A Study to assess the effectiveness of Structured Teaching Programme on knowledge regarding thyroid problems among adolescent girls

 

Ms. Alan Mary John 1, Ms. Arya Roy1, Ms. Ayisha Mohamed1, Ms. Deepa John1, Ms. Jincy John1, Mrs. Jyothi Lakshmi2

1Third Year B.Sc. Nursing Students, Bishop Benziger College of Nursing, Kollam, Kerala

2Nursing Tutor, Department of Community Health Nursing, Bishop Benziger College of Nursing,

Kollam, Kerala

*Corresponding Author E-mail: jyothi.sreelal@gmail.com

 

ABSTRACT:

The research project under took was to assess the effectiveness of structured teaching programme on knowledge regarding thyroid problem among adolescent girls in the selected school at Kollam.The objectives of the study were to assess the knowledge regarding thyroid problem among adolescent girls,to evaluate the effectiveness of structured teaching programme on knowledge regarding thyroid problems among adolescent girls,to find out the association between knowledge score regarding thyroid problems among adolescent girls and selected demographic variables. A quantitative research design was adopted for this study. The study was conducted among 60 adolescent girls in Infant Jesus Anglo Indian School, Kollam. In order to assess the knowledge of adolescent girls regarding thyroid problems, the study sample was selected by convenience sampling technique. The tool used for data collection consisted of demographicvariables and structured knowledge questionnaire. The analysis of the data was based on the objectives of the study using descriptive and inferential statistics. The present study revealed that out of 60 samples 96.66% of adolescent girls had poor knowledge, 3.33% had average knowledge and no adolescent girls had good knowledge regarding thyroid problems in pretest. After a structured teaching programme 28.33% had good knowledge, 68.33% had average knowledge and 3.33% had poor knowledge. The present study shows that the mean posttest score was 14.55 (± 1.92) was greater than the mean pretest score 6.72 (±2.13). The ‘t’ test value was 27.93. So that structured teaching programme was effective to increasing the knowledge regarding thyroid problems among adolescent girls. There was significant association between knowledge and demographic variables like monthly income.

 

KEYWORDS: Effectiveness, structured teaching programme, knowledge, thyroidproblems, adolescent girls

 

 

 

INTRODUCTION:

The thyroid is vitally important hormonal gland that plays a major role in the metabolism, growth and maturation of human body. It helps to regulate many body functions by constantly releasing a steady amount of hormones into the blood stream. More hormones are produced when the body needs more energy, like when it is growing old or during pregnancy. Thyroid disorders such like hyper and hypo causes physical and intellectual dysfunctions in adolescent age group. In adolescent girls it causes delayed menstrual pattern and early puberty. Inadequate secretion of thyroid hormone during fetal and neonatal development results in stunted physical and mental growth because of general depression of metabolic activities. Also it affect intellectually by decreased concentration, increased day time sleeping and poor attention. This can lead to poor academic performance of children. In adults, hypothyroidism manifests as lethargy, slow mentation, and generalized slowing of body functions1. Disorders of thyroid gland include hypothyroidism, goiter, thyroiditis, hyperthyroidism, thyroid nodules and cancers. Hyperthyroidism is an overactive thyroid gland, there is a sustained increase in synthesis and release of thyroid hormones known as hyperthyroidism2. Hyperthyroidism occurs in women more than men, with the highest frequency in persons of 20 to 40 years of age. The most common form of hyperthyroidism is Grave’s disease. Grave’s disease accounts for up to 80% cases of hyperthyroidism. Hypothyroidism is a deficiency of thyroid hormone that causes general slowing of metabolic rate. The prevalence of hypothyroidism in India is about 3.9%. It is estimated that the prevalence of subclinical hypothyroidism is approximately 9% in the population. Hypothyroidism is more common in women than in men. Iodine deficiency is the most common cause of hypothyroidism worldwide. Enlargement of the thyroid gland is called goiter. In a person with a goiter the thyroid cells are stimulated to grow, which may result in an overactive thyroid (Hyperthyroidism) or underactive thyroid (Hypothyroidism). Thyroid cancer is the most common form of an endocrine system cancer. Among all the cancer cases, thyroid cancer accounts only for 0.1%-0.2%. Incidence of thyroid cancer in India is 1 for males and 1.8 for females per 100,000 population3. Thyroiditis, an inflammation of the thyroid gland, is a frequent cause of goiter. Thyroid problems unless treated properly can lead to various health problems. An overactive thyroid (Hyperthyroidism) may lead to eye problems, such as bulging eyes, blurred or double vision or even vision loss, ophthalmic, heart problems such as tachycardia, atrial fibrillation or heart failure, osteoporosis, red swollen skin, thyrotoxic crisis, which is a worsening of symptoms causing fever, muscle weakness, decreased body weight, intolerance to heat, oligomennorhea or amnorrhea and delirium. This requires urgent medical attention. Based on the survey conducted in India 2015, the profile of thyroid disorders encountered in pediatric and adolescent age group in India is similar to that seen in most parts of the world except for the prevalence of iodine deficiency disorders in certain endemic regions of this country4. Clinical presentation is most commonly for hypothyroidism and goiters and infrequently for hyperthyroidism. Of nearly 800 children referred for thyroid problems, 79% had hypothyroidism, 19% had euthyroid goiter and 2% had hyperthyroidism. Diagnostic delay in hypothyroidism is common and is related to lack of awareness amongst primary health care practitioners and family physicians as well as the cost availability of laboratory investigations. So, prevention is better than cure. Thyroid problem can be prevented in women by early diagnosis and treatment helps in preventing complications. Lifestyle modification including weight management, nutritional plans, exercise are beneficial in managing thyroid problem patients and is often considered the first line therapy for the treatment and management of thyroid problem.5

