RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, …
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| |“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING POST MENOPAUSAL BLEEDING AND ITS |
| |MANAGEMENT AMONG MENOPAUSAL WOMEN ATTENDING AT HSK HOSPITAL AND RESEARCH CENTRE, BAGALKOT”. |
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| |PROFORMA FOR REGISTRATION OF SUBJECT FOR |
| |DISSERTATION |
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| |MS.EVANGELINE MARY |
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| |SHRI. B.V.V.SANGHA’S |
| |SAJJALASHREE INSTITUTE OF NURSING SCIENCES, |
| |NAVANAGAR, BAGALKOT, KARNATAKA. |
| |2012 |
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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
| |Name of the candidate and address |MS.EVANGELINE MARY |
| |(in block letters) |I YEAR M. Sc. NURSING |
| | |SAJJALASHREE INSTITUTE OF |
| | |NURSING SCIENCES, BAGALKOT. |
| |Name of the Institution |SAJJALASHREE INSTITUTE OF NURSING SCIENCES, BAGALKOT. |
| |Course of Study and Subject |M. Sc. NURSING |
| | |OBSTETRICS AND GYNAECOLOGICAL NURSING. |
| |Date of Admission to the course |15/05/2012 |
| |Title of the Topic |
| |“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING POST MENOPAUSAL BLEEDING AND ITS |
| |MANAGEMENT AMONG MENOPAUSAL WOMEN ATTENDING AT HSK HOSPITAL AND RESEARCH CENTRE, BAGALKOT”. |
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| |6.Brief Resume of the Intended Work |
| |“Charm is deceptive, beauty is fleeting; but a woman who fears |
| |the lord is to be praised.” |
| |Proverbs: 31:30. |
| |Introduction |
| |Every living thing in nature is susceptible to change. The flower that blooms today will wilt tomorrow the leaf that looks green |
| |today will fall off. This is the case with human too, Human beings experience various turning points in their life. Aging is a |
| |fact of life and it is a normal process. A transitional change of a girl starts when she attains menarche. Thus a girl transformed|
| |to a women, At last the women will reach to the stage of menopause in which various physiological as well as psychological changes|
| |will takes place.1 |
| |Women are the vital set up of the heart of the family when women have been tired altered women facing lot of problem through their|
| |life one of the most common problem they are facing is menopause.2Menopause is derived from Greek word Men (Month) and Pauos (to |
| |stop or cessation) who has defined menopause as the permanent cessation of menstruation resulting from the loss of ovarian |
| |follicular activity.3 |
| |Menopause is the time in a women’s life when her periods (menstruation) eventually stop and the body goes through changes that no |
| |longer allow her to get pregnant. It is her natural even that normally occur in women in the age group |
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| |between 45 to 55 years. Thus it is an important phase for dramatic hormone and other changes in life span of a woman.4 |
| |Life expectancy during this era, hence, many will experience post menopausal bleeding is a common complaint from women seen in |
| |general practice. Post menopausal bleeding (PMB) is defined as bleeding that occurs after one year of Amenorrhea in a woman of a |
| |age where the menopause can be expected on the average of 50 year.It is a frequent and alarming sign and exclusion of genital |
| |tract malignancy.5 |
| |The significance of post menopausal bleeding what ever slight it may be , should not be under estimated. As many as one third of |
| |the cases are |
| |due to malignancy. The some importance is also given to those cases where normal menstruation continues even beyond the age of 55 |
| |years.6 |
| |Approximately one in 10 women experience this problem usually, this occurs in early years of menopause and is less frequent after |
| |3 or more years of menopause. Increasing time internal bleeding is highly indicative of malignancy. In developed countries more |
| |than 60% cases are due to benign lesions like atrophic vaginitis, uterine or cervical polyp endometrial hyperplasia and atrophic |
| |endometritis.The average age of menopause is 51 years any woman who is still menstruating after 55 years should be viewed with |
