A Study to Evaluate the effectiveness of Structured Teaching Programme on knowledge regarding of Polycystic Ovarian Syndrome among School teachers of selected school of Ghaziabad

 

Ms. Savita Vashist¹, Mrs Lavanya Nandan², Mrs. Jony Sharma²

¹H.No. B-20 Street No.2/1, West Nathu Colony, Delhi- 110093

²Nightingale Institute of Nursing, Noida.

 

ABSTRACT:

 

INTRODUCTION:

“Having children just puts the whole world into perspective. Everything else just disappears.”

                                                               Kate Winslet

Adolescent period is a unique period where there is a change from childhood to adulthood, a time of physiological, psychological, social and emotional adaptation. During this period individual attains physical and sexual maturity, whereas emotional maturity will be imbalanced.¹

 

Adolescence has been identified as a distinct period in human development marked by biological changes beginning at the onset of puberty. With the arrival of puberty, hormonal changes particularly, the production of male and female hormones lead to an increase in sex drive. The first development task relating to sex, adolescence must master over forming new and more mature relationship with members of opposite sex. Based on their status of mind set Three main stages of adolescence can be discerned. Early adolescence (9-13years) characterized by a spurt of growth and the development of secondary sex characteristics. Mid adolescence (14-15 Years) this stage is distinguished by the development of a separate identity from parents, of new relationship with peer groups and the opposite sex and age of experimentation. Late adolescence (16-19) at this stage adolescents have fully developed physical characteristics (similar to adults)²

 

The changes in adolescent period have important implications to understand the health risk is associated with this syndrome during this period, the body changes and there will be development of secondary sex characteristics. Any difference of secondary sex characteristics can inversely affect the physical and emotional adaptation of the adolescent. Polycystic ovarian syndrome is a condition in which woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cyst in the ovary, failure to conceive and other health problems. It is a common health problem among teenagers and young women. It affects 5% to 10% of women in their reproductive years. These problems causes infertility. Although there is no cure PCOS, there are several ways to treat and manage the condition. If a girl is overweight, Weight loss can be very effective in lessening many of the health conditions associated with PCOS. Sometimes weight loss alone can restore hormone level to normal, causes many of the symptoms to disappear or become less severe.³

 

Healthy food habits and exercise helps to combat the weight gain. Research has suggested that PCOS may be related to increased insulin production. PCOS seems to run in families, too, so if someone in the family has it, they might be more likely to develop it. India has witnessed about 30% rise in polycystic ovarian syndrome (PCOS) cases in the last couple of years. Lack of knowledge and lifestyle changes are considered to be the major factor leading to this phenomenon⁴.

 

There is a need to increase awareness among women so as to avoid major cases of fertility problems in the future. A Nurse holds a critical role in health care that goes beyond the day to day duties. Nurses are in a position to provide comprehensive care to adolescent afflicted with the syndrome. Polycystic ovarian syndrome is an endocrine disorder which affects the adolescent girls. It has been found through studies that it affects around 5% to 10% of women in their reproductive years. Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. PCOS causes a woman’s body to produce excessive amounts of androgens or testosterone, hormones that are associated with male sex characteristics and reproduction. PCOS disrupts the balance of both follicle-stimulating hormone (FSH), the hormone that causes the follicle and egg to develop and luteinizing hormone (LH), the hormone that causes the follicle to release the egg. The result is that a small cyst is formed in the ovary, which disrupts the woman’s hormonal balance⁵

 

Polycystic Ovarian syndrome is very common among girls the main symptoms are irregular or no menstruation, multiple small cysts in the ovaries which is a common finding, high blood pressure, excessive pimples and rise in level of insulin are the common findings.⁶

 

Present day lifestyle, food habits, environmental exposure to toxins along with hereditary predisposition for metabolic syndrome and stress has contributed to the common problem faced by today’s female population which is PCOS. Children as young as 16 years are diagnosed with polycystic ovarian disease which occurs due to the imbalances or abnormalities in the hormones. Hormonal abnormalities can make the ovaries produce more eggs. These eggs turn into cysts and the ovaries become large and studded with numerous cysts. It begins as early as in teenagers and mostly effects adult girls of childbearing age.⁷

 

NEED OF THE STUDY:

Polycystic ovarian disease or syndrome (PCOS) is a common problem which may start in the adolescence and affect the girls till her old age. In this condition the ovary develops many small cysts. This results in an abnormality of the hormones, with the male hormone dominating.⁸

 

An inclusive study on Polycystic Ovarian syndrome (PCOS) to observe the trends in Polycystic Ovarian disease cases in young women in India revealed, that one in five women suffer from PCOS problem and East India leads the chart with 1 in 4 women suffering from Polycystic ovarian syndrome⁹

 

The study performed in adolescent girls regarding polycystic ovarian disease which uses a well-validated instrument shows that health related quality of life was worse in those with polycystic ovarian disease specially in the areas of general health perceptions, behavior, physical functioning and family activity. However, qualitative psychological studies have demonstrated higher levels of depression, psychological and psychosexual morbidity and an increased response to stress in girls with polycystic ovarian disease compared with control group. Low self-esteem, decreased social activity were reported in girls with polycystic ovarian disease. Modification of life style in polycystic ovarian disease is very important because sedentary lifestyles and lack of exercises and fast food consumption by the ladies are leading to the rise in cases of polycystic ovarian disease especially among adolescent girls¹⁰

 

Deficient knowledge and the negative lifestyle attitude towards polycystic ovarian syndrome among girls and not taking any measures to improve their lifestyles by girls which leads to depression, psychological problems and even death(due to suicide) in many cases, so girls can be helped by their teacher by providing the knowledge regarding polycystic ovarian syndrome and with a view to change their lifestyle.

 

STATEMENT OF THE PROBLEM:

“A study to evaluate the effectiveness of structured teaching programme on knowledge regarding polycystic ovarian syndrome among School teachers of selected school of Ghaziabad.”

 

OBJECTIVES OF THE STUDY:

·       To assess the knowledge regarding awareness of polycystic ovarian syndrome among school teachers.

·       To evaluate the effectiveness of structured teaching programme on knowledge regarding polycystic ovary syndrome among school teachers.

·       To determine the association between post test knowledge score of school teachers regarding polycystic ovarian syndrome and selected demographic variables.

 

HYPOTHESIS:

H1:   There is significant difference between pretest and post test knowledge scores of school teachers regarding polycystic ovarian syndrome as measured by structure knowledge questionnaires at the 0.05 level of significance.

H2:   There is significant association between the post test knowledge scores of school teachers with selected demographic variables at 0.05 level of significance.

Operational Definitions:

Effectiveness:

It refers to the extent of desired knowledge gained by the teachers after administering the structured teaching programme regarding poly cystic ovarian syndrome.

 

Structure Teaching Programme:

It refers to the systematically planned teaching strategy designed to provide information to school teachers regarding Poly cystic ovarian syndrome.

 

Knowledge:

Knowledge refers to the facts and information about Polycystic ovarian syndrome expressed by teachers participating in the study as measured by the scores obtained according to their responses to items on structured knowledge questionnaire.

 

Teacher:

In this study, the school teachers refers to the women who enrolled in school, teach and guide the students in selected school of Ghaziabad

 

Poly Cystic Ovarian Syndrome:

A hormonal disorder in which the graffian follicles in the ovary fail to develop completely. So that they are unable to ovulate, remaining as multiple cysts, that distends the ovary. The result is in infertility, obesity and hirsutism.

The Components are Anatomy and functions of ovaries definition incidence, etiology, clinical features diagnosis and managements, complications of polycystic ovarian syndrome

 

MATERIAL AND METHOD:

Research approach:

The research approach adopted for this study was Quantitative research approach

 

Research design:

Pre experimental one group pre test-post test design was used for the study.

 

Setting of the study:

The study was conducted at J D Public school Ghaziabad

 

Target population:

The target population comprised of all School teachers working in JD Public School Ghaziabad.

 

Sample and sample size:

Sample comprised of 30 school teachers working in J D Public school and who met the inclusion criteria.

 

Sampling technique:

The sample technique used was non-Probability convenient sampling technique.

 

Inclusion criteria:

School teachers who were

·       Willing to participate in the study.

·       Available at the time of data collection.

