Quasi Experimental Pre Test And Post Test Design Essay
Quasi Experimental Pre Test And Post Test Design Essay
This chapter deals with the methodology adopted for the study. It includes the research design, variables, setting, population, sample, criteria for selection of the sample, sample size, sampling technique, development and description of the tool, content validity, pilot study, reliability of the tool, data collection procedure and plan for data analysis.
3.1 RESEARCH APPROACH
A Quantitative research approach was used to carry out the study.
3.2 RESEARCH DESIGN
Quasi experimental pre-test and post-test design was used in this study.
This chapter deals with the methodology adopted for the study. It includes the research design, variables, setting, population, sample, criteria for selection of the sample, sample size, sampling technique, development and description of the tool, content validity, pilot study, reliability of the tool, data collection procedure and plan for data analysis. Quasi Experimental Pre Test And Post Test Design Essay
3.1 RESEARCH APPROACH
A Quantitative research approach was used to carry out the study.
3.2 RESEARCH DESIGN
Quasi experimental pre-test and post-test design was used in this study.
According to Polit and Hungler (2011) the schematic representation of the design is given below
Group
Pre test
Intervention
Post test
Experimental
Assess the pre test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
Demonstration on breathing technique followed by video clippings.
Assess the post test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association. Quasi Experimental Pre Test And Post Test Design Essay.
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Control
Assess the pre test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
Hospital routine.
Assess the post test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
3.3 VARIABLES
Independent Variable
Breathing technique.
Dependent Variable:
Pulmonary function among asthmatic children.
Extraneous Variables:
Age, gender, type of family, education status of father and mother, education status of child, previous history of hospitalization, duration of asthma, history of any other respiratory illness, treatment , pet animals.
3.4 SETTING OF THE STUDY:
The study was conducted in Government General hospital , Vellore .
3.5 POPULATION:
Target population
The study population comprised of all asthmatic children between the age group of 6 to 12 years.
Accessible population
Accessible population includes, asthmatic children admitted at Government General hospital in Vellore, during the period of data collection.
3.6 SAMPLES:
The sample consists of children who fulfilled the inclusive criteria were selected for the study.
SAMPLE SIZE:
The sample size for the study comprised of 60 children with asthma who got admitted in the government general hospital, Vellore. Among 60 asthmatic children, 30 children were experimental group and 30 children were in control group.
SAMPLING TECHNIQUE:
Sampling technique adopted for this study was non probability purposive sampling technique.
CRITERIA FOR SAMPLE SELECTION
INCLUSIVE CRITERIA:
Asthmatic children in the age group of 6 to12 years.
Asthmatic children who were willing to participate in the study.
Asthmatic children who were categorized under mild and moderate grades by using peak flow meter.
Children who can understand english or tamil language. Quasi Experimental Pre Test And Post Test Design Essay.
EXCLUSIVE CRITERIA
Children who are critically ill.
Children who are mentally ill.
3.7 DEVELOPMENTAL AND DESCRIPTION OF TOOL
The tool was developed after the extensive review of literature and consultation with experts in order to select the suitable observational checklist. It consists of
PART I : DATA COLLECTION TOOL SECTIONS
PART II : INTERVENTION TOOL
PART I:
It consisted of three sections.
SECTION A : Demographic variables
Age, gender, type of family, education status of father and mother, education status of child, previous history of hospitalization ,duration of asthma, history of any other respiratory illness, treatment, pet animals. Quasi Experimental Pre Test And Post Test Design Essay.
SECTION B : Tool to assess the pulmonary function
Modified pulmonary index of guidelines for diagnosis and management of asthma in children given by American Medical Association.
The pulmonary index score consisted of
SNO
ITEMS
CRITERA
SCORE
1.
Respiratory rate
<20breath/min
21-35breath/min
36-50breath/min
>50breath/min
1
2
3
4
2.
Heart rate
<100 b/min
101-110b/min
111-120b/min
>120b/min
1
2
3
4
3.
Wheezing
None
Terminal expiration with stethoscope
Entire expiration with stethoscope
Inspiration &expiration
Without stethoscope
1
2
3
4
4.
Peak flow reading
90-100%
80-89%
60-79%
<60%
1
2
3
4
5.
