A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Cervical Cancer among women of PHC Dabki Road, Akola District

 

J. Gnanadhinahari1, P. Sheema2

1Principal, Samarth Nursing College, Akola.

2Vice Pirncipal, Samarth Nursing College, Akola.

*Corresponding Author E-mail: jgnanadhinahari@gmail.com

 

ABSTRACT:

Cervical cancer is cancer that starts in the cells of the cervix. The cervix is the lower narrow end of the uterus (Womb). The cervix connects the uterus to the vagina (birth canal). The ectocevix is covered with then flat cells called squamous cells. The endo cervix is covered with column shaped glandular cells that make mucus types of cervical cancer. Squamous cell carcinoma – 90% Adenocarcinoma. “A study to study to assess the effectiveness of structured teaching programme on knowledge regarding cervical cancer among women at PHC, akola district”. Objectives: 1 To assess the knowledge regarding the cervical cancer among womens. To determine the effectiveness of structured teaching programme. To associate the pre - test and post – test knowledge regarding cervical cancer. To correlate the knowledge the pre – test and score on cervical cancer among womens. The research design was selected as group pre – test and post – test design variables – independent variables – structured teaching programme and dependent variables – cervical cancer. Target population womens with age group of 25-50yrs. The purposive sampling technique was used. Sampling criteria inclusion and exclusion criteria. Sample size 60 womens from the age group 45 – 55yrs. The questionnaire consisted 01 – 12 items and knowledge questionnaire on cervical cancer. The tool was reliable the validity of the tools done by experts findings majority of the (88.3%) women respondents were living in Rural (11.7%) being in urban areas. The knowledge level of cervical cancer has been increased from mean value of (3.8) at pre – test to (24.67) at post test. It seems that the attitude of women has changed at higher level mean (41.83) compare to knowledge mean of (15.87). The difference between pre and post test for both knowledge and attitude is significant effect of intervention on improving knowledge and positive attitude that in education of women towards cervical cancer. The obtained factors age, marital status are significant. There was a significant increase in knowledge among + = 27.543 (P = 0.05) Attitude among + = 34.931 (P = 0.05). Recommendations: A true experimental study with experimental and control groups can be conducted. Conclusion: The study promotes the womens knowledge and attitude awareness of cervical cancer.

 

KEYWORDS: Cervical Cancer, Women of PHC Dabki Road, Akola District.

 

 

INTRODUCTION:

Cervical cancer is a type of cancer that occurs in the cells of the cervix the lower part of the uterus that connects to the vagina.

 

Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia in which abnormal cells begin to appear in the cervical tissue.

 

1)    Causes: Long – casting infection with certain types of human papillomavirus (HPV)

2)    Risk Factors:

Age 35 -44

·      Women, trans – men

·      Non - binary people

 

 

3)    Signs and Symptoms:

·      Vaginal bleeding after sex

·      Vaginal bleeding after menopause

·      Vaginal bleeding b/n periods

·      Vaginal bleeding that is watery and has a strong odour

·      Pelvic pain

 

Warning Signs:

1)    Change in bowel or bladder habits

2)    A sore that does not heal

3)    Unusual bleeding or discharge

4)    Thickening or lump in the breast

5)    Ingestion

6)    Nagging cough

 

NEED FOR THE STUDY:

The cervical cancer shows changes in the epidemiological pattern with a shift of incidence towards the younger age group. Due to this reason, cervical cancer ranks foremost among the health problems of women in socially reproductive age group. The uterine cervix is the commonest site of malignancy among females in India, especially among the multiparous and women from socially background groups.

 

Awareness of women in rural areas regarding the cervical cancer is less. By educating them, their attitude can be changed and knowledge can be improved. Linder Michie (1993) suggest that population based health education campaigns can create awareness among the rural population regarding cervical cancer and its prevention through early detection.

 

It is reported that cancer is the cause for one tenth of all death and in developed countries it is 2nd most frequent cause of death. WHO reports that without rigorous control measures cancer will become the leading cause of death and there will be 300 million new cancer cases and 200 million deaths from cancer in the coming 25 years.

 

Cervical cancer is the 5th most common cancer worldwide with approximately 471,000 new cases diagnosed each year. Globally every 2 minutes a women dies of cervical cancer and accounts for up to 300,000 deaths annually.

 

In India 366.58 million women are at risk of developing cervical cancer. Cervical cancer ranks as the 1st most frequent Cancer among women in India, and the 1st most frequent cancer among women between 15 to 44 Years age group.

