A Study to assess the HPV Vaccination Status and to Evaluate the Effectiveness of Structured Teaching Programme regarding Cervical Cancer and its Prevention among Adolescent girls in Selected Colleges at Mysuru

 

Mrs. Munirathnamma K¹,  Mr. Paramesha², Mrs. Mamatha G², Mrs. Dhanalakshmi N²

¹Assistant Professor cum HOD of Obstetric and Gynecological Nursing, Department JSS College of Nursing, Mysuru.

²Assistant Lecturer, Psychiatric Nursing Department, Department JSS College of Nursing, Mysuru.

²Assistant Professor Medical Surgical Nursing, Department JSS College of Nursing, Mysuru

²Assistant Lecturer, Obstetric and Gynecological Nursing Department JSS College of Nursing, Mysuru

 

ABSTRACT:

Background: Cancer is the most progressive and devastating disease posing a threat to the entire world despite significant advances in medical technology for its diagnosis and treatment.¹ Cervical cancer is one of the most common cancers among women worldwide, with highest mortality in India. The incidence and mortality of cervical cancer can be reduced by screening women for precancerous lesion and by administration of human papilloma virus vaccine to adolescent girls. Knowledge of the women about cervical cancer and awareness about its prevention are the key factors that determine their utilization of screening services.¹

Aim: The aim of this study was to assess the HPV Vaccination status and to assess the effectiveness of structured teaching programme (STP) regarding cervical cancer and its prevention among adolescent girls in selected colleges at Mysuru.

Methodology: The study adopted one group pre test post test design. Using non probability convenience sampling technique, total of 60 samples were selected. Tool used to collect the data consisted of two part: Proforma for selected personal variables (07 items) and the structured knowledge questionnaire (30 items).

Results: Results revealed that none of adolescent girls were immunized with HPV vaccination and majority of adolescent girls did not have adequate knowledge regarding prevention of cervical cancer. There was statistically significant difference between the mean pre test and post test knowledge scores (t ₍₅₉₎ =18.27) i.e., p<0.05 indicating that STP was an effective strategy to improve the knowledge of adolescent girls regarding cervical cancer and its prevention.

Conclusion: The present study has revealed that the awareness programmes regarding cervical cancer and its prevention will have positive influence on knowledge of adolescent girls.

 

 

 

BACK GROUND OF THE STUDY:

Cervical cancer is the most common cancers among women world wide². Cervical cancer results from the uncontrolled growth of abnormal cells in the cervix². It’s mortality exemplifies health inequity, as it’s rates are higher in low and middle income countries (LMIC_S), and in low socio-economic groups within countries. Women of poorest communities are mostly affected with this condition as it is reported that 83% of world’s new cases and 85% of all cervical cancer deaths occur in developing countries. This condition affects not only the health and lives of women, but also their children, families and their communities at large.¹

 

India accounted for a quarter of both the world’s estimated cervical cancer burden of 592,000 cases and 275,000 deaths in 2015. Incidence rates are seen to rise sharply from age 35 years with approximately 87% of cases over the age of 35 years. The common risk factor is sexually transmitted infection caused by Human Papilloma Virus (HPV) and it is estimated that 50 to 80% of sexually active women are infected at least once in their life time with the virus. Several factors increase the risk of cervical cancer, including multiple sexual partners, early sexual activity, family history of cervical cancer, weak immune system and other sexually transmitted infections.²

 

NEED FOR THE STUDY:

Cervical cancer is serious public health problem. Globally, every year around 4, 90,000 women develop cervical cancer and almost 2, 74,000 of them die from the disease. It is the second most common cancer among women and the most common in under developed and developing countries which bear more than 80%of the global burden of the disease.³

 

According to the WHO report, globally cervical cancer comprises 12% of all cancers in women and it is the leading gynecological malignancy in the world. According to the national cancer registry programmes of India, cervical cancer and breast are the leading malignancies noted in Indian women. It has been estimated that in India, 1, 00,000 new cases of cervical cancer occur annually, lack of uniform policies and the programmes in organizing cervical cancer control activities have led to this disease remaining a major cause of death among Indian women.⁴

 

OBJECTIVES:

The objectives of the study are:

1.        To assess HPV vaccination status among adolescent girls

2.        To assess existing level of knowledge regarding cervical cancer and its prevention.

3.        To evaluate effectiveness of structured teaching programme regarding cervical cancer and its prevention.

4.        To find out the association between level of knowledge of adolescent girls regarding cervical cancer and its prevention with their selected personal variables.

