RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,

KARNATAKA, INDIA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.

NAME OF THE CANDIDATE

Miss. SONIAMOL CHACKO M

AND ADDRESS (IN BLOCK

FIRST YEAR M.Sc. NURSING,

LETTERS)

BAPUJI COLLEGE OF NURSING,

DAVANGERE 4,
KARNATAKA.

2.

NAME OF THE INSTITUTION

BAPUJI COLLEGE OF NURSING,

DAVANGERE - 4.

3.

COURSE OF STUDY AND

FIRST YEAR M.Sc. NURSING,

SUBJECT

OBSTETRICS AND
GYNECOLOGICAL NURSING.

4.

DATE OF ADMISSION TO

30.6.2008

COURSE
5.

TITLE OF THE TOPIC

EFFECTIVENESS OF
STRUCTURED TEACHING
PROGRAMME ON KNOWLEDGE
AND PRACTICE REGARDING
MENSTRUAL HYGIENE AMONG
STUDENTS STUDYING IN
GOVERNMENT GIRLS HIGH
SCHOOL, DAVANGERE.

6. BRIEF RESUME OF THE INTENDED WORK :

6.0 INTRODUCTION :
Changes are inherent in life, changes within and changes without, it is the
eternal changefulness of life, that makes life so beautiful said sigmund Freud.
Yes, change makes life worthliving if only one knows how to adapt oneself and
adjust to the challenges created by the changing situation.1
Puberty is a period of rapid physical change and personality growth. A
girls has entered puberty when she begins to menstruate (menarche). 2 Puberty for
girls is the period for her sexual maturity.3
Adolescence is the physiological period between the beginning of puberty
and cessation of bodily growth. 2 It is regarded as unique phase of human
development. Among adolescent girls menarche is an important landmark in the
process of growth and maturation.4 A modern description of adolescence is
teenager.3 It is the time period extends from age of 10 or 12 years through atleast
18 years of age.5
Twelve million girls are born every year in India. MC Cauley and Salter
(1995) reported that 19% of worlds population are in the age of 10 and 18 years.6
Menstruation is a phenominenon unique to the females. The onset of
menstruation (menarche) is one of the most important changes occurring among
the girls during adolescent years. The first menstruation occurs between 11 and
15 years with a mean of 13 years.7
The word menstruation is derived from Greek word menmonth. It is the
monthly vaginal bleeding coming at interval of about 28 days from uterine
endometrium. It occurs during the reproductive period of a women except during
pregnancy and sometimes during lactation.3
According to Hurlock (1987) 50% of all girls mature between 12.5 and
14.5 years of age with average maturity at 13 years in India. 6 Studies conducted in
the Gazipur village in East Delhi has reported that the mean age at menarche 13.6
years in the study group.8 The average age of menarche in the UK is 13 years and
95% of the female population will have reached it between the age of 11 and 15. 9

Though menstruation is a natural and normal physiological process for all

healthy adult women, as ever it has been surrounded by secrecy and myths in
many societies.4 Even in India mere mention of the topic has been a toboo in past
and even to this day it is not freely discussed among women (mendal 1995)6
Study conducted in the village of Gazipur in East Delhi has reported that
during menstruation complaints like irritability, headache, malaise and tenderness
of the breast affected 62.9%, 49.6%, 24% and 9.4% respectively. Dysmenorrhea
was prevalent in 63.73%, only 1/3 of the girls did not complain of any
premenstrual syndrome.8
Menstrual hygiene, a very important risk factor for reproductive tract
infections, is a vital aspect of health education for adolescent girls.7
6.1 Need for the study :
Approximately 1/5th of the world population is adolescent of which more
than 4/5th in the developing countries.1 Adolescence is a period of transition
during which an individual develops into an adult. About 10% of the total
population in India are adolescents (Mendal 1998)6
Adolescent girls constitute a vulnerable group, particularly in India where
female child is neglected one. Menstruation is still regarded as something unclean
or dirty in India society. Menstruation 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, which sometimes
result into adverse health outcomes. Hygiene related practices of woman during
menstruation are of considerable importance, as it has a health impact in terms of
increased vulnerability to reproductive tract infection. Today million of women
are suffering of Reproductive Tract Infection and its complication.7
Up until now, poor menstrual hygiene in developing countries has been an
insufficiently acknowledged problem.10

