Organ Donation Leagal Aspects

― A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED
TEACHING PROGRAMME ON KNOWLEDGE AND ATTITUDE
REGARDING LEGAL ASPECTS OF ORGAN DONATION AMONG STAFF
NURSES IN CRITICAL CARE AND EMERGENCY UNITS IN SELECTED
HOSPITALS AT MYSORE .‖
By
MR. ANAND .T.O
Dissertation submitted to
Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka
In partial fulfilment of requirements for the degree of
Master of Science in nursing
(Medical and Surgical Nursing)
Under the guidance of
Prof. Mrs. N.T ARUNADEVI
DEPARTMENT OF MEDICAL AND SURGICAL NURSING
BGS COLLEGE OF NURSING
KUVEMPUNAGAR, MYSORE.
2012
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation /thesis entitled ― A study to assess the
effectiveness of structured teaching programme on knowledge and attitude
regarding legal aspects of organ donation among staff nurses in critical care and
emergency units in selected hospitals at Mysore.‖ is a bonafide and genuine
research work carried out by Mr.Anand.T.O under the guidance of Prof. Mrs. N.T
Arunadevi, Principal and HOD of Medical Surgical Nursing .
Date : Signature of the candidate
Place: Mysore (Mr. Anand .T.O)
ii
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled ― A study to assess the
emergency units in selected hospitals at Mysore.‖ is a bonafide research work
done by Mr Anand.T.O in partial fulfilment of the requirement for the degree of
Master of science in Nursing ( Medical Surgical Nursing )
Date Prof. N T Arunadevi
Place: Mysore Principal
HOD, Medical Surgical Nursing
BGS College of Nursing
Kuvempunagar, Mysore
iii
ENDORSEMENT BY THE HOD ,PRINCIPAL/
HEAD OF THE INSTITUTION
This is to certify that the dissertation entitled ―A study to assess the
emergency units in selected hospitals at Mysore.‖ is a bonafide research work done
by Mr Anand.T.O under the guidance of Prof .NT Arunadevi, HOD, Medical
Surgical Nursing.
Seal and signature of HOD Seal and signature of Principal
Prof. N T Arunadevi Prof. N T Arunadevi
Principal Principal
HOD, Medical Surgical Nursing HOD, Medical Surgical Nursing
BGS College of Nursing BGS College of Nursing
Kuvempunagar, Mysore Kuvempunagar, Mysore
Date:
Place: Mysore
iv
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of Health Science,
Karnataka shall have the rights to preserve, use and disseminate this dissertation/
thesis in print or electronic format for academic / research purpose.
Date:
Place: Mysore Anand. T. O
© Rajiv Gandhi University of Health Science, Karnataka
v
ACKNOWLEDGEMENT
―Gratitude is not only the memory but also the respect of heart rendered to the person
for his /her guidance and goodness‖
I praise and thank My Almighty for His blessing and abundant grace that enriched me
throughout this study.
I express my thanks to Sri Sri Sri Balagangadranatha Maha Swamiji, President of

BGS Groups, Sri Someshwaranatha Swamiji, Secretary of BGS Institution, Mysore
for the facilities that provided me in the institution ,which enabled me to do this
study.
I owe my heartfelt gratitude and sincere thanks to Prof. Mrs. Arunadevi , Research
Guide ,HOD- Department of Medical Surgical Nursing, for her efficient guidance,
timely correction ,encouragement ,inspiring motivation and valuable suggestions
which helped me to lay strong foundation for this study.
I express my sincere gratitude to Mrs. Nithya priya, Asst professor, Department of

Medical and Surgical Nursing for her guidance and support throughout the study.
My special thanks to Mr S.Balachandar HOD Psychiatry, Mr Arul V HOD

Paediatrics Nursing Mrs Komala.H.K, HOD Community Health Nursing and Mrs
Myelu.M, HOD Obstetrics and Gynaecology for their sincere support.
I express my thanks to the Nursing Superintends, and Administrators Apollo BGS

hospitals, Basappa Memorial Hospital and Holdsworth Memorial hospital for
granting administrative permission to conduct the study.
I express my thanks to Mr. Samuel Sudharshan.D, MA (English) for his valuable

suggestions and English correction.
I gratefully acknowledge all the experts for validating the tool and giving necessary
corrections.
I gratefully acknowledge the librarians of BGS college of Nursing, Rajiv Gandhi

University of Health Sciences .Bangalore and DR.M G R University, Tamil Nadu for
vi
their cooperation and assistance in collection of study material and relevant
literature.
I am indebted to Dr LANCY DI’ZOUSA, Professor, Maharaja College,

Manasagangothri, and Mysore for his suggestion and correction for the statistical
works.
I would like to thank the office staff, BGS College of Nursing for their wholehearted
cooperation and encouragement during this study.
It gives me an immense pleasure and proudness to offer profound gratitude to my

beloved parents and siblings Sri Tori.A and Smt Ophir Thankam.G, Ahlad.T.O, all
family members for their affection, constant support and timely assistance in all
situations to conduct this study smoothly.
A special word of thanks to all my classmates and friends, especially to, Arun,
Samson, Jismy, Ujjaula, who helped me in need.
Last but not least, I extend my thanks to all those who helped me directly or indirectly
to complete this study successfully but not mentioned in this acknowledgement.
Date:
Place: Mysore Anand. T.O
vii
List of abbreviations
et.al : And Others
CCU : Critical care unit/ Coronary care unit
HCP : Health care personnel
ICU : Intensive care units
LRD : Living related donor
STP : Structured Teaching Programme
viii
Research Abstract
Background
Organ shortage is a Global problem. Every day an average of 18 people are
dying while waiting for organ donation in India. There are currently 110.00 people
waiting for organ donation. More than 200,000 Indians require organ transplantation
annually. Lack of proper knowledge regarding the organ transplantation and organ
donation process among public and health care personnel seems as one of the major
reason for organ shortage in India. Increasing the knowledge of the health care
personnel is one of the important measures to overcome this situation.
Objectives
The objectives of the study were to assess the effectiveness of Structured
Teaching Programme on knowledge and attitude regarding legal aspects of organ
donation among staff nurses in critical care and emergency units, and to find out the
correlation between knowledge and attitude regarding legal aspects of organ donation
among staff nurses of critical care and emergency units and also to find out the
association between knowledge and attitude with selected background variables.
Method
The research approach adopted for the study was evaluative approach and the
research design adopted was pre-experimental, one group pre-test – post-test design.
Sixty staff nurses of critical care and emergency units had been selected from BGS
Apollo Hospital and Holdsworth Memorial Hospital, Mysore by using convenience
sampling. Structured questionnaire containing 25 items on knowledge and of 15
ix
statements 5 point Likert scale on assessing attitude were used. The reliability of the
tool was tested by using spearman brown split half method and it was found to be r =
0.84 for knowledge questionnaires and r = 0.916 for attitude scale. Structured
Teaching Programme on legal aspects of organ donation was administered to the
samples after pre-assessment and analyzed post test after 2 weeks Data were analyzed
by SPSS version -15, „t‟ test was used for finding the effectiveness , Karl Pearson
correlation coefficient was used for finding the co-relation between knowledge and
attitude and Chi square test was used for finding out the association between
knowledge and attitude.
Results
The findings of the study revealed that the Structured Teaching Programme
on knowledge and attitude regarding legal aspects of organ donation was effective and
the post test knowledge and attitude score on legal aspects of organ donation was
higher than the pretest score. There found a significant association in the knowledge
and attitude with previous source of information.
Interpretation and conclusion
The present study revealed that the majority of the staff nurses have average
knowledge and good attitude towards legal aspects of organ donation and the overall
findings of the study revealed that there was a high significant increase in the
knowledge and attitude of the staff nurses in critical care and emergency units after
the administration of Structured Teaching Programme on Legal aspects of organ
donation. Therefore it was concluded that the Structured Teaching Programme was
x
highly effective in improving the knowledge and attitude of the staff nurses regarding
legal aspects of organ donation.
The nurse play an important role in organ donation and health promotion
education programme with effective teaching strategies, which motivate the staff
nurses to follow healthy practices in day to day life.
KEY WORDS: Knowledge; Attitude; Structured Teaching Programme;
Legal aspects of organ donation.
xi
TABLE OF CONTENTS
Chapter
No. Title Page No.
1. Introduction 1-7
2. Objectives 8-14
3. Review of Literature 15 – 28
4. Methodology 29 – 44
5. Results 45 – 66
6. Discussion 67 – 75
7. Conclusion 76 – 77
8. Summary 78 -84
9. Bibliography 85-89
10. Annexure 90-148
xii
LIST OF TABLES
Table No. Title Page No.
1 Representation of Research design 30
2 Interpretation of Knowledge questionnaires 37
3. Interpretation of scoring Attitude Scale statements 38
4 Interpretation of Attitude Scores 38
5. Frequency and Percentage distribution of staff nurses 48

according to back ground variables.
6. Pre test and post test overall level of knowledge regarding 55

7. Data on paired „t‟ test values for knowledge scores 57
8 Pre- test and posttest overall level of attitude regarding legal 58
aspects of organ donation.
9 Data on paired „t‟ test values for attitude scores 60
10 Data on co relation between knowledge and attitude. 61
11 Data on association between pre-test knowledge and 63

demographic variables.
12 Data on association between pre-test attitude and 66

demographic variables.
xiii
LIST OF FIGURES
Figure No Title Page No
1. Conceptual Framework of the study based on Daniel 13

Stuffle Beam Program Evaluation Model (CIPP Model)
2. Schematic representation of study design 32
3. Bar diagram shows percentage distribution of staff 50

nurses.
4. Cylinder diagram shows percentage distribution of staff 51

nurses.
5. Cone diagram shows percentage distribution of staff 52

nurses.
6. Pie diagram shows percentage distribution of staff 53

nurses.
7 Pyramid diagram shows percentage distribution of staff 54

nurses.
8 Multiple Bar diagram indicates the distribution of staff 55

nurses by pretest and post test overall level of knowledge
9 Multiple Bar diagram indicates the distribution of staff 56

nurses by pretest and post test overall level of attitude.
xiv
LIST OF ANNEXURES
Annexure
Title Page No.
No.
1. Letter seeking permission to conduct research study 90-91
Letter seeking consent of subjects for participation in

2. 92
Research study
Letter requesting the opinion of expert on content

3. validity Research tool and Structured teaching 93-94
programme
4 Acceptance form for validation of the tool 95
5 Criteria rating scale for validating the tool 96-98

99
6 Content Validity Certificate
7 List of Experts 100
8 Research Tool & Blue Print for knowledge questionnaires 101-108
Certificate for English Validation 109

9
10 Lesson plan on Legal aspects of organ donation 110-136
11 Statistical Formulas used in the study 137
12 AV Aids 138-140
13 Master Data sheet 141-148
xv
CHAPTER - 1
INTRODUCTION
―We should give meaning to life, not wait for life to give us meaning‖ – Stacy
Life is a dynamic process. It starts from birth and ends with the death of the
individuals. In between comes different stages of life with different diseases and its
problems. Medical Science is expanding its horizons by leaps and bounds and edging
towards newer successes by unveiling God‟s miraculous mystery. In case any of the
organs of the human body fails of function, medical science can extend its functioning
for some time, but when an end stage failure is reached, just like a machine whose
1
parts are changed, the failed organ needs to be replaced.
The concept of organ transplantation as a therapy for replacement of non-
functioning organs began in India, originated in mythological medicine in the twelth
century B.C. Lord Ganesha, revered as a God of wisdom and vanquisher of obstacles,
is an example of the very first xenograft performed by Lord Shiva using an elephant's
head. This mythical timeline lasted up to second century B.C, when Sushruta, our
ancient Indian surgeon introduced the surgical timeline of transplantation by using
skin auto grafts for rhinoplasty. Several Greek, Italian and other surgeons from many
other parts of the world followed suit. Their efforts provided a tremendous insight into
the likely surgical problems to be encountered in organ transplantation. 2
Organ Transplantation being a boon to medical industry as it has helped in
saving the lives of those who would have died otherwise. The fact is medical
advances in the field of transplant immunology, surgical management; organ donation

