VI

CHAPTER-VI

Summary, findings, conclusion, implication,

limitation and recommendations.

This chapter deals with the summary of the study its findings
and conclusion. The implementation of the structured teaching
programme is to strengthen the knowledge, to create the positive
attitude and for desirable behaviour modification of pre-university
students on AIDS and its prevention. Limitations are stated.
Explanations based on the objectives and findings are presented
followed by recommendations.

6.1 Summary of the Study.

The primary aim of the study was to “Assess the effectiveness

of structured teaching programme on knowledge, attitude and
behaviour with regard to AIDS and its prevention among the Pre-
University students”.

The objectives of the study were:

 To assess the level of knowledge, attitude and behaviour of

Pre-University students on AIDS and its prevention.

 To find the effectiveness of structured teaching programme

[STP] on knowledge, attitude and behaviour regarding AIDS
and its prevention for Pre-University students.

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  To study the correlation between level of knowledge, attitude
and behaviour on AIDS and its prevention.

 To study the association between pre-test level of

knowledge, attitude and behaviour of Pre-University
students with selected socio-demographic variables.

The study attempted to examine the following research

Hypotheses.

H1. There will be significant difference in the level of

knowledge on AIDS and its prevention between experimental
group and control group.

H2. There will be significant difference in the level of attitude

on AIDS and its prevention between experimental group and
control group.

H3. There will be significant difference in the level of

behaviour on AIDS and its prevention between experimental
group and control group.

H4. There will be significant correlation between knowledge,

attitude and behaviour on AIDS and its prevention in
experimental group and control group.

H5. There will be significant association between pre-test

level of knowledge, attitude and behaviour with selected socio-
demographic variables in experimental group and control group.

The conceptual framework adopted for the study is based on

modified integrated General Systems Theory developed by
Bertanlanfly (1968), and Roberta straessele Abruzzese (RSA)

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evaluation model. It consists of input, through put and output,
and provides a comprehensive systematic ongoing framework.

Review of literature was organized as follows:

 Historical aspects of HIV/AIDS.

 Magnitude of HIV/AIDS at global level
 Magnitude of HIV/AIDS in India.
 Preventive and control measures of HIV/AIDS.
 Youth and HIV/AIDS.
 Knowledge, attitude and behaviour studies related to HIV/
AIDS.
 Knowledge, attitude and behaviour studies on students
related to HIV/AIDS.
 Heath professionals and prevention of HIV/AIDS.
 Nurses and prevention of HIV/AIDS.
 Studies related to structured teaching programme.

The research approach selected for the study was Evaluative

Approach. The research design included pretest and post-test
with both the experimental group and control group. Independent
variable in the study was structured teaching programme and
dependent variables were knowledge, attitude and behaviour
scores.

The tools developed and used for data collection were self-
administered knowledge questionnaire on AIDS and its
prevention, the attitude scale related to social and emotional

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aspects of having HIV/AIDS and the behavioural checklist on
individual aspects.

The content validity of the tool was established by sixteen

experts. The tool was found to be valid, reliable and feasible. The
reliability of the tool was established by “Splithalf method” and by
using “Spearman browns prophecy formula”. The co-efficient of
correlation of knowledge questionnaire, attitude scale and
behavioural checklist was found to be statistically significant.

The teaching plan consisted of various aspects on AIDS and

its prevention. The teaching plan was organized in sequence and
in continuity.

The teaching plan was prepared in a view to enhance the

knowledge, change of attitude and behaviour in a positive
direction of pre-university students on AIDS and its prevention by
utilizing lecture cum group discussion method with the use of
audio-visual aids like charts, transparencies and black board. The
content of teaching include introduction to HIV/AIDS, causative
organism, signs and symptoms, routes of transmission,
misconceptions, diagnosis, social and emotional aspects of having
HIV/AIDS, management and prevention of AIDS risk prone
behaviour and non-risk prone behaviour. The medium of teaching
plan was in English.

