1

FACULTY OF NURSING
BSC (HONS) IN NURSING (POST REGISTRATION)

ASSIGNMENT COVER PAGE

Student’s Name Mrs. K.Shalina

Student’s ID 0007000026 Student’s NRIC

Year/Semester 2015/ 3rd Semester Lecturer’s Name Mr.Duke

Faculty Faculty of Nursing

Programme BSc. (Hons) in Nursing (Post Registration)

Subject Name LBNS 3206 (Research 1)

Assignment Title Research Proposal

No. of Page
(excluding this
page)

Required words 3000 Actual # of 3390
words

Date submitted February 2016 Due Date

Soft copy included Yes / No

DECLARATION BY STUDENTS:
I certify that this assignment is my own work in my own words. All resources have been
acknowledged and the content has not been previously submitted for assessment to
LINCOLN or elsewhere. I also confirm that I have kept a copy of this assignment.

Signed: Date:

Remarks: This assignment must be submitted in hard copy, either (1) in person to the
college
office or by post, ensuring that either the assignment or envelope is date
stamped. Also must sign this sheet as proof of submission.

1

2 Title An observation study on the increasing serum cholesterol level among adult obese patients admitted to government hospitals in the eastern part of Sri Lanka the period of April 2016 to October 2016. 2 .

and purpose of the study. back ground and significance of the problem. statement of the objectives. It is called as scientific because the results are verifiable. literature review. Research is process systematically searches for new facts and relationship (Notter. problem statement. This is the first progress report of the research study on an observation study on the increasing serum cholesterol level among adult obese patients admitted to government hospitals in the eastern part of Sri Lanka.3 Table of Contents Introduction 01 Background 06 Purpose of study 07 Objectives 08 Literature review 09 Methodology 12 Data analysis 13 References Appendix Permission letter 14 Questionnaire 16 Questionnaire (in Tamil) Introduction Research is a scientific process. The systemic method has an order and follows an acceptable procedure for conducting research. conceptual and operational definitions and overall summary. In this progress report we wish to describe the introduction to the research topic. It is a systemic search for answers to questions about facts and relationship between facts. 1974). 3 .

Therefore. 4 . and play a major role in reducing the risk of developing serum cholesterol level. Dietary intervention and life style changes are an important component of the factors. The study of elevating serum cholesterol level is one of the current health problems in the world. their more highly developed nervous system has enable them to develop sounds and symbols that make possible the communication and recording of their questions. (Turkey and Dictschy. observations. 1988). Cholesterol is a solid. (ICN. cholesterol bind with them to travel through the blood stream. As elevated serum cholesterol level is the most important treatable risk factor. Human beings are the unique product of their creation and evolution. 1986). In contrast to other forms of animal life. We hope this mini nursing research also will take an important place in solving the current health problem. Elevating serum cholesterol level is a major cause of morbidity and mortality in world. waxy substance product by all animals as part of their normal metabolism. LDL carries cholesterol out to all the tissue in the body. including productions of energy. experiences and ideas.4 Introduction to the research topic Nursing research as a means of improving the health and welfare of the people. Much health care questions remain to be answered by nurse researchers and many answers remain to be utilized by practicing nurses. HDL called good cholesterol. The public has been advised to reduce dietary cholesterol intake as a strategy for reducing serum cholesterol level. repair of cell membrane and hormone production. Low density lipoprotein (LDL) and High density (HDL) do by liver are considered to be the carriers of cholesterol molecules so that. It is not a fat itself. accumulate and plugging up the arteries and blocking the blood flow and therefore LDL called bad cholesterol. where it may use for various metabolic functions. Nursing research involves a systematic research for knowledge about issues of importance to the nursing profession. HDL carries cholesterol back to the liver from tissues and the body. but it is always found with fats in animal derived foods cholesterol such as low density lipoprotein cholesterol. LDL bond cholesterol tends to stick to damaged artery linings.

