RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

ANNEXURE-ISYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1 NAME OF THE CANDIDATE

AND ADDRESS

Mr. SMITH S KUMAR

1st yr MSc NURSING,

THE KARNATAKA COLLEGE OF

NURSING, #12,

KOGILU MAIN ROAD,

YEHLANKA, BANGALORE-

64

2 NAME OF THE INSTITUTION

THE KARNATAKA COLLEGE OF

NURSING, #12,

KOGILUMAINROAD,

YEHLANKA,

BANGALORE-64

3 COURSE OF STUDY

SUBJECT

I YEAR M.Sc. NURSING

PAEDIATRIC NURSING

4 DATE OF ADMISSION 15-06-2010

5 TITLE OF THE TOPIC “A STUDY TO ASSESS THE

EFFECTIVENESS OF ERGONOMICS

AWARENESS EDUCATIONAL

PROGRAMME FOR SCHOOL

CHILDREN STUDYING IN SELECTED

PRIVATE SCHOOLS, BANGALORE”.

1

6 BRIEF RESUME OF INTENDED WORK

6.1 INTRODUCTION

“Life is movement, even when we are sitting”

If a body is permanently inactive, brain activity is reduced.

It is estimated that 6.75 million Indian students become sick from sitting –

children sit up to 10 hours per day. This is the reason why ergonomic

standards for the school as place of work must be emphatically demanded.

From their first year in elementary school on, children are exposed to sedentary

strain under adverse ergonomic conditions. The most dangerous form of sitting,

however, is sitting still and for long periods of time.

School-children want to be really “good” at school. If they want to stay awake

and focused they have to be able to move even when seated. Their temporary

fidgety or restlessness is just another expression of this need. And the result is

that this mental and physical “survival strategy” will only earn them the

premature and wholly inappropriate label ADD or AD/HD.

Computer use among school age children is increasing. While this opens up

some new avenues for education, it also has resulted in an alarming trend –

injuries among young people related to long hours at the computer. 1

Classroom work, homework, surfing the web and playing computer games all

2

involve repetitive typing and mouse use, often done in awkward postures due to

sitting at adult-sized, unadjustable tables on similarly ill-fitting chairs. This in

turn has led to some adult-sized injuries - musculoskeletal disorders (MSDs)

such as tendonitis and carpal tunnel syndrome.

In the past, these types of injuries, which are sometimes referred to as RSIs

(repetitive strain injuries) or CTDs (cumulative trauma disorders) were only

seen in adults after years of exposure to risk factors at work and at home. 2

The fact that these injuries are being diagnosed among younger people has not

escaped the notice of medical professionals, educators, ergonomists and

businesses, who are concerned not only for the welfare as the students of today,

but also for their future as the workforce of tomorrow.

To help raise awareness of the issues and provide help in protecting

schoolchildren from injury, the Puget Sound Human Factors and Ergonomics

Society (PSHFES) is kicking off Ergonomics for Schools program during

October, which is National Ergonomics Month. 3

6.2 NEED FOR THE STUDY

A child’s healthy brain will signal its need for a dynamic load shifts

unconsciously by rocking or fidgeting on conventional chairs. Neuro-scientific

findings confirm the hypotheses that physical activity and related psychological-

emotional control processes are essential for cognitive performance.

A common proverb says: “The mind forms the body”. But what about the body

forming the mind? There have been studies confirming that physical activity

alone and its sensory effects develop, maintain and strengthen synapses in the

brain (Hollmann et al. 2005; Spitzer 2002).4

Ergonomics is the application of scientific information concerning humans and

their work

3

A fairly new field of ergonomics is developing. This is known as ergonomics for

children. This field deals with teaching children how to work safely with

computers and other things that may be hazardous or harmful to them in the

future.

The computer is going to be a much-used tool in the lives of students. Attention

needs to be paid to how children are introduced to and learn how to use these

computers and develop good work habits.

Ergonomics is the science of people-machine relationships. Properly sized and

placed equipment will help prevent injury and allow for comfort and efficiency

in the equipments use.

Children are used to living in an over-sized world, but sometimes this can lead

to discomfort, and even injury. Back pain, sports injuries, and with more and

more time spent online, eye strain and wrist injuries have all become epidemic

among our children. No matter how old a child is, preventing computer-related

disorders is much easier than treating them after they strike.

There are several warning signs that children may be experiencing repetitive

stress in the hands, wrists, back, or neck.