1
and organ preservation have made the transplantation of vital organs possible. Thus
providing a viable approach to the management of diseases that cause irreversible
organ failure.3
Organ donation means that a person pledge during his life time that after
death organ from his /her body can be used for transplantation to help terminally ill
patients and giving them a New Lease of Life .Two ways of organ donation are there
.living related donors and cadaver organ donation. 3
There is a great need for human organs for transplantation. In fact, the need
far exceeds the supply of transplantable organs. This disparity and unethical practice
of commercial dealings of organ transplantation has led to the formulation of various
legislations, attempting to regulate the scare resources (transplantable human organs)
and to help establish an equitable system to allocate the organs where they can do the
most good. Legal Aspects is concerned with the legal issues of organ donation process
as per the Transplantation of Human Organ Act 1994. 4
The organ transplantation act is an Act to provide for the regulation of
removal, storage and transplantation of human organs for therapeutic purposes and
for the prevention of commercial dealings in human organs and for matters connected
therewith or incidental .The law formed when there has been a persistent demand
for such a legislation in parliament and from various national bodies ,medical and
social experts ,particularly when reports about commercial dealings in human
organs especially kidneys have increased .there has been persistent demand for
prohibiting this unethical practise .another thing is absent of any legal sanction ,the
removal of organs from persons suffering brain death has not been possible. 5
2
Despite India being the leading Asian country in organ transplantation organ
shortage remains major problem in the country. The shortage in organ transplantation
rate is seems to be due to lack of the knowledge of the technical growth in the field of
medicine and legal proceedings among public. Many publications have demonstrated
that the willingness of health care professionals to participate in the organ donation
process can improve donation rate. Since Nurse are usually the first people among
health care staff to recognize a patient as a potential donor ,they have an important
role in the procurement of organ and tissue from cadaveric donors, especially critical
care and emergency nurses must have a specific knowledge regarding the legal
aspects of organ donation process.
NEED FOR STUDY
Organ shortage is a Global problem but Asia lags behind much of rest of the
world. The organ donation rate from dead bodies in India is estimated to be a
minuscule 0.05per million [although India has among the world‟s highest number of
death from road accidents] Hong Kong donation rates is less than 5 per million, while
it is less 25 per million in the US.6
As of January 2011 over 110,000 people are waiting for a transplant.
In 2010, there were 12,081 organ donors, resulting in 23,953 organ transplants. There
are currently over 110, 00 people waiting for an organ donation. The largest group
waiting is from 18-49 years of age .An average of 18 people die each day while on the
waiting list for an organ donation. Organs and tissues from a single non-living donor
can be used to benefit more than 50 people. 7
3
As per a study by Asian development bank on road in Asia pacific(1998)
Asia pacific has 44% of road death ,although only 16% of the vehicle in the world
.In India about 300,000 accidents and 59,927 facilitates occurred on roads and
20.3%death per 10,000 motor vehicles .It is estimated that by 2020 RTA will occur
occupy 6th position in the list in cause of death .There are a huge number of potential
donor who if motivated properly can fulfils the gap between the requirement of
organ for transplant and number of donor available . 8
New Delhi , Delhi in august 26 .2010, Asia‟s largest and most trusted
health care provider .Apollo has performed 534 solid organ transplant across the
nation in less than 8 months in the year 2010. It includes 134 liver transplants, 398
renal transplants, 51 bone marrow and 2 heart transplants. The statistics portray an
alarming need for organ transplant in India according to estimated statistics every 3
minutes a patient is added to the list of patient needing a transplant. More than
200,000 Indians require organ transplantation annually an estimated 20,000 liver
transplant is required per year in India.9
Recent estimated and communicated by WHO in 98 countries show that
the most sought after organ is kidney. 66000 were transplanted in 2005 representing a
mere 10% of estimated need. In the same year 21000 livers and 6000 heart was
transplanted. Both kidney and liver transplants are on the rise but the demand is also
increasing and remains unmatched. 10
Transplantation is increasingly seen as the best solution to the end stage
organ failure, end stage kidney disease. For instances can only be repaired with a
4
kidney transplant without it patient will die or require dialysis for year which is an
expensive procedure and often out of reach of poorer patients .Transplantation is the
only option for some liver conditions such as liver cirrhosis of liver cancer and
number of severe heart conditions . 11
A huge gap exists between patient who needs organ transplants and
potential donors. It is not that there aren‟t enough organs to transplant nearly every
person dies naturally or in an accident is a potential donor. Even so innumerate
patients cannot find a donor. 12
Readers Digest did an Asia wide study of organ donation and found that
India lags far behind other countries. In this regard the Managing Trustee of the Multi
Organ Harvesting Aid Net work Foundation an NGO that promotes organ donation
states that “Healthy people are unaware of suffering of the people with organ failure”
A senior consultant in urology and kidney transplantation and an expert in the area of
organ donation estimates that anywhere between 2 and 3 million Indians may have
died in the last five years because they could not get an organ transplant. (Although
India has among the world‟s highest number of death from road accidents. 13
A study conducted in Delhi metropolitan among Doctors, Nurses Students and
public regarding knowledge attitude and practice of organ donation found out that the
majority of the staff nurses had only partial knowledge and negative attitude towards
the organ donation and half of the respondents were not aware of the correct practice
of organ donation. The study recommended that there should be regular training of
medical professionals to improve their attitude and motivation to talk to family of
5
brain dead patients for organ donation so that it can indirectly raise the organ
transplantation rates of the country. 14
The New York State Nurses Association believes the registered nurse may
assume an integral and valuable role in overcoming the shortage of suitable, viable
organs and tissue for transplantation. In the roles of clinician, health educator and
counselor, the registered professional nurse should: Provide the public with accurate
and objective information concerning donation. Participate in activities to identify
possible donors, work closely with the healthcare facility, the organ procurement
organization (OPO) and/or tissue bank, and members of the health team to seek
consideration for such donation, Provide clinical expertise, emotional support and
objective and accurate information to families who are considering organ and tissue
donation and advocate for patients and families in the informed choice process,
recognizing and respecting their cultural and religious beliefs. 15
The studies and surveys highlights that the nurses lacked confidence in
approaching relatives for organ donation consent because of the lack of knowledge
regarding legal aspects of organ donation. It was also apparent that a significant
number of nurses could not identify the potential donor for organ donation. All this
reviews and statistical information made the investigator to do a research in finding
out the effectiveness of an educational programme covering organ donation and Legal
Aspects of organ donation issues in enhancing nurse‟s knowledge and attitude
towards the organ donation process and ultimately increase the number of potential
donors.
6
Summary
This chapter has dealt with the back ground of study and need for the study to
conduct research on finding the effect of a teaching programme on the topic legal
7
CHAPTER 2
OBJECTIVES
This chapter presents the statement of the problem, objectives of the study,
operational definitions, assumptions, hypotheses and conceptual framework.
Statement of Problem
― A study to assess the effectiveness of structured teaching programme on
knowledge and attitude regarding legal aspects of organ donation among staff
nurses in critical care and emergency units in selected hospitals at Mysore‖.
Objectives
1. To assess the effectiveness of Structured Teaching Programme on knowledge
and attitude regarding legal aspects of organ donation among staff nurses.
2. To co-relate knowledge and attitude on legal aspects of organ donation among
staff nurses.
3. To find the association between pre-test knowledge regarding legal aspects of
organ donation and selected back ground variables.
4. To find the association between pre test attitude regarding legal aspects of
8
Hypotheses
Hypotheses will be tested at 0.05 level of statistical significance,
H1: There will be a significant difference in pre test and post test mean score
regarding the knowledge on legal aspects of organ donation among staff nurses.
H2 There will be a significant difference in pre test and post test mean attitude score
regarding the legal aspects of organ donation among staff nurses.
H3: There will be significant co-relation between knowledge and attitude regarding
legal aspects of organ donation among staff nurses.
H4: There will be a significant association between pre-test score of knowledge
regarding legal aspects of organ donation with the selected back ground variables.
H5: There will be a significant association between pre-test score of attitude regarding
legal aspects of organ donation with the selected back ground variables.
ASSUMPTIONS
The researcher assumes that
 Inadequate knowledge regarding organ donation process and legal aspects may
reduce the confidence of staff nurses in approaching relatives for donation
consent and clarifying the doubts of relatives.
 Knowledge regarding legal aspects of organ donation among staff nurses in
critical care and emergency nurses may increase the organ donation statistics.
9
 Education may enhance the knowledge of staff nurses.
OPERATIONAL DEFINITIONS
Effectiveness: Effectiveness refers to determine the extent to which Structured
Teaching Programme on legal aspects of organ donation has brought about result
intended and which is measured in terms of significant knowledge gain and attitude
change in post test.
Structured Teaching Programme: In this study Structured Teaching Programme
refers to a systematically organised need based material regarding legal aspects of
organ donation prepared in the form of a lesson plan.
Knowledge: It refers to awareness and amount of information or understanding about
legal aspects of organ donation among staff nurses as measured in terms of knowledge
score.
Attitude: It refers to ideas opinion or perspective towards legal aspects of organ
donation among staff nurse of critical care and emergency units.
Legal aspects of Organ donation: It refers to all the legal facts coming in organ
donation process according to the law of Indian Government.
Staff nurses: Staff nurses refer to male and female registered nurses working in
critical care and emergency units of selected hospitals of Mysore.
Selected back ground variables: Refers to those factors that are thought to
influence the knowledge and attitudes of staff nurses in critical care unit‟s and
emergency nurse‟ s regarding legal aspects of organ donation eg: Age, sex, religion,
10
professional educational qualification, present area of experience, years of experience,
their designation and previous source of information.
Conceptual frame work
A conceptual framework is a group of concepts and set of proportions that
spell out the relationship between them. Conceptual frame work deals with
abstractions (concepts) that are assembled by virtue of their relevance to a common
theme .Conceptual frame work plays several interrelated roles in progress of science
.It serves as a spring board for the generation of research hypothesis and can provide
an important context for scientific research. The conceptual framework facilitates
communication and provides systematic approach to nursing research education,
administration and practise. The conceptual frame work selected for this study was
based on Program Evaluation Model, (CIPP MODEL) developed by Daniel Stuffle
Beam (1983).
According to Stufflebeam the Context, Input, and Process, Product Model
provides a systematic way of looking at many different aspects of the educational
development and evaluation process.
The model includes,
 Context evaluation
 Input evaluation
 Process evaluation
 Product evaluation
11
Context evaluation
It highlights the environment or critical external factors for the development
and evaluation of mission, vision, values, goals and setting of objectives, and
priorities in which the proposed program exists describes the plan for decisions and
collection of data, In this study it refers to age , sex, professional qualification,
professional area of experience and previous source of information on legal aspects
of organ donation and pre assessment of knowledge and attitude among staff nurses
in critical care and emergency units regarding legal aspects of organ donation.
Input evaluation
It serve as a basis for structuring decision .It specifies the designing of a
program to meet the objectives and determine the resources needed to deliver the
programme and also to determine whether staff and available resources are
adequate to implement the programme. In this study it refers to the preparation of a
Lesson plan and other study materials for the processing of Structured Teaching
Programme regarding Legal aspects of organ donation and to determine whether staff
and available resources are adequate to implement the program.
Process evaluation
It refers the implementation of the programme as per the plans and objectives.
In this study it refers to the administration of Structured Teaching Programme on
Legal aspects of organ donation and various Teaching Learning activities post test
evaluation of knowledge and attitude regarding legal aspects of organ donation.
12
CONTEXT INPUT PROCESS PRODUCT
Structured
Teaching
Demographic variables Administration of
Post test knowledge and attitude regarding legal aspects of organ donation Programme
 Age Structured Teaching Effective
 Sex Preparation of Programme on legal
 Gender lesson plan on Legal aspects of organ
 Professional Aspects of Organ donation Effectiveness
qualification donation of
 Present area of Structured
experience Teaching
 No of years of Programme
Teaching Learning Structured
experience on legal Teaching
 Nurses designation Activities aspects of
NURSE EDUCATOR Programme
 Previous source of organ Not
information donation Effective
Pre test assessment of
Lecturing
Knowledge regarding legal
Discussion
aspects of organ donation. 60 Staff nurses
Clarification
of the critical Evaluation of post test
Pre test assessment of care and Knowledge and Attitude
Attitude
MODEL) regarding legal emergency units regarding legal aspects of
organ donation
Fig-1: conceptual frame work based on Daniel Stuffle Beams Program Evaluation Model (CIPP Model)
13
Product evaluation
It refers to energy, information (or) matter that is transferred to environment
and enables recycling of decision as it relates to goals and objectives of input
information and process information. In this study it refers to the effectiveness of the
Structured Teaching Programme regarding legal aspects of organ donation and
determination of effectiveness or non effectiveness of the study.
Summary
This chapter has dealt with the objectives, the operational definitions,
assumptions and hypotheses which are predictive statements of the relationship
between the independent and dependent variables, of the study. The conceptual
framework of the present study was based on Program Evaluation Model, (CIPP
MODEL) developed by Daniel Stuffle Beam (1983).
14
Chapter 3
REVIEW OF LITREATURE
Review of literature is regarded as a preparatory stage for research process. It
refers to an extensive, exhaustive and systematic examination of publications relevant
to the topic under study. Literature reviews are from the sources that are important in
providing the in-depth knowledge needed to make changes in practice. The task of
reviewing research literature involves identification, selection, critical analysis and
written description of existing information on the topic of interest.
In the present study the literature review has been organised in categories
under the following headings:
1) Studies regarding organ donation
2) Studies regarding knowledge and attitude of staff nurses regarding organ
donation.
1) Studies regarding organ donation
An experimental study was conducted in turkey on 100 students from one
urban high school to identify student-related factors that might affect organ donation,
and then use this information to develop some essential strategies and policies. Pre
structured questionnaire was used for data collection on initial assessment and post
training assessment. Descriptive and inferential statistical analysis was done. The
study analyzed the changes from before to after the educational program in order to
assess the program's effectiveness, Concerning brain-death, 66.1% of the respondents
identified the correct definition of this concept before training, and 92% did so after
15
training (p<0.001). The correct definition of transplantation was chosen by 68.3% of
the respondents before training, and by 90.6% after training (p<0.001). It is clear that
this educational program greatly enhanced the students' level of knowledge 16
A study was conducted by the Italian university among third-year
undergraduate nursing students enrolled in seven nursing schools to assess their
attitude towards organ donation. The sample size was 183. Attitude scale was used for
data collection with demographic variables. Descriptive analysis was done The study
found out that majority of students show positive attitude and no significant
correlation were found to exist between organ donation attitude and sex ,age, clinical
practice in hospitals with a transplant unit, nursing care to patients waiting for a
transplant or dialysis patients and also finds 16 % had a signed donor card. This study
highlighted that students' awareness of organ donation was not adequate and that
attitude levels were lower than in other countries and recommended adequate training.
17
A retrospective study was conducted at the University hospital of Essen
regarding suffering from a primary or secondary cerebral Age, date of death, duration
of stay in the intensive care unit, main and additional diagnoses and diagnostic test for
assessing brain death as well as discussions with relatives were recorded
anonymously. The study was conducted on the back ground that a chronic shortage of
organs for transplantation. For that data collected from all patients who died between
January 1, 2006 and December and the result was found that 424 deaths with primary
or secondary cerebral injury (group A) were identified during the study period. 267
deaths (62.9 %) (group B) were further evaluated for organ donation after excluding
absolute medical contraindications, In 68 cases (16.0 %), diagnostic test of brain
16
death had been completed (group C). Despite a high refusal rate, 36(8.5 %) organ
procurements were realized (group D) resulting in 140 transplanted organs (3.9 per
organ donor). It was concluded that the first crucial step to improve the rate of organ
donation is to identify any potential donor. 18
A study was conducted at United States to assess Knowledge regarding organ
donation in view of identifying and overcoming barriers to organ donation. The
sample size was 455 under graduate students. The tool was 21 true/false questions
regarding factual knowledge about organ donation. Descriptive statistical analysis
was done. The study found out that knowledge of organ donation facts was found to
be related to whether subjects carried or requested an organ donor card, their attitude
towards organ donation and their willingness to donate their own organs or the organs
of a deceased loved one. These findings suggest strategies for raising public support
for organ donation.19
A survey was conducted to assess the attitude of health professionals toward
cadaveric tissue donation. The subjects were given 23 questions. The samples selected
are those who are having donation experience from 2 university hospitals. The sample
size was 514 and 399 female / 115males. The study results of the sample, 31% of
health professionals had never been in contact with a transplant recipient and 99.4%
had knowledge about cadaveric organ donation compare with 89.7% about tissue
donation. %. The study was concluded that insufficient knowledge about cadaveric
tissue was demonstrated among health professionals more exposed to the donation
process. These results highlighted the importance of health professional's education to
facilitate public information about organ and tissue donation. 20
17
A descriptive study was conducted by the University of Colorado among 141
samples representing critical care and perioperative nurses, transplant surgeons,
medical examiners, organ procurement personnel, neurosurgeons, and neurologists to
assess their attitudes toward organ donation after cardiac death .Attitude scale was
used for data collection. Descriptive statistical analysis was done. The study found out
that the study participants had moderate attitude and identified a lack of standards for
patient prognostication and cardiopulmonary death and a failure to prevent a conflict
between patient and donor interests as obstacles to acceptance of organ donation after
cardiac death. The study recommended future research is warranted to examine the
effect of standardized procedures on reducing moral distress. The hypothesis
generated by this qualitative study is that use of neutral third parties to broad the
subject of organ donation may improve acceptance of organ donation after cardiac
21
death.
A descriptive study was conducted under the Tamil Nadu Dr MGR Medical
University to assess the awareness and attitudes of health care professionals towards
organ donation. 691 medical students participated in the study. The samples are 595
under graduates, 65 interns and 31 post graduate students. Attitude scale was used for
data collection. Descriptive statistical analysis was done. The study found out that
none of the participants had complete knowledge as to who should authorize brain
death as stated in the "Transplantation of Human Organs Bill". The study reveals that
there is a poor understanding of the concept of brain death and organ donation even
among medical students. It was also observed that they were interested in knowing
more about the subject of organ donation. 22
18
2) Studies regarding knowledge and attitude of staff nurses regarding organ
donation
A descriptive study to assess the Knowledge, Attitude and Practice regarding
organ donation was conducted in major government and private hospitals of Delhi
among 183 sample Doctors, Nurses, Students and Public. Tool used was pre
structured questionnaire, Descriptive statistics analysis was done and result was only
25% had adequate knowledge and 53.04% of respondents had only partial knowledge
and remaining in adequate knowledge , 3.30% of respondents had a positive Attitude
towards organ donation whereas 46.70% has negative attitude 50 having neutral. It
was found that 78.02% were aware of the Correct Practice, whereas 21.98% were not
aware of the Correct Practice of organ donation. The study recommended that there
should be regular training of medical professionals to improve their attitude and
motivation to talk to family of brain dead patients for organ donation. 23
A descriptive study was conducted at Tehran university of Medical sciences,
among 418 staff nurses regarding the concept of brain death and attitude towards
cadaveric donor renal transplantation ,Pre structured questionnaire and attitude scale
were used. Descriptive analyses were used for statistical analysis. The study finds
75.6% expressed favourable attitudes and (25.1%) stated positive attitudes toward
living kidney donation. It was observed that the relatively high rate of
misinterpretation of the brain-death concept among respondents negatively affected
nurse‟s attitudes toward cadaveric renal transplant. It was concluded that the “concept
of brain death” and the “preferences of transplant over other treatment modalities” are
the two items that need further attention in educational programs for nurses. 24
19
A cross-sectional survey was conducted at three major Turkish cities to assess
health care professional‟s knowledge, attitudes, and behaviour related to cadaveric
organ donation and transplantation. 1184 HCP s were randomly selected. Descriptive
analyses were used for statistical analysis. The study founds doctors are having
significantly better knowledge regarding cadaveric organ donation and transplantation
than nurses. Physicians have significantly better knowledge about legal aspects of
organ donation and transplantation Overall, the survey revealed that lack of
knowledge has a negative impact on people's attitudes toward organ donation even
among health care professionals and concluded that Improvements must be made to
develop a nationwide Donor Hospital Education Program that will provide training
concerning transplantation and organ donation. 25
A survey was conducted at Canterbury Christ Church University College,
North Holmes Road, Canterbury U.K, on an adult intensive care unit nurses to assess
their existing knowledge and deficits in organ and tissue donation. The sample size
was 31. Descriptive analysis was done. The survey found out that the samples lacked
confidence in approaching relatives for donation consent, deficits in brain stem death
testing and donor criteria. It was also apparent that a significant number of nurses
could not identify which tissues can be donated and the contraindications for tissue
donation. The study concluded with a suggestion that educational programmes
covering donation issues should enhance nurse‟s knowledge and confidence in the
26
organ donation process and ultimately increase the number of potential donors.
20
A survey was conducted by Donor Action Foundation's Hospital in assessing
hospital staffs attitude towards organ donation and collect data from critical care
units from their own university hospital (study group) and 2 other Belgian university
hospitals (control group). In total, 92 physicians, 433 nurses, and 26 other staff
members participated. Pre Structured attitude scale was used for data collection and
descriptive analysis was done for statistical analysis. The study results that the 2
groups did not differ significantly with regard to donation-related attitudes. The study
concluded that support rates for donation are high overall, and previous training is
associated with improved attitudes and decreased educational needs. Educational
efforts tailor-made for nurses should increase nurses' confidence levels when
27
confronted with potential donors and their next of kin.
A cross sectional analysis survey was conducted on 520 Korean intensive care
unit nurses as a part of Implementation of the new Organ Transplant Act. The study
focuses on assessing the importance of identifying Korean intensive care unit nurses'
knowledge regarding brain death and organ donation. The tool used was a pre
structured questionnaires consist of 18 items. The data was collected and descriptive
statistical analysis was done. The study find out that Most of the participants had a
sound knowledge of diagnostic testing for brain death, but demonstrated a lack of
knowledge regarding co-morbid factors of brain dead patients. The study
recommend the need for further research in related areas of nursing practice and
concluded as effective education for intensive care unit nurses is necessary to increase
the organ donor pool in Korea. 28
A descriptive study was conducted by south-western medical center to assess
knowledge and attitude of nurses regarding organ donation. The samples are 46
21
critical care nurses. Self-reported knowledge and attitudes were measured using the
Organ Donor Attitude Questionnaire and compared with respondents' demographic
characteristics. Descriptive analysis was done. Knowledge scores were found to be
average (74% correct). Attitude scores reflected a strongly positive attitude toward
organ donation. Increased knowledge of organ donation was not found to be related to
a positive attitude. The study results indicate that exposure to patients affected by
organ procurement has increased the knowledge and improve the attitudes of the
nurses who provided care and recommended that increased knowledge and positive
attitude are important when providing support to families and caring for potential
donors.29
An experimental study was conducted at Kaohsiung, Taiwan among Intensive
care unit (ICU) nurses to assess the knowledge and their attitudes concerning their
presumed role in organ donation, and their motivation toward a more prominent role.
The data collected with 3 questionnaires, it was administered before and after training
on promotion of organ donation. The sample size was 12. The study results a marked
gain in knowledge (P<.001), change in attitude (P<.001), and increase in motivation
(P<.001) were seen after training. The study concluded that active participation of
ICU nurses in the identification of potential deceased donor organs and their direct
participation in organ procurement though continuous re-education and video-
illustrated lectures may promote an increased number of deceased donor organs.30
A descriptive prospective study was conducted at Eskisehir, Turkey among
400 staff nurses of 3 general and 2 midwifery hospitals, Data were collected using 25
structured and semi-structured questionnaires, a conference on the issue was offered
on completion of the questionnaire if desired. Descriptive analysis was done .The
22
respond rate was 65.6%. Of the nurses, 87.7% had positive thoughts about the organ
donation, but only 10.8% knew the donation law, 68.8% would consider donating
organs of their own, 58.7% would consider signing a consent card, and only 36.7%
would donate organs from their family members. The study concluded that Nurses
were found in need of education about all aspects of brain death and organ donation
including how and when to approach families to inform and ask for organs, and how
to support families throughout the process. 31
A descriptive study was conducted on Spanish and Latin American nursing
personnel to analyze the attitude of nursing personnel about organ donation and
transplantation in hospitals in Spain and Latin America, and factors that affect this
attitude. The sample was random and stratified by type of service among nursing
personnel (n = 1194) .Data regards attitude was evaluated using a psychosocial
questionnaire. Descriptive analysis was done. The results was find that of nursing
personnel surveyed, 77% (n = 922) were in favour of organ donation. . No differences
were found according to whether they were directly involved in transplantation-
related services. The study was concluded that attitude toward deceased organ
donation among nurses varies between countries.32
A study was conducted by a Spanish hospital to assess for assessing Attitude
of nursing staff toward organ donation with a solid-organ transplant program. Data
collection was done by a random sample of 305 nurses in different hospital services
was taken and stratified by type of service. A validated psychosocial questionnaire
was used to evaluate attitudes toward donation. The survey was completed
anonymously and was self-administered. Student t test, chi2 test, and logistic
regression analysis were used for statistical analysis. The study results are most
23
respondents (63%) favoured organ donation. The study concluded that Attitudes
toward organ donation among nurses are similar to attitudes of the general public in
Spain. Given the influence of nurses on the general public, promotional campaigns
directed at nurses are a priority.33
A study was conducted at 3 universities in the southeast of Spain among 721
Nursing Diploma students to assess their understanding on brain death. Validated
psychosocial questionnaire was used. The questionnaires were self-administered and
anonymous. The Student t-test and the chi square test were applied. The questionnaire
completion rate was 98% (n = 721). A total of 70% (n = 508) of students correctly
understood the concept of brain death; 27% (n = 193) had doubts; 3% (n = 20)
believed a person with brain death could recover to lead a normal life. Knowledge
was greater among final year than first year students (81% vs 59%; P = .000).
However, knowledge was not related to their university. The study concluded that
Thirty percent of nursing students did not know or had doubts about the concept of
brain death. It is therefore important to take this group into account in information
campaigns to improve training of these future professionals. 34
A cross sectional survey was conducted by Hamad General Hospital, to assess
the knowledge level, attitudes, and personal views of physicians and nurses toward
organ donation and transplant. The sample size was 521 .Data were collected using
Face-to-face interviews were based on a Pre structured questionnaire. The study
results that of the 521 participants, there were 268 physicians (51.4%) and 253 nurse
(48.6%). The knowledge level of nurses was significantly lower for most of the
questions related to organ donation, compared with physicians. The study was
concluded that although the physicians and nurses had an acceptable level of
24
knowledge about organ donation, the mean knowledge score for physicians showed
significantly better understanding of the criteria for organ donation and procurement
and recommended further improvement in increasing the knowledge of nurses.35
A experimental study was conducted on Loma Linda University Children's
Hospital, 196 Paediatrics critical care nurses perceptions, knowledge, and attitudes
regarding organ donation after cardiac death and the effect of an educational
intervention. Pre structured questionnaires and attitude scale was used for data
collection. The intervention was D C D education (Donation after Cardiac Death).
Descriptive and Inferential statistics was done. The study found out that the DCD
process improved from 20% to 79%. Confidence with knowledge, comfort answering
family questions, and comfort in calling the organ procurement agency about DCD
donors improved by 41%, 25%, and 18%, respectively and recommended that a
simple educational intervention can improve PCRNs' knowledge of the DCD process
and their confidence and comfort with this process. As DCD policies are
implemented, specific interventions should target these key members of the intensive
care unit team.36
A descriptive Study was conducted by Tel Aviv University, Israel to assess the
Attitude of health care professionals to brain death and factors influence on the organ
donation process. The sample size was 2366 (629 doctors and 1737 nurses)
Questionnaires were distributed to health care professionals involved in the organ
procurement process. Descriptive statistics was done. The study results were found
out that Overall, 78.9% of respondents had a positive attitude to brain death. This was
significantly associated with increasing age, higher professional status and was most
prevalent amongst intensive care unit staff (p < 0.001 for all variables). The study was
25
concluded that the understanding and acceptance of brain death as a valid
determination of death was associated with a positive effect on the level of comfort of
health care professionals in performing key donor-related tasks. Reinforcing a positive
attitude to brain death among health care professionals may facilitate the procurement
process.37
A descriptive study was conducted in view of the Polish nurses attitude toward
organ transplantation. The aim of the study was to analyze basic knowledge and
attitude toward organs transplantation among nurses working in Polish hospitals. The
original questionnaire was sent to 269 nurses and 246 answers were received.
Descriptive analysis was done. The study find out that the nurses present had positive
attitude toward organ donation and reception independently of the place of work
(dialysis/transplantation or other department). LRD (living related donor) kidney
donation is the most accepted transplantational procedure. 38
A study was conducted at Spain primary care nurses to assess their attitude
toward living kidney donation. Attitudes toward living donation were evaluated using
a questionnaire with various psychosocial variables.139 nurses was selected using
stratified random sampling method. The chi-squared test and Student's t test were
applied. The study results show that the attitudes toward living kidney donation were
favourable in 93%. Only one nurse was against the idea of donating a kidney from a
living person (1%), (6%) had doubts about this kind of donation in view of the
attitude of primary care nurses toward living kidney donation. the study concluded
that attitudes of primary care nursing personnel toward living kidney donation were
favourable, especially if it was related donation.39
26
A descriptive study was conducted on Denmark among health care
professionals in the ICUs to assess their attitude towards organ donation. The study
sample size was 689. The tool was structured questionnaires. Descriptive statistical
analysis was done. The study result finds that 11 % declares to be against organ
donation, 89% shows favourable attitude towards organ donation. Doctors were more
positive toward organ donation than the nursing staff. The survey demonstrates the
health professional has significant lack of experience in organ donation and a
considerable need for more education and training. The survey also discloses a
substantial need for information regarding the results of transplantation. 40
A survey was conducted at Toronto General Hospital among critical care
health professionals to assess understanding of the knowledge, attitudes, and
perceived barriers that healthcare professionals toward organ donation and
transplantation, and to identify factors that influenced participation in the donation
process. The sample size was 135. Pre-structured questionnaires and attitude scale
was used for data collection. Descriptive Statistics was done .The findings found out
that respondents were least knowledgeable about transplant statistics and religious
beliefs regarding donation, although overall, attitudes reflected positive support for
organ donation. Respondents exhibited reluctance in approaching a potential donor
family, and believed inadequate resources were allocated for organ donation. The
study concluded that Educational programs are needed to increase knowledge of
organ donation and transplantation for critical care personnel.41
A experimental study was conducted at Canada in view of the Curriculum
effect on nursing students' attitudes and knowledge towards organ donation and
transplantation. The study objective was to determine the impact of a nursing school's
27
curriculum on student nurses' attitudes towards organ donation and whether specific
educational directives could improve these attitudes. The samples were 1st to 4th year
nursing students at a Canadian University School of Nursing. Pre structured
questionnaire and attitude scale was used for data collection. Descriptive and
inferential statistics analysis was done. The study results found that No difference in
attitudes were found between first- and fourth-year nursing students. The introduction
of specific education strategies improved the attitudes and knowledge base of third
year students. The study recommended the importance of organ transplantation,
nursing curricula should incorporate effective strategies to teach students the role of
the nurse in organ donation. 42
This chapter includes the review of literature in to two sub sections, studies
related to organ donation and studies related to knowledge and attitude of staff nurses
regarding organ donation. The review of literature has provided the investigator with
an in depth understanding of the subject of organ donation, legal issues and broadened
the outlook necessary for forming the tool and conceptual frame work .literature
served as an integrative function and facilitated the accumulation of knowledge gain
and in depth view of the problem.
28
CHAPTER 4
RESEARCH METHODOLOGY
Research methodology is needed because it facilitates the smooth sailing of
the various research operations, thereby making research as efficient as possible
yielding maximal information with minimal expenditure of effort, time and money.
This chapter deals with the methodological approach adopted to evaluate
effectiveness of structured teaching programme on legal aspects of organ donation for
staff nurses working at critical care and emergency units of selected hospitals at
Mysore.
Methodology is the framework used to conduct the study. It includes the
research design, the setting, population, sample and sample size, sampling technique,
development and description of tool, validity and reliability, pilot study, data
gathering process and plan for data analysis.
Research approach
The research approach adopted for this study was evaluative approach. Pre-
experimental design was selected for the study. It helps to explain the effect of
independent variable on dependent variable. The study includes manipulation only
and no control and randomization. It involved implementing a structured teaching
programme and examines the effect of it on knowledge and attitude using selected
methods of measurement.
29
Research design
Research design is the researcher‟s overall plan for obtaining answers to the
research questions being studied and for handling some of the difficulties encountered
during the research process. The research design is the architectural back bone of the
study.43
The research design used in this study is preexperimental design. The design is
most suitable for study purpose to test the effectiveness of structured teaching
programme on legal aspects of organ donation among staff nurses of critical care and
emergency unit‟s emergency units. It is a one group pretest and post test design and is
a subtype of experimental design. The principles are manipulation, no control group
and non probability-convenient sampling used in this study.
Table 1: Representation of Research Design
Pre experimental one group pretest post test design
Group Pre test Intervention Post test
Staff nurses of emergency O1 X O2