Without these first three hormones you would not have a desire for sexual activities. 2003). emotional perception (anger. stress. the people who are affected with highest risk of heart diseases.5 One of the most important functions of the serum cholesterol is to serve as the basic raw material from which your body makes many major steroid hormones. diet and lifestyle can control the elevating serum cholesterol level. ethnic and genetics are the factors cannot control the elevating serum cholesterol level but. 2010). including testosterone. Background The present study was planned to investigate the level of cholesterol in obese adult patients according to their body mass index (BMI) in different patients admitted to Ashraff Memorial hospital in Eastern part of Srilanka. and without aldosterone your body could not properly balance your sodium and water levels. Most of the patients’ perceive that anti cholesterol drugs can reduce the serum cholesterol level rather the dietary control and life style modification (Sampath and Bernadette. negligence of health advices and no willingness to change their life style and diet patterns are the reasons among public for increasing their serum cholesterol level (Sampath and Bernadette. When serum cholesterol is more than 240mg/dl. 2007). Giving the critical nature of complicated conditions affected by high serum cholesterol free services are provided by the government on reducing serum cholesterol level such 5 . 2010). Age. When patients are affected by increasing serum cholesterol level they are admitted to hospital and get complications such as cardiovascular diseases. cortisone and aldosterone. estrogen. Lack of proper knowledge regarding the importance of maintaining optimal serum cholesterol level. Without cortisone your body could not cope with stress. (Kumar and Clerk. neutral and happy). and neurological disorders and affected economically and psychologically in turn (Mendis and Lindholm. Normal value of serum cholesterol is 220 – 240 mg / dl. 1988). Serum cholesterol elevation has become an important life threatening condition in Sri Lanka and also it becomes one of the major challenges for health providers to reduce the cholesterol level among people who have its higher values (Abeywardene. stress. progesterone. gender. fear.

Purpose of study To observe the statistical evidence of an increase serum cholesterol level among adult obese patients admitted to a government hospital in eastern part of Srilanka.high blood pressure. type 2 diabetes and its complications. as well as endometrial. This is resulted in increasing the number of admissions with complications related to high serum cholesterol level. audio. including high choledterol. In spite of that there are many awareness programs and free health services for the public. school health services and well woman clinics. Obesity poses a major public health challenge. obesity contributes to an estimated 112. osteoarthritis and respiratory problems. 2010). 2003). as well as psychological problems. breast. coronary heart disease. Each year. Most of the public fail to obtain required knowledge to have expected health outcomes (Sampath and Bernadette. Problem statement Elevated serum cholesterol level among people becomes a critical public health issue in srilanka (Abeywardene. Despite the above facilities given free of charge by the government. Obese adults are at increased risk for many serious health conditions. visual aids. prostate. hospital statistics reported that number of number of admission with high serum cholesterol and its complications are getting high. gallbladder disease. socio. and colon cancers. leaflets.6 as lifestyle modifications centers in each hospital and medical officers of health (MOH) office. gender and genetic are admitting the wards and clinic and they represents the Sri Lankans. video. Obese adults also may experience social stigmatization and discrimination. stroke. Ashraff Memorial hospital and Base hospital kalmunai were selected for this study as patients will be from different ethnic. cultural and economical background and also from different age. Therefore with the intention of understanding why more people get admitted to hospitals with high cholesterol level. Among the free services given by their institutes are blood tests. monitor the blood pressure and advised to life style modification and dietary pattern by handouts.000 preventable deaths. books. 6 .

But. there is no one does study related to increasing serum cholesterol level of adult obese patients. there is a gap between patients’ knowledge. unfortunately. Someone try to study the related between lifestyle and diet pattern and increasing serum cholesterol level. 7 . believes and attitude and high serum cholesterol level Research Question: Is there statistical evidence on the increasing serum cholesterol level among adult obese patients admitted to government hospital in eastern part of srilanka? Hypotheses: There is significant information of an increasing serum cholesterol level among adult obese patients admitted to government hospital in eastern part of srilanka Variables: Cause: [independent] because of obesity (BMI) Effect: [depend] serum cholesterol level Objective • to investigate on the widespread of level of serum cholesterol among adult obese patients admitted to government hospitals in eastern part of sri lanka • To identify the number of adult obese patients admitted with diagnosis of increasing serum cholesterol level Significance of the study • This research study to analyze reasons for increase serum cholesterol level among adult obese patients.7 Significance of the study In researches of srilanka and other countries there are many research studies are related to increasing serum cholesterol level but.

unfortunately. But. • Control of serum cholesterol level helps to reduce the rate of morbidity and mortality in the world. First. Such a review can play a number of important roles. in the start up phase of a project. selection. believes and attitude and high serum cholesterol level Literature review The main objectives of doing this progress reports are to improve my knowledge regarding to how to give the introduction to my research topic and classify the literature review related to my research topic in local and international. • In researches of srilanka and other countries there are many research studies are related to increasing serum cholesterol level but. there is no one does study related to an increasing serum cholesterol level among adult obese patients admitted to government hospital in eastern part of srilanka. • Dietary intervention and lifestyle changes are an important component of the factors. critical analysis. there is a gap between patients’ knowledge.8 • Findings of the study help to understand obesity how increasing serum cholesterol level. Someone try to study the related between lifestyle and diet pattern and increasing serum cholesterol level. The task of reviewing research literature involves the identification. and written description of existing information on the topic of interest. and play a major role in reducing the risk of developing serum cholesterol level. It is usually advisable to undertake a literature review on a subject before actually conducting a research project. a review of work conducted in an area of general 8 .

