Since the main goal was to evaluate the effectiveness of structured teaching program,
quantitative descriptive and evaluative research approach was used. A descriptive
approach (Phase I) included administering structured questionnaire to collect
demographic characteristics of patients and then administering pretest using structured
knowledge questionnaire in experimental group and control group and then providing
structured teaching program to experimental group. The evaluative approach (Phase II)
included administering post-test after 7th day of structured teaching program to both the
groups.
Fore mostly, pre-test was conducted to assess the knowledge of participants using
structured questionnaire in experimental group and control group. The participants were
asked to mark one correct option among the 3 given options for each item in the tool. Pretest knowledge score was checked.
Preparation of Structured questionnaire
A structured questionnaire was prepared to evaluate the effect of structured teaching
program on knowledge related to self-identification and management of hand foot
syndrome among participants receiving chemotherapy for colon cancer. The tool was
developed by the investigator by reviewing literature, personal experiences, opinion,
suggestions and guidance from the experts of the field. The tool was prepared in English.
The items in the structured knowledge questionnaire were distributed under the following
content areas- (1) Self Identification of Hand Foot Syndrome (50%) and (2) SelfManagement of Hand Foot Syndrome (50%). The structured knowledge questionnaire
included 4 domains – knowledge 3 items, comprehension 5 items, application 7 items,
and analysis 1 item and the total number of items were 16.
It was divided into three sections: Section A consisted of demographic data, basically
developed for the purpose of assessing the sample characteristics. It included age, gender,
educational status, marital status, income, occupation, diagnosis and treatment related
information-name of protocol, dose of capecitabine, and specific chemotherapy cycle of
treatment protocol.
Section B included structured knowledge questionnaire of 8 items. The items were
developed to assess knowledge of participants on self-identification of hand foot
syndrome. The aspects covered under self-identification of hand foot syndrome was
meaning of hand foot syndrome, pathophysiology of hand foot syndrome, name of drug
which causes hand foot syndrome, clinical features of various grades of hand foot
syndrome and its outcomes. Each item carried 3 options, out of these, only one option is
correct response. Other two were distracters. Each correct response was awarded with one
mark and zero mark for incorrect response.
Section C included structured knowledge questionnaire of 8 items. The items were
developed to assess knowledge of participants on self-management of hand foot
syndrome. Each item carried 3 options, out of these, only one option was correct
response. Other two were distracters. Each correct response was awarded with one mark
and zero mark for incorrect response.
The items related to demographic characteristics were not scored. The structured
questionnaire consisted of 16 items under Section-B and Section-C. Each section
consisted of 8 items. Both Section-B and Section-C were interpreted together for scoring.
Each item carried 3 options, out of these, only one option was a correct response, the
other two options were distracters. Each correct response was awarded with one mark and
for incorrect response or unattempted items with zero mark. Maximum score for the
questionnaire was 16 and minimum zero.
The scores were arbitrarily graded to assess the level of knowledge into- Excellent: Score
greater than 14; Very Good (V.Good): Score 11-14; Good: Score 7-10; Fair: Score 4-6;
Poor: Score less than 3.
2. Structured teaching program was then administered to the participants in experimental
group. The structured teaching program was not given to participants of control group. In
total, 16 individual teaching and 2 group teaching to a group of 2 members was
administered.
Preparation of Structured Teaching –Intervention Program
The structured teaching program was prepared in lesson plan format. The structured
teaching program was developed in English. Structured teaching was given using a
prepared teaching plan for a period of 40-45 minutes, using lecture cum discussion with
audio visual aids such as power point presentation, imparted to participants on individual
basis or group of maximum 2 participants. The steps involved in the preparation of
structured teaching program were a review of literature, discussion with experts,
preparation and organization of content, content validity of structured teaching program
and preparation of final draft of structured teaching program.
Content was organized into specified areas including the meaning of hand foot syndrome,
anatomy and physiology of sweat glands, name of drugs which causes hand foot
syndrome, pathophysiology of hand foot syndrome, clinical features of various grades of
hand foot syndrome, outcome of hand foot syndrome and self-management strategies.
To ensure the content validity, the structured knowledge questionnaire along with
structured teaching program, objectives and research proposal was sent to 9 experts
including medical oncologists, professors and lecturers with specialization in medicalsurgical nursing, Nursing Superintendents and Assistant Nursing Superintendents of
tertiary cancer care centers and statistician.
Reliability of the structured questionnaire was established by collecting data from 5
participants receiving chemotherapy for colon cancer at Tata Memorial Hospital. The
reliability of the tool for the present study was established by Karl Pearson correlation coefficient using test-retest method. In this study the structured questionnaire was
administered on the first and seventh day to same participants after the enrollment of
participants to the study project. The scores on two separate occasions were then
correlated. In this study the reliability of tool was found to be 0.74. It was statistically
significant, ensuring stability of the tool and thus reliability.
A Pilot study was conducted at Tata Memorial Hospital, Mumbai to assess the
practicability and feasibility of the study for 6 participants (3 participants in experimental
arm and 3 participants in control arm). The samples of pilot study were not included in
the main study.
3. Post test was conducted after 7th day of structured teaching program using same
knowledge questionnaire in both the groups. The data was then compiled for
analysis.