RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 Name of the candidate and SUJI. Y.

address (in block letters) I YEAR M.Sc. NURSING
MASOOD COLLEGE OF NURSING
BIKARNAKATTA, KULSHEKAR POST,
MANGALORE-575005.

2 Name of the institution MASOOD COLLEGE OF NURSING

BIKARNAKATTA,
KULSHEKAR POST,
MANGALORE-575 005 .

3 Course of the study and M.Sc. NURSING

subject OBSTETRIC AND GYNAECOLOGICAL
NURSING

4 Date of admission to the 16.06.2012

course

5 Title of the study

“A STUDY TO ASSESS THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE
REGARDING SEXUALLY TRANSMITTED DISEASES AMONG THE
ADOLESCENT GIRLS IN A SELECTED COLLEGE AT
MANGALORE”.

6 BRIEF RESUME OF THE INTENDED WORK

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INTRODUCTION

Adolescence is a transition period in life, when an individual is no longer a child,

but not yet an adult. The term adolescence comes from the Latin word “adolescere” which
means to grow up. Adolescence is the period from puberty to early adulthood. Adolescents,
defined by WHO as persons between 10 and 19 years of age which make up about 20%of the
world’s population, of whom 85% live in developing countries.1

The generation entering into the adolescent years now is the largest in human
history. In 2000, in the developing world as a whole, the population of adolescents aged 10-19
was estimated at 995 million, about one-fifth of the total population. According to the medium
population projections of the United Nations, this number will reach 1,060 million by 2020 –
an increase of 65 million, or 65%. The gender ratio in India is adverse, with males
outnumbering females in every age group. The present gender ratio of 0-6 year olds is 927
girls for every 1000 boys, will affect the adolescent population in coming years. Indeed, a
variety of developmental indicators already reflect a wide gender disparity.

Malnutrition, high workforce participation, low enrolment figures in school, human

trafficking, victimization by being forced into non-consensual sex, and a lack of awareness,
information and education are high among girls.2

A general lack of understanding about the particular needs of Indian adolescents,

specifically adolescent girls, persists in India and the wider global community. The Indian
context calls for a focus on adolescent girls due to their general vulnerability, inaccessibility
to basic healthcare and education, unmet sexual and reproductive health needs and rights, and
age old traditions and misconceptions that have seen this cohort marginalised.3

The major causes of mortality and morbidity among young people include suicide,
road accident, drug use (including tobacco use) and sexual and reproductive ill health. Many
adolescents around the world are sexually active and because many sexual contacts among
them are unprotected, they are potentially at risk of contracting sexually transmitted infections
(STIs). STIs may be the consequence of unprotected sex with a number of short-term
partners, but may also occur among those who have a long-term unfaithful, perhaps older,

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partner or husband.4

Adolescents’ use of contraception is generally low and they are less likely to use
condoms than adults because of lack of access and, for girls in particular, the inability to insist
on their use. Furthermore, for biological reasons, sexually active girls may be at greater risk of
contracting STIs than boys and also adolescence is the milestone of women hood, so for
healthy tomorrow it is necessary to teach the girl students about the of Sexually Transmitted
Diseases and its prevention.4

6.1 NEED FOR THE STUDY

Many people experience critical and defining life events – first marriage, first
sexual intercourse, and parenthood during adolescence. These life events were once
considered inseparable, but this is no longer true for many young people. Adolescents are
staying in school longer, marrying late, and are increasingly becoming sexually active
before marriage. Young people now experience puberty at early ages than did previous
generations, with girls entering between the ages of 8 and 13 and boys between 9 and 14.
Because the time between puberty and marriage has increased, many young people
experience first sexual intercourse and child bearing in a different personal and social
context than did previous generations.5

Sexually transmitted infection is prevalent among adolescents. Due to biological

vulnerability of the immature reproductive organ, cognitive inability to fully comprehend
consequences of personal actions, social and cultural norms about sexual activity, this group
represents a priority audience for education about STI prevention and about HPV vaccination.
Understanding adolescents and their decision-making abilities, educating them about safer
sexual practices, providing STI information are all critical aspects of adolescent healthcare
today.5

One of the reasons why young people are particularly vulnerable to STIs is the lack
of sex education, including on STI prevention. There is still reluctance in some quarters to
acknowledge and properly address adolescent sexual activity despite widespread evidence of
how early sex begins and the extent of unwanted pregnancies and STIs in young age groups.

