RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCESBANGALORE , KARNATAKA

ANNEXURE – I I

PROFORMA FOR REGISTRATION OF SUBJECT FORDISSERTATION

1Name of candidate and Address( In block letters )

Ms.SHILPA.N.MI YEAR MSc. NURSINGSHREE DEVI COLLEGE OF NURSINGMAINA TOWER , BALLALBAGHMANGALORE - 575003

2 Name of the InstitutionSHREE DEVI COLLEGE OF NURSINGMAINA TOWER , BALLALBAGHMANGALORE - 575003

3 Course of Study and Subject

MSc. NURSING,(COMMUNITY HEALTH NURSING )

4 Date of Admission to the Course 09.06.2010

5

Title of the Topic

“A STUDY TO EVALUATE THE EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME ON DYSMENORRHOEA AND ITS MANAGEMENT

AMONG ADOLESCENT GIRLS IN A SELECTED COLLEGES AT MANGALORE”

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6.1

BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION:

The word ‘adolescent’ is derived from Latin word adolescere meaning ‘‘to grow up’’.

Adolescent is a period of transition between childhood and adulthood. Adolescence is the

phase, usually between 10-19years, in which children undergo rapid changes in body size,

physiology and psychological and social functioning. During this period, all body dimensions,

development and maturation are completed. According to WHO adolescent is the period of life

that extends from 10 -19 years,1

Dysmenorrhoea means pain or discomfort with menstruation. They may be mild,

moderate, or severe. Although it is not a serious medical problem but severe enough to keep

her from functioning for a day or two days each month.2

One of the major physiological changes that take place in adolescent girls is onset of

menarche, which is associated with dysmenorrhoea ,excessive bleeding and irregular

menstruation. Of these, dysmenorrhoea is one of the common problem experienced by many

adolescent girls. It is called “primary” when there is no specific abnormality and “secondary”

when the pain is caused by an underlying gynecological problem.3 It is characterized by

6.2

crampy pelvic pain beginning shortly before or at the onset of menses and lasting one to three

days. Primary dysmenorrhoea is less common in physically active women.3

The management of dysmenorrhoea is multifaceted and depends on the severity of the

problem and the individual women’s response. In addition to drug therapy, the other

management include nutritional supplement, acupressure, acupuncture, warm application,

massage, yoga and aerobic exercise.3

NEED FOR THE STUDY:

Dysmenorrhoea is defined as painful menses in women with normal pelvic

anatomy usually begins during adolescence. It is caused due to the production of

prostaglandin, reduced blood supply to the uterus and psychological factor, premenstrual

syndrome, low body mass index4. It is the leading cause of the absenteeism from school and

work among women. It is usually characterized by sharp intermittent pain or dull, aching pain

on lower abdomen that may radiate to the thigh and sacrum.8

According to the report of British medical authorities, 80% of the worldwide women

have different degree of dysmenorrhoea.20 Globally 50-70% of young girls had experienced

dysmenorrhoea.5 Pain during menstruation or dysmenorrhoea occur in 50% of menstrual

women and about 10% are in capacitated for 1-3 day each month. In the first year after

menarche 38% of girls develop dysmenorrheal pain. In the second and third year after

menarche 20% experience pain related to menstruation.6 In India there have been 80% of

women experienced dysmenorrhoea in their reproductive year7.Karnataka has reported 1648

adolescent girls with dysmenorrhoea, and the incidence of dysmenoorhoea was 87%, of these

46.69% had severe problem of perceived pain during menstruation .7

A descriptive study was conducted to find the prevalence of dysmenorrhoea among

970 adolescent high school of age 15-20 years studying in higher secondary school,Gwalior .

