Rajiv Gandhi Universiy of Health Science

Rajiv Gandhi Universiy of Health Science

RAJIV GANDHI UNIVERSIY OF HEALTH SCIENCE

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

SUBMITTED BY

MS. AMBIKA DAYAL

FIRST YEAR M.Sc. NURSING

CHILD HEALTH NURSING

BATCH – (2010-2012)

SUSHRUTHA COLLEGE OF NURSING

# 23, PAPAIHA GARDEN, DIAGONAL ROAD

CHENNAMANAKERE, BSK STAGE,

BANGALORE – 85.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE

Bangalore, Karnataka

Proforma for registration of Subjects for Dissertation

1 / Name of the Candidate and address / Ms. Ambika Dayal
First year M.Sc.Nursing, Sushrutha College of Nursing, #23, Papaiah Garden, Diagonal Road, Chennamanakere BSK Stage, Bangalore – 85.
2 / Name of the Institution / Sushrutha College of Nursing
3 / Course of the study and subject / Degree of Master of Science in Nursing, Child health nursing
4 / Date of the admission to course / 07/06/2010
5 / Title of the topics / A study to asses the effectiveness of Structured teaching programme on knowledge regarding reproductive health among adolescent girls of 12-14 years in selected schools of Bangalore, with a view to provide an informational booklet.

6.0 BRIEF RESUME OF THE INTENTED WORK

INTRODUCTION:

“REPRODUCTIVE HEALTH IS MORE THAN FREEDOM FROM SEXUAL DISEASES AND DISORDERS”.

Human beings as they develop, their needs differs according to their age. There is a cumulative affect across the life course and events at each phase having important implication for future well being, failure to deal with the health matters at any stage in life sets the scene for later health and developmental problems1.

Reproductive health is a crucial part of general health and a central feature of adolescent development, reproductive health is a universal concern, but is of special importance for women particularly during the reproductive years, that is, from 12-19 years. Social and gender relationships and the traditional and legal structures within which they are born and bought up affect the growth of an individual1.

Sexual and reproductive behaviors are governed by complex biological, cultural and psychosocial factors. The status of the girls and women in society and how they are treated and mistreated is a crucial determinant of their reproductive health1.

As the adolescent girls steps into the reproductive age, many parents do not adequately explain to them, the various changes which occur in the body contour that indicate puberty and about how to take care of themselves. Before attaining the reproductive stage, children should be well oriented to the automatic and functional differences between the sexes2.

Many adolescent girls do not have a clear understanding of ovulation, fertilization pregnancy and birth have not been told about menstruation and sexually transmitted diseases, due to the factors like cultural background, religion, family pattern, parent’s education etc., these factors makes the adolescents to acquire incorrect and inadequate information’s, filled with wrong beliefs and taboos. Adolescents gathers all the wrong information’s and lands up committing mistakes which affects their reproductive health adversely2.

The incidence of HIV, unsafe abortions, pregnancy STDs are now a days increasing at a rapid speed in adolescent population in the country, specially affecting the girls health, therefore, the adolescent girls are to be concentrated more and proper sexual and reproductive hygiene and health related should be transferred in a best way possible2.

There are many services started by the government which have started working for adolescent health and are made accessible. These services are passing information including education regarding reproductive health, counseling of adolescents about how to prevent sexually transmitted diseases and on how to defect and avoid unwanted pregnancies and abortions. These services are also concentrating on care, management and rehabilitation of reproductive health related problems. Adequate education of adolescents is also necessary through parents and school2. “PROPER EDUCATION AND INTERVENTION IS BETTER THAN ALLOWING THE DANGER TO OCCUR”.

6.1 NEED FOR THE STUDY

In India, the population of the adolescents are increasing day by day, and so is the demand for their health.

The young adolescents have special needs in all circumstance and each age group within this population has different problems and requirements3.

So for the health system has been more specifically targeted to infants and children below 6 Years, therefore unmarried adolescents have been totally ignored by the government and other health sectors.3

Adolescents know very less regarding reproductive hygiene or diseases. This is because of the reason that, many families does not pass the proper information to their children regarding reproductive health matters .

In many areas of the country adolescents are having least knowledge about their reproductive heath. Parents merely talk any aspect related to reproductive health in front of their children, example, about menstrual hygiene, STD transmission, pregnancy, abortion, contraceptive measures etc., as they consider it as irrelevant information for their children and in some other families the information is passed on wrongly, which puts the adolescents into the danger of falling into serious health related problems4.

