An Experimental Study to Assess the Effectiveness of Planned Teaching Program on Knowledge regarding Reproductive Tract Infections (RTI) among Adolescent Girls in selected Schools of Jind, Haryana

 

Reena¹, Sathish Rajamani²

¹Tutor, Govt Nursing Institute, Safidon, Haryana.

²Professor, Ved Nursing College, Panipat, Haryana.

 

ABSTRACT:

Reproductive tract infections are endemic in developing countries and entail a heavy toll on adolescent girls. If untreated, reproductive tract infections can lead to adverse health outcomes such as infertility, ectopic pregnancy and increased vulnerability to transmission of HIV. This study was conducted to assess the existing level of knowledge regarding RTI among adolescent girls and to assess effectiveness of planned teaching program on knowledge. True experimental (pre-test- post-test control group) design was used for the study. A total of 100 samples (50 samples in experimental group and 50 samples in control group) were selected by using simple random sampling from two selected private schools of Jind, Haryana. Semi structured knowledge questionnaire was used for data collection. Descriptive statistics (Frequency distribution, Standard deviation mean, mean difference) and inferential statistics (unpaired ’t’ test, Chi-square test) were used for data analysis. The study findings revealed that the mean post-test knowledge sores (36.88) of experimental group was higher than the mean post-test knowledge score (31.16) of control group. The planned teaching program was effective for improving knowledge of adolescent girls [‘t’ value 6.187 at, P<0.05]. In experimental group, there was a significant association of age, educational status, income of the family per month and source of information regarding reproductive tract infections with pretest level of knowledge. whereas in control group, there was no association of selected demographic variables with pretest level of knowledge. Hence planned teaching program is very effective to improve knowledge.

 

 

INTRODUCTION:

Among women the issue of reproductive tract infections gets much severe attention an estimated 340 million new cases of RTIs, including sexually transmitted infections (STI), emerge every year, with 151 million of them occurring in Asia (World Health Organization, 2001).¹

 

In addition, the presence of an RTI is often associated with an increased risk for acquiring and transmitting HIV in many different populations.² Among adolescent girls in developing countries like India, the universal public health problem is reproductive tract infections RTIs which occupy the second position in public health problems.³

 

According to WHO estimates in 2008, globally 499 million new cases of RTIs occur annually among women in the reproductive age group^.4 In India, one among four women in the reproductive age group has any one type of RTIs and the annual incidence of RTI estimated is about 5%. Consequently, the prevalence rate of RTIs in various states of India was 19% to 71%.⁵

 

A study suggests that about 40 million cases of RTIs occur in India every year. National Family Health Survey (NFHS-3) reported that 11% women and 5% men in the 15-49 years age group had STI/RTIs related symptom in the past year.⁶ RTIs lead to several complications in adolescent girls such as tubal blockade, pelvic inflammatory diseases, chronic pain syndromes, sexual dysfunction and many others. They cause significant morbidity among males as well including strictures, sexual dysfunction, genital ulcers, and kidney and bladder problems.⁷

 

Most youngsters lack access to age- and sex-appropriate health info, skills, and services. What is more, discussion on generative and sexual health matters inside and between generations is shaded by varied cultural taboos. The content and myths close these problems makes adolescents liable to the implications of inappropriate sexual behaviours like early physiological condition resulting in early adulthood or abortion and sexually transmitted diseases (STDs). As long as these issues square measure allowed to persist, a lot of the energy, creativity, and idealism of youth are lost. However, age- and sex-appropriate education will assist youngsters to form educated selections concerning their generative sexual health.

 

On the basis of the importance of developing healthy adolescent girls to the modern India the current study had been taken with the aim of this study was to evaluate the effectiveness of planned teaching programme on knowledge regarding RTIs among adolescent girls of selected schools of Jind. Haryana.

 

OBJECTIVES OF THE STUDY:

1.     To assess pre-test and post-test level of knowledge regarding reproductive tract infections among adolescent girls in experimental group and control group.

