A Descriptive Study to assess the Knowledge and Preparedness for Menarche among Pre-Adolescent girls Studying at selected Schools, of Kurali Punjab

 

Ms. Shivani Sharma¹, Ms. Kiran. B Pebma²

¹M Sc. Nursing Student, Saraswati Nursing Institute, Dhianpura

²Associate Professor, Obstetrical and Gynecological Nursing, Saraswati Nursing Institute, Dhianpura

 

ABSTRACT:

Menarche is an important event in the life of adolescent girls, most of whom experience menarche before the age of 16 years. During this period, girls go through physical changes that are important in the psychological perception of sexual identity and that considerably influence mental maturity. The main objective of the study is to assess the knowledge of menarche among pre-adolescent girl, to assess the preparedness for menarche among pre-adolescent girls, to develop and disseminate the pamphlets in view to create awareness among pre-adolescent girls, and to determine the correlation between knowledge and preparedness of menarche among pre-adolescent girls, To determine the association between knowledge and preparedness for menarche among pre-adolescent girls with the selected socio demographic variables. Descriptive study was conducted on 200 subjects through purposive sampling technique. The result of present study revealed that 146 (73%) girls had average knowledge regarding menarche. Majority of the girls 159 (79.5%) were not prepared for menarche. There was mild positive correlation between knowledge score and preparedness for menarche (0.033). There was no significant association of knowledge and preparedness for menarche. The finding of the study was indicated a strong need of creating awareness and providing knowledge about menarche before its onset. The study concluded that a strong need of creating awareness and providing knowledge about menarche before its onset.

 

 

INTRODUCTION:

Adolescent girls are the future mothers. Going through the puberty can be challenging times for them. Although it may occur at different ages for different girls, adolescent girlhood is always a critical time of identity formation and a period of transition from childhood to womanhood. In most societies, menarche is an indication of a girls’ developing sexuality.¹

 

 

 

Menarche is the first menstrual cycle or first menstrual bleeding in human beings both social and medical perspectives it is often considered the central event of female puberty as it signals the possibility of fertility. In some parts of India when a girl has menarche, her parents invite close friends and relatives for a party to celebrate the new young women. In some communities young women are given a special ceremony called “ruthu sudangu”².

 

Menstruation is the monthly vaginal bleeding at an interval of about 28 days from the uterine endometrium. Menstrual flow is dark color and contains 60-150 ml of fluid. It usually lasts for about four to five days³.

 

Menstrual hygiene refers to the personal hygiene practices during menstruation. A girl needs to practice a high level of personal hygiene during her periods and the personal hygiene starts from the selection of best sanitary products, its proper usage, disposal, body cleanliness, diet, etc. Menstrual hygiene is important because it is a natural process of hygiene related to practice of girls during menstruation as it has an impact in terms to prevent reproductive tract infections and urinary tract infections, used pads should be dispose off by wrapping in paper and then into the dustbin because if blood soaked pad comes in environment (without any covering on it) flies will suck that blood and cause various type of infection¹.

 

This leads to lack of knowledge at accurate time regarding her physiological maturation and onset of menarche further that makes misunderstanding of the need of the teenage girls. So the investigator felt the need to provide knowledge to the adolescent girls before menstruation⁴.

 

NEED OF THE STUDY:

Today’s adolescents are tomorrow’s adults who are the strength of the nation. Today’s adolescent girls are our future homemakers. Most of the adolescents tend to be extremely unaware of their own ⁵.

 

Adolescent girls constitute one fifth of the female population in the world. Generally this group is considered healthy and has not been given adequate attention in health programmes. The reason is age specific mortality is comparatively low in this age group as compared to others. In countries like India, adolescent girls can face serious health problem due to socio-economic, environmental conditions and gender discrimination. These factors make them more vulnerable to health risks⁵.

 

Menstruation is the time of change for every adolescent girl. Due to lack of knowledge regarding menstruation, the adolescent girls go through the physiological and emotional stresses. In Indian society girls` do not get adequate knowledge about their own body’s physiological changes and about menstruation. If we are providing adequate knowledge to the adolescent girls, it will be help full for them at the time of menstruation⁶.

