A Study to assess the Effectiveness of Planned Teaching regarding Reproductive Health among adolescent girls in Pune City

 

Mrs Supriya Sushant Chakre

Clinical Instructor, Sadhu Vaswani College of Nursing, Pune.

 

ABSTRACT:

Good reproductive health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system. Human beings are beings, it means human beings are capable to reproduce, and able to maintain reproductive health. Adolescence represents acceleration in terms of biological, psychosocial and  sexual development. The reproductive health and sexual needs of an adolescent are not so openly discussed in Indian scenario due to cultural and traditional norms in society. Inadequate information about sexuality and reproductive health has the potential to create misunderstanding in the youth, due to which they cannot adopt healthy practices and attitudes towards sex and reproductive health.  Adolescents period is nurtured by awakening endocrine forces and a new set of psychosocial tasks.   Due to the long-standing tradition in which girls are married very early, especially in rural areas, gives rise to many pregnancy-related problems and unsafe abortions leading to death among women aged 15-19 yrs. The risk of maternal mortality among adolescent mothers stands twice as high that of mothers aged 25–39 years. Adolescents must know the varies changes physiological and psychological changes which takes place. During this period, the body starts to develop and grow into physical maturity. This is the time when the body will start developing all the secondary sexual characteristics. The physiological changes during puberty differs in boys and girls. Adolescent girls should be aware about the reproductive health, scientific reasons and hygienic health practices.  Menstruation is a major part of life for millions of young girls and women worldwide. On an average, a woman will menstruate for 3,000 days during her lifetime. According to Eric Erickson, before the adolescent can successfully abandoned the security of childhood, and dependence on others, he must have some idea about himself. An adolescent boy not only needs information but also an adult to guide him when he has his first seminal emission when he has fantasies and to relieve his doubts about masturbation in case of boys. Similarly adolescent girl’s needs information and an adult to guide her when she gets her first menstruation, and to deal with the body changes. youngsters should be comfortable with their own sexuality and have an understanding of their bodies to develop self-confidence and self-esteem. Education about physiological changes during puberty, family planning, conception, and contraception could give the young women an opportunity to make her own informed decisions. Education regarding reproductive health can help to overcome the culture of ignorance, hesitation, shame and fear associated with the community. Objectives of the study – 1. To assess the knowledge of adolescent girls regarding reproductive health before planned teaching 2. To assess the effectiveness of planned teaching of adolescent girls on reproductive health 3. To find out significant association between the knowledge score with selected demographic variables. Method- A Quasi experimental pretest posttest design which included Adolescent girls in the age group of 13 yrs to 15 yrs. Non probability purposive sampling technique was used to select 60 adolescent girls from St Mira’s Secondary School, Pune city. Result – Descriptive inferential statistical method was used to analyse the data. Paired “t” tests was applied to determine the effect of planned teaching on pretest and posttest knowledge score and compared. Majority of the samples 72.86% had a family income of Rs. 9000/- month, 60.00% had a income of 5001-7000/-Month ,70.33%had an income of 7001-9000/- month and 67.52 had a income more than 3000/-5000-month. Mean knowledge score of adolescent girls regarding reproductive health in pretest was 15.16 and in the post test it became 20.43. The paired ‘t’ value was also computed to find out the effect of planned teaching on knowledge of adolescent girls at the degree of freedom (df59). The calculated value was (11.98) which was greater than table value of 't' (2.00) at 0.05 level of significance. Conclusion - Thus from the above statistical data the researcher found that the planned teaching was highly effective in enhancing the knowledge of girls regarding reproductive health.

 

 

 

 

INTRODUCTION:

Need for the study

According to WHO, adolescent is the age group between 11 yrs to 18 yrs. This is a period of rapid growth for adolescent with development of primary and secondary sexual characteristics along with maturation of reproductive functioning.¹ Sexuality has a deep and significant value throughout the human cycle no matter what the age, gender, sexual disposition, economic status, state of health, nationality, religion. Men and women need to be educated in order to develop responsible sexual behavior.¹ Our society is having closed system and has double standard of questions on sexuality. This can be confusing to adolescent as they get information about sex from sources such as friends, relatives, etc. This information may be incorrect and would have a damaging effect. young people and adults experience a great deal of anxiety emerging out of a lack of knowledge on sexuality and from various myths and misconception regarding sexuality.¹ Experimentation is common at this stage of development; peer encourages adolescents to have sex. Sex related behavior can also take extreme forms. Sexual urges may result in masturbation, viewing of pornographic materials, magazines, blue films or visiting commercial sex workers.¹

 

