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RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION


1. NAME OF THE CANDIDATE AND ADDRESS : SHILBY I YEAR M.Sc NURSING SMT VASANTHA COLLEGE OF NURSING, NAUBAD, BIDAR

2. NAME OF THE

INSTITUTION

SMT VASANTHA COLLEGE OF NURSING, BIDAR

3. COURSE OF STUDY AND SUBJECT

MASTER DEGREE OF NURSING, PADEATRIC NURSING.

4. DATE OF ADMISSION TO COURSE

1 .1 .2 11

!. TITLE OF THE TOPIC

: "A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNO#LEDGE AND PRACTICE OF MENSTURAL HYGIENE AMONG ADOLESCENT GIRLS IN SELECTED SCHOOL AT BIDAR$.

%. BRIEF RESUME OF THE INTENDED #ORK INTRODUCTION

Yesterday I dared to struggle. Today I dare to win. Bernadette Devlin


In INDIA about 34%of total population belongs to adolescent period. The blossoming of adolescence in each generation is as fascinating a sight as the unfolding offspring each year predictable and repetitive. Adolescents belong to vital age group not only because they are the entrant population to parenthood but also because they are threshold bet!een childhood and adulthood. As they attempt to cross this threshold they face various physiological psychological and developmental changes. The !ord "#Adolescent## is derived from the $atin !ord "adolescere# !hich means to gro! to maturity that indicate the defining features of adolescence. During puberty the physical changes occur !hich transform the body of child into that of an adult changes in body si%e and changes in body proportions. &enstruation is a physiological phenomenon !hich is uni'ue to females that begins in adolescence. &enstruation is also properly called menses (or) catamenia and more commonly a period of monthly flo!. &enstruation is not an illness. It is a healthy normal mature process. The ages of onset is from *+,- years and termination occurs appro.imately every /0days and last for about five days. &enstrual flo! consists of blood mucus and tissue particles. Average blood loss is about three

ounces. 1actors that may alter the menstrual cycle are stress fatigue e.ercises acute (or) chronic illness and changes in climate. 2ersonal hygiene to be follo!ed during

menstruation are to use sterile pads during early period of heavy flo! bathe daily for comfort and to feel fresh 3eep perineal area clean from anterior to posterior cotton under garments preferred. The most stri3ing change in adolescent girls is the onset of menstruation 3+4 days bleeding from the uterus once a month that !ill occur throughout the lifetime till menopause. The first menses is called 5&enarche6. &enarche is the signal that se.ual maturation of the young female has occurred and that the body is capable of supporting pregnancy. 7ith onset of menstruation a girl becomes a!are of her emerging identity as a female capable to reproduce. 8er understanding and acceptance of her ne! identity !ill be greatly influenced by the feed bac3 she receives from peers educators and most importantly her parents. &enstruation occurs periodically throughout the child bearing years e.cept during pregnancy and lactation. The ages of onset of menstruation differ from person to person but seem to be affected by heredity racial bac3ground and nutritional status. &ost of the girls receive their gynecological information from their mothers religious boo3s older sister or a peer. 8o!ever such information !as generally given after menarche rather than before A study conducted in (/99-) using 'ualitative research data and 'uantative survey revealed that prior to menarche the 3no!ledge about menstruation !as deficient among the respondents and ten percent of !omen respondedants and reported various taboos related to menstruation. 8ence there is a need to provide healthy family life education to the !oman particularly the adolescent girls. :ery fe! similar studies have been conducted in India !hich has

e.plored the 3no!ledge and practice areas. But the attitudinal aspects of menstruation have not been studied specifically.

