INTRODUCTION:

Menstruation is a normal physiological cycle common to all females of the reproductive age group. The initiation of menstruation takes place during early adolescent period. Menstrual cycle is a series of event, occurring regularly every 26 to 30 days throughout the childbearing period and the changes that take place simultaneously in the ovaries and uterine walls. It is stimulated by changes in the concentration of hormones in the blood. Menstruation is associated with several physical and psychological problems (Ross and Wilson, 2001).

BACK GROUND OF THE STUDY:

Until now, menstruation in developing countries has been an insufficiently acknowledged problem in several cultures. There are cultural and religious taboos concerning blood, menstruating girls and women and menstrual hygiene.

Worldwide there is also structural gender inequality, which continue to exist through the wide spread preservation of preconceptions, stereotypes and cultural patriarchal attitudes, because of which the position of women as independent actor is being undermined daily.

Although there are differences by country, culture, ethnic group, social class (or) family, the depression of women has its effect on issues concerning reproductive health and its functions and process. Most striking is the restricted control, which many women and girls have over their own mobility and behavior during menstruation, including the myths, misconceptions, suspensions and taboos concerning menstrual blood and menstrual hygiene.

The results of previous studies showed that, majority of the adolescent girls were with one or the other menstrual abnormalities and have the disturbance in coping with those disturbances.

A descriptive, cross-sectional method to assess the level of knowledge, attitude and behavior of female students, aged 15 to 18 years, with regard to dysmenorrhea and menstrual hygiene in which 250 students were selected using random sampling method. The data were collected by applying a 44 item questionnaire. The result showed that 77% of the subjects claimed that they had adequate knowledge of dysmenorrhea. But only 32% practiced personal hygiene such as taking a bath, and used hygienic material. About 33% of the students knew regarding the development of healthy behavior in their menstrual periods (Udgiri R, Angadi MM, Oatil S, Sargavani V, Aug 2010).

A descriptive, cross sectional study was conducted among 160 adolescent girls of a secondary school situated in the field practice area of rural health unit and training center, Singur, West Bengal, with the help of a pre-developed and pre-tested questionnaire. Data were analyzed statistically by simple proportions out of 160 respondents, 108 (67.5%) girls were aware about menstruation prior to attainment of menarche. Mother was the first informant regarding menstruation in case of 60 (37.5%) girls. One hundred and thirty eight (86.75%) girls had known the use of sanitary pad during menstruation. Regarding practices, only 18 (11.23%) girls used sanitary pad during menstruation. For cleaning purpose, 156 (97.5%) girls used both soap and water. Regarding the restrictions practiced, 136(85%) girls practiced different restrictions during menstruation (Dasgupta A, Sarkar M, 2007).

Thus thispaper attempts to provide an in-depth discussion on; menstrual problems encountered by adolescent schoolgirls, relationship between menstruation and selected variables and mechanisms used by adolescent schoolgirls to cope with menstruation.

STATEMENT OF THE PROBLEM:

A Study on coping strategies of menstrual disturbances among adolescent girls at selected schools of Coimbatore district.

OBJECTIVES:

· To assess the demographic variables of the adolescent girls at Coimbatore district.

· To assess the prevalence of menstrual abnormalities among adolescent girls at Coimbatore district.

· To evaluate the coping measures towards menstrual pattern among the adolescent girls.

METHODOLOGY:

Research Methodology

Descriptive research method is used in the present research project.

Research Design

A school based descriptive cross sectional research design.

Setting

Randomly selected school from rural and urban Coimbatore.

Samples

Adolescent girls between the age group of 13 to 17 years and who attained menarche are the samples in the present research.

Sample Size

Randomly selected adolescent girls of 100 in number, 50 from rural and 50 from urban Coimbatore.

Sampling Technique

Multi Stage Sampling Technique is used to select the samples.

Criteria for Sample Selection

Inclusion Criteria

· Age group between 13 and 17.

· Adolescent girls who attained menarche.

· Adolescent girls who got consent from their parents.

· Adolescent girls who are willing to participate.

Description of the Tool

The tool was constructed after extensive literature survey and consultation with the research guide.

The tool consists of four parts.

Part 1: Demographic variables of the adolescent girls.

Part 2: History about the menstrual pattern of the adolescent girls

Part 3:Check-list on the symptoms associated with the menstrual disturbances among the adolescent girls.

Part4:Check-list on the coping strategies towards the menstrual disturbances among the adolescent girls.

Method of data collection

Data was collected by the researcher through schedule technique. Since the school timing and the permission given were little troublesome, the researcher has decided to collect the data by this method where the questions were distributed to the samples and after reasonable time (30 min) the questionnaire were collected.

Conceptual Framework  for this Study

This study is guided by Leininger’s transcultural nursing model. According to this model, adolescent girls learn to adapt to their new physiological development. They need to adopt a role that is acceptable to the community, while at the same time understanding that some simple habits should be taken in order to address basic hygiene and well-being (Leininger, 1991; Morgan, 2002).According to Leininger’s sunrise model, cultural practices that are beneficial to a community should be adopted, while harmful practices should be modified.