and critical care units
30
KEYS
O1- Administration of structured knowledge questionnaire and attitude scale to staff
nurses of emergency and critical care units.
X- Administration of structured teaching programme on the same day.
O2 – Administration of structured knowledge questionnaire and attitude scale after 7
days of administration of structured teaching programme
31
Target Population: Staff Nurses of critical care and emergency nurses
Accessible population: Staff nurses of critical care units

and emergency units of selected hospitals at Mysore
Sampling
Sample and sample size: staff nurses of emergency method:
Back ground
and critical care units, 60 convenient
variables
Age
sampling
Gender
Religion
Pre test Tool & data
Qualification collection Procedure:
Present area of Structured knowledge
experience questionnaire and
Intervention: Structured Teaching
No of years of experience attitude scale
Programme on legal aspects of organ
Nurse’s designation regarding legal aspects
donation
of organ donation
Previous source of
information
Post test
Data analysis & Interpretation
Distribution of Paired t test is used to Karl Pearson Chi square test is used to
sample compare pretest and correlation associate selected socio
characteristics in post test knowledge coefficient is used demographic variables
frequency and and attitude level to find out the with level of pre- test
percentage regarding organ correlation between knowledge and pre- test
donation. knowledge and attitude regarding organ
attitude donation.
Study Findings Criterion Measures
Knowledge and
attitude scores
Dissertation / Thesis regarding legal aspects
of organ donation
Figure: 2- Schematic Representation of Research Design
32
Variables
Variables are the qualities, properties, or characteristics of persons, things or
situations that change or vary and are manipulated or measured in research. The
variables mainly included in this study are independent variable and dependent
variable.
Independent variable
An independent variable is the variable that stands alive and it does not
depend on any other. In this study the independent variable is Structured Teaching
Programme on Legal aspects of organ donation.
Dependent variable
The dependent variable is the variable, the researcher is interested in
understanding, explaining or predicting. The knowledge and attitude of staff nurse
regarding legal aspects of organ donation is the dependent variables in this study.
Demographic variables
The demographic variables in my study are age, gender, religion, and
qualification, present area of experience, no of years of experience, nurse‟s
designation and previous source of information.
33
Research setting
Setting refers to the area where the study is conducted. It is the physical
location and condition in which data collection takes place in a study. The selection of
an appropriate setting for conducting a study is crucial for its successful completion.
The study was conducted in Basappa Memorial Hospital, Mysore, Apollo
BGS Hospital, Mysore and Holds worth Memorial Hospital, Mysore. After obtaining
permission the study was conducted on staff nurses of critical care and emergency
units of Mysore.
Population
Population is a group whose members possess specific attributes that a
researcher is interested in studying. Target population is the aggregate of cases or
subjects to whom the researcher would like to make generalization for the present
study. Target population was the staff nurses of critical care and emergency
units.Accessible population is the aggregate of cases that is accessible to investigator
for conducting the study .The accessible population of the present study comprised of
staff nurses of critical care and emergency units in Basappa Memorial Hospital,
Mysore, Apollo BGS Hospital, Mysore and Holdsworth Memorial Hospital, Mysore.
Sample and sample size
Sample is a proportion or subset of population.The sample size is the number
of elements of the population to be sampled. The sample size of the study is

34
determined based on the type of study, availability of samples, sampling technique
used, nature of population and statistical test adopted. The sample for the present
study consisted of 60 samples of staff nurses from critical care and emergency units of
Apollo BGS Hospital, Mysore and Holdsworth Memorial Hospital, Mysore. Out of 60
staff nurses, 35 were selected from Apollo BGS Hospital, Mysore, and 25 were
selected from Holdsworth Memorial Hospital.
Sampling technique:
Sampling is the process of selecting a portion of the population to represent the
entire population so that the inference about the population can be made In this study
non probability, convenience sampling was used to select the samples.
SAMPLING CRITERIA
Inclusion criteria:
1) All registered staff nurses (both male and female) working in the critical care
and emergency units of selected hospitals at Mysore.
2) Staff nurses who were willing to participate in the study.
Exclusion criteria.
1) Nursing superintendents in the hospitals.
35
Data Collection Method and Tool
Selection of the tool
Tool is an instrument used by the researcher to collect the data. The instrument
selected in a research should be as far as possible be vehicle that would be best
obtaining data for drawing conclusions, which are pertinent to data. A structured
questionnaire and attitude scale was used to assess the level of knowledge and attitude
regarding legal aspects of organ donation among staff nurses of critical care and
emergency units which is prepared by the researcher.
Development of the tool
Based on the objectives of the study, demographic profile, structured
knowledge questionnaire & Attitude scale were prepared to assess the area,
knowledge and attitude. After extensive and systematic review of literature the
investigator developed this tool.
The tool was divided into three –section 1, 2 and 3
Section – 1 Demographic profile
This section consist of 8 items pertinent to the staff nurses of critical care and
emergency units ,age ,gender ,religion,qualification,present area of experience
,number of tears of experience, nurses designation, and previous source of
information.
36
Section – B Knowledge of legal aspects of organ donation
This section consisted of 25 items regarding the legal aspects of organ donation.
The items were developed as to cover the following groups.
 9 - General questions related to organ donation.
 14 - Related to legal aspects of organ donation.
 2- Related to nurses role in organ donation.
For each questionnaire, four options were given and only one correct answer
for each correct answer the score was 1, if answer was wrong, the score was given as
0, the highest score was 25. Based on the marks gained by the staff nurses the
knowledge of respondents was arbitrarily categorized in the following groups.
Table 2: Interpretation of knowledge scores
SL No Range of Marks Category

1 0-5 Below average
2 6-10 Average
3 11-15 Good
4 16-20 Very good
5 21-25 Excellent
37
Section 3 Attitude scale
This section consists of 15 statements to know the attitude of staff nurses
regarding legal aspects of organ donation. Out of this, 7 statements stating positive
attitude regarding legal aspects of organ donation and 8 stating negative attitude
regarding legal aspects of organ donation.
Attitude of staff nurses regarding legal aspects of organ donation was
measured in terms of attitude scores. Attitude was scored on a 5 point Likert scale
where the scores were given as follows –
Table 3: Interpretation of scoring Attitude Scale statements
Options Positive Negative

for statements statements statements
Strongely agree 4 0
Agree 3 1
Neutral 2 2
Disagree 1 3
Strongely Disagree 0 4
Table 4: Interpretation of Attitude Scores
SL No Range of Marks Category