2.     To assess the effectiveness of planned teaching program on level of knowledge regarding reproductive tract infections among adolescent girls in experimental group.

3.     To compare the effectiveness of planned teaching program on level of knowledge regarding reproductive tract infections among adolescent girls in experimental and control group.

 

HYPOTHESES:

H₁:   The mean posttest knowledge score on reproductive tract infection will be significantly higher than the mean pretest knowledge score in experimental group.

H₂:  There will be a significant difference between mean posttest knowledge score in experimental group and control group.

 

OPERATIONAL DEFINITIONS:

·       Knowledge:

Knowledge refers to response of adolescent girls regarding reproductive tract infections and it is measured by a knowledge questionnaire.

 

·       Planned Teaching Program:

Health education provided to the adolescent girls by using systematically developed instructions, with the use of charts, black board, power point presentation, to improve knowledge regarding RTI.

 

·       Adolescent Girls:

School going girls in the age group of 13-18 years.

 

·       Reproductive Tract Infections:

Reproductive tract infections (RTIs) are the infections of genital tract caused by organisms normally present in the reproductive tract, or introduced during sexual contact or medical procedures or due to poor reproductive health.

 

Conceptual Framework:

 

Figure 1: Modified conceptual frame work on Planned Teaching Programme on knowledge regarding Reproductive tract infections. Based on WHO SEARO “System Model” (1983)

 

METHODOLOGY:

Research Approach: Quantitative and Evaluative Approach

 

Research Design: True Experimental (Pre-Test and Post-Test Control Group) Research Design

Variables: Independent Variable – Planned Teaching Programme

 

Dependent Variable – Knowledge regarding RTIs

 

Settings of the Study: Two selected private schools in Jind, Haryana.

 

Population: Adolescent girls:

Samples: Adolescent girls aged 13-18 years in selected private schools in Jind

 

Sampling Technique: Simple random sampling technique with lottery method

 

Sample Size: Total 100 girls were selected randomly for the study. 50 were kept in control group and 50 in experimental group

 

Tool: Self Structured Knowledge Questionnaire on RTIs

 

Data Collection Procedure: Self reporting questionnaire method

 

Data Analysis: Descriptive and Inferential statistics

 

Data Analysis and Interpretation:

 

Table I: Frequency and Percentage Distribution of Subjects According to Experimental Control Group          (N = 100)

S. No.	Variables	Experimental Group		Control Group
		F	%	F	%
1	Age:
	a. 13- 14 years	29	58	21	42
	b. 14-15 years	18	36	14	28
	c. 15-16 years	2	4	14	28
	d. 16-17 years	1	2	1	2
	e. 17-18 years	0	0	0	0
2	Educational Status:
	a. 6th-7 th class	21	42	12	24
	b. 8 th-9 th class	29	58	19	38
	c. 10 th-11 th class	0	0	18	36
	d. 12 th class	0	0	1	2
3	Religion
	a. Hindu	50	100	31	62
	b. Muslim	0	0	3	6
	c. Christian	0	0	6	12
	d. Others	0	0	10	20
4	Educational status of the mother:
	a. Illiterate	10	20	12	24
	b. Primary	5	10	3	6
	c. Secondary	20	40	13	26
	d. Higher secondary	10	20	19	38
	e. Graduation	5	10	2	4
	f. Post-graduation	0	0	1	2
5	Residence:
	a. Rural	24	48	21	42
	b. Urban	26	52	29	58
6	Income of the Family per month, in rupees:
	a. Below 20000/-
	b. 20001-30000	24	48	25	50
	c. 30001-40000/-	8	16	16	32
	d. Above 40001/-	11	22	6	12
		7	14	3	6
7	Source of information regarding reproductive tract infection:
	a. Family and friends
	b. Television and radio	32	64	18	36
	c. Magazines and newspapers	7	14	12	24
	d. Health team members	11	22	11	22
		0	0	9	18

 

Table I depicts the frequency and percentage distribution of subjects according to selected sociodemographic variables in experimental and control group.