It is estimated that, more than 10% of all births each year are to women aged 15-19 years. Approximately 2 million adolescent girls in developing countries undergo unsafe abortions each year. The risk for maternal mortality is 20 times higher for pregnant adolescent girls than for pregnant women. In 2006 it was noticed that over 400,000 teens girls become pregnant and about 1 million young adolescents contracted on STDs5.

All the estimated finding shows it is very important to provide education to the adolescent girls regarding the aspects of reproductive health, for which this study is conducted.

6.2 REVIEW OF LETERATURE

A study was conducted by Rondini S. Krugu JK on knowledge, attitude and practice on reproductive. Health among secondary school students in bolgatanga Ghama, Qualitative and quantitative dates was conducted on how adolescents perceives, STD, HIV fly planning and vulnerability to sexual violence. The results showed that their was low familiarity of student population c fly planning methods & HIV, AIDS transmission etc., which had put them at high risk for having unwanted pregnancies and sexual infections transmission. Study concluded that poor infrastructures and low accessibility of reproductive health programs in the rural areas was the cause and suggested to improve them6.

A study was conducted by Gwarzo UM Sabitu K, Idnis SH on knowledge and practice of B.E. among female undergraduates of Ahmedu Bello University Xaria, on 221 female students aged 16-28 years and found that 57.7% had only heard Breast Self Examination and only 19% of them more performing this examinants monthly this study concluded that there was disparity between high levels of knowledge compared to low level of practice. Public health education through the media could significantly reduce the knowledge – practice gap7.

A study was conducted by Jahnavi G. and Patra SR on awareness regarding contraception and population control among school going adolescents. The cross sectional survey was done taking higher secondary school girls, of which about 94.4 percentage were aware of contraceptives and their easy availability. Very few were aware of the names and to use them. Most of the adolescents are misinformed about contraceptives and their usage. Study concluded with a suggestion that steps should be taken by the government to improve the knowledge and altitude of adolescent girls regarding the need and usage of contraptions8.

A study was conducted by Karayurt O, Ozmen D, Cetinkaya AC on awareness of breast cancer risk factors and practice of breast self-examinants among high school students in Turkey. The study was conducted in a high school in Manisa, Turkey, by taking 718 female high school students. The female had insufficient knowledge regarding breast cancer and breast self examination about 98.5% girls quoted the reason as “Not knowing here perform BSC” 68.7% of girls know that the risk factor of breast cancer was personal history of B.C. the study concluded that, the knowledge of AG have to be increased regarding knowledge of BC and its risk factors heath care professionals should develop effective breast health care programs and help young women to acquire good health habits9.

A study conducted on need of awareness generation regarding component of reproductive and child health programme by Mr. Haldar A and Ram Chatterjee, taking 156 adolescent girls study concluded that majority of the girls were aware of the family planning methods and sexually transmitted disease. Many of them used cloth and re-used them during menstrual periods. Study concluded that the reproductive adolescent knowledge was not adequate among adolescent girls in the community10.

A study was done, undertaking the issues related to menstrual practices and to examine the association of menstrual practices with reproductive morbidity by Khanna A Goyal S.R.and Bhawsar R. The date was collected from 730 adolescent girls. The study concluded that minimum member of girls were not even aware of that menstruation was a normal phenomena. The major reported symptoms of RTIs / STIs among girls were discharge and pain in the lower abdomen. About ¾ Three – Fourth of the girls re-used cloth during menstruation which was at most unhygienic11.

A study was conducted in Ile-Ife Nigeria on knowledge attitude and practices of students regarding menstruation by Irinoye oo, Ogungbemi A, Ojo Ao, Data was collected from 200 students from school by multi-stage sampling technique, only Five Percent of respondents’ defined menstruation. Materials used during menstruation were sanitary pads, pieces of cloth, toilet rolls, cotton wool pads etc., Eight Percent of girls stated that menstruation was associated with restriction in diet and social interaction. 20.5% stated that menstruation was an abnormal, dirty and a disease kind of process. The study concluded that, education programmes should be planned to correct misconceptions and to promote healthy practices, among young adolescent12.

A study was conducted on Indigenous practices of Saudi girls in Riyadh during their menstrual period by Moawed S. A sample of 600 girls was taken of 11-18 years of age from outpatient clinics. Structured interview technique was used to collect the data. The results revealed that about Two Third of the girls avoided certain foods, drinks and activities including showering and performing perineal care during menstruation. Mother, religious books and sisters were the source of information. The study suggested that the teachers, nurses and health care providers should take all the opportunities available to educate young girls about the menstrual hygiene13.