1 0-15 Poor
2 16-30 Average
3 31-45 Good
4 46-60 Very good
38
Preparation of Blue print
A blue print on structured knowledge questionnaire on legal aspects of organ
donation was prepared, which consisted of eight areas. It depicted the distribution of
items according to content area based on three domains namely knowledge,
understanding, and application. There were 12 items of knowledge (48%) and 5 items
on understanding (20%) and (32%) on application covering all aspects of legal aspects
of organ donation. Then the prepared items were subjected to content validation,
pretesting and estimation of reliability.
Validation of tool
Content validity refers to degree to which an instrument measures what it is
supposed to measure when an instrument is valid, it truly reflects the concept, it is
supposed to measure.
The prepared instrument along with the statement of problem, objectives
scoring key, lesson plan for teaching, attitude scale were submitted for validation to
seven experts ,4 nursing personnel‟s 2 medicine personnel‟s and 1 law personnel to
establish the validity.
Based on the expert opinion some of the question is modified and some of
questions have been deleted and arrangement of the options was done in proper way
according to suggestions given by the expert .The tool and structured teaching
programme was edited by an English language expert and finalized with the guide.
39
Reliability of tool
Reliability of research instrument is defined as the extent to which the
instrument yields the same results on repeated measures.
The tool after validation was subjected to test it for reliability. The structured
knowledge questionnaire was administered to 6 staffs of emergency and critical care
units of Basappa Memorial Hospital. The reliability was established by using
spearman brown split-half method and it was found to be r = 0.84 for knowledge
questionnaires and r = 0.916 for attitude scale and, which indicated the tool was
reliable.
Description of Structured Teaching Programme
The teaching programme on “Legal aspects of organ donation” among staff
nurses of critical care and emergency units. The teaching programme was organized
in to various headings.
 Definition of organ donation
 Organs for donation.
 Types of donors.
 Inclusion criteria for organ donation.
 Contraindication for organ donation.
40
 Factors affecting organ donation.
 Legal aspects of organ donation.
 Requirements of successful organ donation.
 Organ donation registries in India.
 Role of Nurse in organ donation.
PILOT STUDY
“A pilot study is the whole study operation in miniature” it reveals the
investigator about the feasibility, weakness, practicability of carrying out the main
study. It helps to confirm the duration and to familiarize with administration and
scoring of tools.
The pilot study was conducted in the month of November 2011 by selecting
six staff nurses of Basappa Memorial Hospital, Mysore. After explaining the purposes
of the study, the knowledge and attitude of the staff nurses was assessed by using a
structured knowledge questionnaires and attitude scale with the socio demographic
variable .After pretest the STP was given to the staff nurses regarding legal aspects of
organ donation .After 7 days post test was conducted using the same tool to assess the
effectiveness of STP. The data collected during pretest and post test were coded
numerically and tabulated and a concise analysis was done using descriptive and
inferential statistics. The results show that the knowledge scores has a mean
difference of 8.33 and attitude score find a mean difference of 9.83,after
administration of structured teaching programme. It was found effective in increasing
41
the knowledge and attitude regarding legal aspects of organ donation in staff nurses of
critical care and emergency units.
After conducting the pilot study it was found that the study was feasible,
subjects are co-operative, the research approach was relevant and the time and cost for
the study was within the limit.
Data Collection Procedure
As the first step in the data collection procedure, the investigator met the head
of Apollo Hospitals and Holdsworth Memorial Hospitals in order to establish support
and cooperation to conduct study successfully. The formal permission was taken from
hospital authority for the data collection according to duties of staff nurses. After
obtaining the permission the investigators met the subjects and establish rapport with
them. 35 samples from Apollo hospitals and 25 samples from Holdsworth memorial
hospital were taken for the study. A written informed consent was taken separately
from each staffs. Appropriate orientation was given to staffs about the aims of the
study, nature of questionnaire, attitude scale and adequate care was taken for
protecting the subjects from potential risks including maintaining confidentiality,
secure and identity.
The subjects were asked to answer a structured questionnaire, attitude scale
with demographic data after the pretest, STP was given for the staff nurses. Post test
was conducted using the same tool, with an interval of 7 days to assess the
effectiveness of STP. The data was collected from 15:11:2011 to15:12:2011. Data
42
collection process was terminated after intimating the participants and thanking each
respondent for their participation and co-operation.
Plan for data Analysis
Descriptive statistics are useful for summarizing empirical information.
Inferential statistics which is based on laws of probability provide a means for
drawing conclusions about the population from which data is obtained for sample.
The collected data will be analyzed using descriptive and inferential statistics
using the following steps:
 Organizing the data in master sheet
 Frequency and percentage of data will be calculated to describe demographic

variables
 Mean mean deviation and standard deviations of knowledge and attitude

scores would be used to determine the effectiveness of the instructional
demonstration.
 Mean , standard deviations and “r” values to assess the correlation between
knowledge and attitude.
 The statistical significance of the effectiveness of the teaching programme

would be analyzed by using paired „t‟ test.
 Analyzed data would be presented in tables, graphs and figures.
43
Ethical Consideration
The research title and objectives were approved by the research committee. Formal
permission was obtained from the Managing Directors and Nursing superintendents of
Holdsworth Memorial Hospital Mysore and Apollo BGS Hospital Mysore. Confidentiality
was ensured. An informed consent was obtained from the individual staff nurses .The
individual had rights to refuse to participate in the study. No physical and psychological pain
was caused.
Summary
This chapter has dealt with the methodology adopted for the study. It includes
research approach, design, sample and sampling technique, research setting, the study
instrument, validity, reliability, pilot study, data gathering process and statistical analysis.
The study design was pre experimental design. In this study the dependent variables were
knowledge and attitude. The independent variables was the Structures Teaching Programme
The pre-test score was assessed before the administration of teaching programme and post
test was conducted after seven days . The data were analysed using statistical tests like paired
t test, chi-square and Karl Pearson correlation coefficient.
44
CHAPTER– V
RESULTS
Data Analysis and Interpretation
Analysis is the process of organizing and synthesizing data in such a way that
research questions can be answered and the hypotheses tested. Interpreting the findings is the
most challenging and structured step in the research finding which requires the investigator to
be creative.
This chapter deals with the analysis and interpretation of the data collected in order to
compare and determine the most effective nursing intervention in reducing complications
related to intravenous therapy. The main purpose of this chapter is to summarize, organize,
evaluate, interpret, and communicate numerical information.
Objectives
1) To assess the effectiveness of Structured Teaching Programme on knowledge and
attitude regarding legal aspects of organ donation among staff nurses.
2) To co-relate knowledge and attitude on legal aspects of organ donation among staff
nurses.
3) To find the association between pre-test knowledge regarding legal aspects of organ
donation and selected back ground variables.
4) To find the association between pre-test attitude regarding legal aspects of organ
45
Hypotheses
At 0.05 level of significance
H1: There will be a significant difference in pre test and post test mean score regarding the
knowledge on legal aspects of organ donation among staff nurses.
H3: There will be significant co-relation between knowledge and attitude regarding legal
aspects of organ donation among staff nurses.
H4: There will be a significant association between pre-test score of knowledge regarding
H5: There will be a significant association between pre-test score of attitude regarding legal
aspects of organ donation with the selected back ground variables.
46
ORGANIZATIONS OF THE FINDINGS:
The findings of the study are organized in terms of the objectives tested. The data are
presented under the following headings.
Section 1: Data on back ground variables of staff nurses.
Section 2: Data on effectiveness of structured teaching programme on knowledge
regarding legal aspects of organ donation among of staff nurses.
Section 3: Data on effectiveness of structured teaching programme on attitude
Section 4: Data on assessment of correlation between knowledge and attitude
regarding legal aspects of organ donation among staff nurses.
Section 5: Data on association between pre-test knowledge regarding legal aspects of
Section 6: Data on association between pre-test attitude regarding legal aspects of
47
Section -1 Data on Back ground variables of staff nurses.
Table -5: Frequency and percentage distribution of staffs nurses according to
their back ground variables. n = 60
Demographic variable
Frequency Percentage
1 Age group 21 – 25yrs 39 65

26-30 yrs 13 21.67
31-35 yrs 2 3.33
Above 35yrs 6 10
2 Gender Male 10 16.67
Female 50 83.33
3 Religion Hindu 29 48.33
Christian 28 46.66
Muslim 1 1.67
Others 2 3.33
4 Qualification GNM 44 73.33
BSC Nursing 16 26.67
5 Present Area of ICU 46 76.67
Experience Casualty 10 16.67
CCU 4 6.67
6 No of years of <1 years 12 20
experience 1-2 years 15 25
2-3 years 11 18.34
3yrs and above 22 36.67
7 Nurses Staff nurse 53 88.34
designation Head nurse 1 1.67
Ward incharge 6 10
8 Previous source Mass media 6 10
of information Part of curriculum 10 16.67
Inservice education 33 55
Magazine /journal 10 16.67
Other s 1 1.67
48
The above table shows the percentage and frequency distribution of staff nurses
according to their back ground variables.
The study sample consist of 65 % (39) at the age 21 – 25 yrs age group , 21.67 %
(13) in the age group 26 -30 yrs,3.33%(2) in the age group 31-35 yrs and 10% (6) having age
above 35 yrs.
As per gender 83.33 % (50) were females and 16.67(10) were males.
As per their religion 48.33% ( 29) were Hindus 46.66 (28) were Christians ,1.66%(1) were
Muslims and 3.33%(2) were belong to other religion.
As per the staffs educational qualification 26.66 % (16) were graduates and 73.33(44) were
Diploma holders in Nursing.
As per the staffs present area of experience 76.66% (46) were from ICU,16.66% (10) from
Casualty and 6.66(4) were from CCU.
As per the staffs number of year of experience 36.66%(22) were having more than 3yrs
experience.18.33%(11) having 2 – 3 yrs experience ,25%(15) having 1-2 yrs experience and
20%(12) are having less than 1 yr experience.
As per designation of the staff nurses 88.33(53) having the designation of staff nurses, 1 was
head nurse and 10 % (6) was ward incharges.
According to the staff nurses previous source of information 55%(33) having information
from inservice education ,16.66%(10) having information from part of curriculum,15% (6)
having information from mass media 11.66%(10) having information from magazine
/journals and 1 having information from other sources.
49
Fig 3: shows the percentage distribution of staff nurses according to age .It is inferred that
majority of staffs 39 (65%) were between age limit of 21 – 25yrs and least 2( 3.33) were
between age limit 31 – 35 yrs .
Fig 3: Simple bar diagram showing the percentage distribution of staff nurses
according to age.
50
Fig 4: percentage distribution of staff nurses according to Religion. It is inferred that majority
of staff nurses are following Hindu religious beliefs 29 (48.33%) and the least 1(1.66)
following Islamic beliefs.
Fig 4: Cylinder diagram showing the percentage distribution of staff nurses of
according to Religion
51
Fig 5: percentage distribution of staff nurses of critical care and emergency units according to
their present area of experience. It is inferred that majority of staff nurses 46 (76.66 %) were
from ICU, (10) 16.66 % from Casualty and least 4(6.67 %) were from CCU
Fig 5: Cone diagram showing percentage distribution of staff nurses according to their
present area of experiences.
52
Fig 6: percentage distribution of staff nurses according to their no of years of experience. It is
inferred that majority of staff nurses 22(36.67%) are having more than four years experience
and least 11(18.33%) are having 2-3 years of experience.
Fig 6: Pie diagram showing percentage distribution of staff nurses according to their
no of years of experiences.
53
Fig 7: percentage distribution of staff nurses according to their designation in hospital. It is
inferred that majority of nurses designation is staff nurses 53 (88.33) and least staff nurses 1
(1.66 %) are head nurse and 6(10 %) were ward incharge nurses.
Fig 7: Pyramid diagram showing the percentage distribution of staff nurses according
to their designation.
Section 2: Data on effectiveness of structured teaching programme on knowledge
54
Table 6: Pre test and Post test overall level of knowledge scores of staff nurses regarding
legal aspects of organ donation
The above table shows that most of the staff nurses i.e. 53 % (32 ) got excellent ,46.67
% (58) got very good marks on post test and in Pretest 50 % (30) got average marks ,41.67 %
Sl no Level of Marks Pretest Post test

knowledge F % F %
1 Below 0-5 2 3.33 0 0
average
2 Average 6-10 30 50 0 0
3 Good 11-15 25 41.67 0 0

4 Very good 16-20 3 5 28 46.67
5 Excellent 21-25 0 0 32 53.33
Total n=60 100 n=60 100
(25) got good marks ,5% (3) got very good marks and 3.33% (2) got below average marks.
55
FIGURE 8 : Multiple Bar diagram indicates the distribution of staff nurses by pretest
and post test overall level of knowledge
For the purpose of the study the following null hypothesis was stated as:
56
H01 There will not be a significant difference in pre test and post test mean score regarding
the knowledge on legal aspects of organ donation among staff nurses.
Table-7: Reveals the data of ‗paired‘ test value of groups for knowledge scores
n = 60
Pretest Post test MD

Paired t test
Overall pretest Mean SD Mean SD ―t‖ values
and post test
knowledge 10.8 2.87 22 2.03 11.2
score t = 22.8
p = 0.001
S*
S* SIGNIFICANT P < 0.05
The obtained posttest mean value (22) was higher than pretest mean value (10.8) ,The
mean difference value is (11.2) and the obtained „t‟ value is (22.8) which is greater than
table value of t (59) = 2.0010. Since the obtained„t‟ value is highly significant at p < 0.05
level the null hypothesis H01 rejected, and research hypothesis H1 accepted. It is interpreted
that the structured teaching programme on legal aspects of organ donation is effective in
increasing knowledge of staff nurses.
Section 3: Data on effectiveness of structured teaching programme on attitude
57
Table: 8 Pre test and Post test overall level of Attitude scores of staff nurses regarding
The above table shows that in Pre test most of the staff nurses i.e., 80 % ( 48 ) had
Sl no Level of Marks Pretest Post test

attitude F % F %
1 Poor 0-15 1 1.66 1 1.66
2 Average 16-30 8 13.33 0 0
3 Good 31-45 48 80 21 35
4 Very good 46-60 3 5 38 63.33
Total n= 60 100 n= 60 100
good attitude , 13.333 % ( 8 ) had average attitude ,5 % ( 3 ) had very good attitude and
1.666 % ( 1 ) is having poor attitude and in Post test 63.33% (38) having very good attitude
,35% ( 21) having good attitude and 1.66 % (1) having poor attitude towards legal aspects
of organ donation .
58
FIGURE: 9 Multiple Bar diagram indicates the distribution of staff nurses by pretest and
post test overall level of attitude
H02: There will not be a significant difference in pre test and post test mean attitude score
59
Table-9: Reveals the data of paired‗t‘ test value of groups for attitude scores
n = 60
Pretest Post test

MD Paired t test
Overall pretest Mean SD Mean SD
and post test ―t‖ values
attitude score 12.6
36.6 6.8 49.2 7.6
t = 8.7
p = 0.001
S*
S* SIGNIFICANT P < 0.05
The obtained posttest mean value (49.2) was higher than pretest mean value (36.6)
,The mean difference value is (12.6 ) and the obtained „t‟ value is (8.7) which is greater than
table value of t (59) = 2.0010. Since the obtained‟t‟ value is highly significant at p < 0.05
level the null hypothesis H02 rejected, and research hypothesis H2 accepted. It is interpreted
that the structured teaching programme on legal aspects of organ donation is effective in
increasing the attitude of staff nurses.
60
Section 4: Data on assessment of correlation between knowledge and attitude regarding
H03: There will not be a significant co-relation between knowledge and attitude regarding
Table 10: Reveals the data of correlation coefficient ―r‖ value, mean, s d of pre-test
knowledge and attitude scores.
n = 60
Variables Mean Std deviation Range “r” value

Knowledge score
on legal aspects of 10.8 2.87 16
organ donation 0.228
Attitude score legal
aspects of organ 36.6 6.812 25
donation NS
NS = NOT SIGNIFICANT
The” r” value of group‟s pre-test knowledge and attitude is 0.228. The obtained „r‟
value is less than table value of t (58) = 0.254, it shows there is no correlation between the pre
test knowledge and attitude regarding legal aspects of organ donation. By this: Null
hypothesis H03 accepted and research hypothesis H3 is rejected. It is interpreted that the
knowledge and attitude regarding legal aspects of organ donation are independent to each
other.
61
Section 5: Data on association between pre-test knowledge score of staff nurses
regarding legal aspects of organ donation and selected back ground variables.
H04: There will not be a significant association between pre-test score of knowledge
regarding legal aspects of organ donation with the selected back ground variables.
62
Table 11: Reveals summary of chi-square values of pre-test knowledge score
of staff nurses and selected background variables. n = 60
Median = 10
Demographic variable Frequency
Sig
≤ median >
Median
1 Age 21 – 25 39 22 17 χ² = 3.13
26-30 13 6 7 df=3
31-35 2 2 0 p > 0.05
Above 35 6 2 4
NS
2 Gender Male 10 5 5 χ² = 0.536
df=1
Female 50 27 23 p > 0.05 NS
3 Religion Hindu 29 17 12 χ² = 3.61
Christian 28 14 14 df=3
Muslim 1 1 0 p > 0.05
Others 2 0 2 NS
4 Qualification GNM 44 23 21 χ² = .746
BSC Nursing 16 9 7 df=1
p > 0.05 NS
5 Present Area of ICU 46 24 22 χ² =2.43
Experience Casualty 10 7 3 df= 2
CCU 4 1 3 p > 0.05
NS
6 No of years of <1 years 12 7 5 χ² =0.956
experience 1-2 years 15 7 8 df= 3
2-3 years 11 7 4 p > 0.05
3 yrs and above 22 11 11 NS
7 Nurses Staff nurse 53 28 25 χ² =0.907
designation Head nurse 1 1 0 df= 2
Ward incharge 6 3 3 p > 0.05
NS
8 Previous Mass media 6 6 0 χ² =13.3
source of Part of 10 3 7 df= 4
information curriculum p < 0.05
Inservice 33 19 14 S
education
Magazine 10 3 7
/journal
Other s 1 1 0
63
Keys
χ² = chi square p < 0.05 = Significant
S = Significant NS = Not significant
df = degrees of freedom
The data on table : 11 represents association between pre-test knowledge score of
staff nurses with age in years ,gender ,religion qualification, no of years of experience ,area
of present experience ,nurses designation and previous source of information of nurses .
The result shows that there is significant association between pre-test knowledge and
previous source of information, as the chi-square value is greater than the table value 9.49
(df= 4), therefore Null Hypothesis (H04) was rejected and H4 accepted with the selected
background variables previous source of information and H04 accepted in relation to age in
years ,gender ,religion qualification, no of years of experience ,area of present experience
,nurses designation, as the chi-square value is less than the table value.
Section 6: Data on association between pre-test attitude score of staff nurses regarding
legal aspects of organ donation and selected back ground variables.
H05: There will not be a significant association between pre-test score of attitude regarding
64
Frequency Median = 38 Chi square
Demographic variable Value
Table 12: Reveals summary of chi-square values of pre-test attitude score of staff nurses
and selected back ground variables.
65
≤ median >
Median
1 Age 21 – 25 39 24 15 χ² = 5.79
26-30 13 3 10 df= 3
31-35 2 1 1 p > 0.05
Above 35 6 3 3 NS
2 Gender Male 10 6 4 χ² = .334
df= 1
Female 50 25 25 p > 0.05 NS
3 Religion Hindu 29 17 12 χ² = 5.09
Christian 28 11 17 df= 3
Muslim 1 1 0 p > 0.05
Others 2 2 0 NS
4 Qualification GNM 44 22 22 χ² = 0.184
BSC Nursing 16 9 7 df= 1
p > 0.05 NS
5 Present Area ICU 46 22 24 χ² = 1.42
of Experience Casualty 10 6 4 df= 2
CCU 4 3 1 p > 0.05 NS
6 No of years of <1 years 12 6 6 χ² = 1.87
experience 1-2 years 15 10 5 df= 3
2-3 years 11 5 6 p > 0.05
3 yrs and above 22 10 12 NS
7 Nurses Staff nurse 53 28 25 χ² = 1.10
designation Head nurse 1 0 1 df= 2
Ward incharge 6 3 3 p > 0.05 NS
8 Previous Mass media 6 0 6 χ² = 14.6
source of Part of curriculum 10 6 3 df= 4
information Inservice education 33 15 18 p < 0.05
Magazine /journal 10 9 1 S
Other s 1 1 0
n = 60
Keys
χ² = chi square p < 0.05 = Significant
S = Significant NS = Not significant

66
df = degrees of freedom
Data on table :12 represents association between pre-test attitude score of staff nurses
regarding legal aspects of organ donation with age in years ,gender ,religion qualification, no
of years of experience ,area of present experience ,nurses designation and previous source of
information.
The result shows that there is significant association between pre-test attitude and
previous source of information, as the chi-square value is greater than the table value 9.49
(df= 4), therefore Null Hypothesis (H05) was rejected and H5 accepted with the selected
background variables previous source of information and H05 accepted in relation to age in
years ,gender ,religion qualification, no of years of experience ,area of present experience
,nurses designation, as the chi-square value is less than the table value.
SUMMARY
This chapter dealt with the statistical analysis and interpretation of data. The
objectives of the study were attained through various statistical method and interpretation.
The samples characteristics were dealt with frequencies and percentages. Descriptive
statistics was used to find out the mean, median and SD. Inferential statistics was used to find
out the association, co relation, and effectiveness.
67
CHAPTER 6
DISCUSSION
The chapter presents the major findings of the study and discusses them in relation to
similar studies conducted by other researchers. The present study is an effort to assess the
effectiveness of a structured teaching programme regarding legal aspects of organ donation
on knowledge and attitude among staff nurses of emergency and critical care units of selected
hospitals at Mysore.
In order to achieve the objectives of the study, pre experimental one group pretest post
test design was adopted. Sixty subjects those who fulfilled the inclusion and exclusion criteria
were selected by non probability convenience sampling technique. The subjects were
assessed by using socio demographic data, questionnaire and attitude scale on legal aspects of
organ donation. . The findings of the study have been discussed with reference to the
objectives and hypotheses stated with findings of other studies.
Objectives
nurses.
donation and other selected back ground variables.

