A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Warning Signs and Prevention of Reproductive Cancer among Female Non Health Professionals in a selected Hospital, Mangaluru

 

Divya. V.1,   Celia. J. Sharel.2

1M.Sc (N) Department of Medical Surgical Nursing, Masood College of Nursing, Mangaluru, Karnataka. India.

2Assistant Professor, Department of Medical Surgical Nursing,

Mangaluru College of Nursing, Mangaluru, Karnataka. India.

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

 

ABSTRACT:

Female reproductive cancer is cancer of the organs related to female reproductive system. In order to identify these cancers in early stage women needs to have knowledge regarding warning signs of these cancers. Possessing knowledge helps to reduce mortality and enhances number of cure rate among women’s at risk of reproductive cancer and it is one of the prime responsibility of all health care personnel’s to disseminate information regarding warning signs and prevention of reproductive cancer. The present investigation was aimed to evaluate the effectiveness of structured teaching programme on knowledge regarding warning signs and prevention of reproductive cancer among female non health professionals working in selected hospital and to find out the association between the pre test knowledge score regarding warning signs and prevention of reproductive cancer and their selected demographic variables. The research design used in the study was pre – experimental one group pre-test post-test and non-probability purposive sampling technique was used to draw sample. The data was collected from 60 non health professionals using the structured knowledge questionnaire. Structured teaching programme was conducted and post-test was administered after 7 days using the same structured knowledge questionnaire to find out the effectiveness of structured teaching programme. The results revealed that the overall mean percentage knowledge score in the pre-test and post-test were 34% and 74.56% respectively. Enhancement mean percentage knowledge score was found to be 40.56%. The statistical paired ‘t’ test (t= 44.44) indicates that enhancement in the mean percentage knowledge score was found to be significant at 0.05 level for all the aspects under study. The association found to be significant between pre-test knowledge scores & selected socio demographic variables such as age, educational status, occupation, monthly income, and information regarding reproductive cancer at 0.05 levels (P< 0.05). There is no significant association and some demographical variable such as religion, marital status and family history of cancer, presence of children.

 

KEYWORDS: Warning signs and prevention, Reproductive cancer, Female non health professionals.

 

 


 

 

INTRODUCTION:

The most admired creations of God are women. Not just the symbol of beauty, they are the mentors of the young ones, helping hands of needy and the pillars of the homes. What is more difficult to explain is why more women in India are diagnosed with cancer than men, according to a new study published in “The Lancet Oncology”.  Men report a 25% higher incidence of cancer than women all over the world, but India bucks this trend. The world's oldest documented case of cancer hails from ancient Egypt in 1500 BC. The details were recorded on Papyrus, documenting eight cases of tumors occurring on the breast.1 Reproductive cancers are cancer that is in the organs related to reproduction. The most common reproductive cancers in women are breast, cervical, uterine, vulvar, ovarian, vaginal.  Breast cancer is now the most common cancer among women in India, accounting for 27% of all cancers among women. Oncologists say there has been a sharp uptick in cases in the last six years. The second most common cancer is cervical cancer.2

 

The word cancer is derived from the Latin word “crab”, probably because of the way a cancer adheres to any part that it seizes upon in an obstinate manner like the crab.  It is a popular, generic term because the actual medical term for cancer is “neoplasia” which, from the Greek, means new formation.  Cancer cells are described as malignant neoplasm and are classified and named by tissue of origin.  The failure of the immune system to promptly destroy abnormal cells permits these cells to grow too large to be managed by normal immune mechanisms.  Certain categories of agents or factors implicated in carcinogenesis (malignant transformation) include viruses, physical agents, chemical agents, genetic or familial factors, dietary factors, and hormonal agents.3               

 

Cancer is the leading cause of mortality in many countries around the world.4 The majority of deaths from cancer occur in low and middle income countries and is most likely because of delayed presentation.5  This is due to a number of factors including poor awareness of the signs and symptoms of cancer, cancer risk factors, poor availability of tests or screening programs and limited access to standard treatment.6

