Effectiveness of Structured Teaching Module (STM) on Knowledge Regarding Home Care of Intellectual Disability Children among Primary Caregivers in a Special Schools at Tirunelveli District

Jeba T^* and Cheranmahadevi AR

^*Correspondence: Jeba T, Department of Nursing, Bharath Institute of Higher Education and Research, Selaiyur, Chennai, India, Email:

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Introduction

Welcoming the newborn baby is the great excitement and expectations of joy and happiness for the family. This expectation may become shattered with the birth of an intellectually disabled child. Having an intellectual disabled child born in a family and grow into adulthood is one of the most stressful experiences a family can endure. Intellectual disability may be one of the most difficult conditions for primary care givers to accept. Worldwide, approximately 156 million people, or 3% of the world’s population are intellectually disabled. Census of India (2011) revealed that, 6% or 1.2 million are intellectually disabled. It is estimated that 1, 00,847 persons in Tamilnadu State, and 5195 persons in Tirunelveli District have intellectual disability children.

Intellectual disability children will most likely not be able to grow up to realize their caregiver’s dreams and expectations. The primary caregivers of intellectual disability children require lifelong adjustment. Hence the primary caregivers need guidance through teaching module which is an important aspect of management. The primary caregivers should understand the actual condition of the intellectual disability child and should avoid attitudes like rejection or over protection. They should not feel guilty, depressed or responsible for the condition. Home is the vital place of care for intellectual disability child. The child may be dependent on the primary caregivers help throughout his or her life. Care giving is a natural aspect of primary caregivers and need to help the child twenty-four hours a day with basic tasks such as feeding, dressing, hygiene etc. While primary caregivers describe the positive benefits that the child with intellectual disability brings to their lives, the care of these children can have a significant impact on the family, the home and on the physical, emotional and mental health of the primary caregivers [1-8].

Methodology

True experimental research design with the study population comprised of experimental group (60) and control group (60). Simple random sampling technique was used to draw the samples from selected special schools at Tirunelveli District. The tools used for the study were, part I - Demographic variables. Part II - Structured knowledge closed ended interview schedule regarding home care of intellectual disability children. This study was approved by the research development committee members from Himalayan University, Itha nagar, Arunachel Pradesh. Formal permission was obtained from the Annai Jothi Seva Trust, Adayakarungulam, and Anbu illam, Cheranmahadevi, Tirunelveli District. The knowledge of primary caregivers was assessed using pretest knowledge questionnaire. After the pre-test was done, structured teaching module was given to the primary caregivers on an experimental group consists of 60 primary caregivers of intellectual disability children and discussed. After one-month duration of gap the post test was carried out consequently for three times to the primary caregivers with the same questionnaire and structured teaching module.

Findings and interpretations

Descriptive statistics (mean and SD) and inferential statistics (ANOVA and Bonferonni) were computed for analyzing the results by using SPSS software version 16.

Description of demographic data

In the experimental group, highest percentage of the caregivers were in the age group of 31 and above (70%), Hindus (65%), had higher secondary schooling (40%), homemaker (96.7%), had income 5001-10000 (81.7%), parents had consanguineous marriage (83.3%), primary caregivers as mothers (98.3%), male child (98.3%), 11-15 years old children (50%), first child (93.3%), below one year disability was recognized (96.7%), moderate level of intellectual disability (76.7%), causes of disability is genetic (95%), child had autism (68.3%), no previous knowledge regarding homecare of intellectual disability (88.3%).

In the control group, the highest percentage of the caregivers were in the age group of 31 and above (83.3%), Hindus (53.3%), had primary schooling (50%), homemaker (100%), had income 5001-10000 (83.3%), parents had consanguineous marriage (80%), primary caregivers as mothers (95%), male child (91.7%), 6-10 years old children (73.3%), first child (98.3%), below one year disability was recognized (91.7%), moderate level of intellectual disability (66.7%), causes of disability is genetic (91.7%), child had autism (61.6%), no previous knowledge regarding homecare of intellectual disability (93.3%) (Table 1).

Table 1: Frequency and percentage distribution of primary care givers according to their demographic data.

Table 2 depicts that poor knowledge was found in both experimental group (60%) and control group (61.6%) before the implementation of STM. In the experimental group knowledge scores had consequently improved after the implementation of STM. That is 80% in post-test one and 90% in post-test two and 100% in post-test three.

Table 2: Comparison of pre and post-tests knowledge scores before and after implementation of STM (N=60+60=120).

It was observed that in control group post-test one, two, and three (8.3%) had good knowledge.

findings it can be interpreted that STM improved the level of knowledge in the experimental group significantly higher than the control group.

ANOVA is a method used to compare the means of repeated measurement. As ‘F’ test is used to test the null hypotheses that means of all the groups are equal. The data presented in the table 3 depicts that there was significant increase in knowledge scores in the experimental group (F=602.73, P<0.001) than the control group was found (F=1.94, P<0.053) (Table 3).

Table 3: ANOVA for repeated measure of knowledge scores of experimental and control groups to assess the effectiveness of STM on home care of intellectual disability children among primary caregivers (N=60+60=120).

The Bonferroni test presented in table 4 shows that there was significant difference in knowledge scores from pretest to post-tests both in the experimental and control groups (p<0.001). Mean difference was 15.9 to 19.26 in the experimental group and in the control group mean difference was 0.8 to 1.56. Experimental group showed significant improvement in knowledge scores whereas, Bonferroni test showed mean difference was significantly higher in the experimental group than the control group which was minimal. This indicates significant improvement in knowledge among the experimental group (Table 4).

Table 4: Comparison of knowledge scores within and between experimental and control groups through Bonferroni comparison post hoc test to assess the effectiveness of STM on homecare of intellectual disability children among primary caregivers (N=60+60=120).

These findings is supported by a study done by Tara to evaluate the effectiveness of planned teaching programme on home based care for the parents of mentally retarded children in a special school at Mangalore in 2004. The study findings revealed that the mean post-test knowledge was significantly higher than the mean pre-test knowledge score (t=52.6, p<0.001) showed effectiveness of planned teaching programme in improving the knowledge of parents in home based care of mentally retarded children. The finding is also supported by study done by Chakravorthy in which 30 mothers were given a planned teaching programme and found that it was effective in increasing the knowledge of mothers. Similarly Traneha concluded that the psycho educational programme based on Roy’s adaptation model was effective in improving knowledge of mothers.

Conclusion

The findings of the present study revealed that, on comparison, the post-tests knowledge scores were significantly higher than the pre-test knowledge score. This indicates that the structured teaching module (STM) on homecare of intellectual disability children was effective in increasing the knowledge of primary caregivers. The study identified that, almost all the primary caregivers were devoid of knowledge before implementation of structured teaching module regarding homecare of intellectual disability children. Hence structured teaching module on homecare of intellectual disability children for primary caregivers will be helpful in increasing the knowledge.

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