1) Pain

2) Fatigue

3) Weakness

4) Tingling or numbness

5) Stiffness

Children just like adults can suffer from eyestrain as well. They may have dry

eyes, blurred vision, bloodshot eyes, or sore tired eyes.

Two other areas that children benefit from ergonomic analysis are the effect of

backpacks a hand stress from handwriting.

4

Ergonomics is something people tend to focus on as adults, and neglect the need

for it in regards to children, but children are just as susceptible to the dangers of

repetitive stress injuries as adults are, maybe even a little more.

Kids have I-pod, computers, handheld games, and almost everything they

encounter is likely to be related to ergonomics. Using one of those is likely to

cause a repetitive stress injury.

The symptoms of repetitive stress injuries in children includes

-a tingling feeling in the body part, which may be accompanied by a numbness

or pain

-stiff or sore neck and back

-weak or tired feeling in hands and arms

-a feeling that the body part is popping or clicking.5

Prevalence rate

Children who notice these symptoms need to tell a parent or doctor immediately

before it gets too severe. If a repetitive stress injury occurs as the result of poor

ergonomics, it can stop the child from participating in everyday activities. Some

of those disorders include; Bursitis, Carpel Tunnel Syndrome, and Tennis

Elbow.

Higher prevalence of MSD reported pain occurs more frequent among female

then the male students. MSD for back pain common among female than in male

(25.4% versus 15.2%). The highest prevalence of MSD associated with

demographic and behavior factors in which the prevalence of MSD pain was

much higher (55.9%) than the present study (36.6%). Higher MSD pain reported

in lifetime for 5th grade (67.2%) compared to 2nd grade (36.4%). Dominant

pain location for lifetime prevalence recorded for 5th grade was the neck

5

(37.8%) followed by the shoulder (31.9%) and thigh (19.3%). Total reported

MSD pain in one week was also recorded higher at the neck area (22.7%) for the

5th grade as compared to the 2nd grade (8.2%). Most of the 2nd grade (11 – 12

years) school children in Karnataka reported as having higher thigh pain

(>30%). For the 2nd grade students, the highest reported musculoskeletal pain

was the shoulder area (16.4%) followed by the neck (14.5%) and leg (12.7%).

The strongest complaints were observed in the neck, upper back and low back

pain. 30.5% of children reported headache at least once a week compared with

54% of children who also reported musculoskeletal pain, while students with

any body part of muscle pain especially at lower back and headache reported

higher stomach ache than those who had no symptoms. There are other factors

that may influence the reporting of pain symptoms among the children and need

to be thoroughly understood when interpreting the findings from

musculoskeletal pain studies.

The prevalence rate of (ADHD) among school children in Bangalore were

Attention deficit hyperactivity disorder (ADHD) is one of the most common

childhood onset psychiatric disorders1 that affects 2.0-14.0% of school age

children. Boys are more commonly affected by ADHD than girls and the male:

female ratio is approximately 3:1 to 4:1.The onset is usually by three years of

age but the diagnosis is not made until the child is in elementary school.

Computer use by children at home and school is now common in many

countries. Child computer exposure varies with the type of computer technology

available and the child's age, gender and social group. This paper reviews the

current exposure data and the evidence for positive and negative effects of

computer use by children.

Potential positive effects of computer use by children include enhanced

cognitive development and school achievement, reduced barriers to social

interaction, enhanced fine motor skills and visual processing and effective

rehabilitation.

Potential negative effects include threats to child safety, inappropriate content,

6

and exposure to violence, bullying, Internet 'addiction', displacement of

moderate/vigorous physical activity, exposure to junk food advertising, sleep

displacement, vision problems and musculoskeletal problems.

The case for child specific evidence-based guidelines for wise use of computers

is presented based on children using computers differently to adults, being

physically, cognitively and socially different to adults, being in a state of change

and development and the potential to impact on later adult risk. Progress

towards child-specific guidelines is reported.

Finally, a set of guideline principles is presented as the basis for more detailed

guidelines on the physical, cognitive and social impact of computer use by

children. 6

The principles cover computer literacy, technology safety, child safety and

privacy and appropriate social, cognitive and physical development. The

majority of children in affluent communities now have substantial exposure to

computers. This is likely to have significant effects on child physical, cognitive

and social development.