Pilot study was conducted during the month of October-

2006 at Sapthagiri Pre-university College. The purpose of
conducting the pilot study was;

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  To evaluate the effectiveness of structured teaching
programme.
 To find out the feasibility of conducting the final study.
 To determine the method of statistical analysis.

Pre-testing of the tool was done to check the clarity of the

items, their feasibility and practicability. It was administered to
ten pre-university students. The sample chosen were similar in
characteristics to those of the population under study.

The main study was conducted in selected eight Siddaganga

pre-university colleges, Tumkur District. Simple random sampling
by using simple random table was adopted to select the students
studying in II year Pre-University course to form experimental
group-300 and control group-300.

The study was conducted between January-2007 to May

2007 at selected eight Siddaganga Pre-University colleges. The
teaching plan was tested for its effectiveness by pre-tests and post-
test. On day One, the pretest was administered, followed by
administration of structured teaching programme in four sessions
and on 8th day and on 30th day post test and post-post test (post
post-test for 20% of the sample) was administered to experimental
group in batches of 10 with 30 students in each batch. For
control group on day One, pre test and on eighth day the post test
was administered without any intervention.

The data gathered were analysed and interpreted according to

the objectives of the study. The descriptive and inferential
statistics were used for the data analysis.

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 6.2 Findings of the study
Major findings of the study are summarized as follows:

Majority of the respondents from both the groups are females,

in the age group of 17 years and belong to science group.

Majority of the respondents from both the groups are first

child in the family, having only one sibling and belong to nuclear
family.

Majority of the respondents from control group belonged to

family size of 3-4 members in comparison with experimental
group which belong to family size of 5-6 members.

Majority of the respondents from both the groups were

residing at rural area and belong to the family income of Rs.
6000/- and above per month.

Majority of the respondent’s parents of both the groups are

studied up to high school. Mothers are housewives and fathers
are involved in agricultural activities.

Majority of the respondents from both the groups are reading

story books during their leisure time and had no history of
previous illness.

Majority of the respondents from experimental group receive

pocket money as compared to control group and have no personal
habits like drinking, smoking/pawn chewing.

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 It was found that pre-test 14.42 and post-test 16.27
knowledge mean scores with negligible difference of 1.85
knowledge mean score in control group due to lack of
intervention.

Further it is also observed that pre-test 16.32 and post-test

28.55 knowledge mean scores with considerable difference of
12.23 knowledge mean score in experimental group as a result of
intervention.

It is also found that, there is minimal difference in pre-test

and post-test in dimension wise mean knowledge scores in the
control group since there is no intervention.

It is found that there is considerable difference in pre-test

and post-test in dimension wise mean knowledge scores in
experimental group as a result of intervention.

It is interesting to note that the enhancement in the

knowledge mean score found to be 12.23 between pre-test and
post-test of experimental group.

The ‘t’ value was computed and found to be statistically

significant i.e. (t=37.16** at p<0.01) indicating the effectiveness of
structured teaching programme.

The computed ‘t’ value reveals that the enhancement of the

dimension wise knowledge mean score and found to be
statistically significant due to the effectiveness of structured
teaching programme in experimental group (p<0.01).

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 Further, significant change in level of knowledge is noticed in
post test by almost all respondents i.e. 99.3 % had Adequate
knowledge showing the effectiveness of structured teaching
programme.

It is interesting to note that there is decline in the

knowledge mean score of 1.57 between post test and post-post
test knowledge scores and found to be statistically
significant(t=11.06** P<0.01). The computed ‘t’ value reveals that
the dimension wise knowledge mean score is found to be
statistically significant at 1% level.

The findings of the study depicts that pre-test 78.4 and post-
test 80.1 Attitude mean scores with negligible difference of 1.7 in
control group due to lack of intervention.

Further, it is also observed that pre-test 79.8 and post-test

105.0 attitude mean scores with considerable difference of 25.2 in
experimental group as a result of intervention.
The ‘t’ value was computed and found to be statistically
significant i.e. (t=51. 35** at p<0.01) indicating the effectiveness of
structured teaching programme.