 

About 80% of the new cervical cancer cases occur in developing countries, like India, which reports approximately one fourth of the world’s cases of cervical cancer each year. There has been a regular campaign against cervical cancer for 30 years in India, but this has had little impact on the morbidity and mortality from the disease, with India ranking fourth worldwide.

 

In urban areas, cancer of the cervix account for over 40% of cancers while in rural areas it accounts for 65% of Central and South America and the Caribbean’s too report very high incidence of cervical cancer.

 

PBRC (Population based registries cancer)

Crude Incidence Rate

Age-Adjusted Incidence Rate

Chennai

22.2

24.5

Delhi

16.3

22.7

Mumbai

14.6

18.0

Kolkata

17.4

19.9

Nagpur

19.1

23.2

Pune

20.5

22.5

 

Incidence of cervical cancer in India 2022:

The available evidence for control of cervical cancer is through secondary prevention, namely-early detection through Pap smear. At present in India one life time screening for women should be done at the age of 45 years. During the last 50 years in the United States, the Pap smear tests have reduced the deaths related to cervical cancer by three-quarters. But at one time cervical cancer was one of the most dreaded cancer and the leading causes of death in women in the US but now it is the eighth most common cancer.

 

STATEMENT OF PROBLEM:

Study to assess the effectiveness of structured teaching programme on knowledge regarding cervical cancer among women at Primary health center Dabki road, Akola district.

 

OBJECTIVES:

·      To assess the knowledge regarding the cervical cancer among women.

·      To determine the effectiveness of structured teaching Programme on cervical cancer among women.

·      To associate the post test knowledge and attitude on cervical Cancer with their selected demographics variables.

·      To correlate the knowledge and attitude, Pre test and Post-Test score on cervical cancer among women.

 

HYPOTHESIS:

H1: There will be a significant difference between pre and post test knowledge score after structured teaching programme on cervical cancer among womens.

H2: There will be a significant correlation between knowledge on cervical cancer among womens.

H3: There will be a significant association between the knowledge on cervical cancer and background features among womens.

 

OPERATIONAL DEFINITIONS:

1)    Effectiveness:

      The degree to which something is successful in producing a desired result success.

2)    Cervical cancer:

      It refers to cancer of cervix which is a part of babys bagie female reproductive system.

3)    Structured Teaching Programme:

It refers to systematically organized series of teaching content on cervical cancer which is delivered through power point discussion method for womens in Dabki road PHC.

4)    Women:

It refers to a female of age 25-50 years who are attending OPD at selected Dabki raod PHC.

5)    Knowledge:

It refers to knowledge is a familiarity, awareness or understanding of someone or something such as facts information descriptions or skills which is acquired through experience or education by perceiving discovering or learning regarding cervical cancer a mean used by scoring the items in the structured knowledge questionnaire.

 

ASSUMPTIONS:

·      Items in the questionnaire were be adequate to assess the Knowledge of cervical cancer among womens.

·      Womens are respond honestly to the questionnaire Employed for The data collection.

·      Womens were participate in the study honestly.

·      Information were be provide by the womens were closely reflect their Knowledge level towards cervical cancer.

 

LIMITATION:

·      A study settings selected was Dabki Raod in akola district.

·      Womens who were present at the time of data collection.

·      Womens who were willingly participated in the study.

 

PROJECTED OUTCOME:

By giving structured teaching programme the womens were gained knowledge regarding cervical cancer.

 

CONCEPTUAL FRAME WORK BASED ON NURSING PROCEES MODEL:

 


METHODOLOGY:

Methodology for the study is defined as the way pertinent information is gathered in order to answer the research question to analyse the research problem.

 

RESEARCH APPROACH:

Research that explores the interrelationships among variables of interest without intervention on the part of the researcher is a correlation study. There is no manipulation of one independent variables and to determine if there is a correlation between variables. In the present study, the investigator intended to correlate the knowledge.

 

RESEARCH DESIGN:

The research design selected for the present study was quasi experimental design.

The present study attempts to assess the knowledge among womens in PHC, Dabki Road at Akola district.

 

Design

01

X

02

Pre-experimental design

Pre-test on knowledge and attitude regarding cervical cancer.

Structured teaching programme.

Post test on knowledge and attitude on cervical cancer.

 


SCHEMATIC REPRESENTATION OF RESEARCH DESIGN:

 


VARIABLES:

Independent variables:

Structured teaching programme.

