RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, …



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGLORE KARNATAKA

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

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| | |BINDHUKUMARI S |

|1 |NAME OF THE CANDIDATE AND ADDRESS |NAVANEETHAM COLLEGE OF NURSING |

| | |NO:132/1, 5th CROSS ROAD, |

| | |HORAMAVU |

| | |BANASAWASI, BANGLORE |

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| | |NAVANEETHAM COLLEGE OF NURSING |

|2 |NAME OF THE INSTITUTION AND ADDRESS |NO:132/1, 5th CROSS ROAD, |

| | |HORAMAVU |

| | |BANASAWASI, BANGLORE |

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|3 |COURSE OF STUDY AND SUBJECT |MSc NURSING I YEAR |

| | |OBSTETRICS AND GYNAECOLOGICAL NURSING |

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|4 |DATE OF ADMISSION TO THE COURSE |08-06-2010 |

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|5 |STATEMENT OF THE PROBLEM |“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING |

| | |PROGRAMME REGARDING HOME REMEDIES IN REDUCING DYSMENORRHOEA ON|

| | |KNOWLEDGE AMONG THE NON MEDICAL UNDERGRADUATE STUDENTS IN |

| | |SELECTED COLLEGES IN BANGLORE WITH A VIEW TO DEVELOP AN |

| | |INFORMATION BOOKLET” |

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6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

“DYSMENORRHEA IS THE LEADING CAUSE OF SHORT-TERM CLASS ABSENTEEISM.”1

Dysmenorrhoea literally means painful menustration. But a more realistic and practical definition includes causes of painful menustration of sufficient magnitude so able to capacitate day to day activities.2

Dysmenorrhea (or dysmenorrhoea) is a gynecological medical condition characterized by severe uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.3

Dysmenorrhea can feature different kinds of pain, including sharp, throbbing, dull, nauseating, burning, or shooting pain. Dysmenorrhea may precede menstruation by several days or may accompany it, and it usually subsides as menstruation tapers off. Dysmenorrhea may co-exist with excessively heavy blood loss, known as menorrhagia.3

Although reproductive health, in particular related to maternal health and reproductive tract infections (RTIs), is recognised as a health priority in developing countries, much less attention is paid to menstrual health and menstrual disorders. A recent review of menstrual disorders in developing countries in this journal revealed high rates of menstrual morbidity in population-based studies. However, much of the existing research focuses on prevalence estimates; there is little information on the determinants and consequences of menstrual dysfunction. Of all menstrual complaints, dysmenorrhoea is by far the most common and, arguably, the least understood and addressed complaint.4

Dysmenorrhea can be classified as either primary or secondary based on the absence or presence of an underlying cause. Secondary dysmenorrhea is dysmenorrhea which is associated with an existing condition. The most common cause of secondary dysmenorrhea is endometriosis. Other causes include leiomyoma, adenomyosis, ovarian cysts, and pelvic congestions. The presence of a copper IUD can also cause dysmenorrhea. In patients with adenomyosis, the levonorgestrel intrauterine system (Mirena) was observed to provide relief.3

6.2 NEED FOR THE STUDY

Dysmenorrhoea is a common condition that occurs in 52%, 72% or even 90% of women. Previous studies have found high rates of absenteeism from work and school due to dysmenorrhoea, with 13–51% of women ever absent and 5–14% frequently absent. Although the majority of women experience dysmenorrhoea at some time, data on the natural history of primary dysmenorrhoea over the reproductive life span are lacking. Only two prospective studies, both focussing on women in their teens and early 20s, have examined the natural history of dysmenorrhoea. The purposes of the present study were to describe the prevalence and severity of primary dysmenorrhoea in a large cohort of women, over half of whom were over 30 years of age at the time of the baseline assessment; to examine the longitudinal course of this symptom using a second evaluation six years later; and to identify factors associated with a change in symptoms.5

Reports of dysmenorrhea are greatest among individuals in their late teens and 20s, with reports usually declining with age. One study indicated that 67.2% of adolescent females experienced dysmenorrhea. A study of Hispanic adolescent females indicated a high prevalence and impact in this group. Another study indicated that dysmenorrhea was present in 36.4% of participants, and was significantly associated with lower age and lower parity. Childbearing is said to relieve dysmenorrhea, but this does not always occur. One study indicated that in nulliparous women with primary dysmenorrhea, the severity of menstrual pain decreased significantly after age 40. A questionnaire concluded that menstrual problems, including dysmenorrhea, were more common in females who had been sexually abused.3

