A Study to Assess the Effectiveness

 

K. Lalitha

Principal cum, Professor, Lalitha College of Nursing, Door. No. 16-19-119,

Old Guntur Main Road, Guntur – 1 (A.P)

 

Statement:

A study to assess the effectiveness of the structured teaching programme on the knowledge of cervical cancer vaccination among adolescents in a selected junior college, Guntur.

 

Objectives of study:

·        To assess the knowledge of adolescent girls regarding prophylactic vaccination for cervical cancer.

·        To assess the attitude score of adolescent girls regarding prophylactic vaccination for cervical cancer.

·        To evaluate the effectiveness of structured teaching programme on prophylactic vaccination for cervical cancer by comparing pre and posttest knowledge and attitude scores.

·        To find an association between posttest knowledge score among adolescent girls with their selected demographic variables.

·        To find an association between posttest attitude score among adolescent girls with their selected demographic variables.

·        To assess the knowledge regarding cervical cancer vaccination among adolescent girls of (age group between 15-20 years) selected junior college by pretest knowledge score.

·        To assess the knowledge regarding cervical cancer vaccination among adolescent girls of age group between (15-20 years) in selected junior college by post knowledge score.

 

Research hypothesis:

H₁:  There will be a significant difference between pre and post test knowledge scores of adolescent girls on prophylactic vaccination for cervical cancer.

H₂:  There will be a significant difference between pre and posttest attitude scores of adolescent girls on prophylactic vaccination for cervical cancer.

H₃:  There will be a significant association between posttest knowledge scores of adolescent girls with their selected demographic variables.

H₄:  There will be a significant association between posttest attitude scores of adolescent girls with their selected demographic variables.

 

Operational Definitions:

Effectiveness:  It refers to the extent to which the structured teaching programme has achieved the desired outcomes as measured in terms of knowledge and attitude scores of adolescent girls.

Structured teaching programme: It refers to systematically developed instructional and teaching aid designed for educating adolescent girls regarding prophylactic vaccination for cervical cancer.

Knowledge:It refers to the correct responses and information given by adolescent girls regarding prophylactic vaccination for cervical cancer, elicited through a structured knowledge questionnaire.

Attitude:  It refers to opinion or feeling expressed by adolescent girls related to prophylactic vaccination for cervical cancer as measured by five point Likert scale.

Prophylactic vaccination:  It refers to the substance which prevents the occurrence and spread of cervical cancer.

Cervical cancer: It is the malignant neoplasm which occurs in the cells of the cervix of uterus.

Adolescent girls: It refers to the girls aged between 12 years and 20 years who are studying in a selected junior college.

 

Setting of Study:

·        The setting selected for present study was Govt. Women’s college at Guntur, A.P.

·        The school functioned in all days except Sundays. The rationale for selection of this college was our familiarity with the setting, each transport facility, administrative approach,, cooperation and availability of subjects.

 

Target Population:

The target population is the aggregate of case about which the investigator would like to make generalizations. The adolescent girls, who were studying at Govt. Women’s College at Guntur are target population.

 

Accessible Population:

The accessible population is the aggregate of cases that confirm to the designated criteria. The adolescent girls who were studying at Govt. Women’s College in Guntur were accessible population.

 

Sampling Technique :

Totally 50 samples for final study were taken.

 

Sampling Criteria:

a) Inclusion criteria:

The criteria that specify the characteristics of the sample population are referred to inclusion or legibility criteria. The inclusion criteria of present study were:

·        Intermediate college, 2^nd year students, Guntur

·        Female students

·        English medium students

b) Exclusion criteria:

The criteria that specify the characteristics which are not passed by the sample population are called exclusion criteria. The exclusion criteria are:

·        Students not willing to participate

·        Male students

 

DEVELOPMENT OF THE TOOL:

·        A tool is an instrument that measures the variables of interest of study accurately, precisely and sensitively. The tool used for the data collection was a structured interview schedule.

·        An interview schedule was used to get an exact and complete information from the students. It was felt that a face to face contact would encourage the student to give free and frank information regarding the knowledge on cervical cancer vaccination. The average time to collect data from one student was around 30 minutes.