Associate Variable:

Age,

Marital status,                                  

Age at Menarche,

Age at Marriage,

Family history of  cancer,

Religion, Educational Status,

Income,

Occupation,

No of children,

Source of Information,

Residence.

 

Dependent variables:

Cervical cancer

 

POPULATION:

The entire set of individuals or objects having some common characteristics selected for a research study. Target population is the set of individuals or objects on whom the research wishes to generalize the findings. The target population for the study was the womens. Accessible population is the portion of the target population that is available to the researcher. Accessible population was womens with the age group of 25-50 years in selected PHC Dabki Road At Akola District.

 

Population                   : Womens

Targeted population    : Womens with the age group of

                                      25 – 50 years.

Accessible population : Womens with the age group of

                                      25 – 50 years in Dabki PHC.

 

SAMPLE AND SAMPLE SIZE:

The samples for the present study were womens in selected Dabki Road in Akola district who fulfilled the sample selection criteria. The main purpose of the study was to obtain large enough sample to show statistical significance and being economical at the same time. The sample size is arbitrarily decided to be 60 womens from the age group of 25-50 years considering the availability of time, sample acquaintance of the investigator with the PHC.

 

SAMPLING TECHNIQUE:

In this study samples were choosen by non random sampling technique of convenient sampling.

 

SAMPLING CRITERIA:

Sampling criteria is the list of characteristics of the elements that we have determined beforehand that are essential for eligibility to form part of the sample.

 

Inclusion Criteria:

·      Womens who were with the group of 25-50 years.

·      Womens who were willing to participate in this study.

·      Womens who can able to read and write.

 

Exclusion Criteria:

·      Womens who were diagnosed with cancer.

·      Womens who were suffering with abilities, pelvic inflammatory disease.

·      Womens who were taking regular hormonal therapy.

·      Women who were below 20 years of age and above 50 years if age.

·      Women who were not willing to participate.

 

DEVELOPMENT OF THE TOOL:

A modified standardized self-administered questionnaire was identified and used to collect data regarding cervical cancer knowledge and Likert Scale used for attitude; the questionnaire consisted of 3 sections with a total 72 items.

 

DESCRIPTION OF THE TOOL:

The study tool consisted of two sections

Section A: Back ground factors

Section B: Knowledge questionnaire on cervical cancer

Section C: Attitude scale on cervical cancer

 

Section A: Background factors of women:

The questionnaire consisted of 12 items seeking general information about women like age, marital status, age at menarche, age at marriage family history of cancer, religion, educational status, income, occupation, no of children, source of information, locality. Information collected by interview method.

 

Section B: Knowledge questionnaire on cervical:

Cancer Section C: Attitude scale on cervical cancer:

This section seeks the information regarding the attitude on cervical cancer on 5 point scale; it is considered of 30 items.

0 = Undecided

1 = Strongly Disagree

2 = Disagree

3 = Agree

4 = Strongly Agree

 

TRY OUT:

The tool was administered and checked for its clarity and appropriateness. The subjects chosen were similar in characteristics to those of the population under the study. The tool prepared by the research and was administered to twenty womens.

 

RELIABILITY:

The stability of an instrument refers to the instruments reliability to produce the same result with repeated testing. Inter rater reliability was done. The purposive sampling. Two persons who were equally exposed to the caring of the patients and researcher administered the tool simultaneously. Correlation coefficient was found r = (0.8). The tool was found highly reliable.

 

VALIDITY OF THE TOOLS:

The background factors, the knowledge scale, and attitude scale in the structured questionnaire and the translated tools are sent along with the request for validation to 3 nursing experts and 2 obstetrics and Gynaecology doctors. Suggestions were considered and modification of tool was done according to the opinion of experts in the back ground attitude Scale. Language experts did translation of the tool into Marathi and retranslation into English was done. The validity was confirmed.

 

DATA COLLECTION PROCEDURE:

The data on knowledge and attitude towards cervical cancer were collected from Dabki Raod womens. The data were collected for 4 weeks from the month of April and May 2022. Permission was sought and  obtained from PHC authoritative. The womens were selected using non random sampling method among those who fulfilled the sample selection. Initial rapport was developed and the purpose of the study was explained to them. Informed consent was obtained from the womens. The questionnaire was administered to the womens, regarding knowledge and attitude regarding cervical cancer separately. Confidentiality of the information shared was assured. The womens were co- operative. On an average, it took 30 minutes to complete one sample. At the end, the tool was edited for completion.