A qualitative exploratory study was conducted on perception of adolescents on low resourced areas towards pregnancy and the choice on termination of pregnancy by Ratlabala ME, Makofane MD Jali MN. A purposive sampling technique was used and 24 adolescent girls were chosen for the study. The major findings indicated that most adolescents were uninformed about Termination of Pregnancy. It was found that lack of co-ordination among health professionals and educators were the cause. Majority of the adolescents expressed discomfort at receiving termination of pregnancy services from the local public clinics / hospital as they considered such facilities as youth and friendly. If adolescents continue to lack information about termination of pregnancy they are unable to utilize available services to terminate unplanned pregnancies. If termination of pregnancy services remain inaccessible to the youth, the problem of backstreet abortion will not be eradicated14.

A descriptive study was conducted by Mushi DL, Mpembeni RM, John A to assess the knowledge about safe-motherhood and HIV/AIDS among school girls in rural area of Tanzania. A sample of 135 students were selected of age 9-17 years from three primary school. Attitudes were assessed through focus group interview, knowledge of adolescent students were generally low. 07% of students were not be able to mention the age at which a girl may be able to conceive, Eighty percent reported that it was safe for a girl to be married before 18 years. Birth preparedness, important risk factors, danger signs, postpartum care and transmission of HIV and its preventive measures were almost unknown to the students. Study concluded that, school children must be provided with appropriate safe motherhood information as early as possible through innovative school based interventions15.

A study was conducted by El-Gilany AH, Badawi K, El-Fedawy S, on Menstrual hygiene among school going girls in Mansoura, Egypt, taking 664 school girls aged 14-18 years were selected by cluster sampling method, Data was collected by self-administered open ended questionnaire. Aspects of personal hygiene in majority of the girls were found to be poor, such as not changing the pads regularly and not bathing during menstruation. The study suggested that, instruction in menstrual hygiene should be linked to an expanded programme of health education in schools16.

STATEMENT OF THE PROBLEM

“ A study to asses the effectiveness of STP (Structured teaching programme) on knowledge regarding reproductive health among adolescent girls of 12-14 Years in selected schools of Bangalore with a view to provide an informational Booklet.

6.3 OBJECTIVES OF THE STUDY

6.3.1 To asses the knowledge of adolescent girls regarding reproductive health.

6.3.2 To asses the effectiveness of structured teaching programme on reproductive

health by comparing the pre test-post test score.

6.3.3 To determine the association between their knowledge, scores and selected

demographic variables such as age, education and religion

6.3.4 To develop a factual informational booklet.

6.4. HYPOTHESIS OF THE STUDY:

Ho – There will not be any significant difference between the pre and post test

knowledge score regarding reproductive health among adolescent girls.

Ho – There will not be any significant association between the selected

demographical variable.

6.5 VARIABLES

Dependent variable – knowledge on reproductive health among adolescent girls of selected schools.

Independent variable – Structured teaching programme regarding knowledge on respective health among adolescent school girls (12-14 years)

6.6 OPERATIONAL DEFINITIONS

ASSESS: It refers to judgment of adolescent girls (12-14 years) knowledge regarding reproductive health

EFFECTIVENESS: It refers to significant gain in knowledge as determined by increase in post test knowledge score.

STRUCTURED TEACHING PROGRAMME: It refers to the systematically developed instruction for adolescent girls.

KNOWLEDGE: It refers to the state of possessing information regarding reproductive health.

REPRODUCTIVE HEALTH : It is health of an adolescent girl of age 12-14 years, in the absence of reproductive diseases or infirmity.

REPRODUCTIVE HEALTH :

ADOLESCENT GIRL : “A female in the age group of 12-14 Years, who has reached puberty and is studying in selected schools.

BOOKLET: It a printed educational material that gives the comprehensive knowledge of reproductive health usable by adolescents.

6.7 ASSUMPTIONS

1. Adolescent girls of age 12-14 years, may not have adequate knowledge regarding reproductive health.

2. Adolescent girls of age (12-14 years), may have interest to know about the reproductive health.

6.8 LIMITATIONS

1. The study is limited to the adolescent girls who are in the age of 12-14 years, studying in selected schools of Bangalore.