Ergonomics can provide and promote guidelines for wise use of computers by

children and by doing so promote the positive effects and reduce the negative

effects of computer-child, and subsequent computer-adult, interaction.7

The present study evaluates the effect of a classroom-based behavioral

intervention package to improve Japanese elementary school children's sitting

posture in regular classrooms (N=68). This study uses a multiple-baseline

design across two classrooms with a modified repeated reversal within each

class. The article defines appropriate sitting posture as behavior composed of

four components (feet, buttocks, back, and a whole body). The intervention

package includes modeling, correspondence training, prompt, and

reinforcement, among others. The authors counted the number of children with

appropriate sitting posture in each classroom across all 28 sessions throughout

7

the study. Interobserver agreement of appropriate sitting posture ranged from

80% to 100%. As a result of the intervention, the mean proportion of children

with appropriate posture increased from approximately 20% to 90%. In addition,

their academic writing productivity increased with the improved sitting posture.

Teachers' acceptance of the intervention program proved to be excellent.8

Ergonomics now has developed training programs targeted specifically for

children and young adults in schools and educational facilities. These programs

are instructive, fun and teach the essential skills needed to prevent injury while

at the computer.

The principle aim of this study is to provide the right tools for children, and

teaching them the right way to use them, is at the heart of ergonomics for kids.

The goal is to keep the kids safe and comfortable.

Ergonomics awareness educational program will help the child to gain insight

towards a balanced-posture, body-function and movement patterns, as well as

their ergonomic implications, can minimize and even prevent musculoskeletal

discomfort and back pain problems. Such an ergonomics awareness educational

program has to start at childhood and should be an integral part of the

curriculum in the schools.9

As a Pediatric nurse, have a responsibility to use professional knowledge of

ergonomics solutions to protect future generations against unnecessary

exposures to musculoskeletal injury risks.

REVIEW OF LITERATURE

In the present study review of literature was complied and classified as

Literature related to awareness towards ergonomics of school children.

Literature related to the effectiveness of ergonomics awareness

educational program.

8

Syazwan Aizat Ismail, Shamsul Bahri Mohd. Baharudin and Zailina

Hashim (2010) conducted a study with the objective of investigating the

effectiveness of two ergonomics intervention programs in reducing ergonomic

risk factors among 229 school children in 2nd Grade (age 8 years) and 5th

Grade (age 11 years) in three schools. Group 1 (G1) assigned to one school,

which implemented the ergonomically design furniture in their class (among

2nd and 5th grade students), Group 2 (G2) from other school implemented

ergonomics program with intensive health promotion toward ergonomic

awareness consisted with exercising and education to reduce MSD, while Group

3 from another school selected as Control Group (Cx). Musculoskeletal

symptoms were recorded using modified nordiq body map questionnaires.

Modified Rapid Upper Limb Assessment (RULA) was used to assess the

awkward posture of the school children. Ergonomic awareness test performed

namely Ergonomic Quiz (EQ) to evaluate the awareness level before and after

ergonomic intervention programs. Tanita weight measurement was used to

measure school bag weight and students’ weight. Weight of the bag, RULA

score and EQ were used as main indicator to analyze the effectiveness of

programs to reduce ergonomic risks. A significant reduction of RULA scores

among sub-sample students and mean bag weight observed among G1<G2 and

Cx indicate the ergonomic risk were reduce accordingly. Higher EQ score

recorded among G1 students compared to G2 and Cx but the result were

insignificant. The implementation of ergonomically design furniture in

classroom able to reduce risk and reported MSD symptoms.10

Rowe G, Jacobs K, (2002) conducted a pilot study were to examine the

working position of middle school children during their media/technology class,

test student's knowledge of healthy computing habits, and evaluate the efficacy

of two educational interventions compared to a control group. A multi-group

pre-test/post-test design was used. 19 students (mean age 11.6) participated in

the study during their media/technology class. Students' postures while

computing were evaluated on-site. Additionally five students were video

recorded while they used the classroom computers so that on-site observations

could be compared to video recorded data. All participants were given a written

9

pre-test prior to educational interventions. The 12-minute educational

intervention session focused on healthy computing habits, the importance of

stretching, and group performance of specific upper extremity stretches.