 

Descriptive of the tool:

A structured interview questionnaire comprises 3 parts:

Part-I:    Consists of items regarding the background factors of the student.

Part II:Consists of items regarding the knowledge of cervical cancer vaccination, dosage, time, and route of vaccination, definition, etiology and diagnostic measures and prevention of cervical cancer.

Part-III: Used to record the knowledge of adolescent girls regarding the cervical cancer and its vaccination.

 

Scoring:

Instruction to the respondent was adequately stated second year intermediate college students’ knowledge is measured regarding cervical cancer vaccination.

Positive response caries 2 marks

Neutral response caries 1 mark

Negative response caries 0 mark

 

Pilot Study:

Formal permission was obtained from the principal of the Govt. Women’s College, Guntur. The pilot study was conducted at Abhyudaya College, Guntur.

 

 

 

Ethical Issues:

Permission was obtained from the principal of the Govt. Women’s College and verbal consent was obtained from the students before starting the data collection.

 

Summary:

 

 

INTRODUCTION:

The health status of women in India has been subjected to many grate changes over the past few millennia. It is estimated that each year almost 7.6 million women suffering from carried cancer cases, cervical cancer is the second most common cancer in the world for women after the breast cancer. The incidence of insitu cervical cancer is increasing but invasive cancer and overall mortality are declining owing to the detection of cytologic testing.

 

In developing countries the incidence of cancer cervix is often equal to mortality. Globally there are on estimated 4,50,000-5,10,000 new cases of cancer cervix annually with approximately 300000 deaths. If the undiagnosed early cases are taken into account, the number of new cases each year would be 900,000 worldwide.

 

Cervical cancer are caused by HPV. It’s a common virus that spread through sexual incontinence. There are many types of HPV. Some lead to cancer cervix and some may cause genital wars while others do not cause any problems.

 

Bad sexual habits and patterns can increase risk for cervical cancer. Factors such as having sex at early age, multiple sex partners may lead to development of cancer cervix. Vaccines to prevent cancer cervix was approved by US Food and Drug Administration in June 2006. the name of vaccine is Gardasin. Studies have shown that vaccine appears to prevent early stage cervical cancer and precancerous lesions.

 

Empowering women with knowledge about cervical cancer, its early warning signals, combined with the availability of adequate therapies, could have a major impact. Non-participation may be due to several factors but an adequate knowledge and negative attitude towards screening are thought to be the major impediments among women specially in developing countries like India.

 

Indian women face a 25% cumulative lifetime risk and 1.4% cumulative death risk from cervical cancer.

 

At any given time, about 6.6% of women in the general population are estimated to harbour cervical HPV infection. HPV serotypes 16 and 18 account for nearly 76.7% of cervical cases in India.

 

Warts have been reported in 2-25% of sexually transmitted disease clinic attendees in India. However, there is no data on the burden of anogenital warts in the general communication. By 2030, cervical cancer is expected to kill over 474,000 women per year. Over 95% of these deaths are expected to be in low and middle income countries.

 

HPV immunization programs face several challenges. Firstly it is not entirely clear who should receive the vaccine and when. Females tend to become infected with HPV soon after they become sexually active. So it makes sense to immunize them at a relatively early age before they become sexually active. It is not yet known, however, whether they will require booster shots later in life or whether a catch-up immunization campaign for older, sexually active women can reduce cancer rates.

 

Need for study:

Cervical cancer is malignant neoplasm of the cervix, uterus or cervical area. Human Papiloma Virus (HPV) infection is responsible for virtually all cases of cervical cancer. In order to save and prevent the fear, we have to take prevention against loop forwarded by blocking the first step along the pathway to cervical cancer and HPV infection.

 

Cervical cancer starts in the cells on the surface of the cervix. cervical cancer usually develops very slowly. Its starts as a precancerous condition called displasia. This precancerous condition can be detected by a papsmear and is 100% treatable. It can take a year for precancerous changes to turn in to cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular papsmear or they have not followed upon abnormal papsmear results.