 

 

Figure 2: Percentage Distribution of Level of Knowledge Among Subjects in Experimental Group

 

From figure 2 we interpret the subject’s level of knowledge during pre-test and post -test in experimental group. During pre – test 58 % of the subjects were with good level of knowledge, others 42 % were with average level of knowledge. None of them were with poor level of knowledge. With regard to the post – test level of knowledge an overwhelming majority of the subjects 96 % had good knowledge and few subjects 4 % were with poor knowledge.

 

 

Figure 3: Percentage Distribution of Level of Knowledge Among Subjects in Control Group

 

Table II: Mean, mean difference, standard deviation and Paired ‘t’ value of samples in experimental group    (N – 50)

*- Significant at ‘P’ value < than 0.05

 

Figure – 3 depicts the percentage distribution of subject’s knowledge during pre and post - test in control group. In pre – test majority of the subjects 60 % were with good knowledge and 40 % were with average level of knowledge. In case of post – test majority of the subjects 82 % were with good knowledge and those who were with average knowledge were 18 %.

 

Table – II: depicts mean, mean difference, standard deviation and ‘t’ value of samples in experimental group.

Pre-test mean score of experimental groups and mean post- test score of experimental groups were 26.88 and 36.88 respectively. The mean difference was 10, the standard deviation was 5.005 and 4.369 respectively in Experimental group and paired ‘t’- value was 16.093 which was statistically significant at ‘P’ value 0.000 It shows that after planned teaching programme knowledge was improved.

 

Table – III: depicts mean, mean difference, standard deviation and ‘t’ value of samples in control group.

Pre-test mean score of control group and mean post- test score of control group were 27.62 and 31.16 respectively. The mean difference was 3.54, the standard deviation was 4.873 and 4.863 respectively in control group and paired ‘t’- value was 4.242 which was also statistically significant at ‘P’ value 0.002.

 

Table – IV shows the Post – Test Mean, Mean Difference, Standard Deviation and Independent ‘t’ test

 

Post- test mean score of experimental groups and mean post- test score of control group were 36.88 and 31.16 respectively. The mean difference was 5.72, the standard deviation was 4.369 and 4.863 respectively in Experimental and Control Group and unpaired ‘t’- value was 6.187 which shows statistically significant at ‘P’ value, then 0.005. it shows that intervention was effective for experimental group, in improving knowledge.

 

Table III: Mean, mean difference, standard deviation and Paired ‘t’ value of samples in control group (n – 50)

*- Significant at ‘P’ value < than 0.05

 

 

Table IV: Mean post test score, mean difference, standard deviation and Independent t’ test score in experimental group and control group. (N = 100)

Group	Mean Post-Test	Mean Difference	Standard Deviation	Independent ‘t’ test value	Degree of freedom	‘P’ Value
Experimental Group	36.88	5.72	4.369	6.187*	98	0.000
Control Group	31.16		4.863

*- Significant at ‘P’ value < than 0.05

 

 

DISCUSSION:

In the present study Table – IV shows the Post – Test Mean, Mean Difference, Standard Deviation and Independent ‘t’ test. Mean post – test score in experimental geoup was 36.88 and for control group the mean post – test score was 31.16, the standard deviation was 4.369 and 4.863 respectively among experimental group and control group. The independent ‘t’ test score was 6.187 for the degree of freedom 98. The ‘P’ value was 0.000 so it was concluded that planned teaching program enhanced the level of knowledge of subjects regarding reproductive tract infections among subjects in experimental group. These findings were supported by the studies mentioned below.

 

Study done by Padhy K. G, Pattanayak A and Jena D (2013) with an objective to assess the impact of planned teaching programme on reproductive health among adolescent girls in high school in Ankuli, Berhampur. The study sample consisted of 144 adolescent girls results of the study revealed there was gain in knowledge in various aspects after conduction of PTP. Regarding nutrition the average score increased from 39.24% to 88.85% (before and after PTP respectively). Regarding knowledge of high risk behaviour the score increased from 19.44 % to 82.87%. The knowledge on Anatomy and physiology of reproduction, AIDS and STD, reproductive health and personal hygiene etc also improved significantly after PTP.⁸

 

NURSING IMPLICATIONS:

Nursing Practice:

The study has revealed that maximum adolescent girls have good and average knowledge regarding reproductive tract infection but still some knowledge gap is there which should be fulfilled.

