A Study to Evaluate the Effectiveness of Structured Teaching Programme on Knowledge Regarding Heatstroke and its Prevention among Farmers : Indian Journal of Community Medicine

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A Study to Evaluate the Effectiveness of Structured Teaching Programme on Knowledge Regarding Heatstroke and its Prevention among Farmers

Elias, Nidhin; Sreejesh, K.P

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Indian Journal of Community Medicine 47(4):p 626-627, Oct–Dec 2022. | DOI: 10.4103/ijcm.ijcm_7_22
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Globally, climate change is a serious issue, causing disasters such as floods, earthquakes, snowstorms, and tsunamis in different parts of our planet. There is an increase in temperature, reduced snow cover, and changes in habitat range. The Intergovernmental Panel on Climate Change confirmed that the global average surface temperature increased warming by approximately 0.85°C from 1880 to 2012. According to the Intergovernmental Panel report, with the continuous discharge of greenhouse gases such as carbon dioxide, methane, and nitrous oxide, further warming of about 1°C per decade should be anticipated after 2000 AD. In India, the Lancet Planetary Health journal reports 83,700 death due to high temperatures.[1] The Indian Meteorological Department’s study in 2020 predicted that regions in North Karnataka (Bidar, Raichur, Vijayapura, and Bagalkot) are likely to resemble a boiling cauldron with mercury levels around 44°C–46°C.

The wet-bulb globe temperature has exceeded 26°C–30°C; it can reduce work capacity, especially during noontime and can cause serious health problems such as sunstroke, muscle cramps, heat exhaustion, heatstroke, and even death. It is based on regional humidity, wind movement, and heat radiation. Underdeveloped and developing countries are more vulnerable because many of them need to engage in heavy physical work, either outdoors under direct sunlight or indoors without effective cooling.[2] Thus, farmers are obviously at high risk of heat stress as they work under high pressure, extended hours under direct sunlight and high temperature, leading to dehydration. Perhaps they do not have sufficient knowledge about the preventive measures for heatstroke. A study conducted in Nigeria verified that the impact of heatstroke affects the productivity among maize farmers in a tropical area, revealing that out of 396 maize farmers, most experienced heavy sweating (93.2%), fatigue (48.5%), nausea (34.1%), and headache (40.4%).[2]

Considering the above, it is evident that open-field cultivating farmers, especially those working in tropical areas, are at high risk of heatstroke. Even unpredictable climate change has an important role in this burning heat. Hence, proper knowledge about the preventive measures of heatstroke and its complications will help the farmers to prevent complications and related health issues.

The objectives of the study were to (1) assess the knowledge of farmers regarding heatstroke and its prevention, and (2) evaluate the effectiveness of the structured teaching program regarding heatstroke and its prevention among farmers.

The researcher used a one-group pre-test post-test design with a quantitative approach. Farmers of Sikkeri village, Bagalkot were selected as the study population, and a convenient sampling technique was used to select 120 participants. Farmers with more than 5 years of experience and who spend up to 8 h in the field daily were included. A structured knowledge questionnaire with 32 questions (17 to assess knowledge and 15 to assess the preventive measures) was developed. The answers were rated as poor knowledge for scoring <40%; average level if scored between 40% and 60%, and good knowledge for 60% and above. After obtaining the necessary approval, the researcher conducted a pre-test for each farmer followed by the structured teaching program. The subjects were approached after 15 days to conduct a post-test using the same questionnaire.

The main findings of this study are as follows. Demographic variables revealed that out of 120 samples, 60 (50%) samples belonged to 40 years and above; 86 (71.7%) samples were males. The majority (44; 36.70%) of them had primary education, and most of them belonged to the Hindu religion (82;68.3%). Furthermore, 70 (58.30%) samples were vegetarian and the main cynosure is that monthly earnings were less (52;43.30%) than the national earnings for farmers and 80 (66.7%) of them had previous experience of health-related illness.