In May 2017, WHO published a major report: “Global Accelerated action for the health of adolescents” guidance to support country implementation The AA-HA has drawn on inputs received during extensive consultations with member of States, United Nations agencies, adolescents and young people, civil society and other parterns.It aims to assist government in deciding what they plan to do it as they respond to the health needs of adolescents in their countries. This reference document targets national–level policy–makers and programme managers to assist them in planning, implementing, monitoring and evaluation of adplescents health programmes. As per the survey conducted by WHO, More than 2 million adolescents are living with HIV Although the overall number of HIV related deaths is 30%.¹¹

 

In the year 2002 the Central Board of Secondary Education (CBSE) had asked the schools to incorporate the subject of sex education in schools across the country, but sex education as a subject is yet to be accepted as a normal part of the school curriculum.  The main debate for the subject had canters arround the question about the benefits of teaching children about contraceprion. Yet research had shown that comprehensive sex education programme, which teach the children about the benefits of both abstinance and contraception, had been quite effective in making the young adults take better decisions.¹²

 

Statement of the problem:

“A study to assess the effectiveness of planned teaching regarding reproductive health among adolescent girls in Pune city"

 

OBJECTIVES OF THE STUDY:

·      To assess the knowledge of adolescent girls regarding reproductive health before planned teaching

·      To assess the effectiveness of knowledge of adolescent girls regarding reproductive health after planned teaching

·      To find out significant association between the knowledge score with selected demographic variables like family income, type of family, and class.

 

Operational definitions:

Assess:

In this study assess means gathering information foe evaluation of knowledge regarding sexual health.

 

Effect:

In this study effect means to check the change in score between pre and post test whether positive or neutral.

 

Planned teaching:

Planned teaching means giving group systematic information or a planned formulated and detailed method, which imparts knowledge.

 

Adolescents:

t begins with start of puberty which in girls usually at the age of above 12 yrs and in boys the age is above 14 yrs. In this study the adolescents group selected is 13-15 yrs of adolescent girls.

 

Sex:

The characteristics that differentiate males and females in most plants and animals

 

Reproductive health:

A capacity to enjoy and control sexual behavior in accordance with a social and personal ethic. Reproductive health addresses the reproductive process, functions and systems at all stages of life.

 

Assumptions

·        The adolescent group have limited or inadequate knowledge regarding reproductive health and changes in puberty.

·        Planned teaching is useful strategy for learning and to enhance knowledge regarding sexual health.

 

Hypothesis:

H1a - There will be significant association between pretest knowledge score with the selected demographic variables, at 0.05 level of significance.

 

H1b - There will be no significant difference in knowledge score before and after planned teaching.

 

MATERIALS AND METHOD:

Research approach:

Quantitative approach was adopted for this study

 

Research design:

Quasi experimental pretest posttest group design was used.

 

Setting:

The study was conducted in St Mira’s, secondary school, Pune city.

 

Population:

The population for the present study was adolescent girls in Secondary School.

 

Sample:

Adolescent girls in the age group of 13 yrs to 15 yrs were selected in the study.

 

Sample size:

The sampling size selected for present study consists of 60 adolescents girls in secondary school of Pune.

 

Sampling technique:

Non probability purposive sampling technique was used to select the samples in the study

 

Criteria for sample selection:

Inclusive criteria

·      Adolescent girls in the age group of 13 yrs to 15 yrs.

·      Adolescents who can understand English.

 

Exclusive criteria:

Adolescent girls who had undergone and attended training programme on reproductive health.

 

Description of the tool:

The structured questionnaire include 2 parts

A - It consist of items on demographic variables such as age, sex, education, family, income, etc

 

B- It consists of structured questionnaire on reproductive health:

·      Definition

·      Anatomy and physiology

·      changes during puberty

·      Menstrual cycle and menstrual hygiene

·      Abnormal sexual behavior practices

 

There were 30 numbers of questions in total scoring 30 marks carrying 1 mark each.

 

Validity of the tool:

The content validity of the tool was obtained from research experts.

 

Reliability of the tool:

The reliability of the tool is computed by using split half technique, reliability co-efficient found to be r = 0.7

 

Process of data collection:

·      Official permission was taken for data collection

·      The researcher introduced herself to the adolescent girls in St Mira's secondary school and developed a good rapport.

·      Informed consent was taken from the selected samples

·      After collecting the data on demographic variables pretest was conducted.

·      Planned teaching was given to the group and posttest was conducted on the 5^{t h} day by using the same tool.

·      Based on the collected data effectiveness was found by comparing the pretest and post test scores.

 

Analysis and interpretation of data:

The’t’ tests was applied to determine the significance of mean difference between pretest and posttest knowledge score and compared.

