Effect of structured teaching programme on level of knowledge on preparation of girl for menarche among mothers in selected urban area, Thrissur.

 

Ashitha Aravindhakshan¹*, Anu K. Babu¹*, Ann Wilson¹*, Blessy Varghese¹*, Josiya Jose¹*, Deena Joy¹*, Riya Reji¹*, Snehamol K. F. ¹*, Mrs. Justy Joy², Mrs. Reena Vincent³,

Dr. Angela Gnanadurai⁴

¹III year BSC (N) students, Jubilee Mission College of nursing, Thrissur.

²Asst.Professor, Jubilee Mission College of nursing, Thrissur.

³Professor, Jubilee Mission College of nursing, Thrissur.

⁴Professor, Jubilee Mission College of nursing, Thrissur.

 

ABSTRACT:

Introduction: Adolescence is a highly dynamic period characterized by rapid growth and development. Adolescent girls have limited knowledge about menstruation and its hygiene. The importance of the parent’s role in the education of adolescent regarding puberty sanitation, the knowledge of mothers regarding puberty and its health issue is very important. Objective: The main objective of the study was to compare the level of knowledge regarding preparation of girl among mothers before and after structured teaching programme and to associate the pretest level of knowledge of mothers on preparation of girl for menarche with selected socio demographic and clinical data variables. Methodology: Pre experimental one group pre-test post-test design was used. 30 mothers of girl was selected by using Convenience sampling. Pre-test in seven domains (Anatomy of female reproductive system, menarche and physiological changes, menstrual hygiene, nutritional aspects, home remedies for reducing pain, emotional support and complication of poor menstrual hygiene) was conducted followed by a structured teaching programme given on preparation of girl for menarche. Post test was conducted after 4 days the data was analyzed by using descriptive and inferential statistics. Results and interpretation: The socio demographic and clinical variables reveals that 18(60%) of mothers belongs to the age group 30-39yrs, 18 (60%) mothers have high school education and 24 (80%) mothers were housewives. It was found that 23(76%) mothers live in joint family and 23(76%) have only one girl child. In the pre-test 14 (46.6%) had moderate level of knowledge, 16(53.3%) had inadequate level of knowledge and none of them had adequate level of knowledge. In the post-test 27(90%) of mothers had adequate level of knowledge, 3(10%) had moderate level of knowledge and none of them under the category of inadequate level of knowledge. The post-test mean knowledge scores are higher than the pre-test means knowledge scores on all domains. The calculated t value of 21.63 was found to be statistically significant (p < 0.001). There is no significant association between the pre-test level of knowledge score of mothers on preparation of girl for menarche with selected socio demographic and clinical data variables. Conclusion: The study concluded that the structured teaching programme was an effective method to bring significant improvement in the level of knowledge among mothers for the preparation of their girl for menarche in all seven domains.

 

 

INTRODUCTION:

It is the need of society that a girl child to become a woman, that is necessary for the development of society. Girl experiences menarche at different ages, which depends on several factors like physical, physiological, genetic and environmental. Family, especially the mother has the most important role in education, transformation of Information and health behavior of girls in order for them to have a healthy transition from the critical stage of menarche.

 

The menstrual cycle is governed by hormones that rise and fall in rhythmic pattern, influencing the variety of physical sensations and emotional shifts that the girl child may experience for several days before menstruation and sometimes during the first few days of menstrual flow.¹ In India recent years, reproductive health care has been one of the main concerns of the ministry of health and medical education and the ministry of education.

 

There are 355 million menstruating women in India. A study found that 71% adolescent girls in India are unaware of menstruation till menarche. In India 68.92% of girl child develop urinary tract infection due to unhygienic menstrual practices. 38.74% of girls face cervical problems and uterine cancers due to the use of non-absorbable clothes and long-term use of sanitary pads.^2,3

 

A study conducted among schools in India regarding menstrual hygiene preparedness and the study aimed to conduct a systematic review regarding the existing evidence of menstrual hygiene management. The study used meta-analysis to estimate the pooled prevalence of menstrual hygiene practices. It shows less than half of girls were aware about menstruation before menarche (PP 0.45, 0.39 to 0.51, I²= 100%, n=122) and teachers were a less common source of information (PP 0.07, 0.05 to 0.08, I²= 100%, n=86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I²= 100%, n=11). The study concluded that menstrual hygiene practices in schools should be strengthened.⁴

 

Lack of knowledge regarding menarche and menstrual hygiene will contribute to uterine infections and cervical cancers. Along with this problem many taboos are prevalent in the country regarding menstrual practices. This taboo makes a great influence in the mothers and girls of adolescent age. This may lead to some malpractices.

