Effect of Structured Teaching Programme on Level of Knowledge on Iron Deficiency Anemia and Prevention of Anemia among Adolescent Girls in selected Higher Secondary School, Thrissur

 

Agnes Anto¹, Anagha Joshy¹, Hanna Elizabeth George¹, Herlin Maria¹, Jerald Johny¹, Jestina P. L¹, Jini Mary Jose¹, Mariya M. J¹, Justy Joy², Reena Vincent³, Angela Gnanadurai⁴

¹IV Year BSC(N) Students, Jubilee Mission College of Nursing, Thrissur.

²Asst. Professor, Jubilee Mission College of Nursing, Thrissur.

³Professor, Jubilee Mission College of Nursing, Thrissur.

⁴Principal, Jubilee Mission College of Nursing, Thrissur.

 

ABSTRACT:

Introduction: Iron deficiency anemia develops when body stores of iron drop too low to support normal red blood cell (RBC) production. Anemia is currently one of the most common and intractable nutrional problems globally.  The requirement of iron in doubles during adolscence as compared to younger age group. Following growth spurt, the risk of iron deficiency anemia continues to be a public concern. Objectives: To assess the effect of structured teaching programme on level of knowledge on iron deficiency anemia among adolescent girls and to associate the level of knowledge of iron deficiency anemia and prevention of anemia among adolescent girls with selected socio demographic and clinical data variables. Methodology:  Pre- experimental, one group pre-test post-test design was used. 40 samples were selected by purposive sampling. Pre-test was conducted on 1^st day followed by structured teaching programme on iron-deficiency anemia and prevention of anemia and post test was conducted on 4^th day. Results: The socio demographic and clinical data variables reveals that the adolescent girls 30(75%) belonged to the age group of 16 years. All adolescent girls had education level of 11th standard 40(100%), more than half of the adolescent girls 21(52.5%) belonged to Hindu religion, majority of the adolescent girls 34 (85%) belonged to nuclear family. Majority of the adolescent girls 24 (60%) lives in rural area, more than half of adolescent girls 21(52.5%) attained menarche at the age of 13 years or less and all the adolescent girls 40(100%) have a mixed type of dietary pattern. In the pre-test, none of the samples 40(100%) had adequate knowledge and 38(95%) samples had inadequate knowledge on iron deficiency anemia and prevention of anemia. There was a significant difference between the pre-test and post test level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls. There was no significant association between the level of knowledge on iron deficiency anemia and prevention of anemia with socio-demographic and clinical data variables. Conclusion: The study concluded that structured teaching programme is an effective method to improve the knowledge regarding iron deficiency anemia and prevention of anemia among adolescent girls.

 

 

 

INTRODUCTION:

Anemia is a condition in which the number of red blood cells or the amount of haemoglobin is low. Red blood cells contain haemoglobin protein that it enables them to carry oxygen from the lungs and deliver it to all parts of the body. An inadequate supply of oxygen in the tissues produces the symptoms of anemia.¹

 

Adolescence has been defined by the world health organization as the period of life spanning the ages between 10 to 19 years. This is the formative period of life when the maximum amount of physical, psychological, and behavioural changes take place. That is a vulnerable period in the human life cycle for the development of nutritional anemia, which has been constantly neglected by public health programmers. During adolescence, (i.e. 10-19 years of age) iron deficiency anemia is estimated to be the greatest nutritional problem since overall iron requirement increases two /three folds during adolescence due to high growth spurt and loss of 12.5-15mg iron each month.²

 

Iron deficiency anemia is estimated to cause 591,000 prenatal deaths and 115,000 maternal deaths globally.³ Prevalence of anemia in South Asia is among the highest in the world, mirroring overall high rates of malnutrition. Anemia remains a major cause of mortality and morbidity in developing countries where resources to determine the underlying etiology remain poor. ⁴

 

WHO estimates the number of anemia people worldwide to be a staggering two billion with approximately 50% of all anemia attributable to iron deficiency. Adolescents, particularly girls, are vulnerable to iron deficiency. following the growth spurt, the risk of iron deficiency continues to be a public health concern through the entire reproductive age.⁴Another cause of iron deficiency Anemia in adolescence is low dietary intake and poor bioavailability of iron consumed against the significant increase in requirements. The data from India indicates that the diets of girls aged between 13-18 years provide much lower level of iron than the diets of boys in the same age group. Although the iron density in the diets of both boys and girls is similar, the lower total food intake or energy intake by adolescent girls compared to boys, combined with menstrual losses cause adolescent girls to be at greater risk of Iron deficiency and iron deficiency Anemia. According to latest WHO report Iron deficiency anemia (IDA) prevalence in India reported to vary from 56%90.1% in adolescent girls anemic.⁵ Anemia on the adolescence causes stunted growth, poor school performance, decrease memory, diminished concentration in work, school dropout, decrease immunity, susceptibility to infection and also poses a major threat to future safe motherhood in girls.

