Assessment of Techers' Knowledge about Hemophilic Students in Primary Schools

Redan, Zahraa Shammam; Ajil, Zaid W. Ajil

doi:10.33899/mjn.2022.175417

Journals List

Assessment of Techers' Knowledge about Hemophilic Students in Primary Schools

Mosul Journal of Nursing (Print ISSN: 2311-8784 Online ISSN: 2663-0311)

Article 21, Volume 10, Issue 3, August 2022, Pages 147-153

Document Type: Original Articles

DOI: 10.33899/mjn.2022.175417

Authors

Zahraa Shammam Redan¹; Zaid W. Ajil Ajil²

¹Academic Nurse, University of Baghdad, College of Nursing, Pediatric Nursing Department, Iraq. Email: zahraa.shamaam1204a@conursing.uobaghdad.edu.iq

²Assistance professor, University of Baghdad, College of Nursing, Pediatric Nursing Department, Iraq. Email: zaid_ahjil@conursing.uobaghdad.edu.iq

Abstract

Back ground: Hemophilia with bleeding symptoms that are roughly proportional to the degree of plasma factor deficiency. Joints and muscles are the most common locations of spontaneous bleeding, which, if not treated properly, can cause persistent injury to the musculoskeletal system, culminating in severe handicaps and impairment. Furthermore, uncontrolled bleeding occurs as a result of trauma and surgical treatments and they are usually diagnosed before the age of five to six years.
Objectives: To assess the level of teachers' knowledge about students with hemophilia, and to find out relationships between teachers’ knowledge and their demographic characteristics.
Methodology: Using the pre-experimental design of the current study, for one group of 100 teachers working at the primary schools in Baghdad, data was collected from 16th February 2022 to 20th May 2022. Using non-probability samples (convenient samples), self-management technology in which trainers fill out the questionnaire form themselves was used in the data collection process; it was analyzed through descriptive and inference statistics.
Conclusion: The study concluded that there was no significant or weak correlation between the teacher's knowledge and socio-demographic characteristics. The knowledge of the teachers ranged from low to medium in various dialogues.

Keywords

assessment; Teachers' Knowledge; Hemophilia

Full Text

Assessment of Techers' Knowledge about Hemophilic Students in Primary Schools

Zahraa Shammam Redan¹, Zaid W. Ajil²

Academic Nurse, University of Baghdad, College of Nursing, Pediatric Nursing Department, Iraq. Email: zahraa.shamaam1204a@conursing.uobaghdad.edu.iq
Assistance professor, University of Baghdad, College of Nursing, Pediatric Nursing Department, Iraq. Email: zaid_ahjil@conursing.uobaghdad.edu.iq

Corresponding author:Zahraa Shammam Redan

Email: zahraa.shamaam1204a@conursing.uobaghdad.edu.iq

ABSTRACT

Objectives: To assess the level of teachers' knowledge about students with hemophilia, and to find out relationships between teachers’ knowledge and their demographic characteristics.

Methodology: Using the pre-experimental design of the current study, for one group of 100 teachers working at the primary schools in Baghdad, data was collected from 16th February 2022 to 20th May 2022. Using non-probability samples (convenient samples), self-management technology in which trainers fill out the questionnaire form themselves was used in the data collection process; it was analyzed through descriptive and inference statistics.

Conclusion: The study concluded that there was no significant or weak correlation between the teacher's knowledge and socio-demographic characteristics. The knowledge of the teachers ranged from low to medium in various dialogues.

Key word: Assessment, Teachers' Knowledge, Hemophilia.

Received: 03 September 2021, Accepted: 15 December 2021, Available online: 20 January 2022

INTRODUCTION

Hemophilia is an inherited X-linked recessive bleeding illness caused by a lack of coagulation factor VIII (hemophilia A) or factor IX (hemophilia B) due to clotting factor gene abnormalities ⁽¹⁰⁾, according to the World Federation of Hemophilia's (WFH) annual report from 2016, the total number of patients with all forms of hemophilia in Iraq in 2016 was estimated to be 1346, resulting in a prevalence ⁽³⁾.

Hemophilia with bleeding symptoms that are roughly proportional to the degree of plasma factor deficiency. Joints and muscles are the most common locations of spontaneous bleeding, which, if not treated properly, can cause persistent injury to the musculoskeletal system, culminating in severe handicaps and impairment. Furthermore, uncontrolled bleeding occurs because of trauma and surgical treatments ⁽⁷⁾.