 

REVIEW OF LITERATURE:

Dudeja P, Sindhu A, et.al. (2016) conducted a cross-sectional descriptive study to assess the awareness about menstruation in adolescent girls of an urban slum. The data collected by pilot tested questionnaire. A total of 250 girls participated. Study revealed that the mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97. It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. The knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). Most of the school girls (90.5%) used sanitary pads. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises. The study concluded that Correct knowledge in adolescent young girls regarding menstruation was lacking⁷.

 

Hennegan J, Dolan C, et.al. (2016) conducted a cross sectional descriptive study for measuring the prevalence and impact of poor menstrual hygiene management. Survey data collection technique was used for data collection 205 menstruating schoolgirls (10-19 years) were selected rural primary schools. 90.5% of girls failed to meet available criteria for adequate menstrual hygiene management, with no significant difference between those using reusable sanitary pads 88.9%, and those using existing methods, predominantly cloth (91.5%, 95% CI 85.1% to 95.3%; χ² (1)=0.12, p=0.729). Aspects of MHM predicted some consequences including shame, not standing in class to answer questions and concerns about odour⁸.

 

MATERIALS AND METHODS:

A Non-Experimental, Quantitative research approach and descriptive research design was adopted in the present study to assess the knowledge and preparedness for menarche among pre-adolescent girls studying at selected schools, of kurali (punjab). The conceptual framework used for present study was based on health promotion model.

 

The research design used for the present study was descriptive research design. The study was conducted at selected schools of kurali National Senior Secondary School Chakwal, Khalsa Senior Secondary School Kurali, DAV model Senior Secondary School kurali, District Mohali, Punjab. Accessible Population: Preadolescent girls at schools studying in 4^th 5^th 6^th 7^th class. Sample size was 200 Preadolescent girls and Purposive sampling technique was used to select the sample.

 

DEVELOPMENT OF TOOLS:

Tool A:

This tool includes socio demographic data of the subjects.

 

Tool B:

This section Structured Interview Schedule knowledge based questionnaire it consist of 21 questions to assess the knowledge on menarche among preadolescent girls.

 

Part C:

Checklist it consist of 20 items to assess preparedness for menarche.

 

Ethical Considerations

1.     Written permission was taken from the institutional ethical committee,

2.     Informed consent was taken from each subject prior data collection.

3.     Confidentiality and anonymity of responses was assured and maintained throughout study.

 

RESULTS AND INTERPRETATION:

Table 1 Frequency and Percentage distribution of the demographic characteristics among the subjects.  N=200  

Socio Demographic Variables		f (%)
Age in years	9 10 11 12	018 (09.0) 025 (12.5) 063 (31.5) 094 (047)
Class	4th 5th 6th 7th	027 (13.5) 037 (18.5) 067 (33.5) 069 (34.5)
Religion	Hindu Muslim Sikh Christian	093 (46.5) 013 (06.5) 087 (43.5) 007 (03.5)
Residence	Urban Rural	131(66.5) 069 (34.5)
Type of family	Joint Nuclear Extended	103(51.5) 093 (46.5) 004 (02.0)
Dietary pattern	Vegetarian Non-vegetarian Eggtarian	160(80.00) 019(09.5) 021 (10.5)
Onset of menstruation	Yes No	067 (33.5) 133(66.5)
Awareness of menstruation	Yes No	100 (50.00) 100 (50.00)
Education of mother	Non Formal Education Primary Secondary Higher Secondary Graduate or Post graduation	033 (16.5) 046 (023) 071 (35.5) 033 (16.5) 017 (08.5)
Occupation of mother	Homemaker Self Employed Private Employed Government Employed	164 (82.00) 014 (007) 016 (008) 006 (03.0)
Source of information	Mass Media Health Personnel’s Peer Group/ Friends Family Members/Relatives	019 (09.5) 019 (09.5) 035 (17.5) 127 (63.5)
Family income monthly	≤ 5000 5001≤ 10,000 10,001≤ 15,000 Above ≥15000	074(37.00) 056 (28.00) 031 (15.5) 039 (19.5)

 

Fig 1 Frequency and percentage distribution of knowledge on menarche among subjects. N=200

 

Fig 1 Depicts that majority of the subjects i.e 146 (73.0%) had average knowledge related to menarche, while 48(24.0%) subjects had inadequate knowledge where as 6(3%) subjects had good knowledge.

