INTRODUCTION:

A happy marriage is a long conversation which always seems too short

We are all connected to life, every choice we make and every belief we hold exerts an influence upon life and we live with the consequences of our choice. As a part of our biological health, this unique truth has physical expressions in honour, loyalty, family and group bonds. Probably this forms the basis of marriage, one of the most vital and powerful of our relationships. The human population has seen modern civilization and is still within family boundaries. One such familial- social bond in consanguineous marriage¹.

India is a fascinating country where people of many different communities and religions live together in unity. Indian Population is polygenetic and is an amazing amalgamation of various races and cultures².

Indian culture is an assimilation of diverse conventions, customs, rituals, and ideas harmonizing in one central core of sealed entity. In India, people learn the essential themes of cultural life within the bosom of a family. Social interaction is regarded as being of the highest priority in Indian families and social bonds are expected to be long lasting³.

In societies where marriage is nearly universal and the fertility process is almost entirely through marital union, the factors associated with the occurrence of marriage and through it the reproduction and rearing of children need to be continuously assessed. Marriage in Indian society is a religious duty. Consanguineous marriage is more common in India, especially in rural area where individuals prefer to marry within their clan; such marriages are preferred because of various reasons like fear of marrying a stranger, increased familial bond and restructuring wealth in families⁴.

Consanguineous unions range from cousin –cousin to more distant relatedness and their prevalence varies by culture. Children of such a marriage are at greater risk of being homozygous for a harmful gene and who suffer from autosomal recessive genetic disorders. Consanguineous marriage has been known to increase the chance of the husband and wife carrying an identical gene derived from common ancestors⁴.

Consanguinity is a term that is derived from two Latin words "con" meaning common, or of the same and "sanguineous" meaning blood, hence, referring to a relationship between two people who share a common ancestor or blood. In other words, consanguineous marriage refers to unions contracted between biologically-related individuals⁵. Consanguinity and inbreeding are the terms used interchangeably. Inbreeding describes the situation in which individuals from a small population tend to choose their mates from within the same population for cultural, geographical or religious reasons. Just as with consanguinity inbreeding increases the chance that individuals will be homozygous for an allele inherited from a common ancestor. Thus, in taking family history it is important to ask not only about consanguinity but also about the geographical origins of the ancestors⁶.

Data was collected on infant mortality in children born from first-cousin marriages around the world and it was found that risk of death is 1.2%. Risk of birth defects rise from about 2% in the general population to 4% when the parents are closely related. The genetic conditions more common in populations with high rates of consanguineous marriage are rare recessive disorders which cause a wide range of problems such as birth defects, blindness, deafness, skin diseases, and neurodegenerative conditions⁷.

We all carry gene mutations but when a population has a small gene pool the gene mutation can become more frequent. If two people carrying a recessive gene reproduce, their children have a one in four chance of having the disorder and a one in two chance of becoming carriers themselves. In obstetrical practice, it is important to investigate the history of consanguinity even in preconception and during the antenatal period which helps to offer proper counselling about increased risk of genetic diseases⁸.

As genetic disorders affect all strata of society, irrespective of the social and economic status, it is essential for health care planners to have a macro and micro level planning for devising and implementation of preventive genetic programme. One of the health promotion measures in genetics is prevention of consanguineous marriage⁹.

A community based cross sectional study was conducted to know the effects of consanguineous marriages, among 130 married couples in the field practice area of KBNIMS, Kalaburgi, Karnataka, by using simple random sampling technique. Data was collected in pre designed pre tested questionnaire. Out of 130 married couples 58 were consanguineously marriage (44.6%). Among these families, consanguineous marriages were more in Muslim families (56.06%) as compared to Hindu families (25%). Prevalence of abortions and preterm deliveries was noted to be 60% and 64.28% respectively in consanguineous marriages. It had been witnessed that 66.6% of hearing defects in the community were in consanguineous families and a 100% of all vision defects were seen in consanguineous conceptions¹⁰.

A study conducted to examine the “Role of consanguineous marriages in causing congenital heart disease (CHDs) in Mysore, South India”. A total of 144 confirmed CHD married females about causes and effects of consanguineous marriages. Prevalence of consanguineous marriages among 500 married females was 22.8% with the highest frequency among marriage between first cousins (15.8%). Average inbreeding coefficient up to the marriage between second cousins equals to 0.01172. Longstanding familiarity and sharing same traditions and customs with male relatives were the main causes of consanguineous marriages. The majority of the studied females (42.2%) reported that consanguineous marriage is harmful while 29.6% reported that it has no effect on offsprings¹¹.