The results shows that 95.7% of respondents fall in

favourable level of attitude in post test when compared to 51.3%
of respondents in pre-test. Hence, structured teaching programme
was also found to bring forth positive\favourable attitude changes
in the respondents.

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 The data reveals that the experimental group post-test
attitude mean score is 104.5 and experimental group post post-
test attitude mean score is 107.8 with the minimal enhancement
of attitude mean score of 3.3. The‘t’ value was computed and
found to be statistically significant (t=8.81** at p<0.01).

The data reveals that pre-test 7.56 and post-test 8.67

behaviour mean scores with negligible difference i.e. 1.11 in
control group due to lack of intervention. Further it is also
observed that the pre-test 8.34 and post-test 15.82 behaviour
mean score with considerable difference of 7.48 in experimental
group as a result of intervention.

The ‘t’ value was computed and found to be statistically

significant i.e. (t=40.49**at p<0.01) indicating the effectiveness of
structured teaching programme.

The data shows maximum number (52%) of respondent’s

behaviour score is <50 % and hence fall under risk prone
behaviour category, followed by 41 % falling under Moderately
risk prone behaviour (51-75 %) and very few have i.e. 7.0 % falling
under Non risk prone behaviour (>75 %) in the pre-test. Whereas
the majority of respondents 97.3% in the post test of the
experimental group fall in the category of non risk prone
behaviour (>75 %) and only 2.7 % fall under Moderately risk
prone behaviour (51-75 %) and no one in the Risk prone
behaviour (<50 %) category. Hence the structured teaching
progamme was found to bring forth positive behaviour in the
respondents.

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 The data reveals that the experimental group post-test
behaviour mean score is 8.28 and experimental group post post-
test behaviour mean score is 8.65 with the minimal enhancement
of behaviour mean score of 0.37. The ‘t’ value was computed and
found to be statistically significant (t=5.73** at p<0.01).

It is evident from the findings that the relationship between

Knowledge, Attitude and Behaviour aspects of AIDS and its
prevention of experimental group was found to be positive.
Further it is found to be significant between knowledge and
attitude, knowledge and behaviour and non significant in
behaviour and attitude in both pre-test and post-test.

Further the data also reveals that relationship between

knowledge, attitude and behaviour aspects on AIDS and its
prevention in post test and post post-test is found to be positive.
and it is significant between knowledge and attitude, knowledge
and behaviour where as non-significant between behaviour and
attitude in both post test and post post-test of experimental
group.

Respondents from science group have higher knowledge level

when compared with respondents from Arts group and found to
be statistically significant at 1% level.

Female respondents have higher knowledge when compared

with male respondents and found to be significant at 1% level.

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 The association between age group and knowledge level of
respondents shows that increase in the age, better the knowledge
and found to be significant at 1% level.

The findings shows that increase in the ordinal position

better the knowledge however the difference exhibits statistical
non-significance (P>0.05).

The findings shows that more the number of siblings lesser

the knowledge level and found to be significant (P<0.05).

In relation to type of family, the knowledge level is higher in

nuclear family compared to joint family and found to be
statistically significant (P<0.05).

The data shows that the increase of family size there is

decrease in knowledge level and statistically significant (P<0.01).

The findings reveals that the respondents from rural area

exibits relatively inadequate knowledge level compared to the
respondents from urban area and found to be significant (P<0.05).

The respondents from Science group shows relatively

favourable attitude compared to the respondents of Arts and
found to be statistically significant (P<0.01).

The female respondents have favourable attitude when

compared to male respondents however the results exhibits
statistical significance (P<0.05).

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 The data reveals that respondents belonging to the age
group of around 17 years have more favourable attitude and
exhibits statistical non-significance (P>0.05).

The findings shows that higher the ordinal position better the
attitude level and found statistical non-significance (P<0.05).

The findings reveals that increase in the number of siblings

lesser the attitude level and found to be significant (P<0.01).

The respondents of nuclear family have relatively favourable

attitude level as compared to the respondents of joint family and
found statistical non-significance (P>0.05).

