'A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED ...



"A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAME (STP) ON KNOWLEDGE REGARDING REPRODUCTIVE HEALTH AMONG ADOLESCENCTS OF 15-19 YEARS STUDYING AT SELECTED PRE UNIVERSITY COLLEGES IN TUMKUR."

PERFORMA FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

SUBMITTED BY

Miss. BINDU .C. KURIAN

FIRST YEAR M. Sc (NURSING)

OBSTETRICAL AND GYNAECOLOGICAL NURSING

2009-2011

SRI SIDDHARTHA COLLEGE OF NURSING

AGALAKOTE, TUMKUR.

rajiv gandhi university of health science

bangalore karnataka

pErforma for registration of

subject for dIssertation

|1. |NAME OF THE |Miss. BINDU .C. KURIAN |

| |CANDIDATE AND |FIRST YEAR MSC NURSING |

| |ADDRESS |SRI SIDDHARTHA COLLEGE OF NURSING |

| | |AGALAKOTE, TUMKUR. |

|2. |NAME OF THE |SRI SIDDHARTHA COLLEGE OF NURSING AGALAKOTE, |

| |INSTITUTION |B. H. ROAD, TUMKUR. |

|3. |COURSE OF STUDY |FIRST YEAR MSC NURSING |

| |AND SUBJECT |OBSTETRISCS AND GYNAECOLOGICAL NURSING |

|4. |DATE OF ADMISSION |8TH JUNE 2009 |

| |TO COURSE | |

|5. |TITLE OF THE STUDY |"A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAME (STP) ON |

| | |KNOWLEDGE REGARDING REPRODUCTIVE HEALTH AMONG ADOLESCETS OF 15-19 YEARS STUDYING AT |

| | |SELECTED PRE UNIVERSITY COLLEGES IN TUMKUR." |

6.BRIEF RESUME OF THE INTENTED WORK

INTRODUCTION:-

"Social representations are ideas, thoughts, images, and the knowledge belongs to society and which shape individual consciousness"

{Augoustinos, 1995}

Adolescence is bounded by the advent of puberty at the lower end and the capacity to take on adult responsibilities at the upper end. In our society adolescents are 'neither fish or nor fowl', as the saying goes neither children nor adult1. On this way they may face troubles due to lack of right kind of information regarding their own physical and sexual development2. Increasing penetration of international mass media is changing the social values and shifting the standard of societal behavior from conservatism to liberal interaction with both sexes. Adolescents find themselves sand witched between a glamorous western influence, which arouses their curiosities and instincts, and stern conservatism at home, which strictly forbids discussion on sex. This dichotomy aggravates the confusion among adolescents3. Changes in social values may lead to increased premarital sexual activity, pregnancy and possibly child bearing among unmarried girl, apart from increasing incidence of abortion and STD's (4.5)

The world health organization (2003) defines adolescence is a period of life between age 10-19. Adolescence is a stage of developmental frustration, a bridge between childhood and adulthood. It involves progress from appearance of secondary sex characteristics (puberty) to sexual reproductive maturity. It is the stage of development of adult mental process and identity and transition from socioeconomic dependence to relative independence. So far the health system has been more specially targeted to infants, children below six years and pregnant women. There for, unmarried women and adolescent have been ignored by the government and health sector. It's only since 1996 that reproductive health programme has included adolescence health in its spectrum of package. Current world population is 6.798 Billon. Nearly half of the world population is under the age of 25. Despite this reproductive health needs are poorly understood and ill served. Adolescents often have poor information about reproductive health services, sex and sexuality etc (6,7)

While for many, adolescence is a time to learn and grow in nurturing environments, for others-especially those living in poverty-it is time of heightened risk. Many drop out of school to help with family survival or face violence, sexual abuse or HIV infection .Nearly half of (45percent) young women in India marry before age 18; legal age at marriage for a women. Contraceptive use is very low. Unplanned child bearing among adolescents in is not uncommon. 14% recent births were unplanned in 2006. Proportion that basically unchanged from that in 1993 ( 8,9).