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Although much of the sex education in schools is probably insufficient or begun too late,
adolescent sexual health needs have gradually gained recognition in the last two decades.
Education on sexuality is now on the agenda of ministries of education and ministries of
health in most countries, even if implementation has remained weak or limited to certain
aspects of sexual health, e.g. information on HIV but not other STIs. However, in many cases
young people are not provided with the skills to protect themselves against the risk of
infection.4

The sexually transmitted infection is largely due to factors which are preventable.
Teens may become sexually active in response to peer pressure, the need to experience
closeness, the desire to feel older or more mature, to experiment, or to feel pleasure. Although
teens are exposed to sexual topics, they have few qualified resources to help deal with these
issues. Thus, it is important for healthcare professionals to be knowledgeable about adolescent
sexually and to be able to answer questions, validate feelings, and assist in solving problems
that may present. Hence, the researcher felt the need to impart knowledge regarding the
prevention of sexually transmit ted infections using a planned teaching programme, which is
also to be an effective method to spread health-related information and awareness among
adolescent girls, thus preventing the occurrence of reproductive problems among adolescent
girls, thus preventing the occurrence of reproductive problems.

6.2 REVIEW OF LITERATURE

Literature related to incidence of sexually transmitted disease

In 2008, the Chlamydia rate among African American/black women ages 15 to 19

was nearly seven times higher than among white females (10,513.4 and 1,534.5 per 100,000
females, respectively). In the same year, the Chlamydia rate among American Indian/Alaskan
Native (three times higher) and Latina/Hispanic (two times higher) women ages 15 to 19 were
also higher than among white females (4,792.6 and 3,186.2 per 100,00 females,
respectively). Among black males ages 20 to 24, the Chlamydia rate was eight times higher
compared to white males (3,825.4 and 465.9 per 1000,000 males, respectively). Also, in 2008,
the Chlamydia rate among American Indian / Alskan Native (nearly three times higher) and
Latino/Hispanic (two times higher) were higher compared to their white male peers (1,299.2

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and 1,024.4 per 100,000 males, respectively).6

A cohort study was conducted among 1275 young women aged 12-24 years
in Kampala, Uganda, about infection with HPV and HIV. Data was collected with a structured
questionnaire about reproductive and menstrual factors, sexual behaviours, and history of
sexually transmitted disease among women and their partner. The result showed that the
prevalence of human papilloma virus infection was 74.6%. The researcher concluded that
great caution is essential to prevent the infection and motivate adolescents for vaccination.7

Literature related to knowledge regarding prevention of Sexually transmitted disease

among adolescent girls

A longitudinal study was conducted in a Swedish city among 79 young women

aged 16-23 years to assess the knowledge about the prevention of sexually transmitted
diseases. The questionnaire, testing knowledge about the mode of transmission and
prevention of STDs, gave a total score of correct answers varying between 44% and 64% with
less knowledge about human papilloma virus (33%). The researcher concluded that the most
important finding of the important finding of the study was the low awareness of HPV as
asymptomatic infection. It is concluded that Information has to focus more on the possibility
of asymptomatic transmission and motivating use of condoms.8

