INTRODUCTION:

“To an adolescent, there is nothing in the world more embarrassing than a parents.” “Dave Barry”

Adolescence belongs to important age group not only because of inhabitant’s population to parenthood but also some portal between childhood and adulthood. A research is always attempted by the adolescent to cross this portal with the various physiological, psychological, and developmental changes.

The word “adolescent” is derived from the Latin word “adolescere” which means to grow to maturity that indicates to define features of adolescent. Menstruation is the first sign of puberty. During puberty, the physical changes in body size and proportion occur which modify the body of child into an adult. Menses is still regarded as something impure or dirty in Indian society. The reaction to menstrual period depends on awareness and mastery about the menstruation. The way a girl learns about menstruation and associated changes may have a consequence to the event of menarche¹

Adolescent throughout the world are more. So developing countries are at a greater risk of reproductive health adverse consequences. The world experience the largest adolescent population in the history. As the result shows adolescent reproductive health is an increasingly important component of global health. According to the survey conducted b Federation of OBG Society the age of attaining sexual maturity among urban girls dropped from 11-13 years. So far as we accepted the global average more than 50%of girls in cities are reaching puberty in the age of 11years². Menstruation refers to the monthly discharge of blood and other substances from the uterus (through the vagina) in non-pregnant adult female. Although every adolescent has an individual cycle of menstruation, which varies in length, the average cycle is taken to be 28 days long and recurs from puberty to menopause except when pregnancy intervenes. The endometrium is shed and degenerate 400 times in the life of an adolescent. The menstrual cycles occurs in four phases and affect the tissues structure of endometrium in response to the production of progesterone and oestrogen. The first day of the cycle is the day on which menstruation begins.³

During the residue of the menstrual cycle the uterine lining regrows to prepare for pregnancy. If the fertilisation does not occur the menstrual cycle continues and the uterine lining is shed to start next menstrual period. A woman begins menstruation at an average age of 13 and on average continues menstruating till the age of 51 years. Menstruation involves highly complex hormonal interchanges. Up to 80% of adolescents report some symptoms prior to menstruation that interfere with normal routine life. Premenstrual symptoms (PMS) are a composite of physical, psychological, emotional and mood disturbances that occurs after an ovulation and typically with the beginning of menstrual flow.⁴

Nearly 50 to 60% of adolescents occurrence of physical symptoms such as tiredness, bloating, breast tenderness, acne and appetite changes with food cravings an approximate 3 of every 4-Menstruating adolescent girls may observe same form of premenstrual symptoms and 20 to 30% of mood related symptoms such as irritability, sadness, crying, hypersensitivity and mood swings with alternating sadness and anger. These problems tend to peak in late 20 years and early 30 years. A serious form of premenstrual syndrome dysphonic disorder (PMDD), also known as late secretory phase dysphonic disorders.⁵

Premenstrual symptoms prevalence from 5-20% from moderate to severe clinically applicable premenstrual complaints and up to 75% of all women of fertile age may experience symptoms of premenstrual syndrome. Exact cause of premenstrual syndrome is unknown, but several factors may given to the conditions. Premenstrual symptoms changes with hormonal variations and will vanish with pregnancy and menopause.⁶

Experimental studies suggest that up to 40% of adolescent girls with premenstrual symptoms had depression and some adolescent girls with intense premenstrual symptoms had undiagnosed depression though depression alone does not cause all the symptoms. Poor eating habits connected to low level of vitamin A, vitamin E, minerals and eating salty foods. Fluid retention, drinking alcohol and caffeinated beverage might cause mood and energy level disturbances.⁷

The treatment of premenstrual symptoms can occasionally be challenging as making the diagnosis of premenstrual symptoms. Several treatment approaches have been used to treat premenstrual symptoms.⁸ There is no cure for premenstrual symptoms but eating a healthy diet, exercising regularly and taking medicine may help. General management include a healthy lifestyle, avoid salt before menstrual period, aerobic exercise, reduce sugars, increase of fibre intake, adequate rest and sleep.⁹Adolescent girls using a clean menstrual management material to soak up or accumulate menstrual blood. Using soap and water for washing the body as need and having access to safe and appropriate facilities to throw away used menstrual management materials¹⁰

