INTRODUCTION:

Oral cancer is a significant public health importance to India. It is the sixth most common cancer reported globally with an annual incidence of over 300,000 case, of which 62% arises in developing countries. ^[1] The Incidence of oral cancer in India caused by tobacco chewing is one of the world’s highest at nearly third of all cancer cases.

Indian Council of Medical Research says that nearly 1,60,000 people developed each year as a result of tobacco consumption. [2]

Tobacco use and alcohol are known risk factors for cancers of the oral cavity. Estimates indicate 57% of all men and 11% of women between 15-49 years of age abuse some form tobacco. Approximately 12% deaths worldwide occur due to cancer. ^[3]Oral cancer occurs on sites in the oral cavity: tongue, lips, floor of the mouth, soft palate, tonsils, salivary glands and oropharynx. ^[3]

As children between 16-19 years have influential peer, fashion and media sectors to create personality and build image, Many youngsters also get indulged in variety of habit formations, one of them the disasters is the tobacco chewing and smoking which leads to cancer if not controlled. Hence the investigator feels to create awareness and impact knowledge on preventive measures of oral cancer among late adolescents

OBJECTIVES:

· Assess the level of knowledge on prevention of oral cancer before and after structured teaching programme among late adolescents.

· Determine the effectiveness of structured teaching programme on prevention of oral cancer among late adolescents.

· Find out the association between post test knowledge regarding preventive measures of oral cancer with selected demographic variables.

METERIALS AND METHODS:

Study Design:

The study design was pre experimental research design was used to assess the effectiveness of structured teaching programme on knowledge regarding preventive measures of oral cancer among late adolescents at selected junior college, Karimnagar, Telangana. In the present study the investigator selected a pre experimental design one group pre test and post test design.

Study Samples:

In this study with the help of non-probability simple random sampling technique 30 samples late adolescents from selected Govt Junior College of Karimnagar.

Duration of the Study:

The data collection procedure was carried out from 2^nd March 2015 to 14^th March 2015 with help of structured questionnaire using questionnaire technique at Government junior college, Karimnagar District, Telangana. The investigator herself collected both pre test and post test data and also implanted structured teaching programme.

Instrument:

A data collection instrument was structured knowledge questionnaire. Data was collected from them by using a structured knowledge questionnaire before and after administration of STP.

The Questionnaire contains was age, gender, religion, personal habits, educational qualifications, occupation of the father and mother, income per month, type of family, source of information and any family history of cancer. Content validity was established by 07 experts comprising 05 nursing experts from medical surgical nursing department, 01, oncologist, 01 Biostastician.

RELIABILITY:

The reliability was established by using split half technique and spearman’s browns formula(r = 0.06). This tool was found reliable.

STATISTICS ANALYSIS:

Data was analyzed by descriptive and inferential statics such as standard deviation, chi-square test and paired` t’ test.

RESULT:

Section -I Frequency and percentage distribution of late adolescents according to their demographic variables.

S. No

Demographic Variables

Late Adolescents

Frequency

Percentage %

Age

a) 16-17 years

b)18-19 years

53.4

46.66

Gender

a) Male

b) Female

63.34

36.66

Religion

a) Hindu

b) Muslim

c) Christian

d) Others

3.33

6.67

Personal habits

a) Eating hot foods

b) Smoking

c) Drinking alcohol

d) Tobacco chewing

99.66

3.34

Educational qualifications

a) Inter 1^st year

b) Inter 2^nd year

Occupation of the father

a) Coolie

b) Unemployed

c) Business

d) Professional

83.33

6.66

Occupation of the mother

a) House wife

b) Professional

c) Skilled worker

d) Coolie

3.33

26.66

Income per month

a) > 5000/month

b) 5001-10,000/month

c) 10,000-15,000/month

d) >15,000/month

63.33

26.68

3.33

6.66

Type of family

a) Nuclear family

b) Joint family

c) Extended family

46.66

13.34

10.

Source of information

a) News paper

b) Television

c) Internet

d) Others

53.33

33.33

6.67

11.

Any family history of cancer

a)Yes

b) No

c) If yes specify which type of cancer

3.34

96.66

According to age (53.4%) of the late adolescents were in the age group 16-17 years of age and (46.66%) were 18- 19 years. Genders (63.34%) were males and (36.66%) were females.

Personal habits (96.66%) were eating hot foods, smokers were (3.34%). personal habits (96.66%) were eating hot foods, smokers were (3.34%). source of information news papers were (53.33%), television were (33.33%), internet were (6.67%), and (6.67%) were others, Family history of cancer yes were (3.34%) and (96.66%) were no history of cancer,

Section -- II

Part-1: Frequency and percentage distribution of late adolescents according to their pre test knowledge score on preventive measures on oral cancer.

The finding reveals that 63.3% of late adolescents had below average knowledge and 36.6% of late adolescents had average knowledge, none of late adolescents had above average knowledge.

Part -2: Frequency and percentage distribution of late adolescents according to their post test knowledge score on preventive measures on oral cancer.

The findings reveals that 66..6% of late adolescents had average knowledge, 33.3% of late adolescents had above average knowledge and none of the late adolescents had below average knowledge.

Section—III Comparison of pre test and post test score of late adolescents among preventive measures of oral cancer.

Parameters	Time table	No. of subjects	Mean	Standard deviation	t- value	Critical value
Knowledge regarding preventive measures of oral cancer	Pre test	30	9.6	3.14	*7.83	1.701
Knowledge regarding preventive measures of oral cancer	Post test	30	17.43	4.64	*7.83	1.701

*significant, NS =non significant

The above table shows that the mean of knowledge score during pre test was 9.6 and standard deviation 3.14 was as during post test mean was 17.43 and standard deviation 4.64. The computed t- value is 7.83 that is more than table value 1.701 at 0.05 level. This reveals that there is a significant difference between pre and post test.