&enstruation is still regarded as something unclean or dirty in Indian society. The reaction to menstruation depends upon a!areness and 3no!ledge about the sub;ect. The manner in !hich a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Although menstruation is a natural process it is lin3ed !ith several misconceptions and practices !hich sometimes result into adverse health outcomes. &enstruation is still regarded as something unclean or dirty in Indian society. The reaction to menstruation depends upon a!areness and 3no!ledge about the sub;ect. The manner in !hich a girl learns about menstruation and its associated changes may have an impact on her response to the event of menarche. Although menstruation is a natural process it is lin3ed !ith several misconceptions and practices !hich sometimes result into adverse health outcomes. 8ygiene+related practices of !omen during menstruation are of considerable importance as it has a health impact in terms of increased vulnerability to <eproductive Tract Infections (<TI). The interplay of socio+economic status menstrual hygiene practices and reproductive tract infections are noticeable. Today millions of !omen are sufferers of <eproductive tract infections and its complications and often the infection is transmitted to the offspring during pregnancy. 7omen having better 3no!ledge regarding menstrual hygiene and safe practices are less vulnerable to <eproductive Tract Infections and its conse'uences.

Therefore increased 3no!ledge about menstruation right from childhood may escalate safe practices and may help in mitigating the suffering of millions of !omen.

The social stigma attached to menstruation causes many girls and !omen to carryout dangerous hygiene practices. $ac3ing a platform to share menstrual hygiene problems girls and !omen often suffer from discomfort and infection avoiding urination during menstruation and using any 3ind of cloth available old (or) un!ashed as an absorbent. These 3inds of practices can lead to problems li3e infection boils and itching but still girls are not visiting medical practitioners.

%.1 NEED FOR THE STUDY:


Today#s adolescents (34%) are tomorro!#s adults !ho are the strength of the nation. Today#s adolescent girls are our future homema3ers. &ost of the adolescents tend to be e.tremely una!are of their o!n body their physical !ell being and psychological change. 8alf of the adolescence do not 3no! about menstruation until its onset. &enstrual cycle has come to occupy an increasingly important place in discussions of !oman#s health attention is again focusing on the impact of the onset of menarche. =tudies of girl#s response to menarche have determined that it is a highly salient intensely e.perience event and a turning point in female development. They also have demonstrated that more ade'uate preparation is associated !ith a more positive initial response .Despite a sense of being prepared and even e.cited about impending event ho!ever most girls still find menarche mildly stressful.

A study !as conducted in (/99>) due to lac3 of information on this natural phenomenon and culturally divergent beliefs and practices rural adolescent

girls in India often manage menstruation in an unsafe manner that leads to reproductive tract infections and other reproductive health problems. The girls should be educated about significance of menstruation and development of secondary se.ual characteristics selection of sanitary menstrual absorbent and its proper disposal. =o that she does not develop psychological upset and received education !ould indirectly !ipe a!ay the age+old !rong ideas and ma3e her feel free to discuss menstrual matters !ithout any inhibitions. &enstruation and puberty hygiene is rarely discussed at home as !ell as schools? especially in the regions the current study !as conducted. Due to some cultural and religious restrictions many young girls in this country lac3 appropriate and sufficient information regarding menstrual hygiene causing incorrect and unhealthy behavior during their menstrual period. A study !as conducted by @ames (/993) on 53no!ledge and practice of menstrual hygiene6 in 2un;ab. The main finding of the study !as that adolescent school girls as a !hole had an inade'uate 3no!ledge on menstrual hygiene. A study !as conducted by Aolf (/99,) on 5Bnderstanding of menstruation in early adolescent girls6. Their e.planation for menstruation reflected at best incomplete 3no!ledge and more typically a variety of misconception or ignorance.

A study !as conducted by =reenivasa (,***) on 5Ano!ledge and Attitude of adolescent girls regarding menstruation6 sho!ed that the emotional response of the ma;ority of girls (-9%) at the onset of menstruation. The above studies and personal vie!s of the investigator and her e.posure to the surroundings in the form of relatives neighborhood !ho faced certain problems in

the aspect of menstruation and its crisis situation created an insight to conduct a study to assess the effectiveness of =T2 on menstrual hygiene and practice among adolescent girls in selected school at Bidar.