Inadequate Management of sanitary protection lead not only to health problems. But it also leads to adolescent girls dropping out of school thus negatively impacting on education. Aggravating concern brought to force that press the need for water and sanitation enough to menstruating girls to maintain sanitarians.¹¹

A majority difficulty are faced by the teachers in school is to teach knoweledge regarding the entire process of menstruation and its management, but teachers doesn’t have proper knowledge and training about menstruation to maintain girls with disabilities. The problems of menstruations are most susceptible and risk for various type of sexual harassment, attacks and also shame among the girls.¹²

One of the most management tips during menstruation is to wash private parts after every 3 to 4 hours. This will help in keeping the germs away. Cloths or utilise a sanitary napkin for longer than 4 hours can act as an ideal environment for growth and multiplication of harmful germs and yeast. The health problem can be keep away by utilise sun dried and clean sanitary or hygienic napkin for periods and wash external genitalia with clean water and light soap.¹³

In recent generation there has been lot of shame around girls while first experience of bleeding and these reactions are being passed down. The lack of adequate information and support can created anxiety and isolatons among girls. Menarche is the first significant passage of girls in their womenhood. The experiences that girls have time and reaction of their mothers and adult women lives long term impact.

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of structure teaching program regarding knowledge on premenstrual syndrome and it's management among the adolescent girls of selected high school, Mangaluru.

OBJECTIVES:

· To assess the pre-test knowledge on premenstrual symptoms and its management among the adolescent girls.

· To develop a structured teaching programme on premenstrual symptoms and its management among the adolescent girls.

· To evaluate the effectiveness of structured teaching programme regarding the knowledge on premenstrual symptoms and its management among the adolescent girls.

· To find out the association between the pre-test knowledge level of management of premenstrual symptoms in selected demographic variables like age, type of family, educational study,Religious, source of information.

RESEARCH HYPOTHESIS:

H1: The mean post test score will be significantly higher than the mean pre-test knowledge score regarding premenstrual symptoms and its management among adolescent girls.

H2: There will be a significant association between the pre-test knowledge score on premenstrual symptoms and its management with selected demographic variables like age, religion, education, income, type of family, previous source of information.

MATERIALS AND METHODS:

Research approach:

The researcher utilized Pre experimental approach.

Research design:

Pre experimental one group pre-test post-test design.

Research setting:

The setting for the study was Kauvempu government high school, Mangaluru.

Sample:

The sample would comprise of 30 Adolescent girls in the age group of above 10-20years at selected government high school, Mangaluru.

Sampling technique:

The samples were selected by using Simple random sampling technique (Lottery Method)

Description of the final tools:

The tool used in the study consists of 2 parts

Part 1: Demographic variables

Part 2: Assessment of knowledge on administration of premenstrual symptom and its mangement.

· Knowledge on menstruation

· Knowledge on premenstrual symptoms

· Knowledge on mangememt of premenstrual symptoms

Plan for data analysis:

· The Data collected used to be analyzed on the foundation of targets and hypothesis. Data analysis is the systemic business enterprise and synthesis of lookup facts and trying out of the research hypothesis the usage of gathered data.

· Demographic facts and information were analyzed the use of descriptive statistics; number, percentage, mean, median, well known deviation.

· The effectiveness of structured teaching software used to be analyzed “t” test.

· The affiliation of pre-test knowledge score with selected demographic variables was assessed by way of chi rectangular test.

RESULTS:

Section A. Demografic Proforma of adolescent girls.