Painful menstruation affects approximately 50% of menstruating women, and 10% are incapacitated for up to 3 days. Painful menstruation is the leading cause of lost time from school and work among women of childbearing age. This pain may precede menstruation by several days or may accompany it, and it usually subsides as menstruation tapers off. Although some pain during menstruation is normal, excessive pain is not. Dysmenorrhoea refers to menstrual pain severe enough to limit normal activities or require medication. It may co-exist with excessively heavy blood loss (menorrhagia).6

6.3 STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME REGARDING HOME REMEDIES IN REDUCING DYSMENORRHOEA ON KNOWLEDGE AMONG THE NON MEDICAL UNDERGRADUATE STUDENTS IN SELECTED COLLEGES IN BANGLORE WITH A VIEW TO DEVELOP AN INFORMATION BOOKLET”

6.4 OBJECTIVES OF THE STUDY

➢ To assess the level of knowledge regarding home remedies in reducing dysmenorrhoea among the non medical undergraduate students before and after structured teaching programme.

➢ To compare the level of knowledge regarding home remedies in reducing dysmenorrhoea between pre test and post test score.

➢ To associate the level of knowledge with the selected demographic variables among non medical under graduate students.

6.5 HYPOTHESIS

There will be significant difference in the level of knowledge regarding home remedies in reducing dysmenorrhoea among non medical undergraduate students.

6.6 ASSUMPTIONS

➢ Home remedies will relieve dysmenorrhoea to some extent.

➢ Group teaching will enhance each participant for achieving learning.

➢ Knowledge of students has strong influence in adaptation of healthy behaviour.

➢ Information booklet will help the student to improve knowledge about home remedies in reducing dysmenorrhoea.

6.7 OPERATIONAL DEFINITIONS

Assess:- It is the act to measure the knowledge on home remedies in reducing

dysmenorrhoea.

Effectiveness:- Refers in terms of increased scores in the knowledge on home

remedies in reducing dysmenorrhoea among non medical undergraduate students after post test.

STP:- Systematically, scientifically prepared information on home remedies in reducing dysmenorrhoea for 45 minutes to 1 hour by using flash card, flip chart, OHP,chart after pre test. It includes definition, incidence, etiology, pathophysiology, clinical manifestations, diagnostic measures and management.

Home Remedies:- A means of dealing with or improving an undesirable situation at home.

Dysmenorrhoea:- Pain or discomfort experienced just before or during menstrual periods.

Knowledge:- Refers to the number of correct responses of the non medical undergraduate students to the questions stated in the closed end questionnaire.

Non medical undergraduate students:- They are the under graduate students of arts colleges.

6.8 CRITERIA FOR SELECTION OF THE SAMPLE

Inclusion Criteria

➢ Students of non medical undergraduate students.

➢ Students present on the day of the presentation.

➢ Students who are willing to participate in the study.

Exclusion Criteria

➢ Medical undergraduate students

➢ Those who are not willing to participate in the study.

➢ Those students who are on medical leave or absent.

6.9 DELIMITATION OF THE STUDY

➢ The study is limited to non medical undergraduate students.

➢ Sample size is limited to 80 students.

➢ Prescribed data collection period is 4 to 6 wks.

➢ Study designed is limited to quasi experimental design.

6.10 SIGNIFICANCE OF THE STUDY

The purpose of the present study is to find out knowledge of the student about home remedies in reducing dysmenorrhoea and to help them to develop scientific knowledge which in turn may help to reduce dysmenorrhoea and to promote health status by practicing positive health practice.

6.11 CONCEPTUAL FRAMEWORK

Conceptual model of the study is based on system model (1985) guide for development, utilization and evaluation.

6.12 REVIEW OF LITERATURE

Review of literature is an essential step in development of research project. The presentation of review of literature is organized under the following headings.

➢ Literature related to dysmenorrhoea

➢ Literature related to home remedies in reducing dysmenorrhoea

Literature Related To Dysmenorrhoea

A study conducted by V Patel, V Tanksale, M Sahasrabhojanee, S Gupte, P Nevrekar on The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, India, the purpose of the study is to To describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India. A total of 2262 women were eligible. More than half reported dysmenorrhoea; moderate to severe dysmenorrhoea was reported by 755 participants (33.4%, 95% CI 31.4–35.4). There was a linear association between severity of pain and impact (medication and taking rest) and the onset of pain (premenstrual onset associated with more severe pain). On multivariate analyses, the risk of moderate–severe dysmenorrhoea was associated with the experience of violence (OR 2.23, 95% CI 1.5–34); other somatic complaints (OR 3.67, 95% CI 2.7–4.9 for highest somatoform symptom score category compared with the lowest); gynaecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI 1.3–2.3; dysuria: OR 1.98, 1.4–2.7); menorrhagia (OR 1.92, 95% CI 1.4–2.6); and illiteracy (OR 1.32, 95% CI 1.0–1.7). Having had a pregnancy (OR 0.53, 95% CI 0.4–0.7), older age of menarche (OR 0.70, 95% CI 0.5–0.9, for age >14 compared with 0.05. 22

7. SOURCE OF MATERIAL AND METHOD

7.1 SOURCE OF DATA

The data will be collected from non-medical undergraduate students in selected colleges.

