chapter 123 (repaired)rearch

7/29/2019 Chapter 123 (Repaired)Rearch

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A STUDY TO ASSESS THE INCIDENCE AND

KNOWLEDGE RELATED TO ANEMIA AMONG GIRLS OF

NURSING COLLEGE OF LUDHIANA, PUNJAB WITH A

VIEW TO DEVELOP INFORMATION BOOKLET

Research Project submitted for the partial fulfillment of

the requirement for the degree of

POST BACHELOR OF SCIENCE IN NURSING

Of

Baba Farid University of Health Science,

Faridkot, Punjab

2013

Group B

Guru Hargobind college Of Nursing , Rakot (Punjab)

A STUDY TO ASSESS THE INCIDENCE AND

KNOWLEDGE RELATED TO ANEMIA AMONG GIRLS OF

NURSING COLLEGE OF LUDHIANA, PUNJAB WITH A

VIEW TO DEVELOP INFORMATAION BOOKLET


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Research Project submitted for the partial fulfillment of the

requirement for the degree

of

POST BACHELOR OF SCIENCE IN NURSING

Of

Baba Farid University of Health Science,

Faridkot, Punjab

2013

Group B

Name & Signature of Supervisor

Mrs.Gursangeet kaur

Assisstant professor M.Sc (N)

Obstretric and Gynaecology

Name & Signature of Co-Supervisor

Mrs .Mandeep kaur

(Assisstant Professor M.Sc (N)

Obstretric andGynaecology

Guru Hargobind College Of Nursing, Raikot (Punjab)


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Certificate of the Supervisor and Principal

This is to certify that Group B (Paramjeet kaur Dhaliwal,Parmjeet kaurChahal,Ramandeep kaur grewal, Ramandeep kaur batth ,Ramandeep kaur

grewal,Rashpinder kaur Dhindsa,Ravinder kaur Dhillon,Sandeep kaur

Chahal,Veerpal kaur Mahli)has carried out the study titled , Astudy to assess the

incidence and knowledge related to anemia among girls of nursing college

Ludhiana,Punjab with a view to develop information booklet. It is the original work

of the above said Group conducted under guidance and supervision.

Supervisor Co- Supervisor

Mrs.Gursangeet kaur Mrs.Mandeep kaur

Assisstant professor Asssisstant professor

Obstetrics and Gynaecology Obstetrics and Gynaecology

PrincipalProfessor(Mrs) Shamim Sagar

Guru Hargobind College of Nursing,

Raikot, Ludhiana, Punjab.


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Acknowledgement

Your Name, O Transcendent Lord, is Ambrosial Nectar; whoever meditates on it,

lives.

We praise and thank Lord Almighty for His love and care that He showered on us

during our present study and we acknowledge that without which it would not have

been a possibility.

It is a sense of honor and pride for us to place on record, our sincere thanks to

honorable Mrs. Shamim Sagar, Principal, INE, GHG COLLEGE OF

NURSING,RAIKOT, Ludhiana for her valuable guidance and inspiration to

complete this research project

We express our heartfelt gratitude to our Guide MRS Gursangeeet kaur, Assistant

Professor, INE,and our Co-Guide GHG COLLEGE OF NURSING,RAIKOT, Mrs.

Mandeep Kaur, Assistant Professor INE, GHG COLLEGE OF

NURSING,RAIKOT,, Ludhiana for their , guidance, inspiration, support and

encouragement during the investigation and manuscript preparation throughout the

course of our research project.

We are also thankful to our beloved class teacher Mrs. Jaspreet kaur maan ,Clinical

instructor and Miss. Chamandeep kaur, Clinical instructor, INE, GHG COLLEGE

OF NURSING,RAIKOT, Ludhiana, for their guidance, inspiration, support and

encouragement during the investigation and manuscript preparation throughout the

course of our research project. It was not possible to complete the project without

their endless efforts and sincere guidance.

Words cannot express the gratitude and thanks we feel towards our research

coordinator Mr. Narendra kumar sumeriya, Associate Professor, GHG COLLEGE

OF NURSING,RAIKOT,, Ludhiana for this guidance, encouragement and for giving

us an opportunity to undertake this research project.

We are also our sincere thanks to honorable M.Sc experts Mrs. Asha

Emanual(Professor), Mrs. V.Shantha laxmi (Associate Professor), Mrs.Charlotte

Ranadive (Associate Professor), Mrs.Navneet kaur (Assistant Professor),

Mrs.kuldeep kaur (Assistant Professor), Mrs.Manveerpal kaur(Assistant

Professor)Mrs.Veena baksh(Assistant Professor), for their valuable suggestions and

guidance.


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Very deep appreciation for giving feedback valuable suggestions goes to faculty

members of INE, , GHG COLLEGE OF NURSING,RAIKOT, Ludhiana.

We also want to thank all our wonderful classmates, library staff and friends for

their encouragement and motivation

Word acknowledgment would remain incomplete if we do not express our sincere

and deep sense of indebtedness to our parents and loved ones and also to the study

subjects who helped us in gathering the data.

Above all we bow our heart before almighty GOD and our gratitude to him for his

abiding grace and for being the guiding for guiding for behind our task.

All may not be mentioned, but none is forgotten from the heart.

WITH BOUQUETS THANKS

MISS.Paramjit kaur Dhaliwal

MISS.Parmjeet kaur Chahal

MISS Ramandeep kaur Grewal

MISS.Ramandeep kaur Batth

MISS .Ramandeep kaur Grewal

MISS.Rashpinder kaur Dhindsa

MRS.Ravinder kaur Dhillon

MISS.Sandeep kaur Chahal

MISS.Veerpal kaur Malhi


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TABLE OF CONT

S.NO CHAPTER PAGE NO.

1 INTRODUCTIONIntroductionNeed of the studyStatement of problemObjectives

AssumptionsLimitationOperational definition Delimitations

2 REVIEW OF LITERATURE3 METHODOLOG

Resarch approachResearch designResearch SettingPopulationMethod of data collectionSampling techniqueSample sizeCriteria for selection of the sampleDevelopment and description of toolsValidity of the toolsPilot studyReliability of the toolsData collection procedure


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TABLE OF CONTENTS

S.NO CHAPTER PAGE NO.