%.2 REVIE# OF LITERATURE


<evie! of literature is a broad systematic and critical collection and evaluation of important scholarly published literature as !ell as unpublished materials. The revie! serves as an essential bac3ground for any research. A study !as conducted by T&'()* T&')* +2 3,. "Determination of

3no!ledge and practices about menstruation6. The data !as collected using a /,+item 'uestionnaire developed by the researcher based on information in the literature. The mean age of the girls included in the study !as ,/.00C9.*4. &ore than half of the girls (4/%) had begun menstruating and the mean age for menarche !as ,/./*C9.0,. The ma;ority (*9%) had received information about menstruation but ,9% had not. A significant difference !as found bet!een fre'uency of changing sanitary pads and the studentsD income status (pE9.99,). As their income level decreased their fre'uency of

changing pads decreased. In conclusion the children had a 3no!ledge deficit about menstruation and education needs to be given at their schools and in their families.

A study !as conducted by P)'-./.S, K&0)', A1)'-)2 AK. +2

!,

5F.periences in relation to menstruation6. The study finding sho!ed that most of the girls tal3ed about ho! their menstrual bleeding ma3es they feel dirty and unclean and reported feelings of embarrassment and shame. During menstruation one !as completely shoc3ed? another reported that she !as not allo!ed to enter in the temple and 3itchen. =uch prohibitions do induce feelings of isolation and shame in young girls.

A study !as conducted by R.03.c( G I, M422.' .M. +2

%,. " Attitude and

feelings to!ards menstruation and !omanhood in girls at menarche6. To elucidate early adolescent girlsD attitudes thoughts and feelings to!ards menstruation and their bodies. &FT8GD=H 39* ,/+y+old girls ans!ered 'uestionnaires. Gne part of the 'uestionnaire dealt !ith thoughts and feelings to!ards menstruation. The other part dealt !ith thoughts and feelings to!ards menstruation and se. and ability to communicate on aspects of !omanhood. The study reveals that 2ostmenarcheal girls !ere less positive to!ards menstruation than premenarcheal girls (p E , . ,9(+-)). &any girls (43%) did not reaffirm the statement II li3e my bodyI and almost one

'uarter stated being teased for their appearance. &any of the girls claimed that they had been called IcuntI (30%) or I!horeI (4-%). If called IcuntI or I!horeI ,>% stated that they felt alone >-% felt anger and 49% !ere offended. &others !ere those !ith !hom girls could most easily IchatI about their period. =i.ty+seven per cent received information about menstruation from school nurses.

A study !as conducted by T'5*46. OO, OP1&*17405 A, A/4 AO. +2

3,

5&enstruation H 3no!ledge attitude and practices of students in Tai!an6. The purpose of the study !as to e.plore gender differences in 3no!ledge and attitudes to!ards menstruation among Tai!anese adolescents. This study !as a secondary data analysis of a cross+sectional comparison study conducted in Tai!an. A total of /0> female and /-* male students at a ;unior high school participated in the study. The results sho!ed that almost all the students had heard about menstruation and most of

them had received menstrual information at school. 8o!ever their 3no!ledge about menstruation !as not accurate. &oreover the male students e.pressed more negative attitudes to!ards menstruation than the female students

A study !as conducted by D)81&9:) A, S)'()'. +2

;, 5&enstrual hygiene?