 

However, poor public knowledge of the signs and symptoms of cancer is considered to be the predominant reason for delayed presentation, particularly if these symptoms are atypical in nature.7  It is known that certain types of cancer have high chance of cure if detected early and treated adequately.8

 

Ovarian and cervical cancers are identified to be the most common gynaecological cancers affecting women worldwide and in India. There is an alarming rise in cervical cancer second only to breast cancer. A survey shows that every year in India, 122,844 women are diagnosed with cervical cancer and 67,477 die from this disease.9

 

Reproductive cancers may present in variable forms clinically, and  symptoms of cancer in women manifest differently at different stages of illness. Consequently, these conditions are often not identified as early as they should be as awareness levels of these cancers are relatively low. Open communication is a very important step towards greater awareness of symptoms and ultimately early diagnosis for all gynaecological cancers.10

 

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of structured teaching programme on knowledge regarding warning signs and prevention of reproductive cancer among female non health professionals in a selected hospital Mangaluru.

 

OBJECTIVES OF THE STUDY:

The objectives of the study are 

·       To assess the knowledge of female non health professional on warning signs and prevention of reproductive cancer.

·       To evaluate the effectiveness of structured teaching programme on knowledge regarding warning signs and prevention of reproductive cancer among female non health professionals working in selected hospital.

·       To find out the association between the pre test knowledge score regarding warning signs and prevention of reproductive cancer and selected demographic variables.

 

RESEARCH HYPOTHESIS:

H1: There will be a significant difference between pre-test and post-test knowledge scores of the female non health professionals regarding warning signs and prevention of reproductive cancer.

H2: There will be a significant association between pre test knowledge scores of female non health professionals regarding warning signs and prevention of reproductive cancer and selected demographic variables.

 

MATERIALS AND METHODS:

Research approach: The researcher utilized experimental research approach

 

Research design: In this study, Pre-experimental, one group pre-test and post-test design was adapted.

 

Research setting: The setting for the study is Yenepoya hospital and Indiana hospital.

 

Population: In this study, population consists of female non health professionals working in selected hospitals in Mangaluru.

 

Sample: The sample would comprise of 60 female non health professionals of selected hospitals, Mangaluru.

 

Sampling technique: The samples were selected by using non probability purposive sampling techniques.

 

Description of the final tools:

The tool used in the study consists of 2 parts

Part 1:  Socio Demographic proforma

Part 2: Structured knowledge questionnaire

 

Plan for data analysis:

The data were analysed by using both descriptive and inferential statistics

·       Organization of ungrouped data into grouped data.

·       Frequencies and percentages were used for analysis of socio-demographic characteristics.

·       Calculation of mean, standard deviation of pre and post-test scores.

·       Paired ‘t’ test was used to ascertain whether there is significant difference in the mean knowledge score of pre-test and post-test values.

·       Chi- square test was used to find the association between socio-demographic variables with  pre-test knowledge scores.

 

RESULTS:

Section I: Description of sample characteristics:

In the present study, a total of 100 pre menopausal women  participated. 40(66.67%) respondents belongs to the age group of  26-35 years, Majority 47(78.33%) respondents belongs to Hindu religion, majority 37(61.67%) respondents were married, majority 42(70%) respondents had Degree and above education, Majority 24(40%) respondents were receptionists, Majority  39(65%) respondents had monthly income of 5,001 – 10,000Rs, Most of the respondents 43(71.67%) are not having family history of cancer in the family, Majority 31(51.67%) respondents are having children, Majority 39(65%) respondents don’t have previous information about reproductive cancer.

 

Section II: Level of knowledge of female non health professionals.

 

Table 1: Frequency and percentage distribution of subjects according to their  pre-test knowledge score              n = 60

Sl. No

Level of knowledge 

Frequency (f)

Percentage (%)

1

Inadequate

36

60

2.

Moderately adequate

24

40

3.