1 INTRODUCTIONIntroductionNeed of the studyStatement of problemObjectivesAssumptionsLimitationOperational definition Delimitations

2 REVIEW OF LITERATURE3 METHODOLOG

Research approachResearch designResearch SettingPopulationMethod of data collectionSampling techniqueSample sizeCriteria for selection of the sampleDevelopment and description of toolsValidity of the toolsPilot studyReliability of the toolsData collection procedureEthical considerationPlan of data analysisSummary


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4 ANALYSIS AND INTERPRETATATIONOF DATA

Main Analysis and interpretationMajor findingDiscussionSummary

5 CONCLUSION , IMPLICATION AND SUMMARY6 BIBLOGRAPHY

7 ANNEXURES


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LIST OF TABLE

S.NO TABLES PAGE NO.

1 Frequency and Percentage distribution of

Demographic data of girls.

2 Frequency and percentage distribution of

knowledge Level regarding anemia among girls

3 Overall mean SD, mean percentage of knowledge

Score of girls regarding anemia .

4 Association between knowledge regarding anemia.

5 Incidence regarding anemia among girls.


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LIST OF FIGURES

S.NO TITLE PAGE NO.

1.1 Conceptual framework1.2 Research design2.1 Bar diagram showing the frequency

distribution of subjects according to

level of knowledge regarding anemia

4.1 Pia diagram showing the percentage

distribution of knowledge according to

girls age



area of parmenent residence

4. 3 Pia diagram showing the percentage


type of family

4. 4 Pia diagram showing the percentage


type of residence.



dietary habits




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monthly income.



source of information

5.1 bar diagram showing percentage distribution

according to incidence of anemia among girls


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LIST OF ANNEXURE

S.NO ANNEXURE PAGE NO.

1 Experts opinion for content validity

Of the tool.

2 Content validity certificate3 Letter requesting permission for

pilot study.

4 Letter requesting permission forfinal study

5 List of experts6 Structured interview schedule7 List of formulas


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CHAPTER1

INTRODUCTION

Anemia is a world-wide problem with the highest prevalence of developing countries. It is

found especially among child-bearing age and girls. In India the incidence of anemia is

highest among women and young children. Anemia can be classified according to thecauses i.e. Impaired production of RBCs and hemoglobin, Accelerated destruction of

RBCs ,Blood loss and also classified morphologically.1

Iron deficiency can arise either due to inadequate intake or poor bioavailability of dietary

iron or due to excessive losses of iron from the body. Although most habitual diets contain

seemingly adequate amounts of iron only a small amount is absorbed. This poor

bioavailability is considered to be a major reason for the widespread iron deficiency. Iron

deficiency anemia (IDA) is a formidable health challenge in developing countries and

remains persistently high despite national programs to control this deficiency. In the

period of later school age and early adolescence nutrient requirements are high2.

According to WORLD HEALTH ORGANISATION the hemoglobin level should be 12

gm/dl for girls . When the hemoglobin level less then 12 gm/dl is considered as iron

deficiency anemia . WHO graded the Hb level 10 gm/dl is considered as moderate iron

deficiency anemia and Hb less than 7 gm/dl is considered as severe iron deficiency anemia

3

The decreased dietary iron intake , poor absorption , warm infestation , increased body

demand , menstruation are the major causes of iron deficiency anemia among adolescent

girls.4

Iron deficiency anemia typically results when the intake of dietary iron is inadequate for

hemoglobin synthesis. The body can store about one fourth to one third of its iron, and it is

not until those stores are depleted that iron deficiency anemia actually begins to develop.

Iron deficiency anemia is the most common type of anemia in all age groups, and it is the

most common anemia in the world more than 500 million people are affected more

commonly in underdeveloped countries where inadequate iron stores can result from

inadequate intake of iron. Iron deficiency is also common in the United States5.

Anemia is a sign, which can present at any age. It is important to investigate the cause of

anemia exclude a serious under laying aliment. Anemia is present when the hemoglobin

level in the blood is two standard deviations below the mean for the particular age and sex

being evaluated. The physiologic definition of anemia is a condition in which tissue

hypoxia occurs due to inadequate oxygen carrying capacity of blood6.


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Iron deficiency anemia occurs when there is a decrease in total body iron content, severe

enough to diminish erythropoietin and cause anemia. Diminished dietary iron absorption

in the proximal small intestine or excessive loss of body iron can result in iron deficiency.

Iron is essential for multiple metabolic processes, including oxygen transport, DNA

synthesis and electron transport. In severe iron deficiency the iron containing enzymes are

low and this can affect immune and tissue function7.

Anemia in girls is one of the social health problems. Iron deficiency anemia leads to

weakness, reduced exercise capacity, slower physical growth, impaired cognitive

development, decreasing the ability to light infections, delayed wound healing, behavioral

abnormalities and also . Anemia may compromise pubert. It may also reduce physical

work capacity because the decrease in hemoglobin reduces the availability of oxygen to

the tissues which in turn affects the cardiac output. Further in iron deficiency changes in

brain iron content and distribution and in neurotransmitter function may affect cognition8

.

NEED OF THE STUDY

Anemia is one of the most prevalent common nutritional deficiencies in the world

especially among girls9.

High prevalence of iron deficiency anemia reflects their poor status of nutrition because of

their rapid growth combined with poor eating habits and menstruation10.

In world health report of World Health Organization (WHO) states that the world wide

morality rate of iron deficiency anemia is 60,404,000 in 2005

10

.In Victoria 1996, the incidence rate of iron deficiency anemia was 1,87,979 cases among

girls11.

In USA, the incidence rate of iron deficiency anemia was 1 in 24 cases or 4.12% or 11.2

million people12.

In Australia the incidence rate of iron deficiency anemia is 2,17,000 girls in 200413.

National Family Health survey in 2006 showed that 56% of girls are anemic in India14.

World health report of World Health Organization states that the mortality rate of iron

deficiency anemia is 13,704,953 cases in India 200515.

The study was conducted on Prevalence of iron deficiency anemia among girls in 16

districts of India in 2006. The survey showed that 90.1% of girls are having iron

deficiency anemia. In this 60.1% of girls were exposed to moderate iron deficiency

anemia and 7.1% of girls were exposed to severe iron deficiency anemia16.