 

It should be remembered that when the monthly menstrual cycle has stopped because of menopause, that does not mean a women cannot get cervical cancer. Therefore, proper screening is imperative to understand cervical changes and get a regular papsmear test. Regular screening beginning from 21 or within 3 years of the beginning of sexual activity can detect problems related to HPV infections before cancer develops.

 

Limit the amount of sexual partners and use a condom. Quit smoking and 2^nd hand smoking, cancer causing foods and spices. Folic acid which has been shown to minimize cervical displasia and certain cancer. Eat diet high in antioxidant rich foods are less likely to develop cancer. Fruits and green leaf vegetables have been shown to prevent cancer. Followup abnormal papsmear. More test are carried out if the papsmear reveals abnormal cells.

 

Human Papiloma Virus Vaccine must be acquired for cure. The most common cancer causing types of HPV – 16, HPV - 18. This is important to know because these two types alone cause about 70% of all cervical cancer. Only 41% women with cervical cancer in the developing world are able to access treatment for their illness. HPV vaccine prevents infection with certain serotypes of human papiloma virus associated with the development of cervical cancer genital warts and some types of common cancer.

 

The HPV vaccine is given in three infections over in a six month period. So far screen tests know that the vaccine is effective for at last five year. It shows no decreasing immunity after that time. Protection may last even longer. Researches are still studying long term effectiveness and whether a booster vaccine will be needed.

 

It can be explained that the HPV vaccine is the cervical cancer vaccine. It only protects against some type of HPV that leads to cancer. It offers no protection against HIV, gonorrhea, Chlamydia, syphilis, Herpes and other STD.

 

Human papiloma virus vaccine protects against the two types, HPV-16 and HPV-18 that cause about 70% of cervical cancer. Types of vaccine are Gardosil against 16,18,6 and 11. cervix against 16 and 18.

 

CCV is recommended for girls and boys aged 11-12 although it may be given as early as at age 9. It’s important for4 boys and girls to receive the vaccine before they have several contacts and are exposed to HPV. Once infected with HPV, the vaccine may not be effective.

 

If not fully vaccinated at ages 11-12 the centres for disease control and prevention (CDC) recommended that girls and women through age 26 and boys and men through 21 receive the vaccine. However men may receive the HPV vaccine at age 26 if cleared.

 

Both vaccines are given as a series of 3 infections over a period of six months. The 2^nd dose is given one 2 months after the first dose and third dose given six months after the first dose.

 

The CCV is not recommended for pregnant women or people who are moderately or severely ill. The doctor must be told if the patient has any severe allergies including an allergy to yeast or latur.

 

The HPV vaccine is currently not licensed for use in female patient younger than a year or older than 26 years for use in male patient it is contra indicated in people with a history of immediate hypersensitivity to yeast or to any vaccine component. The vaccine should be deferred in patients with moderate or severe acute illness. The vaccine may be administered in  sitting or lying down position and the patient should be observed for 15 minutes post vaccination for syncope.

 

The vaccine is not recommended for use in pregnant women. Although it has not been casually associated with adverse outcome of pregnancy data are limited. Any exposure to the vaccine during pregnancy must be immediately reported. Lactating women and immuno-suppressed female patient can receive the vaccine. The efficacy and the degree of immuno response could be poor in the later group.

 

Researchers don’t know that antibody level provides adequate protection from infection. In early clinical manifestation, researchers observed the women antibody level continued to increase with each of the third dose of the vaccine. Since antibody levels inevitably fall ones you stop getting a vaccine. It means sense to start with high antibody levels and attempt to get the greatest HPV prevention for longer possible time or ever delayed for more years.

 

Over time however researcher may find that three doses of vaccine may find necessary or that a booster shot is needed years later. This is a wealth of evidence suggesting that cervical screening is one of the best defenses against the development of cervical cancer. Liver could be saved if medical practitioner makes a point of routinely enquiring the date and result of the patients last cervical smear test and if they repeatedly emphasize the importance of attendance for cervical smear test, especially in post menopausal women.

 

Regular cervical screening is the best way to identify about cells changes in the cervix. So it is important that all girls who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.

 

Many of the women may never have been screened. This could provide an important opportunity for health education, as many older women are skill under the misconception that cervical cancer is a disease that only affects young promiscuous women.