ho! hygienic is the adolescent girls6. &enstruation and menstrual practices are still clouded by taboos and socio+cultural restrictions resulting in adolescent girls

remaining ignorant of the scientific facts and hygienic health practices !hich sometimes result into adverse health outcomes. A descriptive cross+sectional study !as conducted among ,-9 adolescent girls of a secondary school situated in the field practice area of <ural 8ealth Bnit and Training Jenter =ingur 7est Bengal !ith the help of a pre+designed and pre+tested 'uestionnaire. Data !as analy%ed statistically by simple proportions. <esults sho!s Gut of ,-9 respondents ,90 (->.4%) girls !ere a!are about menstruation prior to attainment of menarche. &other !as the first informant regarding menstruation in case of -9 (3>.4%) girls. Gne hundred and thirty+ eight (0-./4%) girls believed it as a physiological process. =eventy+eight (40.>4%) girls 3ne! the use of sanitary pad during menstruation. <egarding practices only ,0 (,,./4%) girls used sanitary pads during menstruation. 1or cleaning purpose ,4(*>.4%) girls used both soap and !ater. <egarding restrictions practiced ,3- (04%) girls practiced different restrictions during menstruation. JonclusionsH &enstrual hygiene a very important ris3 factor for reproductive tract infections is a vital aspect of health education for adolescent girls. Fducational television programmes trained school nursesKhealth personnel motivated school teachers and 3no!ledgeable parents can play a very important role in transmitting the vital message of correct menstrual hygiene to the adolescent girl of today.

A study !as conducted by S7&(2) .S +2

!,. "!or3ing on menstruation !ith

girls in &umbai India6. &enstruation is considered a polluting factor among 8indus. In many places menstruating girls and !omen are considered untouchable. =uch attitudes and practices are unli3ely to create a positive self image !ith in girls. =hu3la found that girls and !omen teachers !ere very 3no!ledgeable about the intricate system of taboos and sanctions that pertained to menstruation but had very little actual 3no!ledge about the biological process of maturation and normal physiology. This is lac3 of factual information compounded by the prevalence of myths means that girls practical needs related to managing menstruation are often not appreciated (or) appropriately addressed e.g. of the provision of ade'uate sanitary protection .&ost girls are left to cope as they can !ith rags (or) other insufficient protection.

A study !as conducted by E5<G52)*6 AH, B)=)-)5 K, +2

!,. "&enstrual

hygiene among adolescent schoolgirls in &ansoura Fgypt6. This study among --4 schoolgirls aged ,4+,0 in Fgypt as3ed about type of sanitary protection used fre'uency of changing pads or cloths means of disposal and bathing during menstruation. Lirls !ere selected by cluster sampling techni'ue in public secondary schools in urban and rural areas. Data !ere collected through an anonymous self+ administered open+ended 'uestionnaire during class time. Bse of sanitary pads may be increasing but not among girls from rural and poor families and other aspects of personal hygiene !ere generally found to be poor such as not changing pads regularly or at night not bathing during menstruation. $ac3 of privacy !as an important problem. But a large ma;ority of girls said they needed more information.

A study !as conducted by K5'( .J, S400.', M. +2

!,. "&enstruation and

a!areness? critical issues for girls education6. $ac3 of sanitary protection during menstruation is often mentioned as a barrier to girl#s regular attendance in school. In many poor families providing ade'uate clothing for the !hole family can be a challenge. Insufficient (or) inade'uate sanitary protection can be very embarrassing for a girl attending school during her monthly period.

A study !as conducted 36 B58:),M.B+2 on girls education in Nepal6. Bista reports

4). 5A revie! of research literature local cultural e.pectations that

menstruating !omen should remove themselves from public spaces has led to classes taught by female teachers being discontinued for several days at a time (or) to !omen teachers !ho continue to teach during menstruation being vie!ed negatively by the community not only does this disrupt the learning process but it may simultaneously very negative messages about !hat is e.pected of !omen and girls.

A study !as conducted by R)/)87'.. R. K)032. +2

1,. 5A study to access

the 3no!ledge and practice of menstruation and menstrual hygiene among school girls6. The findings of the study sho!ed that -,.--%of the girls had an average 3no!ledge regarding menstruation on menstrual hygiene and 0>.--% of the girls follo!ed correct practices.