The prevalence of iron deficiency anemia among girls are consistently high. Nowadays

most of the girls are having an intension to maintain a slim structure. So they are eating


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very less quantity of food. An influence of Jung foods and fast foods was reduce the

intake of dietary iron rich foods17.

Changes in the educational system and improvement in the standards of education was

increase the workload of students. This was increase the stress among students. It was

leads to meal skipping and gives a way to develop iron deficiency anemia. Due to iron

deficiency the at girls may get impaired physical work, poor intelligent quotient,

decreased motor and cognitive function. So all girls should know about iron rich foods,

importance of iron intake and functions of iron in Human body18.

If the iron deficiency is prolonged, the functions of heartis also affected gradually, because

of an excessive oxygen demand. It was increase the extra workload of the heart, so it can

produce myocardial infarction and angina in the later years. Complications of iron

deficiency anemia should be prevented strictly, to create a healthy human being19

In order to tackle this public health problem a multi-prolonged 12 x 12 initiative has been

launched by Family and Community Health Department in India. The initiative is targeted

at all adolescents across the country with the aim for achieving hemoglobin level of 12

g/dl by the age of 12 years by 2012. The important elements of the initiative are as

follows:

Capacity building Health and nutrition education

Increasing iron intake Weekly supplementation of iron tablets Parasite control through periodic de-worming Appropriate immunization

This initiative has been launched with the support of Government of India, Indian Council

of Medical Research, World Health Organization, UNICEF, Federation of Obstetrics and

Gynecological Societies of India, Professional bodies and others20.

All the above mentioned information suggests that it is mostly the girls who are affected

with the iron deficiency anemia. In the journey of life the girls has various chances to

experiment with the pleasures of life. In this situation as health professionals it is our

responsibility to provide more awareness on this subject and prevent the coming

generation from indulging in such deficiency. Based on these information the researcher

feels that it is important to prevent the iron deficiency anemia among girls21


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Statement of Problem

A study to assess the incidence and knowledge related to anemia among girl s of selected

college of ludhiana, Punjab with a view to develop information booklet.

Objectives: To assess the knowledge related to anemia among girls . To assess the level of hemoglobin among girls of selected college. To find out the association of the knowledge related to anemia with the selected

demographic variables.

To develop information booklet related to anemia.

Assumptions: Girls do have less Knowledge related to anemia Most of the girls going to colleges are anemic due to less knowledge.

Operational definition:

Knowledge: - it is defined as the information, understanding and skills that onegains through education and experience. In this knowledge refers to the level of

information of girls related to anemia as evaluated through the structure knowledge

questionnaire. Anemia: - Anemia is decrease in the number of red blood cell or hemoglobin

resulting in lower ability for the blood to carry oxygen to body tissues. In the study

anemia refers to the lower levels of hb component as assessed by the estimation of

Hemoglobin.

Delimitations:

Studies limited to nursing students only. Studies limited to selected nursing college of Patiala The study was limited to sample of (60) girls


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CONCEPTUAL FRAMEWORK

A conceptual framework represents a less formal attempt of organizing phenomena than

theories.Conceptual models like theories,deal with abstractions that are assembled by

virtue of their relevance to a common theme.

(Denise f. Polit and Cheryl Beck,2006)

In this study , it is conceptualized that are many factors which influence the knowledge

regarding prevention of anemia.these factors include age, area of permanent residence,

type of residence , type of family, monthly income, source of information .Knowledge was

assessed regarding the prevention of anemia .Knowledge levels are categorized as five

areas like excellent, good, average, below average.

Thus, the investigator was conceptualized the interrelationship between knowledge and

selected demographic variables of subjects


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Chapter II

Review of Literature

A review of literature is an essential aspect of study; it involves the systematic,

identification, location, scrutiny and summary of written materials that contains

information on a research problem. It broadens the view of the investigator regarding theproblem under investigation, help in focusing on the issues specifically concerning the

study. The investigator has made an attempt to explore studies, publications and reports

related to the study21.

The review of literature in this study was carried out under the following headings:

Studies related to incidence and prevalence of anemia Studies related to knowledge of nursing student Studies related to prevention of anemia among girls

Studies related to incidence and prevalence of anemia :

Study was conducted to assess the Prevalence of anemia and determine serum The ferritin

status among 1120 healthy adolescent (12-18 years) girls in a rural school at Chandigarh

in India. The cross sectional study was conducted. The results were 23.9% of adolescent

girls having a high prevalence of iron deficiency anemia22.

The study was conducted on deleterious functional impact of anemia on young adolescent

school girls, Gujarat, India. A standard method was used among 9-14 years of adolescent

girls. The result was the prevalence of iron deficiency was 67%. It is a higher incidence

rate23.

The study was conducted on anemia among adolescent females in the urban area of

Nagpur, Maharashtra in India. A cross sectional survey was

conducted among 296 girls (10-19 years). The results were the prevalence of anemia

among adolescent females was found to be 35.1%. A higher prevalence was found17.

The study was conducted on effectiveness of weekly supplementation of iron to control

the iron deficiency anemia among adolescent girls of Nashik, Maharastra in India. The

cluster sampling technique was followed in each stratum 30 clusters were identified. 10

adolescent girls from each cluster were identified. The prevalence of iron deficiency

anemia came down significantly 54.3% from 65.3%24.

The study was conducted on risk factors for anemia in school children in Tanga region,

Tanzania. A total of 845 school children were randomly selected in a cross sectional

survey conducted. The prevalence of iron deficiency anemia was 79.6%25.


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The study was conducted on prevalence of iron deficiency anemia among adolescent

school girls from Kermanshah, West Iran. A cross sectional study was conducted to

determine the prevalence of Iron deficiency anemia. The result was 47 girls 12.2% with

iron deficiency anemia26.

The study was conducted on excess adiposity and iron deficiency anemia in female

adolescent. The cross section study was conducted to assess the iron status and excess

adiposity, menarche, diet, physical activity and poverty status included in the National

Health and Nutrition examination survey 2003-2004. The results were the heavier weight

girls had an increased prevalence of iron deficiency anemia compare to those with normal

weight27.