Accessory Muscle Use
No apparent increase
Mild Increase
Increased
Maximal activity
1
2
3
4
SCORE INTERPRETATION
1 – 5 – normal
6 – 10 – mild impairment
11- 15 – moderate impairment
16- 20 – severe impairment
PART B: INTERVENTION TOOLS
The selected nursing intervention included simple breathing technique such as
1. Humming Breathing
2. Diaphragmatic Breathing
3. Buteyko Breathing
4. Whistle Blowing
Procedure:
S:NO
EQUIPMENT
RATIONALE
1.
2.
Peak flow meter
Pen, notebook
To assess the pulmonary function.
To record the findings. Quasi Experimental Pre Test And Post Test Design Essay.
INTERVENTION:
S:NO
ACTION
RATIONALE
1.
2.
3.
4.
5.
Establish interpersonal relationship with child and parents.
Explain the procedure to the child and parents.
Get consent from the parents to assess the effectiveness of breathing exercise on pulmonary function.
The Children those who had mild and moderate asthma invited to play therapy room and was provided the selected intervention like humming, Diaphragmatic breathing, Buteyko and whistle blowing breathing exercises.
Willing Children and parents were instructed to come to play therapy room at morning 8am -12noon. Quasi Experimental Pre Test And Post Test Design Essay.
Humming breathing:
It involves a short inhalation and long exhalation while making a humming sound which enhance exhalation 2-3 times for 5 to 10 minutes.
Diaphragmatic breathing :
It involves slow deep inhalation then hold for 2 seconds and exhaled completely while placing the child’s palm over the chest and abdomen each 8seconds and practice for 5to10 minutes.
Buteyko breathing technique:
It is a set of simple breathing exercises which includes,
Step 1: Take two normal breath and hold for 30 -45sec then breath out is called control pause.
Step 2 : Breath only using nose for five minutes and take control pause then breath through nose.
Repeat 1 -2 times for 5 to 10minutes.
Whistle blowing by lips:-
It includes slow inspiration and fast expiration through a pursed lip which produces sound. It practice for 2-4 times about 2 minutes.
These was done at 8am and 12 noon with the duration of 10 minutes to 30 minutes preferably half an hour before 2-3 times a day for consecutive days
Children are encouraged to practice the breathing technique for 3 days along with hospital routine.
After 3-4 days of intervention post assessment was done using same tool.
To gain confidence and trust.
To gain cooperation.
To maintain ethical aspect of study
To assess the effectiveness of selected nursing intervention.
It allows for chest expansion & improve the level of pulmonary function.
Regular practice increases the depth of respiration.
To assess the effectiveness of breathing exercises.
In experimental group, hospital routine with breathing technique was practiced and in control group only hospital routine was practiced.Quasi Experimental Pre Test And Post Test Design Essay.
CONTENT VALIDITY
Content validity of the tool was ascertained from the experts in the field of expertise.
Nursing experts – 3
Paediatrician – 2
Pediatric pulmonologist – 1
All the expert’s suggestion were incorporated in the tool to conduct the study.
3.8 PILOT STUDY
The pilot study was conducted for a period of one week after obtaining formal consent from the Principal, Omayal Achi College of Nursing, the research committee ICCR and the Medical Director of government general hospital, Walajah. The hospital superintendent and ward in charge sister were informed regarding the conduction of study. Data pertaining to demographic variables were collected by interview method from parents and physician records.
The investigator introduced themselves and gave information regarding the nature of the study to each of the selected children and their parents so as to get their co-operation in the procedure of data collection. Quasi Experimental Pre Test And Post Test Design Essay. After obtaining the consent, pre test level of pulmonary function was assessed using modified pulmonary index score.
For experimental group the investigator selected 5 children by using non probability purposive sampling technique. Children were invited to play therapy room and administered selected nursing interventions such as simple breathing techniques each one had 3-10 minutes interval of about 30-40 minutes morning afternoon and evening, before intake of food was given along with hospital routine for 3-4 days. The investigator assessed the post test level of pulmonary function by using the same tool after three days.