According to Table 1, data depicted that in the pre-test, 84 (70%) of them had average knowledge, 24 (20%) had poor knowledge, and 12 (10%) of them had good knowledge, which became 90 (75%) having average, 16 (13.33) having poor knowledge, and 14 (11.67) having good knowledge in the post-test.

Table 1:
Comparison of pre-test and post-test scores of knowledge and its dimensions (n=120)

Apart from that, a comparison of pre-test and post-test of whole sample score about knowledge and preventive measure score separately calculated with the help of paired t test was done. The P value was < 0.0001 at a 0.01 level of significance. The test had only 13.84 ± 0.91 scores for pre-test, while the post-test mean was 27.34 ±0.86. From this data, it is evident that the structured teaching program was very effective.

The study revealed that the pre-test and post-test scores of age, gender, and monthly income had a significant association with knowledge regarding heatstroke and its preventive measures. On the contrary, the type of diet and educational qualification had no significant association. It also shows that out of 120 farmers, 80 had previously experienced heat-related illness. A similar epidemiological study in Shaoxing, China in 2008–2014 revealed that among 1676 samples, 1485 had mild heatstroke, and 191 had severe heatstroke, including 9 deaths due to heatstroke.[3]

This study shows that 84 (70%) farmers have average knowledge about heatstroke and its preventive measures. A homogenous study was conducted on heat-related illness, first aid, and self-reported measures; a total of 60 migrant farmers were selected in this study, and the result highlighted that 50% (n = 30) did not know the exact first-aid measures for heatstroke. This study concluded that appropriate illness interventions based on health education and first-aids measures help to reduce morbidity and mortality.[4]

Particularly, post-test scores regarding knowledge about heatstroke were higher (15.39 ± 0.64) than pre-test scores (6.36 ± 0.48). However, post-test scores for knowledge about the prevention of heatstroke were also higher (11.96 ± 0.33) as compared with the pre-test scores (6.36 ± 0.48). Thus, it clearly showed that knowledge about heatstroke and its preventive measures increased after the structured teaching program. An analogous study was conducted in Pedatadepalli; the study result revealed that the mean post-test knowledge score was 15.3 ± 2.84, which was higher than the pre-test score of 12 ± 3.10, and the paired value was 4.50. It cleared that the structured teaching program helped to increase the knowledge and preventive measures.[5] This study helped farmers to improve their knowledge regarding heatstroke and its prevention.

Heatstroke is one of the major occupational health illnesses. It can be eliminated from our country by conducting preventive programs; the government needs to frame new regulations for the protection of farmers from heavy heatstroke, such as safe and adequate drinking water, protective clothing, and restriction to work during peak hours. Meanwhile, health workers need to monitor each farm area, and need to focus on heat stress, preventive management, climate change its associated heat stoke.

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Conflicts of interest

There are no conflicts of interest.


1. The Hindu. Over 7 lakh yearly deaths in India linked to abnormal temperatures: Lancet study. 2021. Available from: https://www.thehindu.com/sci-tech/science/over-7-lakh-yearly-deaths-in-india-linked-to-abnormal-temperatures-lancet-study/article35210559.ece#. Last accessed on 2021 Jul 08.
2. Sadiq LS, Hashim Z, Osman M. The impact of heat on health and productivity among maize farmers in a tropical climate area. J Environ Public Health 2019;2019:9896410. doi:10.1155/2019/9896410.
3. Jiang GQ, Li M, Xing C, Wang SS, Tao JH. Epidemiological features of heatstroke in Shaoxing, China in 2008-2014. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2016;34:131–3.
4. Smith DJ, Ferranti EP, Hertzberg VS, Mac V. Knowledge of heat-related illness first aid and self-reported hydration and heat-related illness symptoms in migrant farmworkers. Workplace Health Saf 2021;69:15–21.
5. Monica KC. A study to assess the effectiveness of structured teaching programme on knowledge regarding the prevention and complications of heatstroke among middle-aged men in the selected village of Pedatadepalli. Int J Sci Eng Res 2018;9:716.
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