RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / Name of the candidate and address(in block letters) / MISS. JASLIN JAMES
I YEAR MSC. NURSING
CITY COLLEGE OF NURSING
SHAKTHINAGAR
MANGALORE -575 016
2. / Name of the Institution / CITY COLLEGE OF NURSING
MANGALORE – 575 016.
3. / Course of Study and Subject / M. SC. NURSING
OBSTETRICS AND GYNAECOLOGICAL NURSING
4. / Date of Admission to the course / 14.5.2007
5. / Title of the Topic
EFFECTIVENESS OF VIDEO-ASSISTED TEACHING REGARDING ABORTION AND ITS HEALTH HAZARDS TO ADOLESCENCE GIRLS IN SELECTED COLLEGE AT MANGALORE
6. / Brief resume of the intended work
Introduction
With the advent of new millennium, urban adolescents are finding new forms of enjoyment. Even youth of low profile colleges, do have sex but are afraid to admit it and this situation is much more worse than in high profile areas. Youth are treating premarital sexual relation as the westernised way of life and covering it up in the envelop of modern way of living and leaning behind the tradition findings, makes the situation more disastrous, far mole than that could ever be thought of youngsters. In some cases due to less sexual knowledge, youth try to experiment with it in their life. Their excitement is further egged on by vast mass media exposure. Discarding the strong base of culture and tradition, adolescents with their unsafe sexual practice place themselves at higher risk of abortion and contracting health hazards1.
Each year, an estimated 210 million women become pregnant. Worldwide, more than one-fourth of there pregnancies will end in either abortion or an unplanned birth. Women often have an abortion because of a desire to delay or avoid pregnancy; 15 to 20% of pregnancies will end in miscarriage or stillbirth. Early abortion is nature’s way of expelling abnormal zygote. Every year approximately 19 million unsafe abortions occur. Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Healthcare workers and policy makers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women’s health2.
6.1 Need for the study
A majority of US women obtaining abortion since 1990 have been women 25 years of age or younger and about half had one previous abortion3. All governmental and relevant inter-governmental and non-governmental organisations are urged to strengthen their commitment to women’s health, to deal with the health aspect of unsafe abortion as a major public health concern, and to reduce the rate of abortion. Prevention of unwanted pregnancies must always be given the highest priority and every attempt should be made to eliminate the need for abortion2.
About 26 million legal and 20 million illegal abortions were performed worldwide in 1992, resulting in a worldwide abortion rate of 35 per 1000 women aged 15-44 years. The highest abortion of 83 per 1000 population was reported for Vietnam and the lowest seven per 1000 for Belgium and the Netherlands4.. Abortion accounts for 13% of maternal mortality world wide. About 70,000 women die every year from unsafe abortions. An additional five million women suffer permanent or temporary injury5.
In India, about 6-7 million abortions take place each year. The important circumstances which lead to unwanted pregnancy and induced abortion include socioeconomic status, cultural, psychological and societal. Disempowerment in relationships combined with financial resources forces the women to terminate their pregnancies5. Analysis of 8,073 abortions performed in Karnataka between April 1972 and March 1975 indicates that abortions have increased rapidly6.
A descriptive study was conducted to assess the knowledge about the experiences of unplanned pregnancy for college students in Virginia, US. The selection was by one or two hour interview. The interview questions focussed on the effects they experienced as a result of pregnancy. The findings of the study showed that 50% of the 100 students were ethnic minorities, 30% were African American women, and 10% biracial Hispanic women. In this, 90% women terminated the pregnancy, 10% miscarried. This study recommended that some women experience a developmental process in their response to unplanned pregnancy7.
A research study was conducted to assess the knowledge, attitude and problems of abortion in a college population in Pune. One hundred and fifty students were surveyed. The profile of the students was north Indians – 95%, young 16-20 years – 87%, single – 87%, middle and lower middle class and catholic – 70%. Eighty-two percent supported abortion choice, 86% had engaged in premarital sex, 26% had premarital pregnancies.. The findings reveals that the students reported many problems in their families: alcoholic home – 39%, loss of a parent through death, divorce or separation – 33%, victims of severe corporal punishment – 31%, one or more family members physically abused – 20%, and deprived of parental affection while growing up – 20%. Comparison of women who had abortion with the women who had their baby indicated that they were more battered by their boyfriend or husband, and greater tendency to have been raped. This study recommended that they are aware about abortion and less aware about its complications8.