| |suspicion and post menopausal bleeding must be evaluated for endometrial carcinoma.1 |
| |The assessment includes evaluation of risk factors like obesity, parity, family history of endometrial / breast carcinoma, |
| |personal history of carcinoma and drug history as the hormone replacement therapy Tamoxifen and anticoagulants. Perhaps the most |
| |common cause of post menopausal bleeding is the decline of estrogen |
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| |levels. For the majority there is an innocent cause for the bleeding the common |
| |precisiting symptoms.7 |
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| |Post menopausal includes:- |
| |P – Polyp (cervical) is about 12 % |
| |O – Ovarian cancer is about 10 % |
| |S - senile vaginitis, endometritis |
| |T- Trauma |
| |M – Myoma |
| |E – Endometrial hyperplasia 80 % |
| |N- Not removed pessary leading to ulceration |
| |O – Oestrogen (intermittent) |
| |A – after radiation ulceration |
| |U – Urethral carbuncle |
| |S – Sarcoma Uterus |
| |E – Erosion in cervix.8 |
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| |The main aim of investigations for PMB post menopausal bleeding is to exclude endometrial cancer which presents with post |
| |menopausal bleeding in over 95% case, The probability of endometrial cancer in women presenting with post menopausal bleeding is |
| |approximately 5 – 10 %. It is clear therefore, that 90 – 95 % of cases of PMB /post menopause bleeding results from benign. In |
| |these circumstances treatment of the underlying problem will usually resolve the symptoms.9 |
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| |Managing women presenting with PMB will have to assess their practice in the light of this evidence and their own |
| |facilities and experience. The aim of the management of post menopausal bleeding / PMB is to establish a reliable |
| |diagnosis patient due to fear of a potential uterine malignancy do present early responding to vaginal bleeding during this |
| |period.9 |
| |Post menopausal bleeding in women regardless of initial USS endometrial thickness measurements. There is a continued risk of |
| |serious endometrial disease with post menopausal bleeding. “It may be more prudent to offer these women testing with all available|
| |modalities.” In most health care system, women with PMB/post menopause bleeding will present to a primary care physician with |
| |general expertise, who then refers them to a specialists in Gynaecology for further quantitative reviews of diagnostic accuracy |
| |and subsequent cost effectiveness analysis.10 |
| |However, more research is required to evaluate the impact of improvements in ultrasound technology or diagnostic accuracy, the |
| |true value of testing when the whole clinical process is accounted for and the preferences of patients and clinicians with regard |
| |of diagnosing both malignant and benign disease. The problems of how to manage recurrent post menopausal bleeding and the |
| |effectiveness of community delivered ‘ ambulatory’ service also requires further evaluation to keep guide best practices.11 |
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| |6.1.Need for the study |
| |“Post menopausal women stand at a cross road, facing the possibility of living the remainder of their lives.” |
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| |Post menopausal is a common clinical problem post menopausal bleeding is a problem in both general and hospital setting |
| |postmenopausal bleeding must be considered as indicative of malignant disease until proven otherwise” still holds true in our |
| |circumstances. The incidence of spontaneously occurring post menopausal bleeding in the general population can be as high as |
| |10% immediately after menopause. It is common gynaecological problem seen in about 5 to 10 % of gynaecological patient is likely |
| |to increase further. About 25 million women pass through menopause each year. By 2030 the world population of menopausal and |
| |postmenopausal women is projected to increase to 1.2 billion with 47 million new entrances each year.12 |
| |The pathology as the cause is often over seen specific interrogation to such cause is of almost importance. One of these causes |