 

 

Table 2 Frequency and Percentage distribution of subjects regarding preparedness for menarche.  n= 200

Sr. No.	Category	Frequency	Percentage
1	Prepared (11-20)	41	20.5%
2	Not prepared (0-10)	159	79.5%
	Total	200	100%

 Mean score ±SD= 8. 67± 2.39

 

Table 2 Shows that distribution of subjects as per level of preparedness for menarche. The data shows that maximum 79.5% of the subjects had not yet prepared for menarche and only 20.5% of subjects had already achieved and prepared for menarche.

 

 

 

Table 3 Correlation between knowledge and preparedness for menarche among subjects. N=200

	Mean	SD	Correlation
Knowledge	9.57	2.46	0.033
Preparedness	8.66	2.38

(p<0.05)

 

Table 3 Showing the correlation between knowledge and preparedness for menarche among preadolescent girls. Findings shows that there was non significant positive correlation between knowledge and preparedness. Hence research hypothesis was rejected.

 

 

 

Table 4 Association between knowledge on menarche and socio demographic variables of subjects.                                                    n=200

Demographic variables		Inadequate knowledge	Average	Good knowledge	Df	ᵪ2
Age in years	9 years 10 years 11 years 12 years	03 12 13 20	15 13 48 70	00 00 02 04	6	10.670
Class	4th class 5th class 6th class 7th class	10 08 10 20	17 28 55 46	00 01 02 03	6	7.798
Religion	Hindu Muslim Sikh Christian	22 01 23 02	68 11 62 05	03 01 02 00	6	3.322
Residence	Urban Rural	35 13	92 54	04 02	2	1.571
Type of family	Joint Nuclear Extended	24 21 03	77 68 01	02 04 00	4	6.770
Dietary pattern	Vegetarian Non vegetarian Eggetarian	40 02 06	115 17 14	05 00 01	4	3.332
Onset of menstruation	Yes No	17 31	48 98	02 04	2	0.105
Aware of menstruation	Yes No	24 24	75 71	01 05	2	2.776
Education of 1mother	Non formal education Primary Secondary Higher secondary Graduate or post graduation	04  09 23 07 05	27  36 48 23 12	02  01 00 03 00	8	13.444
Occupation of mother	Homemaker Self employed Private employed Government employed	38 05 05 00	121 09 11 05	05 00 00 01	6	7.561
Source of information	Mass media Health personnel’s Peer group/friends Family members/Relatives	02 07 15 24	15 12 18 101	02 00 02 02	6	18.500*
Famly income monthly	≤5000 5001≤10,000 10,000≤15,000 Above≥15000	22 14 06 06	49 42 24 31	03 00 01 02	6	5.874

p<0.05 significance level

 

Table 4 Showing the calculated χ²value (18.500) was greater than the tabulated value (12.592) at 0.05 level indicate that there was significant association between source of information and knowledge score of students.