Prevalence of dysmenorrhoea in adolescent girls was found to be 79.6%. Most of them 37.96%

suffered regularly by dysmenorrhoea . Three most common symptom present in both days i.e.,

day before and first day of menstruation were lethargy and tiredness ,depression in 2 nd day

and inability to concentrate to work on 3rd day , where as the ranking of these symptom on the

day after the stoppage of menstruation showed depression as first common symptom. Finally

the researcher concluded that negative correlation had found between dysmenorrhoea and

general health status as measured by body surface area9

A cohort study was conducted to investigate the epidemiology of dysmenorrhoea in

823 women of menstrual age 18-51years, in Japan. Dysmenorrhoea of mean duration 1.75

days; range 1-5 days was reported in 95%, during the first month study period. Common

associated symptoms included headache 10.77%, back pain 6.92%, and fatigue 5.38%.No

participant with dysmenorrhoea visited a physician, while 51.5% of the women used self

medication, and 7.7% used complementary/alternative medicine. The study conclude that

dysmenorrhoea is common among Japanese women10

A Descriptive study to evaluate the effectiveness of fish oil on reduction of

dysmenorrhoea was conducted among adolescents in USA. The population of the study was 42

adolescents of age 15 – 18 yearss. For two months, half the participants received a daily dose

of 6g of fish oil, providing 1080mg of EPA( eicosapentaenoic acid) and 720mg of

DHA( docosahexaenoic acid) 1.5mg vitamin E daily, they were switched to placebo for

another two month. The researcher concluded that these adolescent experienced significantly

less menstrual pain while they were taking fish oil.11

6.3

A cross sectional survey was conducted in New Delhi to find the type and frequency

of problem related to menstruation in adolescent girls and the effect of these problem, among

198 adolescent girls in the age group 13-19 years. About 35.9% of the study subject were in

the age group of 13-15 years followed by 15-17, 17-19 years respectively. Mean age of the

study participants was 16.2 years. Dysmenorrhoea (67.2%) was the common problem and

(63.1%) had one or the other symptom of premenstrual syndrome. Other related problems

were present in 55.1% of the study subject. Daily routine of 60% girls was affected due to

prolong bed rest, missed social activities/commitment, disturbed sleep, decrease appetite.

Nearly 15% had to miss a class and 10% had to abstain from work. Finally author concluded

that screen adolescent girls for menstruation related problems and provide them with

counseling services and relevant information on possible treatment options.12

The researcher observed that dysmenorrhoea occurs mostly among adolescents. Due to lack

of knowledge, some of the adolescent girls believed that a nutritious diet could positively

affect menstrual period pain. So this could also increase the chance of developing certain

infections as well as increase the discomfort associated with secondary dysmenorrhoea.

Therefore, the researcher felt the need to study the effectiveness of planned teaching

programme on dysmenorrhoea and its management which would help to impact knowledge

and positive attitude towards dysmenorrhoea and also prevent certain menstrual problems. The

health care is moving towards complementary and alternative therapy in managing of many problems,

which also improve the lifestyle and decrease the absenteeism of the adolescent girls.

REVIEW OF LITERATURE:

A Descriptive study was conducted in USA, to assess the level of knowledge on

dysmenorrhoea and its treatment. A multiple-choice questionnaire was administered to 182

adolescent girls, ages 14–18 years. Of the study group, 72.7% reported “pain or discomfort”

during their period, 58.9% reported decreased activity, and 45.6% reported school or work

absenteeism. Of the dysmenorrheic sample, only 15.5% had used a prescription medication

and only 14.7% could name any nonsteroidal antiinflammatory agent, except aspirin, as

potentially effective in relieving dysmenorrhoea. The study concluded that there is substantial

ignorance or misinformation among adolescent females regarding dysmenorrhoea and its

treatment11

A comparative cross-sectional study was conducted on dysmenorrhoea and managing

the dysmenorrhoea among 101 girls in urban areas and 79 girls in rural areas in the district of

Karimnagar, Andhra Pradesh. A pretest questionnaire was given among 180 adolescent girls

in urban and rural settings. The results revealed that, the prevalence of dysmenorrhoea was

54% (53% in girls in urban areas and 56% in girls in rural areas) (X 2(df) = 0.1, P = 0.05).