The study was conducted on iron deficiency anemia among adolescent girls in

Bangladesh. The sample size was 355 adolescent girls. The result was iron deficiency

anemia has 24.8% of adolescent girls28

.

Choudary et al., (2008) conducted a cross sectional study to assess anemia among

unmarried adolescent girls in South India, 100 adolescent girls, aged from 11 to 18 years

were selected as samples by purposive sampling method. Blood samples were collected

and haemoglobin test was done. The result showed that 29% of adolescent girls were

affected with severe anemia, rest of them had mild anemia 71% (P


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morbidity history, anthropometric measures, mental history, frequency of lemon

consumption with meals, consumption of locally available iron rich foods. The result

showed that 1.3% of girls were severely anemic and 58% of girls were moderately anemic

(P< 0.01) in the study population31.

Sunitha et al., 2009conducted a descriptive study to assess the prevalence of anemia

among adolescent girls in Jhirli. Random sampling technique was used and 105 school

adolescents were selected as samples. Blood samples were collected and analyzed and a

record of one-week dietary recall was maintained. The result showed that 82% of girls

were anemic based on their dietary intake (P= 0.15). The report was concluded that

anemia is an emerging problem among the world population, nearly 2000 million

adolescent girls are suffering from this iron deficiency anemia32.

Suman.k et.al (2008) conducted a cross sectional study to screen out the health pattern of

the adolescent girls in the age group of 10-14 years. A total of 110 healthy adolescents

were taken as samples by random sampling technique. Diet survey and serum

haemoglobin level were assessed. The result showed that less than 10% of the girls had

12gm/dl of haemoglobin and others were anemic with haemoglobin level in the range of 6

to 11.9 gm/dl (p


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Pawashe (2009) conducted a study regarding iron nutritional status of adolescent girls

belonging to an urban slum and rural areas. Overall anemia was observed in 25% of the

girls irrespective of their residence. A higher percentage of rural girls (37.5%) especially

below the age of 12 years showed evidence of anemia. Thereafter, the prevalence was

similar in both urban and rural girls who had not attained menarche. With increasing age,

urban girls who had attained menarche showed an increase in the prevalence of anemia.

The prevalence of iron deficiency (serum ferritin < 12 mcg /dl) showed a progressive

increase from 28% to 60% over 12 years especially in the girls (P= 0.03). Findings

suggested that distribution of iron and folate tablets to correct anemia to the vulnerable

groups is essential36.

Leenstra et al. (2008) conducted a cross sectional study by using multistage random

sampling design with a total of 648 adolescent school girls aged 12-18 years were

randomly selected. The prevalence of anemia (Hb


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compared to boys (p


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rural adolescent girls have mild to moderate anemia. Thus, awareness must be created and

nutritional supplements need to be provided42.


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Chapter III

METHODOLOGY

Research methods are the steps, procedures & strategies for gathering & analyzing the

data in research investigations. The chapter includes:

Research approach

Research design Selection & description of setting Population Delimitations Sample & sampling technique Development & description of the tool Reliability Content validity Pilot study Plan of data analysis Summary

RESEARCH APPROACH:

Descriptive survey approach was used for this study.

Research designA experimental research design was utilized to assess the knowledge regarding anemia

among girls

RESEARCH SETTING:

The study will be conducted in a swift institute of nursing Patiala.

POPULATION:The population of present study compose of an girls student of the

nursing college.

SAMPLING TECHNIQUE:

Purposive sampling technique.


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SAMPLE & SAMPLE SIZE:

The sample size were 60 girls.

INCLUSION CRITERIA:

Age group between 17 to 23 years.

Those who are willing to participate in this study.

Girls who understand , read & write English .

EXCLUSION CRITERIA:

Those who are sick at the time of data collection.

Those who are not present at the time of data collection

DEVELOPMENT AND DESCRIPTION OF TOOL:A questionnaire was developed after the review of literature to design the appropriate tool

for collection of data . Review of literature from books , journals& internet , experts

opinion and investigators own experience in the field area provided foundation for the

construction of the tools . A proposed draft was prepared comprising of (08) questions

related to demographic variables and (31) related to knowledge questions .

The tools was given to 09 experts and deletion , addition , and modification were done

according to experts opinion as follow :Number of item deleted = 2 in demographic variables and 10 in knowledge questionnaire

Number of items added =4 in knowledge questionnaire

Number of items modified= 02

After inclusion of experts opinion, tool consisted of item as follow :

Part 1 : Demographic variables = 08

Part 2: Knowledge questionnaire = 31

Description of tools : To accomplish the objective of the study , a structured questionnaire

was constructed to measure the knowledge respectively. The tool consisted of two parts :

Part 1 : This part consisted (08) item related to demographic data of females related to

their . Age of females , type of residence , type of family , dietery habit , monthly income ,

drug addiction and source of information.

Part 2 : this part consisted of (31) structured multiple choice questions having one correct

answer among the four option to assess the knowledge of females regarding anemia .

The total score is = 31

For correct answer score is =1


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For incorrect answer is= 0

Part 3 : Incidence of anemia through HB Estimation.

METHOD OF DATA COLLECTION:

The 31 structured questionnaires wasused to assess the knowledge regarding the

prevention of anemia among girls in swift institute of nursing Patiala (Punjab) .The datawas collected within two weeks.

Information booklet : information booklet was distribution and division after the

data collection.

ETHICAL CLEARANCE:

Ethical clearance was obtained from the research committee of College of Nursing. The

permission was obtained from Head of the Institution of swift institute of nursing and

consent was obtained from the . girls during the data collection.

VALIDITY OF TOOL:

The content validity was established in consultation with experts from various nursing

field.

PILOT STUDY: The pilot study was conducted in march to see the feasibility and

reliability of the study after obtaining the formal permission from the principal of swiftinstitute of science and technology. Oral consent was obtained from the participants after

explaining the purpose of the study. Females who met inclusion criteria were selected by

using convenient sampling technique. The subject were asked to complete the

questionnaire followed by discussion to identify questions the respondent were likely to

misinterpret . The time taken for the completion of questionnaire varied from 20-30

minutes . The purpose of the study was explained and the confidentiality of theirresponses

was assured . Subject were satisfied with the questionnaire . It was found feasible and

reliability to conduct main study.