Psychosocial concerns linked with hemophilia, such as those related to school, can have a significant impact on the lives of hemophiliacs and caregivers of hemophiliac children. Hemophilia-related absenteeism, difficulties doing specific activities due to discomfort or movement limits, and difficulties concentrating due to patient-identified bleeding or pain are all factors that might influence education ⁽⁴⁾, in 2014, studies established a consistent association between hemophilic children's perceptions of bad quality of life and physical function, emotion, and school function being much lower than in normal children ⁽⁹⁾.

This study aimed to:

To assess the level of teachers' knowledge about students with hemophilia.
To find out relationships between teachers’ knowledge and their demographic characteristics that include age, gender, level of education, years of employment, marital status, have you ever seen a student with hemophilia, the medical training courses you have participated, and did you have a background about hemophilia If yes, from a newspaper, internet, lecture, and book.

METHOD

Study Design: Using the pre-experimental design of the current study, for one group of 100 teachers working at primary schools in Baghdad, data was collected 16th February 2022 to 20th May 2022.

Study Sample: Using non-probability samples (convenient samples), self-management technology in which trainers fill out the questionnaire form themselves was used in the data collection process; it was analyzed through descriptive and inference statistics.

The Study Instruments: A questionnaire has been created to accomplish objectives of the study; the questionnaire is divided into two axes.

Axis I: Demographic Characteristics:

This part contains demographic information of students took part in the research. which consists of (9) items including: age, gender, Marital status, years of service, have you met students with hemophilia, health courses you attended, do you have any previous knowledge of hemophilia and Source of information.

Axis II: Related trainers' knowledge: Consists of the teacher’s knowledge about hemophilia (8) items including: disease definition, severe level of bleeding, Mild to moderate level of bleeding, Symptoms and signs of joint bleeding symptoms and signs of intramuscular hemorrhage and recurrent joint bleeding, complications of hemophilia, diet for a hemophiliac child quality of toys for the hemophiliac child, the answer to it is I know, not sure, I don't know.

Axis III: Consists of the teacher’s roles about child with hemophilia:

This part contains (8) items including: wounds care, joint bleeding care, Epistaxis care, mouth bleeding care, bruising care, teacher’s role with use sport and excesses and teacher’s role the answer to it is always, sometimes, never.

Rating and Scoring:

Likert scoring scale are used, of three categories responding, such that (Don't know, not sure, and I know), which are given by integer numbers (1, 2, and 3) respectively.

Validity of the study: To make the instruments more valid, it was introduced to a panel of (13) experts from various fields who assessed the clarity and adequacy of its items.

Reliability of the study: Cronbach’s Alpha was used to determine the accuracy of the questionnaire (0.886). [L: Low (0.00 – 0.66)]; [M: Moderate (0.67-1.33)]; [H: High (1.34-2)].

Data collection: Data were obtained through face-to-face interview techniques as a method of data collection. Trainers was asked to complete a self-administered questionnaire, after taking the initial consent from them to participate in the study.

Data Analysis: Descriptive and inferential statistics were used to analyze the results of

the study under application of the statistical package (SPSS) ver. (18.0). Frequencies, and Percentages for socio- demographic; weighted arithmetic mean (MS), stander deviation (SD), Relative Sufficiency (RS%), for trainers' knowledge; ANCOVA to find relationship.

Ethical Considerations: After the study has been accepted by Council of the University of Baghdad's College of Nursing, Permission to collect the sample was also obtained from Ministry of Labor and Social Affairs commission of persons with Disabilities and special needs care\Directorate of Social Special needs, for private autism centers in Baghdad city.

RESULTS

Table (1) displays the frequency counts for selected variables. As mentioned above. Most of the participants are in the (no= less than 50) years-old age groups (n = 41; 41 %). Most of the participants according to their gender is female (n= 83; 83 %). Most of the participants are married (n = 69; 69 %). Most of the participants are graduated from institute (n = 53; 53 %), followed by those who graduated from college (n=47; 47%). shows that the years of employment ranged from 21-25 years (n = 38; 38 %), followed by those who have 26-30 years (n = 17; 17 %), and who have 11-15 years, 16-20 years (n = 11; 11 %) respectively. Most of participants have seen a student with hemophilia (n=58; 58%), while (n=42; 42%) have not ever seen a student with hemophilia. All the participants have not participation in a medical training course. Most of participant do not have a background regarding hemophilia (n=88; 88%).

Figure (1) demonstrates that there are mean score of the all domains related to teachers’ knowledge where show low significant.

Figure (2) demonstrates that there are mean score of the all domains related to teachers’ knowledge teacher’s role according to students with hemophilia where show moderate significant.

