Research

Proposal

“Knowledge regarding chronic kidney disease among 30-60 years old

people between March to August of 2024 in Renal Clinic, TH –
Badulla.

Group 07
2019 B

TABLE OF CONTENT

Topic Page No

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1. Introduction
Background and Significance
Justification of the Study
Problem Statement

2. Objective of the Research Study

3. Literature review
4. Research Methodology
Research design
Population and sampling
Research sitting
Data collection methods

5. Ethical consideration
6. Reference
7. Appendix Permission letter
Gantt chart
Budget plan
Questionnaire

Introduction

CKD is a non communicable disease defined by a chronic impairment in the Kidneys’

structure of function that lasts longer than three months. (1) CKD is a progressive
deterioration of renal function, which if left untreated, eventually results in death
because of uremia & its complications. The treatment for end stage renal failure is

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dialysis and renal implantation (Lippincott Manual of Nursing Practice, Suresh K.
Sharma)

Dialysis refers to the diffusion of solute molecules through a semi – permeable

membrane, passing from the side of higher concertation to that of lower
concentration. (Lippincort Mannual of Nursing Practise, suresh K. Sharma) Teaching
Hospital, Badulla is the tertiary care level curative hospital and 1589 beds which
entering service to almost 1.3 million population. All the secondary care district
general hospitals and peripheral hospitals in uva province are referring patients to their
center for specialized care. (2)

Almost all surgical and Medical disciplines are available including 63 specialities and
full spectrum of radiological and laboratory investigation facilities. (2) The ward 13 is
the renal care unit and it consists with three units, Transplantation unit, Renal care and
dialysis unit. These 3 units conducts 3 clinics, renal transplantation clinic, Dialysis
clinic and Renal clinic. Approximately 33 patients come to the dialysis unit per day
for dialysis (Hemodialysis). According to the data taken by renal clinic at 63 room,
approximately 68 patients come to the clinic per day.

The knowledge is very important to prevent and reduce renal impairments. Public
knowledge and awareness regarding CKD is an important factor influence in the
successfully implementation of CKD prexention & screening programme. Higher rate
of risk of developing CKD might be possible among population with high levels of
knowledge. (sami Alobaidi (2021) knowledge of chronic kidney Disease among
population in Saudi Arabia.) This study aimed at knowledge regarding CKD within
30-60 years is the most risk age for CKD and early detection may results to reduce
deaths.
Background and significant

CKD also called chronic kidney failure, describes the gradual loss of kidney function.

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The kidney’s filter waste & excess fluids from the blood, which is then excreted in the
urine. when chronic kidney disease, reaches and advanced stage, dangerous levels of
fluid, electrolytes & wastes can build up in the body.
(Who guideline)

If it is untreated, it leads to gradual decrease in renal function. cardio vascular

diseases, premature mortality are 2 main risk factors for CKD. & main public Health
challenge in low & middle income countries. According to the recent analysis 13.4%
of people world wiled are predicted to have CKD. In 2017 the expected global
prevalence of CKD was 9.1% & 1.2 million deaths caused by the disease.
In Sri Lanka, although CKD has become a major public Health issue. the Prevalence
rate of the diseases is not well documented. published reports of disease prevalence
range from 2%- 3%.

Worldwide efforts are made to prevent and detect CKD early because of the
significant morbidity and high death rate among individuals with ESKD. An essential
public health strategy in this regard is the prevention, early detection, and appropriate
treatment of important risk factors for chronic kidney disease, such as diabetes
mellitus, hypertension & obesity. This is especially significant in the Arab world,
where these risk factors are widely prevalent. According to estimates the incidence of
CKD can be reduced by up to 40%. If these risk factors are successfully prevented
through population level public Health programs. Another significant technique used
by many nations to slow the advancement of the CKD disease is screening people
with risk factors.
The Knowledge deficit causes death due to chronic kidney disease. The primary
purpose of this study to improve knowledge regarding in chronic kidney Disease.