Adequate

0

0

 

 

The above table shows that the majority of the samples 36(60%) had inadequate, 24(40%) had moderately adequate knowledge regarding warning signs and prevention of reproductive cancer

 

 

Table 2: Overall and area-wise pre test mean, SD and mean percentage value of the samples    n=60

Sl.No

Area

Max possible score 

Mean±SD

Mean %

1

Anatomy and physiology of the reproductive system.

3

2.02

1.05

67.22

2

Definition and types of cancer

3

1.25±0.73

41.67

3

Types and risk factors of reproductive cancer.

6

2.35±0.97

39.17

4

Warning signs, diagnostic evaluation and prevention of reproductive cancer.

15

3.57±1.5

23.8

Overall

27

9.18±2.87

34.04

 

The data in Table 2 shows that in pre-test maximum knowledge was in the area of anatomy and physiology of the reproductive system, mean percentage was 67.22% with mean and standard deviation of 2.02±1.26. Lowest knowledge score was in the area related to warning signs, diagnostic evaluation and prevention of reproductive cancer, mean percentage 23.8% with mean and standard deviation of 3.57±1.5.  In the area related to definition and types of cancer, mean percentage was 41.67 with mean and standard deviation of 1.25±0.73 and in the area related to types and risk factors of reproductive cancer mean percentage was 39.17 with mean and standard deviation of 2.35±0.97. The overall mean percentage was 34.04 with mean and standard deviation of 9.18±2.87.

 

Section III: Effectiveness of structured teaching programme on level of knowledge regarding warning signs and prevention of reproductive cancer among female non health professionals.

 

Table 3: Frequency and percentage distribution of subjects according to the pre-test and post-test knowledge score          n=60

Sl.

No

Pre test

Post test

level of knowledge

Frequency

(f)

Percentage

(%)

Frequency

(f)

Percentage

(%)

1

Inadequate

36

60

0

0

2

Moderately adequate

24

40

13

21.67

3

Adequate

0

0

47

78.33

 

The data in table 3 shows that the in pre test, majority of the samples 36(60%) had inadequate, 24(40%) had moderately adequate and no one had adequate level of knowledge regarding warning signs and prevention of cancer whereas in post test majority of the samples 13 (21.67%) had Moderately adequate of knowledge, 47 (78.33%) had adequate level of knowledge and none had Inadequate level of knowledge regarding warning signs and prevention of reproductive cancer.

 

 

Table 4: Overall Mean, SD, Mean percentage and ‘t’ value showing the difference between mean pre-test and post-test knowledge score.                                                                  n=60

Period of observation

Mean

Standard deviation

Mean percentage

‘t’
value

Pre-test

9.18

2.87

  34

44.44*

Post-test

20.13

2.08

74.56

t59 =1.68, p<0.05                                                                 *significant

 

Data in Table 4 shows that overall mean percentage of pre- test is 34 with mean and Standard deviation (SD) 9.18±2.87, which is lower than the mean percentage of post-test mean percentage 74.56 with mean and SD 20.13±2.08. The calculated’ value t=44.44 is greater than the table value (t59=1.68) at 0.05 level of significance. Hence the null hypothesis is rejected and research hypothesis is accepted. This shows that Structured teaching programme was effective.

 

Data in table 5 shows that in pre-test and in post test maximum knowledge was in the area of anatomy and physiology of the reproductive system, mean percentage was 67.22 with mean and standard deviation of 2.02±1.05 whereas in post test, mean percentage was 99 with mean and standard deviation of  2.97±0.18 and the calculated “t” value was 6.913.

 

Lowest knowledge score in pretest and  post test was in the area related to Warning signs and prevention of reproductive cancer , mean percentage 23.8 with mean and standard deviation of 3.57±1.5 whereas in post test mean percentage 65 with mean and standard deviation of 9.73±1.54 and the calculated “t” value was 36.2. In the area related to definition and types of cancer, pretest mean percentage was 41.67 with mean and standard deviation of 1.25±0.73 whereas in post test  mean percentage was 96 with mean and standard deviation of 2.88±0.32 and the calculated “t” value was 15 and in the area related to Types and risk factors of reproductive cancer mean percentage was 39.17 with mean and standard deviation of 2.35±0.97 whereas in post test test  mean percentage was 76 with mean and standard deviation of 4.55±1.1 and the calculated “t” value was 13.5. It is found that the calculated ‘t’ value is greater than the table ‘t’value (t59=1.68) in allthe four areas. Hence the research hypothesis is accepted and null hypothesis is rejected.This shows that structured teaching programme was effective in all areas in improving the knowledge among female non health professionals regarding warning signs and prevention of reproductive cancer. 