Additional education regarding overall postural health including good body

mechanics was provided to one intervention group. The results of this study

indicate that a twelve-minute educational intervention significantly improved

participants' knowledge of healthy computing habits as measured by written pre-

tests and post-tests. Participants who received additional education on overall

postural health and body mechanics demonstrated the largest rate of

improvement in positioning while computing. No statistical difference between

intervention groups was noted on post-test scores, which attempted to measure

long-term learning of healthy computing habits. Although more research in this

area is warranted, it appears that education regarding correct positioning at

computer workstations combined with instructing students on the importance of

overall healthy posture may foster correct positioning while students use

computers at school.11

Sanders MJ, Morse T. (2005), conducted a study to identify the frequency,

type, and severity of musculoskeletal symptoms in parents of children less than

4 years old. The study further examined the factors that contribute to

musculoskeletal pain in this sample. A convenience sample of 130 parents with

children younger than 4 years old completed a seven-page survey that included

questions related to the parents' demographics, their musculoskeletal discomfort,

their performance of child-care tasks with high biomechanical risks (such as

carrying a child in a car seat), and parents' perceived psychological strain related

to caring for their children. Ninety-two percent (92%) of the providers were

mothers. Sixty-six percent (66%) of the sample reported the presence of

musculoskeletal pain. The parts of the body most affected were the low back

(48%), neck (17%), upper back (16%), and shoulders (11.5%). Factors

associated with musculoskeletal pain were performing child-care tasks defined

as having high biomechanical risks (p = .001), the perception that caring for

children is highly demanding (p = .003), and performing hobbies less than 1

hour per week (p = .04). Parents' working status, age, and participation in other

10

daily activities were not significantly related to musculoskeletal discomfort.

This study demonstrates the high prevalence of musculoskeletal pain in parents

of children under the age of 4 years. It underscores the association between

physical and psychological factors in the development of musculoskeletal

discomfort. It suggests the need for occupational therapy wellness programs that

focus on preventing musculoskeletal discomfort and providing support for the

parenting role.12

Sotoyama M, Bergqvist U, Jonai H, Saito S. (2002), conducted a study among

elementary, junior high and high schools in Yokohama and Kawasaki Cities

regarding the use of personal computers by pupils and students. The survey

included the questions that asked how often and in what environment computers

are used, whether any instructions are given as to their use, children's working

posture, and the effect on health. The results show that most schools are slow to

develop instructive programs from the environmental or ergonomic point of

view. So far there are not many children who complain of any serious symptoms

such as pain in the neck, head or shoulders, but a future increase in the number

of classes which involve computing, as well as the widespread popularity of

home computers, will surely arouse a legitimate concern about the health of

pupils and students, since they will spend more and more time operating the

devices. An effective way to anticipate the problem is to provide young students

with adequate knowledge of easy-on-body usage and environmental design, and

now there is an urgent need for specific guidelines to protect them.13

Limon S, Valinsky LJ, and Ben-Shalom Y. (2004), conducted a study to

identify and describe risk factors for low back pain that exists in the elementary

school environment. A prevalence survey of 101 randomly selected elementary

schools in the Israel Central District. A questionnaire, completed by school

nurses, measured risk factors among 10,000 children in elementary schools in

Israel. These included backpack and student weight, the availability of storage

facilities, the appropriateness of chair and desk height to student height, seating

arrangements during frontal lessons, and physical activity at recess. Between

11

30% and 54% of students carried >15% of their body weight. Nearly 15% of the

first graders and 20% of sixth graders had inappropriate chairs. In 74% of the

classes, students sat with their side facing the teacher and in 35% students sat

with their backs. In 6% of schools, no physical activity is offered at recess.

Shortcomings were found in all areas investigated. There is an urgent need for

health promotion programs to increase awareness and reduce risks in the school

environment.14

Skoffer B. (2007), conducted a study to estimate the relationship between the

occurrence of low back pain (LBP) and various types of school furniture and

anthropometric dimensions in schoolchildren, and physical loading by school

bag carrying. Cross-sectional sample with longitudinal information. Five

hundred forty-six schoolchildren aged 14 to 17 years answered a questionnaire

about sitting positions during school hours and the presence and severity of

LBP. Furthermore, the anthropometric dimensions and the weight of the school

bags were measured. The types and dimensions of the school furniture were

described and measured. In multivariate analyses was adjusted for physical

activity and other possible risk factors. More than half of the adolescents

experienced LBP during the preceding 3 months, and 24.2% reported reduced

daily function or care seeking because of LBP. LBP occurrence was not

associated with the types or dimensions of the school furniture or body

dimensions, but was positively associated with carrying the school bag on 1

shoulder [OR: 2.06 (1.29-3.31)]. The present study does not support the

hypothesis of different types of school furniture being a causative or preventing

factor for LBP. Carrying the school bag in an asymmetric manner may play a

role.15

Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. (2007), conducted

a study to investigate the effects of a back education program at 2-year follow-

up, in youngsters aged 13-14 years, on back posture knowledge, fear-avoidance

beliefs and self-reported pain. An additional purpose was to evaluate which

aspects of postural behavior were integrated in youngsters' lifestyles. At 2-year