| |is the use of “ natural Hormones” as patient do not consider these as active medication further more practioniers still prescribe |
| |un opposed oestrogen therapy with an intact uterus, this is still a common cause of endometrial malignancies.13 |
| |A handy diagnostic tool in the management of postmenopausal bleeding is intra uterine saline infusion with ultra sound imaging. |
| |Infusion is done with the help of a baby feeding tube markedly enhances the visibility of uterine polyps use of saline infusion |
| |sonography as a second step in the evaluation of postmenopausal bleeding. The study shows that all patients with typical history |
| |of postmenopa usal bleeding were |
| |evaluated it tells total 50 patients of postmenopausal bleeding were included. Benign lesion was found in 24 (48%) cases, |
| |followed by malignant pathology is 15 (30%) pre malignant lesion was responsible for postmenopausal bleeding in 7 (14%) cases, |
| |while pathology remained undetermined in 4 (18%) patients.14 |
| |The earlier studies conducted in different parts of the world showed a prevalence of malignancy in postmenopausal bleeding of |
| |around 35% while the more recent prevalence is quoted to be around 9.9% - 11 %. This drop in prevalence |
| |of malignancy reflects the awareness of women and availability of screening facilities.14 |
| |In Pakistan malignancy of the genital tract is the existing pathology in a large number of cases Pamelaetal from India showed |
| |prevalence of 63.6% woderossen-from Ethiopia 60.8%, Liaguatest at 53.7%, Asifet at 44% and Ghazi et at 20%. The frequency found in|
| |study is (30%) occupies a middle position when compared with local studies. Evaluation of post menopausal bleeding needs an |
| |exclusion of corpus cancer which is fourth common cancer in women and most common gynaecological malignancy in USA. This situation|
| |reflects a long life span of women more than 70 years, required for development of endometrial carcinoma.5 |
| |The present study was carried out to ascertain various causes of postmenopausal bleeding and to determine its prevalence. |
| |Prognosis is excellent as postmenopausal bleeding is an early warning sign lead women to seek medical advice. |
| |Post menopausal bleeding is a very big concern among many patient, this topic was required by doctors and patients who was |
| |diagnosed and treated post menopausal |
| |bleeding that occurs in a menopausal woman. It is usually accompanied by hot flashes mood changes and insomnia. Women with |
| |recurrent post menopausal bleeding should be re-investigated but are not likely to have endometrial cancer.17 |
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| |Many women experiences some post menopausal bleeding how ever, post menopausal bleeding is not normal because it can be a symptom |
| |of serious medical condition, any episodes of post menopausal bleeding should be brought to the |
| |attention of a women’s doctor. Post menopausal bleeding is not a printable disorder. However a healthy weight will decreases the |
| |change of its occurring. Post menopausal bleeding is a symptom not to be underestimated. The result showed that atrophic |
| |endometrium was the most common cause of the post menopausal bleeding. Among |
| |the malignant causes, cervical carcinoma accounts for 44.4% of malignant pathologies responsible for postmenopausal bleeding. This|
| |high incidence may point to the need for more public awareness to integrate routine screening definitive diagnosis of |
| |postmenopausal bleeding is to be made.16 |
| |From the above mentioned facts it is clear that post menopausal bleeding is very important condition it affects the health of the |
| |women leading to cancer. So that women should be aware of the bleeding after the menopause. Hence the investigator has made an |
| |attempt to improve the knowledge regarding post menopausal bleeding and its management. |
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| |6.2.Review of literature |
| |Review of Literature is a key step in research process refers to the activities involved in searching for information on a topic |
| |and developing a comprehensive picture of the state of knowledge on that topic. This provides a background for understanding what |
| |has already been learned on a topic and illuminates significant of new study. |