 

The vaccine in dose is 0.5ml given in either in the deltoid muscle or in the anterior lateral thigh. It is available as a sterile suspension for injection in a single dose vial or prefilled syringe and should be shaken well before use, manufacture instruction for storage and administration of vaccine should be followed.

Overall the effects are usually mild, the most common side effect of both HPV vaccine include soreness at the injection site (the upperarm) headache, low grade fever or flu like symptoms. Sometimes, giddiness or fainting occurs after the injection, especially in adolescents. Remaining seated for 15 minutes after the injection reduce the risk of fainting. In addition, cervix may also cause vomiting, diarrhea or abdominal pain including a severe allergic response and neurological conditions such as paralysis, weakness and brain swelling.

              

Prevention of HPV by vaccine may be a more effective way of lowering the disease burden in developing countries than cervical screening. HPV vaccines are effective in preventing cervical cancer for women up to 45 years of age.

 

ANALYSIS AND INTERPRETATION OF DATA

Table – 1-Frequency and percentage distribution of the effectiveness of structured teaching programme on knowledge, demographic variables regarding cervical cancer vaccination among adolescent girls

Sl. No	Demographic variables	Frequency	Percentage
01	Age a)    12-14 years b)    15-17 years c)    18-20 years	0 45 5	0 90% 10%
02	Religion a)    Hindu b)    Christian c)    Muslim	19 22 9	38% 44% 18%
03	Educational status a)    Illiterate b)    Primary school c)    High school d)    Higher secondary / Intermediate e)    Undergraduate	0 0 0 50   0	0 0 0 100%   0
04	Sex a)    Male b)    Female c)    Others	0 50 0	0 100% 0
05	Occupation a)    Government employee b)    Private employee c)    Business d)    None of the above	0   0 0 50	0   0 0 100%
06	Family income a)    10,000-15,000/month b)    15,000-20,000/month c)    20,000-25,000/month d)    More than 25,000/month	23 14 8 5	46% 28% 16% 10%
07	Age of menarche / maturity a)    10-12 b)    13-15 c)    15-18	15 35 0	30% 70% 0
08	Marital status a)    Married b)    Unmarried c)    Widow d)    Divorced	5 45 0 0	10% 90% 0 0
09	Age of marriage / when married a)    18-20 years b)    20-23 years c)    24-26 years d)    27-29 years e)    None of the above	5 0 0 0 45	10% 0 0 0 90%
10	Total number of births a)    One b)    Two c)    More than two d)    None of the above	0 0 0 50	0 0 0 100%
11	Number of abortion underwent a)    One b)    Two c)    More than two d)    None of the above	2 0 0 48	4% 0 0 96%
12	Types of abortion a)    Spontaneous b)    Threatened / by diseases c)    None of the above	2 0   48	4% 0   96%
13	Health status a)    Good b)    Moderate c)    Poor	26 20 4	52% 40% 8%
14	Residential area a)      Urban b)      Semi urban c)       Industrial d)      Rural	12 31 0 7	24% 62% 0 14%
15	Personal habits a)      Tobacco chewing b)      Betel leaves with tobacco c)       Smoking d)      Alcoholism e)       None of the above	0 0 0 0 50	0 0 0 0 100%
16	Body built a)      Thin built b)      Moderate built c)       Obese built	15 26 9	30% 52% 18%

 

Table–1 shows the distribution of adolescent girls according to background factors such as age, sex, religion, education, family income, age of menarche, age of marriage, total no. of births, body built. 50 college students were included in the study. They were observed at intermediate college set up.

·        Regarding the age, majorities 0(0%) belong to the age group of 12-24 years, 45(90%) belong to the age group of 15-17 years, 5(10%) belong to the age group of 18-20 years.

·        Regarding religion, majority 22(44%) of Christian, 19(38%) are Hindu, 9(18%) belongs to Muslim

·        Regarding education, 50(100%) are intermediate students

·        Regarding sex, 50(100%) are females.

·        Regarding occupation, 50(100%) None of the above, 0(0%) business, 0(0%) private employee, 0(0%) belongs to Government employee.