12

follow-up, the study sample included 94 secondary schoolchildren in the

intervention group (mean age 13.3 +/- 0.8 years) and 101 controls (mean age

13.2 +/- 0.7 years). The back posture program that had been implemented for

two school years consisted of back education and the stimulation of postural

dynamism in the class through support and environmental changes. A

questionnaire was completed comparable to the pretest, posttest and follow-up

evaluations. The current study demonstrated at 2-year follow-up stability of the

improved general (F = 1.590, ns) and specific (F = 0.049, ns) back posture

knowledge in children who had received early back posture education. Back

posture education did not result in increased fear-avoidance beliefs (F = 1.163,

ns) or mounting back and/or neck pain reports (F = 0.001, ns). Based on self-

reports for postural behavior, youngsters who had received the back posture

program in the elementary school curriculum integrated crucial sitting and

lifting principles conform to biomechanical favorable postural behavior. The

steady intervention effects 2-year post-intervention demonstrated that intensive

back posture education through the elementary school curriculum is effective till

adolescence. Future research on the impact of early school-based back posture

promotion in relation to the integration of back posture principles according to a

biomechanical favorable lifestyle and back pain prevalence later in life is

essential.16

Parcells C, Stommel M, Hubbard RP. (1999), conducted a study to examine

possible mismatch between the individual body dimensions of students and the

classroom furniture they use. A total of 74 (37 male and 37 female) sixth-

through eighth-grade students in a Michigan school district participated in the

study; their ages ranged from 10 years, 11 months to 14 years, 3 months.

Anthropometric measurements (including elbow height, shoulder height, upper

arm length, knee height, popliteal height, buttock-popliteal length, and stature)

were gathered in several physical education classes, each during a single

session. In addition, the furniture dimensions were measured for three styles of

chairs and three styles of desks prevalent in the students' classrooms. Based on

both the information about student body dimensions and furniture dimensions,

measures of fit or mismatch were constructed. The data indicate a substantial

13

degree of mismatch between the students' bodily dimensions and the classroom

furniture available to them. Fewer than 20% of students can find acceptable

chair/desk combinations. Most students are sitting in chairs with seats that are

too high or too deep and at desks that are too high. Even after controlling for

body stature, girls are less likely to find fitting chairs. Based on the evidence

presented, many sixth through eighth graders must endure seating arrangements

in their classrooms that are not conducive to learning.17

Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. (2006), conducted

a study to investigate effects of a 2-school-year multifactorial back education

program on back posture knowledge and postural behavior in elementary

schoolchildren. Additionally, self-reported back or neck pain and fear-avoidance

beliefs were evaluated. A quasi-experimental pre/post design. The study sample

included 193 intervention children and 172 controls (baseline, 9-to-11-year-

olds). The multifactorial intervention consisted of a back education program and

the stimulation of postural dynamism in the class through support and

environmental changes. Evaluation consisted of a questionnaire, an observation

of postural behavior in the classroom, and an observation of material handling

during a movement session. The intervention resulted in increased back posture

knowledge (P < 0.001), improved postural behavior during material handling (P

< 0.001), and decreased duration of trunk flexion (P < 0.05) and neck torsion (P

< 0.05) during lesson time. The intervention did not change fear-avoidance

beliefs. There was a trend for decreased pain reports in boys of the intervention

group (P < 0.09).The intervention resulted in improved postural aspects related

to spinal loading. The long-term effect of improved postural behavior at young

age on back pain prevalence later in life is of interest for future research.18

Lorusso A, Bruno S, L'Abbate N. (2009), conducted a cross-sectional survey

to estimate the prevalence of musculoskeletal symptoms among students using

personal computers and to investigate the features of occupational exposure and

the prevalence of symptoms throughout the study course. Another objective was

to assess the students' level of knowledge of computer ergonomics and the

14

relevant health risks. A questionnaire was distributed to 183 students attending

the lectures for second and fourth year courses of the Faculty of Architecture.

