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A Study to Assess the Effect of Video-Assisted Teaching on Knowledge and Attitude Regarding Prevention of Head Injury among Young Adults in Selected Colleges of Guwahati , Assam

Introduction: The young adults need to be aware of head injury and its preventive aspects. They need to understand the causes of head injury, risk factors, and its application of preventive measures. It is utterly important and urgent to make aware and motivate young adults to practice preventive measures of head injury. Aim: This study aims to assess the effect of video-assisted teaching on knowledge and attitude regarding prevention of head injuries among young adults. Materials and Methods: The study sample consists of 50 young adults from different colleges of Guwahati, Assam. The methods and materials used were self-administered questionnaires and 4-point Likert Scale. Results: The study revealed, before the intervention, 58% had inadequate knowledge and none of them had adequate knowledge. After the intervention, 70% of them had adequate knowledge and none of them had inadequate knowledge. Before the intervention, 21% had inadequate attitude and none of them had adequate attitude. After the intervention, 32% had adequate attitude and 4% of them had inadequate attitude. The study revealed that there is a significant relationship between knowledge and attitude and found association between pre-test knowledge score of the young adults on prevention of head injury with their gender as well as between the pre-test attitude score on prevention of head injury with their age and educational qualification. Conclusion: The study revealed that the video-assisted teaching was effective and it improved knowledge and attitude of young adults on prevention of head injury.


Introduction
In patients who reach the hospital alive, complications from closed head injuries are the single largest cause of morbidity and mortality. Head trauma is usually the primary injury in patients who require long-term rehabilitation. The data are generally applicable to children as well, evident by head trauma's accountancy for an annual mortality rate of 1/1000 in this age group. [1,2,10] The management of head injury has been revolutionized by round the clock monitoring, carotid angiography, isotope brain scan, computerized axial tomography, and monitoring of intracranial pressure. Intermittent positive pressure ventilation, dehydration therapy, and better techniques of operations have made a tremendous difference in the ultimate outcome of severe brain trauma. Recently introduced multimodality evoked potential technique has further improved its management. [8,9,11] Despite all the advances, a lingering lacuna for further research for the betterment of outcomes following head injury still persists. In spite of the best management, 15-20% of head injuries prove fatal. Furthermore, any therapeutic inadequacies may result in further increase in morbidity and mortality. Consequently, the importance of protecting the head from injury is gaining wider recognition. Firm preventive efforts will clearly be effective in reducing the incidence of serious head injuries and their complication. Compulsory wearing of protective devices, for example, helmets and automatic shoulder belts, in cars, etc., has reduced the incidence and degree of serious research, and epidemiological data are required to initiate appropriate preventive measures and to plan necessary services. [1,5,7,9,11,12]

Statement of the study
This study was to assess the effect of video-assisted teaching on knowledge and attitude regarding prevention of head injury among young adults in selected colleges of Guwahati, Assam.

Objectives
The objectives of the study were as follows: 1. To assess the knowledge regarding prevention of head injury among young adults before and after implementation of video-assisted teaching. 2. To assess the attitude regarding prevention of head injury among young adults before and after implementation of video-assisted teaching. 3. To assess the effectiveness of video-assisted teaching on knowledge and attitude regarding prevention of head injury among young adults.
4. To correlate the pre-test and post-test knowledge and attitude regarding prevention of head injury among young adults. 5. To find out the association between the pre-test knowledge and attitude with selected demographic variables.

Assumptions
• The young adults may have some knowledge regarding the prevention of head injury. • The video teaching program may help to improve knowledge and attitude regarding the prevention of head injury.

Research design
An experimental pretest-posttest design was used for the study. The independent variable in this study was video-assisted teaching on prevention of head injury and the dependent variables were knowledge and attitude of young adults regarding the prevention of head injury. The study was conducted in selected colleges of Guwahati, Assam.
A total of 50 samples were included as study samples using convenient sampling technique. Sample selection was based on inclusive and exclusive criteria.