NEED FOR THE STUDY:

Around the globe, consanguineous marriages have been practiced by many societies from time immemorial. The marriage between biologically related or blood relatives is consanguineous marriage. The marriage with a relative is related to the health quality of society as well as a genetic concept. Consanguinity is prevalent in many regions of Asia, Africa, and India due to socioeconomic, ethnic, cultural, and religious factors. Consanguinity is thus colour blind, region blind and religion blind. Globally, the most common form of consanguineous union contracted in between first cousins, in which the spouse’s share 1/8^th of their genes inherited from a common ancestor, and so their progeny are homozygous at 1/16^th of all loci¹².

Even today, in many communities in India, the first preference is to look within the family. Intra – community and consanguineous marriages are still more common as it has been for centuries. Much of India, particularly south India has practiced endogamy or marriages within the community for centuries. In many communities’ preference has been given to uncle – niece marriages and between cousins – mother’s brother’s child or father’s sister’s child. Yet there is a lot of unease and worry that has been expressed about the health outcome of consanguineous marriages, both in scientific circles and the societal mind¹³.

The marriage with a relative is related to the quality of health and genetic defects are one of the leading problems in the society. The practice of consanguinity which is a contributing factor for the occurrence of genetic defects must be removed from the society. Public health education and genetic screening are one of the preventive aspects¹⁴.

Globally, it is estimated that one billion of the current population live in communities with a preference for consanguineous marriage (Bittles and Black 2010, Modell and Darr 2002). Consanguineous marriage is traditional and respected in most communities of North Africa, Middle East and West Asia, where intra-familial unions collectively account for 20-50+% of all marriages (Bittles 2011; Hamamy 2011), around 10.4% of world population are either married to a biological relative or are the progeny of a consanguineous union¹⁵.

The state wise prevalence of consanguineous marriage in India revealed that consanguineous union is highest in Tamil Nadu (38%) followed by Andhra Pradesh (30%), states like Maharashtra and Karnataka also show considerable occurrence of consanguineous marriages that is (29%) and (28%) respectively. The practice of consanguineous marriages in Karnataka is widely prevalent, religion wise interpretation shows that, the incidence varies from Marriage in Indian society is a religious duty. Consanguineous marriage is common, where individuals prefer to marry within their clan. Traditionally, some cultures have practiced and continue to practice marriage between relatives such as cousins, as a means of strengthening family ties and retaining property within the family¹⁶.

In India, the recent estimation of consanguinity rates vary from as low as 1-4% in the northern region to as high as 40-50% in the southern region. In comparison to a non-consanguineous couple, consanguineous are more likely to have marriage, at early age. Consanguineous unions range from cousin-cousin to more distant relatedness, and their prevalence varies by culture. Consanguinity has been known to increase the chance of the husband and wife carrying an identical gene derived from a common ancestor. Children of such a marriage, therefore, are at greater risk of being homozygous for a harmful gene and consequently suffer autosomal recessive genetic disorders¹⁷.

India needs to take a big leap in this direction with consanguineous marriages being more prevalent. The need of the hour is setting up infrastructure with basic research and good medical facilities with genetic testing and counselling. Many hospitals in our country lack genetic testing facilities with few well trained genetic counsellors to handle the situation. Adopting better translational research concept and intervention strategies help consanguineous couples reach informed and intelligent reproductive decisions, with which they have to live throughout their lives¹⁸.

Based on the above-mentioned research reviews and facts, the investigator felt the need to assess the knowledge regarding consanguineous marriage among degree students and to create awareness about the consanguineous marriage in order to make the college students to take intelligent reproductive decisions in their life.

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of structured teaching programme on knowledge regarding consanguineous marriage among pre-adults in selected degree college at Bangalore.

OBJECTIVES OF THE STUDY:

1. To assess the pre-test knowledge of pre-adults regarding consanguineous marriage.

2. To assess the post-test knowledge of pre-adults regarding consanguineous marriage.

3. To assess the effectiveness of structured teaching program on knowledge regarding consanguineous marriage among pre-adults.

4. To find out the association between pre-test knowledge regarding consanguineous marriage among pre-adults with their selected demographical variables.

HYPOTHESES:

H₁: There will be a significant difference between the pre- test and post- test level of knowledge regarding consanguineous marriage among pre-adults.

H₂: There will be a significant association between pre-test knowledge score regarding consanguineous marriage with their selected demographic variables.