Data concerning personal characteristics, ergonomic and organizational aspects

of computer use, and the presence of musculoskeletal symptoms in the neck and

upper limbs were collected. Exposure to risk factors such as daily duration of

computer use, time spent at the computer without breaks, duration of mouse use

and poor workstation ergonomics was significantly higher among students of the

fourth year course. Neck pain was the most commonly reported symptom

(69%), followed by hand/wrist (53%), shoulder (49%) and arm (8%) pain. The

prevalence of symptoms in the neck and hand/wrist area was significantly

higher in the students of the fourth year course. In our survey we found high

prevalence of musculoskeletal symptoms among students using computers for

long time periods on a daily basis. Exposure to computer-related ergonomic and

organizational risk factors and the prevalence of musculoskeletal symptoms

both seem to increase significantly throughout the study course. Furthermore,

we found that the level of perception of computer-related health risks among the

students was low. Our findings suggest the need for preventive intervention

consisting of education in computer ergonomics.19

Murphy S, Buckle P, Stubbs D. (2007), conducted a study to identify the

associations between ergonomics and other factors with back and neck pain

among schoolchildren. Self-reported questionnaires were used to record health

outcomes and potential risk factors in state schools. Six hundred and seventy-

nine schoolchildren from Surrey in the United Kingdom aged 11-14 years took

part. Twenty-seven percent of children reported having neck pain, 18% reported

having upper back pain, and 22% reported having low back pain. A forward

stepwise logistic regression was performed with pain categories the dependent

variables. Neck pain was significantly associated with school furniture features,

emotional and conducts problems, family history of low back pain and previous

treatment for musculoskeletal disorders. Upper back pain was associated with

school bag weight (3.4-4.45 kg), school furniture features, emotional problems

and previous treatment for musculoskeletal disorders. Low back pain was

associated with school furniture features, emotional problems, family history

15

and previous injury or accident. It is important to recognize the influence of

physical, psychological and family factors in children's pain.20

Williams CD, Jacobs K. (2002), conducted a study in the homes of middle

school children (average age = 12.7 years, SD = 0.52 years) to determine if an

educational intervention would increase both the children's and their parents'

knowledge of ergonomically correct setup of a computer workstation and

computer use. Six children and their parents (n = 6) participated in this study.

The study consisted of two data collection sessions over a two-week period.

Results suggest a significant (p < 0.05) increase in knowledge of computer use

and workstation setup for both parents and children, however, no significant

changes in posture were noted between sessions. It was concluded that

education is an effective method to increase knowledge of ergonomics in both

middle school children and their parents but more research is indicated to

understand the linkage between ergonomic understanding and durable

accommodations.21

Shinn J, Romaine KA, Casimano T, Jacobs K. (2002), conducted a study to

assess body mechanics and ergonomics for computer workstation usage can

increase a student's knowledge regarding these areas. This was a quasi-

experimental design using a questionnaire. Subjects included seventy-three male

and forty-four female sixth-grade students enrolled in a word processing class at

a New York Middle School. A non-standardized demographic and ergonomic

based questionnaire was administered before and after an in-service. An

environmental checklist was used to formulate a percentage of ergonomically

correct computer workstations. There was a statistically significant difference

between pre and post-test scores, indicating that learning took place. Pre-test

scores suggest that there exists a need for ergonomic education in classrooms.

Results from an environmental checklist support the need for revision of

computer workstations in classrooms. Ergonomic education is one way to help

students to reduce their risks of developing musculoskeletal injury in a

classroom environment that impedes correct positioning.22

16

6.3 PROBLEM STATEMENT

“A study to assess the effectiveness of ergonomics awareness educational

programme for school children studying in selected private schools, Bangalore”.

6.4 OBJECTIVES

To assess pre-test awareness level regarding the ergonomics among school

children studying in selected private schools.

To develop ergonomics awareness educational programme for school

children.

To evaluate the effectiveness of ergonomics awareness educational

programme in terms of gain in awareness level of school children studying

in selected private schools.

To find the association between the pre-test awareness regarding

ergonomics and selected socio-demographic variables.

6.5 OPERATIONAL DEFINITIONS

a) Assess:

It refers to the statistical measurement regarding the awareness on ergonomics

of school children studying in selected private schools as observed from scores

obtained on self-administered questionnaire and the socio-demographic

variables.

b) Effectiveness:

It refers to gain in level of awareness as determined by significant difference in

pre-test and post-test awareness scores.

c) Ergonomics awareness educational programme:

It refers to planned educational intervention, is the interactive discussion to gain

insight in relation to the ergonomics.

d) School children:

It refers to a child attending school between the ages of 10 to 15 years.