Rakesh (1988) as cited by Mandal in 1994, reported that especially the

mothers do not educate their daughter about various aspects of menstruation such
as age of its onset, its duration and healthy practices during menstruation. The
girls are not motivated to take the event lightly. So, the inadequate knowledge,
misconception and wrong ideas lead to undue fear, anxiety and undesirable
attitudes in the minds of adolescent girls.4
In the study they found that girls were not properly maintain menstrual
hygiene only 6.0% girls know that menstruation is a physiological process, 36.7%
know that it is caused by hormones.11
James (1997) in a study on menstrual hygiene reported that adolescent
schoolgirls generally hadnt adequate knowledge of menstrual hyiene. Thus the
present study was undertaken to identify the learning needs of preadolescent girls
with a view to develop and a planned teaching programme on menstrual hygiene.
It will help them to improve their self care ability and follow healthy and hygienic
menstrual practice.4
Learning of about menstrual hygiene is a vital aspect of health education
for adolescent girls.12
6.2 Review Of Literature :
The purpose of review of literature is to obtain comprehensive knowledge
base and in depth of information from previous studies.
A study was conducted among 150 adolescent girls of age 13-15 years from
3 schools to evaluate the knowledge and practice on different aspects of hygiene.
The results, they were not properly maintaining the menstrual hygiene. Only 60%
of girls know that menstruation is a physiological process, 36.7% knew that it is
caused by hormones, 94% use pads during the periods but only 11.3% dispose it.
Overall knowledge and practice were 40.6%.12

A descriptive, cross sectional study was conducted among 160 adolescent

girls of a secondary school to elicit the beliefs, conception and sources of
information regarding menstruation and to find out status of menstrual hygiene.
The result, 67.5% girls were aware about menstruation prior to attainment of
menarche. Mother was the first informant in case of 37.5% girls, 86.25% girls
believed it as physiological process, 48.75% knew the use of sanitary pad.
Regarding practice only 11.25% girls used both soap and water and 85% girls
practiced different restrictions during menstruation.7
A study was conducted among 198 adolescent girls in the age group 13-19
years who had menarche for atleast one year, to study the types and frequency of
problems related to menstruation in adolescent girls and the effect of these
problems on daily routine. The result, 67.2% dysmenorrhea (67.2%) was the
commonest problem and 63.1% had one or the other symptoms of premenstrual
syndrome. Other related problem was present in 55.1% subjects. 17.25% had to
miss a class and 25% had to abstrain from work.13
A community based cross-sectional study was conducted among 251
adolescent girls in the Gazipur Village in East Delhi through door to door survey.
The result; the mean age of menarche was 13.6 years. 29% subjects said that they
had prior knowledge regarding menstruation. Mothers (41%) were the most
common source of information, while 92% of girls said they were restricted from
worshipping, 70% restricted from household activities. 74.8% of the girls used
homemade sanitary pads.8
A study was conducted to identify practical way to address the menstrual
hygiene needs of school girls based on the case study in Katakwi participants
were local officials, non governmental organization, teachers, and school girls
and observation were made in schools and internally displaced persons camps.
Additionally information was sought from field staff of various operating
worldwide. The study learns of the independent issues that affect school girls

menstrual hygiene, namely : education, support and guidance, affordable and

effective menstrual materials and private and hygienic sanitation facilities. 14
A integrated qualitative and quantitative study was conducted on
reproductive health of Indian women among 1205 women to ascertain the
perception and experience of women regarding menstruation. The result, major
source of information about menarche or menstruation was friends or relatives
(72%). Mean age of menarche was 15 years. Very few women (0.4%) used
sanitary napkin. Majority of women had strong beliefs about effect of diet on
menstruation.15
A study was conducted among 664 school girls aged 14-18 years. Girls
were selected by cluster sampling technique in public secondary schools in urban
and rural area. The result, lack of privacy was important problem. Mass media
were the main source of information about menstrual hygiene followed by
mothers, but a large majority of girls said they needed more information.12
A one year prospective menstrual diary study was conducted among 165
women aged 17-19 years, to describe how menstrual craps vary from cycle to
cycle within a woman over time and to examine the influence of weight and
lifestyle factors on occurance, duration and severity of menstrual pain. The result
was that menstrual pain occurred 71.6% observed menstrual bleeds, most
commonly first day of menses, the median duration was 2 days. 60% of women
reported atleast one episode of severe pain, while 13% reported severe pain more
than half the time. Earlier age of menarche and long menstrual periods increases
the occurrence, duration and severity of pain.16
A descriptive cross-sectional study was conducted among 250 students
were selected through cluster random sampling method to assess the level of
knowledge, attitudes and behaviours of female students aged 15-18 years with
regards to dymenorrhea and menstrual hygiene. The result, 77% had adequate
knowledge of dysmenorrhoea, but only 32% of these practiced personal hygiene,