Justification of the study

Chronic kidney disease is a growing public health issue affecting approximately 10%
of the global population. Early detection and management of CKD are crucial to

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preventing progression to end stage renal disease which requires costly interventions
such as dialysis or transplantation.

Research indicates that awareness of CKD and its risk factors is alarmingly low
among the general population. Many individuals in the 30- 60 years age group many
not recognize symptoms until the disease has progressed significantly. This lack of
awareness can lead to delayed diagnosis result in poorer health outcomes and
increased health care cost. Understanding the current level of knowledge about CKD
in this demographic is essential for addressing these gaps'

Various factors, including socioeconomic status, education level, and access to health
care, influence individuals, understanding of CKD. The findings from this research
will provide a solid foundation for developing targeted educational programmes aimed
increasing awareness of CKD among adult age 30 -60 years.

Research Problem Statement

Chronic kidney disease is a significant public health concern that affects millions of
individuals world wide, particularly those aged 30-60 years. Despite its prevalence,
awareness and understanding of CKD among individuals are unaware of the risk
factors, symptoms, and preventive measures associated with the disease, which can

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lead to late diagnosis, increased morbidity and preventive measures associated with
the disease, which can lead to late diagnosis, increased morbidity and higher health
care costs.
This lack of knowledge is compounded by various factors, including socioeconomic
status, educational level, an access to health care resources.

General Objective

To assess the level of knowledge and awareness regarding chronic kidney disease
among individuals aged 30-60 years in rental clinic
TH – Badulla between March to August 2024

Specific Objectives
To assess the level of knowledge regarding kidney and kidney functions, aged 30-60
years in
To assess the level of knowledge regarding risk factors associated with chronic kidney
disease.

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To assess the level of knowledge regarding signs and symptoms relate to chronic
kidney disease.
To assess the patient’s attitude regarding dietary habits
To assess the level of family support to the patient

Literature Review

To find out background information & literature review covering with the topic that
related to identify knowledge regarding chronic kidney disease among 30-60 years old
people between march to June 2024 in Renal clinic TH – Badulla.

In Sri Lanka only few research studies were identified among published literature
regarding knowledge of chronic kidney disease more research studies were found on
middle easte countries.

Awareness, knowledge and perception of chronic kidney disease

Fathma Al Rahbi and Issa Al Salmi are done on “Awareness knowledge and
perception of chronic kidney disease patient at renal medicine outpatients clinic in
Royal hospital oman. They initially a literature review was made through pubmed
upon which opended interviews a focus group and questionarrie were developed. They

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used cross sectional descriptive research design. They selected total 300 patients were
approached and 200 patients agreed to participated in the study. CKD becoming a
world wide public health problem. According to summary of this research study
patient need for more information about their kidney problems that they suffer from
and any patients had false knowledge or uncertainty & shared decision of patients
and their family are importance in curtailing the burden of CKD in our society.

Knowledge regarding chronic kidney disease

In 2021 sami Alobaidi did title of research was knowledge of chronic kidney disease
among the population of Saudi Arabia. He used source of a cross – sectional online
survery . study conducted between 12 January 2022 and 11 february 2021. He
validated the CKD knowledge among the Saudi population using a validated
questionnaire. A structured study questionnaire in the google platform with socio –
demographic variables and questions He used a snowball sampling techniques to
recruit participants. He selected total of 983 people accessed the survey and 951
provided a complete response. The most of the respondets had family history of
kidney failure. The CKD Knowledge of the Saudi population was poor. However,
significantly higher CKD knowledge was found almond respondents with higher
educational and economic status. His study result highlights the need for conducting
targeted CKD educational activities among those in the population with Lower
educational & economic status.

Knowledge, attitude & practices of the risk for chronic kidney disease

In 2014, Dariah Mohd yusoft, Junaity Yusof, yee cheng kueh They did tittle of
research was knowledge, attitude and patients in a tertiary teaching hospital . They
used “The Malaysian Journal of Nursing ” The Used research design was a cross –

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sectional study. Sample size was determined using software version 22. The inclusion
criteria involved about male and female within the age group of 18 to 85 years old. for
being higher risk for CKD. The instrument used in this study was self-administered
questionnaire. They find out the study revealed 61% of respondents indicated in their
study indicated that the respondents had good attitudes and practices toward CKD.