17

e) Ergonomics in school children:

It refers to the application of scientific information concerning humans and their

work.

In this study it deals with teaching school children how to work safely with

computers and other things that may be hazardous or harmful to them in the

future.

f) Private schools:

It refers to a school established and controlled privately and supported by

endowment and tuition.

6.6 ASSUMPTION

School children may have inadequate awareness regarding ergonomics.

Ergonomics awareness educational programme will improve the level of

awareness of school children regarding ergonomics.

Socio-demographic factors of school children can be influence on the

learning needs.

6.7 HYPOTHESIS

HO1 There will be no significant differences in the mean pre-test and post-test

level of awareness scores regarding ergonomics of school children at 0.05 level

of significance.

HO2 There will be a no significant association between the awareness levels and

selected socio demographic variables of school children at 0.05 level of

significance.

6.7 DELIMITATIONS

Study is limited to School children studying in selected private schools,

Bangalore.

18

7. MATERIALS AND METHODS

7.1 Sources Of Data : The data will be collected from the School

children studying in selected Private schools.

7.2 Method of collection of data

i. Research design:

Pre - experimental one group pre-test post-test design.

ii. Research variables:

a. Independent variable: Ergonomics awareness educational

programme for school children.

b. Dependent variable: Gain in awareness level of school children

about ergonomics.

c. 3. Associated variable: Age, Religion, Parents occupation,

Parents education, Residing area, Type of family, Sources of

information.

iii. Setting:

The study will be conducted at selected private schools in

Bangalore.

iv. Population:

All the school children of age group between 10 to 15 years in

private schools, Bangalore.

v. Sample size:

The school children who fulfill inclusion criteria & the sample

size will be 50

vi. Criteria for sample selection:

Inclusion criteria

The study includes:

Studying in selected private school.

Between the age of 10 to 15 years.

19

Willing to participate in the study.

Exclusion criteria

The study will exclude:

Diagnosed with acute/chronic illness.

Sick at the time of data collection

vii. Sampling technique:

Simple random sampling

viii. Research Approach:

Evaluative.

ix. Tool for data collection:

The tool consists of two sections:

Part I - Demographic variable such as age, gender, etc.,

Part II- The investigator will develop Awareness based structured

questionnaire is used to assess the awareness on the school

children regarding ergonomics

x. Method of data collection

After obtaining the permission from the concerned authorities and

Investigator introduces himself to subject and notifies about his aims,

objectives, and steps of study and takes written consent from the

respondents. The investigator will collect the data in following 3 phases.

Phase – One: Pretest will be given to assess the existing awareness on

school children regarding ergonomics with the help of structured

questionnaire.

Phase – Two: On the same day ergonomics awareness educational

programme (EAEP) will be given to the school children regarding

ergonomics by using A.V. Aids for 45 minutes to 1 hour duration.

Phase – Three: Same questionnaire will be administered to the school

children regarding ergonomics after 7 days.

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Duration of the data collection is 4 to 6 weeks.

xi. Plan for data analysis

The data collected will be analyzed by means of descriptive statistics and

inferential statistics.

Descriptive statistics:

Frequency and Percentage distribution of demographic variables

will be analyzed. Mean and Standard deviation will be use to

assess the level of awareness of the school children regarding

ergonomics.

Inferential statistics:

Paired‘t’ test will be use to compare the pretest and posttest

awareness regarding ergonomics among the school children; chi

– square test will be used to associate pretest awareness on

ergonomics of the school children with selected demographic

variables.

xii. Projected outcomes:

Ergonomics Awareness Educational Programme will improve the

level of awareness of the school children regarding ergonomics.

This will enable the school children to improve their self help

skills in their activities of daily living.

7.3 Does the study require any investigation to be conducted on patients or

other human or animals? If so please describe briefly?

Yes, [Ergonomics Awareness Educational Programme] will be administered for

the school children regarding ergonomics in selected private schools, Bangalore.

7.4 Ethical clearance has been obtained from your institution?

Yes, Consent will be obtained from concerned subjects and authority of

school management.

Privacy, confidentiality and anonymity will be guarded.

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Scientific objectivity of the study will be maintained with honesty and

impartiality.

LISTS OF REFERENCE

1. Lueder, R., & Berg Rice, V. Ergonomics for children: Designing products and

places for toddlers to teens. London: Taylor & Francis. 2008.