 

Hence the researcher feel the need of giving heath education regarding the menstruation and hygienic measures is very essential part of development of the country.⁵

 

STATEMENT OF STUDY:

A study to assess the effect of structured teaching programme on level of knowledge on preparation of girl for menarche among mothers in selected urban area, Thrissur

 

OBJECTIVES OF THE STUDY:

·       To assess the level of knowledge regarding preparation of girl for menarche among mothers before and after the structured teaching programme.

·       To compare the level of knowledge of mothers regarding the preparation of girl for menarche before and after structured teaching programme.

·       To associate pre-test level of knowledge of mothers on preparation of girl for menarche with selected socio-demographic and clinical data variables

 

HYPOTHESIS:

·       H₁: There is a significant difference between the pre and post test scores of level of knowledge regarding the preparation of girl for menarche among mothers.

·       H₂: There is a significant association between the pre-test scores of level of knowledge of mothers on preparation of girl for menarche with selected socio demographic and clinical data variables.

 

ASSUMPTIONS:

·       Mothers of girl child between the age of 7-14 years, may not be adequately aware about preparation of girl for menarche.

·       The structured teaching programme may enhance the knowledge of mothers regarding the preparation of girl for menarche.

 

MATERIAL AND METHODS:

An evaluative research approach with Pre-experimental, one group pre-test post-test design was used to conduct the study. The study was conducted in urban areas of Kachery, Thrissur. 30 mothers of girl were selected by using non probability convenient sampling technique. The tool was developed in 2 sections. Section -A socio-demographic and clinical data variables of mothers and Section B consist of a self-structured knowledge questionnaire regarding preparation of girl for menarche. Ethical clearance to conduct the present study was obtained Pre-test in seven domains (Anatomy of female reproductive system, menarche and physiological changes, menstrual hygiene, nutritional aspects, home remedies for reducing pain, emotional support and complication of poor menstrual hygiene) was conducted followed by a structured teaching programme given on preparation of girl for menarche. Post test was conducted after 4 days individually. The data was analyzed by using descriptive and inferential statistics.

 

Criteria for sample collection:

Inclusion criteria:

Mothers of girl who have not attained menarche, who are able to read and understand Malayalam and who are willing to participate in study

 

Exclusion criteria:

Mothers who have only boy child and mothers of girl with existing any diseases or congenital anomaly of reproductive organs.

 

RESULTS:

The result was organized in four sections.

 

Section A: Socio-demographic and clinical data variables among mothers of girl.

Table 1: Distribution of samples according to socio demographic and clinical data variables     n = 30

Socio-demographic and clinical variables	Frequency (f)	Percentage (%)
Age of mothers(years)
20-29	3	10
30-39	18	60
40-49	9	30
Educational Status
Primary	1	3.33
High school	18	60
Graduate	9	30
Post graduate	2	6.67
Occupation of mothers
House wife	24	80
Coolie	1	3.33
Technical	3	10
Professional	2	6.67
Type of family
Nuclear	23	6
Joint	7	23.3
Number of girl children
One	23	76
Two	4	13.3
Three or more	3	10
Previous knowledge
Yes	17	56.8
No	13	43.2

 

Table 1 shows that the socio demographic and clinical variables reveals that 18 (60%) of mothers belongs to the age group 30-39yrs, 18 (60%) mothers have high school education and 24 (80%) mothers were housewives. It was found that 23 (76%) mothers live in joint family and 23 (76%) have only one girl child.