OPERATIONAL DEFINITIONS:

Assess:

It refers to determining the level of knowledge regarding consanguineous marriage among pre-adults.

Effectiveness:

It refers to determine the extent to which the structured teaching program has achieved the desired effect as expressed by gain in knowledge score.

Knowledge:

It refers to the awareness regarding consanguineous marriage, its health effects and preventive aspects among pre-adults as measured by structured knowledge questionnaire.

Structured teaching programme:

It refers to systematic teaching method which help to impart knowledge regarding consanguineous marriage.

Consanguineous marriage:

In this study it refers to marriage among blood relations.

Pre-adults:

It refers to male and female students in the age group between 18 – 20 years, who are studying in selected degree college at Bangalore.

MATERIALS AND METHODS:

Research approach:

Evaluative research approach.

Research design:

Pre experimental one group pre-test and post-test design was adopted for the present study to find out the effectiveness of structured teaching programme on knowledge regarding consanguineous marriage among pre-adults.

Population:

The population of the study included Pre-adults who are studying in Spurthy College of Science and Management Studies, Marasur gate, Bangalore.

Sampling technique and sample size:

The investigator selected 60 pre-adults through convenient sampling technique.

RESULT:

· Among 60 samples 37(62%) belong to the age group of 18 years, 30(50%) of subjects were females and 30(50%) of subjects were males. In relation to the course of study 37(62%) of the subjects were studying B.Com. 33(55%) subject’s mothers were educated up to SSLC and 30(50%) subjects father were educated up to SSLC. 32(53.33%) of subjects were belongs to nuclear family. In relation to the family income per month, the above graph shows that 24(40%) subjects income was above 9000. 37(62%) subjects were belongs to rural area. 23(38%) subjects have got information through mass media. In relation to the family history of consanguineous marriage, 23(38%) subjects have a family history of consanguineous marriage.

· In pre-test level of knowledge which comprises 40(67%) are having Inadequate knowledge, 20(33%) are having Moderate level of knowledge and 0(0.00%) are having Adequate knowledge.

· In the post-test level of knowledge which comprises 48(81.67%) are having adequate knowledge, 12(18.33%) are having moderate knowledge and 0(0.00%) are having inadequate knowledge.

· The unpaired ‘t’ test value shows that the, Pre-test mean is 9.38, SD is 4 and mean% is 37.52% after structured teaching programme in the post-test the mean is 20.57, SD is 2.1 and mean% is 82.28%. It is evident that there is an enhancement of mean is 11.19, SD is 4 and the mean percentage if 44.76%. Unpaired t value 20.7 is significant at P<0.01 level indicating that structured teaching programme was effective in improving the knowledge regarding consanguineous marriage. Hence H₁ was retained.

· There was a significant association found between educational status of the mother (x²=15.5) and course of study (x²= 7.9) with the level of knowledge score at the level of p<0.05. Hence H₂ was accepted.

Table-1: Pre-test and Post-test level of knowledge regarding consanguineous marriage among pre-adults

n=60

Level of knowledge	Score	Pre test		Post test
Level of knowledge	Score	No	%	No	%
Inadequate	Less than 50%	40	67	0	0
Moderate	50 – 75%	20	33	12	18.3
Adequate	Greater than 75%	0	0	48	81.7
Total		60	100	60	100

The data presented in Table shows that in the pre-test majority of the pre-adults 67% had inadequate knowledge and 33% had moderate knowledge regarding consanguineous marriage, but in post-test 81.7% pre-adults had adequate knowledge and 18.3% had moderate knowledge regarding consanguineous marriage.

Figure 1: Pre-test and Post-test Level of Knowledge.

Table 2: Evaluation of effectiveness of structured teaching programme on knowledge regarding consanguineous marriage among pre-adults with statistical significance.

n= 60

Domain	Mean	SD	Mean%	Unpaired ‘t’ test
Pre-test	9.38	4	37.52
Post-test	20.57	2.1	82.28	20.7**
Enhancement	11.19	4	44.76

*S- Significant at P<0.01, df 59, t- value 2.6

The effectiveness of structured teaching programme was assessed through unpaired t test. There was a significant improvement obtained following structured teaching programme on the knowledge regarding consanguineous marriage among pre-adults. Pre-test mean is 9.38, SD is 4 and mean% is 37.52% after structured teaching programme in the post-test the mean is 20.57, SD is 2.1 and mean% is 44.76%. It is evident that there is an enhancement of mean is 11.19, SD is 4 and the mean percentage if 44.76%. Unpaired t value 20.7 is significant at P<0.01 level. It shows that the structured teaching programme is effective in improving the knowledge regarding consanguineous marriage among pre-adults.

