segmentasi tepi citra Paru research

CHAPTER I
INTRODUCTION
1.1 BACKGROUND
"A state of complete physical, mental and social well - being and not merely the absent of
disease or infirmity".1
WHO
Health is a dynamic life experience. Dynamic implies a continuous adjustment to stressors in
internal and external environments and the use of one’s resources to achieve maximum
potential.2
Occupational Health is the promotion and maintenance of the highest degree of physical, mental
and social well-being of workers in all occupations by preventing departures from health,
controlling risks and the adaptation of work to people, and people to their jobs. Identification and
assessment of the risks from health hazards in the work place is the priority because people
spend their complete 8-12 hours in the work place 3.
Occupational environment too plays a major role on the health of the exposed. The health
hazards get more severe when the duration of exposure increases. This fact is more important in
situations as the personnel engaged in traffic duty. These personnel have to undergo physical
strain in an environment polluted by fumes, exhaust of vehicles, use of blowing horns, blow of
dust in the air by a speeding vehicle, etc.4
The purpose of health promotion is to positively influence the health behavior of individuals and
communities as well as the living and working conditions that influence their health. Health

promotion improves the health status of individuals, families, communities, states, and the
nation. Health promotion enhances the quality of life for all people. By focusing on prevention,
health promotion reduces the costs (both financial and human) that individuals, employers,
families, insurance companies, medical facilities, communities, the state and the nation would
spend on medical treatment. 5
There are still more occupational disorders that the traffic police personnel face in day today
life. Everywhere we go, large vehicles are running along the road honking loudly, exposing these
officers to high decibels of noise. Sound waves below 60 decibels are not harmful; they become
annoying at 80; and when they are above 85, they could lead to hearing impairment upon
prolonged exposure
According to WHO , outdoor air pollution caused about 3.7 million premature deaths
worldwide in 2012, 88% of those occurring in low and middle income countries .A study
conducted in 2006 in |Nepal reveled a fact that over 1900 premature death occur per year in
1

Kathmandu valley due to air pollution . According to the metropolitan traffic police office in
Singha Durbar , Kathmandu as many as 50 traffic police personnel fall ill daily due to hazard
dust on the recently demolished but yet to be reconstructed road .8
Traffic police who spend much of their time busy in controlling traffic at heavy traffic junction
suffer from ill effects of noise, air pollution must of the people need to take a preventive measure

to prevent from occupational hazard.
1.2 STATEMENT OF THE PROBLEM
"A STUDY TO ASSESS THE KNOWLEDGE REGARDING PREVENTION OF
OCCUPATIONAL HAZARD AMONG TRAFFIC POLICE IN BUTWAL. "
1.3 RATIONAL OF THE STUDY
An occupational hazard is a hazard experienced in the workplace. The traffic police comprise of
the only positive face of the' new Nepal', considering they always appear to be coming up with
innovative idea to better city. But there is a profession fraught with hazard, environmental
pollution play a significant role in the development of various respiratory diseases. Different
particles and gases from vehicles emissions like carbon dioxide, carbon mono-oxide, sulphur,
benzene, lead nitrogen dioxide and black smoke are of the root of the problem. Traffic police
who work at busy intersections are at the highest risk of developing asthma or chronic bronchitis,
apart from other allergic condition like pharyngitis rhinitis etc.
Another factor is the noise , there is no anti- honking law in Nepal and everywhere you go ,
large vehicles are running along the road honking loudly exposing their offices to high decibel
noise, sound waves below 60 decibels are not harmful, they become annoying at 80; they could
lead to hearing impairment .
There are also the consequences of prolonged standing to consider. Traffic police who are on the
streets every day are prone to developing varicose vein, a dilation of the superficial vein of the
lower limbs due to damage of value . These leading to swelling in the leg and a lot of

discomforts' 9.
A descriptive exploratory study was conducted among traffic police in Kathmandu. The study
revealed that 88% of the respondents has below level of practice and knowledge to prevents
respiratory problem. Therefore, this study aimed to assess the knowledge regarding occupational
hazard among traffic police in Butwal.
Above study has suggested that occupational hazard has caused a lot of health measures.
Prevention and awareness of occupational hazards can reduce the health problems.