68
Hypotheses
H2 There will be a significant difference in pre test and post test mean score regarding the
attitude on legal aspects of organ donation among staff nurses.
The findings of the study have been discussed under the following sections:
Section 1: Description of sample characteristics
Section 2: Data on the effectiveness of Structured Teaching Programme on knowledge and
attitude on regarding legal aspects of organ donation among staff nurses.
Section 3: Data on assessment of co-relation between knowledge and attitude on legal
Section 4: Data on the association between pre-test knowledge regarding legal aspects of
organ donation and other selected back ground variables.
Section 5: Data on the association between pre-test attitude regarding legal aspects of organ

69
1) Section 1: Description of sample characteristics
 Based on the age : 39( 65 %) were distributed in 21- 25 years, 13(21.67 %) distributed
in 26 -30 years ,6 (10 %) were distributed in the age group above 35 years and 2(
3.33%) distributed in the age group 31 – 35 years .
 Based on the gender: 50 (83.33 %) were females and 10 (16.67 %) were males.
 Based on the religion: 29 (48.33%) were distributed in Hindus, 28( 46.67 %) were
distributed in Christians ,1(1.666 %) were Muslims
 Based on the qualification: 44 (73.33%) were distributed in GNM, 16 ( 26.67 % ) were
distributed in Bsc Nursing.
 Based on present area of experience: 46(76.67 %) were distributed in ICU, 10 (16.67
%) were distributed in Casualty, 4(6.67 %) were distributed in CCU.
 Based on no of years of experience : 12(20 %) were distributed in less than one years
,15( 25 %) were distributed having 1 – 2 years of experience ,11(18.34 %) were
distributed having 2 – 3 years of experience and 22 (36.67 %) were distributed having
experience more than 3.
 Based on nurses designation: 53( 88.34 %) were distributed in staff nurses ,1(1.67 %)
were head nurses and 6(10 %) were distributed in ward incharge .
 Based on previous source of information : 9(15 %) were distributed as having
information from mass media ,10( 16.67) were having information from part of
curriculum ,33 (55%) having information from inservice education,7 (11.67 %) were
distributed as having information from magazines /journals and 1(1.67) from other
sources.
70
Section 2: Data on the effectiveness of Structured Teaching Programme on knowledge
and attitude on regarding legal aspects of organ donation on staff nurses.
In this study Table - 6 shows that on Pretest 50% (30) got average marks, 41.67 %
(25) got good marks, 5% (3) got very good marks and 3.33% (2) got below average marks.
and most of the staff nurses i.e. 53 % (32 ) got excellent ,46.67 % (58) got very good marks
on post test and the data on table 5 reveals that the overall pretest knowledge score Mean is
(10.8) and SD is( 2.87). and post test knowledge score Mean ( 22) and SD ( 2.03) .The
obtained „t‟ value is 22.8 which is greater than the table value t(59) 2.0010. So the
structured teaching programme on legal aspects of organ donation is effective in increasing
knowledge of staff nurses.
In this study table 8 shows that in Pre test most of the staff nurses i.e., 80 % ( 48 )
had good attitude, 13.333 % ( 8 ) had average attitude ,5 % ( 3 ) had very good attitude
and 1.666 % ( 1 ) is having poor attitude and in Post test 63.33% (38) having very good
attitude ,35%( 21) having good attitude and 1.66 % (1) having poor attitude towards legal
aspects of organ donation and the table 6 reveals that the overall pretest attitude score Mean (
36.6) and SD is (6.8) ,and post test attitude score Mean is (49.2) and SD is ( 7.6) .The
obtained „t‟ value is 8.7 which is greater than the table value t(59) 2.0010 So the structured
teaching programme on legal aspects of organ donation is effective in increasing attitude of
staff nurses.
The findings were strongly supported by the studies on health care professionals in
assessing the effect of educational programme on knowledge, attitude and practises regarding
organ donation and organ transplantation. A study conducted at, Loma Linda University
Children's Hospital among Paediatric critical care nurses. The objective of the study was to
assess their perception, level of knowledge, and understanding of DCD (donation after
71
cardiac death) and the effect of an educational intervention. The study find out that the DCD
process improved from 20% to 79%. Confidence with knowledge, comfort answering family
questions, and comfort in calling the organ procurement agency about DCD donors improved
by 41%, 25%, and 18%, respectively. The study recommended educational programmes in
increasing knowledge and attitude of the health care professionals regarding organ donation
and its legal aspects.
Section 3: Data on assessment of co-relation between knowledge and attitude on legal
In this study the data on table 10 reveals that the mean pre-test knowledge value of
the group is (10.8), the SD is ( 2.87) and mean value of pre-test attitude score of the group is
36.6, the SD is 6.812 and the” r” value of groups pre-test knowledge and attitude is 0.228 .
The obtained „r‟ value is less than table value of t (58) = 0.254, so there is no correlation
between the pre-test knowledge and attitude regarding legal aspects of organ donation. It
infers knowledge and attitude regarding legal aspects of organ donation are independent to
each other.
assessing the knowledge, attitude and practises regarding organ donation and organ
transplantation. Most of the studies found that majority of nurses are having good attitude
regarding organ donation and its legal aspects. A study was conducted by south-western
medical center to assess knowledge and attitude of nurses regarding organ donation. The
samples are 46 critical care nurses Knowledge scores were found to be average (74%
correct). Attitude scores reflected a strongly positive attitude toward organ donation. The
study found out that increased knowledge of organ donation was not found to be related to a
positive attitude. The study explains that both attitude and knowledge were found to be
72
positively correlated with previous experience in caring for either organ donors or recipients.
The studies results indicate that exposure to patients affected by organ procurement have
increased the knowledge and improve the attitudes of the nurses.
Section 4: Data on the association between pre-test knowledge regarding legal aspects of
In this study the data on table : 11 represents association between pre-test knowledge
score with age in years ,gender ,religion qualification, no of years of experience ,area of
present experience ,nurses designation and previous source of information of staff nurses of
emergency and critical care units . The result shows that there is association between post
test knowledge and previous Source of information and there is no association between pre-
test knowledge score and age in years, gender, religion qualification, no of years of
experience, area of present experience, nurse‟s designation.
transplantation. A survey conducted by Donor Action Foundation's Hospital in assessing
Attitude and collect data from staff members in critical care units found out that nurses with
more than 5 years of critical care experience were consistently more confident with donation-
related tasks. Support rates for donation are high overall, and previous training is associated
with improved attitudes and decreased educational needs. Educational efforts tailor-made for
nurses should increase nurses' confidence levels when confronted with potential donors and
their next of kin.
Section 5: Data on the association between pre-test attitude regarding legal aspects of
73
In this study the data on table no 12 represents association between pre-test attitude
score with age in years ,gender ,religion qualification, no of years of experience ,area of
present experience ,nurses designation and previous source of information of nurses of
critical care and emergency units. The result shows that there is association between pre-
test attitude and previous source of information and there is no association between pre-
test knowledge score and age in years ,gender ,religion qualification, no of years of
experience ,area of present experience ,nurses designation.
transplantation. A survey conducted by Donor Action Foundation's Hospital in assessing
Attitude and collect data from staff members in critical care units found out that nurses with
more than 5 years of critical care experience were consistently more confident with donation-
related tasks. Support rates for donation are high overall, and previous training is associated
with improved attitudes and decreased educational needs. Educational efforts tailor-made for
nurses should increase nurses' confidence levels when confronted with potential donors and
their next of kin.
Summary
This chapter has dealt with the major findings and discussion of the study with the
help of the review of literature. There were many studies from review of literature that
supported this study. The researcher got similar findings compared to the review.
74
75
CHAPTER – VII
CONCLUSION
The aim of the study was to assess the effectiveness of Structured Teaching
Programme on knowledge and attitude regarding legal aspects of organ donation among staff
nurses of critical care and emergency units of selected hospitals at Mysore. The following
conclusion was drawn from the result of the study.
Most of the staff nurses of emergency and critical care units had an average
knowledge and good attitude regarding legal aspects of organ donation before the
administration of Structured teaching Programme. So the administered Structured teaching
Programme among staff nurses facilitated them to learn more about the legal aspects of organ
donation and improving their attitude towards legal aspects organ donation. This was evident
in the comparison of the pre test and post test knowledge and attitude scores and paired “t
test” values. It reveals the effectiveness of Structured teaching Programme.
The pre-test knowledge and attitude score regarding legal aspects of organ donation
among staff nurses in critical care and emergency units were assessed for co-relation using
Karl pearsons correlation coefficient and it founds no significant correlation between pre-test
knowledge and pre-test attitude .It infers knowledge and attitude regarding legal aspects of
organ donation are independent to each other as per the findings.
The pre-test knowledge and attitude score regarding legal aspects of organ donation
was assessed for association with selected back ground variables using chi- square test. It was
found that there is a significant association between pre-test knowledge and attitude regarding
legal aspects of organ donation and previous source of information, and it founds no
76
significant association with age, gender, religion, qualification, present area of experience,
no of years of experiences and nurses designation.
CHAPTER – VIII
SUMMARY
77
This chapter gives the summary of statement of problem, objectives, hypothesis,
conceptual frame work, methodology, salient finding, and implications in nursing education,
nursing practice, nursing administration and nursing research followed by limitations and
recommendation.
Statement of the problem
“A study to assesses the effectiveness of structured teaching programme on
knowledge and attitude regarding legal aspects of organ donation among staff nurses in
critical care and emergency units in selected hospitals at Mysore.”
Objectives
nurses.
Hypotheses
78
Conceptual Framework
Conceptual framework deals with concepts assembled together by the writer of their
relevance to the research problem which provides a certain framework of reference for
clinical practice, research and education. The conceptual frame work selected for this study
was based on Program Evaluation Model, (CIPP MODEL) developed by Daniel Stuffle
Beam (1983).
Methodology
The investigator keeping in mind the objectives of the study, choose the Pre
experimental design approach. To evaluate the effectiveness of Structured Teaching
Programme the investigator selected one group pre test- post test design. The data was
collected by convenience sampling technique. The sample consisted of 60 staff nurses from
emergency and critical care units of Holdsworth Memorial Hospital and Apollo BGS
Hospital Mysore.
79
A Structured knowledge questionnaire, attitude scale was developed and used to
collect the data. The validity of the knowledge questionnaire and attitude scale was
established by the subject experts from the related field. Reliability of the tool was tested by
spearman brown split-half method. A pilot study was conducted to find out practicability and
feasibility of the study. Data from the samples were collected through structured interview
schedule. Data was analyzed using SPSS-15th version. Both descriptive and inferential
statistics were used.
Nursing Implications
The results of this study have scope on nursing practice, nursing education, nursing
administration and nursing research.
Nursing Practice
Several implications can be drawn from the present study for nursing practice.
Educational programs conducted by the nursing personnel helps in improving knowledge
regarding legal aspects of organ donation.
 The nurse play an important role in organ donation and health promotion education
programme with effective teaching strategies, which motivate the staff nurses to
follow healthy practices in day to day life.
 Structured teaching programme once developed and evaluated for its effectiveness
can be modified to teach other groups of the staff nurses.
 Health information can be imparted through various methods like lecture, mass
media ,pamphlets, structured teaching programme etc .Nurses have to position
80
themselves in all areas . Hence nurse should take interest in preparing different
teaching strategies suitable for themselves and community.
Nursing Education
 The nursing curriculum should consist of knowledge related to health information
with different method of teaching, Nursing students should be made aware of their
role in health promotion and disease prevention in present and future years, which
may helps in achieving the goal of health for all. the student teaching experience
should emphasize of teaching students on preventive ,promotive and management of
health practices.
 Nurse at PG level have to develop their skill in preparing health teaching material
according to the community level of understanding .Improved and new techniques
have to be used for motivating nurses and public on organ donation and its legal
aspects.
 The information on legal aspects of organ donation and organ donation process can be
included in Nursing Education curriculum.
Nursing Administration
 The nurse administrator should take active role in providing information on health,
knowledge on organ donation its legal aspects and nurses responsibilities to the health
personnel‟s and public.
 The nurse as an administrator should plan and organize educational programme for
nursing personnel and motivating them in conducting educational programme on
legal aspects of organ donation and general aspects and organisation of such
81
programme require efficient team work, planning for man power ,money material
and method and minutes to conduct successful educational programmes both at the
hospital and community level. She should also encourage and depute nurse to
participate in such programmes conducted by other voluntary health organisations.
Nursing Research
 There is a need of extensive and intensive research in this area, so that strategies for
educating nurses on legal aspects of organ donation and its general information can be
developed. The researcher should conduct research on various aspects of organ
donation its process which provides more scientific body of information to the nursing
profession.
Limitations
1) The study was conducted for the representative group of whole staff nurses of
emergency and critical care units of Apollo Hospital and Holdsworth memorial
Hospital of Mysore. Hence generalisation is limited to the staff nurses of critical care
and emergency units of Apollo Hospital and Holdsworth memorial Hospital of
Mysore.
2) The study was limited to 60 samples.
3) Randomization is not done.
4) Only staff nurse of critical care and emergency units were included in the study.
5) The study didn‟t have control group.
82
Recommendations
Based on the finding of the study, the following recommendations are made
1) A similar study can be replicated on different settings.
2) A similar study may be replicated with a control group.
3) A similar study may be replicated on a larger sample for wider generalisation.
4) A comparative study may be conducted to find effectiveness between structured
teaching programme and self instructional module regarding the same topic.
5) A exploratory study can be done to assess the barriers in organ donation in the
hospitals.
6) A descriptive study can be done to evaluate nursing and non nursing student‟s
knowledge and attitude regarding organ donation.
Summary
The researcher felt a deep sense of satisfaction and fulfillment for having undertaken
the study. The study provided the investigator with deeper insight about legal aspects of
organ donation. The direction from the guide, expert opinions and help from the staffs of the
hospital made the study fruitful and interesting.
83
84
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22) Amalraj R, Edwin ,Raja D, Attitudes of health care professionals towards organ
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89
Annexure – 1
Letter seeking permission to conduct Research study
90
91
Annexure – 2
Letter seeking consent of the subjects for participation in Research study
Dear participant
I Mr. Anand .T.O ,2nd year Msc Nursing student of BGS college of nursing ,Mysore
would like to conduct a research study titled
―A study to assess the effectiveness of structured teaching programme on knowledge

and attitude regarding legal aspects of organ donation among staff nurses of
critical care units and emergency units of selected hospitals of Mysore ―
The required information for the same is proposed to be collected using a knowledge
questionnaire and attitude scale regarding legal aspects of organ donation. All the
information collected from you will be utilized only for the study purpose, we assure you
that anonymity will be maintained .if you are willing to participate, kindly give consent for
same in the following profoma and fill up the questionnaire and attitude scale attached.
CONSENT FORM
I ................................................. hereby agree to participate in the study titled
―A study to assess the effectiveness of structured teaching programme on

knowledge an d attitude regarding legal aspects of organ donation among staff
nurses of critical care units and emergency units of selected hospitals of Mysore‖
......................................................................
.......................................................................
(Name and Signature of participant)
92
Annexure – 3
Letter requesting the opinion of expert on content validity Research tool and
structured teaching programme
From,
Anand T.O
2nd Msc nursing
BGS CON
To,
_____________________
_____________________
_____________________
Forwaded through
The principal
BGS CON
Sub: Request for acceptance to validate the research tool.
Respected Sir/Madam
I ,Anand .T.o ,2nd year Msc nursing student (MSN ) of the above mentioned institution ,kindly
request you to give consent to validate my tool on:
Topic : ― A study to assess the effectiveness of structured teaching programme on

knowledge and attitude regarding legal aspects of organ donation among staff nurses of
critical care and emergency units of selected hospital at Mysore‖
Here I have enclosed with
 Objectives of the study

