Chapter - 1
Chapter - 1
Chapter - 1
Introduction
Learning is the beginning of health, learning is the beginning of wealth
Learning is the beginning of spirituality searching and learning is where the miracle process
all begins
Women with PCOS may have in frequent or prolong menstrual periods or excess male
hormone (androgen) level. The ovaries may develop numerous small collections of fluid
(follicles) and fail to release eggs. Early diagnosis and treatment along with weight loss may
reduce the risk of long-term complication such as type 2 diabetes and heart disease,
infertility. Since it is one of the causes of infertility, we have to educate the women about
boosting fertility in PCOS.
It affects about 5-10% of the female population who are in the age group of 12-45 years.
Poly cystic ovarian syndrome (PCOS) was formally called Stein- Levinthal syndrome. in
1935 Dr. Stein and Levinthal described a syndrome in which women suffered irregular and
rare menstrual cycle, hirsutism and varying degree of infertility. The exact cause of PCOS is
unknown but it is thought of abnormal disturbances in androgen and insulin produced by the
combination of genetic and environmental factor such as lifestyle and obesity.
Currently PCOS is affecting 2.2-26% of young girls in India with 9.13% - 36% prevalence in
adolescent girls only. Females are facing many problems due to the hormonal imbalances.
Women of child bearing age with PCOS have demonstrated higher rate of mood disorders
including bipolar disorder, depression, anxiety (5-8%) and lower quality of life.
The study will evaluate the effectiveness of structure teaching program of knowledge
regarding among adolescent girls.
Problem statement:
A study to assess the effectiveness of structural teaching programme on knowledge
regarding poly cystic ovarian syndrome among adolescent girls at selected government
school, Lucknow, U.P.
Aim of the study:
To aware the adolescent girls about polycystic ovarian syndrome and how it can be
prevented by taking early intervention, preventive measure and by lifestyle
modifications.
Objectives:
• To assess the pre-test level of knowledge regarding PCOS among adolescent girls.
• To assess the effectiveness of structured teaching programme regarding PCOS
in adolescent girls at selected government school of Lucknow.
• To find the association between pre-test knowledge score with their selected
demographic variables among adolescent girls.
Operational definitions:
Effectiveness:
In this study the term effectiveness means the extend to which our structured teaching
programme has fulfills it’s role.
It refers to a systematically developed programme that uses audio- visual method to provide
information about polycystic ovarian syndrome.
Polycystic ovarian syndrome:
Polycystic ovarian syndrome, it is a hormonal disorder that cause enlarged ovaries with
small cysts on the outer edge.
Adolescent:
In this study adolescent means the girls between the age group of 14 to 18 years.
Hypothesis:
H1: there will be significant difference in the pre-test and post-test knowledge regarding
PCOS among girls.
H2: there will be significant association between the pre-test knowledge score and their
selected socio-demographic variable of adolescent girls.
Conceptual framework:
The Conceptual framework is a theoretical approach to the study of problem that is
scientifically based and which lay emphasis on the solution.
The very brief time frame in which research must be conducted to know about the knowledge
of adolescent girls regarding polycystic ovarian syndrome and provide structural teaching
programme to increase their knowledge in selected government school of Lucknow UP.
The present study aims to aware the adolescent girls regarding polycystic ovarian syndrome
and how it can be prevented.
Health belief model:
History
The Health Belief Model was first developed in the 1950s by Social Psychologists
Hochbaum, Rosenstock and Kegels working in US Public Health Services who wanted to
explain why so few people were participating in programs to prevent and detect diseases.
The model was developed in response to the failure of a free Tuberculosis (TB) health
screening program.
HBM model is an approach or competence-oriented model rather than one include fear or
threat as a key concept.
In this revised model, importance of health and cues to action were deleted, definition of
health, perceived status and demographic and biological characteristics were moved and
included in a category labelled “personal factors. Three new variables, activity related affect,
commitment to a plan of action and immediate competing demands and preferences were
added to the model.
HBM is a value-expectancy theory.
COMPONENTS OF HBM
Perceived susceptibility: How likely do you think you are to have this health issue?
Perceived seriousness: How serious a problem does you believe this health issue is?
Perceived Benefits: how well does the recommended behaviour reduce the risk (s) associated
with this health issues?
Perceived barriers: what are the potential negative aspects of doing this recommended
behaviour?
APPLICATION OF HBM
Health behaviours and subject populations.
Preventive health behavior, which include health promoting and health risk behaviours.
Sick role behaviour, which refers to compliance with recommended medical regimens ,
usually following professional diagnosis of illness .
Clinical uses, which includes physician visits for a variety of reasons.
LIMITATION
• It does not account for environment or economic factors that may prohibit or promote
the recommended action.
• It assumes that everyone has access to equal amounts of information on the illness or
disease.
• It assumes that cues to action are widely prevalent in encouraging people to act and
that “health” actions are the main goal in the decision-making process.
The model addresses the relationship between a person’s belief and behaviour. It provides
away of understanding and predicting how client will behave in relation to their health. The
model describes about three variables
1. Individual perception
2. Modifying factors
3. Likely hood of action
Individual Perception
View of susceptibility to disease and seriousness of disease combine to form her perceived
threat to illness.
The present study is done among adolescent girls of selected government school of Lucknow
U. P.
Perceived susceptibility towards knowledge regarding Polycystic ovarian syndrome.
Demographic Variables are age of puberty, area of living, age of menarche, number of days
of menstrual cycle, any family history of PCOS, dietary pattern, source of information.
Modifying Factors
Modifying factors include demographic variables such as Age of puberty, area of living, age
of menarche, number of days of menstrual cycle, any family history of PCOS, dietary pattern,
source of information. Present study is done among adolescent girls of selected government
school of Lucknow U.P.