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1.4 SIGNIFICANCE OF STUDY




The study helps in the assessing the knowledge regarding prevention
of occupational hazard among traffic police
It can help in the institution to plan awareness and educational Programs
It can help to provide baseline data for the students researcher in the future

1.5. OBJECTIVE OF THE STUDY
1.
2.

1.6

The objectives of this study is
To assess the knowledge regarding prevention of occupational hazard among traffic
police in Butwal
To associate knowledge regarding among traffic police with their selected demographic
variables.

RESEARCH HYPOTHESIS

H1: There will be significance association between knowledge and score with their sociodemographic variables.

1.7 CONCEPTUAL FRAMEWORK
The conceptual framework is developed to gain insight about this research. It formalized the
thinking process. So that other may read and clear frame of the reference basis of the research
problem.

For conceptual framework, I adopted the theory of Calista Roy.
Calista Roy was born on October 14, 1939 in Los Angeles, California. She received BS in
nursing from mount saint Mary’s college, Los Angeles in 1963, MS in nursing in 1966. MA in
sociology in 1973 and PHD in sociology from the University of Los Angeles in 1977. Roy is a
fellow of American academy of nursing and active in many nursing organization including sigma
theta tau and the North American nurses diagnosis association (NANDA). The nursing
philosophy or model of Sister Calista Roy focuses on the individual as a bio psychosocial
adaptive system. According to Roy nursing is a discipline that emphasizes strengthening
expanding and improving upon the person‘s coping abilities for the expanding and improving
upon the person’s coping abilities for the purpose of enhancing the patient’s wellness or health.

ELEMENTS OF ROY ‘S ADAPTATION MODEL:
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There are five essential element of the Roy adaptation model. They are:
1) The person who is recipient of nursing care.
2) The goal of nursing
3) The concept of health
4) The concept of environment
5) The direction of nursing activities.

THE PERSON: the first area of concern is the identity of recipient of nursing care. The recipient
of nursing care may be the person, a family, a group, a community, or a society. Each is
considered by the nurse as a holistic adaptive system. The idea of an adaptive system combines
the concepts of adaptation and system.
As an open system, an individual receives input or stimuli from both the self and the
environment. Roy identifies three classes of stimuli:
1) Focal stimulus: the internal or external stimulus most immediately confronting the
person and contributing to behavior. Focal stimuli are those that immediately confronting
the individual in a particular situation. In this study investigator assess knowledge of
prevention of occupational hazard among traffic police
2) Contextual stimulus: all other internal or external stimuli that influence the situation that
is financial and physical resources, presence or absence of support systems, butwal area .
3) Residual stimuli: Beliefs, attitudes or traits having an intermediate effect on the person‘s
behavior but whose effects are not validated. Residual stimuli include the individual
beliefs or attitudes that may influence the situation that is stage of development, cultural
background, spiritual beliefs, goals, expectations.
The secondary subsystem is an Effector Systems that manifests cognates and regulator activity. It
consists of four adaptive modes:
•THE PHYSIOLOGIC MODE: involves the body basic physiologic needs and ways of
adapting in regard to fluid and electrolytes, activity and rest, circulation and oxygen, nutrition

and elimination, protection, the senses and neurologic and endocrine function.
•THE SELF CONCEPT MODE: includes two components: the physical self, which involves
sensation and body images and the personal self which involves self-ideal, self-consistency and
the moral ethical self. Need is psychical and spiritual integrity: so that one can be exist with a
sense of unity, meaning and purposefulness in the universe.
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•THE ROLE FUNCTION MODE: is determined by the need for social integrity and refers to
the performance of duties based on given positions within society.
•THE INTERDEPENDENT MODE: involve one’s relations with significant others and
supports systems that provide help, affection and attention.
THE GOAL OF NURSING: the promotion of nursing is the promotion of adaptive response in
relation to the four adaptive modes. Adaptive responses are those that positively affect health.
Nursing seeks to reduce ineffective responses and promote adaptive responses. Human existence
is viewed as dynamic and purposeful. The person is respected as creative and active in use of
his/her coping and as an active participant in his / her care.
NURSING ACTIVITIES: nursing activities are delineated by the model as those that promote
adaptive responses in situation of health and illness. As a rule, these approaches are identified as
actions taken by the nurse to manipulate the focal, contextual or residual stimuli impinging on
the person. By making these adjustments the total stimuli; fall within the adaptive zone of the

person.