| | A cross-sectional study was conducted in Chandigarh, India. The objective of the study was to ascertain the |
| |knowledge about menopause and postmenopausal bleeding in women of urban and slum area of Chandigarh, Systematic random sampling |
| |was used. The study population comprised of women above 40 years and resident of study area. Out of total 528 women interviewed, |
| |302 (56.1) were residing in urban |
| |area and rest were the residents of slums. 78.8%, urban and 60.2% from slums have attained menopause. Majority (70.3%) of urban |
| |residents have heard about menopause as compared to 30.9% in slums. Thus the study concluded that there is lack of |
| |awareness regarding menopause and related aspects especially PMB in both |
| |urban and slum population.17 |
| |A cross-sectional study was done in the department of obstetrics and gynecology patient in J.N.M medical college and Dr.B.R |
| |Ambedkar memorial hospital, Raipur. the participants were 146 women who came with the complaints of postmenopausal bleeding, by |
| |interviewing these women information was collected about different demographic factors like age, socio-economic status, parity |
| |etc. The data collected was put in the master chart and analyzed .The result included the proportion of post menopausal bleeding |
| |causes was 3.5% maximum causes(50%) with postmenopausal bleeding were found in the age group of 45-54yr 60% of patients were from|
| |rural areas and 62% were illiterate.65% of the patient were grand multipara. Most of the patient belonged to lower socio-economic |
| |status. The study concluded post menopausal bleeding is high, requiring immediate investigation lack of awareness led to |
| |presentation of most of the patient so education is required.18 |
| |A retrospective study carried out in post menopausal bleeding clinic department of Obstetrics and Gynecology, Southern General |
| |Hospital, Glasgow, UK. The objective of the study was to determine the prevalence of endometrial cancer in patients presenting |
| |with recurrent postmenopausal bleeding. A total of 1536 women with PMB were seen over a period of 56 months. 66 required |
| |definitive treatment after their first visit.126 re-presented with recurrent bleeding. The prevalence of endometrial cancer in |
| |women presenting for the first time with PMB was 3.04% whereas that in women presenting with recurrent PMB after initial negative |
| |investigations was 4%.One woman had an endometrial cancer even though the endometrial thickness was less than 3 mm. The study |
| |concluded that women with recurrent PMB after initial negative investigations are no more likely to have endometrial cancer |
| |than those presenting for the first time but re-investigation is indicated if six months has elapsed.19 |
| |A cross sectional study was conducted by the department of obstetrics and Gynaecology, Shaikh Zayed post graduated medical |
| |institute and hospital, Lahore. The objective of the study was to find out the causes of postmenopausal bleeding and its |
| |correlation with medical illness. A total 50 patient were included in the study maximum number of patients with postmenopausal |
| |bleeding were between 56-60 years (32%), most of the patients were having parity between 4 – 6 (48 %) majority of patients (32%) |
| |had symptom about 10 years after menopause 70% patients were having benign cause while 30% patients had malignant cause for |
| |postmenopausal bleeding, The study concluded that carcinoma of genital tract is one of the most important cause of post menopausal|
| |bleeding so early detection of the cause can be life saving.20 |
| |A retrospective study was conducted to investigate the clinical significancy endometrial pathology in patient with postmenopausal|
| |bleeding in term of etiology risk factor incidence of malignancy and histopathological evaluation. 304 cases of postmenopausal |
| |bleeding admitted to Babylon Teaching Hospital for Gynaecology, the age range of the patient was from (45 – 77 years) with a mean |
| |of (49 years),result showed that benign pathology was found in (167 / 304) cases. This includes senile atrophic endometrium, |
| |endometrial hyperplasia endometritis, and cervical polyps. Malignant pathology was found in (27) cases including (12) cases of |