Description of the tool
The tool used to prepare in this study was prepared in three sections.
Section I: This section attempted to seek information regarding sample characteristics.
This consists of age, gender, educational qualification, unhealthy habit, source of information, family history of head injury, common mode of travel, history of head injury in the past, and history of hospitalization due to head injury.
Section II: This section attempted to seek information regarding opinion about knowledge of the prevention of head injury. The structured questionnaire consisted of 22 questions and each question had only one correct response. For each correct response, a score of 1 mark was given and for every incorrect answer, a score of 0 was given.

Development of the video-assisted teaching
The following steps were adopted in the development of the video-assisted teaching.
• Outlined the objectives • Preparation of the video and final draft of the video • Development of the 4-point Likert scale.
• Content validity of the teaching program. The content validity was obtained from two experts from the field of medicine and seven from the field of nursing. • Preparation of the final draft: The final draft was prepared after being evaluated by all expects, whereby necessary corrections and modifications were incorporated.

Data collection procedure
The data collection was done from June 3 rd , 2014 to July 5 th , 2014 for a period of 5 weeks. A formal written permission from the principal of B Borooah College, Handique Girls' College, and Arya Vidyapeeth College, Guwahati, Assam, was taken. The purpose of the study was explained in details. Then, the principal of each college has given one professor for guiding the investigator to the class. The investigator met the students and explained the purpose of the study. The participants were gathered in a space as provided by the college authority and consent was obtained from each one of them. Pre-test was done to assess the knowledge and attitude regarding the prevention of head injuries using self-administered questionnaire and 4-point Likert scale for assessing attitude. Following pre-test, the investigator delivered a video regarding the prevention of head injury for 30 min. Post-test was conducted after a period of 7 days using the same tool.
• Pre-test: A pre-test was administration of selfadministered questionnaire and 4-point Likert scale. The duration of 30 min was given for the samples to complete the tool at the same time. • Video-assisted teaching program: On the same day after pre-test, the teaching was administered for 30 min using a video. The video-assisted teaching contained information regarding definition of head injury, diagnosis, causes, risk factors, management, complication, and the most important is the prevention of head injury. • Post-test: Post-test was done after a period of 7 days for the same samples using the same structured questionnaire and 4-point Likert scale.

Summary of the Findings
Data on demographic variables of young adults from selected colleges of Guwahati Table 1 shows that the majority of adults (60%) were under the age group of 21-24 years. About 20% belong to 18-21 years; 20% belong above 25 years. Majority of young adults (74%) was male and 26% were female. Most of them were graduate (60%) and 20% were postgraduate and 20% were higher secondary. About 62% of them were had a family history of head injury and other 38% did not have a history of head injury. Most of them 54% were had head injury and 46% did not have a history of head injury. Most of them 52% were not hospitalized and 48% were hospitalized due to head injury. About 46% were having unhealthy habit and other 54% did not have. About 26%

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were from media (T.V), 6% were from health service, 6% were from newspaper and magazines, and others were from 62%. Majority 54% were travel through four-wheeler and 46% were two-wheeler.
The first objective was to find out the knowledge regarding the prevention of head injury among young adults before and after implementation of video-assisted teaching In Table 2, the frequency and percentage distribution of pre-test and post-test knowledge score of young adults were presented. The table depicts that 58% of participants were having inadequate knowledge, 42% were moderately adequate, and none of them were having adequate knowledge in pre-test, whereas 70% of participants were having adequate knowledge, 30% were moderately adequate, and none of them were having inadequate knowledge in post-test.
The second objective was to find out the attitude regarding the prevention of head injury among young adult after and before implementation of video-assisted teaching In Table 3, the frequency and percentage distribution of pretest attitude score of young adults are presented. The table depicts that 21% of participants were having unfavorable attitude, 58% were moderately favorable, and none of them were having favorable attitude in pre-test, whereas 32% were having favorable attitude, 64% were moderately favorable, and 4% of them were having unfavorable attitude.
The third objective was to assess the effectiveness of video-assisted teaching on knowledge and attitude regarding the prevention of head injury among young adults

Effect of video-assisted teaching on knowledge regarding the prevention of head injuries
Before calculating z value, null hypothesis (Ho1) was stated as Ho1: There is no significant difference between mean pre-test knowledge and post-test knowledge score. Table 4 shows that the mean knowledge in pre-test was 11.12 and standard deviation of 2.35 in post-test, the mean score was 16.62 with standard deviation of 2.40. The improvement was statistically tested by Z test. The calculated value was greater than tabulated value at 0.01% level. Hence, the null hypothesis was rejected, and hence, research hypothesis was accepted. This indicated that video-assisted teaching on head injury on knowledge among young adult was effective.