Improving Drug & Disease Related Knowledge of patient with chronic

kidney disease. Randomized controlled trial form a Sri Lanka out Patient
clinic.

In 2024, Wickrasinghe, Dilmi, Catherine, coombes, Judith, jayamanne, Shaluka, De

Silva, Shamila. They did tittle of research was improving drug & disease related
knowledge of patients with chronic kidney disease, Randomized controlled trial from
a Sri Lankan out patients clinic. A randomized controlled clinical trial was conducted
at an outpatient renal clinic, teaching Hospital Anuradhapura, Sri Lanka.
The Mann Whitney U test was used as the analyze initial & 12 months in between
group data. 100 patients were enrolled in control group & 101 in intervention group.
Drug & disease information booklet provided. Median drug & disease knowledge
questionnaire scores were similar at 6 months at 23.00. At the end of the research the
provision of medication counseling disease – specific knowledge in patients with
CKD.

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 Methodology
The aim of the study is to improve the knowledge of regarding chronic kidney disease
among 30-60 years old people in medical renal clinic teaching hospital Badulla.

Study design
The research approach is a quantitative survey design. Data will be collected using a
questionnaire

Target Population
The study population is CKD patients.

Sample Population
The sample population is patients who are having chronic kidney disease among 30 to
60 years old people in medical renal clinics in Teaching hospital Badulla.

Sample size
Sample size calculated by using Taro Yamane Method. n=
N/ (1+N (e)2)
Where,
N = Total number of population taken as 200
e= Error or confidential level, taken at 0.05
n= 200/[1+200(0.05)2] n= 133 Patients
Therefore, according to the above calculation sample size will be 133 patients.

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Sampling Method
Non probability convenient sampling method will be used.

Inclusion and Exclusion criteria

Inclusion criteria
Both male and female patients with chronic kidney disease, who are attending to the
renal clinic in T H – Badulla.

Exclusive Criteria
Patients who are in below 30 years and above 60 Years.
Patients with AKI patients with renal transplant

Study Setting and Study Period

The Study will be carry out in the renal clinic at TH – Badulla about 4 Months of
duration.

Data Collection method and Tools.

Data Collection will be carry out in the renal clinic at TH – Badulla about 4 months of
duration.

Data Collection method and Tools.

Data collection will be done by a trained interviewer using a questionnaire in Sinhala

Part 1 – Socio demographic data & Contains & Questions

Part 2 – Knowledge about kidney functions & Contains
Part 3 _ Knowledge regarding chronic kidney disease & Contains 4 questions.
Part 4 – Knowledge regarding diet pattern of CKD & Contains 2 questions.
Part 5 – Family Support regarding treatment methods of CKD & contains 2 questions.

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Data Analysis
It will be started soon after collecting data. It will be done by descriptive data analysis
using Microsoft exel.
Data will be presented by using percentage with formatted tables, Bar charts and pie
charts.

Ethical Consideration

Ethical approval will be obtained from the ethical committee of Teaching Hospital
Badulla, Sri Lanka. Permission for the study will be obtained from the director and
chief nursing sister and Consultant letters. Permission for the study will be obtained
from the principal, School of Nursing Badulla'

Voluntary participants will be selected for the study. Written Content will be Obtained
Prior to the study. All the collected data will be treated confidentially. There are no
any anticipated risks or harm to participants in this study.

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 References

1. Chen TK, Kinkily DH, Grams Me, chronic kidney disease diagnosis &
management.

2. Frag YM, Kari JA, Singh AK, Chronic Kidney disease in the arab world ; a call
for action. Nephron clin pract
3. Sami Alobaidi (2021) Knowledge of chronic kidney Disease among the
Population of Saudi Arabia
Evaluated using a validated questionnaire.