| |cervical cancer and (15) case of adenocarcinoma of the endometrium. It is concluded that postmenopausal |
| |bleeding is an important symptom and requires careful and promote evaluation to eliminate the possibility of malignancy as quickly|
| |as possible.1 |
| |A prospective observational study was carried out in the department of Obstetrics Gynaecology Fauji foundation Hospital |
| |Rawalipindi, Pakistan. The objective of the study includes to as certain various causes and prevalence of genital organ |
| |malignancy in patient presenting with postmenopausal bleeding. A study comprising of 167 consecutive cases presenting with |
| |postmenopausal bleeding one year after menopause. Results showed that the commonest cause of PMB was atrophic endometritis and |
| |vaginitis 33 (21.2%). Overall incidence of various genital tract malignancies was 25 (16.0%).The study concluded that overall |
| |incidence of genital tract malignancies in patients presenting with PMB is high (16.0%),therefore, it needs to be taken seriously |
| |and requires prompt and thorough investigations.21 |
| |A cross-sectional study was conducted in Gynaecological oncology centre in united Kingdom. The population included all |
| |postmenopausal women referred with vaginal bleeding .The objective of the study is to determine the risk of endometrial cancer. |
| |All women were investigated using Gray-scale transvaginal ultrasonography. Main outcome measures, were endometrial cancer |
| |diagnosis. The study was over a 50-month period, 4454 women were investigated for postmenopausal vaginal bleeding. A total of 259 |
| |(6%) of women were diagnosed with endometrial carcinoma. The odds of endometrial cancer in women where the endometrial thickness |
| |was not visualized were found to be significantly higher than the odds of cancer for women with an endometrial thickness of |
| |5–9.9mm The study concluded that for women presenting with postmenopausal bleeding ultrasonography, hysteroscopic evaluation is |
| |recommended.22 |
| | An observational cross section study was conducted in the department of obstetrics and gynecology at peoples medical |
| |college and hospital Nawabshah, sindh. All patient with a typical history of postmenopausal bleeding were evaluated under |
| |anesthesia and diagnostic dilatation and curettage was done for histopathological assessment of endometrial lining. |
| |Cervical biopsy was taken in selected patients. Total 50 patients were included, Benign lesion was found in 24(48%) cases, |
| |followed by malignant pathology in 15(30%), premalignant lesion was responsible for postmenopausal bleeding in 7(14%) cases, |
| |while pathology remain undetermined in 4(8%) patients, The study concluded that malignancy has an important role in the etiology |
| |of postmenopausal bleeding which needs a careful evaluation. This study showed a high prevalence of malignant disorders (30%) with|
| |carcinoma of cervix and endometrium having an equal contribution. Multiparity was the most significant factor for carcinoma of |
| |endometrium.7 |
| |A retrospective study was conducted on 163 consecutive patients who presented with postmenopausal bleeding in kandang kerbau |
| |Hospital, Singapore. The objective of the study was to study the etiology and pattern of postmenopausal bleeding in the local |
| |population. Results of the study included that malignant causes were found in 42(25.7%) patient .Cervical carcinoma was the most |
| |common malignancy (12.9% of the patients)followed by endometrial carcinoma (11%).Important benign causes are cervicitis |
| |(12.9%),atrophic vaginitis( 12.3% ) and cervical polyp (6.7%).Other benign causes include endometrial hyperplasia (3.1%),urethral |
| |car uncle (2.5%) and estrogen replacement therapy(1.8%).The study concluded that postmenopausal bleeding is a varied aetiologies. |
| |The associated incidence of malignancy is high and a thorough diagnostic evaluation is mandatory.23 |
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| |A retrospective analysis has been made of 160 cases of postmenopausal bleeding, the women were at least 45 years old and the time |
| |lapse from the last menstruation was at least 2 years, the cause was a malignant neoplasm in 23·75%. The incidence of malignancy |