·        With regards to the family income, majority 23(46%) 10,000-15,000/month, 15(28%) 15,000-20,000/month, 8(16%) 20,000-25,000/month, 5(10%) more than 25,000/month.

·        Regarding age of menarche, majority 35(70%) are 13-15 years, 15(30%) are 10-12 years.

·        Regarding marital status, majority 45(90%) are unmarried, 5(10%) are married.

·        Regarding age of marriage, majority 45(90%) are none of the above, 5(10%) are 18-20 years.

·        Regarding total no. of births, majority 50(100%) are none of the above, 0(0%) more than two, 0(0%)  two, 0(0%) belongs to one.

·        Regarding no. of abortion underwent, majority 48(96%) are none of the above, 2(4%) are one, 0(0%) are two, 0(0%) belongs to more than two.

·        Regarding types of abortion, majority 48(96%) are none of the above, 2(4%) are spontaneous, 0(0% belongs to threatened.

·        Regarding health status, majority 26(52%) are good, 20(40%) are moderate, 4(8%) belongs to poor.

·        Regarding residential area, majority 31(62%0 are semi-urban, 2(4%) are urban, 7(14%) are rural, 0(0%) belongs to industrial.

·        Regarding personal habits, majority 50(100%) are none of the above, 0(0%) are tobacco smoking, 0(0%) are betel leaves with tobacco, 0(0%) are smoking, 0(0%) are alcoholism.

·        Regarding body built, majority 26(52%) are moderate built, 15(30%) are thin built, 9(18%) are obese built.

 

Knowledge of adolescent girls on cervical cancer vaccination

Sl. No.	Knowledge of adolescent girls	Correct		Incorrect
		No. of girls	%	No. of girls	%
1	Causative organism of cervical cancer	46	92%	4	8%
2	Common age group of cervical cancer	26	52%	24	48%
3	Common diagnostic measure of cervical cancer	19	38%	31	62%
4	National cancer awareness month	36	72%	14	28%
5	White discharge from vagina	48	96%	2	4%
6	Definition of cervical cancer	34	68%	16	32%
7	Predisposing factor of STDs	37	74%	13	26%
8	Screening age and the interval	37	74%	13	26%
9	Vaccine for HPV	29	58%	21	42%
10	Usage of oral pills leads to cervical cancer	32	64%	18	36%

 

 

 

Table- shows the frequency and percentage distribution of adolescent girls on cervical cancer vaccination.

·        Regarding causative organism, majority of adolescent girls 42 (92%) answered correctly and 4(8%) incorrectly.

·        Regarding common age group, majority of adolescent girls 26 (52%) answered correctly and 24(48%) incorrectly.

·        Regarding common diagnostic measures, 19 (38%) answered correctly and 31(62%) incorrectly.

·        Regarding national cancer awareness month, majority of adolescent girls, 36 (72%) answered correctly and 14(28%) incorrectly.

·        Regarding common white discharge 48 (96%) answered correctly and 2(4%) incorrectly.

·        Regarding definition, 34 (68%) answered correctly and 16(32%) incorrectly.

·        Regarding predisposing factors, 37 (74%) answered correctly and 13(26%) incorrectly.

·        Regarding screening age and interval, 37 (74%) answered correctly and 13(26%) incorrectly.

·        Regarding vaccine for HPV, 29 (58%) answered correctly and 21(42%) incorrectly.

·        Regarding usage of oral pills, 32 (64%) answered correctly and 18(36%) incorrectly.