Table (2) results shows relationships between (SDCv.) and trainers' knowledge were weak in all variables except the Educational Level variable with degree of significant (0.001).

Table (1): Distribution of the sample by their Socio-demographic characteristics (SDCv.) with comparisons significant

No	Variable	Groups	study group
No	Variable	Groups	Freq.	%
1	Age Group	20-less than 30	2	2.00
		30-less than 40	15	15.00
		40-less than 50	44	44.00
		50-less than 60	37	37.00
		60 or more	2	2.00
		Total	100	100.00
2	Gender	Male	17	17.00
		Female	83	83.00
		Total	100	100.0
3	Marital Status	Single	14	14.00
		Married	69	69.00
		Divorced	6	6.00
		Widower	11	11.00
		Total	100	100.0
4	Educational level	Institute	53	53.00
		College	47	47.00
		Total	100	100.0
5	Years of Employment	1 - 5	7	7.00
		6 - 10	9	9.00
		11 - 15	11	11.00
		16 - 20	11	11.00
		21 - 25	38	38.00
		26 - 30	17	17.00
		31 - 35	4	4.00
		36 - 40	2	2.00
		Above 40	1	1.00
		Total	100	100.0
6	Have you ever seen a student with hemophilia?	Yes	58	58.00
		No	42	42.00
		Total	100	100.0
7	The medical training courses you have participated	Participated	0	0.00
		Not- Participated	100	100.0
		Total	100	100.0
8	Did you have a background about hemophilia If yes, from	Newspaper	2	2.00
		Internet	10	10.00
		Lecture	0	0
		Book	0	0
		No	88	88.00
		Total	100	100.0

HS: Highly Sig. at P<0.01; Testing based on Frequencies, and %(Percentages).

Table (2): Relationships (ANCOVA) concerning trainers' knowledge about pragmatic language for children with ASD and SDCv.

List	ANOVA
List	Demographical data	Sum of Squares	Df	Mean Square	F	Sig.
1	Age.	2.177	4	0.544	0.848	0.498
2	Marital Status.	0.736	4	0.184	0.285	0.887
3	Educational Level.	2398.12	1	2398.12	13.913	0.001
4	Years of Employment.	4.505	4	1.126	0.379	0.823
5	The medical training courses you have participated.	0.000	4	0.000	.	.
6	Have you ever seen a student with hemophilia.	0.041	4	0.010	0.205	0.935
7	Did you have a background about hemophilia If yes, from a newspaper, internet, lecture, and book.	2.351	4	0.588	0.531	0.713

a. R Squared = .749 (Adjusted R Squared = .476), df= degree of freedom Statistical hypothesis based on Analysis of variance (ANCOVA).

DISCUSSION

The result of table (1) the socio demographic characteristics of the sample, the findings higher percentage of the study sample (n = 41; 41 %), were between (40 – 49) year age group. This finding supported in a quasi-experimental study conducted in Shubra city in Egypt by ⁽⁸⁾, the results of the study (60%) among the age group over 40 years.

The finding indicated that two third of nurses were females. In descriptive study was carried out in Indonesia ⁽⁵⁾, the finding indicating that most of teachers were females.

According to teacher’s participation related to Marital Status, the finding higher percentage of the study sample (n = 69; 69 %) with married. Also, in Bali ^{(
9)} found that more than half of participation with married.

As regard to teachers’ level of education, the finding shows that less than half of teacher had bachelor’s degree and (n= 53; 53 %) their educational attainment was institute degree. This finding opposite by the finding that most of teachers had bachelor degree where they were (n= 91; 82%) ⁽⁵⁾.

The results of experience and training courses shows that the years of employment ranged from 21-25 years (n = 38; 38 %), followed by those who have 26-30 years (n = 17; 17 %), and who have 11-15 years, 16-20 years (n = 11; 11 %) respectively. All the participants have not participation in a medical training courses. This finding opposite by the most of school teachers were less than 5 years of experience (41.7%) ⁽¹⁾. In terms of training, it is obvious among study findings that the teachers to attend training sessions this finding supporting the results of study ⁽¹⁾.

The result of figure (1) The finding of the teacher’s knowledge related to hemophilia shows that teachers have low level of knowledge about definition of hemophilia, level bleeding severity, mild and moderate of bleeding, signs and symptoms of joint bleeding, signs and symptoms of muscles and joint bleeding, complication of hemophilia, nutrition with hemophilic child, sport and exercise with hemophilic child, there are studies support that Only few (16.3%) teachers had good knowledge about hemophilia, 44.2% of them were senior primary school teachers ⁽⁵⁾.