7.2 METHODS OF DATA COLLECTION

7.2.1 Research Design

The Research Design is used in the study is Quasi Experimental design with one group pre test- post test design and no control group was taken for the study.

|GROUP |PRE TEST |TREATMENT |POST TEST |

|Experimental Group | | | |

| |01 |x |02 |

Key:-

01- Prêtest to assess the knowledge of home remedies in reducing dysmenorrhoea.

x- Administration of structured teaching programme regarding home remedies in reducing dysmenorrhoea.

02- Post test to assess the knowledge of home remedies in reducing dysmenorrhoea.

7.2.2 Research Setting

The present study will be conducted in selected colleges in Bangalore.

7.2.3 Population of the Study

The study population comprise of all the student of non medical undergraduate students of selected colleges in Bangalore.

7.2.4 Sample

The students of non medical undergraduate students who fulfill the exclusion criteria.

7.2.5 Sample Technique

The sample technique used in the study is simple random sampling technique that is the lottery method.

7.2.6 Sample Size

The study sample is 80 students.

7.2.7 Collection of Data

The data will be collected by using structured questionnaire schedule.

7.2.8 Data Collection Procedure

The main study will be conducted at selected colleges in Bangalore

Formal administrative permission will be obtained from the principal of the college. Self introduction and establishment of rapport will be done by the investigator.

The questionnaire will be administrated to the selective sample. This will be engaged as pre test. Following the structured teaching programme will be given and then post test will be conducted.

7.2.9 Data Collection Tools and Technique

The most important aspect of any investigation is the collection of appropriate information which provides data to answer the question raised in the study. Based on the objectives study the following data collection instruments were constructed in order to generate necessary information and knowledge.

7.2.10 Development and Observation of Tool

Tools is divided into two section. That is Sec A and Sec B. Sec A include selected socio demographic variable of the sample and Sec B contain the knowledge questionnaire schedule.

8. VARIABLES UNDER STUDY

In the present study the variables under study were,

➢ Independent Variable- Structured teaching programme on home remedies in reducing dysmenorrhoea.

➢ Dependant Variable- Knowledge of non medical undergraduate students about dysmenorrhoea.

9. PALN FOR DATA ANALYSIS

Descriptive Statistics. The descriptive statistical analysis includes percentage, frequency, mean, standard deviation for the students of non medical undergraduate students.

Inferential Statistics: Pre test and post test differences will be analyzed using student paired t-test and McNemar chi square test. Association between level of knowledge and demographic variables will be analyzed using Pearson chi square test and Yates corrected Chi square test.

10. PILOT STUDY

The pilot study is planned with 10% of the population.

11. ETHICAL CONSIDERATION

➢ Does the study require any interventions to be conducted on non medical undergraduate students?

---- yes. Informed consent will be obtained from respondent.

➢ Has ethical clearance being obtained from your institution?

---- yes. Ethical clearance has been obtained from the institution.

➢ Has the consent being taken from the college?

---- yes. Consent has been taken from the college.

12. LIST OF REFERENCES

1. .

2. D.C Dutta, Text Book of Gynaecology, New Central Agency Private Limited, 5th Edition, Page No174-180.

3. .

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5. BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 4, pages 345–352, April 2004.

6. .

7. BJOG: An International Journal of Obstetrics & Gynaecology, Volume 113, Issue 4, pages 453–463, April 2006.

8. Indian Journal of Pediatrics, Volume 75, Number 2, 125-129.

9. .

10. BJOG: An International Journal of Obstetrics & Gynaecology, Volume 86, Issue 6, pages 484–487, June 1979.

11. BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 4, pages345–352, April 2004.

12. BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 4, pages 345–352, April 2004.

13. Health Journal, Volume 11 Nos 1&2  January - March , 2005.

14. Women,s Health Medicine, Volume 2, Issue 1, Pages 40-43 (January 2005.

15. (98)00147-5/abstract.

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21. Social Science and Medicine, Volume 18, issue 9, 1984, Pages 757-766.

22. The Journal of Alternative and Complementary Medicine.

23. Volume: 15 Issue 2: February 23, 2009.

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