PLAN FOR ANALYSIS:

The collected data will be planned and analyzed in the form of descriptive statistics and

inferential statistics. The analyzed data will be presented in the form of tables and figures

by using mean, percentage, standard deviation, X2 test .

Does the study require any investigation or intervention to be collected on patients or

other human or animals? If any please describe briefly.


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SUMMARY:This chapter deal with the research approach, research design , research

setting, target population , sample , sample size, technique , development and description

of tool, criterion measure , content validity , ethical consideration , pilot study , reliability

of the tool, data collection procedure and plan of the data analysis.


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Chapter-IV

ANALYSIS & INTERPRETATION

The chapter deals with analysis and interpretation of

the data collected from 60 girls regarding the knowledge of

anemia. The data thus obtained was analysis and

interpretation in accordance with the objectives by using

descriptive and inferential

In descriptive statistics, mean, mean, mean percentage

and degree of freedom, chi-square test was used for analyzing

the distribution of knowledge and attitude of girls.

OBJECTIVES

1. To assess the knowledge related to anemia among girls.2. To asses the level of hemoglobin among girls of

selected college.

3. To find out the association of the knowledge related to

anemia with the selected demographic variabls.

4. To develop information booklet related to anemia.


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Section A: Distribution of demographic data of girls

Table -1

Frequency and percentage distribution of demographic data of girls.

Demographic data f %

1. Age of girls in year

17-18 year 3 5

19-20year 25 42

21-22year 25 4223 above 7 11

2. Area of the permanent

Residence

Rural 22 37

Urban 32 52

Semi urban 02 03

Semi rural 04 08

3. Type of residence

Hostler 13 13

Day scholar 47 78

4. Type of family

Joint family 15 27

Nuclear family 45 73

Extended 00 00


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5. Dietary habits

Vegetarian 51 85

Non vegetarian 09 15

6. Monthly incomeRs 15000 26 44

7. Drug addictionNone 60 100

Smoking 00 00

Alcohol 00 00

Both alcohol & smoking 00 00

Other drug (if any special) 00 00

8. source of information

Print media 49 81

Multi media 10 17

Family member 00 00

Health care worker 01 02

Table 1: reveal that (42%) of girls were 21-22 year and (42%) 19-20 year

of age followed by (11%) 23 above ,(05%) 17-18 year respectively.

Major no. girls (52%) were permanent residence urban area followed by

(37%) rural area, (08%) semi rural ,(03%) semi urban area .

Major no. of girls (78%) day scholar followed by (13%) hostler.

Major (73%) no. of girls belonged to nuclear family followed by (27%)


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joint family .

Major (85%) no. of girls were vegetarian followed monthaly incone Rs

>15000 and information from print media.by (15%) non vegetarian.

Major (26%) no. girls belonged to monthly income Rs >15000 followed

by (16%) girls from Rs 10000-15000 , (15%) girls from Rs 5001-10000 ,

and (03%) Rs


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Section (b)

Objective 1 :To assess the knowledge regarding anemia among girls.

TABLE 2

Frequency and Percentage distribution of knowledge

regarding anemia among girls

Knowledge score

Level of knowledge score f %

Excellent 7 0 0

Table 1: illustrate that highest number 36(60%) of girls had good knowledge

followed by 12(20% ) excellent knowledge and 12(20%) average knowledge

score regarding anemia .

Thus was deduced that girls had good knowledge regarding anemia.


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Level of knowledge

Fig 2.1: frequency distribution of subjects according to level of knowledge

regarding prevention of anemia.

12

36

12

00

5

10

15

20

25

30

35

40

excellent good average below average

frequency


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Table :3

Overall mean, sd and mean percentage of knowledge score of subjects

regarding assess the knowledge among anemia.

Area Maximum

score

Knowledge score

mean Standard

deviation

Mean

persentage

Knowlegedge

And

incidence

regarding

anemia

among girls

31 19.33 70.9 62.3

Table: 3 reveals that mean knowledge score obtained by subjects is

19.33 ,sd 70.9 which is 62.3 of total score . The shows that the

subjects had average knowledge regarding prevention of anemia

among girls.


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Table :4

Association between knowledge regarding anemia among girls

Demograph

ic

variable

frequency df x2

(calculated

value)

Table

value

Level of

significant

Excelle-nt Good Aver-

age

Age of

year

12 37 10 6 9.13 12.59 Not

significant

Area of

Permanent

residence

14 37 09 6 7.82 12.59 Not

significant

Area of

residence

12 38 10 2 1.73 5.99 Not

significant

Type of

family

12 38 09 2 0.34 5.99 Not

significant

Dietary

habit

17 34 09 2 7.25 5.99 significant

Monthly

income

10 40 10 6 9.9 12.59 Not

significant

Source

Of

information

08 44 08 4 8.98 9.48 Not

significant

Objective 3:

To find out association between knowledge regarding anemia among girls

and selected demographic variables i.e. age of girls area of present residence

, type of family , monthly income , dietary habits , source of information

regarding anemia .


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Table -4 (a)

Association between knowledge regarding anemia with age of girls(in year)

N=60

Knowledge level

Age of Excellent Good Average Total Df x2

Girls(

In year)

f f f

17-18 0 01 2 0319-20 3 18 4 25 06 9.13

21-22 8 14 3 25

Above 23 1 05 1 07

Total 12 38 10 60

= non significant

Table 3(a) delineate that highest (8) girls were with excellent knowledge about

anemia in age group 21-22 year followed by (3) 19-20 year , (1) above 23 year

respectively.

Girls who had good knowledge belong to age group (18) 19-20 year, followed

by (14) 21-22 year, (5) above 23 and(1) 17-18 year respectively.

The average knowledge score was highest (4) 19-20 year followed by (3) 21-

22 year (2) 17-18 year and (1) above 23 year.

The x2 value was found statistically non significant between age of girl (in

year) and knowledge.