Second. (Indrani. Therefore. Firefox and Internet explorer search and using the combination of following key words. encyclopedias and internet. Third. conference reports and other disciplines. 2005). searched the articles up to ten years back and it was impossible to find even one nursing research article related to this topic in Sri Lanka Theoretical literature also searched to find out related details such as books. Yoshiaki Keno. thereby facilitating the cumulation of scientific knowledge. The researcher found literature from other countries related to this topic. There were adequate research articles related to this topic but not in the local literature. Katsuto Tokunaga. Etsuko Shinohara. abstracts and experts. There were few research articles available during past five years. Shigenori Fujioka. Source of review literature are journal. journals. Ken-ichi Hirano. Naohiko Sakai. Masato Ishigami. Yahoo. Shuichi Nozaki. the researcher may be in a better position to assess the feasibility of a proposed study by becoming familiar with related work.H. Fourth. A. web based literature search has been conducted. Shizuya Yamashita. thereby minimizing the possibility of unintentional duplication. and Yuji Matsuzawa 9 . Finally.M. Waliul Islam. Kazuaki Kotani. Google scholar. Tadashi Nakamura. the review can be highly useful in providing methodological suggestions for the actual conduct of the investigation. dictionaries. the review provides a conceptual context or frame work for the research community. Kaoru Kameda- Takemura. a scrutiny of previous work acquaints the researcher with what has been done in a field. It was found more articles from Google. bibliography. First one is” Increased Plasma Cholesterol Ester Transfer Protein in Obese Subjects” A Possible Mechanism for the Reduction of Serum HDL Cholesterol Levels in Obesity. Mitsukazu Yamane. Authors are Takeshi Arai. In this mini research.9 interest can help in the formulation or clarification of a research problem. increase serum cholesterol level among adult obese patients 20700 result Google scholar. Initially found 02 studies related to this topic.

Science 280 Authors are Hill.) Key word is • cholesteryl ester transfer protein • fat distribution • HDL • obesity • reverse cholesterol transport 2nd is Environmental contributions to obesity epidemic.1±4.28 versus 1.01). J. whereas postheparin LPL activities were significantly decreased.10 It is well known that obesity is frequently associated with low levels of serum high density lipoprotein (HDL) cholesterol. CETP activities. body fat ratio (r=.05). These results suggest that high levels of plasma CETP may partly explain the reduction of serum HDL cholesterol in obese subjects and that plasma CETP levels may be regulated by the degree of total body fat accumulation. The average body mass index of the obese subjects was 33. P<.34 mmol/L. P<.05) and negatively with visceral fat/subcutaneous fat ratio (r=-.52.O. and subcutaneous fat area determined by abdominal CT scan imaging (r=. J.05) And the cholesteryl ester to triglyceride ratio of HDL2 and HDLj (r=-.05. 26. P<. independent of postheparin HTGL and LPL activities.C 10 . After body weight reduction by caloric restriction.04±0. P<.01). (Arterioscler Thromb. werecorrelated negatively with HDL cholesterol (r=-. The obese subjects showed significantly lower serum HDL cholesterol levels than control subjects (1. P<. We also investigated the relationship between these variables. P<. However. both activities and protein mass of CETP and postheparin HTGL activities were significantly increased. & Peters. age 44±14 years.49.8 kg/m2 (range. total adiposity. mean±SD). Cholesteryl ester transfer protein (CETP) transfers cholesterol ester from HDL to apolipoprotein B-containing lipoproteins and plays an important role in regulating the concentration and composition of HDL.8 kg/m2).36. we analyzed serum lipoproteins. and indices of body fat distribution. In the obese subjects. To elucidate the mechanism for the reduction of serum HDL cholesterol in obesity. CETP activities were correlated positively with body mass index (r=.50±0. both activities and protein mass of CETP were reduced. CETP. respectively).38. P<.05). and postheparin lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) activities in 30 obese subjects (17 women and 13 men. the mechanism for this reduction has not been fully clarified.39.4 to 43. r=-M. 14:1129-11M.05. 1994. P<.42.

11 The current epidemic of obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity. a waxy substance made by the liver and acquired through diet. cell membrane and myelin. p. (Medical dictionary) Believes is defined as. Control of portion size. but it is becoming difficult to adopt and maintain these behaviors in the current environment. public health efforts need to be directed toward prevention Summary of the reviewed literature According to the above reviewed literature. ideas and concepts developed by an individual over a period of time from cultural influences. 47) Key word: 11 . It is found in the blood and in all cells in the body. nurses dictionary. 301) Cholesterol defined as. some hormones. very few studies attempted to identify the relationship between high serum cholesterol levels and risk of CVD. thoughts. 2000. and regular physical activity are behaviors that protect against obesity. While studies have focused to identify the relationship between certain diets and serum cholesterol levels. Conceptual definitions Patient is defined as. Because obesity is difficult to treat. parents and family. 2000. Although humans have evolved excellent physiological mechanisms to defend against body weight loss. (Barbara. (Barbara. a person who is ill or is undergoing treatment for disease. vitamin D. Srilankan literature is not available to evident that research attention has paid to this issue in Srilanka. religion. The body uses cholesterol to produce bile. consumption of a diet low in fat and energy density. p. education. they have only weak physiological mechanisms to defend against body weight gain when food is abundant. High blood cholesterol has been linked to heart diseases. While all these studies were carried out in other countries. A high level of cholesterol in the blood is called hypercholesterolemia. nurses dictionary.