Effect of video-assisted teaching on attitude regarding the prevention of head injuries
Before calculating z value, null hypothesis (Ho1) was stated as Ho1: There is no significant difference between mean pretest attitude and post-test attitude score. Table 5 shows that mean attitude in pre-test was 30.18 and standard deviation of 5.82. In post-test, the mean score was 38.36 with standard deviation of 6.10. The improvement was statistically tested by Z test. The calculated value was greater than tabulated value at 0.1% level. Hence, the null hypothesis was rejected, and hence, research hypothesis was accepted. This indicated that video-assisted teaching on head injury on attitude among young adult was effective.

The fourth objective was to correlate the pre-test and post-test knowledge and attitude regarding the prevention of head injury among young adults
In Table 6 the overall mean score of pre-test knowledge and pre-test attitude on prevention of road traffic accident among young adults was 11.12 and 2.35 with SD of 30.18 and 5.82, respectively. The "r" value (0.29) shows that there was a positive relationship between knowledge and attitude.
In Table 7 the overall mean score of post-test knowledge and post-test attitude on prevention of road traffic accident among young adults was 16.62 and 38.36 with SD of 2.40  © 2020 IJNS | Published by Innovational Publishers and 6.10, respectively. The "r" value (0.13) shows that there was a positive relationship between knowledge and attitude. Table 8 shows that the calculated Chi-square value at 0.01% level of significance was greater than the tabulated value. Therefore, the null hypothesis was rejected and concluded that there was an association between the pretest knowledge score of the young adults on prevention of head injury with their gender. Table 8 shows that the calculated Chi-square value at 0.01% level of significance was less than the tabulated value. Therefore, the null hypothesis was accepted and concluded that there was no association between the pretest knowledge score of the young adults on prevention of head injury with their age, education qualification, family history of head injury, history of head injury, history of hospitalization, and mode of traveling. Table 9 shows that the calculated Chi-square value at 0.01% level of significance was greater than the tabulated value.

The fifth objective was to find the association between the pre-test knowledge and attitude with selected demographic variables
Therefore, the null hypothesis was rejected and concluded that there was an association between the pre-test attitude score of the young adults on prevention of head injury with their age and educational qualification. Table 9 shows that the calculated Chi-square value at 0.01% level of significance was less than the tabulated value. Therefore, the null hypothesis was accepted and concluded that there was no association between the pre-test attitude score of the young adults on prevention of head injury with their gender, family history of head injury, history of head injury, history of hospitalization, and mode of traveling.