Sickness absenteeism (28-48%), socio economic losses, and perceived quality of life losses are

more prevalent among girls in urban areas than in girls in rural areas. The study concluded that

dysmenorrhoea can be managed effectively by natural methods without resorting to medicines,

provided one is psychologically prepared to face it without anxiety.12

A descriptive survey was conducted in West Indies, to determine the prevalence of

dysmenorrhoea among 706 female adolescents; grades 9 to 12 and completed a 31-items

questionnaire about the presence, duration, severity, treatment, and limitation of

dysmenorrhoea at a local urban high school and its impact on academic performance, school

attendance, sports and social activities; It results that, among the participants who had a

period in the previous three months, 85% reported dysmenorrhoea,38% reported missing

school due to dysmenorrhoea during the three months prior to the survey and 33% reported

missing individual classes. Activities affected by dysmenorrhoea included class concentration

59%, sports 51%, class participant 50%, socialization 46%, homework 35%, test taking skill

36%, and grade 29%. Heating pad26%,tea 20%,exercise 15%,herbs 17% were the treatments

sought for dysmenorrhoea. The study concluded that dysmenorrhoea is highly prevalent

among adolescents and is related to school absenteeism and limitation on social , academic ,

and sports activities.13

A Descriptive study was conducted to find the prevalence of dysmenorrhoea among

high school girls in Masjed solayman khzestan,Iran. About 660 students participated in this

study. Overall prevalence of dymenorrhoea was 84.2%. The severity of dysmenorrhoea was

(78.0%), the factors associated with dysmenorrhoea were, age at menarche(p<0.05) and

duration of menstrual flow(p<0.05). The results indicate that 60% respondents suffered from

dysmenorrhoea which disturbed their daily activities. The study concluded that,

dysmenorrhoea is highly prevalent among adolescents and there was a significant correlation

between dysmenorrhoea and current biological factors.14

A comparative study was conducted in Taiwan, to find the effectiveness of Rose tea

for relief of primary dysmenorrhoea among130 female adolescents who were randomly

assigned to an experimental (n=70) and a control ( n=60) group. Preintervention and post

intervention data at one month, three month, six month were gathered on the biopsychosocial

outcomes of dysmenorrhoea. The results showed that, the experimental group perceived less

menstrual pain, distress and anxiety and showed greater psychophysiologic well-being through

time, at one, three , and six month after intervention. The study suggested that, drinking rose

tea is safe and simple treatment for dysmenorrhoea, which female adolescents may take to suit

their individuals needs.15

A Quasi experimental study was conducted to find the relationship between aerobic

physical exercise and primary dysmenorrhoea among adolescent girls of age15-16 years, in

Manipal, Karnataka. The sample consist of 60 student girls of secondary schools from

Liberec region, 30 were in experimental and 30 were in control group. The experimental group

were given exercise to be done. After 8 weeks of exercise, dysmenorrhoea was reduced to

70% in the experimental group. In the control group it was 20%(6 from 30 girls). The study

concluded that, there was positive relationship between the exercise and primary

dysmenorrhoea with adolescent girls is significant in both group.16

An experimental study to find the effect of aromatherapy on menstrual cramps and

symptoms of dysmenorrhoea among 67 female college students was conducted in Korea.

Subjects were randomized in to three groups, (1) an experimental group ( n=25) who received

aromatherapy, (2) a placebo group (n=20), and (3) a control group (n=22).Aromatherapy was

applied topically to the experimental group in the form of an abdominal massage using two

drops of lavender, one drop of clary sage, and one drop of rose in 5 cc of almond oil. The

placebo group received the same treatment but with almond oil only, and the control group

received no treatment. The finding reveals that menstrual cramps were significantly lowered in

the aromatherapy group than in the other two groups at both post-test time points.( first and

second day of menstruation after treatment). From the multiple regression aromatherapy was

found to be associated with the changes in menstrual cramp levels first day( p < 0.001); second

day( p = 0.02) and the severity of dysmenorrhea first day( p = 0.02); second day( p = 0.006)

than that found in the other two groups.The study concluded that aromatherapy was found to

be associated with the changes in the menstrual cramps than that found in the other two

groups.17

6.4

6.5

6.6

STATEMENT OF THE PROBLEM:

“A study to evaluate the effectiveness of planned teaching programme on

dysmenorrhoea & its management among adolescent girls in a selected colleges at

mangalore”

OBJECTIVES OF THE STUDY:

To determine the pretest knowledge scores on dysmenorrhoea & its management

among adolescent girls through structured knowledge questionnaire.