Exclusion:  Below 34 and above 61 age patients  Adult Obese patient. and also Clinic attendance  Adult obese patients (Age between 35-60).  Must be want serum cholesterol report on patients hand.observation • Sample – random • Design – cross sectional • Settings – Ashraff Memorial Hospital and Base hospital kalmunai • Sample Size – 150 Patients from ward and clinic • Analysis-data will we collected by questionnaire and collected data well be analysis with soft ware spps • Ethical Permission – Approval from Hospital Administration was granted • Protection of Participants – Informed Consent Anonymity Free to refuse Inclusion sampling:  Admitted to the government hospital in eastern part of Srilanka. they do not have serum cholesterol report  Obese patients in the community Data collection Method: observational data collection via questionnaire 12 .12 Increase serum cholesterol level of among obese adult patient 20700 result Google scholar Methodology • Focus – Quantitative Research Approach • Method.

Shalina. Kalmunai. Kalmunai Through: The ward manager / clinic in-charge AMH. Kalmunai Through: Visiting physician AMH. Ashraff memorial Hospital. Kalmunai 13 .02. Through: The Chief Nursing Officer AMH. 27.2016. Kalmunai.13 Tool: researcher administrated questionnaire K. To: The Medical Superintend Ashraff memorial hospital.

following BSC (HONS) IN NURSING (POST REGISTRATION)direct at Lincoln university of Malaysia study continue of addalachenai ICBS. Through: The Chief Nursing Officer BH.Shalina. Base Hospital. Kalmunai. Thank you You faithfully ……………….14 Dear Sir. 14 .02. Kalmunai Through: The ward manager / clinic in-charge BH. To: The Medical Superintend Base hospital. Kalmunai.Shalina working as a nursing officer at AMH kalmunai . Kalmunai Through: Visiting physician BH. K. Request for Permission to collect data I’m Mrs. So please grand me the permission to do the research at AMH. My research topic is an Observational study on increasing serum cholesterol level among adult obese patients admitted to a government hospital in eastern part of Srilanka the period of April 2016 to October 2016.2016. Parcel fulfillment of my degree I have to submit a research thesis. 27. Kalmunai Dear Sir.K.

Height :- 15 . Body weight :- 06.15 Request for Permission to collect data I’m Mrs. So please grand me the permission to do the research at BH Kalmunai. 01 . Parcel fulfillment of my degree I have to submit a research thesis.Shalina working as a nursing officer at AMH kalmunai . Please write the correct answer to the question and mark (√) sign to give your correct answer. QUESTIONNAIRE ON THE INCRESING SERUM CHOLESTEROL LEVEL AMONG ADULT OBESE PATIENTS Venue: Medical wards and medical clinics.following BSC (HONS) IN NURSING (POST REGISTRATION)direct at Lincoln university of Malaysia study continue of addalachenai ICBS.…………………………………………………. Thank you You faithfully ……………….K.Age of the patient :- 02. Ethnicity :- 03. My research topic is an Observational study on increasing serum cholesterol level among adult obese patients admitted to a government hospital in eastern part of Srilanka the period of April 2016 to October 2016.. Sex :- 04. Educational level :- 05.

) 10.. No (….. not regularly (…. Are you attending clinics? I....16 07..) II.. 11. once in a while (…. No (….) 14.) II. Yes (…. Do you have increase in cholesterol? YES NO 12.) II. Waist circumference :- 08.. Yes (….) II.) 16. Please specify……………………………………… 13.... What are the diseases you have? I.) No (…. Bronchial Asthma (…. Yes....) III.) IV. Yes.. No clear idea (…) 16 .) III. Hyper tension (….. when I have complications on severity (….) IV..... Others.) II... No (…... Are you aware of diagnosis with hypercholesterolemia? I.) III. Familial position :- 09. Do you know about hypercholesterolemia? I.. Are you an employee? Yes (….) III. Do you have any relatives who are having hypercholesterolemia? I. regularly (…. Yes (….. Diabetes mellitus (…. No.. If your answer for above question is yes what is your occupation?...... Not known (…) 15... Yes.

17 Researcher BMI: ……… Report (cholesterol level): ……… 17 .