ROY’S ADAPTATION THEORY AND FOUR MAJOR CONCEPTS
1) PERSON / CLIENT: a bio physiological being who is in constant interaction with the
environment and who has four modes of adaptation, based on physiologic needs, self-concept
(physical self, moral ethical self, self-consistency, self-ideal and expectancy and self-esteem) role
function and interdependence relations.
2) ENVIRONMENT: all the conditions of circumstances and influences surrounding and
affecting the development and behavior of persons or groups: the input into the person as an
adaptive system involving both internal and external factors.
3) HEALTH: a state and a process of being and becoming an integrated and whole person.
Lack of integration represents lack of health.
4) NURSING: a theoretical system of knowledge that prescribes a process of analysis and
actions related to care of the ill or potentially ill person.
As a science, nursing is a developing system of knowledge about person used to observe classify,
and relate the processes by which persons positively affect their health status. As a practice

5

discipline, nursing scientific body of knowledge is used to provide an essential service to people

that is to promote ability to affect health positively

6

CONCEPTUAL FRAMEWORK
ADAPTIVE
GOOD
KNOWLEDGE
ON
PREVENTION OF
OCCUPATIONAL
HAZARD

RESIDUAL STIMULI
KNOWLEDGE ON
PREVENTION OF
S
OCCUPATIONAL HAZARD

COGNATOR

SUBSYSTEM
PERCEPTION
EMOTION

GOOD PRACTICE

JUDGEMENT
FOCAL STIMULI
ADAPTIVE

ENVIRONMENT

KNOWLEDGE OF
TRAFFIC POLICE

KNOWLEDGE OF
PREVENTION OF
OCCUPATIONAL
HAZARD AMONG
TRAFFIC POLICE

Informal health
teaching

ADAPTIVE
MODES

CONTEXTUAL STIMULI

REGULATOR
SYSTEM

MALADAPTIV
E

INADEQUATE
KNOWLEDGE
REGARDING ON
OCCUPATIONAL
HAZARD

CHEMICAL
SEX, EDUCATIONAL LEVEL, YEAR
EXPERIENCE, WORKING AREA,
ENDOCRINE
SOURCE OF INFORMATION SOCIO
POOR KNOWLEDGE
ECONOMIC
STATUS
FIG 1: MODIFIED
CONCEPTUAL FRAMEWORK
BASED
ON
SISTER
CALLISTA
ROY – ADAPTATION
NEURAL

SYSTEM THEORY

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1.8 OPERATIONAL DEFINITION
a) Study: It refers to the devotion of time and attention to gain knowledge
b) Assess: It refers to the level of knowledge regarding prevention of occupational hazard
through questioner in Butwal.
c) Knowledge: Refers to fact and information regarding prevention of occupational hazard
among traffic police at Butwal
d) Prevention: Prevention is to take precaution in a early time is call prevention
e) Occupational hazard :Occupational hazard are conditions surrounding a work
environment that increase the probability of illness , death or disability to a traffic police
which are respiratory problem , ear deaf , varicose vein
g) Traffic police; In this study, it refers to police officers policing unit enforcing rules of
road. Includes officers who patrol major roads and also who address traffic infractions on the
other roads of Butwal.

1.9 DELIMITATION OF THE STUDY
THE STUDY IS DELIMITED TO:
Study period includes only 9 week
 Participations who are available during the period of data collection
 Participants willing to participate in the study
 The respondents will be only 50 traffic police.
The study will be conducted in selected area Butwal

CHAPTER II
LITERATURE REVIEW
8

2.1 LITERATURE REVIEW
Literature review is a systematic and critical review of the most important scholarly literature on
a particular age.
WOOD L G SUDITH

2.2 INTRODUCTION
Review of literature is a key step in a research Process. Review of literature refers to the
extensive, exhaustive and systematic examination of publication relevant to research project. The
purpose of literature review is to situate our research in context of what is already known about
the topic. It is needed to show how work benefit is the Whole. It should be theoretical basis for
our work. It provides theoretical support to the conceptual framework.
The purpose of this literature review is to develop understand and insight into the previous
research works that relates to present study .so it helps to gain deeper insight about the subject ,
to develop instrument for data collection that could be applicable in the interpretation and the
conclusion of the study . The collected information is organized about knowledge regarding
prevention of occupational hazard among traffic police.

