EFFECT OF A NURSE-LED TRAINING PROGRAMME ON KNOWLEDGE OF RISKY BEHAVIOURS AMONG MOTORCYCLE OPERATORS IN ADO – EKITI, EKITI STATE, NIGERIA
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ABSTRACT
Commercial motorcycling emerged, and has become established, as a popular means of transportation in Nigeria due to the inadequacy of the conventional modes of mass movement to meet commuters’ expectations and demands. Unfortunately, motorcycle crashes continue to escalate the already grim statistics of road traffic morbidities and fatalities. This has not been unconnected with the risky behaviours demonstrated by the motorcycle operators. Although there are advances in roadway construction and vehicular design, knowledge and prevention of these risky behaviours have been low.
Using a quasi-experimental one-group design,72 registered motorcycle operators in Ado – Ekiti were selected to participate in a Nurse-led training programme.The sample size was determined using Leslie Kish formula and multi-stage sampling technique was employed to select the participants. A structured, self-administered questionnaire was used to obtain data on the respondents’ socio-demographic characteristics and their knowledge regarding traffic-, substance abuse- and health-related risky behaviours during their operations, after the research supervisor and a group of experts in the field evaluated, and ascertained its content and face validity. The data collection took place before and after the intervention. The reliability of the instrument was ascertained bya pre-test and the derivation of Cronbach’s alpha coefficient. Prior testing of the training modules was also done before the study was undertaken. The data were coded into, and analysed using the Statistical Package for the Social Sciences (SPSS), version 20.0. With the aid of descriptive and inferential statistics using the students’ t-test to determine the difference in mean knowledge scores pre- and post-intervention, the research questions were answered and the hypotheses tested.
Findings from this study showed that the level of knowledge of the motorcycle operators in Ado – Ekiti regarding risky behaviour was low, as majority of the respondents had a poor knowledge of these risky behaviours pre-intervention. Also, there was a significant improvement in the knowledge of the motorcycle operators on risky behaviours following the nurse-led training programme (P = 0.000).
The study therefore concluded that the nurse-led training programme resulted in an improvement in the knowledge of the motorcycle operators regarding traffic-related, substance abuse- and health-related risky behaviours. The need to scale up awareness campaigns and education regarding risky behaviours among the motorcycle operators cannot be overemphasized.
TABLE OF CONTENTS
Content Page
Title page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract v
Table of Contents vi
List of Tables viii
List of Figure ix
Appendices x
List of Abbreviations xi
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study 1
1.2 Statement of the Problem 4
1.3 Objective of the Study 4
1.4 Research Questions 5
1.5 Hypotheses 5
1.6 Scope of the Study 5
1.7 Significance of the Study 5
1.8 Operational Definition of Terms 6
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Definition of risky behaviours 7
2.2 Types of risky behaviour s 7
2.3 Manifestations of Risky Behaviours 8 2.4 Effects of risky Behaviours 8
2.5 Preventive Measures 8
2.6 Road Transport and Safety 9
2.7 Prevalence of Motorcycle Accidents 15
2.8 Concept of Risky Behaviours 16
2.9 Components of Human Behaviour: Planned behaviour 18
Content Page
2.10 Key Variables of Human Behavioural Concepts 19
2.11 Conceptual Model for Knowledge to Action Model 20
2.12 Components of the Model 21
2.13 Application of the Model 23
CHAPTER THREE: METHODOLOGY
- Introduction 24
3.1 Research Design 24
3.2Population 24
3.3 Sample size and Sampling Technique 25
3.4 Instrumentation 26
3.5Validity and Reliability of the Instrument 26
3.6 Method of Data Collection 26
3.7 Method of Data Analysis 27
3.8 Ethical Considerations 28
CHAPTER FOUR: DATA ANALYSIS, RESULTS AND
DISCUSSION OF FINDINGS
4.0 Introduction 29
4.1 Data Analysis and Result Presentation 30
4.2 Discussion of Findings 36
CHAPTER FIVE: SUMMARY, CONCLUSION AND
RECOMMENDATIONS
5.1 Summary 38
5.2 Conclusion 39
5.3 Recommendations 39
5.4 Limitation of the Study 40
5.5 Suggestion for Further Studies 40
5.6 Implications for Nursing 41
REFERENCES 42
APPENDICES 45
CHAPTER ONE
INTRODUCTION
- Background to the Study
Transportation is a basic and indispensable component of all human endeavour, and has strong influence on the interrelations that exist when people with common interests live together. It plays a major function in the continued existence of urban communities by forming the basis for interaction, vocation, leisure and choice of residence (Oluwaseyi, Edward, Eyinda, &Okoko, 2014). Once a nation truly decides to embark on a large scale development of its transportation system, it must ensure that it not only improves access to the citizens’ places of vocation and residential areas, but in a safe and healthy manner, such that the risks of death and long-term disabilities are eliminated or reduced to the barest minimum (Lukasik and Szymanek, 2012).