 

The national family health survey-3 (NSHS-3) data suggests that the prevalence of anemia in adolescent girls (15-19 years) is 56%. According to national nutritional monitoring bureau survey 2006, the prevalence of anemia in adolescent girls (12-14 years) is 68.⁶

Globally anemia affects 1.62 billion people which corresponds to 24.8% of the world population.⁷ In India the prevalence of anemia among adolescent girls were 56% and in Kerala it is 19.13% among college students and 96.5% in tribal area.⁸ Presently the prevalence of anemia among adolescent girls is on the rise in India. 

 

Prevalence of iron deficiency anemia in India is high because of low dietary intake, poor availability of iron and chronic blood loss due to hookworm infestation and malaria. Due to lack of current information and proper heath education regarding iron and folic acid supplementation and diet, most of the adolescent girls suffer with iron deficiency anemia. 

 

STATEMENT OF THE PROBLEM:

A study to assess the effect of structured teaching program on level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls in selected higher secondary school, Thrissur 

 

OBJECTIVES OF THE STUDY:

1.     To assess the level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls. 

2.     To assess the effect of structured teaching programme on level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls. 

3.     To associate the level of knowledge of iron deficiency anemia and prevention of anemia among adolescent girls with selected socio demographic and clinical data variables

 

HYPOTHESES:

H1:There is significant difference between the pret and post-test level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls. 

H2: There is significant association between the pretest and post-test level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls with selected socio-demographic and clinical data variables. 

 

MATERIALS AND METHODS:

Quantitative, evaluative approach was used in the study.

 

Research design:

Pre-experimental, one group pre-test post-test design was used for the study.

 

Research Variables:

Independent variables:

Structured teaching program on iron deficiency anemia and prevention of anemia.

 

Dependent variables:

Level of knowledge on iron deficiency anemia and prevention of anemia.

 

Socio demographic variables and clinical data variables:

Name, age, education, type of family, religion and area of living, age of menarche, duration of menstrual cycle, previous knowledge and its source of information

 

Setting of the study:

Marthoma Girls Higher Secondary School Thrissur.

 

Population:

All the adolescent girls studying in Marthoma Girls Higher Secondary School Thrissur.

 

Sample:

Adolescent girls in the age group between 15-17 years studying in the Marthoma GHSS Thrissur and who met the inclusion criteria. 

 

Sample size:

40 adolescent girls

 

Sampling technique:

Purposive sampling.

 

Criteria for sampling technique:

Inclusion criteria:

Adolescent girls who were 

·      Studying in 11^th and 12^th class.

·      In age group between 15-17 years.

·      Willing to participate in the study

 

Exclusion criteria:

Adolescent girls who were 

·      Known case of iron deficiency anemia and on treatment

·      Have any blood and blood product related diseases.

 

Description of tool:

The tool consist of section A and of section A and section B  

Section A:- Socio demographic  data variables questionnaires among adolescent girls. 

Section B: - Structured knowledge questionnaire to assess the knowledge of adolescent girls on iron deficiency anemia and prevention of anemia. The questions were organized under four domains.it consist of 30 questions with 4 choices. Each correct response carries one mark and the wrong answer scored zero marks. The maximum score was 30 and minimum score was zero. 

 

Data collection process:

Permission from authorities was obtained and samples were selected by purposive sampling technique. The purpose of the study was explained and an informed consent was obtained from adolescent girls. A pre-test was conducted for 40 samples in the 1^st day of data collection using structured questionnaires. Followed by, a structured teaching programme on iron deficiency anemia and prevention of iron deficiency anemia was given by using power point presentation for 30 minutes. Post test was conducted on 4^th day of teaching using same questionnaire among the adolescent girls. The descriptive and inferential statistics were used to analyze the data. 