 Hypothesis of the study
93
 Tools
 Criteria check list
 Structured teaching programme
I request you to kindly go through the items and give your valuable suggestions and opinions to
develop the content validity of the tool. Kindly suggest modifications additions and deletions, if any,
in the remark column.
Thanking you, in anticipation
Place: Mysore yours faithfully
Date. Anand .T.o
SIGNATURE OF PRINCIPAL
94
Annexure - 4
ACCEPTANCE FORM FOR TOOL VALIDATION
Name:
Designation:
Name of the Institution:
Statement of acceptance /Non acceptance
Topic
“A study to assess the effectiveness of structured teaching programme on knowledge and

attitude regarding legal aspects of organ donation among staff nurses of critical care and
emergency units of selected hospital at Mysore”
I give my acceptance /non acceptance to validate the tool.
Place:
Date:
95
Signature
Annexure - 5
CRITERIA RATING SCALE FOR VALIDATION OF THE TOOL
Instructions: kindly go through the items in the enclosed tool and place a tick mark (√ )
against each item in the column provided indicating your opinion best. There are 2
columns namely, agree (A) and disagree (DA),if there are any suggestions ,please mention
them in the remarks column.
SECTION A
ITEM A DA REMARKS
NO
1
96
SECTION B
KNOWLEDGE QUESTIONARE ON LEGAL ASPECTS OF ORGAN DONATION
ITEM NO A DA REMARKS
1
10
11
12
13
14
15
16
17
18
19
20
21
97
22
23
24
25
98
SECTION C
ATTITUDE SCALE FOR ASSESSING NURSES ATTITUDE TOWARD LEGAL

ASPECTS OF ORGAN DONATION
ITEM NO Agree DA REMARKS
10
11
12
13
14
15
SIGNATURE OF VALIDATOR
99
Annexure – 6
CONTENT VALIDITY CERTIFICATE
I hereby certify that I have validated the tool of Anand .T.o .II year Msc nursing student
,BGS college of nursing ,Mysore who is under taking the following study:
― A study to assess the effectiveness of structured teaching programme on

knowledge and attitude regarding legal aspects of organ donation among staff
nurses of critical care and emergency units of selected hospital at Mysore‖
Place: Signature of expert
Date: Designation and address
100
Annexure – 7
List of Experts
1) Dr P Srinivasan M D DM
Consultant Nephrologist, Transplant physician
BGS Apollo Hospital
Adichunchanagiri Road, Kuvempunagar, Mysore
2) Dr Vijay P
Junior consultant, Nephrology department
BGS Apollo Hospital
Adichunchanagiri Road, Kuvempunagar, Mysore
3) Mr. Jagadish Kumar

Advocate
High court of Karnataka
4) Mrs. Lannet smitha

Reader
St.Anns College of nursing
Mangalore
5) Mrs. Latha David
Asst professor
Gopala Gowda College of Nursing
Mysore
6) Mrs. Sarvamangala
Vice Principal /Associate Professor
Cavary College of Nursing
Mysore
7) Mrs. Janet Mathias

Asst Professor
JSS College of Nursing
1st main Saraswthipuram
Mysore
101
Annexure – 8
Research tool
Section A Demographic profile
1) Age :
a) 21 -25yrs
b) 26 – 30yrs
c) 31– 35yrs
d) Above 35 yrs
2) Gender :
a) male
b) female
3) Religion
a) Hindu
b) Christian
c) Muslim
d) Others
4) Qualification :
a) GNM
b) BSC Nursing
5) Present Area of experience :

a) ICU
b) Casualty
c) CC U
6) No of years of experience :
a) <1 yrs
b) 1 – 2 yrs
c) 2 – 3yrs
d) 3 yrs and above
7) Nurses designation :
a) Staff nurse
b) Head nurse
c) Ward incharge
8) Previous source of information

a) Mass media
b) Part of curriculum
c) In-service education
d) Magazine /journal
e) Others specify
102
Section B
Knowledge questionnaires on legal aspects of organ donation
Kindly answer the following questions by putting a tick mark ( √ ) against the option
given below.
1) Organ donation is defined as surgical replacement of following except :
a) Diseased organ
b) Healthy organ
c) Defective organ
d) Injured organ
2) Organ transplantation is indicated for :
a) Organ failure
b) Organ infection
c) Organ injury
d) Diseased organ
3) The following organs can be donated except :

a) Liver
b) Kidney
c) Brain
d) Heart
4) Who can be the eligible donor:
a) Living
b) cadaver
c) brain death
d) all the above
5) The following organ which has no age limit for donation:
a) Cornea
b) Pancreas
c) Kidney
d) Liver
6) The following are the absolute contra indications of organ donation except:
a) Hypertension
103
b) HIV
c) Disseminated intravascular coagulation
d) Age older than 80 yrs
7) The type of people from which we can‟t take organ for donation :
a) Sudden death due to an R T A

b) New born
c) Persons with communicable ,transferable disease
d) healthy people
8) Cornea is to be removed within how many hours after death:

a) 6hrs
b) 8hrs
c) 9hrs
d) 12hrs
9) Heart valves has to be removed within how many hours after death .
a) 1-2hrs
b) 2-4 hrs
c) 4-8 hrs
d) 6 -8 hrs
10) The Law associates control of organ donation come under:
a) Public law
b) Humanitarian law
c) Civilary law
d) civil law
11) The transplantation of human organ bill was passed in the year :
a) 1992
b1994
c) 1996
d)1990
12) The organ transplantation act constitutes the following number of chapters :
a) 5
b) 6
c) 7
d) 8
13) Brain stem death means the stage at which :
a) Functions of body is temporally reversible

b) Functions of brain stem have permanently and irreversibly ceased.
c) Functions of brain except brain stem are functionally reversible.
104
d) Functions of brain stem have temporarily and reversibly ceased
14) As per the organ donation act...Near relative excludes:
a) Son
b) Daughter
c) Father
d) Daughter in law
15) In case of unclaimed bodies in hospitals or prison, how many hours the authority has
to wait from the time of death for removal of any organ :
a) 12 hrs
b) 24hrs
c) 36hrs
d) 48hrs
16) Bone has to be removed from cadavers within how many hours after death :
a) 24hrs
b) 12hrs
c) 36hrs
d) 48hrs
17) The Typical kidney preservation time :
a) 48 -72 hrs
b) 6 – 12 hrs
c) 12- 24 hrs
d) 2-8hrs
18) Heart and lung preservation time :
a) 4 – 6 hrs
b) 6 – 8hrs
c) 8- 10 hrs
d) 10-12 hrs
19) Bone may be freeze dried or stored up to:
a) 15 days
b) Within 2 days
c) 2yrs
d) Up to 5yrs
105
20) How many transplantations has to be carried out minimum in an year at a city for the
formulation of Authorization committee by central or state govt :
a) >25
b) >50
c) >75
d) >100
21) The patients under gone brain death and who is about to donate organs should fulfil :
a) rule of 9
b) rule of 100
c) rule of 10
d) rule of 99
22) Nurses role in organ donation include :
a) Acquire knowledge regarding organ donation

b) Motivate people regarding organ donation
c) Deflate myth
d) All the above
23) The state organ transplantation authorization committee members excludes :
a) Chief medical officer

b) Senior medical practitioner
c) Secretary ( Health )
d) Member of parliament
24) How many witness are required for allotting an authorized organ donation .if the
person is ready to donate :
a) 1
b) 2
c) 3
d) 4
25) The punishment for removal of human organ without approval of authority is :
a) 5yrs
b) 6yrs
c) 7yrs
d) 8yrs
106
SECTION C
107
Read the following statements carefully before you begin to respond to the questionnaire given in
this scale.
Scoring + Key to answers for knowledge questionnaires
Statement s Strongly Agree Neutral Dis Strongly

agree agree disagree
1 Organ donation is a merciful act.
2 Ethical and legal issues are not

necessary for organ donation.
3 Organ donation insults human rights
and dignity.
4 The legal proceeding will lag the
organ donation process.
5 I think lack of knowledge or

awareness is the reason for shortage of
organ donation.
6 Donating organs to another person

improves sense of humanity.
7 I think organ donation is consistent

with my moral beliefs.
8 Nurses do not have rights to talk about

organ donation to the patients or
attenders.
9 I feel I don‟t have proper information
on legal aspects of organ donation
10 I am confident of my ability to request
an organ donation from family.
11 Organ donation is a positive option for

the family at the time of death of a
family member.
12 I think requesting of organ or tissue
donation places an additional burden
on grieving family.
13 I don‟t want to do anything apart from

my job.
14 Organ donation process has to be

more transparent.
15 Talking with relatives regarding organ

donation will affect inter personal
relationship.
108
Questions Answers Score
1 B 1
2 A 1
3 C 1
4 D 1
5 A 1
6 A 1
7 C 1
8 A 1
9 D 1
10 A 1
11 B 1
12 C 1
13 B 1
14 D 1
15 D 1
16 D 1
17 A 1
18 A 1
19 D 1
20 A 1
21 B 1
22 D 1
23 D 1
24 B 1
25 A 1
Scoring for attitude scale
Items Strongely Agree Neutral Disagree Strongly

agree disagree
1,5-7 ,10,11,15 4 3 2 1 0
2,3,4,8,9,12,13,14 0 1 2 3 4
Blue print of questionnaire on legal aspects of organ donation

109
S Domain of objective
L
CONTENT TOTA L
N
O KNOWLEDGE UNDERSTANDING APPLICATION
1 Definition of 1 1
organ donation.
Or
2 organs for donation 3, 1
Or
3 organ transplantation 2 4 2
and
Ty Types of donors
4 Inclusion criteria for 5 1

organ donation
Ind
5 Indications and 6 7 2
Contra Indication
Fac
6 Factors affecting 8,9 2
Organ donation
7 Legal Aspects of 10,11,12,14. 13,15 16,17,18,19, 14

Organ donation 23,20.25 24
8 Nurse role in 22 21 2
organ donation
Total 12 5 8 25
110
Annexure – 9
Certificate for English Editing
111
112
Annexure - 10
Lesson plan on legal aspects of organ donation
Under the guidance of Prepared by

Prof. N T Arunadevi Mr. Anand T O
Principal IInd Msc Nursing Student
Guide in Dept of Medical and Surgical Nursing Medical and Surgical Nursing
BGS College of Nursing BGS College of Nursing
110
Structured Teaching programme on legal aspects of organ donation
SUBJECT : Medical and Surgical Nursing
TOPIC : Structured Teaching Programme on legal aspects of organ donation
PLACE :
DURATION : 1hrs
No OF PARTICIPANTS : 60
AV AIDS : Black Board, LCD projector
111
General objectives
On completion of the Structured Teaching Programme the students will be able to acquire scientific knowledge regarding legal aspects of
organ donation and practise the same within the clinical setting with desirable skill and attitude.
Specific objectives
1) Define organ donation
2) List the organs for donation.
3) List the types of donors.
4) Explain the inclusion criteria for organ donation.
5) Explain the contraindication for organ donation.
6) List the factors affecting organ donation.
7) Discuss the legal aspects of organ donation.
8) Discuss the requirements of successful organ donation.
9) List the organ donation registries in India.
10) Explain the role of Nurse in organ donation
112
Specific Content Teacher learner Av Evaluation
objectives activity aids
Legal aspects of Organ donation
Topic Introduction
2min
Introduction
Organ donation is the gift of an individual to help someone who
The teacher will
needs a transplant. Organ transplantation has greatly improved the
introduce himself
grim outlook of patient s suffering from end stage organ failure.
to the students
People who are legally competent may choose organ donation. Any
and introduces
body part or entire body may be donated. The decision to donate
the topic to the
organs or to provide anatomic gift may be made by a person before
students .
death. The decision to donate organs may be made immediately by
family members following death. It is necessary for a nurse to be
aware about the knowledge regarding all aspects of organ donation.
2min Define organ LCD What is organ

Organ donation
donation The teacher will donation?
Organ donation is defined as a surgery which involves the read the definition
and explains the
replacement of diseased and defective organ and tissues with healthy
content .The
from the donors. students will listen
the content to the
student .
113
Organ s for donation
2min List the organs
for donation The commonly transplanted organ or donated organs are heart, The teacher will
explain the organs Which are the
lung, liver intestine, kidney and pancreas.
for donation. The LCD organs which can
Tissues include whole blood component tendon ligament students will listen be donated?
the class and
fascia, duramater, corneas, connective tissue, skin heart valves,
clarifies the doubts
bone, bone marrow and blood vessels .
A living donor can donate kidney, partial liver, bone marrow, blood
to help saved life of another.
A non heart beating donor can donate eyes , bone , heart valves
,connective tissue ,skin.
2min
Types of Donors
List the type
of donors. LCD
What are the
1) Living
The teacher will types of
2) Deceased (cadaver) explains the types donors?
of donors to the
3) Brain death
students the
 Living : In living donors ,the donor remain alive and donates a students will
listen the class
renewable tissue cell or fluid (eg: blood, skin) or donate an organ or and write down
part of an organ in which the remaining organ can regenerate or take the notes.
on the work load of the rest of the organ – primarily single kidney
114
donation partial donation of liver ,small bowel or pancreas . .
 Deceased : also known as cadaver are donors who have been
declared brain dead and where organ are kept viable by ventilator or
other mechanism until they can be excised for transplantation or those
who have donated their organ after their death .
 Brain-stem death: means the stage at which all functions of the

brain-stem have permanently and irreversibly ceased and is so
certified by a medical practitioner.
[Doctors panel includes
1) R.M.P, incharge of the hospital in which brainstem death has
occurred.
2) R.M.P, nominated from panel of names approved by the Appropriate

authority
3) Neurologist/Neuro-surgeon nominated from the panel of names
approved by the appropriate authority.
4) R.M.P treating the aforesaid deceased person
All the four doctors sign each test done to document absence of
brainstem function namely pupillary reflex, doll‟s head eye
LCD
movement, corneal ,reflex (both sides), gag reflex, cough (tracheal),
115
eye movements on caloric testing bilaterally, absence of motor
response in any cranial nerve distribution and apnoea test. Reversible
causes of coma should be excluded by all possible means namely
the absence of any intoxication (alcohol), depressant drugs and
neuromuscular blocking agents. Primary hypothermia, hypovolaemic
shock and metabolic and endocrine disorders should also be sought
for and excluded.
First medical examination ....6hrs..... Second medical examination

1st 2nd 1st 2nd
2min [patient has to be carefully examined twice after an interval of
about six hours]
LCD
Explain the
inclusion Inclusion Criteria of organ donation The teacher will What is the
criteria for explains inclusion inclusion
 Age : new born to 70 yrs (except for cornea, for cornea no age
organ criteria of organ criterion for
donation limitation ) donation to the organ
students. donation?
2min  Brain death or impending brain death with ventilator support.
 No evidence of history of IV drug abuse.
116
Explain the
contra The teacher will What are the
Contra indication for organ donation
indication explain the contra conditions
for organ 1) Absolute indications for contra
donation organ donation to indicated for
2) Relative
the students . organ
Absolute: donation?
a) Age older than 80 yrs
b) HIV, Hepatitis B ,and hepatitis c
c) Acute metastasis cancer
d) General bacterial and viral infection
e) Prolonged hypotension or hypothermia.
f) Disseminated intra vascular coagulation
g) Sickle cell anaemia or other haemoglobinopathy.
Relative
a) Malignancy other than in CNS or Skin that is in remission.
b) Hypertension.
5min
c) Diabetes mellitus
d) History of smoking. LCD
List the
factors
Factors affecting organ donation are.
117
affecting Gender, educational level, occupation, socio demographic status, The teacher will
organ income level, culture .religion. health status .time constraints. explain the
donation. various factors
which affect
organ donation to
the students . What are the
 Time constraints for Cadaver organ acquirement The students will factors which
listen the class. affects organ
Sl donation?
30 no Name of organ ,tissue Hours after death
min
1 Cornea Within 6 hrs
2 Heart valves Within 6 – 8hrs
3 Bone, skin and 48hrs
connective tissue
LCD
Discuss the
legal aspects LEGAL ASPECTS OF ORGAN DONATION
of organ
Donation. THE TRANSPLANTATION OF HUMAN ORGANS ACT 1994 ,
The organ transplantation acts comes under public law. The students will
listen the class
An Act to provide for the regulation of removal, storage and and write down What are the
transplantation of human organs for therapeutic purposes and for the the notes. things organ
transplantation
prevention of commercial dealings in human organs and for matters act deals with?
connected therewith or incidental thereto.
The teacher will
explains the legal
118
aspects of organ
donation to the
Reason for legislation
students .
There has been a persistent demand for such a legislation in LCD
parliament and from various national bodies ,medical and social
experts ,particularly when reports about commercial dealings in
human organs especially kidneys have increased .their has been
persistent demand for prohibiting this unethical practise .another The students
will listen the
thing is absent of any legal sanction ,the removal of organs from
class and write
persons suffering brain death has not been possible down the notes .
There are seven chapters included in the Act