The nine most complications which can occur at the time of an abortion are infection, excessive bleeding, embolism, ripping or perforation of the uterus, anaesthesia complications, convulsions, haemorrhage, cervical injury, and endotoxic shock. The most common minor complications included infection, bleeding, fever, second degree burns, chronic abnormal pain, vomiting, gastrointestinal disturbances and Rh sensitisation. Approximately 10% women undergoing elective abortion will suffer immediate complications, of which, approximately one-fifth (2%) are considered life-threatening The immediate complications of abortion were usually treatable, these complications frequently lead to long-term reproductive damage of much more serious nature. Major physical sequelae related to abortion include death, breast cancer, cervical, ovarian, and liver cancer, uterine perforation, cervical lacerations, placenta previa, complications of labour, handicapped newborns in later pregnancies, ectopic pregnancy, pelvic inflammatory disease, and endomeriosis. The psychological effects of abortion include emotional paralysis or post-abortion numbness, depression, loss of self-esteem, self-destructive behaviour, sleep disorders, memory loss, sexual dysfunction, chronic problems with relationships, dramatic personality changes, anxiety attacks, guilt and remorse, difficulty grooming, increased tendency towards violence, chronic crying, difficulty concentrating, flashbacks, loss of interest in primarily enjoyed activities and people, and difficulty bonding with later children9.
During the clinical experience of the investigator it has been found that the rate of abortions were more among the age group between 14 - 18 years . The aborted individuals underwent many number of health hazards . This stimulated the investigator to spread accurate information regarding abortion and its health hazards through video assisted teaching.
6.2 Review of literature
A descriptive study was conducted to evaluate the knowledge of college students of the Cameroon. A convenient sample of 700 students between the age group of 14-18 years was selected for the study. Data was collected by a knowledge questionnaire. The study findings showed that the response rate was 94.9% and general level of awareness of abortion was 63.0%. Up to 65% of college students believed that abortion was unsafe. Around 74% of them had undergone abortion. Knowledge level of abortion and its health hazards was low and the method was still underused. The study focused on spreading accurate information regarding abortion and its health hazards through medical and informal sources10.
A cross-sectional questionnaire based study was conducted among 1,107college going undergraduate female students between the age group of 14 -18 years of Punjab University, Chandigarh. Systematic random sampling was used to select the respondents. The study findings showed that about 49.9% knew about abortion and its health hazards, 47.1% of them had maximum awareness and only 7.3% students had knowledge and about 88.9% of them had idea about its health hazards. This study highlighted about the decreased awareness of female college students about abortion and its health hazards and appropriate awareness programmes are need to them11.
A descriptive study was conducted to assess the knowledge of adolescent girls in the age group between 14-18 year admitted to hospitals with abortion-related complications in Kathmandu, Nepal. The data was analysed from 100 college students. The data was analysed and compared to data from other sources. The findings showed that about 43% had two children and 40% had more than high school education. This study recommended to decrease the number of abortions and its health hazards12.
A descriptive study was conducted to assess the knowledge and attitudes about abortions in young women in State University of New York. Eighty-nine male and 215 female college students completed a questionnaire on abortion during routine visits to their university health centre. The salient findings were that most respondents took a pro-abortion stance for girls under 18 in cases of rape, 92% of students, incest about 90% or danger to the girls health that is about 90%. Abortion was considered acceptable of circumstances by 46% of students. The outcome of unplanned pregnancies for minors should be decided by the girl, about 90% of students, and parents (29%), and state or federal law about 8%. Abortions for minors should require parental notification (45%) or consent (33%). Although only one student felt illegal abortions were safe, 19% would seek this kind of abortion and 4% of females would try to cause their own miscarriage if abortions were outlawed in the United States. The highest priority for abortion was given to girls who had been victimized or whose health was at risk. The study suggested about the awareness of the hazards of abortion13.
A cross-sectional descriptive study carried out between July 1995 and June 1996 in an urban and a rural district in Kenya among adolescents aged 14-18 years in schools in Nairobi and Kiambu districts. One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortions. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in colleges. The information obtained was recorded on paper and in a tape-recorder; 1952 adolescents, comprising of 1048 college girls and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion and 71% of college students were aware of abortion related complications most commonly found ones – infection, death, haemorrhage and infertility. About 72% college girls felt that abortions were preventable . This study highlighted about the awareness of abortion and related complications, but there is more variability in their knowledge and preventive measures14.
6.3 Statement of the problem
EFFECTIVENESS OF VIDEO-ASSISTED TEACHING REGARDING ABORTION AND ITS HEALTH HAZARDS TO ADOLESCENCE GIRLS IN SELECTED COLLEGE AT MANGALORE .
6.4 Objectives of the Study
The objectives of the study are to:
1. determine the knowledge of adolescence girls regarding abortion and its health hazards.
2. evaluate the effectiveness of video-assisted teaching in adolescents and of its knowledge score.
3. find out the association between the pre-test knowledge scores and selected demographic variable like age, education of adolescence , socio economic status and urban –rural community .
6.5 Operational definitions
1. Effectiveness: In this study, effectiveness refers to determining the extent to which the video-assisted teaching has achieved the desired effect as expressed by gain in knowledge score.
2. Video-assisted teaching : It is a set of planned teaching method on abortion and its health hazards to provide accurate information and to improve the knowledge adolescence girls. .
3. Abortion: Abortion is the expulsion or extraction of an embryo or foetus weighing 500 grams or less when it is not capable of independent survival.