The result of figure (2). The finding of the teacher’s role according to students with hemophilia. Shows that teachers have moderate level of teachers knowledge related to teachers roles which include (wounds care, joint bleeding care, Epistaxis care, mouth bleeding care, bruising care, teacher’s role with use sport and excesses, giving instructions to the child, and teacher’s role), there are studies support that⁽²⁾ indicated that the participant’s knowledge related to care which can be provided by the participants to the child has achieved at all clauses mean which was (1.62) this indicates the care and practices provided by the participants was below the required level.

The result of table (2) The findings revealed there is there is no association between teacher' knowledge and their socio-demographic characteristics (age, gender, years of employment, marital status, have you ever seen a student with hemophilia, the medical training courses you have participated, and did you have a background about hemophilia If yes, from a newspaper, internet, lecture, and book). Except the educational level we note that is the only variable that has appeared highly significant (0.001), it has a meaningful relationship that which have an effect on teacher’s knowledge about hemophilia.

Alsofound that there the high significant relationship between participants age and education level with participant’s knowledge online ⁽⁶⁾.

CONCLUSION

The study concluded that there was no significant or weak correlation between the teacher's knowledge and socio-demographic characteristics.

The knowledge of the teachers ranged from low to medium in various dialogues.

RECOMMENDATIONS

1.The educational lectures and courses should be regularly done and updated for teacher’s knowledge about students with hemophilia.

2. Applying global educational standards to promote teacher’s knowledge about students with hemophilia

3. Periodic publication of booklets brochures in simple approach dealing with the review related to about students with hemophilia for continuous education of teaching staff by the ministry of higher education and scientific studies and ministry of health.

LIMITATIONS

1. Difficult processes in government departments for obtaining permits that will make data collection for primary schools.

2. Difficult access to many schools, which are distributed in Rusafa II.

ETHICALCONSIDERATIONSCOMPLIANCEWITHETHICALGUIDELINES

This study was completed following obtaining consent from the University of Baghdad.

FUNDING
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

AUTHOR’SCONTRIBUTIONS

Study concept, Writing, Reviewing the final edition by all authors.

DISCLOSURESTATEMENT:

The authors report no conflict of interest.

REFERENCES

1.Abd Al-Hamza, A., J., Obaid, K., B., & Mahmood, S., B. (2022). Primary School Teachers Knowledge towards Management of Students with T1DM. [Master’s thesis]. University of Baghdad. Hospital/Al-Hilla City. Iraqi Academic Scientific Journals, 6(1).

2. Header, M. D., Khaleel, M. A., Muhabes, J. F., (2016). Assessment of Mothers' Practices Regarding their Children with Hemophilia in Blood Disease Center at Maternity and Pediatric Babylon

3.Kadhim, K. A. R., Al-Lami, F. H., & Baldawi, K. H. (2019). Epidemiological profile of hemophilia in Baghdad-Iraq. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56(66).

4.Konkle, B. A., Huston, H., Cutter, S., Molter, D., Dunn, S., Hunter, S., Peltier, S., Haugstad, K., & Cooper, D. L. (2017). Impact of mild to severe hemophilia on education and work by US men, women, and caregivers of children with hemophilia B: The Bridging Hemophilia B Experiences, Results and Opportunities into Solutions (B‐HERO‐S) study. European journal of haematology, 98)18.

5.Mantik, J., Gunawan, S., Wowiling, S., (2020). Knowledge about hemophilia among teachers of patients with hemophilia in Indonesia. Journal Pre-proof ,3(5).

6.Mohammed, A., & Hattab, K., M., (2013). Assessment of Mothers Knowledge and Practices with Hemophilic Children type A at Azadi Teaching Hospital in Kirkuk City. Iraqi National Journal of Nursing Specialties, 2(26).

7.Rangarajan, S., Walsh, L., Lester, W., Perry, D., Madan, B., Laffan, M., & Pasi, K. J. (2017). AAV5–factor VIII gene transfer in severe hemophilia A. New England Journal of Medicine, 377(26), pp.2519-2530.

8.Sebaq, A., G., & Deraz, S., F., (2021). Improve Caregivers' Competency Level Regarding Care of Children Suffering from Hemophilia: An Educational Program. Egyptian Journal of Health,12(1).

9.Windiani, I. G. A. T., Antara, P., Soetjiningsih, I., & Adnyana, K. A. (2020). The Quality of Life in Children with Hemophilia in Bali. American Journal of Pediatrics, 6(4), pp.459-462.

10.World Federation of Hemophilia. (2020). Available from; Guidelines for the Management of Hemophilia. https://elearning.wfh.org/resource/treatment-guidelines/

References