Amarjit Kaur Nafra, Bindu Mol Jacob, Jasvir Kaur

Abstract : Little is known about the level of knowledge of swine flu amongst nursing personnel working in an acute care setting. A descriptive study, therefore, was undertaken to assess the knowledge of swine flu amongst nursing personnel in selected wards of Nehru Hospital, PGIMER, Chandigarh. A total of 100 nursing personnel were selected using convenient sampling technique. A multiple choice questionnaire was used to assess their level of knowledge. Results revealed that the mean knowledge score of the subjects was 13.68 + 2.6 with the range 9-17. About 20% of the subjects had very good level of knowledge while 72% respondents’ level of knowledge was good followed by 8% having average level of knowledge. Since nurses are the key providers of health care to the swine flu patients, it is essential for all of them to have thorough knowledge. Therefore, in- service education programmes should be organized during epidemics or pandemics.

Key words :knowledge, swine flu, nursing personnel

Correspondence at : Mrs. Amarjit Kaur Nafra, Nursing Superintendent, PGIMER, Chandigarh.

Introduction:Despite significant medical gains, the danger posed by emerging infectious diseases in the form of epidemics or pandemics has become even greater. Since 1990 a lot of infectious diseases have emerged (such as SARS in 2003, Dengue fever in last few years.)1 The most recent e.g., H1N1 influenza, and its dramatic spread also reminds us that we have entered into a new age of global pandemics, largely because of the rapidity with which newly emergent pathogens are capable of being transmitted around the world2. The first case of novel influenza infection was announced in Mexico in April 2009. By the end of June 2009, the strain had already spread to more than 120 countries3. The swine flu outbreak (2009) in humans is due to new strain influenza A sub type H1N1. The history of previous flu pandemics suggests that the current viral strain will spread widely in the autumn or winter causing more illness and death. The increasing travel and trade within and beyond the region has been a significant contributing factor in this emergence1. From the acute hospital perspective, the major challenges include prevention of nosocomial spread to other patients and staff in health care facilities. It is important to protect health care staff so that they avoid infection and can continue to perform their jobs3. With the looming threat of re- emergence of swine influenza, the study was conducted with the objective to assess the knowledge of nurses regarding swine influenza in Nehru hospital PGIMER, Chandigarh. Assessment of knowledge will facilitate planner and manager of health care services to delineate the areas of low knowledge and for making efforts to plan and implement an effective in-service education programme.

Materials and Methods:A descriptive research approach has been employed in this study to assess the knowledge level of nurses related to swine flu. The study was conducted in selected wards of Nehru Hospital in the months of March-April, 2010. To assess their knowledge, a multiple choice Knowledge Assessment Questionnaire was developed. The Knowledge Assessment Questionnaire included 20 objective type questions on epidemiology, etiology, incubation period, diagnosis, symptoms, treatment, complications, prevention and control of swine flu. Content validity of the tool was established by obtaining valuable opinion and suggestions from experts in the field of tropical medicine, internal medicine and department of nursing. Each question was allocated score. Each correct answer was graded as 1 and incorrect answer as 0. The score ranged from 0 – 20. It was divided into four categories i.e. Very good, Good, Average and Poor with the score range of 16-20, 11-15, 6-10, and 0-5 respectively.There were total 1200 bedside nurses in PGIMER, Chandigarh. Through purposive sampleing nurses present in morning & evening duty in Nehru Hospital were selected as sample. Total 130 nurses were present on morning & evening duty during the last week of March.A total of 130 questionnaires were distributed to the Staff Nurses in morning and evening shifts. The nurses were requested to answer the questions at their own and not consult each other. Par ticipation of the subjects was voluntary. Collected data has been analyzed by using descriptive statistics. Percentage, mean, and standard deviation were used for describing the socio-demographic distribution of subjects and their level of knowledge. Out of the 130 questionnaires distributed we received 110 filled up questionnaires. Ten questionnaires were incompletely filled up and were excluded from the study. Thus, 100 questionnaires were finally analyzed for their responses.

Results:Socio – demographic characteristics of the subjects

Table-1 depicts the socio- demographic characteristics of the subjects. The mean age of subjects was 34.4 + 9.95 years. A total of 49% subjects were of the age group between 21-30 years followed by 24% in the age group of 31-40 years. Females formed the majority (87%) while 13% of the subjects were males.Majority of the subjects (81%) were Sister Grade-II nursing officials while 19% were Sister Grade-I nurses. Out of total subjects 70% were married and 27% were single. Majority of subjects (72%) had done 10+2, 26% subjects were graduates and only 2% were post graduates. Out of total subjects 72% were having professional qualification diploma in General Nursing and Midwifery while 27% were graduates in nursing and only one subject (1%) was postgraduate in nursing. Two third of subjects (63%) had more than 5 years of experience while 36% had less than 05 years of experience.