Lager the family size of respondents unfavourable the

attitude level but found to be non-significant (P>0.05).

The respondents from urban area exhibit more favourable

attitude level compared to respondents from rural area and found
statistical non-significance (P>0.05).

The respondents from Science group shows better behaviour

level as compared to respondents of Arts group and found to be
significant (P<0.01).

The female respondents have better behaviour level when

compared to male respondents and found to be significant
(P>0.05).

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 The findings reveals that lesser the age group shows better
the behaviour level of respondents and found to be significant
(P<0.01).

Higher the ordinal position of respondents better the

behaviour level and found statistical non-significance (P>0.05).

The finding reveals that respondents having only one sibling

showed better behaviour level and found to be statistically
significant (P<0.01).

The respondents of nuclear family have better behaviour

level as compared to the respondents of joint family and found to
be significant (P<0.01).

The increase in the family size of respondents there exists

decrease in the behaviour level and found to be significant
(P<0.01).

The respondents from rural area exhibits better behaviour

level compared to respondents from urban area and found to be
non-significance (P>0.05).
6.3 Conclusion

This study assessed the knowledge, attitude and behaviour of

pre-university students and evaluated the effectiveness of
structured teaching progemme on AIDS and its prevention.

The study revealed that even though the pre-university

students had less knowledge, moderate level of attitude and

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behaviour on AIDS and its prevention they had keen interest to
learn about all aspects of HIV/AIDS.

The pre-test conducted to identify the knowledge, attitude and

behaviour of pre-university students on AIDS and its prevention
showed that, the pre-university students had minimum
knowledge, attitude and behaviour on AIDS and its prevention.

The analysis of the findings indicated that, structured teaching

programme is an effective means to increase the knowledge and to
change the attitude and behaviour of pre-university students on
AIDS and its prevention in a positive direction, as the computed ‘t’
test was significant at 1% level of significance.

The post post-test was conducted on the experimental group-

shows that there is a very minimal difference as compared to post-
test indicating that the structured teaching programme is effective
and there is a need for reinforcement.

The results of the study will enable the nurse/health

professionals to utilize the structured teaching programme to the
pre-university students in the community/college settings as an
additional intervention in prevention of AIDS by improving the
knowledge, change of attitude and behaviour in a positive
direction.

STP is one of the effective teaching methods in imparting the

knowledge, attitude and behaviour of Pre-university students on
AIDS and its prevention.

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 The STP may be implemented by involving the teachers in
“training of trainees programme” and to equip themselves to
conduct the STP to the pre-university students in the college
setting as an Additional intervention on AIDS and its prevention
to improve the knowledge, change of attitude and behaviour in a
positive direction.

Hence it is concluded that the Structured Teaching Programme

is an effective teaching strategy where by the pre-university
students could be helped to enhance the knowledge and change of
attitude beahviour in a positive direction.

6.4 Nursing Implications

As the saying goes “Prevention is better then cure” is very

true in the prevention and control of HIV/AIDS. Prevention is the
only weapon in the war against AIDS since there is no cure to it.
The health professionals play a key role specially, the nurses in
educating the public in general and youths in particular on AIDS
and its prevention.

The findings of this study have implications in various areas

of nursing namely: nursing practice, nursing education nursing
administration and nursing research.

Nursing Practice.

Nurses play an important role in the prevention of

HIV/AIDS among adolescents in various settings. The findings of
the study shows that the structured teaching programme on AIDS
and its prevention is effective in gaining knowledge and change of

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attitude and behaviour in a positive direction among pre-
university students. Further, the study also suggests that there is
a need for reinforcement of structured teaching programme on
AIDS and its prevention.

If the nurses have a thorough knowledge and awareness

regarding AIDS and its prevention, they can incorporate this in to
their practice while providing high quality care in cost effective
way and make these health services accessible to under served
population. more than that the nurses are able to become efficient
health team members and get automomy, authority and
independency in practice.

