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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.

Chapter One

Introduction

1.1 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

What is the level of knowledge of risky behaviours among motorcycle operators in Ado-Ekiti?

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 motorcycle operators 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

1. Effect:

This is the difference in the mean knowledge scores on risky behaviours

2. 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

3. 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.

4. Motorcycle Operator:

A man who rides motorcycle for commercial purposes.

5. Motorcycle:

A name commonly used for a two-wheeled machine.

6. 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.

7. Traffic –Related Risky Behaviour:

Involving violation of road traffic laws and regulations.

8. Substance-Abuse Related Risky Behaviors:

Pertaining to the use things like alcohol-based product or drugs that can influence mental alertness.

9. Health-Relatedrisky Behaviours:

pertaining to the health of the motorcycle operators that can cause harm.

Chapter Five

Summary, Conclusion and Recommendations

5.1 Summary

The effect of a nurse-led training programme on the knowledge of risky behaviours among motorcycle operators in Ado –Ekiti was the basis and focus of this study. The dependent variable for this study was the nurse-led training programme while the independent variables were the risky behaviours and the motorcycle operators. Two(2) research questions were answered and two(2) research hypotheses were tested at 0.05 level of significance. The study adopted a one-group quasi-experimental design with pre- intervention and post-intervention test administration.

Sample size was determined using Leslie Kish formula and multi-stage sampling technique was adopted to pick six (6) respondents each from twelve (12) units out of the two branches selected (from the 4 main branches of motorcycle operators) in Ado-Ekiti, totalling 72 respondents.The respondents were informed through the Association’s Executive members to come on the scheduled day. At the first contact in February 2017, they were informed about the purpose and method of the research. They were then pre-tested, and later had the training programme (intervention) which was done with the aid of a power point lecture (via a multimedia projector) and audience participation. The post-test was administered to the same people that were trained.

The data gathered was analysed using a frequency table, percentage, compared means and cross tab for descriptive statistics with independent sample t-test and chi-square used for inferential statistics using the Statistical Package for the Social Sciences (version 20.0) at 0.05 level of significance. Results revealed that before the researcher’s intervention programme, the respondents demonstrated low knowledge of risky behaviours. Furthermore, the relationship between traffic- and other risky behaviours (substance abuse- and health-related)before and after intervention was found to be statistically insignificant. Thus, these two risky behaviours are independent and not related to the traffic-related risky behaviours.

Regarding the effect of the nurse-led training programme introduced by the researcher after the pre-intervention data collection, the study showed a statistically significant positive effect on the level of knowledge of the commercial motorcycle operators in Ado-Ekiti about risky behaviours. At the end of the analyses, two out of the three hypotheses tested proved significant. Based on these findings, conclusion was drawn and recommendations were made.

5.2 Conclusion

Based on the findings from this study, the knowledge of risky behaviours among the commercial motorcyclists in Ado – Ekiti was low before the intervention. There was significant difference (improvement) in the knowledge concerning risky behaviours among motorcycle operators in Ado-Ekiti after the training programme. The study observed a significant difference in mean knowledge post-intervention when compared with pre-intervention. Hence, the training programme has helped to improve the level of knowledge of the motorcycle operators regarding traffic-related, substance abuse- and health-related risky behaviours. This implies that the nurse-led training programme was effective. The need to scale up awareness campaigns and education regarding risky behaviours among the motorcycle operators cannot be overemphasized.

5.3 Recommendations

Based on these findings, the following recommendations were made:

The Federal Road Safety Commission (FRSC) should ensure that the motorcycle operators are mandated to attend a training programme yearly or six-monthly on prevention of risky behaviours to curb the increased incidence of motorcycle related road traffic accident.

The government should provide Breathalyzers to be used by road traffic enforcement agents at check points to identify motorcycle operators who indulge in substance abuse and its related risky behaviours.

Non-governmental organizations should partner with the FRSC to organize refresher training programmes for motorcyclists who had spent more than 5 years as commercial motorcycle operators so as to curb over-confidence and neglect of precautions among the older motorcycle operators.

Concerned authorities like the road union associations at state levels should partner with non- governmental organizations for more intervention programmes that will curb some other identified risky behaviours among the motorcycle operators.

There is need to consistently engage the motorcyclists in such training programmes as this in order to sustain the achievements from the intervention.

5.4 Limitation of the Study

There were mortality of questionnaire as some respondents did not fill some questions leaving them halfway .This was overcome by the 10% attrition rate. The non-availability of a related structured questionnaire made the designing of the instrument challenging. However, these did not negatively affect the validity of this research work.

5.5 Suggestion for Further Studies

Further studies are needed among motorcycle operators of different ethnicity and geographical locations in other Nigerian states where the motorcycle is still being used as a means of transportation.

Further research studies are required to assess the impact of regular training programmes in reducing risky behaviours among motorcycle operators.

Further research studies are needed on other related risky behaviours among motorcycle operators in Nigerian states where motorcycle is still been used.

Further studies are needed on the revision of protocols and policies concerning motorcycle operation in Nigeria.

Further studies on the relationship between age and risky behaviours should be carried out. Also, longitudinal studies could be conducted to assess the long-term retention and practice of the information received during the training programme.

5.6 Implications to Nursing

It will help nursing to recognize the needs of these groups of people in the society and develop strategies for promoting recovery(from these risky behaviours)and learn about networks for supporting them (like the voluntary Federal Road Safety Corps Marshall).

It will nursing gain knowledge on creative activities which can be used to support young adults to expand their behavioural options and begin a open and flexible way of living instead of indulging in use of alcohol and other forms of substance abuse.

It will help to reduce rate of hospitalization and also reduce the number of patients admitted on the ward (orthopaedic ward) with injuries or trauma from motorcycle thereby reducing the workload on this units where nursing personnel are already short staffed.

It will nurses to create a therapeutic milieu in hospital where elements of therapeutic atmosphere included encouraging patient’s self –respect and sense of identity and the general assumption that patients retain capacity for a considerable degree of responsibility and initiative.

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Title: 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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