CHAPTER 1:
it deals with the title, commencement and definitions.
1) Brain-stem death: means the stage at which all functions of the

brain-stem have permanently and irreversibly ceased and is so
certified by a medical practitioner . LCD
2) Deceased person: means a person in whom permanent

disappearance of all evidence of life occurs, by reason of brain-stem
death or in a cardio-pulmonary sense, at any time after live birth has
taken place;
119
3) Donor: means any person, not less than eighteen years of age, who
voluntarily authorises the removal of any of his human organs for
therapeutic purposes.
4) Hospital: includes a nursing home, clinic, medical centre, medical
or teaching institution for therapeutic purposes and other like
institution;
5) Human organ: means any part of a human body consisting of a
structured arrangement of tissues which, if wholly removed, cannot
be replicated by the body;
6) Near relative means: spouse, son, daughter, father, mother, brother
or sister;
7) Recipient: means a person into whom any human organ is, or is
proposed to be, transplanted .
8) Transplantation: means the grafting of any human organ LCD
from any living person or deceased person to some other
living person for therapeutic purposes.
9) Therapeutic purposes: means systematic treatment of any
disease or the measures to improve health according to any
particular method or modality.
120
CHAPTER : 2
It discuss the Authority for the removal of human organ .
1) Any donor may, in such manner and subject to such conditions as

may be prescribed, authorise the removal, before his death, of any
human organ of his body for therapeutic purposes.
2) If any donor had, in writing and in the presence of two or more
witnesses (at least one of whom is a near relative of such person),
unequivocally authorised at any time before his death, the removal of
any human organ of his body, after his death, for therapeutic
purposes .
3) Authority for removal of human organs in case of unclaimed

bodies in hospital or prison.—
In the case of a dead body lying in a hospital or prison
and not claimed by any of the near relatives of the deceased person
within forty-eight hours from the time of the death of the concerned
person, the authority for the removal of any human organ from the
dead body which so remains unclaimed may be given, in the
prescribed form, by the person in charge.
121
4) . Preservation of human organs.
After the removal of any human organ from the body of
any person the registered medical practitioner shall take such steps
for the preservation of the human organ so removed as may be
prescribed.
Organ tissue Preservation time Age criteria How many

hours kidney
Kidney 48 -72 hrs 6 months – 65 yrs can be
preserved?
Heart 4 – 6 hrs New born – 55yrs
Lung 4 – 6 hrs 12 -55 yrs
Pancreas 12 – 24 hrs 1 yrs – 60 yrs
Corneas 96 hrs No age limit
Bone marrow Up to 3 yrs 15m-65 yrs
Skin 5 yrs or more Max 70 yrs

.person need to
have 5 feet tall
and weight 100
pound.
122
Bone 5yrs or more 15 -65 yrs
Liver Up to 24 hrs Term new born -

56 yrs
[Note :If the dead body is lying in mortuary ,then we can remove
eyes up to 96 hours depending upon condition of cornea]
LCD
5) Restrictions on removal and transplantation of human organs.--

No human organ removed from the body of a donor
before his death shall be transplanted into a recipient unless the
donor is a near relative of the recipient.
CHAPTER : III
This chapter deals with the Regulation of hospitals.
1) Regulation of hospitals conducting the removal, storage or

transplantation of human organs.
a) no hospital, unless registered under this Act, shall conduct, or
associate with, or help in, the removal, storage or transplantation of
any human organ.
2) Prohibition of removal or transplantation of human organs for
123
any purpose other than therapeutic purposes. -- No donor and no
person empowered to give authority for the removal of any human
organ shall authorise the removal of any human organ for any
purpose other than therapeutic purposes.
3) Explaining effects, etc., to donor and recipient. -- No registered
medical practitioner shall undertake the removal or transplantation of
any human organ unless he had explained, in such manner as may be
prescribed, all possible effects, complications and hazards connected
with the removal and transplantation to the donor and the recipient
respectively.
CHAPTER : 1V
It deals with the APPROPRIATE AUTHORITY
1) The Central Government and state shall appoint, by notification,

one or more officers as Appropriate Authorities for each of the
Union territories for the purposes of this Act.
2) Authorisation Committee should be hospital based in metro and
big cities .if the number of transplants exceed 25 in a year at
respective transplantation centre . In smaller town there are state or
124
district level committee if transplant less 25 in a year in respective
districts .
Composition of state or district level, authorisation committee ( to be
constituted by state govt and incase of union territory by central
govt .
a) A medical practitioner officiating as chief medical officer or any
other equivalent post in main /major govt hospital of district .
b) Two senior medical practitioner s to be chosen from the pool of such
medical practitioners who are residing in the concerned district and
who are not part of any transplantation team .
c) Two senior citizens ,non medical background (one lady )of high
reputation and integrity to be chosen from the pool of such citizens
residing in same district, who have served in high ranking
government positions ,such as in higher judiciary ,senior cadre of
police service or who have served as a reader or professor in
university grant commission approved university or are self
employed professionals of repute such as lawyers ,chartered
accountants and doctors .
d) Secretary (health) or nominee and Director Health Services or
nominee.
[ The format of authorisation committee approval should be uniform
125
in all institutions in a state .the format may be notified by respective
state Government.]
CHAPTER : V
Registration Of Hospitals
1) Registration of hospitals engaged in removal, storage or
transplantation of human organs.-- No hospital shall commence
any activity relating to the removal, storage or transplantation of any
human organ for therapeutic purposes after the commencement of
this Act unless such hospital is duly registered under this Act.
2) Certificate of registration. –
The Appropriate Authority shall, after holding an

inquiry and after satisfying itself that the applicant has complied
with all the requirements of this Act and the rules made there
under, grant to the hospital a certificate of registration in such
form, for such period and subject to such conditions as may be
prescribed.
Conditions for grant of certificate of registration

126
No hospital shall be granted a certificate of registration under the
act unless it fulfills the following requirement of man power
equipment specialized services and facilities as laid down below.
A) GENERAL MAN POWER REQUIREMENT

SPECIALISED SERVICES
1) 24 hrs availability of medical and surgical(senior and junior staff )

2) 24 hrs availability of nursing staff (general and specialty trained)
3) 24 hrs availability of intensive care units with adequate
equipments and support system, including specialist in
anesthesiology, intensive care.
4) 24 hrs availability of laboratory with multiple discipline testing
facilities not limited to Microbiology, Bio-chemistry, pathology
and hematology and radiology department with trained staff.
5) 24 hrs availability of operation theatre facilities ( OT facilities )
for planned and emergency procedures with adequate staff
,support system and equipments .
6) 24 hrs availability of communication system, with power back up,
including but not limited to multiple line telephones ,public
127
telephone system,fax,computers and paper photo imaging
machine .
7) Experts ( other than the experts required for relevant
transplantation) of relevant and associated specialities including
but not limited and depending ,upon the requirements ,the experts
in internal medicine ,diabetology, gastroenterology ,nephrology
,neurology, paediatrics ,gynaecology, immunology and cardiology
etc should be available in the transplantation centre .
B) EQUIPMENTS
1) Equipments as per current and expected scientific requirements
specific to organ or organ being transplanted .the transplanted
centre should ensure the availability of the accessories ,spare
parts and backups /maintenance/service support system in relation
to all relevant equipments.
C) EXPERTS AND THEIR QUALIFICATIONS
1) Kidney Transplantation
128
M .S(GEN ) SURGERY or equivalent qualification with three years
post M.S. training in a recognized center in India or abroad and
having attended to adequate number of renal transplantation as an
active member of team.
2) Transplantation of liver and other abdominal organs
M.S.(GEN.) Surgery or equivalent ,qualification with adequate
post M.S. training in an established center with a reasonable
experience of performing liver transplantation as an active member
of a team.
3) Cardiac , Pulmonary ,Cardiopulmonary Transplantation
M.Ch. Cardio-thoracic and vascular surgery or equivalent
,qualification in India or abroad with at least 3 years experience as
an active member of the team performing an adequate number of
open heart operations per year and well-versed with coronary by-
pass surgery and heart valve surgery .
4) Cornea Transplantation
M. D./ M.S Ophthalmology or equivalent qualification with one
year post M.D/M.S.training in a recognised hospital carrying out
corneal transplant operations.
129
3) Suspension or cancellation of registration .
The Appropriate Authority may, suo moto or on

complaint, issue a notice to any hospital to show cause why its
registration under this Act should not be suspended or cancelled
for the reasons mentioned in the notice. If, after giving a
reasonable opportunity of being heard to the hospital, the
Appropriate Authority is satisfied that there has been a breach of
any of the provisions of this Act or the rules made thereunder, it
may, without prejudice to any criminal action that it may take
against such hospital, suspend its registration for such period as it
may think fit or cancel its registration
CHAPTER : VI
1) Punishment for removal of human organ without authority.
Any person who renders his services to or at

any hospital and who, for purposes of transplantation, conducts,
associates with, or helps in any manner in, the removal of any
human organ without authority, shall be punishable with
imprisonment for a term which may extend to five years and with
130
fine which may extend to ten thousand rupees.
2) Punishment for commercial dealings in human organs.
Whoever --
a. makes or receives any payment for the supply of, or for an

offer to supply, any human organ,
b. seeks to find a person willing to supply for payment any human

organ ;
c. offers to supply any human organ for payment;
d. initiates or negotiates any arrangement involving the making of

any payment for the supply of, or for an offer to supply, any
human organ;
e. takes part in the management or control of a body of persons,

her a society, firm or company, whose activities consist of or
include he initiation or negotiation of any arrangement referred
to in clause (d); or publishes or distributes or causes to be
published or distributed any advertisement,-- a. inviting
1min persons to supply for payment of any human organ; offering to
131
supply any human organ for payment; or indicating that the
advertiser is willing to initiate or negotiate any arrangement
referred to in clause (d),
Shall be punishable with imprisonment for a term which shall

LCD
not be less than two years but which may extend to seven years
and shall be liable to fine which shall not be less than ten
thousand rupees but may extend to twenty thousand rupees:
CHAPTER VII
Miscellaneous
1) Protection of action taken in good faith.
 No suit, prosecution or other legal proceeding shall lie against any
person for anything which is in good faith done or intended to be
done in pursuance of the provisions of this Act.
 No suit or other legal proceeding shall lie against the Central
Government or the State Govemment for any damage caused or likely
to be caused for anything which is in good faith done or intended to
be done in pursuance of the provisions of this Act.
2) Power to make rules.

132
The Central Government may, by notification, make rules for
carrying out the purposes of this Act.
List the
organ
Organ donation registries in India
donation The teacher will list
registries in down the organ Which are the
India. registries India. organ donation
National level registries registries in
The students will India ?
State level registries
listen the class.
3min
Hospital level registries
1) Indian society of organ transplantation

(http://www.transplantindia.com/ )
2) The Zonal Coordination Committee of Karnataka for Transplantation
(http://www.zcck.in/)
LCD
3) Multi Organ Harvesting aid Net Work( MOHAN FOUNDATION )
( http://www.mohanfoundation.org/inos/index.asp)
4) Mysore Eye Bank And Research Centre
133
1205, Kantharaj Urs Road, Chamrajapuram, Mysore,
Karnataka 570005 , Phone : 0821 233 1216
2min
Explain the
Nurses role in organ donation
2min role of nurse The teacher will
in organ 1) Undergo education about all aspects of brain death and organ explain the nurses What are the
donation. donation . role in organ nurses
donation to the responsibilities
2) Acquire knowledge and skills to be able to work with the healthy students . in organ
team. donation
The students will process?
3) Be knowledge of ethical cultural, religious and social issues. listen the class
134
4) Support organ and tissue donation programme.
5) Receive in-service training and gain knowledge through experience.
6) Be prepared in detail to guide to this task by means of giving
brochure.
7) The therapeutic end-points for adequate tissue perfusion are
summarized by Gelb and Robertson, as follows:
Rule of 100‟s: SBP >100 mm Hg
U /O >100 ml / hr
PaO2 >100 mm Hg
Hb >100 gm / L
Avoiding lactic acidosis (pH = 7.35 – 7.45) and hypothermia

o
(temperature > 34 C).
8) Be familiar with the type of donation and donation criteria know the
agency policy and contact local tissue and organ bank to determine
eligibility.
9) Deflate myths, encourage the truth.
10) Reassure the family bereavement.
Conclusion
Organ and tissue transplant offer patients a new chance of health
productive normal lives and return them to their families, friends
The teacher will
135
and communities .The need for donor is much greater than actual conclude the class
number of donors our commitment to organ donation can save lives after asking
,we have the power and right to change some ones world . questions and
Recapitulation clarifying the doubts
1) Which is the organ s which can be donated?
2) Which is the contra indicated conditions for organ donation?
3) How many chapters are their in organ transplantation act?
4) How many hour kidneys can be preserved?
5) What are the criteria for conducting organ transplantation in a
hospital?
Bibliography
1) Lewis l Sharon ,Margret Mclean Heitkemper ,et.al ,Text book of Medical and Surgical Nursing India MOSBY publications 7th edition
2009..Page number 236-240,155,1225-1230.
2) Brunner and suddharth „s text book of medical and surgical nursing ,Lippincott William Wilkins 10th edition page number 1916,1330,1335
3) Leo C Ginna,Benedict cosimi, Organ Transplantation,1st edition, Weleys John& sons publishers, page number-271-285
4) THE TRANSPLANTATION OF HUMAN ORGAN ACT, 1994, BARE ACT, PROFESSIONAL BOOK PUBLISHERS NEW DELHI.
Internet references
136
1) http://en.wikipedia.org/wiki/Organ_donation
2) http://www.nlm.nih.gov/medlineplus/organdonation.html
3) http://www.mohanfoundation.org/
4) http://www.transplantindia.com/
5) http://www.zcck.in/
6) http://www.donateyourorgan.com/organdonation/aboutorgandonation.aspx
7) http://www.jnrt.info/ojs/index.php?journal=jnrt&page=article&op=viewFile&path[]=16&path[]=27
8) http://www.donateyourorgan.com/donateyourorgan/organdonation/organdonationprocess.aspx
9) http://www.sgrh.com/subcat.aspx?id=51
10) http://www.dcids.org/dci_process.html
11) http://www.visioncareindia.com/donateeyes.html
137
Annexure - 11
STATISTICAL FORMULA USED IN THE STUDY
1) Arithmetic Mean :
ΣfX / Σf
2) Standard deviation
SD = (x- x )2
 n-1
3) Karl pearsons
4) Spearman-Brown Prophecy formula
2r
r1 
1 r
5) Paired „t‟ test
6) Chi square test
138
139
Annexure 12 Audio visual Aids
Organs for Donation

Definition
Organs commonly Tissues
 Organ donation transplanting
Organ donation is defined as a surgery heart, whole blood components tendon
which involves the replacement of lung,