Modifying factors
Demographic variable which can modify is dietary pattern
Perceived seriousness is lack of knowledge regarding polycystic ovarian syndrome.
Likelihood of action
In the study we assess the knowledge of adolescent girls regarding PCOS such as what is
PCOS, it's cause, early symptoms and how it can be prevented and provide structural
teaching programme on PCOS.
Perceived benefits are increased awareness.
CHAPTER – 2
REVIEW OF LITERATURE
10. B. Sunanda, Nayak Sabitha (2016) study to assess the knowledge regarding PCOS among
Nursing student at NUINS, the study was conducted to assess the knowledge on the PCOS
among the student nurse, the data was collected from nursing student by using structured
questionnaire. Descriptive survey approach and descriptive design was adopted in study and
sample size was 150 . Result of the study was most of the student (85%) were in the age
group of 21-25 years and most of the student were Christian (73%) the level of knowledge of
the student was assessed through frequency and percentage which depict the most of the
student (114) had average knowledge. Conclusion Nurse should be aware of the various
organisation which render support counselling for adolescent should be included in
curriculum.
11. Desai N.A., Tiwari R.Y,Patel S.S(3 July ,2018) conducted a study on the prevalence of
polycystic ovary syndrome and its associated risk factor among adolescent girls in
Ahmedabad region. The aim of the study was to determine prevalence and its association
with risk factor among subjects. This is cross sectional multicentric prospective study
including 963 population size from 5 rural and urban school of Ahmedabad. A total of 881
girls were screened & 119 girls (13.54%) were found to have PCOS as defined by Rotterdam
criteria. The highest prevalence of PCOS found at age of 17 (30.35%). Thus, PCOS is an
emerging disorder associated with many health consequences.
12. Nidhi ram, et al (may 20, 2011) conducted a study on the prevalence of PCOS among Indian
adolescents. The objective was to find prevalence of PCOS among adolescent girls. Simple of
460 girls aged between 15 to 18 years from residential college Andra Pradesh, out of which
72 girls with oligomenorrhea evaluated for PCOS by Rotterdam criteria. Result showed that
6.30% had oligomenorrhea with polycystic ovaries and 42 girls (9.13%) had satisfied
Rotterdam criteria for PCOS. hence prevalence rate of PCOS is 9.13%.
13. Choudhary Anjali et al (sept 16, 2017) conducted a study on prevalence and
symptomatology of the polycystic ovarian syndrome in India. the objectives were to study
prevalence and symptomatology of PCOS in urban young women of Uttarakhand. It is a
population based cross sectional survey of 170 women, all were subjected to detailed
history and examination by NIH criteria. Result showed that the prevalence of PCOS was
41%. PCOS is rising in young women & to some extent of changing lifestyle. There is a
increase in the incidences of obesity, diabetes mellitus, metabolic syndrome and insulin
resistance is contributing to PCOS.
CHAPTER – 3
METHODOLOGY
The methodology of research indicates the systemic, theoretical analysis of the methods
applied to the field of study.it comprises the theoretical analysis of the body of methods and
principles associated with the branch of knowledge.
This chapter deals with the brief description of methodology adopted to assess the
effectiveness of structured teaching programme on knowledge regarding polycystic ovarian
syndrome among adolescent girls.
The content included in this chapter are research approach, research design, variables,
research setting, sample size, sample technique, criteria for sample selection, data collection
of tool and content validation and reliability.
Research approach:
It is a plan and procedure that consists of the steps of broad assumptions to detailed method
of data collection, analysis and interpretation.
Definition:
Research approach involves the description of the plan to investigate the phenomenon under
study in a structured, unstructured or a combination of these two methods.
The research approach which is used for our study is quantitative research approach.
Research design:
Research design is a blueprint that researcher select to carry out their research study.
Definition:
Research design is the master plan specifying the methods and procedures for collecting and
analysing the needed information in a research study.
The Research designs which is selected for the present study is pre- experimental research
design
Variables:
Variables are the qualities, properties, things or situations that vary.
Demographic variables:
The demographic variables used in research study were age, gender, educational status,
religion, social class, marital status, occupations, income, other medical diagnosis.
Research setting:
The research setting is the location where the research take place.
For present research study we choose the government school of lucknow as a research
setting.
Sample size:
The sample size is the number of subjects which is included in the data collection.
Sample size of the study is 55.
Sample technique:
The sampling technique is the name or other identification of the specific process by which
the entities of the sample have been selected.
Here we use non – probability sampling technique for this research study.
✓ Adolescent girls who are not present at the time of data collection
✓ Adolescent girls who are less than 14yrs of age
data collection tool are the devices or instruments that are used to collect data, such as a paper
questionnaire computer assisted interviewing system, case studies, checklist etc. The validity
and reliability of data collection instrument is important to yield high quality data.
The present study aimed to assess the awareness of polycystic ovarian syndrome and its
prevention with a view to develop structured questionnaire.
Description of self- structured questionnaire:
Assessment of effectiveness of structured teaching programme regarding awareness of pcos
Content validity of the tool: for content validation of tool structured questionnaire is prepared.
The structured questionnaire is prepared on two basis:
• Questions for demographic variables: 7 questions
• Questions for knowledge assessment: 30 questions
The self -structured questionnaire was sent with request to the 5 experts from the field of
obstetric and gynecological nursing to check the questionnaire for relevancy, clarity,
appropriateness of the tittle and content area. The experts chosen from best in their clinical
expertise. The experts were requested to give their opinion and verify the questionnaire and
suggested modifications by the experts will be done after the discussion with the guide.