Table 3: Association of pre- test knowledge regarding consanguineous marriage among pre-adults with their selected demographic variables.

								n=60
Sl. No	Demographic Variables	No	%	≤ Median (31)		> Median (29)		Chi-square test
Sl. No	Demographic Variables	No	%	No	%	No	%
1	Age
	a. 18 years	36	60	21	58.33	15	41.67	1.94
	b. 19 years	16	26.67	6	37.50	10	62.50	df 2
	c. 20 years	8	13.33	4	50.00	4	50.00	N. S
2	Gender
	a. Male	29	48.33	16	55.17	13	44.83	0.28
	b. Female	31	51.67	15	48.39	16	51.61	df 1 N. S
3	Course of study
	a. BBA	16	26.67	11	68.75	5	31.25	7.9
	b. BCA	9	15.00	1	11.11	8	88.89	df 2
	c. BCOM	35	58.33	19	54.29	16	45.71	S
4	Educational status of the mother
	a. Illiterate	19	31.67	18	94.74	1	5.26	15.5
	b. Up to SSLC	29	48.33	16	55.17	13	44.83	df 4
	c. PUC	8	13.33	4	50.00	4	50.00	S
	d. Graduate	3	5.00	2	66.67	1	33.33
	e. Postgraduate and above	1	1.67	1	100.00	0	0.00
5	Educational status of the father
	a. Illiterate	14	23.33	5	35.71	9	64.29
	b. Up to SSLC	27	45.0	16	59.26	11	40.74	5
	c. PUC	9	15.0	3	33.33	6	66.67	df 4
	d. Graduate	9	15.0	6	66.67	3	33.33	N. S
	e. Postgraduate and above	1	1.67	1	100.00	0	0.00
6	Type of family
	a. Nuclear family	33	55.0	17	51.52	16	48.48	0.3
	b. Joint family	24	40.0	12	50.00	12	50.00	df 2
	c. Extended family	3	5.0	2	66.67	1	33.33	N. S
7	Family income per month
	a. Below 3000	13	21.67	6	46.15	7	53.85	0.57
	b. Rs 3000 -6000	13	21.67	6	46.15	7	53.85	df 3
	c. Rs 6000- 9000	11	18.33	6	54.55	5	45.45	N. S
	d. Above 9000	23	38.33	13	56.52	10	43.48
8	Residential status
	a. Urban	24	40.0	12	50.00	12	50.00	0.04
	b. Rural	36	60.0	19	52.78	17	47.22	df 1 N.S
9	Sources of information
	a. Mass media	23	38.33	11	47.83	12	52.17
	b. Friends	14	23.33	8	57.14	6	42.86	1.35
	c. Family members	13	21.67	6	46.15	7	53.85	df 4
	d. Teachers	4	6.67	3	75.00	1	25.00	N. S
	e. Health personal	6	10.00	3	50.00	3	50.00
10	Is there any history of consan- guineous marriage in the family
	Yes	23	38.33	9	39.13	14	60.87	2.4
	No	37	61.67	22	59.46	15	40.54	df 1 N. S

N.S- Not significant at p>0.05 level, S- Significant at p<0.05 level

From the above table it is evident that obtained chi- square values shows significant in areas of educational status of the mother 15.5 and course of study 7.9. The other demographic variables are lesser than the table value shows non-significant. Hence it is evident that there is significant association found between the two selected demographic variable such as educational status of mother and course of study of the pre-adults with selected demographic variables in the pre-test knowledge score at the level of p<0.05. Hence the research hypothesis was accepted.

CONCLUSION:

The study was conducted to assess the effectiveness of structured teaching programme on knowledge regarding consanguineous marriage among pre-adults in selected degree college at Bangalore. When the pre test scores and the post test scores are compared, the result of the study showed that the structured teaching programme was effective in improving the knowledge of pre adults regarding consanguineous marriage.

RECOMMENDATIONS:

· A similar study can be replicated on a sample with different demographic characteristics.

· A similar study may be replicated with large number of samples.

· A Comparative study can be done between a rural and urban community.

· Different teaching strategies can be adopted on large sample for wider generalization.

· A similar study can be conducted using experimental and control group.

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Received on 25.10.2024 Revised on 12.12.2024

Accepted on 13.01.2025 Published on 22.02.2025

Available online from March 20, 2025

Int. J. Nursing Education and Research. 2025;13(1):25-30.

DOI: 10.52711/2454-2660.2025.00006

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