Evidence shows that withholding information and services from young people only increases the likelihood of that if and sexual initiation occurs, it will be unprotected14. Young people require not only basic information about their bodies, preventing HIV, Sexually transmitted infections and pregnancy but also programmes that address gender equality, empowerment, rights and responsibilities and reproductive negotiation and decision making. The meaningful participation of adolescents in the design of programmes and laws and policies that affect their sexual and reproductive lives should be guaranteed10.

The male role has been gradually declining over the years largely due to the entire focus of these programmes being on women. The male belief that childcare is the exclusive domain of women or regarding STDs as women’s diseases or as shameful diseases has discouraged men participation.11

6.1 NEED FOR THE STUDY

International agreements affirm that adolescents have a right to age-appropriate sexual and reproductive health information, education, and services that enable them to deal positively and responsibly with their sexuality12

"While national strategies and programmes have focused on children and pregnant women, neither services nor research has focused on adolescents and their unique health information needs"13

Adolescent receive most of their information from peers which often lead to misinformation. Adolescent need structured formal and informal learning environment with age appropriate peers to address issues of sexuality14.

The importance of focusing adolescent girls and boys is; 15

↓ about 25 percent girls in the 15-19 age groups have their first child before the age of 19 in India.

↓ Pregnancy before age 18 carries many health risks. Teenagers are more likely to die in pregnancy or child birth than woman ages 20-24.

↓ Adolescent account for fourteen percentages of abortion in India according to International Planned parenthood Federation.

↓ Raising the mothers age at first birth from 18-23 could reduce population momentum over 40 percent according to United Nations Programme on HIV/AIDS.

↓ Those under age 25 account for half of HIV infection India according to joint nations programme on HIV / AID

Adolescent reproductive and sexual programmes should take parents and community into confidence to build a supportive environment for the adolescents to exercise their choices. In the absence of such an integrated approach, there is a work with both boys and girls together so they appreciate sexual and reproductive processes in both sexes. These lead to proper understanding and exercise of sexual rights .The reproductive and sexual health of young men is important, and engagement with their experiences of gender and sexuality are essential because: In a patriarchal country like India, it is assumed that young men will one day be the leaders and decision makers within the family, Community and society.(15,16)

. The study is an intervention designed to improve the lives and prospects of young women in several slum areas of Allahabad. A baseline from these 1518 young men's and 1683 women's reproductive health knowledge indicated that; 17

↓ 39% and 97% girls are familiar with menstrual cycle.

↓ 88% of boys and 42% girls know about sexual intercourse and process of conception

↓ 6% of boys and 2% of girls know peak fertility period in a women's cycle

↓ 87% boys and 67% of girls can name at least one STD

↓ 44% boys and 55% of girls know that a married woman can get HIV from husband.

↓ 84% of boys and 32% of girls know that condom can prevent spread of HIV/AIDS.

A study of 500 adolescent boys and girls in Rural Maharashtra state in western India showed that18;

↓ 25% thought that menstrual blood was located in uterus.

↓ 51% of unmarried girls did not know that a baby delivered through vagina

6.2 REVIEW OF LITERATURE

1. An experimental study conducted with pretest & posttest group on effectiveness of structured teaching programme in improving knowledge and attitude of school going adolescent on reproductive health among 200 adolescent students in Dhahran town of Nepal. All the subjects were divided into experimental and control group each comprising two subgroups of 50 boys and 50 girls. STP consisting of information on human reproductive system, was used as a tool of investigation for experimental group where as conventional teaching method was used for control group. Result of the study showed the mean pretest score of experimental group on knowledge of reproductive health was 38.83 and of the control group was 39.47. The same of the experimental group was after administration of structured teaching programme was (84.60+10.60) and of control group with conventional teaching method (43.93+10.08) was statistically significant (p ................
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