Exclusion criteria:

School Teachers who were

·       Not willing to participate in the study

·       Not available at the time of data collection

·       Not able to read and write English

 

Description of the tools

Part1: Demographic variable ie age, religion, educational status, marital status, types of family, socio-status, source of information, subject taught by teacher and knowledge regarding polycystic ovarian syndrome

 

Part 2: Structure knowledge questionnaires were used to assess the level of knowledge related to polycystic ovarian syndrome among school teachers working in J D Public school Ghaziabad. It had 30 items.

 

Pilot study- Pilot study was conducted on 10 school teachers who were working in Raj Inter college Ghaziabad to find out the feasibility of the study to conduct final study Formal permission was obtained from the authority before conducting the study.

 

Ethical consideration:

·       Formal permission was taken from the principal of Nightingale Institute of Nursing Noida.

·       Formal permission was obtained from selected school (J D Public School Ghaziabad)

·        Permission was obtained from School teachers

·       Informed consent were obtained from sample

·       Anonymity and confidentiality of the participants had maintained.

 

Final data collection procedure:

After obtaining formal administrative approval, the main study was conducted from 17^th December 2018 to31^th December 2018 at, J.D. Public school Ghaziabad. 30 school teachers were taken through non probability convenient sampling technique-

·       On the 1^st day, knowledge was assessed by using Structured Questionnaire. The Structured Teaching Program was administered on the same day.

·       On the 8^th day, a post test with the same knowledge questionnaire was given to evaluate the effectiveness of the Structured Teaching Program on polycystic ovarian syndrome among school teachers.

 

Data analysis:

The data is analyzed as follow:

 

Section 1 Finding related to frequency and percentage distribution of school teachers in terms of demographic variables

 

Section 2 Findings related to assessment of knowledge of school teachers regarding poly cystic ovarian syndrome before and after administration of structured teaching programme.

 

Section 3 Findings related to effectiveness of structure teaching programme regarding poly cystic ovarian syndrome in terms of knowledge among school teachers

 

Section 4 Findings related to association of post test knowledge with demographic variable.

 

Plan for data analysis:

The collected data was organized, tabulated and analyzed by using descriptive and inferential statistic including paired “t”test and fisher exact test

 

RESULT:

Section 1: Frequency and percentage distribution of school teachers in terms of demographic variables

The study consisted of 30 samples. The data obtained describe the characteristics pertaining to their age, religion, education qualification, marital status, type of family, socioeconomic status, source of information subject taught, diagnosed with PCOS. Frequency and percentage was computed for describing the sample characteristics

·         Majority of school teachers 9(30%belongs to the age group of 25-30 years, 9(30%) were 41-44 years and 6(20%) were of 31-35 years and 6(20%) were 36-40 years

·         Most of the school teachers 27(90%) were Hindu. and 2(6.66%) were Christian and1(3.33%) belongs to other category

·         Majority of teachers were Graduate 16(53.33%), 11(36.66%) were post graduate and 3(10%) were undergraduate.

·         As per data majority of school teachers were married 25(85.33%) and 5 (16.66%) were unmarried

·         Majority of teachers were belongs to nuclear family 14(46.66%) and joint family 14(46.66%) were belongs to joint family where as 1(3.33%) belongs to extended and 1(3.33%) belongs to single parent family

·         Most of school teachers belongs to middle class 27(90%) and 3(10%) belongs to upper middle class.

·         Maximum of the school teachers 21(70%) were had no information, 4(13.33%) had Information from mass media and 4(13.33%) had information through friends where as 1(3.33%) through family

·         Majority of school teachers 26 (86.66%) taught other subject, where as 2(6.66%) teaching biology, and 2(6.66%) teaching moral science.

·         In context to diagnosis with PCOS 29(96.66%) were not diagnose with PCOS where a 1 (3.33%) diagnosed with PCOS.

 

 

Diagrammatic representation of the frequencies.