33% subjects avoided any physical activity during menstrual period. 67% of girls
reported taking palliative medicine for their menstrual pain without consulting a
doctor.17
A interviews was conducted with 65 females 14-15 years old attending a
rural high school, to learn their knowledge and practice about menstruation. The
result was that all the students attained menarche at 12-13 years. The cycle was
26-28 days in length for 42 students. Bleeding lasted for 3-5 days for 52 students.
43 knew the menstruation is a physiological process. 12,4 and 5 thought it to be a
curse from God, caused by a sin and a disease respectively. About 50% knew that
hormones were responsible for menstruation. 18 believed weight gain caused it
51 students know bleeding originated from the uterus. 48 received information
from their mothers.18
6.3 Statement of problem :
A study to evaluate the effectiveness of structured teaching programme on
knowledge and practice regarding menstrual hygiene among students studying in
government girls high school Davangere.
6.4 Objectives of the Study :
1. To assess the existing knowledge of students regarding menstrual hygiene
using structured interview schedule.
2. To assess the practice of students regarding menstrual hygiene using
observation checklist.
3. To evaluate the effectiveness of STP on menstrual hygiene as evident from
gain in knowledge score.
4. To determine the association between pretest knowledge score with
selected demographic variables.

6.5 Operational definitions :

1. Evaluate : In this study it refers to a continuing process to examine
outcome achievement among students by structured teaching programme.
2. Effectiveness : In this study it refers to determining the extent to which
the information in the structured teaching programme has achieved the
desired effect as expressed by gain in knowledge score.
3. Structured teaching programme : In this study it refers to systematically
planned teaching program designed to provide informations which is
prepared by researcher. .
4. Knowledge : In this study it refers to information collected by researcher
from the subjects by administrating structured questionnaire.
5. Practice : In this study it Refers to the activities performed by the high
school girls in relation to menstrual hygiene as per the steps in the check
list tool.
6. Menstrual hygiene : It refers to menstrual hygiene is an activity
performed to maintain perineal hygiene by the girls during her menstrual
period.
7. Students : In this study it refers to girls studying in 8th and 9th standard.
6.6 Hypothesis
The mean post test of subjects exposed to structured teaching programme
will be greater than their mean pretest scores as measured by planned knowledge
questionnaire at 0.05 level of significance.
6.7 Assumption :
Assume that,
1)

Students will have inadequate knowledge regarding menstrual

hygiene.

2)

Knowledge of menstrual hygiene directly influence the practice

regarding menstrual hygiene.

3)

Students level of knowledge is influenced by demographic

variables.
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6.8 Limitation :
The study is limited to students,
1. Students studying in 8th and 9th standard in government girls high school,
Davangere.
2. Students those who have attained menarche
3. Students those who are willing to participate in the study.
6.9 Projected outcome :
The students will have;
Enhancement in knowledge and practice, development of extended role,
increased autonomy.
7.

MATERIALS AND METHODS :

7.1 Source of Data collection :
Students who are studying in 8th and 9th standard during the time of data
collection.
Research design :
One group pre-test post-test, experimental design.
Setting :
The study will be conducted in Government girls high school, Davangere.
Population :
In this study population refers to 8th and 9th standard students those who
attained menarche.
Sample size :
In this study the sample size will be 55 students studying in 8 th and 9th
standard.

Inclusion criteria :
1. Students studying in 8th and 9th standard in government girls high school,
Davangere.
2. Students those who have attained menarche
3. Students those who are willing to participate in the research study.
Exclusion criteria :
1. Students those who studying in 10th standard.
2. Students those who have not attained menarche
3. Students those who are not available at the time of data collection.
4. Student those who are not willing to participate in the research study.
7.2 Methods of collection of data :
Sample technique : Purposive sampling
Instrument intended to be used :
Structured knowledge questionnaire.
The structured knowledge questionnaire has three sections,
Section 1 : Socio demographic variable
Section 2 : Structured questionnaires will be prepared to assess the knowledge of
students regarding menstrual hygiene.
Section 3 : Structured questionnaires will be prepared to assess the practice of
students regarding menstrual hygiene.
Variables :
Independent variable : Structured teaching programme.
Dependent variable : Knowledge and practice of students regarding menstrual
hygiene.
Data collection method :
Step I : Investigators introduce herself to students.
Step II : Administration of pretest by giving questionnaire on knowledge and
practice items.

