Rozmus J, collaborative school based oral health programme. Rural
Remote Health.2008 Apr-jun, 8(2), 882 Equb 2008 Apr 23.
14

13. Shidara EK, Mcglothlin JD, A oral health status of school children in a primary
school in Rural Cambodia. International Journal of Dental Hygiene. 2007
Aug,5(3),165-73.
14. Cerulli Mariani .G, Favaretti .F, oral hygiene habits and attitudes in a school
population in L Aquila (Italy). Europ Journal of pactiatric Dentistry. 2006 Sep,
7(3),135-41.
15. Grimoud AM, Verchere AC, a dental health educational programme, Archieves
pediatric 2005 Jan,12(1), 28-33.

16. Farsi JM, Farghaly MM, Farsi N. oral health knowledge attitude and behaviour
amoung Saudi school students in Jeddah city. Journal of Dentristry, 2004
Jan,32(1),47-53.
17. Simon C, Tesfaye F, Berhane Y. Assessment of the oral healthstatus of school
children in Addis Ababa. Ethiop Medicine Journal, 2003 Jul,41(3),245-56.
18. Hartono SW, Lambri SE, Van palenstein. Effectiveness of primary school based
oral health education in west Java, Indonesia, International Dental Journal, 2002
June, 52(3),137-43.
19. Al-Banyan RA, Echeverri EA. Oral health Survey of 5-12 year old children of
National Guard Employed in Riyad, Saudi Arabia. Journal of pediatric Dentistry.
2000.p.45-46.

15

9.

Signature of the candidate

10.

Remarks of the guide

11.

Name and designation of (in block letters)


11.1. Guide

11.2. Signature

11.3. Co-guide (if any)

11.4. Signature

11.5. Head of the Department

11.6. Signature

16

12.

12.1. Remarks of the chairman and principal

12.2. Signature

17