Beneficial practices should be encouraged; at the same time, potentially harmful aspects of traditions should be modified. In this way, existing positive behaviors can be augmented within the traditional framework of the society, in order to preserve the health and wellbeing of the female population. Such changes would have the greatest impact if implemented among adolescents, so that their healthy practices will be passed on to succeeding generations (Sita Devkota, 2011)

Data analysis and interpretation:

The obtained data was coded and analyzed using descriptive statistics.

The demographic data showed that 12% of the adolescent girls were in 13 yrs with the least number and 27% were in their 16 years of age. Majority 96% of the adolescent girls belongs to Hindu religion and 2% belong to both Muslim and Christian religion respectively. 62% of the adolescent girl’s mothers were educated and remaining 38% were uneducated in both urban and rural area.55% of the adolescent girl’s mothers were employed. Majority 90% of the adolescent girls have the habit of consuming fast food which was consumed equally by the rural and urban adolescent girls.

Implications of the study:

The health care professional should be equipped with the knowledge on coping strategies of menstruation among adolescent girls. Appropriate measures must be taken for coping with menstrual disturbances.

Mothers and teachers play a vital role in imparting the coping strategies of menstrual problems among adolescent girls. Hence education to mothers of adolescent girls can be given importance in improving the reproductive health of the adolescent girls.

Table No.1 Percentage Of Adolescent Girls Towards Menstrual History

S. No	Item	Number of adolescent girls in %
1	Source of information
	Mother	12
	Sister	07
	Friends	22
	No one	59
2	Age at menarche
	< 11 years	01
	11-13 years	59
	>13 years	41
3	Menstrual pattern
	Regular	82
	Irregular	18
4	Menstrual bleeding frequency
	< 21 days	08
	21-35 days	83
	> 35 days	09
5	Menstrual bleeding amount
	Scanty	38
	Normal	56
	Heavy	06
6	Menstrual bleeding duration
	< 3 days	38
	3-5 days	56
	> 5 days	06
7	Method of pain relief for menstruation
	Medication	18
	Rest	47
	Exercise	100
	Nothing	100

Figure 1Adaptive Coping Measures of the Adolescent Girls

Figure 2 Maladaptive Coping Measure of the Adolescent Girls

CONCLUSION:

A change in beliefs and attitudes is imperative to ensure optimal behavior and the promotional of a healthy life style. Also in order to develop educational curricula for young girls, health education professionals should clearly recognize the association between a person’s beliefs and attitudes, and their health behavior. Social, environmental, and cultural factors affecting adolescents’ behavior should also be taken into account when imparting health education. By assessing these factors, health education providers would be able to come up with appropriate methods and strategies to empower and educate young girls to adopt necessary life skills that have a positive influence on their lifestyle.

REFERENCES:

1. Boback M. Irene and Margret Duncan et al. “Maternity And Gynecological Care- The Nurse And The Family” , CV Mosby Company, Toronto, 4^th Edition,1989, Page No 1096-1110.

2. Dawn, “Text Book of Obstetrics And Neonatology” 3^rd edition, New Central Publishers, Calcutta, 1999, Page No: 53-55.

3. Dutta D C, “Text Book of Obstetrics Including Perinatology And Contraceptives”, 6th Edition, Calcutta, 2004,Page No: 10-29.

4. Gupta K, “ Fundamental of Mathematical Statistics”, 1^st Edition, Soffit Chand Publications, India, 1999.

5. Hawkins and Borneshows, “Text Book of Gynecology”, 4th Edition, New Delhi, 1991,

6. Page No: 47-50.

7. Arunkumar Aggarwal, “ A Study On Prevalence Of Premenstrual Syndrome Among Adolescent Girls”, The Nursing Journal Of India, New Delhi, 1999,

8. Busari, “ Menstrual Knowledge And Health Care Behavior Among Adolescent Girls In Rural Nigeria”, International Journal Of Applied Science And Technology, Vol 2,No 4, April, 2012.

9. Campbell MA,MeGrath PJ, “ Non Pharmacological Strategies Used By Adolescents For The Management Of Menstruation Discomfort”, Clinical journal of pain,1999 Dec.

10. Franco Rigon , “Menstrual Pattern And Menstrual Disorders Among Adolescents: An Update Of The Italian Data “ , Italian Journal of Pediatrics, 2012, 38:38

11. Fujiwara T, Sato N, Awaji H, Sakamoto H, Nakata R., “Skipping Breakfast Adversely Affects Menstrual Disorders In Young College Students”, International Journal of Food Science and Nutrition. 2009; 60 Suppl 6:23-31.

Received on 14.02.2014 Modified on 01.04.2014

Asian J. Nur. Edu. & Research 4(2): April- June 2014; Page 220-223