Nigeria has sought to develop its own transport system that would meet global standards. Various motorized means of transportation have been employed, including buses, mini-buses, and cabs. These conventional means of public transportation were besieged by recurring and worsening problems such as rapid industrialization, poorly planned urbanization, collapsing infrastructure and road networks, population explosion despite progressively decreasing number of vehicles leading to congestion, prolonged waiting and travelling times at bus stations, and inadequate security. This need made the demand for motorcycle higher among many commuters who usually had to struggle to get transported to and from their residential or official quarters (Olubomehin, 2012). It was due to the failure of the regular means of commuting from one part to another that led to the emergence and perpetuation of the commercial motorcycle as an established mode of transportation in Nigeria. The motorcycle operators are part of the communities in Nigeria and this has made access to them easier (Olubomehin, 2012). An estimated 70 percent of urban and semi-urban Nigerian cities depend on commercial motorcycle for transportation within and around the town (Oluwaseyiet al, 2014).
The spread of the commercial motorcycle vocation was also fuelled by the relatively cheaper spare parts, maintenance costs and greater fuel economy which have increased the patronage and made it a thriving vocation (Olubomehin, 2012).Motorcycle crashes continue to add to the increasing fatality and permanent-disability figures annually. Globally, deaths linked with motorcycle accidents is about 1.2 million while about 50 million injuries are linked with motorcycle accidents yearly, while about half of the people involved in fatal road traffic accidents are pedestrians, motorcycle operators or commuters on motorcycles (Oluwaseyiet al., 2014). It appears that the prevalence of motorcycle-related traffic crashes is directly proportional to the increasing number of motorcycle operators in the nation.Also, for every unit of distance travelled, motorcycles cause far more fatal and permanently-damaging accidents than regular vehicles (Olubomehin, 2012).
Risky behaviour is described as series of activities and lifestyles behaviours that makes a person to be vulnerable to injury that could cause disability (temporary or permanent) or instant death depending on the severity of the injury. It could also mean exposing oneself to danger or possibility of injury or death. This risky behaviour among the motorcycle operators has led to the labelling of the motorcycle as the most dangerous of all motorized means of transportation. Due to the prevailing unemployment and youths’ underemployment in the country, and the relative lucrative nature of the business, it provides an easier and non-formal means of livelihood for many unemployed youths in the face of poverty and inflation. Thus the quest for survival, economically and socially, has forced many unemployed youths to become motorcycle operators, even though a good proportion of them are often untrained or sometimes untrainable due to their poor level of knowledge (Onifade, Aduradola, &Amao, 2012). Unemployed youths now utilize commercial motorcycles for income generation by transporting passengers on roads that are not motorable in remote cities and villages. This mode of transportation became popular and its acceptance began to climb steadily among the populace.
Commercial motorcycle also became popular due to the easy maneuverability in the often chaotic road environments and its low cost relative to four-wheeled vehicles. It now serves as one of the key means of transportation in Nigeria as it provides the citizens with a cheap transportation network. Even in remote villages, the motorcycle operators arrive at regular intervals and are used by all ages and classes of people(Abdussalam&Wahab, 2014). However, the spread of the commercial motorcycle vocation has also resulted in an upsurge in the number of accidents, some of which have resulted into loss of lives and permanent disabilities in the survivors. Motorcycle crashes continue to add to the increasing fatality and permanent disability figures annually. Globally, approximately 1.2 million fatalities and 50 million injuries are linked with motorcycle accidents every year, while about half of the people involved in fatal road traffic accidents are pedestrians, motorcycle operators or commuters on motorcycles (Oluwaseyiet al., 2014). It appears that the prevalence of motorcycle-related traffic crashes has increased in direct proportion to the increasing number of commercially-operated motorcycles in the nation. However, it appears that for every unit of distance travelled, motorcycles cause far more fatal and permanently-damaging accidents than regular vehicles (Olubomehin, 2012), making the motorcycle the most dangerous of all mechanical means of transportation.
In a study in south-western Nigeria (Ogunmodede, Adio, Ebiejuwa, Oyetola, & Akinola,2012), it was discovered that significant contributing factors to the causes of road traffic accidents among motorcycle operators in Nigeria were over-speeding, wrong over-taking, bad roads, sudden mechanical defects, ingestion of alcoholic beverages, non-compliance with road safety highway codes, over-loading by carrying more than one passenger, skidding off a bend due to excess speed or under-cornering, absence of functional horn and headlamps, riding without crash helmet, and riding against the traffic. These account for 95% of the causes of permanent disability and death of motorcycle accident victims (Ogagaoghene, 2011, Ogunmodedeet al., 2012).
Motorcycle accidents, when they occur, could lead to brain injury or severe trauma as the head violently hits the ground or other objects during the collision resulting in convulsion and other severe conditions (Ogunmodede&Akangbe, 2013). Many of these motorcycle operators sometimes know that some of their actions and risky behaviours could result in unpleasant outcomes, but they fail to act or do anything to remedy the situation, thus making themselves and their passengers prone to certain harm or death. There is need for motorcycle operators to be educated on the unpleasant manifestations of the risky behaviours which causes increase in annual motorcycle accidents. Therefore, this study is designed to investigate the effect of a nurse – led training on risky behaviours among motorcycle operators with the aim of reducing to the barest minimum the grim statistics of motorcycle road crashes.