2. This study is limited to the adolescent girls of selected schools, who are willing to participate in the structured teaching programme.

3. The study is limited to the adolescent girls who care able to understand and speak English.

4. The study is limited to adolescent girls who are present during pre-test

7.0 MATERIALS AND METHODS

7.1 SOURCE OF DATA

Data will be collected from the girls of adolescent girls age 12-14 years at selected schools of Bangalore.

7.2 METHODS OF COLLECTION OF DATE

Interview method will be used for data collection

7.2.1 RESEARCH DESIGN

Quasi experimental design

7.2.2 RESEARCH APPROACH

An evaluative research approach

7.2.3 SETTINGS OF THE STUDY

This study will be conducted in the selected schools of Bangalore.

7.2.4 POPULATION

The population of the present study comprises of adolescent girls who are of 12-14 years of age and are studying in selected schools of Bangalore.

7.2.5 SAMPLING SIZE

The sample of the study consists of 60 adolescent girls in the selected settings

7.2.6 SAMPLING TECHNIQUES

Non-probability purposive sampling technique will be used.

7.2.7 SAMPLING CRITERIA

INCLUSION CRITERIA

This study will include,

1. The school children of adolescent age 12-14 years and are studying in selected schools in Bangalore.

2. The adolescent schools girls who are willing to participate in the study.

3. The study is limited to those who can read and write English.

4. The study is limited to the adolescent girls who are present on the day of pretest and post-test.

EXCLUSION CRITERIA

This study will exclude.

1. Who are not present at the time of data collection

2. Who are not willing to participate in the study.

3. Who are not studying the selected schools.

4. Who cannot read and write English

7.2.8 DESCRIPTION OF TOOL FOR DATA COLLECTION

Structured interview method.

It consists of two sections, 1 and 2 section

SECTION 1: Consists of questions or items on demographic variables like age, education, parents education and religion.

SECTION 2: It includes knowledge items or questions on reproductive health.

DURATION OF DATA COLLECTION

The data collection process will be completed within 1 week.

7.2.9 DATA ANALYSIS METHODS

The investigator will use descriptive statistical and inferential statistics.

7.3 DOES THE STUDY REQUIRE ANY INTIMATION TO BE CONDUCTED ON PATIENTS / OTHER HUMANS OR ANIMALS?

The study will be conducted on the adolescent girls to assess the knowledge. “There research committee of Sushrutha college of Nursing and authorities of selected community in Bangalore”

7.4 ETHICAL CLEARANCE

Permission will be obtained from “The research committee of Sushrutha College of Nursing and Authorities of selected schools in Bangalore”.

8.0 List of References :

  1. http//
  1. R.Marlow, Babara A. Redding, Text book of Pediatric Nursing, sixth edition, Sanders publication, Page-1122.
  1. Christine Panchaud, Susheela Singh and Jacqueline E. Darroch, Family planning perspectives, vol.32, (1), Jan/Feb, 2000.
  1. L. Brabin, J. Kemp, N. Dollimore, O. Obunge, N. Reproductive tract infections & abortions among adolescent girls. Vol-345, Issue 8945, Page 300-304.
  1. Fatima. Juarez, Thomas Legrand, Cynthia B, Sudheela Singh. Special issues on adolescent sexual and reproductive health, Vol-39, issue (4), Page 239-244.
  1. Rondini S. Krugu, African Journal of reproductive health, 2009 Dec 13:(4), 51-66.
  1. Gwarzo UM, Sabitu K, Idris. SH Ann. Afr. Medical Jr. 2009 Jan & March 8:(1), 55-58.
  1. Jahnavi G & Patra SR, East African Journal of Public Health, 2009 Dec:6(3) 226, 228.
  1. Karayurt O, Ozemn D, Cetinkaya AC BMC Jr. of Public Health, 2008 Oct.17:(8), 359.
  1. Haldar A, Ram Chatterjee, Indian Journal of Community Medicine, April-
  1. Moawed S. East Mediterr Health J. 2001, Jan-Mar ; 7 (1-2) : 197-203.
  1. Ratlabala ME, Makofane MD, Jali MN. Curationis, 2007, Mar 30(1) ; 26-31.
  1. Mushi DL, Mpembeni RM, John A, BMC, Journal on Pregnancy and Child Birth, 2007, April 24 ; 7-5.

14. El-gilany AH,Badawi.kJ. Reproductive Health matters : 2005 Nov; 13