2.3 REVIEW OF LITERATURE
A descriptive study was conducted by S.Pantha, M.Neupaney on "knowledge and practice
regarding prevention of occupational hazard among traffic police in Kathmandu" among 282
traffic police. Data collection method was done. The result revels that 54.6% had poor practice
on prevention of occupational health hazard, fair 42.9%, good 2.5% practice in prevention of
occupational health hazard. Thus, traffic police knowledge on prevention of occupational hazard
had fair knowledge and poor prevention practice.10

A descriptive exploratory study was conducted by Ambika Aryal Bhandari, Roshany Gautam,
Siva Bhandari on "knowledge and practice on prevention of respiratory health problem among
traffic police in Kathmandu, Nepal."The questionnaires method was used. The study revealed
that 88% of the respondents have below level of practice and knowledge to prevent respiratory
9

problem. The level of practice and knowledge on prevention of respiratory health problem is not
satisfactory. 11
A descriptive exploratory study was conducted by Mrs .devina E Rodrigug on "knowledge on
occupational hazard and utilization of safety measure among 90 traffic police of south kanara
district, India. The structured questionnaires method was used. The study revealed that 78%
average knowledge , 11 % of the subject has poor knowledge. Thus, study revealed do not have
adequate knowledge on the occupational hazard and its safety measure still there is a need to
improved in knowledge 12
A cross sectional, descriptive study was conducted by Shrestha I , Shrestha BL et.al ,.on
prevalence of noise induced hearing loss among traffic police personnel of Kathmandu
metropolitan city among 110 traffic police . The questionnaires method was used. The study
revealed that 66.4% noise induced hearing loss positive cases. Traffic police personnel are in
constant risk of noise induced hearing loss. Screening of hearing loss is recommended for people
exposed to noise thus the study revealed that low knowledge level of the occupational hazard
created hearing loss so still need to continue education to the traffic police .13
A descriptive study was conducted on ' the knowledge of police force on prevention of
occupational hazard and utilization of safety measure in south kanara among 90 traffic police. the
structure questionnaire method was used .the study revealed that 89% had

inadequate

knowledge on prevention of occupational hazard 7% of the subjects showed low utilization of
safety measure .14

2.4 SUMMARY OF LITERATURE REVIEW
From the above literature review it has been revealed that there is poor practice of prevention of
occupational hazard among traffic police.

CHAPTER III
RESEARCH METHODOLOGY
10

3.1 INTRODUCTION
This chapter includes research design , study area , study population , study subject , sample size
, study variables , inclusion variables , exclusive variables , sampling techniques , plan for data
collection , ethical consideration , data collection tool , validity and reliability , plan for data
analysis , budgeting planning , work plan for completing the study.

3.2 RESEARCH DESIGN
Descriptive research design

3.3STUDY POPULATION
The study population consists of traffic police in Butwal.

3.4STUDY SETTING
The setting for research study will be conducted in selected traffic station Butwal.

3.5SAMPLE SIZE
The sample size will be 50.

3.6STUDY VARIABLES
1) DEPENDENT VARIABLES
Knowledge regarding prevention of occupational hazard
2) SOCIO DEMOGRAPHIC VARIABLES
 Sex
 Educational level
 Year of Experience
 Working Area
 Source of information
 Socio economic status

3.7 INCLUSIVE CRITERIA





Traffic police visiting in police station.
Traffic police who are present in class.
Traffic police who are interested.
Traffic police who are taken consent.

3.8 EXCLUSIVE CRITERIA
 Traffic police who are not present in police station
 Uninterested traffic police

3.9SAMPLE TECHNIQUE
In this study, non probability purposive sampling will be used to select the required sample.

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3.10 PLAN FOR DATA COLLECTION
 Administrative approval will be obtained from the concerned authority of butwal
police station
 The schedule of the data collection will be organized to the respondents.
 The respondents will assure that the information obtained from them won't be
disclosed to other.
 The participants will be allowed to refuse the study at any time.
 The objectives of the study will be explained to the respondents.

3.11

ETHICAL CONSIDERATION
Prior conducting research, the following ethical consideration were taken





formal approval will be taken from concerned authority i.e. butwal police station
Those who are unwilling will not be forced in the study.
Privacy and confidentiality will be maintained during the data collection.
Respondent will be ensured the information will be used for the study.