A cross-sectional knowledge, attitude, and practice survey of sexual and

reproductive health was conducted among junior secondary school pupils in the Kassena-
Nankana district. The study found that school pupils had unsatisfactory knowledge about
STDs; boys tended to be more knowledgeable than girls (p < 0.05). In terms of attitude
towards condom use, a significantly higher percentage of boys (70%) compared with girls
(61%) felt confident about insisting on condom condom use whenever they had sex. However,
boys were more likely to be involved in sexual risk behaviours than girls. Eighteen percent of
boys and 8% of girls reported being sexually experienced (p < 0.05). Boys started having sex
earlier than girls (at 14.5 compared with 15.1 years, p < 0.05). Sixty-two percent of boys had
sex with multiple partners compared with 32% of girls (p < 0.05). The mean number of
lifetime sexual partners of boys and girls was 4.2 and 2.5, respectively (p<0.05) The
percentage of people reporting non-use of condoms during last sexual encounter was

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significantly higher among boys (37%) than girls (29%). Differences were observed in
association of knowledge and attitudes regarding STD prevention with sexual activities
among both boys and girls.9

Literature related to effectiveness of planned teaching programme among adolescent

girls

According to World Health Organization, ‘health education is a major mode of

teaching and it is assumed that teaching helps in changing the behavior through cognitive
and effective behavioral changes.’ Each individual is responsible for maintaining his own
health. Health education will influence individual, community and social health. In simple
words health education is a process, which enables an individual to change their beliefs and
improve health through gain in new knowledge3

An experimental study was conducted in Nepal to find out the effectiveness of

planned teaching programme in improving knowledge and attitude of school going
adolescents on reproductive health. All the subjects were divided into two groups:
experimental and control, each comprising of two subgroups of 50 boys and 50 girls. Planned
teaching programme consisting of the experimental information on human reproductive
system was used as a tool of investigation for group, whereas conventional teaching method
was used for the control group. The results revealed that a total of 200 adolescent school
students were included in this study. The mean pre-test score of the experimental group on
knowledge of reproductive health was 39.83±16.89 and of the control group was 39.47±0.08.
The same of experimental group after administration of the planned teaching programme
(84.60±10.60) and of the control group with conventional teaching method (43.93±10.08) was
statistically significant (p<0.001). Similarly, the post-test scores of knowledge of the groups
on responsible sexual behaviour and their attitude towards reproductive health were better in
the experimental group than in the control group (p<0.001). The researcher concluded that
knowledge of adolescent school students on reproductive health is inadequate. Planned
teaching programme was effective in improving knowledge and attitude of the adolescents
on reproductive health.10

An evaluative study was conducted among 600 women to evaluate the

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effectiveness of planned teaching programme on prevention of endometrial cancer at South
Africa. The data was collected through structured interview schedule. The findings revealed
that mean post-test knowledge was higher than mean pre-test knowledge score which showed
that planned teaching programme was effective in increasing knowledge.(t=36, P<0.05).11

A quasi experimental study was conducted to evaluate the effectiveness of planned

teaching programme regarding the adverse effect of tobacco smoking on knowledge gain of
10th standard adolescents in a selected school of Kolar district in Karnataka. Sample (30) was
chosen by convenience sampling technique. The tool used was a structured knowledge
questionnaire to assess student’s prior information, followed by planned teaching programme.
The study finding revealed a significant difference between the pre-test and post-test
knowledge scores (t=19.18, p<0.001) suggesting the effectiveness of PTP in increasing the
knowledge of students regarding the adverse effects of tobacco smoking.12

An evaluative study was conducted on the effectiveness of PTP on awareness

regarding promotion of mental health among adolescents in a selected college at Mangalore.
The finding of the study showed that total mean percentage of the pre-test knowledge score
was 46.11% with total mean and SD 17.52±6.05, whereas the total mean percentage with
mean and SD 30.45±4.02 showed an increase of 34.03% in mean knowledge of
adolescents after planned teaching programme. The findings showed that there was
significant increase in the knowledge compared to the pre-test knowledge score among
adolescents.13

6.3 PROBLEM STATEMENT

A study to assess the effectiveness of structured teaching programme on

knowledge regarding sexually transmitted disease among the adolescent girls in a selected
college at Mangalore.