 

HYPOTHESES:

The following hypotheses are formulated for the study and will be tested at 0.05 level of significance.

H₁-The mean post test knowledge score of adolescent girls regarding cervical cancer and its prevention will be significantly higher than   their mean pre test knowledge score.

H_2-There will be significant association between knowledge of adolescent girls regarding cervical cancer and its prevention with their selected personal variables.

 

METHODOLOGY:

Research Approach / Design:

An evaluative approach was adopted and one group pre test post test research design is used for study.

 

RESEARCH DESIGN:

Research design was one group, pre-test post-test design

 

Study Variables:

The variables of the study were:

1      Independent variable: Structured teaching programme regarding cervical cancer and its prevention.

2      Dependent variable: Knowledge of adolescent girls regarding cervical cancer and its prevention

3      Extraneous variables: age, religion, educational qualification, family history of cervical cancer, HPV vaccination status of adolescent girls and previous exposure to educational programmes regarding cervical cancer and its prevention.

 

Setting of the Study:

The study was conducted in selected colleges in Mysuru.

 

Population:

Population comprises of adolescent girls studying colleges in Mysuru.

 

Sample and Sample Size:

Adolescent girls aged between 16-19 years, studying at colleges in Mysuru.. In the present study, Sixty (60) samples were selected.

 

Sampling Technique:

Non-probability convenience sampling was used to select the samples for the study.

 

SAMPLING CRITERIA:

Inclusion criteria:

Adolescent girls who are:

1.        available during the period of data collection

2.        between the age group of 16-19 years

3.        willing to participate in the study

 

 

Exclusion criteria:

1.        Adolescent girls who are sick at the time of data collection

 

RESULTS:

SECTION I: Description of selected personal variables of Adolescents Frequency and percentage distribution of adolescent girls according to their selected personal variables n=60

 TABLE-1

Sample characteristics	Frequency	Percentage
Age  (in years)
15- 17	32	53.30%
Above 17	28	46.60%
Religion
Hindu	57	95%
Christian	3	5%
Muslim	0	0%
Others	0	0%
Education
I st PUC	0	0%
2nd PUC	60	100%
Family history of  cervical cancer
Yes	1	1.60%
No	59	98.30%
Previous Exposure to Educational programme
Yes	3	5%
No	57	95%
HPV Vaccination Status
Vaccinated	0	0%
Not vaccinated	60	100%

 

In the present study majority of samples were belongs to age group above 15-17 years (53.30%) ,majority belongs to Hindu religion (95%) ,samples were selected from 2^nd PUC ,majority had no family history of cervical cancer (98.30%) and majority had no previous exposure to educational programme and not vaccinated (100%).

 

SECTION II: Effectiveness of structured teaching programme on knowledge regarding cervical cancer and its prevention among adolescent girls.

a)       Description of adolescent girls knowledge regarding cervical cancer and its prevention.

 

Table: 2

Knowledge scores	Pre test frequency (%)	Post test  frequency (%)
Good knowledge	00	28(46.6%)
Average knowledge	36(60%)	32(53.3%)
Poor knowledge	24(40%)	00

It is evident from Table 2 that majority 36 (60%) of adolescent girls had average knowledge regarding cervical cancer and its prevention in the pre-test. Data also revealed that was an increase in the knowledge scores in the post- test i.e., 28 (46.6%) of adolescent girls had good knowledge regarding cervical cancer and its prevention.

 

b)       Mean, median, range and standard deviation of knowledge score

The pre-test and post-test knowledge scores of adolescent girls were tabulated to a master sheet and the total score obtained by each adolescent girls in the pre-test and the post test were  tabulated. Mean median, standard deviation and ranges of pre-test and post-test were computed. The findings are presented in table 3.

 

Table 3:

Test	Mean	Median	Range	Standard deviation
Pre-test	14.33	15.2	4-17	± 4.5
Post-test	19	18.6	17-27	± 4.76

 

The data presented in Table-3 shows that the pre- test knowledge scores ranged from 4 – 17 and post- test knowledge ranged from 17-27, from the possible range of 0-30. The mean pre-test knowledge score is 14.33 with standard deviation of ± 4.5 and the post-test mean is 19 with standard deviation of ±4.76. This indicates that there was an increase in knowledge scores of women after the exposure to STP.

 

c)       Significance of difference between the mean pre test and post test knowledge scores of adolescent girls regarding cervical cancer and its prevention.