 

RESULT:

Table 1: Distribution of sample according to socio demographic variables                      n =40

 

Table 1: shows that 30(75%) of the girls were 16 year old and all the 40(100%) of the adolscent girls were in 11^th standard 21(52.5%) of the adolescent girls were Hindus while none of them were Muslims. 24(60%) were living in rural area and majority 34(85%) of them  were belonged to nuclear family.

 

Table 2: Distribution of samples according to clinical data variabes (n=40)

Figure 1: Effect of structured teaching programme                   n=40

 

Figure 2 : Domains wise pre and posttest knowledge on iron deficiency anemia and  prevention of anemia among adolescent girls.  n=40

 

Table 3: Association of pretest level of  knowledge  on anemia and prevention of anemia among adolescent girls with selected socio demographic variables                                                             (n=40)

Significant(P<0.05) level 

 

Table 2: Shows that all the adolescent girls, 40(100%) of them had mixed type of diet. 21(52.5%) of them attained menarche at age of 13 and less and 22(55%) had a duration of 45 days of menstrual cycle. Majority, 36 (90%) had previous knowledge on iron deficiency anemia and prevention of anemia and 31(77.5%) of them had source of information from school.

 

Data on figure (1) shows that 38(95%) of the samples had inadequate knowledge on iron deficiency anemia and prevention of anemia  in the pre-test. In the post-test 17(42.5%) of them had moderate knowledge and 23 (57.5%) of them had inadequate knowledge on iron deficiency anemia and prevention of anemia.

 

Table 3: shows that there was no significiant association with pretest level of knowledge on iron deficiency anemia and prevention of anemia with socio demographic and clinical data variables such as monthly income, religion, occupation of mothers and type of family. 

 

DISCUSSION:

1.     To asses the level of knowledge on iron deficiency anemia and prevention of anemia among adolscent girls:

The study found that in the pretest, out of 30 samples no one having adequate knowledge and 2(5%) were having moderate knowledge and 38(95%) were having inadequate knowledge. In the posttest 17(42.5%) were having moderate knowledge and 23(57.5%) were having inadequate knowledge on iron deficiency anemia and prevention of anemia among adolescent girls.

 

2.     To assess the effect of structured teaching programme regarding iron deficiency anemia and prevention of anemia among adolscent girls:

It was found that mean post-test knowledge scores are higher than mean pretest knowledge scores on all domains. As the calculated t value is greater than the table value (t=3.725). (P<0.05). Hence the research hypothesis H1:-There is significant difference between the pretest and post-test score of level of knowledge on iron deficiency anemia and prevention of anemia among adolescent girls was accepted.

 

The study findings were supported by a quantitative study to evaluate the effectiveness of structured teaching programme on knowledge regarding iron deficiency anemia among adolescent girls of Jawaharlal Nehru Inter college Kanpur. The research design was one group pretestpost test design. The sample of the study is adolescent girls in Jawaharlal Nehru Inter College Kalyanpur. The Sample size was 40, selected by purposive sampling technique. The mean of overall pre test knowledge score was 13.6 and the mean of overall post test knowledge score was 19.9. Improvement in the knowledge score of the samples from pre test to post was tested for statistical significance using paired t-test (t=2.269), shows significant difference between pre and post test score (p0.05).25

 

3.     To associate the level of knowledge on iron deficiency anemia and prevention of anemia among adolscent girls with selected socio demographic and data variables.           

There is no significant association with pretest knowledge on iron deficiency anemia and prevention of anemia among adolescent girls with socio demographic and clinical data variables. Hence research hypothesis H2:- There is significant association between the pretest and post-test level knowledge of iron deficiency anemia and prevention of anemia among adolescent girls with selected socio demographic and clinical data varibles was rejected           

 

CONCLUSION:

Present study was conducted to assess the effect of structured teaching programme on iron deficiency anemia and prevention of anemia among adolescent girls. The current study proved that there was significant improvement in the knowledge level of adolescent girls regarding iron deficiency anemia and prevention of anemia after structured teaching programme. The researcher concluded that structured teaching programme is an effective educational intervention in improving the knowledge regarding iron deficiency anemia and prevention of anemia among adolescent girls. 

 

REFERENCES:

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4.      WHO [Internet]. Prevention of iron deficiency anemia in adolescents. 2011 [cited 2020 Mar 19]. Available from:https://apps.who.int/iris/handle/10665/205656

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Received on 20.06.2022                                  Modified on 28.06.2022

Accepted on 04.07.2022       ©A&V Publications All right reserved