 

Figure 1 Bar graph showing percentage distribution of school teachers by Age

 

 

Figure 2 Pie graph showing percentage distribution of school teachers by Religion

 

 

Figure 3 Pie graph showing percentage distribution of school teacher by educational qualification

 

 

Figure 4 Pie graph showing percentage distribution of school teachers by marital status

 

Figure 5. Column graph showing percentage distribution of school teachers by Type of the family

 

 

Figure 6 Pie graph showing percentage distribution of school teachers by socioeconomic status

 

 

Figure 7. Column graph showing percentage distribution of school teachers by sources of information

 

 

Figure 8 Pie graph showing percentage distribution of school teachers on subject taught

 

Figure 9 Pie graph showing percentage distribution of school teachers on have been diagnosed with PCOS

 

Section II: Frequency and percentage distribution of pre-test and post-test knowledge score regarding polycystic ovarian syndrome among school teachers

                                                                                              N=30

Knowledg level	Grading	Pre-test		Post-test
Poor knowledge		Frequency	%	Frequency	%
	(0-7)	1	3.33%	0	0
Average knowledge	(8-15)	29	96.67%	1	3.33%
Good knowledge	(16-23)	0	0	23	76.67%
Excellent knowledge	(24-30)	0	0	6	20%

 

Data presented in the table shows that the knowledge score of school teachers in pre test was assessed which revealed 29(96.67%) of population had average knowledge and 1(3.33%) had poor knowledge regarding poly cystic ovarian syndrome. The knowledge of school teachers in post test was assessed and table reveals that 23(76.67%) of population had good knowledge, 6(20%) had excellent level of knowledge and 1(3.33%) had average knowledge regarding poly cystic ovarian syndrome

 

Section III: Mean, mean difference. median, standard deviation, paired “t” test of knowledge score regarding poly cystic ovarian syndrome among school teachers                                                         N=30

Knowledge score	Mean	Mean difference	Standard deviation	Paired “t” test value
pre- test	11.56	9.07	2.37	14.87*
post test	20.63		3.22

*d f (29) =2.05 at 0.05 level of significance

 

The data represents in table that pre-test mean knowledge score of the school teachers was 11.56 and post-test mean knowledge score of school teachers was 20.63 with the standard deviation 2.37 and 3.22 respectively. The mean difference was found 9.07. The obtained mean difference was found to be statistically significant as evident from the “t” value of 14.87 which is greater than table value 2.05 for df (29) at 0.05 level of significance hence the null hypothesis was rejected and research hypothesis was accepted. Thus it was evident that structured teaching program was effective in improving the knowledge among school teachers

 

Section IV: The findings related to association of post test knowledge score with selected demographic variables:

Find out the association between the post test knowledge with the demographic variables. It is evident that there was no significant association between post test knowledge score with demographic variables as the calculated “p” value is more than 0.05 level of significance. Hence the null hypothesis was accepted and research hypothesis was rejected for the demographic variables

 

DISCUSSION:

Present study conducted to evaluate the effectiveness of structured teaching programme on knowledge regarding of polycystic ovarian syndrome among School teachers of selected school of Ghaziabad”. A number of studies have been included in the chapter dealing with review of literature.

 

The study revealed that the majority of school teachers had good knowledge, some have intelligent knowledge few were having average knowledge of polycystic ovarian syndrome.

 

CONCLUSION:

The study concluded that the structured teaching programme was effective in improving the knowledge of school teachers regarding polycystic ovarian syndrome among school teachers.

 

NURSING IMPLICATIONS:

·       To implement preventive health practices and influence positive behavior, nurses must show that they can increase the awareness regarding polycystic ovarian syndrome

·       Nurse can be instrumental in improving adolescent’s health by addressing the impact of polycystic ovarian syndrome on the health and methods to improve them

·       The present study findings have several implications in hospital settings, Nursing Practice, Nursing Education, Nursing Research, and Nursing Administration.

 

Nursing practice:

·       Health teaching is an integral component of Nursing practice. Nursing personnel should plan a teaching program for adolescent girls to enhance their knowledge regarding polycystic ovarian syndrome.

·       If the health status of adolescent girls has to be strengthened, adequate guidance to mother of adolescent girls is important. Therefore health education to mothers of adolescent girls admitted in the hospital and those attending out-patient clinic to be provided

·       The current perspective of health is giving more importance to preventive, curative and rehabilitative services.

·       Nurse can provide information regarding polycystic ovarian syndrome to the adolescent girls and women who are present in the ward for promotion of health and prevention of psychological problems

·       Individual or group discussions can be held in hospitals for all reproductive age group girls and women attending OPD Clinics, for providing effective information in polycystic ovarian syndrome.