| |showed a definite rise with advancing age and with increasing duration of bleeding. It was nearly twice as high in women who |
| |stopped menstruation after the age of 55 years. Malignancy also seemed to be more frequent in patients with profuse bleeding and |
| |in those who had amenorrhea lasting for 20 years or more. The most usual malignant lesions were endometrial and cervical |
| |carcinoma, the ratio of these two conditions being 1·6: 1. Estrogen administration was the most common cause in the non-malignant |
| |group: 12·5%. No cause for bleeding could be demonstrated in 8·8%.The study concluded that the etiology of postmenopausal bleeding|
| |is to be discussed.24 |
| |6.3 .Statement of the problem: |
| |“A Study To Assess The Effectiveness Of Structured Teaching Programme On Knowledge Regarding Post Menopausal Bleeding And Its |
| |Management Among Menopausal Women Attending HSK Hospital And Research Centre Bagalkot.” |
| |6.4. Objectives of the study :- |
| |To assess the knowledge about Post Menopausal bleeding and its management among Menopausal women. |
| |To determine the effectiveness of Structure teaching programme about post menopausal bleeding and its management among menopausal|
| |women. |
| |To find out the association between the knowledge about post menopausal bleeding and its management among menopausal women with |
| |their selected socio-demographic variable. |
| |6.5.Operational definitions: |
| |1. ASSESSMENT: In this study assessment refers to an evaluation of condition of |
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| |knowledge of menopausal women about post menopausal bleeding. |
| |2. EFFECTIVENESS: In this study effectiveness refers to which extent the Structure teaching programme prepared by investigator |
| |was successful in manipulating the knowledge of menopausal women. |
| |3. STRUCTURE TEACHING PROGRAMME: structured teaching programme |
| |refers to lecture given by the investigator to menopausal women about post menopausal bleeding and its management. |
| |4. KNOWLEDGE: In this study knowledge refers to the range of information |
| |awareness or all that has been perceived by menopausal women. |
| |5. POST MENOPAUSAL BLEEDING :- In this study post menopausal bleeding |
| |refers to any bleeding that occurs from genital tract more than 12 months after last |
| |menstrual period. |
| |6. MENOPAUSAL WOMEN:- Menopausal women refers to women of the age |
| |group of 45 – 55 years. |
| |7. SOCIO – DEMOGRAPHIC VARIABLES: Socio – Demographic variables |
| |refers to variables like age, educational status, religion, income, marital status et |
| |6.6 Assumptions: |
| |Menopausal women will have some knowledge regarding post menopausal bleeding and its management. |
| |Menopausal women will willingly participate and give reliable information needed for the study. |
| |Menopausal women will have knowledge related to post menopausal bleeding and its managements, but not practicing properly. |
| |Knowledge many vary according to the demographic variables. |
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| |6.7 Hypothesis: |
| |H1: There will be statistically significant difference between the pre and post |
| |Knowledge scores of menopausal women regarding post menopausal bleeding |
| |and its management. |
| |H2:There will be a significant association between level of knowledge of |
| |women on post menopausal bleeding and their selected socio – demographic |
| |variables. |
| |8 6.8. Delimitation: |
| |The study is delimited to the women who are visiting to HSK Hospital and |
| |Research centre Bagalkot. |
| |7. Materials and Methods: |
| |The study is designed to determine the effectiveness of structured teaching programme on knowledge regarding post menopausal |
| |bleeding and its management among menopausal women attending HSK Hospital. |
| |7.1 Source of Data: |
| |The data will be collected from women who are visiting to HSK Hospital & research centre Bagalkot. |
| |7.1.1Research Design: |
| |A quasi experimental design will be adopted for conducting the present study (one group pre test, post test design). |
| |7.1.2 Setting: |
| |This study will be conducted in HSK Hospital and research centre Bagalkot. |
| |7.1.3 Population: |
