INTRODUCTION:
Women are adult females, about 50% population of the world. They can be rightly called as the groomers of the future generations because they can instil in children’s traits of goodness imbibed from them1. Women’s lives have changed over the centuries. Today women’s health is coming to be viewed as a distinctive field. The areas devoted to women health care, finding information about women’s health matters and focuses directly on topics that are major health concerns for women2.
Menopause is one of women’s most important life stages. It considerably unwelcome phenomena among many women. It marks the end of menstruation leading to women’s aging process when she cannot become pregnant2. In menopause, many women suffer from many problems. One among them is osteoporosis condition in which bones become thin, fragile and highly prone to fractured, which is related to the oestrogen level in the women body that gradually decreases in menopause. Oestrogen hormone is known to be associated for the healthy bones3.
A women’s chances of suffering from an osteoporosis related fracture is greater than risk of cervical, uterine and breast cancer. Its prevalence increases with age and it is particularly common in postmenopausal women. One in two women and one in eight men over the age of 50 will suffer from an osteoporotic fracture. Osteoporosis is often called as “silent disease” because bone loss occurs without symptoms4. The international osteoporosis foundation estimates that osteoporoisis affects about 200 million women worldwide. There is a direct relationship between the lack of estrogen after menopause and the development of the osteoporosis. It is estimated that 30% of postmenopausal women suffer from this disease5.
The key factor to avoid severe effects from osteoporosis is prevention. Women may protect themselves from severe bone loss by maintaining a balanced diet rich in calcium, performing regular weight bearing exercise, limiting alcohol, not smoking. It is a vital for a woman to have access to health care for preventive as well as curative care so that she can play her part in the development of this country. Since women are not only serving their families, the welfare of the society is highly dependent on the health of women2. Women must be made aware of available resources and encourage to take active part in their health maintenance. So, there is need for developing and giving education programme which help the women to understand more available measures for their problems related to menopause.
During the advanced nursing practice clinical posting the investigator noticed that, women are lacking knowledge regarding postmenopausal osteoporosis. Therefore, investigator felt the need to evaluate the effectiveness of structured teaching programme on knowledge regarding postmenopausal osteoporosis among women.
STATEMENT OF THE PROBLEM:
A study to assess the effectiveness of structured teaching programme on knowledge regarding postmenopausal osteoporosis among women of selected self-help groups, Udupi.
OBJECTIVES OF THE STUDY:
1. To determine the level of knowledge of women regarding postmenopausal osteoporosis using structured interview schedule.
2. To find the effectiveness of structured teaching programme on knowledge regarding postmenopausal osteoporosis among women in terms of gain in knowledge score.
3. To find the association of pre-test knowledge scores with selected baseline characteristics (age, educational status, religion, occupation, marital status and source of information)
HYPOTHESES:
H1: There will be significant difference between the mean pre-test and post-test knowledge scores of women on postmenopausal osteoporosis.
H2: There will be significant association between pre-test knowledge scores of women regarding postmenopausal osteoporosis with selected baseline characteristics.
MATERIALS AND METHODS:
Research approach: An evaluative approach was adopted to test the effectiveness of structured teaching programme on postmenopausal osteoporosis.
Research design: pre-experimental (one group pre-test post-test) design was adopted for the study.
Setting of the study: The present study was conducted in selected self-help groups, Udupi. Each self-help group consisted of 10-13 members. Investigator had taken five self-help groups.
Sample: The present study was conducted among 60 women of selected self-help groups, Udupi.
Sampling technique: The investigator used non probability purposive sampling technique to select 60 women from a selected self-help group.
Sampling criteria:
Inclusion criteria:
· Women who were available at the time of data collection.
· Women who were willing to participate in the study.
Exclusion criteria:
Women who had already attended similar teaching programme.
Development of tool for Data collection:
In this study, the data collection instrument was structured interview schedule on postmenopausal osteoporosis. The final draft of the tool was prepared considering suggestions of validators, which comprised of two parts.
Part 1: Baseline characteristics
Part 2: Structured interview schedule on postmenopausal osteoporosis.
Validity of the instrument:
The content validity of the tool was obtained from various experts from different field like medicine, nursing and research.
Reliability of the instrument:
The reliability of the tool was tested by split half technique (Spearman’s Brown Prophecy) where r = 0.78 was found.
Pilot study:
The pilot study was conducted with ten women to refine the methodology. The findings of the study revealed that the Mean±SD of post-test knowledge score (20.6±1.28) was higher than the Mean±SD of pre-test knowledge score (12±2.14). Chi-square analysis showed no association between the pre-test knowledge scores and selected baseline characteristics. The investigator found that the study was feasible and practicable to conduct main study.
Development of the structured teaching programme:
The following steps were adopted for the development of structured teaching programme,
· Review of literature
· Framing outline of the content
· Preparation and organization of the content
· Deciding the method of instruction and audio visual aids
· Development of criteria checklist
· Content validation of the structured teaching programme
· Pre-testing of the structured teaching programme
· Preparation of the final draft
Data collection procedure:
The data collection was conducted among 60 women of selected self-help groups after obtaining written permission from the concerned authorities for undertaking the study and informed consent was also taken from the study participants. The socio demographic data and knowledge regarding postmenopausal osteoporosis of the participants were collected using structured interview schedule. Immediately after pre-test, structured teaching programme on postmenopausal osteoporosis was administered to the participants with suitable audio-visual aids. Post test was conducted on 7th day for the same group to find out the effectiveness of structured teaching programme in increasing participant’s knowledge.
RESULTS:
The data collected from the participants were analysed using descriptive and inferential statistics.
Section 1: Description of the baseline characteristics of women
Most of 33.33% women were between 31-40 years, 31.67% of women were between the age group of 21-30 years. More than half (55%) of women were married whereas 23.33% were widowed. Less than half (40%) of women had secondary education while 33.34% had no formal education. Majority (66.66%) of the women were private employers and 26.67% were unemployed. The findings related to source of information on postmenopausal osteoporosis was family members and friends were the main source of information (46.67%), while 30% of the women got information from health personnel.
Section 2: Knowledge scores of women regarding postmenopausal osteoporosis
Table 1: Distribution of women of self-help groups according to the grading of pre-test and post-test knowledge score
|
Level of Knowledge Score |
Pre-test |
Post- test |
||
|
Frequency (f) |
Percentage (%) |
Frequency (f) |
Percentage (%) |
|
|
Poor (32%) |
0 |
0 |
0 |
0 |
|
Average (32-70%) |
44 |
73.34 |
4 |
6.67 |
|
Good (71-100%) |
16 |
26.66 |
56 |
93.33 |
Maximum score =22
Data in table 1 reveals that majority (73.34%) of the women had average knowledge while 26.66% had good knowledge in the pre-test whereas in the post test highest (93.33%) of women had good knowledge and 6.67% had average knowledge and none of them had poor knowledge.