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Fig: 4.1 percentage distribution of knowledge acorroding to age of

girls of (in year)

5%

41%

42%

12%

Age of girls

17-18 year 19-20 year 21-20 year 23 year above


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Table 4(b)

Association between knowledge regarding anemia with area of permanent

residence

N=60

Knowledge level

Area of Excellent Good Average Total Df x

permanent

Residence

f f f

Rural 8 09 5 22

Urban 6 22 4 32

Semi urban 0 02 0 02 06 7.82

Semi rural 0 04 0 04

Total 14 37 9 60

= non significant

Table 4(b) delineate that highest (8) girls were with excellent knowledge

about anemia area of permanent residence in rural area followed by (6) in

urban area.

Girls who had good knowledge belong about anemia (22) resides in urban

are followed by (9) in rural are ,(4) semi rural and (2) in semi urban

respectively.

The average knowledge score was highest (5) in rural area and (4) urban

area.

The x2

value was found statistically non significant between area of

permanent residence.


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Fig: 4.2 percentage distribution of knowledge according to area of

permanent

5%

80%

5%10%

Area of permanent residence

Rural Urban Semi urban semi rural


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Table 4 (c)

Association between knowledge regarding anemia with type of family

Knowledge level

Type of Excellent Good Average Total Df x2

family

f f f

Joint 05 07 3 15

Nuclear 07 32 6 45 02 3.4

Total 12 39 9 60

non significant

Table 4(c) explicit that excellent knowledge was highest (7) among girls of nuclear

family followed by (5) joint familyMost of (32) girls have good knowledge were from nuclear family followed by (7)

from joint family

The average knowledge score was highest (45) in nuclear family followed by 15 joint

family.

The association between type of family and knowledge of girl was found non

significant.


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Fig: 4.3percentage distribution of knowledge acorroding to type of

family

25%

75%

0%

Type of family

joint family nuclear family extended


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Table 4 (d)

Association between knowledge regarding anemia with type of residence

Knowledge level

Type of Excellent Good Average Total Df x2

Residence

f f f

Hostler m 01 09 3 13

Day scholar 11 29 7 47 02 1.73

Total 12 38 10 60

non significant

Table 4(d) depicts that highest excellent knowledge is (11) in days scholar and (1) in

hostler.And good knowledge (29) in days scholar. Average knowledge in highest (7) in days

scholar and (3) in hostler.

The x2

value was statistically non significant between type of residence.


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Fig: 4.4 percentage distribution of knowledge acorroding to type of

residence

22%

78%

Type of residence

hostler dayscholer


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Table 4(e)

Association between knowledge regarding anemia with dietary habits

Knowledge level

Diet habit Excellent Good Average Total Df x2

f f f

Vegetarian 15 31 5 51

Non vegetarian 02 03 4 09 02 7.25

Total 17 34 9 60

non significant

Table 4(e) depict that excellent knowledge was highest(15) in vegetarianfollowed by(2) in non vegetarian. Good knowledge is highest (31) in

vegetarian followed by (3) in non vegetarian. Average highest knowledge

(5) in vegetarian followed by (4) in non vegetarian.

The x2

value statistically significant between dietary habit and

knowledge of girls.


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Fig:4.6 percentage distribution of knowledge acorroding to diet habits

85%

15%

Dietary habits

vegetarian non vegitarian


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Table -4(f)

Association between knowledge regarding anemia with monthly income

Knowledge level

Monthly Excellent Good Average Total Df x2

Income

f f f

15000 4 21 1 26

Total 10 40 10 60

non significant

.

Table 4(f) depicts that excellent knowledge was highest (4) among income group

>15000 followed by (3) among income group 5000-10000, (2) income group 10000-

15000

And (1) among income group 15000 followed by (9) income group

5000-10000 , (8) in income group 10000-15000 and (2) in income group 15000.

The x2

value statistically no significant between monthly income and knowledge of

girls


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Fig: 4.7percentage distribution of knowledge according to monthly income

5%

25%

27%

43%

monthly income

Rs15000


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Table -4(g)

Association between knowledge regarding anemia with source of information

Knowledge level

Source of Excellent Good Average Total Df x2

Information

f f f

Print media 5 40 4 49

Multimedia 2 4 4 10

Health care 1 0 0 1

Worker

Total 8 44 8 60

Not significant

Table 4(g) depict that excellent knowledge was highest(5) getting

information regarding anemia from print media followed by (2) from

multimedia and (1) from health care.

Highest good knowledge (40) obtain information from print media

followed by (4) obtain information from multimedia.

Average knowledge obtain by girls is equal from print media and

multimedia.

The x2

value statistically no significant between source of information

and knowledge of girls


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Fig: 4.8 percentage distribution of knowledge according source of

information media

82%

17%

0% 1%

source of information

print media multi media family member health care worker


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Table : 5

Incidence regarding anemia among girls

Objective 4: To determination of frequency and percentage of

anemia among girls.

Hemoglobin level Frequency Percentage

Normal 04 7%

Anemic 32 53%

Moderate 23 38%

Severe 01 2%

Table 2 depict that out of 60 girls 32(53%) were anemic girls

23(38%)has moderate level of hemoglobin 4(7%) girls hav

normal level of hemoglobin and 1(2%)girl has severe level

hemoglobin.


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Fig :5.1Percentage distribution according to incidence of anemia

among girls

0

10

20

30

40

50

60

Normal Anemic Moderate Severe

Percantage


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CHAPTER 5

DISCUSSION, MAJOR FINDING, IMPLICATIONS

RECOMMENDATION

This chapter deal with a brief summary of the study undertaken , including discussion

major finding , implication of the study and recommendation for future research.

Discussion :

A descriptive was used to collect data from 60 subject who studied in swift institute of

nursing to assess their knowledge regarding anemia . The collected data was analyzed

using descriptive and inferential statistics.

In this section , the investigator interpretatively discuses the result of the study in the

discussion ; the researcher ties together all the looses end of the study . The finding of the

present study have been discussed in accordance with the objectives of the research and

literature review.


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LIST OF REFERENCE:

REFERENCES

Wongs , essential of pediatric nursing , 8th

edition published by

Mosby publishers , published in India 2009 , page no

915-917

WHO statistics for iron deficiency anemia 2005 from

www.pubmed.com

BT Basavanthappa , nursing research , published by JAYPEE

BROTHERS , page no 49www.WHO.comDorothy , R.Morlow text book of pediatric , 6

thedition

published by ELESEVIER PUBLISHER , published in

new Delhi in 2007 page no 1133-1136

SundarLal, Text book of Community Medicine, published by

CBS publisher, published in New Delhi 2007, Page No. 115-

130.