 

Table.5 Association between preparedness for menarche and socio demographic variables of the subjects.                                          N=200

Demographic variables		Prepared	Not prepared	Df	ᵪ2
Age in years	9 years 10 years 11 years 12 years	04 03 08 26	14 22 55 68	3	6.450
Class	4th class 5th class 6th class 7th class	03 04 18 16	24 33 49 53	3	5.564
Religion	Hindu Muslim Sikh Christian	18 02 18 03	75 11 69 04	3	2.432
Residence	Urban Rural	26 15	105 54	1	0.099
Type of family	Joint Nuclear Extended	21 19 01	82 74 03	2	0.051
Dietary pattern	Vegetarian Non vegetarian Eggetarian	30 04 07	130 15 14	2	2.426
Onset of menstruation	Yes No	24 17	43 116	1	14.511**
Aware of menstruation	Yes No	32 9	68 91	1	16.229**
Education of mother	Non formal education Primary Secondary Higher secondary Graduate or post graduation	11 13 10 5 2	22 33 61 28 15	4	8.203
Occupation of mother	Homemaker Self employed Private employed Government employed	31 5 4 1	133 9 12 5	3	2.498
Source of information	Mass media Health personnel’s Peer group/friends Family members/Relatives	4 0 9 28	15 19 26 99	3	5.673
Family income monthly	≤5000 5001≤10,000 10,000≤15,000 Above≥15000	16 6 10 9	58 50 21 30	3	6.136

p<0.05 significance level

 

Table 6 Showing the calculated χ²value (14.511) was greater than the tabulated value (3.841) at 0.05 level indicate that there is significant association between onset of menstruation and preparedness score of students. Calculated χ²value (16.229) was greater than the tabulated value (3.841) at 0.05 level indicate that there was significant association between awareness of menstruation and preparedness score of students. Hence research hypothesis was accepted.

 

DISCUSSION:

In the present study the results showed that maximum 146(73%) girls had average knowledge, 6(3%) girls had good knowledge and 48(24%) girls had inadequate knowledge regarding menarche. The findings of the present study are similar to the study conducted by Adekemi Eunice Olowokere (2013) assess the knowledge, management of menstrual disorders and the health and academic implications and adolescent. 400 girls participated in the study. Data was collected using a 72-item semi structured questionnaire. Result showed that 61% had inadequate knowledge of menstruation and 20% had adequate knowledge 19% girls had moderate knowledge.

 

In the present study findings revealed that 33.5%(67) girls already attain the menarche. The findings of the same study are similar to the study conducted by Seenivasan P²³, assess the Knowledge, attitude and practices related to menstruation among adolescent girls.500 school going adolescent girls participated in study. Pre-tested questionnaire was used. The study revealed that 69% of the girls attained menarche at 11 to 13 years. Most of the girls felt scared on first menstruation (59%). Study concluded that highlighted the needs of the adolescents to have accurate and adequate information about menstruation and its appropriate management .

 

CONCLUSION:

The finding of the study indicated a strong need of creating awareness and providing knowledge about menarche and menstruation or menstrual hygiene before starting the menarche. Study concluded that there was need to provide accurate and adequate information about menstruation to young girls and its appropriate management. Appropriate information regarding use of sanitary napkins, cloth and their disposal should be provided to girls in premenstrual stage and later.

 

REFERENCES:

1.      Kirk J, Sommer M. Menstruation and body awareness: critical issues fir girls on education.2005:(15) ;4-5.

2.      Verma P. Knowledge and practices about menstrual hygiene among secondary school gilrs. indain journal of community 2013; 25(3) 240-245.

3.      Menarche. Available from: URL: http:// www m.webmed.com/children/tc /menarche.

4.      S.P Singh, Singh M. knowledge assessment regarding puberty and menstruation among school adolescent.2006 Indian J.Prev.soc.med.37:182.

5.      K. Park, “Essential of community health nursing’’6^th edition Banrisdars publishers, Jabalpur.2008:640-645.

6.      Essential Magazine Puberty Blues: Helping Girls to Weather the Storm Words Fran Molloy, John Fairfax Holdings Limited 2007 Sep, http://www.smh.Com.au

7.      Dudeja P. Sindhu.assess the awareness about menstruation in adolescent girls.2016 oct.ijamh.

8.      Yasmin shamina. Menstrual hygiene among adolescent school students. Mar- April 2013. ISOR journal of dental and medical science .5(6):22-26

 

 

 

 

 

Received on 22.12.2018          Modified on 23.01.2019

Accepted on 27.02.2019     © A&V Publications all right reserved