For control group the hospital routine was followed and post test was done after 3 days of pre test using the same scale. The findings of the pilot study data showed that the experimental group had significant effect in improvement on pulmonary function after than control group at p<0.001.The findings of the pilot study showed that the feasibility and practicability to conduct the main study. The report was presented to ICCR and after the concurrence of the committee members the investigator proceeded with main study.
RELIABILTY
The reliability of the tool was assessed using inter rater method. The reliability score was r =0.90, which showed the tool was highly reliable to be used for the main study data collection.
PROCEDURE FOR DATA COLLECTION
The data collection for the main study was done at government general hospital , Vellore. Formal administrative approval was obtained from the Principal, Omayal Achi College , ICCR ethical committee ,Director of general government hospital Vellore, Head of the department, Child health nursing. Ethical clearance certificate and no harm certificate were obtained before the data collection. The information collected from the parents was kept confidential. Data collection was done for the period of four weeks.
Children were selected based on sample selection criteria and grouped by non probability purposive sampling. The data collection procedure began by identifying the number of children who came for admission with asthma and severe symptoms. Quasi Experimental Pre Test And Post Test Design Essay. They required simple breathing exercise such as hummimg , diaphgramatic, butekyo and whistle blow through lip breathing exercise. Asthma severity score scale prepared and kept for use.
Self introduction about investigator and information regarding the nature of the study was explained to each of selected children and their parents so as to get their co-operation in the procedure of data collection. After obtaining the consent pre test level of pulmonary function was assessed using modified pulmonary index score. In experimental group, children were invited to play room and administered selected nursing intervention such as simple breathing technique are humming, diaphgramatic, butekyo and whistle blowing through lips each one take 3-5 minutes interval over for 30 -40 minutes twice a day. The investigator assessed the post test level of pulmonary function using the same tool on 3rd day.
In control group hospital routine was followed and post intervention assessment was done after 3 days of pre assessment using modified pulmonary index score. For uncooperative children parents were invited to stay with the children .The same procedure and instruction were carried on all study participants.
3.9 PLAN FOR DATA ANALYSIS :
Data collected were analyzed by using both descriptive and inferential statistics.
Descriptive statistics:
Frequency and percentage distribution were used to analysis the demographic variables.
Mean and standard deviation was used to assess the effectiveness of breathing technique in pulmonary function.
Inferential statistics :
Unpaired ‘t’ test was used to compare the pre & post intervention level of pulmonary function of asthmatic children.
Paired ‘t’ test was used to find out effectiveness of breathing techniques and hospital routine. Quasi Experimental Pre Test And Post Test Design Essay.
Chi square test was used to find out the association of mean differed level of pulmonary function with selected demographic variabl.
According to Polit and Hungler (2011) the schematic representation of the design is given below
Group
Pre test
Intervention
Post test
Experimental
Assess the pre test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
Demonstration on breathing technique followed by video clippings.
Assess the post test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
Control
Assess the pre test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association.
Hospital routine.
Assess the post test level of pulmonary function by using modified asthma severity pulmonary index score given by American medical association. Quasi Experimental Pre Test And Post Test Design Essay.
3.3 VARIABLES
Independent Variable
Breathing technique.
Dependent Variable:
Pulmonary function among asthmatic children.
Extraneous Variables:
Age, gender, type of family, education status of father and mother, education status of child, previous history of hospitalization, duration of asthma, history of any other respiratory illness, treatment , pet animals.
3.4 SETTING OF THE STUDY:
The study was conducted in Government General hospital , Vellore .
3.5 POPULATION:
Target population
The study population comprised of all asthmatic children between the age group of 6 to 12 years. Quasi Experimental Pre Test And Post Test Design Essay.
Accessible population
Accessible population includes, asthmatic children admitted at Government General hospital in Vellore, during the period of data collection.
3.6 SAMPLES:
The sample consists of children who fulfilled the inclusive criteria were selected for the study.
SAMPLE SIZE:
The sample size for the study comprised of 60 children with asthma who got admitted in the government general hospital, Vellore. Among 60 asthmatic children, 30 children were experimental group and 30 children were in control group.
SAMPLING TECHNIQUE:
Sampling technique adopted for this study was non probability purposive sampling technique.
CRITERIA FOR SAMPLE SELECTION
INCLUSIVE CRITERIA:
Asthmatic children in the age group of 6 to12 years.