3.12 DATA COLLECTION TOOL
Data will be collected in 2 Section.
SECTION 1: socio-demographic.







sex
Education level
Experience
Area of experience
Source of information
Socio economic status

SECTION 2: Structured questionnaire related to knowledge regarding prevention of occupational
hazard

3.13 VALIDITY AND RELIABILITY
The content validity of instrument will be established by peer review, consultation with research
advisor and experts. On the basis of this, necessary modification was done. The questionnaire
was prepared on the basis of objectives and variables of the study in orderly manner.
12

3.14 PLANS FOR DATA ANALYSIS


Data analysis is the systematic organization and synthesis of research data and using of
those data.
The data obtained will be analyzed using both descriptive and inferential statistics.

1.

2.


Descriptive
Frequency and percentage distribution will be used to describe demographic variables
Inferential statistics
Chi square test will be used to associate the knowledge among traffic police.

3.15 BUDGET PLANNING
EXPENDITURE
Stationary
Internet
Travelling
Approval letter

AMOUNTS (RUPEES)
5,000
2,000
4,000
2'000

TOTAL

TENTATIVE AMOUNT

13,000

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3.16WORK PLAN FOR COMPLETING STUDY
Month
Week

1st

2nd

3rd

4th

Statement of problem
Literature review
Preparation and synopsis
presentation
Development of tool
tools validation and
reliability
Pilot study and analysis of
result
Data collection
Data analysis
Report analysis

14

5th

6th

7th

8th

9th

REFERENCES
1. WHO.int/suggestiofag/e
2. Joyce, M.Black. 'Text book of Medical surgical Nursing'. 8 th ed. New Delhi: Saunders and
Elsevier publication; 2010:4.

3. Raymond Agius. What is Occupational Health? [homepage on the Internet]. 2010 [cited
2013 Dec 20].

4. Satapathy, DM, Behera, TR, Tripathy RM. Health Status of Traffic Police Personnel in
Brahmapur City. Indian J Community Med [serial on the Internet]. 2009;34(1)

5. Joyce M.Black.' Text book of Medical surgical Nursing'. 8 th edition . New Delhi: Saunders
and Elsevier publication; 2010:4.
6. Dr.arpanaNeopane. Occupational hazards for traffic police. 2012 [cited 2013 Dec 20].
Available from: Kathmandu Medical College
7. Tea WorldHealthOrganization,Ambient (Outdoor) AirQuality and
Health,World Health Organization, Geneva, Switzerland, 2014,
8. http://www.who.int/mediacentre/factsheets/fs313/en/. ching Hospital, Web Nepal Health
Research Council and World Health Organization,
Development of Procedures and Assessment of Environmental
Burden of Disease of Local Levels due toMajor Environmental
Risk Factors, Nepal Health Research Council, Kathmandu,
Nepal, 2006.
9.

http://kathmandupost.ekantipur.com/printedition/news/2012-03-11/occupational-hazards-for-

traffic-police-officers.html

15

10. S.Pantha , M. Pantha ,"knowledge and practice regarding prevention of occupational hazard
among

traffic

police

in

kathmandu,"2016,

https://www.nepjol.info/index.php/JCMC/article/viewFile/16698/13574
11.Mrs. Devina E R odrigues et.l, "knowkedge on occupational hazard and utilization of safety
mesure

among

traffic

police",

of

south

kanara

distict,

India,

2015http://iasir.net/AIJRHASSpapers/AIJRHASS15-519.pdf
12. Ambika Aryal Bhandari,1 Roshani Gautam,1 and Shiva Bhandari2, Knowledge and Practice on
Prevention of Respiratory Health Problems among Traffic Police in Kathmandu, Nepal", "
http://dx.doi.org/10.1155/2015/716257

13. Shrestha I, Shrestha BL, knowledge of Noise Induced Hearing Loss among Traffic Police
Personnel of Kathmandu Metropolitan City
14.
Mrs. Devina E Rodrigues.,"KNOWLEDGE ON OCCUPATIONAL HAZARDS AND
UTILIZATION OF SAFETY MEASURES AMONG TRAFFIC POLICE", OF SOUTH
Karnataka, INDIA.

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