Section -- IV Association between knowledge score of late adolescents regarding preventive measures on oral cancer with selected demographic variables was analyzed by Chi-square test.

S. No	Variable	Category	Knowledge Score			Chi Square Value	Df	Critical value
S. No	Variable	Category	Below Average	Average	Above Average	Chi Square Value	Df	Critical value
1	Age	a) 16-17 Years b) 18-19 Years	0 0	12 9	4 5	0.407NS	1	3.84
2	Gender	a) Male b) Female	00	147	54	0.999NS	1	3.84
3	Religion	a) Hindu b) Muslim c) Christian d) Others	0000	20100	9000	0.142NS	1	3.84
4	Personal habits	a)Eating hot foods b)Smoking c)Drinking alcohol d)Tobacco chewing	0000	20100	7200	3.84*	1	3.84
5	Educational qualifications	a)Inter 1^st year b)Inter 2^nd year	00	615	3	0.067NS	1	3.84
6	Occupation of the father	a)Coolie b)Unemployed c)Business d)Professional	0000	16 320	9 0 00	10.66*	4	9.49
7.	Occupation of the mother	a)House wife b)Professional c)Skilled worker d)Coolie	0000	16014	5004	47.86NS	1	3.84
8	Income per month	a)<5000Rs /Month b)5001-10,000/Month c)10,001-15,000/ Month d)>15,001/ Month	0000	1541 1	440 1	1.27NS	1	3.84
9	Type of Family	a)Nuclearfamily b)Joint family c)Extended family	000	8112	432	1.27NS	4	9.49
10	Sources of information	a)News paper b)Television c)Internet d)Others	0000	15600	4500	3.87*	1	3.84
11	Any family history of cancer	a)Yes b)No c)If Yes specify the type of cancer	000	1182	090	7.9*	3	7.84

*Significant, NS =Non significant.

DISCUSSION:

India has the highest number of oral cancer cases in the world, and 90% of all oral cancers are related to tobacco use. Half of the total cancers among men and 20% of cancers in women are tobacco related. [4] Overall prevalence of tobacco use among men was 57%, while among women it was 10.8^{%. [5]} school-going youths (aged 13-15 years) in India had already initiated smoking before the age of 10, and 11.9% were other tobacco products. ^[6]According to India Global young tobacco survey (2009) reported a prevalence of tobacco use in any form of 14.6%, while only 4.4% uses cigarettes. ^[7]

This study findings reveals that personal habits, occupation of the father, sources of information, family history of cancer had significant association with knowledge scores the Chi-square value is greater than critical value and there significant association between knowledge score other demographic variables such as age, gender, religion, educational qualifications, occupation of the mother, income per month, type of family.

In present study showed that the late adolescents in post test regarding knowledge; the mean was 3.14 with the standard deviation of 4.64. Statistically, there was an improvement in knowledge and attitude of prevention of oral cancer. The comparison of improved mean and standard deviation of regarding the level of knowledge, attitude and practice of pretest and post test score shows significantly improvement.

After implementation of structured teaching programme regarding preventive measures of oral cancer was effective among late adolescents. Late adolescents had statistically significant increase in knowledge, attitude and practice regarding preventive oral cancer (p<0.05).

CONCLUSION:

Our study results showed that the knowledge regarding preventive measures of oral cancer to be quite low in late adolescents. Hence, it was concluded that structured teaching programme was an effective method to improve the knowledge and attitude regarding prevention of oral cancer among late adolescents.

RECOMMENDATIONS:

Based on the findings of the study the following recommendations are made.

· A study could be conducted on a larger group sample thereby the findings can be generalized.

· An experimental group could be undertaken by having an experimental group.

· A similar study can be conducted along with health practices in late adolescents.

ACKNOWLEDGEMENT:

Authors thank to Principal and Students of Govt. Junior College, Karimnagar.

CONFLICT OF INTEREST:

Nil

SOURCE OF FUNDING:

Nil

ETHICAL APPROVAL COMMITTEE:

The study was approved by Institutional Ethics Committee, Prathima College of Nursing, Karimnagar. Anonymity of the subject and confidentiality of the information was maintained.

REFERENCES:

1. Sankaranaryanan R, Masuyer E, Swaminathan R, Ferlay J, Wjelan S. Head and neck cancer: A global perspective on epidemiology and prognosis. Anti Cancer Res. 1998; 18:4779-4786.

2. Guptal etal. Tobacco use in a rural area of Bihar, India. Indian J Community Med. 2003; 28: 167-170.

3. Shah SP, Praveen BN. Awareness of oral cancer in rural Bangalore population: A Questionnaire based study. Int J Scientific study. 2014; 1:14-16.

4. World Health organization. Tabacco free initiative fact sheet: India; 2008. Available from:http://whoindia.org/linksfiles/tabaccofreeintiative factsheet.pdf.

5. Kaur J, Kishore J, Kumar M. Effect of anti-tobacco audiovisual messages on knowledge and attitude towards tobacco use in North India. Indian J Community Med. 2012; 37: 227-231.

6. Sinha DN. Global Youth Tobacco Survey (GYTS), Tobacco control in schools in India, 2006. Ministry of Health and Family Welfare, Government of India.

7. Philip PM, Parambil NA, Bhaskarapillai BK, Balasubramanian S. Evaluation of a specialty designed tobacco control program to reduce tobacco use among school children in Kerala. Asian Pacific J Cancer Prevention. 2013; 14: 3455-3459.

Received on 12.02.2016 Modified on 20.03.2016

Asian J. Nur. Edu. and Research.2017; 7(1): 21-25.

DOI: 10.5958/2349-2996.2017.00006.4