CHAPTER 3

METHODOLOGY.

Research approach

Research design

Variables

Schematic representation of the study

Setting of the study

Sample

Sample size

Sampling technique

Inclusion criteria

Exclusion criteria

Tool

Development of tool

Description of tool

Content validity

Reliability of the tool

Content validity

Reliability of the tool

Pilot study

Data collection process

Plan for data analysis.

 METHODOLOGY.

Research methodology indicates the general pattern used to gather valid and reliable data

regarding the problem under investigation. It is a systematic, theoretical analysis of the methods

applied to a field of study. The methodology of a research study coins the researchers overall plan for

obtaining answers to research questions and it spell out the strategies that the researcher adopts to

develop the information that is accurate, objective and interpretable. It is a systematic plan of what is

to be done, how it will be done, and how the data will be analyzed.

This chapter deals with methodology selected by the investigator to study the effect of video

assisted teaching on knowledge regarding prevention of deep vein thrombosis among care givers of

post-operative patients from a selected hospital. The methodology procedure followed in this study

includes the research approach, research design and variables, setting of the study, population

,sample and sampling techniques, tool /instrument, content validity of the tool ,reliability, pilot study,

data collection process and plan of data analysis.

RESEARCH APPROACH.

Research approach involves the description of the plan to investigate the phenomena under

study in a quantitative (structured), qualitative (unstructured) or a combination of 2 methods.

Therefore the approach helps to decide about the presence or absence as well as the manipulation and

control over the variables.

In order to achieve the objectives of the study and to determine the effect of video assisted

teaching on knowledge regarding prevention of deep vein thrombosis among caregivers of post-

operative patients a quantitative evaluative approach was used. Evaluative approach is an applied

form of research design, which involves the judgment about how well a specific programme,

practice, procedure, or policy is working.

RESEARCH DESIGN.

Research design is the blue print for conducting a study that maximizes control over

factors that could interfere with the validity of the findings or it depicts the overall plan for

organization of scientific investigation. Research design adopted for the study was quasi

experimental non randomised pre-test post-test control group design.

VIDEO ASSISTED
TEACHING
EXPERIMENTAL
PRE TEST POST TEST
GROUP.

NO INTERVENTIONS

CONTROL
PRE TEST POST TEST
GROUP.

VARIABLES.

Variables are qualities, properties, or characteristics of person, things or situation that change or

vary. The present study identifies three types of variables.

 Independent variable

 Dependent variable.

 Socio demographic variable.

 Independent variable

An independent variable is a stimulus or activity that is manipulated or valid by the researcher

to create the effect on the dependent variable.

 Independent variable in this study is the video assisted teaching regarding prevention of deep

vein thrombosis.

 Dependent variable

The dependent variable is the outcome or response due to the effect of the independent variable,

which researcher wants to predict or explain.

The dependent variable in the study is the level of knowledge regarding prevention of Deep

Vein Thrombosis among care givers of post-operative patients.

 Socio demographic variables.

Socio demographic variables are characteristics and attributes of the study subjects.

Socio-demographic variables of the study includes Age, Gender, Marital status, Occupation,

Education, Previous exposure to any educational programme on DVT prophylaxis, family history of

deep vein thrombosis.

SCHEMATIC REPRESENTATION OF THE STUDY.
SETTING OF THE STUDY.

Setting refers to the physical location and conditions in which data collection takes

place in a study. The setting in this study was Medical Trust Hospital, Ernakulam. The caregivers,

who met the inclusion criteria, were selected for the study.

POPULATION.

Population is the aggregation of all the units in which a researcher is interested. In other

words population is the set of people to which the results of a research are to be generalized. The

population selected for the present study was care givers of post-operative patients admitted at

Medical Trust Hospital, Ernakulam.

SAMPLE AND SAMPLING TECHNIQUE.

Sample is defined as a representative unit of a target population. In other words Sample

consists of a subset of population selected to participate in a research study. Sampling is the

process of selecting a portion of the population to represent the entire population.

In this study, samples consist of 60 caregivers of post-operative patients (30 experimental &

30 control group). Study subjects were selected by using non randomized convenient sampling

technique.

Inclusion criteria.

Care givers of patients who have undergone major surgeries and who are,

 Willing to participate in the study.

 Available at the time of data collection.

 Able to read and write English and Malayalam.

Exclusion criteria.