STATEMENT OF THE PROBLEM:


"A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNO#LEDGE AND PRACTICE OF

MENSTURAL HYGIENE AMONG ADOLESCENT GIRLS IN SELECTED SCHOOL AT BIDAR$.

%.3 OBJECTIVES OF THE STUDY:


,.

To assess the 3no!ledge and practice of menstrual hygiene among adolescent girls.

/.

To evaluate the effectiveness of structured teaching programme in term of 3no!ledge and practice of menstrual hygiene.

3.

To determine the corelation bet!een the 3no!ledge and practice of menstrual hygiene among adolescent girls.

4.

To determine the association bet!een the 3no!ledge and practice of menstrual hygiene among adolescent girls !ith their selected socio+demographic variables

%.4 HYPOTHESES OF THE STUDY:

8,H

There !ill be significant increase in the 3no!ledge and practice on menstrual structured

hygiene among adolescent girls studying in ;:7 to 12th standard after teaching programme.

%.!. OPERATIONAL DEFINITIONS:


1. K*4-2.=1.H <efers to understanding of adolescent girl#s on menstrual hygiene as elicited by the structured 'uestionnaire devised by the 'uestionnaire. 2. E>>.c:5?.*.88 ? it refers to determine the e.tent of significant

3no!ledge among adolescent girls.


3. M.*8:'&)2 7615.*.H Includes all those measures ta3en by the individual to 3eep the genital area clean and dry during the menstrual period K cycle.

4. A=42.8c.*: 15'28: <efers to the girls !ho had attained menarche bet!een ,3+,> years and !ho are studying in 0th and ,/th standards of selected schools. !. S:'&c:&'.= T.)c75*1 P'41')00. @ It is a !ell prepared teaching

programme !ith systematically developed instruction for a group of adolescent girls on &enstrual hygiene 3no!ledge and practice for one hour.

%.%. ASSUMPTION:
,. Adolescent girls may have some 3no!ledge and practice of menstrual hygiene.

%.A. DELIMITATION:

This study is de+limited to ,3+,> years Adolescent girls !ho are studying 0th and ,/th standards. This study is de+limited to young adult females. This study is de+limited to 09% Adolescent girls !ho are studying 0th and ,9th standards.

A. . MATERIALS B METHOD:
A.1. SOURCE OF DATA: Data !ill be collected from adolescent girls !ho are studying 0th and ,9th standards selected at Bidar. A.2 METHOD OF COLLECTION OF DATA: A.2.1 RESEARCH DESIGN: The research design that !ill be used to achieve the ob;ectives of the study is one group pretest posttest e.perimental design. A.2.2RESEARCH APPROCH: The approach of this study !ill be e.perimental in nature. A.2.3 SETTING OF THE STUDY: This study !ill be conducted in selected schools in Bidar.
A.2.4 POPULATION:

The population of the study comprises of adolescent girls !ho are studying 0th and ,9th standards in selected school Bidar.

A.2.! SAMPLE SICE:

The total sample of the study consists of 09 adolescent girls !ho are studying 0th and ,9th standards.
A.2.% SAMPLING TECHNIDUE: Jonvenient and 2urposive sampling techni'ue. A.2.A SAMPLING CRITERIA: INCLUSION CRITERIA

,. Adolescent girls !ho are studying 0th and ,/th standards !ho are !illing to participate. /. Adolescent girls !ho are studying 0th and ,/th standards !ho are available during the period of data collection. 3. Adolescent girls !ho are studying 0th and ,/th standards !ho are able to spea3 and read Aannada. 4. Adolescent girls !ho are studying 0th and ,/th standards bet!een the age bet!een of ,3 to ,> years.
EECLUSION CRITERIA

,. Adolescent girls !ho are studying 0th and ,/th standards are not !illing to participate and not available during the data collection. /. Adolescent girls !ho are studying 0th and ,/th standards are not able to spea3 and read Aannada. 3. Adolescent girls !ho are studying 0th and ,/th standards are above ,> years.