To evaluate the effectiveness of planned teaching programme on dysmenorrhoea &

its management.

To find the association between pretest knowledge scores on dysmenorrhoea & its

management among adolescent girls with selected demographic variables.

OPERATIONAL DEFINITIONS:

EFFECTIVENESS:

In the present study effectiveness refers to the extent to which the planned teaching

programme regarding dysmenorrhoea and its management has achieved the desired

effect as evidenced from the gain in the knowledge score.

PLANNED TEACHING PROGRAMME:

It refers to systematically developed teaching programme designed for individuals or

a group to provide information regarding dysmenorrhoea and its management.

DYSMENORRHOEA: In this study dysmenorrhoea refers to pain, distress and

associate symptoms (nausea,vomiting,backpain,headache) expressed by adolescent

6.7

6.8

6.9

girls during menstruation.

ADOLESCENT GIRLS : Refers to adolescent girls between 17-19yrs with

dysmenorrhoea in selected colleges at mangalore.

ASSUMPTIONS:

The study assumes that :

Adolescent girls will have some knowledge on dysmenorrhoea & its

management

A planned teaching programme will improve the knowledge of

adolescent girls (17-19) on dysmenorrhoea & its management.

DELIMITATIONS:

The study is delimited to:

The study is delimited to adolescent girls with dysmenorrhoea in

selected colleges at mangalore.

The study is delimited to adolescent girls of 17-19years.

Students who are able to understand English.

HYPOTHESIS:

H1: There will be a significant difference between pretest and post test knowledge scores of

adolescent girls regarding dysmenorrhoea and its management.

H2: There will be significant association between dysmenorrhoea and its management scores

among adolescent girls and selected demographic variables.

MATERIAL & METHODS:

Source of data:

The data will be collected from the adolescent girls (17-19 years) in a selected colleges at

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7.1

7.1.1

7.1.2

7.1.3

7.2

7.2.1

7.2.2

7.2.3

mangalore.

Research design:

The research design selected for this study is Pre Experimental one group pretest post test

Research design.

Settings: The study will be conducted in selected colleges at mangalore.

Population:

The population of this study is adolescent girls(17-19years) of selected colleges at

mangalore.

METHOD OF DATA COLLECTION:

Sampling Procedure:

Non –Probability, Purposive sampling will be adopted for this study.

Sample size:

Sample size will be 60 adolescent girls of 17-19yrs

Inclusion criteria:

Adolescent girls who are in the age group of 17-19 years with dysmenorrhoea.

Those who are willing to participate in the study

Adolescent girls who are available at the time of data collection

Those who are able to understand English.

Exclusion criteria:

Adolescent girls who are not willing to participate in the study.

Adolescent girls who not having dysmenorrhoea.

Instrument used:

Tools consists of structured knowledge questionnaire on dysmenorrhoea and its

management among adolescent girls.

7.2.4

7.2.5

7.2.6

7.2.7

Data collection method:

Permission will be obtained to collect data from the institutional authority of selected colleges.

The data will be collected from 60 adolescent girls with dysmenorrhoea after obtaining

consent. Pretest will be conducted using structured knowledge questionnaire & planned

teaching programme will be provided on the same day & post test will be conducted after 7 th

day of pretest by administering same knowledge questionnaire.

Data Analysis Plan:

The plan of data analysis is:

The data will be selected at 0.05 level of significance

Demographic data will be analysed using frequency, percentage, graphs.

Mean and standard deviation will be used to describe the sample characteristics.

Paired ‘t’ test will be used to compare the mean score of pre test and post test.

Association between knowledge scores & demographic variables will be found by

using chi-square test.

(A)Does the study require any investigation to be conducted on patients or other humans

or animals?

Yes , a planned teaching programme on dysmenorrhoea & its management among

adolescent girls will be conducted.

Has ethical clearance been obtained from institution in care of (A)?

Yes ,ethical clearance will be obtained

7.3

7.4

8

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