Knowledge Score of the subjects

Subjects scored in the range of 9-16 with mean knowledge score of 13.68 + 2.6. Most of subjects (72%) scored good score while 20% of them scored very good and only 8% scored average score and none of them scored poor. Level of knowledge of subjects is depicted in Figure – 1

Table -1 Socio – demographic characteristics of the respondents

N = 100

Socio-demographic            No. of characteristics           subjects (f)

Age group in years

21-30 49 Mean = 34.40 yr
31-40 24 SD = 9.95 yr
41-50 19  
51-60 08  


Male                         13

Female                      87


Sister Grade-I           19

Sister Grade-II              81

Marital Status

Married                      70

Single                      27

Divorced/Separated      01

Widow/Widower           02

10+2 medical 41
10+2 non-medical 31
Graduation 26
Post-graduation 02


Academic qualification

Professional qualification

GNM                         72

B.Sc. Nursing           27

M.Sc. Nursing          01

Work Experience

< 05 yrs                     36

05 yrs.                    63

N = 100

Figure -1:Level of knowledge of the subjects

 Table -2 describes the different aspects of knowledge of Swine Flu. It reveals that out of hundred more than 75 nurses knew the county in which first case was identified and the persons who are at higher risk whereas announcement by WHO about epidemic was known to 61 nurses only. All expect one of nurses (99) knew the causative organism but only 61 knew about its animal reservoir. Incubation period of H1N1 virus was known to only 23 nurses. About diagnosis most of nurses (90) knew the specimen required for diagnosis of Swine Flu but only 62 could tell about the diagnostic test. Most of them knew the symptoms (84), treatment (98) and complications (75). About prevention and control most of the nurses knew about Precautions to be taken to prevent the spread of swine flu (83), Personal Protective Equipment (83), Minimum time for which hand washing should be done (77) and local strategy for prevention and control of swine flu (72) but only 40 could tell about the correct use of mask. Though 77 nurses knew about the vaccine but only 57 could tell about the contra indications of vaccine.

Table-2: Different aspects of knowledge of Swine Flu                                        N = 100

Different aspects of knowledge of Swine Flu                                             Number of subjects, responded correctly


  • Country in which the first case of swine flu (2009) was 76
  • WHO announced the swine flu outbreak (2009) as epidemic 69
  • The Persons at high risk of swine 84


  • The causative organism of swine flu (H1N1 virus) . 99
  • Animal reservoir of 61

Incubation period of swine flu organism (H1N1 virus)                    23


  • Specimen required for the diagnosis of swine 90
  • Diagnostic test to confirm swine 62

Symptoms                                                                                             84

Treatment                                                                                             98

Complications                                                                                      75

Prevention and control

  • Precautions to be taken to prevent the spread of swine 83
  • The local strategy for prevention and control of swine 72
  • Minimum time for which hand washing should be 77
  • Personal Protective Equipment (PPE) required while performing 83

an aerosol – generating procedure in a swine flu patient.

  • Precautions while using 40
  • 77
  • The contraindication of vaccine. 57

Discussion: Influenza pandemics are fickle. The virus evolves, patterns vary from country to country and cases come in waves1. If we have the knowledge, experience and tools we can prevent this virus from spreading in the hospital setting. The present study was under taken with the objective to assess knowledge of swine flu amongst nursing personnel working in Nehru Hospital, PGIMER, Chandigarh.The findings of the study revealed that the mean knowledge score of the subjects was 13.68 + 2.6. About 20% of the respondents had very good level of knowledge and majority of respondents’ level of knowledge was good. While discussing the different aspect of knowledge though most of nurses (more than 75%) knew nurses had knowledge related to causative organism, specimen required for diagnosis, treatment, complications, preventive precautions and vaccine but some of the impor tant aspects which are equally important for prevention and management of the disease were not known to many nurses. These aspects were related to animal reservoir, incubation period of virus, diagnostic test, correct use of mask, and contraindications of vaccine. This shows that nurses have some knowledge about identification and management of Swine flue cases, but this is not enough. Since Nurses are the key providers of health care to the swine flu patients, the information provided or care provided or the preventive measures taken by them to protect themselves and prevent nosocomial spread to others will depend upon their level of knowledge on swine flu. It is essential for all of them to keep updating their knowledge. It is also imperative for health care policy makers and administrators to reorient the ongoing training programmes.


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