 


Table 5: Area-wise mean, mean percentage, SD and ‘t’ value showing the difference between the mean pre-test and post-test knowledge score               n=60

Sl. No

Area

Max Score

Pretest

Post test

t value

Mean+SD

Mean%

Mean+SD

Mean%

1

Anatomy and physiology of the reproductive cancer.

3

2.02±1.05

67.22

2.97±0.18

99

6.913*

2

Definition and types of cancer

3

1.25±0.73

41.67

2.88±0.32

96

15*

3.

Types and risk factors of reproductive cancer

6

2.35±0.97

39.17

4.55±1.1

76

13.5*

4

Warning signs, diagnostic evaluation and prevention of reproductive cancer.

15

3.57±1.5

23.8

9.73±1.54

65

36.2*

t59=1.68 p<0.05 ;  *significant

 

Section IV: Association between the pre-test level of knowledge and selected demographic variables

Table 6: Association between pre-test knowledge score and demographic variables  n=60

Sl. No

Demographic variables

Median

χ2

df

Level of significance

<9

>=9

1.

Age in years 

a)26 – 35years

b)36- 45years

c)46-55years,56 and above

 

12

6

5

 

28

8

1

 

 

6.64

 

 

2

 

P<0.05

S

2.

Religion

a)Hindu

b)Muslim

c)Christian

 

18

1

4

 

29

7

1

 

 

5.93

 

 

2

 

p>0.05

NS

3.

Marital status

a)Single

b)Married

 

8

15

 

15

22

 

0.19

 

1

 

p>0.05

NS

4.

Education

a) No formal education, primary education, secondary education, PUC

b)Degree and above 

 

17

6

 

1

36

 

 

34.25

 

 

1

 

P<0.05

S

5.

Occupation

a)Accounts and receptionist

b)Canteen worker

c)Human resource, IT, other

 

3

8

12

 

27

4

6

 

 

20.38

 

 

2

 

P<0.05

S

6.

Monthly income

a)<5000 -10000

b)10001 and above

 

21

2

 

20

17

 

9.1

 

1

 

P<0.05

S

7.

History of cancer in the family

a)Yes

b)No

 

6

17

 

11

26

 

 

0.09

 

 

1

 

p>0.05

NS

8.

Do you have children

a)Yes

b)No

 

13

10

 

18

19

 

0.35

 

1

 

p>0.05

NS

9.

Information regarding reproductive cancer

a)Yes

b)No

 

0

23

 

21

16

P=0.00001

(Fisher exact test)

 

P<0.05

S

P< 0.05, NS= not significant, S=significant  χ= 3.85 at df 1 &χ= 5.85 at df 2

 


The data in table 6 revealed that there is significant association between pre-test level of knowledge and some demographic variables, like age ( χ2=6.64 p value is <0.05) , educational status( χ2=34.25 p value is <0.05), occupation ( χ2=20.38 p value is <0.05), monthly income (χ2=9.91 p value is <0.05), and information regarding reproductive cancer (P =0.00001 p value is <0.05) hence null hypothesis is rejected and research hypothesis was accepted . There is no significant association and some demographical variable such as religion, marital status and family history of cancer, presence of children. Hence the null hypothesis was accepted and research hypothesis was rejected.