Table 1: Frequency and percentage distribution of the subjects according to selected demographic variables N=30

SL. NO

Demographic variable

Frequency

(f)

Percentage

(%)

Age (in years)

a. 10-13years

b. 14-16

c. 17-20

d.above 20

20%

50.0%

30%

Educationa

a. Primary school

b. High school

c. Pre-university

d. College

20%

50%

20%

10%

Religion

a. Hindu

b. Islam

c. Christian

d. Any other

50%

33.%

17%

Family type

a. Nuclear

b. Joint

c. Extended

73%

27%

Age of Menarche

a. Below 13years

b. 13-16 ears

c. Above 17 Years

30%

60%

10%

Previous source of information

a.Health care professionals

b.Teachers

c.Friends/family members

d.Mass media

10%

70%

10%

In the present study, a total of 30 Adolescent girls participated. 15(50%) respondents belong to the age group of 14- 16 years. 15(50%) were girls. Majority 22(73%) respondents were Hindu. Majority belongs to nuclear family. Highest percentage 15(50%) respondents had only high school educational girls. Majority 18(60%) girls attended menarche at the age of 13-16years. Majority 70% respondents that they had previous knowledge regarding management of menustral symptoms from the family members and friends.

SECTION: B ITEMS WISE PRE-TEST AND POST-TEST KNOWLEDGE LEVEL AMONG ADOLESCENT GIRLS REGARDING PREMENSTRUAL SYMPTOMS AND ITS MANAGEMENT.

Table 2.1: Items wise knowledge of adolescent girls in pre-test and post-test on menstruation.

ITEM NO	ITEMS	PRE-TEST		POST-TEST
ITEM NO	ITEMS	N	%	N	%
1	Meaning of menstruation	18	60	24	80
2	Common age group of puberty	12	40	21	70
3	Colour of menstrual flow	20	67	26	86
4	Duration of menstrual flow	19	63	25	83
5	Normal flow of menstruation	6	20	17	56
6	Precautions during menstruation	8	27	19	63

Above the 2.1 table revealed that the item wise pre-test knowledge score, 18(60%) of them were knew the meaning of menstruation, 12(40%) Adolescent girls are the common age group of puberty, 20(%) of them knew the colour of menstrual flow, 6(20%) were knew about the normal flow of the menstruation, 8(27%) were aware about the precautions during menstruation.

During the post-test the improvement of knowledge was found 24(80%) adolescent were aware about the meaning of menstruation, 21(70%) are the common age group of puberty, 26(86%) adolescent girls were aware the colour of menstrual flow, 25(83%) also knew about the duration of menstrual flow, 17(56%) had knowledge about the normal flow of menstruation and 19(63%) adolescent girls are aware about the precautions during the menstruation.

The table 2.2 reveals the item wise pre-test and post-test knowledge scores of each items, only 4(14%) were aware about the premenstrual symptoms, 6(20%) were aware about the causes of premenstrual symptoms, 8(27%) were aware about the cyclic changes, 10(33%) were aware about the psychological symptoms, 4(13%) were aware about the physiological symptoms and only 5(17%) were knew about the menstrual cycle.

Table2.2: Items wise knowledge of adolescent girls in pre-test and post-test on premenstrual symptoms.

ITEM NO	ITEMS	PRE-TEST		POST-TEST
ITEM NO	ITEMS	N	%	N	%
1	Premenstrual symptoms	4	13	15	50
2	Causes of premenstrual symptoms	6	20	20	67
3	Cyclic changes	8	27	16	53
4	Psychological symptoms	10	33	22	73
5	Physiological symptoms	4	13	13	43
6	Menstrual cycle	5	17	15	50

During the post-test most of them had improved knowledge 15(50%) about the premenstrual symptoms, 20(67%) were aware about the causes of the premenstrual symptoms, 16(53%) were aware about the cyclic changes, 22(73%) were aware about the psychological symptoms, 13(43%) were aware about the physiological symptoms, 15(50%) were aware about the menstrual cycle.

Table2.3: Items wise knowledge adolescent girls in pre-test and post-test on management of premenstrual symptoms.

ITEM NO	ITEMS	PRE-TEST		POST-TEST
ITEM NO	ITEMS	N	%	N	%
1	Home remedies	6	20	19	63
2	Medications	3	10	11	37
3	Food items suggested	8	27	19	63
4	Food items avoided	9	30	19	63
5	Preventive measures	7	23	15	50

The table 2.3 reveals the item wise pre-test and post-test knowledge scores of each items, 6(20%) were knew about the home remedies, 3(10%) were knew about the medications, 8(27%) were aware about the food items suggested, 9(30%) were aware about the food item avoided, 7(23%) were knew about the preventive measures of premenstrual symptoms.