 

 

 

Table-7-Frequency and percentage distribution of adolescent girls knowledge regarding cervical cancer vaccination

Sl. No.	Q. No.	Content	Positive attitude	%	Negative attitude	%	Neutral	%
1	1	Cervical cancer is a social problem	36	72%	14	28%	0	0%
2	2	Have you ever had any type of cancer	3	6%	47	94%	0	0%
3	3	Do you get menstruation regularly	50	100%
4	4	Cervical cancer can lead to death	26	52%	15	30%	9	18%
5	5	Cervical cancer is curable	35	70%	11	22%	4	8%
6	6	Do you think that STD is a pre-disposing factor of cervical cancer	43	86%	2	4%	5	10%
7	7	Have you ever heard of HPV	45	90%	0	0%	5	10%
8	8	Have you ever had pap test	50	100%
9	9	Do you think HPV can cause cervical cancer	41	82%	5	10%	4	8%
10	10	Do you think you can get HPV through sexual contact	43	86%	4	8%	3	6%
11	11	Do you think having contact with multiple sexual partners will cause cervical cancer	46	92%	3	6%	1	2%
12	12	Have you ever heard of cervical cancer vaccination	48	96%	2	4%
13	13	Have you interested to get cervical cancer vaccine	47	94%	0	0	3	6%
15	15	Are you ready to get vaccinated if the price is very high	34	68%	19	38%	6	12%

Figure- 1: Bar diagram showing distribution of overall level of average knowledge of adolescent girls about cervical cancer vaccination in pretest

 

Figure- 2: Bar diagram showing distribution of overall level of average knowledge of adolescent girls about cervical cancer vaccination in post test

 

Table- shows the distribution of adolescent girls according to cervical cancer as a social problem occurrence of menstruation, whether cancer is curable or not, STD is a predisposing factor of a cervical cancer regarding cervical cancer vaccination regarding pap test.

·        Regarding cervical cancer is a social problem 36(76%) answered correctly and 14(28%) answered incorrectly and 0(0%) gave neutral answer.

·        Regarding “have you had any type of cancer” 3(6%) answered correctly and 47(94%) answered incorrectly and 0(0%) gave neutral answer.

·        Regarding “do you get menstruation regularly, 50(100%) answered correctly.

·        Regarding “cervical cancer can lead to death” 26(52%) answered correctly and 15(30%) answered incorrectly and 9(18%) gave neutral answer.

·        Regarding “cervical cancer is curable” 35(70%) answered correctly and 4(8%) answered incorrectly and 11(22%) gave neutral answer.

·        Regarding “do you think that STD is a predisposing factor of cervical cancer” 43(86%) answered correctly and 2(4%) answered incorrectly and 5(4%) gave neutral answer.

·        Regarding “Have you ever heard of HPV” 45(90%) answered correctly and 0(0%) answered incorrectly and 5(10%) gave neutral answer.

·        Regarding “have you ever had pap test” 50(100%) answered correctly

·        Regarding “do you think you can get HPV through sexual contact 43(86%) answered correctly and 4(8%) answered incorrectly and 3(6%) gave neutral answer.

·        Regarding “do you think having contact with multiple sexual partner will cause cervical cancer” 46(92%) answered correctly and 3(6%) answered incorrectly and 1(2%) gave neutral answer.

·        Regarding “are you interested to get cervical cancer vaccination” 47(94%) answered correctly and 3(6%) answered incorrectly and 0(0%) gave neutral answer.

·        Regarding “are you ready to get vaccinated if the price is very high” 34(68%) answered correctly and 19(38%) answered incorrectly and 6(12%) gave neutral answer.

 

FINDINGS AND DISCUSSION:

The purpose of the study is to assess the knowledge of intermediate college students regarding the knowledge of cervical cancer vaccination.

 

The discussion of the study based on the findings obtained from the statistical analysis and also according to the objectives.

 

Objective-I:

To assess the knowledge of adolescent girls regarding prophylactic vaccination for cervical cancer.

The pretest was conducted with structured questionnaire. The pretest findings of students in table revealed that overall knowledge level shows the most of the student 36(72%) given incorrect answers 14(28%) given correct answers.

 

Objective-II:

To evaluate the effectiveness of structured teaching programme on prophylactic vaccination for cervical cancer by comparing pre and post test knowledge scores.

The majority of students 29(58%) were having knowledge about cervical cancer vaccination after structured teaching programme and 21(42%) were not having knowledge about prevention and control of cervical cancer.

 

Objective-III:

To find an association between pretest score and posttest score among adolescent girls with their selected demographic variables.

·        The pretest was conducted with structured questionnaire the pretest findings of students in table revealed that over all knowledge level shows the most of the student 36(72%) given incorrect answers 14(28%) given correct answers.