 

PLAN FOR STATISTICAL ANALYSIS:

The data collected from the subjects were edited, compared and correlated using both descriptive and inferential statistics on the basis of objectives and hypothesis of the study. The analysis was done using statitstical package SPSS version 10. The level of significance was 0.05.

1.    Frequency, percentage distribution were used to describe womens regarding their back ground.

2.    Correlation of knowledge and attitude were analysed by mean, standard deviation, range, and – r|| value.

3.    The association between knowledge and selected back ground factors were analysed by linear regression.

4.    The association between attitude and selected back ground factors were analysed by linear  regression.

 

ETHICAL CONSIDERATION:

The researcher committee approved the research problem and objectives. Informed consent was obtained from individual womens by orally. The womens had the freedom to leave the study at her will without assigning any reason. Due permission from hospital authorities were obtained. Explained regarding the purpose of the STP was given to the womens involved in the study. Thus the ethical issues were ensured in this study.

 

SUMMARY:

The prime aim of the study was to assess the effectiveness of structured teaching programme of knowledge and attitude towards cervical cancer among women 25-50 years in selected PHC, Dindigul.

 

MAJOR FINDINGS:

The finding of the study are presented under the following heading based on the objective of the study.

 

OBJECTIVE 1:

To associate the post test knowledge and attitude on cervical cancer with their selected demographic variables.

1.    The obtained chi- square value regarding knowledge, attitude and selected factors such as age, marital status, Age at menarche, Age at marriage, Family history of cancer, Religion, Educational status, Income, Occupation, No of Children, Source of information, residence (P>0.05) were not significant.

2.    The obtained chi- square = 0.985 (P=0.03 0 regarding marital status and knowledge post test, chi square = 0.966 (P = 0.04 ) regarding education and knowledge post test of women was significant.

3.    Selected factor such as age, marital status, Age at menarche, Age at marriage, Family history of cancer, Religion, Educational status, Income, Occupation, No of Children, Source of information, residence, did make no difference in the knowledge and attitude towards cervical cancer among women.

 

OBJECTIVE 2:

1.    There was a significant increase in knowledge after the power point teaching among women between the age group of 25-50 years t = 27.543 ( P = 0.05 )

2.    There was a significant increase in Attitude after the power point teaching among women between the age group of 25-50 years t = 34.931 ( P = 0.05 )

 

FINDING 1:

1.    The obtained chi- square value regarding knowledge, attitude and selected factors such as age, marital status, Age at menarche, Age at marriage, Family history of cancer, Religion, Educational status,  Income, Occupation, No of Children, Source of information, residence (P > 0.05) were not significant.

2.    The obtained chi-square = 0.985 (P = 0.03) regarding marital status and knowledge post test, chi square = 0.966 (P = 0.04) regarding education and knowledge post test of womens was significant.

 

FINDING 2:

1.    There was a significant increase in knowledge after the power point teaching among women between the age group of 25-50 years t = 27.543 ( P = 0.05 )

2.    There was a significant increase in Attitude after the power point teaching among womens between the age group of 25-50 years t = 34.931 ( P = 0.05 ).

 

IMPLICATIONS FOR NURSING PRACTICE:

1.    Power point teaching is an effective measure to increase the knowledge and Attitude. Nursing can use this Power point teaching is an effective measure to increase the knowledge and Attitude towards cervical cancer.

2.    Nurse can plan the gaol of pap smear screening of cervical cancer and enhance the nurse patient relationship and sense of well-being to the patient through the development of mutually agreed the goals.

3.    Power point teaching should be made an integral part of preventive management of cervical cancer among womens.

 

IMPLICATIONS FOR NURSING RESEARCH:

1.    The study will be valuable reference for the further research.

2.    The findings of the study would help to expand the scientific body of professional knowledge up on which further research can be conducted.

 

LIMITATION:

1.    Period of power point teaching only five days.

2.    This study has no control group to prove the effectiveness of structured teaching programme.

3.    The samples were selected by non random method limiting the generalizability.

 

RCOMMENDATIONS:

1.    A similar study can be conducted in large group of womens.

2.    A longer period of intervention can be used studied for more reliability and effectiveness.

3.    A true experimental study with experimental and control groups can be conducted.

 

CONCLUSION:

Structured teaching programme significantly increases the knowledge and attitude. So future nurses can incorporate structured teaching as a part of nursing intervention in treating cervical cancer.

 

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Received on 25.07.2023        Modified on 15.09.2023

Accepted on 03.11.2023       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2023; 2(4):118-124.

DOI: 10.52711/jnmr.2023.30