A.2.; TOOL FOR DATA COLLECTION:

A structured Muestionnaire is drafted for this purpose and the relevant data !ill be collected from the sample. P)': F I: =elected demographic variables such as age educational status religion type of family family income monthly source of information age at menarche educational status of the mother number of elder sisters. P)':< II: =tructured 3no!ledge 'uestionnaire regarding menstrual hygiene PROCEDURE FOR DATA COLLECTION: The data !ill be collected !ith in the prescribed time period in selected Adolescent girls !ho are studying 0th and ,/th standards. The ob;ective of the study !ill e.plained to adolescent girls !ho are studying 0th and ,/th standards before starting the data collection.

A.2.G DATA ANALYSIS METHOD:


The data analysis !ill be carried out through e.perimental and inferential statistics !ith the help of computer soft!are pac3age (=2==).
INFERENTIAL STATISTICS:

Jhi s'uare test !ill be used to find out the association bet!een the 3no!ledge and practice !ith selected demographic variables.
A.3 DOES THE STUDY REDUIRE ANY INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALSH

No health education pamphlet !ill be given to adolescent girls regarding substance abuse based on identified needs. A.4 ETHICAL CLEARANCE:

2ermission !ill be obtained from + The research committee of =mt. :asantha Jollege Gf Nursing. + Authorities of selected areas.

;. LIST OF REFERENCES:

BOOK REFERENCE
1. 2arthasarathy. A Te.t boo3 of pediatrics. /nd edition. ;aypee Brothers (p) Ne! Delhi? /99/? 30+49. /. Aolf.e <ierdan. Farly adolescent girls understanding of menstruation. @ournal of !omen health. ,**4? v //(4)? ,+/,. 3. Basavanthappa B.T. The te.t boo3 of community health nursing. ,stedition. @aypee Brothers (p). Ne! DelhiH ,**0? /94+/9-. 4. Da!n J.=. The te.t boo3 of gynecology.The da!n boo3s (p)H Jalcutta. ,*0/? /34.

JOURNAL REFERENCE
4. &ohammad poureslam. 2ro;ect (online)H /99, Nov ?(cited /99, Nov) availalable 1romH B<$H http?KK!!!.ams.ac.irKAimK9/44K9/44/,*.htm.3/3. -. Dasgupta.A =ar3ar. &enstrual hygiene? ho! hygienic is the adolescent Lirl. Indian @ournal of community medicine. /990H v 33(/)? >>+09. >. <embec3 L.I &oller. &. Attitudes and feelings to!ards menstruation and !omanhood in girls at menarche. @ournal of pediatrics. /99-H v (*4)? 0 . Fi+Lilany .A8 Bada!i Aarima. <eproductive health matters. /994H : ,3(/-)? ,4>+,4/. * . =hu3la. 7or3ing on menstruation !ith girls in &umbai India. :acha 7omen#s resource centre e'uals./994H v (,4)?4+4. ,9. Aric3. @ =ommner.&. &enstruation and body a!areness critical issues for girls on education. /994H v (,4)? 4+4. >9>+>,4. ,,. Bista. &.B. A revie! of research literature on girl#s education in Nepal. @ournal of medical sciences. /994. ,/. Trinoye. Ggunghomi. A. &enstruationH 3no!ledge attitude and practices of students in Nigeria. @ournal of &edical =ciences. /993H v ,/(,)? 43+4,.

,3. 2ar!e;.= 3umar agar!al A.3. <eproductive health education international trial. @ournal of pediatrics India. /994H v (>/)? /0>+/*,. ,4. Tur3an Turan. Determination of 3no!ledge and practices about &enstruation. (Gnline) /993. ,4. <a;ashree <. Aamble. A study to assess the 3no!ledge and practice of menstruation and menstrual hygiene among school girl. @ournal of sch. /99,H v >4 (3)? 0*+**.

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