 

OBJECTIVES:

The objectives of the study was,

·       To assess the knowledge regarding thyroid problem among adolescent girls.

·       To evaluate the effectiveness of structured teaching programme on knowledge regarding thyroid problems among adolescent girls.

·       To find out the association between pre test knowledge score regarding thyroid problems among adolescent girls and selected demographic variables.

 

MATERIALS AND METHOD:

Methods:

A quantitave approach is used in that the research design is adopted for the study is one group pre-test, post-test research design. Here independent variable is structured teaching programme regarding thyroid problems among adolescent girls and dependant variable is knowledge of thyroid problems in adolescent girls. The setting will be Infant Jesus Anglo Indian School situated at Kollam. The populations in the study include 60 adolescent girls. Convenience sampling technique was used in this study.

 

Tools/ instruments:

The instruments used for the present study are demographic data and structured knowledge questionnaire.

 

Data collection:

Data will be collected after obtaining prior administrative permission and informed consent from adolescent girls. The tools for data collection procedure are demographic data including age, religion, monthly income, family type, dietary pattern, menstrual pattern. The data collection was conducted from 26/02/2018 to 05/03/2018. The convenience sampling was used to select the samples. Setting for the study is the Infant Jesus Anglo Indian School at Kollam. Initially, the structured questionnaire was given to 60 samples. On the first day, pretest is done by using demographic data and structured knowledge questionnaire regarding thyroid problems. Then structured teaching programme given to the adolescent girls and post test is done after five days by using the same structured knowledge questionnaire regarding thyroid problems.

 

Data analysis:

The researcher will analyse the data by using descriptive and inferential statistics based on the objectives and hypothesis of the study.

 

RESULT:

Description of sample characteristics:

This section describe the percentage wise distribution of demographic variables. 

 

 

Figure 1: Bar diagram shows that percentage distribution of samples according to age.                                                           N=60

 

 

 

Figure 2: Bar diagram shows the percentage distribution of sample according to religion.                                                                 N=60

 

 

Figure 3: Bar diagram shows the percentage distribution of sample according to family type.                                                           N=60

 

 

 

Figure 4: Bar diagram shows the percentage distribution of sample according to the monthly Income.                                                N=60

 

 

Figure 5: Bar diagram shows the percentage distribution of sample according to the sources of information.                                     N=60

 

 

Figure 6: Bar diagram shows the percentage distribution of sample according to dietary pattern.                                                        N=60

 

 

 

Figure 7: Bar diagram shows the percentage distribution of sample according to the menstrual pattern.                                            N=60

 

 

 

The effectiveness of structured teaching programme on knowledge regarding thyroid problems among adolescent girles.

 

Table 1: Frequency and percentage distribution of pre- testknowledge score on knowledge regarding thyroid problems among adolescent girls.                                                                 N=60

Score

Score range

Frequency

Percentage

0-10

Poor

58

96.66%

11-15

Average

2

3.33%

16-20

Good

0

0%

 

Table 2: Percentage distribution of post test knowledge score regarding thyroid problems among adolescent girls                  N=60

Score

Score range

Frequency

Percentage

0-10

Poor

2

3.33%

11-15

Average

41

68.33%

16-20

Good

17

28.33%

 

 

 

Table 3: Mean, standard deviation, mean difference, ‘t’ value on knowledge regarding thyroid problems among adolescent girls.