 Care givers who are already diagnosed as having DVT

 Age more than 70 years.

 Care givers who are in the health care profession.

SAMPLE SIZE

Based on the prevalence of DVT among post-operative patients (15-18%), the minimum

sample size required for the study is calculated using the formula,

N=Zα2 (p *(1-p))

d2

Where d = 10% the absolute precision required on either side of the population.

P= 18%

Zα = 1.96 the standard normal table value for α = 0.05

N = 1.96 * 1.96 *{0.18*(1-0.18)}

0.1*0.1

N= 3.8416{0.18 (0.82)}

0.01

N= 56.7

Therefore the sample size for the study is calculated as 60.

TOOL.
 A research instrument is a device used to measure the concept of interest in a research project

that a researcher uses to collect data.

DEVELOPMENT OF THE TOOL.

In this study the researcher uses knowledge questionnaire to assess the knowledge level of the

subjects, and video assisted teaching on prevention of deep vein thrombosis, which was prepared

based on the review of literature and in consultation with experts in the field of medical surgical

nursing and related disciplines.

The following steps were taken to develop the tools:

1) Review of research and non-research literature

2) Opinion and suggestion from experts

3) Development of blue print for knowledge questionnaire

Development of video assisted teaching.

Video Assisted Teaching refers to systematically organized and designed instructions and

teaching aids which are designed to provide information for caregivers of post-operative patients

regarding prevention of DVT. The following steps are used by the researcher to develop video

assisted teaching:

1) Formulation of objectives

2) Review of literature

3) Preparation of first draft of teaching content

4) Deciding the method of instruction

5) Content validation
 6) Preparation of final draft

1) Formulation of objectives:

Objectives of the video assisted teaching are listed in behavioral and achievable terms. The outline of

the content was written based on the objectives.

2) Review of literature:

An extensive literature review was undertaken regarding the prevention of deep vein thrombosis

from texts, internet, articles and journals.

3) Preparation of first draft of teaching content:

The first draft was prepared based on the review of literature and expert opinion. The teaching plan

consisted of central objective, specific objectives, content, teaching and learning activities,

description of audio visual aids and evaluation. The content was made clear and comprehensive

keeping in view the teachers capacity to comprehend the information. The areas covered in the

content are definition, aetiology, risk factors, pathophysiology, clinical manifestation, complications,

management of dvt, measures and exercises to prevent deep vein thrombosis.

4) Deciding the method of instruction:

The method of instruction was video assisted teaching.

5) Content validation:

Criteria checklist was prepared and teaching plan was given for content validation to 10 experts.

6) Preparation of final draft:

Based on the suggestions and opinions of the experts, the final draft of video was prepared on

prevention of deep vein thrombosis.

Description of the tool

Tool 1: Socio-demographic Data.

Socio-demographic data consists of Age, Gender, Marital status, Relationship with the

patient, Occupation, Education, Previous exposure to any educational programme on DVT

prophylaxis, and family history of deep vein thrombosis. There was no scoring for these items. The

purpose is to determine the association between knowledge of caregivers on prevention of deep vein

thrombosis and selected socio demographic variables.

Tool II: Structured knowledge questionnaire on prevention of deep vein thrombosis

Knowledge questionnaire consist of twenty six items. All the items were multiple choice questions.

A score of one was allotted to each correct response. The participants were requested to place a tick

mark against the possible answer.

Knowledge scores were arbitrarily scored as,

0-7 POOR

8-13 AVERAGE
14-19 GOOD
20-26 EXCELLENT
The content area includes from deep vein thrombosis and its prevention.

Content validity of the tool.

Validity is the degree to which an instrument measures what it is supposed to measure.

Content validity concerns the degree to which an instrument has an appropriate sample of items for

the concepts being measured. It involves the representativeness of items related to the concept being

tested. The prepared tools along with the blue print, objectives and criteria checklist, lesson plan and

structured knowledge questionnaire were given to ten experts to ensure content validity. Ten experts
were from the field of medical surgical nursing. The experts were requested to give their suggestions

regarding accuracy, relevance and appropriateness of the content. Suggestions and recommendations

given by the experts were accepted and necessary corrections were done for modifying the tool.

Reliability of the tool.

Reliability of an instrument is the degree of consistency or dependability with which an

instrument measures the attribute it is designed to measure. The reliability of a measuring tool can

be assessed in terms of stability, internal consistency and equivalence depending on the nature of the

instrument and aspects of the reliability concept.