During the post-test most of them were understand 19(63%) about the home remedies, 11(37%) were knew about the medications, 19(63%) were aware about the food items suggested, 19(63%) were aware about the food item to be avoided, 15(50%) were knew about the preventive measures of premenstrual symptoms.

SECTION C: EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON PREMENSTRUAL SYMPTOMS AND ITS MANAGEMENT AMONG ADOLESCENT GIRLS.

Mean percentage pre-test and post-test knowledge scores of adolescent girls.

Sl.

No.

Variables

Mean

Mean Percentage

Standard Deviation

Mean Difference

t-Value

Pre-test

2.62

Post-test

Mean percentage pre-test and post-test knowledge scores of Adolescent girls:

Above figure depicts the knowledge scores that the mean percentage post-test knowledge 19 was higher than pre-test mean of 8 and the SD of pre-test was±27 and of post-test was±63 pre-test knowledge scores. The calculated‘t’=22, is greater than table value at 0.05 level of significance. Therefore, the structured teaching programme on management of premenstrual symptoms among adolescent girls was effectively improved the knowledge.

Testing of hypothesis:

In order to evaluate the effectiveness of structured teaching program on knowledge regarding management of premenstrual symptoms, the following research hypothesis was formulated.

HYPOTHESIS 1:

H1: The mean post-test knowledge score will be significantly higher than the mean pre-test knowledge score of adolescent girls.

The above table represents the knowledge mean pre-test and post-test knowledge scores. Paired‘t’ value was found to be significant at p<0.05 level of significance. Hence, the research hypothesis H1 was accepted. It has been evident that the structured teaching programme was significantly effective in improving knowledge regarding management of premenstrual symptoms among adolescent girls.

DISCUSSION:

The purpose of the study was to evaluate the effectiveness of structured teaching programme on Management of premenstrual symptoms and its management among adolescent girls at Kuvempu highschool. adolescent met inclusion criteria were selected using simple random sampling technique convenient sampling and data were collected before administrating the structured teaching programme using structured knowledge questionnaire. Then the structured teaching programme was administered and later after 7 days the knowledge were assessed by using the same tool. This chapter presents the discussion of the study finding with reference to the objectives and hypothesis.

CONCLUSIONS:

It is concluded that majority of the Adolesecnt girls had knowledge regarding menstrual Symptoms and its management. In the pre-test it showed that 83% had inadequate knowledge and 17% had moderate scores. In the post test, that distribution adolescent girls according to the knowledge showed that 93% had moderate knowledge and 7% had adequate scores. Through a structured teaching programme which helped adolescent girls to gain knowledge about management of premenstrual Symptoms. The study findings may help others to formulate suggestions to prevent the problems selected to premenstrual symptoms. Premenstrual symptoms measures to be adopted for healthy lifestyle and homemade management. Proper training should be provided to adolescent girls through school health sciences by the nurse and teachers on management of premenstrual symptoms to empower girls to be a successful citizen in their way of life.

LIMITATIONS OF THE STUDY:

· The study was only limited to 30 samples, only one government high school, so the findings cannot be generalised.

· The study did not assess the attitude of adolesecnt girls regarding the management of menustral symptoms.

RECOMMENDATIONS:

On the basis of the findings of the study following recommendations have been made:

· A Descriptive study to assess the attitude of Adolescent girls regarding management of premenstrual symptoms.

· A Cross sectional study can be conducted with large sample.

· A Comparative study conducted with rural and urban community.

· An Interventional study to assess knowledge of adolescent girls regarding management of premenstrual symptoms.

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Received on 17.04.2024 Modified on 03.06.2024

Asian J. Nursing Education and Research. 2024;14(3):188-192.

DOI: 10.52711/2349-2996.2024.00037