Asthmatic children who were willing to participate in the study.
Asthmatic children who were categorized under mild and moderate grades by using peak flow meter.
Children who can understand english or tamil language.
EXCLUSIVE CRITERIA
Children who are critically ill.
Children who are mentally ill.
3.7 DEVELOPMENTAL AND DESCRIPTION OF TOOL
The tool was developed after the extensive review of literature and consultation with experts in order to select the suitable observational checklist. Quasi Experimental Pre Test And Post Test Design Essay. It consists of
PART I : DATA COLLECTION TOOL SECTIONS
PART II : INTERVENTION TOOL
PART I:
It consisted of three sections.
SECTION A : Demographic variables
Age, gender, type of family, education status of father and mother, education status of child, previous history of hospitalization ,duration of asthma, history of any other respiratory illness, treatment, pet animals.
SECTION B : Tool to assess the pulmonary function
Modified pulmonary index of guidelines for diagnosis and management of asthma in children given by American Medical Association.Quasi Experimental Pre Test And Post Test Design Essay.
The pulmonary index score consisted of
SNO
ITEMS
CRITERA
SCORE
1.
Respiratory rate
<20breath/min
21-35breath/min
36-50breath/min
>50breath/min
1
2
3
4
2.
Heart rate
<100 b/min
101-110b/min
111-120b/min
>120b/min
1
2
3
4
3.
Wheezing
None
Terminal expiration with stethoscope
Entire expiration with stethoscope
Inspiration &expiration
Without stethoscope
1
2
3
4
4.
Peak flow reading
90-100%
80-89%
60-79%
<60%
1
2
3
4
5.
Accessory Muscle Use
No apparent increase
Mild Increase
Increased
Maximal activity
1
2
3
4
SCORE INTERPRETATION
1 – 5 – normal
6 – 10 – mild impairment
11- 15 – moderate impairment
16- 20 – severe impairment
PART B: INTERVENTION TOOLS
The selected nursing intervention included simple breathing technique such as
1. Humming Breathing
2. Diaphragmatic Breathing
3. Buteyko Breathing
4. Whistle Blowing
Procedure:
S:NO
EQUIPMENT
RATIONALE
1.
2.
Peak flow meter
Pen, notebook
To assess the pulmonary function.
To record the findings.
INTERVENTION:
S:NO
ACTION
RATIONALE
1.
2.
3.
4.
5.
Establish interpersonal relationship with child and parents.
Explain the procedure to the child and parents.
Get consent from the parents to assess the effectiveness of breathing exercise on pulmonary function.
The Children those who had mild and moderate asthma invited to play therapy room and was provided the selected intervention like humming, Diaphragmatic breathing, Buteyko and whistle blowing breathing exercises. Quasi Experimental Pre Test And Post Test Design Essay.
Willing Children and parents were instructed to come to play therapy room at morning 8am -12noon.
Humming breathing:
It involves a short inhalation and long exhalation while making a humming sound which enhance exhalation 2-3 times for 5 to 10 minutes.
Diaphragmatic breathing :
It involves slow deep inhalation then hold for 2 seconds and exhaled completely while placing the child’s palm over the chest and abdomen each 8seconds and practice for 5to10 minutes.
Buteyko breathing technique:
It is a set of simple breathing exercises which includes,
Step 1: Take two normal breath and hold for 30 -45sec then breath out is called control pause.
Step 2 : Breath only using nose for five minutes and take control pause then breath through nose.
Repeat 1 -2 times for 5 to 10minutes.
Whistle blowing by lips:-
It includes slow inspiration and fast expiration through a pursed lip which produces sound. It practice for 2-4 times about 2 minutes.
These was done at 8am and 12 noon with the duration of 10 minutes to 30 minutes preferably half an hour before 2-3 times a day for consecutive days
Children are encouraged to practice the breathing technique for 3 days along with hospital routine.
After 3-4 days of intervention post assessment was done using same tool.
To gain confidence and trust.
To gain cooperation.
To maintain ethical aspect of study
To assess the effectiveness of selected nursing intervention.
It allows for chest expansion & improve the level of pulmonary function.
Regular practice increases the depth of respiration.