1.2 Statement of the Problem
With a record fatality rate of 162 deaths from road traffic accidents per 100,000 population, Nigeria is placed 191among the 192 world countries with poor and bad roads. The World Health Organization (WHO) also estimated that over one million people die every year in road accidents with not less than 50 million people sustaining various grades of injuries from such occurrences (FRSC, 2011).
Motorcycle operators have a 35-fold more likelihood of dying than the passenger car occupants and 8-fold risk of injury. Also, while most of the motorcycle crashes generally lead to injuries to the lower extremities, the fatal crashes are frequently associated with head injuries. Risky behaviours like alcohol abuse, smoking and drug abuse are major contributory factors to motorcycle fatal crashes (Lin &Kraus, 2009).Oluwadiya and Fatoye (2012) posited that the use of locally-brewed intoxicants by motorcycle operators was another potential cause of road crashes which could lead to instant death, loss of limbs and significant economic losses.
According to the FRSC, WHO estimated that should the present unhealthy trends in road traffic accidents continue, fatalities from traffic crashes would increase by a margin of 65% between 2015 and 2020, exceeding the burden created by tuberculosis and malaria (FRSC, 2011).There is thus, an urgent need for tackling the menace of motorcycle accidents in our environment and this would require a multi-faceted approach which health workers like nurses can provide. Therefore, the index study is aimed at investigating the effect of a nurse-led training programme on risky behaviours among motorcycle operators in Ado – Ekiti.
1.3 Objective of the Study
The main objective of the study is to assess the effect of a nurse-led training programme on the risky behaviours of motorcycle operators in Ado-Ekiti. The specific objectives are to:
- assess the level of knowledge of motorcycle operators on risky behaviours in Ado-Ekiti;
- give a training programme on risky behaviours to motorcycle operators in Ado-Ekiti and
- assess the effect of the training program on risky behaviours among motorcycle operators in Ado-Ekiti.
1.4 Research Questions
1. What is the level of knowledge of risky behaviours among motorcycle operators in Ado-
Ekiti?
2. What is the effect of the training programme on risky behaviours among motorcycle operators in Ado-Ekiti?
1.5 Hypotheses
H01:There is no significant difference in the knowledge level of motorcycle operators about
risky behaviours pre- and post-intervention.
H02: There is no significant effect of the training program on risky behaviours among
motorcycleoperators in Ado-Ekiti.
1.6 Scope of the Study
The study was delimited to the registered motorcycle operators within the capital city of Ekiti State. It also employed didactic power-point lecture in the training of the motorcycle operators. The researcher delimited the evaluation of the participants to the use of pre-test and post-test questionnaire administration, since this has proven to be a standard way of achieving the research objectives.
1.7 Significance of the Study
Clearly, the causes of road traffic crashes revolve around the motorcycle, the roadway and the cyclist. Great efforts have been made to improve the design of motorcycles such that they are less accident-prone. Countries have invested heavily in roadway networking, infrastructural development and improvement in traffic-security consciousness among the motorcyclists, but rarely has the psycho-mental status of the riders ever been on the front burners of these efforts. The current drive towards reducing the unpleasant statistics of motorcycle-related morbidities and mortalities can be given a boost by including measures to curb risky behaviours in the operators. These interventional measures can only be effective if the level of knowledge of the motorcycle operators on risky behaviours is known, as well as the impact of a training intervention evaluated.
The results of the study might create awareness on risky behaviours among motorcycle operators, particularly in developing nations where commercial motorcycling is a major source of transportation and livelihood to many. It may also provide a basis for reference in the field of nursing and other allied health professions for further studies. The results might help to reduce motorcycle related accidents as well as diminish hospital admission rates of motorcycle operators and commuters of motorcycles. It may also help to reduce workload of the already short-staffed nursing units of hospitals where motorcycle related accident victims are being nursed.
1.8 Operational Definition of Terms
- Effect: This is the difference in the mean knowledge scores on risky behaviours
- Nurse-led training programme: teaching on risky behaviours among motorcycle operators designed and given by a nurse to improve the level of knowledge of the motorcycle operators
- Risky behaviours: These are series of activities and lifestyle behaviour that makes a person to be vulnerable to injury or harm that could cause disability (temporary or permanent) or instant death depending on the severity of the injury.
- Motorcycle operator: A man who rides motorcycle for commercial purposes.
- Motorcycle: A name commonly used for a two-wheeled machine.
- Knowledge of risky behaviour: Being able to recognize thata behaviour is good or bad. It also means having awareness that a behaviour can cause harm.
- Traffic –related risky behaviour: involving violation of road traffic laws and regulations.
- Substance-abuse related risky behaviors: pertaining to the use things like alcohol-based product or drugs that can influence mental alertness.
- Health-relatedrisky behaviours: pertaining to the health of the motorcycle operators that can cause harm.
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