 

N

Mean

Standard deviation

Mean difference

‘ t’ value

Level of significance

Pre- test score

60

6.72

2.13

6.83

27.93

S

Post test score

60

14.55

1.92

t =2.907, significant at 00.05 level of significance

 

 

 

The association between the knowledge score and selected demographic variables like age, religion, family type, monthly income, dietary pattern, menstrual pattern and family history of illness.

Sl No

Variables

Knowledge score

df Values

Chi square

Level of significance

Poor

Average

Good

1.   

Age

 

13years

48

2

0

1

0.414

NS

 

14years

10

0

0

2.   

Religion

 

Christian

35

2

0

2

1.286

NS

 

Muslim

4

0

0

 

Hindu

19

0

0

3.   

Family type

 

Nuclear

41

2

0

2

0.818

NS

 

Joint

16

0

0

 

Extent

1

0

0

4.   

Monthly income

 

Rs<5000

22

0

0

2

6.597

S

 

Rs5000-10000

20

2

0

 

Rs>10000

16

0

0

5.   

Dietary pattern

 

Vegetarian

5

0

0

1

0.188

NS

 

Non vegetarian

53

2

0

6.   

Menstrual pattern

 

Regular

52

2

0

2

0.230

NS

 

Irregular

6

0

0

7.   

Family history of thyroid illness

 

Father

4

0

0

4

1.478

NS

 

Mother

11

0

0

 

Siblings

1

0

0

 

Other

9

0

0

 

Nil

33

2

0

NS = non significant, S = significant

 

DISCUSSION:

This study attempted to assess the effectiveness of structured teaching programme on knowledge regarding thyroid problem among adolescent girls. Findings of the study were discussed based on the objectives and hypothesis of the study Present study shows that. out of 60 samples 96.66% of adolescent girls had poor knowledge, 3.33% had average knowledge and no adolescent girls had good knowledge regarding thyroid problems in pretest. After a structured teaching programme 28.33% had good knowledge, 68.33% had average knowledge and 3.33% had poor knowledge. The present study shows that the mean posttest score 14.55 (± 1.92) was greater than the mean pretest score 6.72 (± 2.13). The ‘t’ test value was 27.93. So that structured teaching programme was effective to increasing the knowledge regarding thyroid problems among adolescent girls. There was significant association between knowledge and demographic variables like monthly income.

 

RECOMMENDATIONS:

Based upon the study findings, the following recommendations were made for the future study:

·       A similar study can be replicated in a large sample to generalize the findings.

·       A quasi experimental study can be conducted to assess the level of knowledge regarding thyroid problem among adolescent girls.

 

CONCLUSION:

The present study aimed to assess the effectiveness of structured teaching programme on knowledge regarding thyroid problems among adolescent girls in selected schools at Kollam. The study results showed that there were a significant improvement in knowledge among adolescent girls after providing a structured teaching programme and were statistically significant at 0.05 level. So the structured teaching was effective in improving level of knowledge regarding thyroid problems.

 

ACKNOWLEGEMENT:

The authors express their gratitude to all who contributed directly or indirectly to the study.

 

REFERENCE:

1.      Brunner, Suddarths. Assessment and management of patients with endocrine disorders. In: Janice l Hinkle, Kerry H Cheever, editors. Textbook of Medical Surgical Nursing. 13 ed. Lippincott Williams: Wilkins; 2014

2.      Lewis. Endocrine problems. In: Lewis, Dirksen, Heitkemper, Bucher, editors. Textbook of Medical Surgical Nursing. Second South Asian ed. Elsevier; 2014

3.      K. Sembulingam, PremaSembulingam. Thyroid Gland. In: Dr M Chandrasekar, Dr P Sai Kumar, Dr B ViswanthaRao, Dr K Sarayu, editors. Essentials of Medical Physiology. 6ed. Jaypee brothers medical publishers; 2012

4.      Desai MP. Disorders of thyroid gland: Indian J Pediatr, 1997 Jan – Feb; 64(1):11-20. Available from https://www.ncbi.nlm.nih.gov/pubmed/10771808

5.      Lazarus J, Brown R.S.c, DaumerieC.d, Hubalewska-DydejczykA.e, Negro R.f, Vaidya B.b.2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children. Eur Thyroid J 2014; 3:76-94. https://www.karger.com/Article/FullText/362597. URL

 

 

 

 

 

 

 

Received on 20.05.2019         Modified on 05.06.2019

Accepted on 24.06.2019       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2019; 7(3):201-205.

DOI: 10.5958/2454-2652.2019.00047.7