In order to find out the significance between the mean pre-test knowledge scores and post- test knowledge scores of adolescent girls, paired‘t’ test was computed and the data are presented in Table- 4.

 

The following Null hypothesis was formulated:

H₀₁: There will be no significant difference between the mean pre-test knowledge scores and post-test knowledge scores of adolescent girls regarding cervical cancer and its prevention.

 

Mean, Mean difference, Standard deviation of difference and paired‘t’ test value of pre-test knowledge scores and post-test knowledge scores of adolescent girls.

 

TABLE -4

t₍₅₉₎=2.0010 ; p<0.05* Significant

 

The data presented in the Table-4 shows that the mean difference between pre test knowledge scores and post test knowledge scores of adolescent girls is 4.67. This indicates an increase in knowledge scores of adolescent girls after administration of STP. To find the significance of difference between the mean pre-test knowledge scores and post-test knowledge scores of adolescent girls, paired ‘t’ test was computed and the obtained value of paired  ‘t’= 18.27  p <0.05 is found to be statistically significant. Hence the result does not support null hypothesis.  It is inferred that there is statistically significant difference between the mean pre-test knowledge scores and post-test knowledge scores of adolescent girls. Hence it is inferred that structured teaching programme was effective in improving the knowledge of adolescent girls regarding cervical cancer and its prevention.

 

 

SECTION 3:

Findings related to association between level of knowledge of adolescent girls regarding prevention of cervical cancer with their selected personal variables;

To find out the association between the pre-test level of knowledge of adolescent girls and their selected personal variables, chi-square was computed and data is presented in Table- 5 and the following null hypothesis was formulated:

 

H₀₂; There will be no significant association between the pre-test level of knowledge of adolescent girls regarding cervical cancer and its prevention and their selected personal variables.

TABLE -5-Chi square values of pre-test knowledge scores of adolescent girls regarding cervical cancer and its prevention and their selected personal variables n=60

χ ²₍₁₎=3.843,p>0.05 *Fisher’s exact formula

 

Data presented in the Table-4 shows that the chi-square values computed between the level of pre-test knowledge of adolescent girls and their selected personal variables viz. age, religion, educational qualification, family history and previous educational exposure regarding cervical cancer and its prevention are not significant at 0.05 level of significance. Therefore, the null hypothesis is not rejected and it is inferred that level of knowledge of adolescent girls regarding cervical cancer and its prevention was independent of their selected personal variables.

 

LIMITATIONS:

The limitations of the study were;

1.        The sample size was limited to 60. Hence the findings cannot be generalized to a larger population beyond the study sample.

2.        The study adopted non probability convenience sampling; hence the generalization of findings outside the study sample is limited.

 

RECOMMENDATIONS:

Keeping in view of the findings of the present study, the following recommendations Were made;

·         Similar study can be carried out on a larger sample for broader generalization.

·         A comparative study can be undertaken to compare the knowledge of adolescent girls in urban and rural areas.

·         Similar study can be conducted to assess the effectiveness of other educational strategies to improve the knowledge of women regarding cervical cancer and its prevention.

 

CONCLUSION:

Though cervical cancer is preventable it has become a leading cancer among women, because they are ignorant about this completely preventable disease. Result of our study has revealed improvement in adolescent girl’s knowledge regarding cervical cancer and its prevention. Hence, extensive health education to the public is needed to improve their knowledge with an emphasis on the fact that both vaccination and screening are the new standards for prevention of cervical cancer, as HPV vaccination prevents most of the cervical cancer and screening can detect precancerous lesions which can be mitigated by treatment. Also utilization of the services of media like television, newspaper and radio can have massive impact in improving the knowledge

 

REFERENCES:

1.        Gifton senapathy J, Umadevi P Kennika PS. The present scenario of cervical cancer control and epidemiology: India. Asian pacific J cancer prev, 12, 1107-1115.

2.        World Health Organization. Comprehensive cervical cancer control: A guide to essential practice. Geneva. 2006.Availablefrom:http://www.who.int/reproductivehealth/publications/cancers/en/index.html

3.        Monjurul Hoque, Ehsanul Hoque, Suriya Bibi Kader. Evaluation of cervical cancer screening programme: South Africa.Jissa V Thulaseedharan, et.al. Socio demographic and reproductive risk factors for cervical cancer: India.2009.

 

 

 

Received on 05.02.2017      Modified on 04.04.2017

Accepted on 02.05.2017     © A&V Publications all right reserved