·       In order to acquire practice, Nurse need rigorous hands on training and practice which includes assessment of girls / women and intervention.

·       Students awareness can be created through health education in schools and colleges.

 

Nursing education:

·       Nursing education bring changes in life. Nurse would be required to do more in depth client education on prevention of diseases. Nursing curriculum should be a way to prepare the students to assist the client in developing healthy life

·       Nurse educator can prepare the Nursing students in order to give importance of teaching programme on polycystic ovarian syndrome by using different educational and teaching aids.

 

Nursing research:

·       The findings of the present study are helpful for the Nursing professionals and Nursing teachers to conduct further studies to find out the effectiveness of various methods of providing education on improving the knowledge regarding polycystic ovarian syndrome.

·       This study helps the Nursing researcher to develop insight into preparation of teaching material to promote the health status of women.

·       The study will be reference for research scholars to conduct studies on larger scale.

 

Nursing administration:

·       Nurse administrator should take interest in motivating the Nursing personnel to improve their professional knowledge and skill by attending the workshops conferences, seminars on polycystic ovarian syndrome.

·       Nurse administrator should organize regular in service education program to the health care workers for updating their knowledge regarding polycystic ovarian syndrome

 

LIMITATIONS:

·       As the sample size was small that 30, hence the findings of the study cannot be generalized.

·       The study was confined to school teachers of selected school of Ghaziabad.

·        Only female school teachers were selected

·       The age limited to 25-44 years

 

RECOMMENDATIONS:

On the basis of the findings of the study, the following recommendations are made:

·       A comparative study can be conduct among private and government school teachers to evaluate the effectiveness of structured teaching programme among school teachers

·       A similar study can be conducted on large sample to assess the knowledge and attitude regarding polycystic ovarian syndrome among school teachers.

·       A similar study can be conducted to the group of adult women.

 

REFERENCE:

1.   B Sunanda; Nayak, Sabitha. Nitte University Journal of Health Science. Sept2016, Vol. 6 Issue 3, p24-26. Available at http://nitte.edu.in/journal/september2016/02.pdf

2.   Ismail Thamarasseri. issues and challenges during adolescence, Human Development Module III -2010, pg no 3-4 Available at: https://www.cukashmir.ac.in/departmentdocs_16/Issues%20and%20Challenges

3.   World Health Organization. Adolescent health. [online]. Available at: URL:www.who.int/topics/adolescent health/en/

4.   Polycystic ovarian syndrome - International Journal of Reproduction. Available at www.ijrcog.org/index.php/ijrcog/article/viewFile/2910/237 (May 11, 2017 )

5.   International Journal of Reproduction, Contraception, Obstetrics and Gynecology Upadhye JJ et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jun;6(6):2297-2301, Available at www.ijrcog.org

6.   Sadhana Gupta, “ A Comprehensive Text book of Obstetrics and Gynecology”, Jaypee Brothers Medical Publishers (P) LTD, p171,178-180 , Available at https://www.abebooks.com/book-search/title/comprehensive-textbook-obstetrics- gynecology/author/sadhana-gupta/

7.   Backken J, et.al “Teaching parents with mental retardation. Knowledge versus skills” American Journal of mental Retardation (1993) 97 (4): 17-405Available at https://www.researchgate.net/publication/14771005_Teaching parents_with_mental_retardation_Knowledge_versus_skills

8.   Akhi. R; “Polycystic ovarian disease” 1 edition Jaypee brothers. 1999; p. 190 192, International Journal of Current Research Vol. 9, Issue, 11, pp.61458-61464, Nov, 2017

9.   Sobiya N Moghul. 1 In 5 Women Affected by PCOS In India But Fre Not, We have solution, Healthmeup Available at

10. https://www.indiatimes.com/health/healthyliving/1-in-5-women-affected-by-pcos-in-india-but-fret-not-we-have-the-solution-244753.html

11. Clark AM, Thornley B,Tomlinson L. “Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment”. Hum Reproductive. 13: 1998; 1502-1505.

 

 

Received on 20.12.2019          Modified on 18.01.2020

Accepted on 16.02.2020  © A&V Publications all right reserved