In the area of nursing practice, nurses should help the

teachers, parents, students and the general public to express,
recognize and develop positive attitude towards people living with
HIV/AIDS.
Nurses;

 should involve teachers, parents, students and General

public in regular teaching programme.

 should organize, conduct and evaluate the structured

teaching programme on AIDS and its prevention on
AIDS and its prevention.

Nursing Education

Education is a key component to update and improve the

knowledge of an individual, the family and the community at
large. Education in nursing has a vital role to play. Since today’s

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nursing students are tomorrow’s staff nurses, educators,
administrators and supervisors, nursing educators should
prepare them not only to care for the patients with HIV/AIDS but
also to handle the complex and changing needs of the society. The
study stresses the need for the assessment of knowledge, attitude
and behaviour of pre-university students and to evaluate the
structured teaching programme on AIDS and its prevention. In
view to prevent the HIV/AIDS among adolescents, the nurse
educators should motivate the student nurses to assess the
learning needs of adolescents on AIDS and its prevention and to
organize the programmes in this direction.

The post graduate courses should prepare clinical nurse

specialist who can take care of the issues related to HIV/AIDS
prevention. They can serve as resource persons for other nurses
and nursing students working with people having HIV/AIDS.
Plan, organize and conduct programmes for the nurses,
community health workers and others concerned with health
team, so that they can update their knowledge and abilities to
deal with the impact of HIV/AIDS on quality of life of people
affected by HIV/AIDS and to adopt effective coping strategies.

Nursing administration

Nursing administrators are the key persons to plan,

organize and execute the curriculum to nursing students. The
study revealed that structured teaching programme on AIDS and
its prevention was an effective teaching strategy to enhance the
knowledge and to change the attitude and behaviour in the
positive direction among pre-universisty students. Therefore the

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nurse administrators should plan, organize and implement such
curriculum that incorporates various teaching methods and other
educational activities. They should take initiative and motivate
the teachers, parents, students and general public in health
education programmes and other health related activities.

Nursing administrators have a responsibility to provide an

opportunities for the staff development activities. This would
enable the nurses to update their knowledge, acquire skills;
develop favourable attitude and demonstrate quality care in
management and prevention of HIV/AIDS.

The nurse administrator should look after the special units

and provide adequate support with money, material and man
power for conducting teaching programmes and developing
teaching material or self instructional module regarding
management and prevention of HIV/AIDS.

Nurse administrators should influence policy makers to

provide better facilities for people with HIV/AIDS in terms of
materials, prospective job placement, position, promotion and
financial security. They should also arrange camps, career day
programme and campus selection etc., for people living with
HIV/AIDS.

Nursing Research

This topic has great relevance to the present day

complexities of the health care delivery. The review of literature
revealed that there is dearth of literature related to the various
findings of the study and it was found that very few Indian

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studies being done to assess the knowledge, attitude, behaviour
and the effectiveness of structured teaching programme among
pre-university students on AIDS and its prevention. Hence the
findings of his study can motivate nurse researchers to conduct
more studies related to structured teaching programme on AIDS
and its prevention.

6.5 Limitations

A sample of 300 pre- university students for control group

and 300 for experimental group only were considered.

Extraneous variables like age, sex and mass media exposure

was beyond the investigator control.

In this study behaviour of pre-university students were

assessed only through behaviour check list.

6.6 Recommendations
The following further studies are directed on the basis of the
present study.

 A similar study can be replicated on a sample with

different demographic characteristics and with different
techniques.

 A comparative study can be done on rural and urban

community, literate and illiterate population.

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  A survey can be done to determine the amount of interest
and attitude among nurses, teachers, public in
participating in the “AIDS and its prevention programme”.

 An extensive teaching strategy protocol may be developed

including all aspects of AIDS and its prevention.

 A similar study can be conducted in a different setting.

 A similar study can be carried out on longer samples for

broader generalization.

 A longitudinal study can be conducted to determine the

long term effectiveness of structured teaching programme.

 A similar study can be conducted with different research

designs.

This chapter has dealt with the summary of the study, major
findings, conclusions, implications in nursing fields, limitations
and recommendations.