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Step III : Administration of structured teaching programme regarding menstrual

hygiene.
Step IV : Administration of post test on knowledge and practice regarding
menstrual hygiene.
Plan for data analysis plan :
The data will be analysed by using appropriate statistical method and will
be presented in the form of figures and tables.
7.3 : Does your study require any investigation or interventions to conduct
on patients or other humans or animals ? If so, please describe briefly.
Yes, structured teaching programme will be administered regarding menstrual
hygiene to the students studying in Government girls high school Davangere.
7.4 : Has ethical clearance been obtained from your institution in case of 7.3?
Yes, written permission will be obtained from college as well as from
Government girls high school.

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8.

LIST OF REFERENCES :
1) Rajashree R. Kamble; A study to assess the knowledge and practice of
menstruation and menstrual hygiene among girls studying in selected high
schools of Belgam city; dissertation year 2001.
2) Adele Pillitteri, Maternal and child health nursing; 4th edition, 2003, Page No.
905.
3) C.S. Dawn; Textbook of Gynaecology and contraception, 9 th edition, 1987,
Page No. 100.
4) George, Minimol; preparing girls for menarche, Nursing Journal of India,
March 2003.
5) Dorothy R Marlow, Barabara A Redding; Textbook of pediatric nursing; 6 th
edition, 2006. Page No. 1114.
6) Paramjit Kaur; A study to assess the learning needs of adolescent girls
regarding menstrual hygiene in selected rural schools in mangalore;
dissertation year 2000.
7) A Dasgupta, M Sarkar; Menstrual hygiene : How hygienic is adolescent
Girl?; Indian Journal of Community Medicine; Volume 33, Issue 2, April
2008; Page No. 77-80.
8) Parvathy Nair, Vijay L Grover, AT Kannan; Awareness and practice of
menstruation and pubertal changes amongst unmarried female adolescents in
a rural area of East Delhi; Indian Journal of community Medicine; year 2007,
volume 32, Issue 2, Page No. 156-157.
9) Dewhursts; Textbook of obstetrics and gynecology for postgraduates, 5 th
edition, 1995, Page 48.
10)Dr. Varina Tjon A Ten, Menstrual hygiene : A neglected condition for the
achievement of several millennium development goals. Zoetermeer, 10 th
October 2007.
11)Adhikari, Kadel, Dhungel, Mandal; Knowledge and practice regarding
menstrual hygiene in adolescent girls of Nepal; Find health-article.com; 8 th
July 2008.

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12)A. EI-Gilany, K. Badawi, S.EI-Fedawy; Menstrual hygiene among adolescent

school girls in Mansoura, Egypt; Elsevier article locator; volume 13, issue 26,
year 2005, page 147-152.
13)Pragya Sharma, Chetna Malhotra, D.K. Taneja and Renuka Saha; Problems
related to menstruation amongst adolescent girls; Springer Link-Journal
article; June 22, 2008.
14)Cooke, Jeanette; Practical interventions to meet the menstrual hygiene needs
of school girls; a case study from Katakwi, Uganda; Cranfield Ceres;
Cranfield University; 2006.
15)AJ Singh, Place of menstruation in the reproductive lives of women and rural
north India, Indian Journal of community Medicine; Volume 31; JanuaryMarch 2006, Page 10-14.
16)Sioban D. Harlow, Meekyong Park; Longitudinal study of risk factors for the
occurrence, duration and severity of menstrual cramps in a Cohert of college
Women; BJOG: An international Journal of Obstetrics and Gynaecology;
volume 1003, Issue 11, Year 2005, Pages 1134-1142.
17)Mohammed Poureslami, Farzaneh Osati-Ashtiani; Attitudes of female
adolescents about dysmenorrhoea and menstrual hygiene in Tehsan Suburbs;
1st May 2002.
18)Drakashayni Devi K, Venkata Ramaiah P, A study on menstrual hygiene
among rural adolescent girls; Indian Journal of Medical Sciences; 1994 June;
Volume 48, issue 6; page 139-43.

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