| |In this study the population includes menopausal women’s attending HSK Hospital and research centre Bagalkot. |
| |7.1.4.Sample |
| |In the present study sample consists of women attending HSK Hospital and research centre Bagalkot. |
| |Methods of Data Collection :- |
| |Sample Size: |
| |The sample size of the study is 50 women. |
| |Sampling technique: |
| |Convenient sampling technique is used to select subjects. |
| |7.2.3. Duration of study |
| |The present study will be conducted for 6 weeks |
| |7.2.4. Criteria for Sampling |
| |Inclusion Criteria for Sampling |
| |The study includes the women |
| |Who are attending the HSK Hospital and research |
| |centre Bagalkot. |
| |Who are willing to participate in the study |
| |Who are available at the time of data collection |
| |The study include women’s in the age group of 45 – 55 years. |
| |Exclusion criteria |
| |The study excludes the women |
| |Who are attending other hospitals. |
| |Who are not able to co-operative throughout the period of study. |
| |The women who are professionals of medical and nursing fields. |
| |Who are having complications. |
| |7.2.5 Selected variables: |
| |Variables selected in the present study are |
| |Independent Variable: Structured Teaching programme on knowledge |
| |regarding postmenopausal bleeding and its management among menopausal women. |
| |Dependent Variable: Knowledge of women regarding post menopausal bleeding and its management. |
| | |
| |Socio Demographic Variables: Socio demographic variable includes socio demographic characteristic of women like age, |
| |education, occupation, family income, marital status, religion. |
| |7.2.6.Data collection instruments: |
| |The investigator has planned to assess the knowledge of women |
| |with the help of structured closed ended questionnaire. |
| |It consist of 2 sections namely section 1,section 2 |
| |Section 1- deals with socio demographic data related to sample. |
| |Section 2- deals with the items related to assessment of knowledge regarding |
| |post menopausal bleeding and its management. |
| |7.2.7. Data collection method |
| |The investigator uses self administered structured closed ended questionnaire for data collection. |
| |7.2.8.Data analysis method: |
| |Numerical data obtained from the sample will be organized and summarized with help of descriptive statistics like |
| |percentage, mean, median, and standard deviation. Testing the level of significance of hypotheses and identifying relationship |
| |between socio demographic variables and knowledge regarding post menopausal bleeding and its management among women’s will be |
| |done with the help of inferential statistics, tests like Chi- square test, co efficient correlation and paired t-test will be |
| |used. |
| |7.2.9. Projected outcome: |
| |The structured teaching programme will help the menopausal women to improve their knowledge regarding post menopausal bleeding and|
| |its |
| |management. |
| |7.3. Does the study require any investigations or interventions to be conducted on patients or other humans or animals? if so |
| |please describe briefly. |
| |Yes, |
| |In present study investigation is done on human beings ie, assessment of knowledge of women regarding post menopausal bleeding and|
| |its management. Intervention is given ie, Structured Teaching Programme will be conducted as an intervention to menopausal women |
| |regarding post menopausal bleeding and its management. |
| | |
| |7.4 .Has ethical clearance been obtained from your institution in case of 7.3? |
| |Yes, |
| |Permission will be obtained from the principal of Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot. |
| |Permission will be obtained from the institutional ethical and research committee of Sajjalashree Institute of Nursing Sciences, |
| |Navanagar. Bagalkot. |
| |Permission will be obtained from the Medical superintendent of HSK Hospital Bagalkot. |
| |Written consent will be obtained from participants. |
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| |8.LIST OF REFERENCES |
| | three stage.htim/. |
| | . |
| |Research on the menopause in the 1990’s report of a WHO scientific group, |
| |WHO tech report series 1996:8861-107. |
| | fitness pre-menopause.htm/ |