The method accepted for checking the reliability was split half technique. In order to

establish the reliability the study was conducted in ten caregivers of post-operative patients. The test

scores of questionnaire were first divided into two equal halves and reliability of the questionnaire

was calculated using spearman’s brown formula that is 0.6.

TECHNIQUES OF DATA COLLECTION.

Based on inclusion criteria samples were selected by convenient sampling technique. On day

1 after obtaining informed consent from samples, the socio-demographic data sheet was entered.

Knowledge regarding prevention of deep vein thrombosis was assessed using a structured knowledge

questionnaire followed by administration of video assisted teaching regarding prevention of deep

vein thrombosis. Posttest level of knowledge was assessed after 7 days of the intervention.

PILOT STUDY.

Pilot study is a small scale version of the actual study conducted with the purpose of testing

and potentially refining the research plan. It was developed with similar subjects, similar setting,

same treatment, same data collection and analysis techniques. The purpose of the study was to find
the feasibility of the study, clarity of language of the tool as well as video assisted teaching and to

finalize the plan for analysis.

Pilot study was conducted among the caregivers of post-operative patients admitted at

Medical Trust Hospital, Ernakulam from 17-2-2020 to 29-2-2020 with 10% sample size (6), 3 in

both experimental and control group. The duration of the pilot study was 2 weeks.

The researcher obtained formal written permission from authorities of the hospital and

samples were selected by using non-probability convenient sampling. The sample chosen were

similar in character to those of the population under study. The care-givers of post-operative patients

were grouped into experimental and control group. The study subjects were informed in detail about

the purpose and nature of the study and assured confidentiality and privacy. Researcher obtained

signed informed consent from participants of the study. Pretest was administered with structured

knowledge questionnaire. On the same day video assisted teaching was administered to the care-

givers in the experimental group. The duration of the session was 15 minutes. Post- test was

conducted on the seventh day for both experimental and control group. After conducting the post test

among the control group an information pamphlet regarding prevention of deep vein thrombosis was

provided. Pilot study subjects were excluded from the main study.

Data collected from pilot study samples were analyzed using descriptive and inferential

statistics. Sample characteristics were analyzed in terms of frequency and percentage. Computation

of Mean and Standard Deviation of the pre and post level of knowledge were assessed. The findings

of the pilot study revealed that the mean post-test knowledge score (22.33) was apparently higher

than the mean pretest score (14) in the experimental group. Hence it is clear that there was

considerable gain in knowledge among care-givers regarding prevention of deep vein thrombosis. t

test was used to determine the main difference in the knowledge level between pre and post-test

score. Paired t test is used to identify effect of video assisted teaching (paired t test of experimental
group was 13.17 whereas paired t test of control group was 2.89) . Chi- square was used to find the

association between knowledge and selected socio-personal variables. Unpaired t test was done to

compare the level of knowledge on prevention of deep vein thrombosis between experimental and

control group (unpaired t test was 6.25, df 4 @ 0.05 = 2.78) calculated value is greater than table

value so hypothesis is accepted.

DATA COLLECTION PROCESS.

The data was collected after obtaining administrative permission from Medical Trust Hospital,

Ernakulam. The samples who met the criteria’s were identified and investigator introduced herself to

the samples and informed consent was obtained. Sixty caregivers of post-operative patients were

selected by convenient sampling technique. Pretest was assessed followed by administration of video

assisted teaching on prevention of deep vein thrombosis and the duration of the video was 15

minutes. The posttest level of knowledge was assessed after seven days of the intervention.

PLAN FOR DATA ANALYSIS.

Data analysis is a systematic organization and synthesis of research findings and testing of

hypothesis. After entering the data into master data sheet the analysis was planned to be made on the

basis of objectives and hypothesis using descriptive and inferential statistics.

Sample characteristics were analyzed in terms of frequency and percentage. Computation of

Mean and Standard Deviation of the pre and post level of knowledge were assessed. t‘ test was used

to determine the main difference in the knowledge level between pre and post-test score. Paired t test

is used to identify effect of video assisted teaching. Chi- square was used to find the association

between knowledge and selected socio-personal variables. Unpaired t test was done to compare the

level of knowledge on prevention of deep vein thrombosis between experimental and control group.