6.4 OBJECTIVES OF THE STUDY

The objective of the study are to:

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  Determine the existing knowledge score of adolescent girls regarding sexually
transmitted disease using a close-ended structured knowledge questionnaire.
 Find the effectiveness of planned teaching programme on sexually transmitted disease
among adolescent girls using the same structured questionnaire.
 Find the association between pre-test knowledge score and selected demographic
variables.

6.5 OPERATIONAL DEFINITIONS

1. Effectiveness: In this study, it refers to the extent to which the structured teaching
programme on sexually transmitted disease has achieved the desired effect as evident
from the gain in knowledge score as measured by the structured knowledge
questionnaire.
2. Structured teaching programme: In this study, it refers to the systematically
developed teaching programme designed for a group of adolescent girls in a college to
provide informat ion on sexually transmitted disease by lecture and discussion with a
view to improve their knowledge on sexually transmitted disease.
3. Sexually transmitted disease: In this study sexually transmitted disease refers to any
any disease transmitted by sexual contact; caused by microorganisms that survive on
the skin or mucus membranes of the genital area; or transmitted via semen, vaginal
secretions, or blood during intercourse.
4. Adolescents: in this study, it refers to the students in the age group of 17-19 years
studying in the selected degree college.

6.6 ASSUMPTIONS

The study assumes that:

 Adolescent girls will have some knowledge regarding sexually transmitted disease
 Structured teaching programme will increase the knowledge of adolescent girls
regarding sexually transmitted disease.

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 6.7 DELIMINATIONS

The study is delimited to:

1. Adolescent girls in the age group 17-19 years.

2. Selected degree college at Mangalore.
3. 60 degree student.

6.8 HYPOTHESES

H1: The mean post-test knowledge score of adolescent girls on sexually transmitted disease
will be significantly higher than the mean pre-test knowledge score as measured by
structured knowledge questionnaire.

H2: There will be significant association between pre-test knowledge score and selected
demographic variable at 0.05 level of significance.
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.
MATERIALS AND METHODS

7.1 Source of data collection

The data will be collected from adolescent girls in the age group of 17-19 years
among selected degree college, who fulfils the inclusion criteria and are willing to participate
in the study.

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7.1.1 Research design

The research design selected for the study is one group pre-test post-test design.

Pre-test Treatment Post-test

O1 X O2

E = O2 – O1

O1 Pre-test

X STP

O2 Post-test

7.1.2 Setting

The study will be undertaken in a selected college at Mangalore (Masood

College of Nursing, Mangalore)
7.1.3 Population

The study population will comprise of adolescent girls in the age group of 17-19

years studying in a degree college.

7.2 Method of data collection

7.2.1 Sampling procedure

In view of nature of problem and to accomplish the objectives of study, simple

random sampling procedure will be used to select the adolescent girls of a degree college in

Mangalore.

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7.2.2 Sampling size

The data will be collected from 60 adolescent girls in the age group of 17-19 years.

7.2.3 Inclusion criteria for sampling

 Adolescent girls in the age group of 17-19 years.

 Adolescents willing to participate in the study.

7.2.4 Exclusion criteria for sampling

Students who are,

 Already exposed to teaching regarding sexually transmitted disease.

 Not available during the period of data collection.

 Not willing to participate in the study.

7.2.5 Instruments used

 A self administered questionnaire including part I, demographic variable and part II,

knowledge questionnaire, to assess the knowledge regarding sexually transmitted

disease, clinical features, diagnosis, complication and management.

7.2.6 Data collection method

1. Data will be collected by the researcher herself after obtaining permission from the

concerned authority of the selected college for one month.

2. The objective of the study will be explained to the participants and a formal written

consent will be taken from the subjects.

3. Pre-test will be conducted using a structured knowledge questionnaire and the

structured teaching programme will be provided to the adolescent girls on the same

day. Post test will be conducted using the same knowledge questionnaire on the

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 seventh day.