 

Section B: Level of knowledge of mothers before and after structured teaching programme.:

Table 2: Frequency and percentage of level of knowledge among mothers regarding the preparation of girl for menarche in pre-test and post-test.   n=30

Level of knowledge	Pretest		Post test
	f	%	f	%
Adequate	0	0	27	90
Moderate	14	46.6	3	10
Inadequate	16	53.3	0	0

 

Table 2 Shows that 16 (53.3%) of mothers had inadequate level of knowledge, 14 (46.6%) had moderate level of knowledge and none of the mothers had adequate level of knowledge in the pre-test. In the post-test 27 (90%) mothers acquired adequate level of knowledge, 3 (10%) had moderate level of knowledge and none of mothers scored inadequate level of knowledge regarding the preparation of girl for menarche.

 

Section C: Comparison of level of knowledge of mothers of girl

Table 3: Mean standard deviation and t value of pre-test and post-test level of knowledge of mothers regarding the preparation of girl before menarche.                                                                                                                                                                                                      n= 30

Sl. No.	Domains of Knowledge	Pre-test		Post-test		t value	df	p value
		Mean	SD	Mean	SD
I.	Anatomy of female reproductive system	1.43	0.77	3.53	0.73	11.18	29	0.001*
II.	Menarche and physiological change	5.23	1.61	8.70	1.12	11.62	29	0.001*
III.	Menstrual hygiene	1.93	0.94	3.70	0.53	10.35	29	0.001*
IV.	Nutritional aspects	1.57	1.28	4.10	0.61	11.33	29	0.001*
V.	Home remedies for reducing pain	1.40	0.89	2.63	0.61	6.50	29	0.001*
VI	Emotional support	1.77	0.42	1.90	0.31	2.11	29	0.043*
VII.	Complications of poor menstrual hygiene	0.77	0.63	1.37	0.72	5.29	29	0.001*
VIII.	Overall level of knowledge	14.10	3.556	25.90	1.561	21.63	29	.000*

*: Significance (p<.001)

 

Table 3 shows that the post-test mean knowledge scores are higher than the pre-test means knowledge scores on all domains. The mean post-test mean knowledge score was 25.90 with S.D 1.561 and the pre-test mean score was 14.10 with S.D 3.556. The calculated t value of 21.63 was found to be highly statistically significant (p < 0.001). Which indicates that structured teaching programme was effective hence the research hypothesis H₁ is accepted.

 

Figure 1: Distribution of mean pre and post knowledge score in different domains of knowledge on menarche among mothers of girl n=30

 

Data from figure 1: shows that mean post-test knowledge scores in different domains of knowledge on menarche are higher than mean pre-test knowledge scores. The highest increment in knowledge score was observed in menarche and physiological change where the mean pre-test knowledge score was5.23 and mean post-test knowledge scores was 8.70.

 

Section D: Association of selected socio-demographic and clinical data variable with pretest level of knowledge among mothers of girl.

Table 4: Association of pre-test level of knowledge of mothers on preparation of girl for menarche with selected socio-demographic and clinical data variables n=30

Socio demographic and clinical variables	Pretest level of knowledge			X2	df	P value
	Adequate	Moderate	Inadequate
Age of mothers	(f)	(f)	(f)	0.16	6	0.69
20-29	0	1	2
30-39	0	10	8
40-49	0	3	6
Educational status				0.14	6	0.70
Primary	0	1	0
High school	0	8	10
Graduate	0	4	5
Post graduate	0	1	1
Number of children				0.18
One	0	0	3
Two	0	10	10		4	0.66
Three or more	0	4	3
Monthly income				0.22	6	0.63
Less than 1000	0	2	3
1001-5000	0	7	5
5001-10000	0	5	6
More than 1000	0	0	2
Religion				0.10	6	0.91
Hindu	0	5	6
Christian	0	9	10
Muslim	0	0	0
Others	0	0	0
Occupation of mothers				0	6	1
House wife	0	11	13
Coolie	0	0	1
Technical	0	3	0
Professional	0	0	2
Type of family				1.20	2	0.270
Nuclear	0	12	11
Joint	0	2	5
Number of girl children				0.40	6	0.52
Zero	0	0	0
One	0	12	13
Two	0	2	2
Three or above	0	2	1
Previous knowledge				0.002	2	0.96
Yes	0	8	9
No	0	6	7

Significant P < 0.05 level

 

Data from table 4 shows that there is no significant association with pretest level of knowledge on preparation of girl for menarche among mothers with socio -demographic and clinical data variables such as age of mothers, educational status and number of children monthly income, religion, occupation of mothers and type of family, number of girl children and Previous knowledge about menarche. Hence the research hypothesis H₂ is rejected.