1.     Nurses can take active part in educating adolescent girls regarding reproductive tract infection through exhibition and role play.

2.     Nurses can improve the knowledge regarding symptoms, prevention and treatment seeking options about reproductive tract infections, which can help in prevention and early diagnosis of reproductive tract infections which in turn can reduce economic burden of country due to reproductive tract infections.

 

Nursing Administration:

Nursing has become a complex and highly varied descriptive with the rapid growing, well developed and well documented scientific and humanistic knowledge base.

1.     Nursing administration should provide necessary facilities to nursing staff and encourage use of cost-effective audio-visual aids and material, models in client teaching.

2.     Continue nursing education can be organized by nursing personal to educate them regarding reproductive tract infection so that nurses can educate adolescent girls.

 

Nursing Education:

Nursing student should be educated about the prevention of reproductive tract infection, so that they can educate regarding reproductive tract infection in community and clinical area.

 

Nursing Research:

There is the need to conduct further research studies in the field related to knowledge, attitude and practice regarding reproductive tract infections.

 

LIMITATIONS:

The study was conducted among adolescent girls who were studying in Supreme senior secondary school and Aaron public school, Jind, Haryana. Therefore, generalization must be done with caution only.

 

RECOMMENDATIONS FOR FURTHER STUDY:

·       The study can be replicated with large sample size to generalize the findings.

·       A study can be undertaken to evaluate the effectiveness of intervention on different samples and in different settings.

·       A study can be undertaken to correlate the level of knowledge with other socio demographic variables.

 

CONCLUSION:

Adolescent period is very sensitive time for learning about reproductive tract infections because by this period they have clear concept of knowledge base related to reproductive organs and its function. This will further help them to learn more about the pathologies related to reproductive system. So, every health care professionals specifically nurse must take this golden opportunity to educate every adolescent girl by using various audio-visual aids. This was considered as one of the most important measures to reduce the prevalence of RTIs among adolescent girls and young adults.

 

REFERENCES:

1.     Li C, Han H-R, Lee J-E, Lee M, Lee Y, Kim MT. Knowledge, behaviors and prevalence of reproductive tract infections: a descriptive study on rural women in hunchun, china. Asian Nurs Res (Korean Soc Nurs Sci). 2010; 4(3): 122–9.

2.     Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, Cuypere G, Feldman J, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism. 2012; 8(1): 13: 165–232.

3.     National Guidelines on Prevention, Management and Control of Reproductive tract Infections including Sexually Transmitted Infections. National AIDS Control Organization, MOHFW, Govt. of India. 2007; 1–2

4.     WHO | Global incidence and prevalence of selected curable sexually transmitted infections – 2008 [Internet]. [cited 2021 Jan 9]. Available from: https://www.who.int/reproductivehealth/ publications/rtis/stisestimates/en/

5.     Latha K, Kanai SJ, Maitra, Bhatt GB. Prevalence of clinically detectable gynecological morbidity in India-result of four community based studies. J Fam Welfare. 1997; 43: 8–16.

6.     International Institute for Population Sciences (IIPS) and Macro International. 2007. Vol. 1. Mumbai: International Institute of Population Sciences; 2005-06. National Family Health Survey (NFHS-3

7.     Rizwan S, Rath RS, Vivek G, Nitika, Anant G, Farhad A, et al. KAP Study on Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) among married women in rural Haryana. Indian Dermatol Online J. 2015; 6(1): 9–12.

8.     Jena D. Effectiveness of planned teaching programme on reproductive health among adoloscent girl. Indian medical gazette. 2013; 1: 287–91.

 

 

Received on 12.01.2021          Modified on 29.01.2021

Accepted on 11.02.2021         © AandV Publications all right reserved