·        The majority of students 28(58%) were having knowledge about cervical cancer vaccination after structured teaching programme and 21(42%) were not having knowledge about prevention and control of cervical cancer.

 

Findings:

The findings were furnished based on the objectives of the study:

1.      Findings related to sample characteristics

·        The highest percentage 45(90%) is between age of 15-17 years.

·        The highest percentage 26(52%) have good body built

·        As per religion 22(44%) belongs to Christian

2.      Findings related to knowledge of the intermediate college students regarding the cervical cancer vaccination in the pre test

·        The highest percentage 36(72%) had given incorrect answer

·        The lowest percentage 14(28%) have given incorrect answer

3.      Findings related to knowledge of intermediate students regarding cervical cancer vaccination

·        The highest percentage 29(58%) had given correct answer.

·        The lowest percentage 21(42%) had given in correct answer.

 

Recommendation:

Nursing Implications:

a. Hospital Nursing Practice:

The nurses who focuses on the emergency management and physical rehabilitation in the hospital and should know about the effects of cervical cancer and cervical cancer vaccination.

·        The nurses should be confident to take care of the parents with cervical cancer the nurse’s must be trained to look after the cervical cancer.

·        It helps them to identify the complications of cervical cancer there by reducing and preventing the effects of cervical cancer.

·        The nurse needs to encourage the young generation to prevent the cervical cancer.

b. Community Nursing Practice:

 The nurse who focuses on the management and prevention measures should know about cervical cancer

·        Nurses can help the adolescent girls to strengthen their knowledge about cervical cancer.

·        Nurses can educate the early adults regarding the effects of cervical cancer and its prevention by vaccination.

 

 

Implication for Nursing Education:

The present study would help the nursing student to understand the preventive measures in the reduction of cervical cancer.

·        The nurses as a teacher, has to educate the college students regarding the effects of cervical cancer vaccination.

·        The nursing education should educate the students in the nursing profession so as to make them study to take care of the cervical cancer.

·        Mass media or posters are used to educate the students regarding the effects and need for the prevention and control of cervical cancer.

 

Implications for Nursing Administrator:

 The nurses administrator has to evaluate the staffs who are working in the oncology department.

·        The nurse administration should develop In-service education programme so as to make them aware of the recent changes in the aspects of oncology.

·        Administrator must provide adequate supply of A.V. Aids for conducting programmes.

Implications for Nursing Research:

·        The study will be a valuable reference material for future research.

·        Research help the nurses to build up the existing knowledge regarding the cervical cancer vaccination and implement their findings in their day to day life.

 

BIBLIOGRAPHY:

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3.       Phipps, “Medical Surgical Nursing”, 7^th edition published by Moshy, page no. 955-962.

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5.       Lewis, Heitkenper, Disken, O’Blien Buches, “Medical Surgical Nursing”, 7^th edition published by Mosby, page no. 1720-1736

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8.       PR Ashalatha, G Deepa, “Textbook of Anatomy and Physiology for Nurses” published by Jaypee Brothers, page no. 45-47.

9.       D.C. Dutta “Textbook of Gynecology”, 7^th edition, new central book agency pvt. Ltd, page no. 327-340.

10.     B.T. Basavanthappa, “Textbook of Nursing Research”, 2^nd edition J.P. Brothers Medical Publications in America, page no. 105-107.

11.     Oxford Dictioniary, 7^th edition, oxford university publications, 1994, page no. 3,15,20,27,30,70.

12.     Dorlands Pocket Medical Dictionary, 27^th edition, Elsevier Publications, page no. 22,228,23,470.

13.     Pollit Hungler, “Importance of Review of Literature”, Text book of Nursing Research”, page no. 13,12,36,38.

14.     Barbara and Nancy, “Introductory Medical Surgical Nursing”, T.B. Lippincott Company, 8^th edition, 2003, page no. 213-217

15.     P. Chandraiah, “Nursing Research and Statistics”, published by Forence Publishers.

 

 

Received on 18.02.2014           Modified on 12.03.2014

Accepted on 20.03.2014           © A&V Publication all right reserved