2. Straker, L., Maslen, B., Burgess-Limerick, R., Johnson, P., & Dennerlein, J.

Evidence-based guidelines for the wise use of computers by children: Physical

development guidelines. Ergonomics, 53, 458–477, 2010.

3. Burton, A. K. How to prevent low back pain. Best Practice & Research:

Clinical Rheumatology, 19, 541–555. 2005.

4. Hollmann et al.and Spitzer; “The mind forms the body”. 2005.

5. Straker L, Pollock C, Maslen B. Principles for the wise use of computers by

children. Ergonomics. 52(11):1386-401. Nov – 2009.

6. Alen Hedge, Katherine Laeser and Shawn Oates; Potential positive and

negative effects of computer use by children.1999.

7. Woodcock, A. and Denton, H.G. The teaching of ergonomics in schools:

What is happening? Annual Ergonomics Conference, in Contemporary

Ergonomics, 2001.

8. Noda W, Tanaka-Matsumi J. Effect of a classroom-based behavioral

intervention package on the improvement of children's sitting posture in Japan.

Behav Modif. 33(2):263-73. Mar-2009.

9. Heyman E, Dekel H. Ergonomics for children: an educational program for

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elementary school. Work. 32(3): 52(11):2006.

10. Syazwan Aizat Ismail, Shamsul Bahri Mohd. Baharudin and Zailina

Hashim. Evaluation of Two Ergonomics Intervention Programs in Reducing

Ergonomic Risk Factors of Musculoskeletal Disorder among School Children.

Volume: 4; Issue: 1, Page No.1-10; 2010.

11. Rowe G, Jacobs K. Efficacy of body mechanics education on posture while

computing in middle school children. Work. 18(3):295-303. 2002.

12. Sanders MJ, Morse T. The ergonomics of caring for children: an exploratory

study. Am J Occup Ther. 59(3):285-95. May-Jun, 2005.

13. Sotoyama M, Bergqvist U, Jonai H, Saito S. An ergonomic questionnaire

survey on the use of computers in schools. Ind Health. 40(2):135-41. Apr-2002.

14. Limon S, Valinsky LJ, and Ben-Shalom Y. Children at risk: risk factors for

low back pain in the elementary school environment. Spine (Phila Pa 1976). 15;

29(6):697-702. Mar-2004.

15. Skoffer B. Low back pain in 15- to 16-year-old children in relation to school

furniture and carrying of the school bag. Spine ,15;32(24): Nov- 2007.

16. Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. Back posture

education in elementary schoolchildren: a 2-year follow-up study. Eur Spine J.

16(6):841-50. Jun-2007.

17. Parcells C, Stommel M, Hubbard RP. Mismatch of classroom furniture and

student body dimensions: empirical findings and health implications. J Adolesc

Health. 24(4):265-73. Apr-1999.

18. Geldhof E, Cardon G, De Bourdeaudhuij I, De Clercq D. Effects of a two-

school-year multifactorial back education program in elementary

schoolchildren. Spine 31(17). Aug-2006.

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19. Lorusso A, Bruno S, L'Abbate N. Musculoskeletal disorders among student

computer users. Med Lav. 100(1):29-34. Jan-Feb, 2009.

20. Murphy S, Buckle P, Stubbs D. A cross-sectional study of self-reported back

and neck pain among English schoolchildren and associated physical and

psychological risk factors. Appl Ergon. 38(6):797-804. Nov -2007.

21. Williams CD, Jacobs K. The effectiveness of a home-based ergonomics

intervention on the proper use of computers by middle school children. Work.

18(3):261-8. 2002.

22. Shinn J, Romaine KA, Casimano T, Jacobs K. The effectiveness of ergonomic intervention in the classroom. Work. 18(1):67-73. 2002.

23. Saravanavel P, Research methodology, 16th edition, Kitab Mahal agencies,

Page 169– 170; 2006.

24. Polit DF, Hungler BP, Nursing research, principles and methods,

Philadelphia: Lippincott; 1999.

25. Kader P. Nursing research: Principles, process and issues. 2nd Ed. New York:

Palgrave Macmillan; 2006.

WEBSITES

www.google.com

www.pubmed.com

www.medline.com

www.pshfes.org

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9 Signature of Candidate

10 Remarks of the Guide

11 Name & Designation Of

11.1 Guide

11.2 Signature

11.3 Co-Guide

11.4 Signature

11.5 Head of the Department

11.6 Signature

12 12.1 Remarks of the

Principal

12.2 Signature

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26