To assess the effectiveness of breathing exercises.
In experimental group, hospital routine with breathing technique was practiced and in control group only hospital routine was practiced. Quasi Experimental Pre Test And Post Test Design Essay.
CONTENT VALIDITY
Content validity of the tool was ascertained from the experts in the field of expertise.
Nursing experts – 3
Paediatrician – 2
Pediatric pulmonologist – 1
All the expert’s suggestion were incorporated in the tool to conduct the study.
3.8 PILOT STUDY
The pilot study was conducted for a period of one week after obtaining formal consent from the Principal, Omayal Achi College of Nursing, the research committee ICCR and the Medical Director of government general hospital, Walajah. The hospital superintendent and ward in charge sister were informed regarding the conduction of study. Data pertaining to demographic variables were collected by interview method from parents and physician records.
The investigator introduced themselves and gave information regarding the nature of the study to each of the selected children and their parents so as to get their co-operation in the procedure of data collection. After obtaining the consent, pre test level of pulmonary function was assessed using modified pulmonary index score.
For experimental group the investigator selected 5 children by using non probability purposive sampling technique. Children were invited to play therapy room and administered selected nursing interventions such as simple breathing techniques each one had 3-10 minutes interval of about 30-40 minutes morning afternoon and evening, before intake of food was given along with hospital routine for 3-4 days. The investigator assessed the post test level of pulmonary function by using the same tool after three days.
For control group the hospital routine was followed and post test was done after 3 days of pre test using the same scale. Quasi Experimental Pre Test And Post Test Design Essay. The findings of the pilot study data showed that the experimental group had significant effect in improvement on pulmonary function after than control group at p<0.001.The findings of the pilot study showed that the feasibility and practicability to conduct the main study. The report was presented to ICCR and after the concurrence of the committee members the investigator proceeded with main study.
RELIABILTY
The reliability of the tool was assessed using inter rater method. The reliability score was r =0.90, which showed the tool was highly reliable to be used for the main study data collection.
PROCEDURE FOR DATA COLLECTION
The data collection for the main study was done at government general hospital , Vellore. Formal administrative approval was obtained from the Principal, Omayal Achi College , ICCR ethical committee ,Director of general government hospital Vellore, Head of the department, Child health nursing. Ethical clearance certificate and no harm certificate were obtained before the data collection. The information collected from the parents was kept confidential. Data collection was done for the period of four weeks.
Children were selected based on sample selection criteria and grouped by non probability purposive sampling. The data collection procedure began by identifying the number of children who came for admission with asthma and severe symptoms. They required simple breathing exercise such as hummimg , diaphgramatic, butekyo and whistle blow through lip breathing exercise. Asthma severity score scale prepared and kept for use.
ORDER A PLAGIARISM -FREE PAPER NOW
Self introduction about investigator and information regarding the nature of the study was explained to each of selected children and their parents so as to get their co-operation in the procedure of data collection. After obtaining the consent pre test level of pulmonary function was assessed using modified pulmonary index score. In experimental group, children were invited to play room and administered selected nursing intervention such as simple breathing technique are humming, diaphgramatic, butekyo and whistle blowing through lips each one take 3-5 minutes interval over for 30 -40 minutes twice a day. The investigator assessed the post test level of pulmonary function using the same tool on 3rd day.
In control group hospital routine was followed and post intervention assessment was done after 3 days of pre assessment using modified pulmonary index score. For uncooperative children parents were invited to stay with the children .Quasi Experimental Pre Test And Post Test Design Essay. The same procedure and instruction were carried on all study participants.
3.9 PLAN FOR DATA ANALYSIS :
Data collected were analyzed by using both descriptive and inferential statistics.
Descriptive statistics:
Frequency and percentage distribution were used to analysis the demographic variables.
Mean and standard deviation was used to assess the effectiveness of breathing technique in pulmonary function.
Inferential statistics :
Unpaired ‘t’ test was used to compare the pre & post intervention level of pulmonary function of asthmatic children.
Paired ‘t’ test was used to find out effectiveness of breathing techniques and hospital routine.
Chi square test was used to find out the association of mean differed level of pulmonary function with selected demographic variable. Quasi Experimental Pre Test And Post Test Design Essay.