 

DISCUSSION:

The results of the present study confirmed that there was a considerable improvement of knowledge after the administration of structured teaching programme on warning signs of reproductive cancer and it is also statistically established as significant at 0.05 level. The study revealed that overall pre-test mean knowledge score was 34% and post test score was 74.56% with 40.56% mean knowledge enhancement. The overall mean knowledge score during pre-test is 9.18 and 20.13 in the post-test. Post test knowledge was found statistically significant by using paired‘t’ test ( t =44.44).

 

The socio demographic variables in the present study such as age (χ2 =6.64, p>0.05), educational status (χ2 =34.25, p>0.05), occupation (χ2 =20.38, p>0.05), monthly income (χ2 =9.1, p>0.05) and information regarding reproductive cancer  (P =0.00001, p>0.05) were found to be significant associated with the pretest knowledge scores at 0.05 level hence null hypothesis is rejected and research hypothesis is accepted. There was no association found between pre test knowledge scores and demographic variables like religion, marital status, monthly income and family history of cardiac disease hence null hypothesis is accepted and research hypothesis is accepted and research hypothesis is rejected.

 

This finding is supported by an Pre experimental design was used to assess the Effectiveness of Planned Teaching Programme (PTP) on knowledge regarding early detection and prevention of cervical cancer. Purposive sampling techniques were used to select 60 women in selected village in Gurugram. A structured questionnaire was administered to assess the knowledge on early detection and prevention of cervical cancer. The collected data was analyzed by using descriptive statistics and inferential statistics. The finding of the study revealed that pre test knowledge 35% had poor, 60% had average,5% had good knowledge regarding early detection and prevention of cervical cancer. Post test knowledge 0% had poor, 25% had average, 75% had good knowledge regarding early detection and prevention of cervical cancer.11

 

There was a significant improvement in knowledge scores of female non health professionals after conducting structured teaching programme on warning signs of reproductive cancer. Thus H1 hypothesis is accepted. The H2 is partly accepted for significant association found between pre- test knowledge scores and the socio demographic variables such as age, educational status, occupation, monthly income, and information regarding reproductive cancer at 0.05 level.

 

CONCLUSIONS:

It is concluded that the respondents had inadequacy in their knowledge in all areas of warning signs and prevention of reproductive cancer. Conducting Structured Teaching programme would be effective in increasing knowledge of respondents.

 

LIMITATIONS OF THE STUDY:

·       The study is limited to female non health professionals of selected hospitals, Mangaluru.

·       The study did not use control group.

·       The study did not assess the attitude and practice of female non health professionals. Only a single domain that is knowledge is considered in the present study.

·       The sample size for the study was limited to 60 female non health professionals only. Hence the results of the study cannot be generalized.

 

RECOMMENDATIONS:

On the basis of the findings of the study following recommendations have been made:

·       A similar study can be replicated on a large number of subjects to generalize the findings.

·       A similar study can be conducted in different settings with a control group.

·       An experimental study can be undertaken with a control group for effective comparison of the result.

·       A study can be conducted with the assessment of attitude and practices of female non health professionals regarding prevention of reproductive cancer.

·       Manuals, information booklets, and self-instruction module may be developed in areas of prevention of reproductive cancer.

·       A study can be carried out to evaluate the effectiveness of video-assisted teaching programme, pamphlets, leaflets, and role play on prevention of reproductive cancer.

 

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8.      Harford JB. Breast-Cancer early detection in low-income and middle-income countries:do what you can versus one size fits all. Lancet Oncol. 2011; 12: 306–12.

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10.   Weiderpass E, Labrèche F. Malignant tumors of the female reproductive system. Saf Health Work. 2012; 3(3): 166-80. doi: 10.5491/SHAW.2012.3.3.166. Epub 2012 Aug 30

11.   Kusumlata, Devi, Akoijam. To assess the Effectiveness of Planned Teaching Program (PTP) on Knowledge Regarding Early Detection and Prevention of Cervical Cancer among Women: Pre-experimental Study. International Journal of Nursing Education. 2019; 11(2)

 

 

 

Received on 18.12.2023         Modified on 17.01.2024

Accepted on 12.02.2024       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2024; 3(1):17-22.

DOI: 10.52711/jnmr.2024.03