| |Ali Hassan at-Timim MBC HBm MS , PhD. Professor of pathology post menopausal bleeding clinic pathological study in |
| |Babel. Journal of Babylon |
| |University.18(3)-2010. |
| |D.C.Datta Gynaecology ; Post menopausal bleeding page no 512. |
| |7. Kauser Jillani ,Razia Bahadur Khero; Prevalence of malignant disorder of post |
| |Menopausal bleeding .JMPA 60: 540 : 2010. |
| |8. Panda JK; One-stop clinic for the post menopausal bleeding .J Reprod med.2002. |
| |Sep : 47(9) : 761-6. |
| |9. J.James A. Meril MD .Management of post menopausal bleeding .Clinical obset |
| | |
| |gynaec 1981; 24(1) :285-99. |
| |10. Evaluation of one stop clinic for the rapid assessment of PMB journal of |
| | |
| |obstetrics and gynaecology volume 18,number 2,March 1998. |
| |Decherney, Alan H, a martinc ,pernoll; “complication of menstruation” in |
| |current obstetric and gynaecological diagnosis and treatment Norwalk. CT |
| |Applitim and Lange 1994. |
| | |
| |12. T1 Cope – Some aspects of post menopausal bleeding.Clinical obset and gynaec |
| |1956;7(2). |
| |13. Dreisler E, Stampe Soresen S, Ibsen PH, Cose G.Prevalance of endometrial |
| | |
| |polyps and abnormal uterine bleeding in danis population aged 20-74 years. |
| | |
| |Ultra sound obset gynecol 2009 ;33(1);102-8. |
| | |
| |14. Kauser Jillani, Razia Bahadur Kheroj prevalence opf malignant disorders of |
| |Post menopausal bleeding .JPMA 60:540:2010. |
| |15. Article for the January 4th edition of today’s Health empowered women 2009. |
| |16 . T.J.Clark P.M, Barton, A. Coomarasamy, J.K.Gupta and K.S.Khan, |
| |Investigation post menopausal bleeding for endometrial cancer; BJ04,vol-113 |
| |No.5 PP 502-510-2006. |
| | |
| |17. S.Puri, V.BhMangat; perception of menopausal and post menopausal |
| |bleeding in women of Chandigarh India.The internet journal family practise |
| |2008 vol.600.2-DOI: 10.55 .80/20BC. |
| |18. Sonia A1 ,Bhyp index A2 ,marwaha, singh vol 24 No 2, April 2012 page no.158. |
| |19. Rashmi Ronghe* and macro Gaudoin women with recurrent post menopausal |
| |Bleeding should be reinvestigsated .Menopause international 2010,16-9-11. |
| |20. Dr.Sadia ZALFIQAR CHEEMA, Dr.Muhammad Iklam, Shaikh Zayed |
| |medical complex, Lahore post menopausal bleeding 328. |
| |21. Department of obstetrics gynaecology fauji foundation hospital, Rawalpindi. |
| |Prevalance of genital organ malignancy. |
| |22 Barbos N, Crocker SG, Morr’s EP, Nieto JJ.DUN Can. Management of post |
| |menopausal women with vaginal bleeding when the endometrial cannot be |
| |visualized.Act-9 obstet gyneco scaned 2012 :91:D01:10/111/16 |
| |23. Lee WH,Tan KH, Lee YW; The aetiology of post menopausal bleeding … |
| |a study of 163 consecuive case in Singapore.Deparment of maternal foetal |
| |medcine, Kandang Kerbal Hospital ,Singapore Med J.1995 Apr.36(2):164-8. |
| | |
| |24. Clinical Review ,Aetiology of post menopausal bleeding, M.J.N.C, Keirse M.D |
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| |Department of obstetrics and gynaecology , sin t- michielskliniek Brussels . |
| |Belgium postgraduate medical journal 49,344-348. |
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|9 |Signature of Candidate | |
|10 |Remarks of the Guide |The proposed study is ethically acceptable and socially beneficent. It is feasible|
| | |for the student researcher to be carried out. |
|11 |Name and Designation of |MRS. KAMALA .K.N |
| |(In Block letters ) |ASSISTANT PROFESSOR AND HOD OF OBG NURSING, |
| |11.1 Guide |SHRI. B.V.V.SANGHA’S SAJJALASHREE |
| | |INSTITUTE OF NURSING SCIENCES, |
| | |NAVANAGAR, BAGALKOT, KARNATAKA. |
| |11.2 Signature | |
| |11.3 Co- Guide (if any) |MRS. JAYASHREE.AWARSANG |
| | |ASSISTANT PROFESSOR |
| | |SHRI. B.V.V.SANGHA’S SAJJALASHREE |
| | |INSTITUTE OF NURSING SCIENCES, |
| | |NAVANAGAR, BAGALKOT, KARNATAKA. |
| |11.4 Signature | |
| |11.5 Head of Department |MRS. KAMALA.K.N |
| | |HOD OF OBG NURSING |
| | |SHRI. B.V.V.SANGHA’S SAJJALASHREE |
| | |INSTITUTE OF NURSING SCIENCES, |
| | |NAVANAGAR, BAGALKOT, KARNATAKA. |
| |11.6 Signature | |
|12 |12.1 Remarks of the principal |
| |The study selected by the candidate is suitable for the present situation. This topic is also approved by the research and ethical|
| |committee of the institute. |
| |12.2 Signature |
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