ligament fascia, duramater, corneas,
connective tissue, skin heart valves,
diseased and defective organ and tissues
 liver bone , bone marrow and blood
with healthy from donors. vessels .
 intestine,
kidney
pancreas.
140
LEGAL ASPECT S OF ORGAN
DON AT ION Chapter 1
 THE TRANSPLANTATION OF HUMAN  it deals with the title, commencement and
definitions.
ORGANS ACT 1994
 organ transplantation acts comes under  Brain-stem death: means the stage at which
public law . all functions of the brain-stem have permanently
and irreversibly ceased and is so certified by a
 There are seven chapters included in the medical practitioner .
Act  Deceased person: means a person in whom
permanent disappearance of all evidence of life
occurs, by reason of brain-stem death or in a
cardio-pulmonary sense, at any time after live
birth has taken place;
CH APT ER : 2 CH APT ER : III
 It discuss the Authority for the removal  This chapter deals with the Regulation of
of human organ . hospitals .
 Authority for removal of human
organs in case of unclaimed bodies in  Regulation of hospitals conducting
hospital or prison. the removal, storage or
 Preservation of human organs. transplantation of human organs.
 Restrictions on removal and
transplantation of human organs.--
141
CH APT ER :V
CH APT ER : 1V Registration Of H ospitals
 Registration of hospitals engaged in
 It deals with the APPRO PRIAT E
AU T H O RIT Y. removal, storage or transplantation
 Composition of state or district level, of human organs.-- No hospital shall
authorisation committee ( to be constituted by
state govt and incase of union territory by central commence any activity relating to the
govt . removal, storage or transplantation of any
 A medical practitioner officiating as chief medical
officer or any other equivalent post in main human organ for therapeutic purposes
/major govt hospital of district . after the commencement of this Act
 Two senior medical practitioner s to be chosen unless such hospital is duly registered
from the pool of such medical practitioners who
are residing in the concerned district and who are under this Act.
not part of any transplantation team .
CH APT ER : VI
CH APT ER VII
Punishment for removal of human Miscellaneous
organ without authority.  Protection of action taken in good faith.
 N o suit, prosecution or other legal
 Punishment for commercial proceeding shall lie against any person for
dealings in human organs. anything which is in good faith done or
intended to be done in pursuance of the
provisions of this Act.
 N o suit or other legal proceeding shall lie
against the Central Government or the
State Govemment for any damage caused
or likely to be caused for anything which is
in good faith done or intended to be done
in pursuance of the provisions of this Act.
142
143
Demographic representation ANNEXURE –13 Master data sheet
CODE NO Age Gender Religion Qualification Present area of Experience Nurses Previous
experience designation source of
information
1 A B A B A B A C
2 B B A A B D A C
3 B A A A C C A D
4 D B A A C D C C
5 A A A A A C A C
6 C B A A B D A C
7 A B A A A A A D
8 B B A A B D A B
9 A A B A B A A C
10 A B A A A A A A
11 A B A A A D A C
12 A B B B A B A A
13 A B B B A B A A
14 A B A A A A A C
15 A B A A B D A C
16 A B A A B A A B
17 A B A A A D A A
18 B A B A B D B C
19 A A B A C D A C
20 B B B A A C A A
21 B A A A A C A C
22 A B B B A C A B
23 A C C B A A A E
24 B B B A A D A C
25 A B B A A B A D
26 A B A A B B A C
27 B B A A A C A C
28 C B A A A D A C
29 B B A A A D A C
30 A B A A A C A C
144
31 A B B B A A A C
145
32 A B A A A D A C
33 B A A A A C A B
34 A B A A B A A C
35 A B A A A C A C
36 B A A A A D A C
37 A B B B A A A B
38 A B D A A B A B
39 B B B A A D A B
40 A B A A A B A B
41 D B B B B D C C
42 D B B B A D C C
43 A B B A A C A C
44 A B B A A B A C
45 B B B A C D C C
46 A B B A A B A C
47 A B B B A A A C
48 A B B A A A A B
49 A B D B A B A D
50 A A B B A D A D
51 A B B B A A A B
52 A B A A A B A C
53 A B A A A B A C
54 D B B A A D A C
55 A B B B A B A D
56 A B B B A B A D
57 A B B B A C A D
58 A B B B A B A D
59 D B A A A D C D
60 D B B A A D C A
146
Pre – test knowledge Score
QST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 1 1 0 0 1 1
2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0 0 0
3 1 1 1 1 0 1 1 1 1 0 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1
4 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 0 0 1 1 0 1 0 0 0
5 1 1 0 1 1 1 0 1 1 0 1 0 0 0 0 1 1 0 1 1 0 1 1 0 0 0 0 1 1 1
6 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1
7 0 1 0 1 1 1 0 0 0 1 1 0 1 1 1 1 0 1 1 0 1 0 1 0 1 0 0 1 1 1
8 1 1 1 1 0 1 0 0 0 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 1 1
9 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0
10 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0
11 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
12 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
13 1 1 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 0 0 1 0 1 1 0 1 0 0 0
14 0 0 0 1 1 1 1 1 1 1 0 1 1 0 0 0 1 1 1 1 0 1 1 1 1 0 0 1 1 1
15 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
16 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
17 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1
18 0 1 0 0 0 1 0 0 0 1 1 1 0 11 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0
19 0 1 0 1 0 1 0 1 0 0 0 0 0 1 1 1 0 1 0 1 0 1 0 1 1 1 1 1 0 0
20 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 0 1 0 0 0
21 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 1 1 0 0 1 1 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 1 0 1 0 0 0 0 0
23 1 1 0 0 1 1 1 1 1 1 0 1 0 0 0 1 0 1 1 0 0 1 0 0 1 0 0 0 0 1
24 1 1 0 0 0 1 0 0 1 0 0 0 1 0 1 0 1 0 0 1 1 0 0 0 1 1 0 1 0 0
25 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0
147
Pre test knowledge score continues
Q 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1 1 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1
2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1
3 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1
4 0 1 0 1 0 0 0 1 1 1 1 1 0 0 1 0 1 1 1 1 0 1 1 1 0 0 0 0 1 1
5 1 0 0 0 0 1 1 1 0 1 0 0 0 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
6 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 0
7 1 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 1 1 1 1 7 1 1 0 1 1 1 1 1 1
8 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1
9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
10 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0
11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 1
13 0 1 1 1 0 0 1 1 0 0 0 0 1 1 0 1 1 0 0 0 0 1 0 0 1 1 0 0 1 1
14 1 1 0 0 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
15 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0
17 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 0 0 1 1 1 0 0 0 0
18 0 1 1 0 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 0 0 0 0 1
19 0 1 0 1 0 0 1 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0
20 0 0 1 0 1 0 0 0 1 0 1 1 0 0 0 1 0 1 1 1 0 0 0 0 0 1 0 0 1 0
21 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 0 1 0 1 0 0 1 1 1 1 0 0 0 1 1 0 1 1 1 1 0 0 1 1 1 1 0 0 1 1
23 1 0 1 0 0 0 0 1 1 1 0 1 0 0 1 0 1 0 1 1 0 1 1 1 1 1 1 1 0 0
24 0 0 0 1 1 0 1 0 0 0 0 0 1 0 1 0 1 1 1 0 0 1 0 0 0 1 1 1 0 0
25 0 0 1 0 0 0 1 0 1 1 0 0 1 1 0 1 1 0 1 0 0 0 0 1 0 0 0 0 1 0
148
Pre test attitude scores
QST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Samples
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1 3 3 3 3 3 3 3 4 4 3 3 3 4 4 3 4 3 4 4 1 3 3 2 4 3 3 4 1 3 3
2 1 3 4 0 4 3 3 3 4 0 4 3 4 3 4 1 2 4 4 3 3 3 4 3 4 3 3 1 2 1
3 3 3 3 1 3 3 4 1 3 0 4 4 3 1 4 1 1 4 3 3 0 4 4 4 4 0 4 0 1 3
4 2 2 1 1 2 1 3 3 1 1 1 1 2 0 1 0 0 1 1 4 3 2 4 1 1 1 0 1 0 1
5 2 2 3 4 3 3 4 3 3 3 3 0 0 4 4 4 2 4 1 3 4 3 4 3 3 3 3 0 3 1
6 3 1 3 3 3 3 3 4 2 3 2 4 4 4 4 4 3 4 3 3 3 3 2 3 1 4 3 1 3 2
7 0 2 2 3 0 1 4 1 2 3 2 4 2 4 4 3 3 3 3 1 4 2 1 1 4 1 1 1 2 1
8 4 3 2 4 4 3 0 0 4 2 1 4 4 3 3 1 3 4 1 1 1 0 1 3 0 2 1 0 1 0
9 2 3 2 1 3 3 1 1 1 1 1 1 1 1 2 2 1 1 1 1 1 1 0 1 1 1 1 1 1 2
10 3 3 2 3 4 2 2 3 2 1 3 3 2 3 4 3 3 3 3 3 3 2 0 3 3 3 3 1 2 1
11 3 3 3 1 2 3 4 2 3 1 3 2 3 3 4 3 3 3 3 3 3 2 1 3 4 3 3 1 3 3
12 4 2 1 1 2 3 2 1 1 1 3 3 2 3 1 3 0 1 2 3 0 2 2 3 1 1 2 1 1 2
13 4 3 3 3 3 3 3 3 2 2 3 4 3 3 3 3 3 1 3 3 1 3 1 4 3 3 4 1 2 3
14 1 1 3 3 2 1 2 3 4 2 1 3 4 3 4 3 3 3 3 3 3 2 3 2 1 3 3 0 1 2
15 3 3 3 1 3 3 4 1 2 1 2 4 1 0 0 0 4 4 3 1 1 3 3 3 4 1 4 1 1 2
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1 3 3 3 4 1 4 4 2 1 4 3 3 4 3 4 3 3 3 4 4 4 4 4 3 3 3 3 3 4 4
2 2 4 1 3 4 4 4 3 1 2 0 3 3 4 4 3 4 3 4 4 4 4 3 2 3 4 1 1 1 1
3 0 0 3 3 4 4 4 3 1 3 3 3 4 3 4 3 1 3 4 4 3 4 3 3 3 3 3 3 3 3
4 1 2 1 1 1 1 2 1 1 1 1 1 1 2 2 1 2 2 1 1 2 1 2 1 2 2 1 1 2 0
5 2 4 4 4 3 3 4 3 1 3 3 3 0 1 0 3 4 3 4 3 4 4 4 0 3 4 3 3 4 4
6 4 4 3 4 3 3 4 3 2 3 3 3 3 2 0 1 4 3 3 4 4 3 3 3 3 3 3 3 3 3
7 2 1 3 3 3 3 4 2 2 2 1 1 3 0 1 1 4 2 4 4 4 3 3 4 1 3 3 3 4 2
8 0 2 3 2 1 1 4 3 3 1 1 1 4 3 3 1 4 2 3 3 3 0 3 0 4 4 3 3 0 3
9 1 3 0 0 4 3 1 1 1 1 1 1 4 4 1 1 1 2 3 3 1 1 0 0 2 1 2 2 1 1
10 2 3 3 3 3 3 4 2 2 2 1 1 4 3 1 1 3 3 3 3 3 1 1 3 2 2 3 3 2 3
11 3 3 3 3 3 4 4 3 3 2 3 3 1 1 3 3 3 4 3 3 3 3 3 4 3 3 2 2 4 4
12 1 3 2 1 3 3 4 2 2 3 1 3 4 4 3 3 2 1 1 1 2 2 2 1 3 3 3 3 4 3
13 3 4 1 3 3 3 4 3 2 2 3 3 4 3 3 3 3 3 3 3 2 3 3 0 3 3 1 1 3 3
14 2 3 3 3 3 1 4 3 3 2 3 3 0 1 3 1 2 1 3 3 3 3 3 4 3 3 3 3 3 3
15 2 3 3 4 3 1 4 3 2 2 3 3 4 4 2 0 2 2 3 3 2 4 3 0 3 1 3 3 1 3S
Post test knowledge scores

149
1 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 1 1
2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1
3 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 0 0 1 1 1 1 1 1 0 1 1 0 0 0 1
4 0 1 0 1 0 1 1 1 1 1 1 1 1 1 0 1 0 1 1 0 1 1 0 1 1 0 1 1 1 1
5 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1
6 0 1 1 1 1 0 0 0 1 1 0 0 1 1 0 1 0 1 1 1 1 1 0 1 0 1 1 1 1 1
7 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
8 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1
9 1 1 1 1 1 1 1 0 0 0 0 1 1 1 1 1 1 0 0 0 1 0 1 1 1 0 0 0 0 0
10 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1
12 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1
13 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
14 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
15 0 1 1 1 0 1 1 1 0 1 1 1 0 0 0 1 0 0 1 1 1 1 0 1 1 0 1 1 1 1
16 0 1 1 1 0 1 1 1 1 1 1 0 1 1 0 1 0 0 1 1 0 1 0 0 1 1 0 1 0 1
17 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 0 1 1 1 1 1
18 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1
19 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 0 0 1 1 1 1 1 0 1 1 1 1 0 0 0
20 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 1 0 1 1 0 1 1 0 1 0 1 1 1 1 1
21 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0
22 1 0 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 0
23 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
24 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0
25 1 1 1 1 1 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 1 0 1 1 0 0 0 1 0 1
150
Post test knowledge continues
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 0 0 1 0 1 1 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0
4 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 0 0 1 1 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1
7 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
8 1 0 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1
9 0 0 0 1 1 1 1 1 1 1 1 1 0 1 0 1 1 0 0 0 0 1 0 0 0 0 1 1 0 1
10 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1
11 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
12 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
13 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
14 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
15 1 1 1 1 0 1 0 0 1 1 0 1 1 1 0 0 1 0 1 1 1 1 0 1 0 0 1 0 0 1
16 0 1 0 0 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 0 1 0 1 0 1
17 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1
18 1 0 1 1 1 0 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 0 1 1 0 1 1 0 1 1
19 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0
20 1 1 1 1 1 1 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 0 0 1 0
21 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1
22 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1
23 1 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
24 1 1 1 0 1 0 0 1 0 1 0 0 0 0 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 0
25 1 1 0 0 1 0 1 1 1 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 0
151
Post test attitude scores
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1 4 3 3 3 4 3 3 3 3 4 3 4 4 4 4 4 4 4 3 4 4 4 4 4 3 4 4 4 4 4
2 3 3 4 4 3 3 4 3 4 4 3 4 4 3 3 4 3 4 4 4 4 4 3 4 4 4 4 4 3 4
3 3 2 4 4 3 3 4 3 3 4 3 4 3 4 3 3 3 3 4 4 3 1 3 3 3 3 4 4 3 0
4 2 1 1 3 2 1 3 1 1 3 1 3 4 3 2 3 1 3 3 3 4 3 2 3 3 3 4 3 3 4
5 3 3 4 4 3 3 4 3 3 4 3 4 4 4 3 4 3 4 4 4 4 4 3 4 3 4 4 4 4 0
6 3 3 3 3 3 3 3 3 3 4 3 4 4 4 3 3 3 4 3 4 3 4 3 4 3 4 3 4 4 3
7 1 2 1 1 1 3 1 1 2 4 1 3 3 4 1 4 1 4 1 4 4 3 1 4 2 4 4 4 4 4
8 3 3 4 4 2 3 4 1 4 3 1 4 4 3 2 4 3 3 4 4 4 4 2 3 3 3 4 4 4 4
9 3 2 3 3 1 3 3 1 3 4 1 4 4 4 1 4 3 4 3 3 4 4 1 4 3 4 4 3 4 2
10 2 3 4 4 3 3 4 3 2 4 3 4 4 4 3 4 2 4 4 4 4 4 3 4 3 4 4 4 4 2
11 3 3 2 2 3 3 2 3 2 3 3 3 3 4 3 3 3 3 2 3 4 3 3 4 3 4 4 3 4 4
12 2 2 3 3 2 3 3 2 2 3 2 4 4 4 2 3 2 3 3 3 3 4 2 4 2 4 4 4 4 4
13 3 3 4 4 3 3 4 3 2 4 3 4 4 3 3 4 3 4 4 4 4 4 3 4 3 4 4 4 4 4
14 3 1 1 1 3 1 1 3 3 4 3 4 4 4 3 4 3 4 1 4 4 4 3 4 1 4 4 4 4 4
15 1 2 4 4 2 3 4 1 2 4 1 4 3 3 2 3 1 4 4 3 4 4 2 4 2 4 4 4 4 4
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1 4 4 4 4 4 4 4 3 4 4 4 3 4 4 4 4 4 3 4 3 4 4 4 4 4 3 4 4 0 3
2 3 4 4 4 3 4 4 3 4 4 4 3 3 4 3 4 4 3 4 4 4 3 4 4 4 3 4 4 4 4
3 3 4 4 3 4 4 4 3 4 3 4 1 4 4 3 4 4 3 3 1 4 4 4 4 3 3 4 3 4 4
4 4 4 4 3 3 3 1 1 4 1 4 0 2 4 4 3 4 3 1 0 4 1 1 3 1 3 4 1 1 3
5 4 4 4 4 2 3 4 3 3 3 4 3 3 4 3 4 4 3 3 4 4 4 4 4 3 3 4 3 4 4
6 4 4 4 3 4 4 4 3 4 3 3 3 3 4 4 4 4 3 3 3 4 4 3 4 3 3 4 4 1 3
7 3 4 4 4 1 4 0 4 3 4 3 2 2 3 4 4 3 2 4 3 3 2 2 4 4 2 3 4 2 4
8 4 4 3 4 1 4 4 4 0 3 3 3 3 4 4 4 4 3 3 4 4 4 3 4 3 3 4 4 4 4
9 4 3 3 4 3 4 1 3 3 4 4 3 3 3 3 4 4 3 4 4 4 3 3 4 4 3 4 1 4 3
10 4 4 4 4 3 4 4 3 4 4 4 4 3 4 4 3 3 3 4 3 3 3 3 4 4 3 4 4 4 4
11 3 4 3 3 3 4 4 3 4 4 3 4 2 4 4 3 4 3 4 4 4 3 4 4 4 3 4 4 4 4
12 4 4 4 3 2 3 4 3 3 3 4 3 3 3 4 3 4 2 3 3 4 2 1 3 3 2 3 3 4 2
13 4 3 4 4 3 4 4 4 4 4 3 4 3 3 4 4 4 3 4 4 4 4 4 3 4 3 4 2 4 4
14 4 4 4 4 3 4 4 3 4 4 4 4 0 4 4 4 4 2 4 4 4 3 4 4 4 2 4 3 4 4
15 4 4 4 4 2 3 4 1 3 0 4 4 3 4 3 4 4 3 0 4 4 4 0 4 0 3 4 1 4 4
152
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Organ Donation Leagal Aspects

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― A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE AND ATTITUDE

REGARDING LEGAL ASPECTS OF ORGAN DONATION AMONG STAFF

NURSES IN CRITICAL CARE AND EMERGENCY UNITS IN SELECTED

MR. ANAND .T.O

Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka

In partial fulfilment of requirements for the degree of

Master of Science in nursing

(Medical and Surgical Nursing)

Under the guidance of

Prof. Mrs. N.T ARUNADEVI

DEPARTMENT OF MEDICAL AND SURGICAL NURSING

BGS COLLEGE OF NURSING

DECLARATION BY THE CANDIDATE

effectiveness of structured teaching programme on knowledge and attitude

emergency units in selected hospitals at Mysore.‖ is a bonafide and genuine

Arunadevi, Principal and HOD of Medical Surgical Nursing .

Date : Signature of the candidate

Place: Mysore (Mr. Anand .T.O)

This is to certify that the dissertation entitled ― A study to assess the

effectiveness of structured teaching programme on knowledge and attitude

emergency units in selected hospitals at Mysore.‖ is a bonafide research work

done by Mr Anand.T.O in partial fulfilment of the requirement for the degree of

Master of science in Nursing ( Medical Surgical Nursing )

Date Prof. N T Arunadevi

Place: Mysore Principal

HOD, Medical Surgical Nursing

BGS College of Nursing

HEAD OF THE INSTITUTION

This is to certify that the dissertation entitled ―A study to assess the

effectiveness of structured teaching programme on knowledge and attitude

emergency units in selected hospitals at Mysore.‖ is a bonafide research work done

by Mr Anand.T.O under the guidance of Prof .NT Arunadevi, HOD, Medical

Seal and signature of HOD Seal and signature of Principal

Prof. N T Arunadevi Prof. N T Arunadevi

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Science,

thesis in print or electronic format for academic / research purpose.

Place: Mysore Anand. T. O

© Rajiv Gandhi University of Health Science, Karnataka

I express my thanks to Sri Sri Sri Balagangadranatha Maha Swamiji, President of

I express my sincere gratitude to Mrs. Nithya priya, Asst professor, Department of

My special thanks to Mr S.Balachandar HOD Psychiatry, Mr Arul V HOD

I express my thanks to the Nursing Superintends, and Administrators Apollo BGS

I express my thanks to Mr. Samuel Sudharshan.D, MA (English) for his valuable

I gratefully acknowledge the librarians of BGS college of Nursing, Rajiv Gandhi

I am indebted to Dr LANCY DI’ZOUSA, Professor, Maharaja College,

It gives me an immense pleasure and proudness to offer profound gratitude to my

Place: Mysore Anand. T.O

et.al : And Others

CCU : Critical care unit/ Coronary care unit

HCP : Health care personnel

ICU : Intensive care units

LRD : Living related donor

STP : Structured Teaching Programme

Organ shortage is a Global problem. Every day an average of 18 people are

personnel is one of the important measures to overcome this situation.

The objectives of the study were to assess the effectiveness of Structured

Teaching Programme on knowledge and attitude regarding legal aspects of organ

association between knowledge and attitude with selected background variables.

Apollo Hospital and Holdsworth Memorial Hospital, Mysore by using convenience

sampling. Structured questionnaire containing 25 items on knowledge and of 15

Teaching Programme on legal aspects of organ donation was administered to the

knowledge and attitude.