4. Chandrajith et, 01,2011, Rajapakshe et al, 2016 Rang o et al , 2015)

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Group 07,
2019 Batch – B,
College of Nursing,
Badulla.
28th of February 2024.

The Principal, College

of Nursing, Badulla.

Dear Madam,

To get permission for the Research Study

We are group 07 students nurses of 2019 Batch Group B, College of Nursing Badulla.
We are interested to conduct a research about “Knowledge regarding Chronic Kidney
disease among 30-60 years old people between March to August of 2024 in renal
clinic TH-Badula”. We are kindly request your permission to conduct this research
study.

Thank you.

Your faithfully, 2019

Batch – Group B,
Group 07.

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 GANTT CHART
Activities March April May June July August

Literature
Review

Proposal Writing

Planning

Ethical
Clearance

Process Analysis

Survey

Simulation

Report Writing
 1
5
 Budjet

The following expend are on out line of expenses that will be required while under
taking this study.

No Expenses Cost (Rs.)

01. Stationary

02. Photocopy

03. Binding

04. Phone and internet charges

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 Questionnaire
Part 1 : Demographic data

1. Age of Participant ……………………

2. Gender (a) Male (b) Female
3. Civil Status (a) Married (b) Unmarried
4. Residence (a) Urban (b) Semi Urban (c) Rural
5. Occupation
(a) House Wife (b) Farmer (c)
Government Sector
(d) Privet Sector (e) Graduate
6. Educational Level
(a) House Wife (b) Farmer
(c) Government Sector
(d) Privet Sector
(e) Graduate
7. Duration of CKD
(a) 1 Years (b) 2-5 years (c) 5
Years
8. Socio economic Status
(a) Low income (30,000)
(b) Middle income (60,000)
(c) High income (60,000)

Part 2 : Knowledge about kidney Yes No

1) A person can lead a normal life with one kidney
True False
I don’t know
2) Do you know about are the functions of kidney Yes
No

Part 3 “ Knowledge regarding CKD

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1. What are the risk factors for CKD
1.1. DM True False I don’t know
1.2. Being Female True I False don’t know
1.3. High Blood Pressure True I False don’t know
1.4. Heart Problem search as HF or Heart attack True d False d
I don’t know d
1.5. Excess Stress True d
False d I don’t know d
1.6. Obesity True d d

False d I don’t know

2. Herbal Supplements can be effective in treating CKD ?

d False d
True I don’t know d

3. Certain medication can help to slow down the worsening of CKD?

True
False d I don’t know
d d
4. What are the sing & symptoms
that a person might have if they have advance CKD?

4.1. Water retention True d False d I don’t know d

4.2. Fever True d False d I don’t know d

4.3. Nausea & Vomiting True d False d I don’t know d

4.4. Loss of appetite True d False d I don’t know d

d
4.5. Increase fatigue True d False d I don’t know

Part 4: Knowledge regarding diet pattern in CKD patients

1. Are you monitoring your fluid intake? Yes d No d

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2. IS low sodium diet good for CKD? Yes d No d

Part 5 : Family Support regarding treatment methods for CKD patients.

1. Do you family members aware that you are taking any kind of CKG treatment?
Yes d No d

2. Do you family members attend with your treatment

d
Yes d No

Group Members
Group – 07

5445 - G.H.A.S. Ganegoda

5498 - K.M.H. Medhani
5499- G.H.D.N.K. Gammanpila
5500- W.A.C.Jayamali
5501- L.A.P. Indrasiri
5502- S.M.D.R.Sewwandi
5503- Y.D.S.Dilrukshi
5504- S.G.R.J.Siyambalagoda
5505- T.Anoja
5506- K.H.L.P.Hewage
5507- P.D. Dissanayake
5508- R.M.P.M.M. Rathnayake
5509- Y.H. Godage
5510- D.G.L.M.N.S. Gunawardhana
5512- M.K.N. Sewwandi
5513- W.M.D.N.Weerakon
5514- M.N.S.M.Nizar
5515- M.H.M.C.N. Tharangani

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