 

Presentation of data:

Section A - Deals with analysis of data to compare the pretest and posttest mean knowledge scores of the samples regarding reproductive health

 

Table 1: Description  of pretest and posttest mean knowledge score

Sr no	Test	Mean knowledge score	SD	SD Difference	t	P value 0.05
1	Pretest	15.16	1.95	0.64	11.98	2.00
2	Posttest	20.43	2.6

 

 

Fig 1:-Bar diagram showing pretest and posttest mean knowledge score regarding reproductive health

 

 

 

 

Section B –

Deals with the relationship of selected demographic variables (type of family, family income,) with knowledge about reproductive health.

 

 

Fig 2:-Bar diagram showing relationship between knowledge score and family income

Table 2:- Description of  selected demographic variable (family income ) with knowledge score

Sr no	Family income	N	Total score	Pretest score	Pretest %	Posttest score	Posttest %
1	3000-5000	7	210	90	42.86	153	67.52
2	5001-7000	4	120	44	36.67	72	60
3	7001-9000	10	300	159	53	211	70.33
4	More than 9000	39	1170	617	52.74	790	72.86

 

Table 3:- Description of  selected demographic variable (Type of family) with knowledge score

Sr no	Type of Family	N	Total score	Pretest score	Pretest %	Posttest score	Posttest %
1	Nuclear family	42	1260	647	51.35	868	70.57
2	Joint family	18	540	263	48.7	358	66.30

 

 

Fig 3:-Bar diagram showing relationship between knowledge score and type of family

 

Results and major findings of the study:

Majority of the samples 72.86% had a family income of Rs. 9000/- month,60.00% had a income of 5001-7000/-Month ,70.33%had an income of 7001-9000/- month and 67.52 had a income more than 3000/-5000-month. Mean knowledge score of adolescent girls regarding reproductive health in pretest was 15.16 and in the post test it became 20.43. After the planned teaching the’t’ value was also computed to find out the effect of planned teaching on knowledge of adolescent girls at the degree of freedom (df59). The calculated value of 't' (11.98) is greater than value of (2.00) at 0.05 level of significance. Thus from the above statistical data, the researcher found  that  the planned teaching was highly effective in enhancing the knowledge of adolescent girls regarding reproductive health.

 

RECOMMENDATIONS:

Based on the study findings

·      The same study can be replicated on a larger population.

·      Similar kind of studies can be undertaken in different settings and different population such as junior college students

·      A comparative study can be carried to ascertain the knowledge regarding reproductive health among adolescent girls and boys.

·      Teaching programme may be designed for health workers and multipurpose health workers.

 

 

CONCLUSION:

The study was undertaken to assess the knowledge of adolescent girls regarding reproductive health of St Mira's secondary school with a view of information guide sheet. Health among adolescent girls was effective in increasing the knowledge score. The research design  for the study was quasi experimental in which Quantitative approach was adopted for this study. There was Adolescent girls in the age group of 13 yrs to 15 yrs. The sampling size selected for present study consists of 60 adolescents girls in secondary school of Pune. Non probability convenient purposive sampling technique was used to select the samples. The group was interviewed by using the structured questionnaire  Descriptive and inferential statistics were used for the analysis of the findings which indicates that the planned teaching on reproductive health was highly effective.

 

ACKNOWLEDGEMENT:

Author is grateful to the research guide and would like to express a heartful of thanks with a deep sense of gratitude to Mrs Manisha Kadam Professor Sadhu Vaswani College of nursing for her constructive suggestions and guidance.

 

REFERENCES:

1.     Dhum Panthaki,” Education in human sexuality”, family planning association of India publication, second edition pages no .38-45.

2.     Oxford medical dictionary, D.K publication, Indian edition, page no151, 256,766.

3.     BT Basvanthappa, “Textbook of nursing research",jaypee publication ,second edition, page no:-92,103,164-240.

3      Dr Bimla kapoor,"psychitric nursing ", vol II Kumar publications, first edition, page no.-178-182.

4      Wanda K Mohr," Psychiatric mental health nursing"Wolters Kluwer publications, fourth edition, page no .846-847.

5      Mahajan B.K "Methods in Biostatistics ", Jaypee publication, sixth edition, 33-50.

6      D C Dutta "Textbook of Obstetrics", New central book agency publication, sixth edition, 2004, page no :-1-15,17-23.

7      Sembulingam, K,"Essentials of medical physiology", Jaypee publication, fifth edition, page no .462-470.

8      Sujata Sethi, “Textbook of Psychiatry, Elsevier publication, first edition. Page no.128-132.

9      Niraj Ahuja "A short textbook of Psychiatry", Jaypee publication, sixth edition, page no: 122-130

10    URL : http://.who .int/mediacentre/factsheets/fs345/en

11    URL:http://www.medindia.net/patients/patientinfo/sexesucation.htm updated on Dec 09-2016

 

 

Received on 03.02.2018       Modified on 08.04.2018

Accepted on 20.05.2018      ©A&V Publications All right reserved