4. Health hazards: In this study health hazards refers to the factors which endanger the condition of an adolescent due to abortion.
5. Adolescence Girls : In this study, it refers to the girls between the age group of 14-18 years studying in selected college at Mangalore.
6.6 Assumptions
The study assumes that:
1. The abortion may be common among 14-18 years of age group students.
2. Video-assisted teaching will improve the knowledge.
6.7 Hypotheses
All hypotheses will be tested at 0.05 level of significance.
H1: The post-test knowledge score will be significantly higher than the pre-test knowledge score.
H2: There is a significant association between the demographic variables and pre-test knowledge score .
6.8 Delimitations
The study is delimited to adolescence girls.
between the age group of 14-18 years.
who are willing to participate.
who can understand English.
7. / Material and methods
7.1 Source of data
The data will be collected from adolescence girls between the age group of 14-18 years in selected college at Mangalore.
7.1.1 Research design
In this study the quasi -experimental research design will be used.
7.1.2 Setting
The study will be conducted in the selected college at Mangalore.
7.1.3 Population
The population in this study will be selected from adolescence girls during the data collection time.
7.2 Method of data collection
7.2.1 Sampling procedure
The samples for the study will be selected by convenient sampling technique.
7.2.2 Sample size
In this study sample size consists of 60 adolescence girls at age group between 14-18 years.
7.2.3 Inclusion criteria for sampling
1. Adolescence girls in the age group of 14-18 years.
2. Adolescence girls who understand English.
7.2.4 Exclusion criteria
1. Students who are absent during data collection period.
2. Students who are not willing to participate.
7.2.5 Instruments intended to be used
1. T.V. and Cassette
2. Structured knowledge questionnaire.
7.2.6 Data collection method
- Permission will be obtained from the authority of selected college.
- Purpose and need for the study will be explained to the adolescence girls .
- Informed consent will be obtained from adolescence girls.
- A sample will be selected by convenient sampling.
- Pre-test will be conducted to identify knowledge score.
- Video-assisted teaching will be given to improve the knowledge on abortion and its health hazards.
- Post-test will be conducted after the teaching to find its effectiveness.
7.2.7 Plan for data analysis
The demographic data will be presented by frequency table, diagram and graphs. The knowledge level of the students will be presented by frequency table, mean, median, standard deviation and graphs. The effectiveness of the video-assisted teaching method will be tested by ‘t’ test. The association between the pre-test knowledge scores and selected demographic variables will be found using chi-square test.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals?
Yes, the investigator needs to assess the effectiveness of video-assisted teaching among adolescence girls in abortion and its health hazards.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, ethical clearance has been obtained from the concerned authority .
List of References
1. George A. Sexual behaviour and sexual negotiation among poor women. The Journal of Family Welfare. 1997;38(3):10-7.
2. Curtis C. Meeting healthcare needs of women experiencing complication of miscarriage and unsafe abortion. Journal of Midwifery and Women’s Health. 2007 Jul-Aug;52(4):368-75.
3. Zeidenstein L. Update on medication abortion. Journal of Midwifery and Women’s Health Volume 2007 Jan-Feb;52(1):23-8.
4. Stanley K, Henshaw S, Susheela S, Taylor H. The incidence of abortion worldwide. The Indian Journal of Obstetrics and Gynaecology 1999 Jan;52(suppl):30-8.
5. Fredrick R. Abortions just as common in countries that ban it as in ones that don’t. Canadian Press 2007 Oct 12;15-25.
6. Rao NB, Kanbargi R. Legal abortions in an Indian state, Stud Fam Plan 1977 Dec;8(12):311-5.
7. Wendi A. The effects of unplanned pregnancy among college women. [Online]. Available from: URL:http://scholar.lib.vt.edu/theses.
8. Bryan JW, Freed FW. Abortion research: attitudes, sexual behaviour and problems in a community college population. Journal of Youth Adolescence 1993 Feb;22(1):1-22.
9. Susana RS. Major physical sequelae related to abortion. Journal of Midwifery 1997 Mar 14;1:28-44.
10. Kongnyuy EJ, Nyassa P, Fomulu N. A survey of knowledge, attitudes and practice of emergency contraception among university students in Cameroon. BMC Emerg Med 2007 Jul 17;7:7.
11. Puri S, Bhatia V, Swami HM. Awareness of emergency contraception among female college students in Chandigarh, India. Indian Journal of Medical Science 2007;61(6):338-46.
12. Thapa S, Padhye SM. Induced abortion in urban Nepal, Journal of International Family Planning Perspectives 2001 Sep;27(3):144-7.
13. Gondor M, Cavanaugh RM Jr., Kernan D. Young adults’ knowledge, attitudes, and behaviour about abortions in young women Journal of Paediatrics Adolesc Gynaecology 1996 Feb;9(1):21-6.
Mutungi AK, Karanja JG, Rogo KO. Abortion: Knowledge and perceptions of adolescents in two districts in Kenya. East Afr Med J 1999 Oct;76(10):556-61.