Discussion
Majority of adults (60%) were under the age group of 21-24 years. About 20% belong to 18-21 years; 20% belong above 25 years. Majority of young adults (74%) was male and 26% were female. Most of them were graduate (60%) and 20% were postgraduate and 20% were higher secondary. About 62% of them were had a family history of head injury and other 38% did not have a history of head injury. Most of them 54% were had head injury and 46% did not have a history of head injury. Most of them 52% were not hospitalized and 48% were hospitalized due to head injury. About 46% were having unhealthy habit and other 54% did not have. About 26% were from media (TV), 6% were from health service, 6% were from newspaper and magazines, and others were from 62%. Majority 54% were travel through four-wheeler and 46% were two-wheeler.
The present study is supported by Boniface, Respicious, Museru, Lawrence, Kiloloma, Othman Munthali, and Victoria (2016). "Factors associated with road traffic injuries in Tanzania" injuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes account for a significant proportion of these injuries. The aim of this study was to determine the pattern, associated factors, and management of road traffic injury patients in Tanzania [13] The first objective was to find out the knowledge regarding the prevention of head injury among young adults before and after implementation of video-assisted teaching The pre-test knowledge score before the intervention showed as 58% were inadequate knowledge, 42% were       moderately adequate, and none of them were having adequate knowledge. After the intervention, the post-test scoring of performance, it was found that out of total 50 samples, 70% were adequate knowledge, 30% were moderately adequate, and none of them were having inadequate knowledge.
The second objective was to find out the attitude regarding the prevention of head injury among young adult after and before implementation of video-assisted teaching The pre-test knowledge score before the intervention showed as 42% were unfavorable attitude, 58% were moderately favorable, and none of them were having favorable attitude. After the intervention, the post-test scoring of performance, it was found that out of total 50 samples, 32% were favorable attitude, 64% were moderately favorable, and 4% of them were having unfavorable attitude.
The present study is supported by Titchener et al. study on "Knowledge, attitudes, and beliefs toward injury prevention: A population-based telephone survey" in Australia. A total of 1030 residents, the youngest members of society were identified as being the most vulnerable to deliberate injury with young adults accounting for 59% of responses aligning with reported data. However, younger adults failed to indicate an awareness of their own vulnerability to deliberate injury in alcohol environments even though 61% of older respondents were aware of this trend. Older respondents were the least inclined to agree that they could make a difference to their own safety in or around the home, but were more inclined to agree that they could make a difference to their own safety at work. [14] The third objective was to assess the effectiveness of video-assisted teaching on knowledge and attitude regarding the prevention of head injury among young adults Table 4 shows that the mean knowledge in pre-test was 11.12 and standard deviation of 2.35. In post-test, the mean score was 16.62 with standard deviation of 2.40. The improvement was statistically tested by Z test. The calculated value was greater than tabulated value. Hence, the null hypothesis was rejected, and hence, research hypothesis was accepted. This indicated that video-assisted teaching on road traffic accident on knowledge among young adult was effective. The present study was supported by Jane Mertz Garciaa et al. on "Evaluation of a health education program about traumatic brain injury" in the UK. The aim was to evaluate a health education program designed to increase public awareness and understanding about TBI through in person (classroom) and computer-based (electronic) learning environments. In the study, they found that participants had significantly higher ratings of knowledge after the program experience. [15] The fourth objective was to correlate the pre-test and post-test knowledge and attitude regarding the prevention of head injury among young adults Table 7 shows that the mean score of pre-test knowledge and pre-test attitude on prevention of road traffic accident among young adults was 11.12 and 30.18 with SD of 2.35 and 5.82. "r" value (0.29) showed that there was a positive relationship between knowledge and attitude. Table 7 shows that the mean score of post-test knowledge and post-test attitude on prevention of road traffic accident among young adults was 16.62 and 38.36 with SD of 2.40 and 6.10. "r" value (0.13) showed that there was a positive relationship between knowledge and attitude.
The fifth objective was to find the association between the pre-test knowledge and attitude with selected demographic variables Table 8 shows that the calculated Chi-square value at 0.01% level of significance was greater than the tabulated value. Therefore, the null hypothesis was rejected and concluded that there was an association between the pretest knowledge score of the young adults on prevention of head injury with their gender. Table 8 shows that the calculated Chi-square value at 0.01% level of significance was less than the tabulated value. Therefore, the null hypothesis was accepted and concluded that there was no association between the pretest knowledge score of the young adults on prevention of head injury with their age, education qualification, family history of head injury, history of head injury, history of hospitalization, and mode of traveling. Table 9 shows that the calculated Chi-square value at 0.01% level of significance was greater than the tabulated value. Therefore, the null hypothesis was rejected and concluded that there was an association between the pre-test attitude score of the young adults on prevention of head injury with their age and educational qualification. Table 9 shows that the calculated Chi-square value at 0.01% level of significance was less than the tabulated value. Therefore, the null hypothesis was accepted and concluded that there was no association between the pre-test attitude score of the young adults on prevention of head injury with their gender, family history of head injury, history of head injury, history of hospitalization, and mode of traveling.

Conclusion
The knowledge and attitude of the young adults on prevention of head injury were assessed using structured questionnaires and 4-point Likert scale. The study revealed that the video-assisted teaching was effective and it improved their knowledge and attitude on prevention of head injury.
The investigator drew the following implications from the study which is necessary concern to the field of nursing service, nursing education, nursing administration, and nursing research.