Dorothy, R.Morlow Text book of Paediatrics, 6th edition,

published by Elesevier publisher, published in New Delhi

2007, Page No. 1133-1136.

K. Park, Text book of Preventive and Social Medicine, 18th

Edition, published by Bhanot, published in Jabalpur 2007,

Page No. 449-450.

Wongs, Essentials of Paediatric Nursing, 8th Edition published

by Mosby publisher, published in India 2009, Page No.

915-917.

Dr. U.N.Panda, Hand book of Paediatrics, published by CBS

publisher, published in New Delhi, 2007, Page No. 115-130.
http://www.pubmed.com/http://www.pubmed.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.pubmed.com/


55/69

IndianAcademy of Paediatrics, Text book of Paediatrics, 4th

Edition, Volume 1, published by Jaypee brothers,

published in New Delhi 2007, Page No. 101-103.

Suraj Gupta, Text book of paediatrics, 11th

edition, published by

Jaypee brothers, published in New Delhi 2009, Page No.

212-214.

Dr. M. Swaminathan, Advanced Text book on Food and

Nutrition,

Volume 1, published by Bappco Publisher, published in

Bangalore2008, Page No. 392-394.

World Health Organization (WHO) statistics for iron

deficiency anemia 2005, fromwww.pubmed.com.

Dr. Huntleys Diagnosis checklist, Health statistics,

www.wrongdiagnosis.com

Centers for disease control and Prevention, Anemia Statistics

(Iron deficiency anemia) MMWR MORB MORTAL

WKLYREP. 2002, Page No. 897-899.

Jeteja G.S. Singh, Prevalence of Anemia among Adolescent

Girls, Journal of Food and Nutrition bulletin 2006,

December Page No. 311-315.

Department of Family and Community Health, National Family

Health Servey-3 (2005-2006), www.indiastat.com.

BT, Basavanthappa, Nursing Research, published by Jaypee

brothers, published in New Delhi 1998, Page No 49.

SabithaBasu, Prevalence of Anemia among AdolescentSchool

going Girls at Chandigarh in India, published in Journal
http://www.pubmed.com/http://www.pubmed.com/http://www.pubmed.com/http://www.pubmed.com/


56/69

of Indian Paediatrics, Volume 42, June 17, 2005, Page No.

593-597.

Sen A Deleterious Functional Impact of Anemia among

Adolescent School Girls, published in the Journal of

Indian Paediatrics, Volume 43, March 2006, Page No. 219-

226.

Chaudhry SM, A study of Anemia among Adolescent

Females in the urban area of Nagpur inIndia,published in

the Journal of Community Medicine, Volume 33, October

2008, Page No. 243-245.

Deshmuk P.R, Effectiveness of Weekly Supplementation of

Iron to Control Anemia among Adolescent Girls,

published in the Journal of Health Population and

Nutrition, Volume 26, March 2008, Page No. 74-78.

Tatala SR, Risk Factors for Anemia in School Children in

Tanga region, Tanzania, published in the Tanzan Journal

of Health Volume 10, October 2008, Page No. 189-202.

A. Kramipour R, Prevalence of Iron Deficiency Anemia

among Adolescent School Girls form Kermanshah,

western Iran, published in the Journal of Haematology,

Volume 13, December 2008, Page No. 352-355.

Tussing-Humphreys LM, Excess Adiposity and Iron

Deficiency Anemia in Female Adolescents,published in

the Journal of American Dietary Association, Volume 109,

February 2009, Page No. 297-302.


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Other research

www.pubmed.com

www.wrongdiagnosis.com

www.indiastat.com

www.WHO.com
http://www.pubmed.com/http://www.pubmed.com/http://www.wrongdiagnosis.com/http://www.wrongdiagnosis.com/http://www.indiastat.com/http://www.indiastat.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.indiastat.com/http://www.wrongdiagnosis.com/http://www.pubmed.com/


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Code no: _____

INSTRUCTIONS:-

The information is purely for research purpose. No information will be revealed or disclosed. Encircle in front of the right answer.

SECTIONADemographic Profile

1. Age of girls in years:-a) 17-18yearsb) 19-20yearsc) 21-22yearsd) 23 and above

2. Area of the permanent residence :-a) Ruralb) Urbanc) Semi urband) Semi rural

3. Type of residence:-a) Hostlerb) Day scholer

4. Type of the family :-a) Joint familyb)

Nuclear familyc) Extended family

5. Monthly income of family :-a) Rs < 5000b) Rs 5,001-10,000c) Rs 10,001-15,000d) Rs > 15,000

6. Dietary habits :-a) Vegetarianb) Non-vegetarian

7. Drug addiction :-a) Noneb) Smokingc) Alcohold) Both alcohol and smokinge) Other drug (if any) specify

8. Sources of information regarding anemia :-a) Print Mediab) Multi mediac) Family membersd) Health care worker


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SECTION B

KNOWLEDGE QUESTIONNAIRE

1. Anemia is :-a) Decreased Thrombocyteb) Increased Erythrocytec)

Decreased oxygen carrying capacity of bloodd) Increased Leukocyte

2. Normal level of hemoglobin in females is :-a) 8 - 10 mg/dlb) 1012 mg/dlc) 1214 mg/dld) 1216 mg/dl

3. The average life span of RBC s is :-a) 120 daysb) 140 daysc) 160 daysd) 180 days4. Anemia may effect:-a) Adolescent

b) Older

c) Children

d) All of above

5. Hemoglobin level is measured with the instrument known as :-a) Glucometerb) Thermometerc) Sphygmomanometerd) Hemoglobin meter

6. Sample required for Hb estimation is :-a) Blood sampleb) Urine samplec) Sputum sampled) Skin sample

7. The blood test done for anemia is :-

a) TLCb) DLCc) VDRLd) Hb Estimation

8. Risk factor for anemia is:-

a) Infectionb) Continuous skipping of meal to lose weightc) Low iron dietd) All of above