 

DISCUSSION:

The first objective study was to assess the level of knowledge regarding preparation of girl for menarche among mothers before and after the structured teaching programme. In the post-test, out of 30 samples no one having adequate level of knowledge and 14 (46.6%) were having moderate level of knowledge and 16 (53.3%) were having inadequate level of knowledge. In the post-test 27 (90%) were having adequate level of knowledge and 3 (10%) were having moderate level of knowledge and no one having inadequate level of knowledge. The study findings were supported by a quantitative study to assess the knowledge, beliefs and source of information regarding menstruation and also to assess hygiene among them. The result of the study done among 100 adolescent girls 72 (72%) were between 15 and 19 year, 47 (47%) having high school education and 27 (27%) girls had menarche at 14 years and 82 (82%) had irregular cycles. About 60% girls used sanitary pads and the rest used cloth pieces. About 22 (22%) used water and no soap for hand washing. So, the study concluded that girls should be educated about the facts of menstruation and proper hygiene practices.⁶

 

The second objective of this study was comparing the level of knowledge of mothers before and after structured teaching programme. It showed that there is a significant increase in the level of knowledge, among mothers of girl on preparation for menarche in the post test, compared to the pre-test which is statistically significant (p > 0.001) with the tested value. These findings are consistent with pre experimental study to assess the effectiveness of structured teaching programme on menarche among the preadolescent girls in selected schools at Nagercovil. The result shows there is marked difference in the pre-post-test e scores level of knowledge of pre-adolescent girls regarding menarche.⁷ In various parts of India, there are several cultural traditions, myths and misconceptions related to menstruation, which make them vulnerable to genital tract infections.⁸

 

The third objective of this study was to associate the pretest level of knowledge of mothers on preparation of girl for menarche with selected socio-demographic and clinical data variables. Result proved that there is no significant association of pretest level of knowledge on mother regarding the preparation of girl for menarche with socio -demographic and clinical data varibles.

 

CONCLUSION:

There are several milestones in the life of a girl.⁹ Menarche and menstrual experiences play a critical role in adolescent girls’ life.¹⁰ Present study was conducted to assess the effect of structured teaching programme on preparation of girl for menarche among mothers in Thrissur. Out of 30 samples no one had adequate level of knowledge in pre-test and in post-test 27(90%) have acquired adequate level of knowledge. So, the current study highlighted that there is significant changes in level of knowledge level of mothers after structured teaching programme. The researcher concluded that structured teaching programme is an effective educational intervention in improving the level of knowledge and developing positive attitude among mothers on the preparation of girl for menarche.

 

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7.      Mathiyalagen P, Peramasamy B, Vasudevan K, Basu M, Cherian J, Sundar B. A descriptive cross-sectional study on menstrual hygiene and perceived reproductive morbidity among adolescent girls in Tamil Nadu, India. Journal of family medicine and primary care. 2017 Apr;6(2):360.

8.      Mudey AB, Kesharwani N, Mudey GA, Goyal RC. A cross-sectional study on awareness regarding safe and hygienic practices amongst school going adolescent girls in rural area of Wardha District, India. Global journal of health science. 2010 Oct 1;2(2):225.

9.      Ameade EP, Garti HA. Age at Menarche and Factors that Influence It: A Study among Female University Students in Tamale, Northern Ghana. PLoS One. 2016;11(5): e0155310. Published 2016 May 12. doi: 10.1371/journal.pone.0155310

10.   Behera D, Sivakami M, Behera MR. Menarche and Menstruation in Rural Adolescent Girls in Maharashtra, India: A Qualitative Study. Journal of Health Management. 2015 Dec;17(4):510-9.

 

 

 

Received on 04.05.2020         Modified on 13.07.2020

Accepted on 02.09.2020       ©A&V Publications All right reserved