7.2.7 Data analysis plan

 Demographic data will be analyzed using frequency, percentage and graphs.

 Data will be tested at 0.05 level of significance.

 Paired‘t’ test will be used to find the gain in knowledge score through the structured

teaching programme.

 Association between pre-test knowledge scores and selected demographic

variableswill be found using chi-square test.

7.3 Does the study require any investigation to be conducted on patients or other

human or animals(if so please describe briefly)

Yes. Only the structure teaching programme will be administered.

7.4 Has ethical clearance been obtained from your institution in case of 7.3?

Yes, Consent from the college will be obtained.

LIST OF REFERENCES

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8. 1. Conard LAE, Bythe MJ. Aspects of sex in adolescence. New Delhi: Elsevier
Publishers; 2003.

2. Park K. Preventive and social medicine. 20th ed. New Delhi:Banarsidas Bhanot
Publishers; 2010

3. WHO department of reproductive health and research. Reproductive health strategy

toaccelerate progress towards the attainment of international developmental goals
and targets. Geneva .WHO; 2006.

4. Karl L Dehne, Gabriele Riedner, Sexually transmitted infection among adolescents.

5. Jane FW, Patricia SS, Ying WN. Human papilloma virus in rural adolescent females:
Knowledge, protected sex and sexual risk behaviors. Journal of Rural Nursing
and Healthcare 2006;6(1).

6. Centers for Disease Control and Prevention. Sexually Transmitted Disease

Surveillance, 2008. Atlanta, GA: U.S. Department of Health and Human Services;
November 2009.

7. Cecily B, Silvia F, Leen jan van D, Annie A, Fredwabwire, Edward KM, et al.
Infection with human papilloma virus and HIV among young women, Uganda.
Journal of Infectious Diseases 2008;197:555-62.

8. Anderson E, Milsom I. Knowledge about prevention of sexually transmitted

diseases among young women from 16- 23 years of age. Adolescent sexual health.
Journal of Sexually Transmitted Infections 2002;78:339-41.

9. Le Quyen Duong sexually transmitted disease prevention: knowledge, attitudes,

and practices among school pupils in rural Ghana, 2007.

10. Dhital AD, Badhu BP, Pandel RK, Uprety DK. Effectiveness of STP in improving
knowledge and attitude of school going adolescents on reproductive health.
Kathmandu University Medical journal.2005;3(4): 380-3.

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 11. Gilbert P, Michal P. Knowledge, attitude and practice of rural women
regarding endometrial cancer. American Journal of Obstetrics and Gynaecology
1992;588-92.

12. Sreevani, Renuka. Effectiveness of planned teaching programme regarding adverse

effect of tobacco smoking on knowledge gain of 10th std students in a selected school
of Kolar district souvenir on first international conference of Indian Society of
Psychiatric Nurses 2005 Feb 7;46.

13. Maya PK. Effectiveness of planned teaching programme on awareness regarding

promotion of mental health among adolescents in a selected college at Mangalore.
Unpublished M.Sc.Nursing dissertation submitted to Rajiv Gandhi University of
Health sciences, Bangalore:2004

9 Signature of the candidate

10 Remarks of the guide

11 Name and designation of(in block letters)

11.1 Guide MRS. SUSHMA DANNY .S

ASSISTANT PROFESSOR
MASOOD COLLEAGE OF NURSING
MANGALORE

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 11.2 Signature

11.3 Co-guide (if any) MRS.SYLVIA SEVERINE NORONHA

PROFESSOR
MASOOD COLLEAGE OF NURSING
MANGALORE

11.4 Signature

11.5 Head of the department MRS.SYLVIA SEVERINE NORONHA

PROFESSOR
MASOOD COLLEAGE OF NURSING
MANGALORE
11.6 Signature

12 12.1 Remarks of the

Chairman and Principal

12.2 Signature

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