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9 .The main cause/causes of anemia among adolescent girls are/is :-

a) Excessive bleeding during menstruationb) Over eatingc) Low dietd)

All of above10.Type/types of anemia is /are:-

a) Iron deficiency anemiab) Sickle cell anemiac) Pernicious anemiad) All of above

11.Most common type of anemia which occur in girls is :-

a) Iron deficiency anemiab) Sickle cell anemiac) Pernicious anemiad) Thalassemia

12.Sign and symptoms of anemia are :-a) Headache, dizziness, weakness.b) Nausea, vomiting, diarrhoeac) Skin rashes and edemad) All of above

13.The color of the skin during anemia is :-

a) Whiteb) Blackc) Paled) Pink

14.Shape of nails in severe anemia becomes :-

a) Spoon shaped nailsb) Normalc) Round shapedd) Curved shaped

15.The color of sclera during anemia becomes :-

a) Redb) Whitec) Pinkd) Pale

16.Diet to be added in anemic patient diet is :-

a) High cholesterol dietb) Green leafy vegetablesc) Fast-foodd) Vitamin D

17.The restricted food for anemic patient is/are:-

a) Greenleafy vegetablesb) Fruitsc) Fried and spicy foodd) None of above

18.The source/sources of rich iron diet is/are :-

a)

Beetroot and pomegranateb) Milk and cheese


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c) Wheat and curdd) Milk and groundnuts

19.Anemia can be prevented by :-

a) Fatty and spicy foodb) Iron rich dietc) Calcium rich dietd) Potassium rich diet

20.Vitamin is helpful in reducing the risk of anemia is :-a) Vitamin Ab) Vitamin B12c) Vitamin Cd) Vitamin d

21.The instruction/instructions to be followed during anemia is :-

a) Do not skip mealb) Nutritious dietc) Proper treatment and follow upd) All of above

22.In anemia following is avoided :-

a) Pulsesb) Fruitsc) Vegetablesd) Alcohol and smoking

23. Combination of food to be avoided in anemia is :-

a) Spinach and cheese.b) Peas and potatoesc) Peas and mushroomd) None of above

24.Action to be taken in case of complication of anemia is :-

a) No action to be takenb) Take doctors advicec) Increased the dose of medicined) All of above

25. Complication of anemia is :-

a) Hypovolemic and cardiogenic shockb) deathc) weaknessd)jaundice

26.Supplementary nutrition to be taken to prevent anemia are:-

a.Amoxicillin

b. Calcium tabletsc.Pantoprazoled. Iron and folic acid tablets

27. Supplementary iron therapy includes :

a) Well balanced dietb) Tablets ferrous sulphate 200 mg with 1 mg folic acidc) Calciumd) All of above

28. Iron is best absorbed in the form of :-

a) In ferrous formb) In potassium formc)

In folic acid formd) In calcium form


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29.Folic acid is not absorbed with :-

a) Milkb) Lemon juicec) Waterd) Orange juice

30.The best absorption of folic acid with :-

a) Sugarcane juiceb)

Milkc) Orange juice

d) Water31.The program is started by government of India to control the iron-deficiency

anemia is:-

a)Mid-day meal programb) Iron supplementation programc) Vitamin A prophylaxis programd) Tuberculosis control program


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Answer KeyS.NO ANSWER1. C

2. C3. A

4. D5. D6. A

7. D8. D9. A

10. D11. A12. A13. C14. A15. B16. D17. B18. C19. A20. B21. B22. D


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23. D24. A25. B26. A27. D28. B29. A30.31.32.

ACB


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APPENDIX-l

EXPERT OPINION FOR CONTENT VALIDITY OF THE TOOL

From,

Group-

Post Basic Bsc(N)2nd

year

Guru Hargobind college of nursing,

Raikot,Ludhiana,punjab

To,

Subject: expert opinion for content validity of tool

Respected madam/sir,

We, the member of group-B, student of Post Basic Bsc(N)2nd

year, Guru Hargobind

college of Nursing, Raikot ,Ludhiana,Punjab have undertaken a research study on

the topic:

A study to assess the incidence and knowledge related to anemia among gir ls of

nursing college of ludhiana, Punjab with a view to develop information booklet

Objective of the study are:

1) To assess the knowledge related to anemia among girls .2) To assess the level of hemoglobin among girls of selected college.


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3) To find out the association of the knowledge related to anemia with the selecteddemographic variables.

4) To develop information booklet related to anemia.

We request you to go through our tool and give your valuable suggestion

regarding appropriateness of items in terms of content, language and

accuracy. Kindly grant your expert opinion and suggestion for the same.

Thanking You.

Yours sincerely,

Group-

Post Basic B.Sc.(N)2nd

year

APPENDIX-Vl

LIST OF EXPERTS

1. Head of Administration

Swift Group Of Colleges,

Patiala

2. Principal,Swift Group Of Colleges,

Patiala

3. Vice- Principal,


Patiala

4. Associate Professor

Community Health Nursing


Patiala

5. Assisst. Professor

Medical- surgical Nursing


Patiala

6. Assisst. Professor

Child Health Nursing


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Patiala

7. Lecturer

Community Health Nursing


Patiala

8. Lecturer

Midwifery & obstetrical Nursing


Patiala

9. Lecturer

Child Health nursing


Patiala

10. Lecturer

Child health Nursing


Patiala

11. Lecturer

Medical- Surgical Nursing


Patiala

12. Lecturer

Midwifery & obstetrical Nursing


Patiala

13. LecturerMedical Surgical Nursing


Patiala

14. Lecturer

Medical- Surgical Nursing


Patiala


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15. Lecturer

Mental Health Nursing


Patiala

APPENDIX-V

LIST OF FORMULAE

Reliability = =xy-xy

{x2-(x)2/N}{ y2-(y)2/N}

Degree of freedom = ( C1 ) =( r1 )

Chi - square =

2


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APPENDIX VII

TO WHOM IT MAY CONCERN

This is to certify that I have edited this thesis by for the partial fulfillment of

requirement for the degree of Post bachelor of science in nursing of Baba Farid

University of health Sciences Faridkot, Punjab.

Topic:A study to assess the incidence and knowledge related to anemia among girls

of nursing college of ludhiana, Punjab with a view to develop information booklet .

Date : .

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