A comparative study to assess the knowledge on polycystic ovary syndrome [PCOS] among rural and urban college adolescent girls with a view to prepare self learning material in selected colleges in Indore. Y.D. Stella. M.Sc (N) (Associate Professor, Department of Obstetrics and Gynecological Nursing, Index Nursing College, Indore India) Email:y.dstella@yahoo.com Abstract: Adolescence' is a crucial phase in the life of women. At this stage, the adolescent girls stand at the threshold of adulthood. The main aim of the study is to compare the knowledge regarding PCOS among adolescent girls of selected urban and rural colleges in Indore. The study assumed that the adolescent girls have minimum knowledge regarding PCOS. This study sample comprised of 120 adolescent girls (60 from urban and 60 from rural college) between 16-19 years of age belonging to the selected urban and rural colleges. The study was conducted in the selected urban and rural colleges using stratified random sampling technique. The sample consisted of 120 (60 from urban and 60 from the rural college) adolescent girls. The needed data for the study was obtained from the structured knowledge blueprint and had given for ten experts to validate the tool. The validity and reliability of the tool was established prior to the pilot study and reliability was found to be 0.88. This pilot study helped the investigator to improve the confidence in conducting the actual study. The collected data were analyzed using descriptive and inferential statistics. Frequency and percentage of knowledge score were calculated. The t test was used to compare the knowledge regarding PCOS between the adolescent girls of the selected urban and rural colleges and association of the selected baseline characteristics (age, stream, religion, education of the father and mother ) with the knowledge score were assessed using the chisquare test. The study result proved that the the selected rural P.U College is comparatively less than the selected urban college adolescent girls. By providing the needed information to the adolescent girls one can improve their reproductive health. Introduction 'Adolescence' is a crucial phase in the life of women. At this stage, the adolescent girls stand at the threshold of adulthood. This stage is intermediary between childhood and womanhood and it is the most eventful for mental, emotional and psychological wellbeing. Adolescence is characterized by physical and psychological changes in the age group of 10-19 years. 1 Polycystic Ovarian Syndrome is actually a set of complications that are related to having multiple ovarian cysts in an ovary. 2 It is possible for a woman to have a polycystic ovary without PCOS but all women with PCOS involve the presence of a polycystic ovary. Polycystic simply means having multiple cysts. This can lead to a host of complications such as bleeding, twisting of the ovaries and others. 3 PCOS is a common endocrine disorder causing infertility that occurs in 5-10% of reproductive-aged women. The precise cause of PCOS is not known. However, PCOS leads to an inability of follicles in the ovary to produce and release mature eggs. This results in polycystic ovaries (i.e., ovaries with many small follicles or cysts), infertility, and hormonal imbalances. 4
Clinical symptoms of PCOS include: menstrual irregularities, inability to get pregnant due to lack of ovulation, increased hair growth in a male distribution pattern (e.g., on face and chest), acne, and obesity. Other problems associated with PCOS include: increased miscarriage rates and long-term health problems including diabetes, dyslipidemias (high cholesterol and triglycerides), uterine cancer, and cardiovascular disease. If diagnosed properly, several treatment options are available that can lead to positive reproductive outcomes and that will mitigate many of the other long-term health effects of PCOS. 5 PCOS is a common endocrine disorder that is frequently diagnosed when a woman presents to her physician with menstrual irregularities, infertility, or cosmetic concerns. There are adequate treatment options for most presenting symptoms, including oral contraceptives, insulin-sensitizing agents, and "fertility" drugs. Treatment must be designed to address both short-term goals and long-term consequences of PCOS to the patient. Statement of the problem: A comparative study to assess the knowledge on polycystic ovary syndrome [PCOS] among rural and urban college adolescent girls with a view to prepare self learning material in selected colleges in Indore. Objectives of the study The objectives of the study were: to determine the level of knowledge of rural adolescent girls regarding polycystic ovary syndrome using structured knowledge questionnaire. to determine the level of knowledge of urban adolescent girls regarding polycystic ovary syndrome using structured knowledge questionnaire to compare the knowledge between rural and urban adolescent girls regarding polycystic ovary syndrome. to prepare and validate self learning material on polycystic ovary syndrome. Hypothesis The hypothesis was tested at 0.05 level of significance. H1: There will be significant difference between the mean knowledge scores regarding PCOS among adolescent girls. Assumptions The study assumes that - adolescent girls may have some knowledge about polycystic ovary. - PCOS is common among adolescent girls. - self learning material is an accepted learning strategy. Delimitations The study is delimited to: adolescent girls who are in the age group of 16-19 years studying in selected P.U colleges adolescent girls who are available during the period of data collection. II. Methodology A descriptive survey approach was used to assess the knowledge regarding PCOS among adolescent girls of selected urban and rural P.U colleges in Indore. The Dependent variable is the variable the researcher is interested in understanding, explaining or predicting. In this study; it referred to knowledge regarding PCOS. The Extraneous variables which are present in the research environment that may interfere with research findings. In this study age, stream, religion, occupation of father, occupation of mother, education of father, education of mother, and
source of information. The population in this study comprised of all the adolescent girls between the age group of 16-19 years studying in 1st & 2nd year P.U colleges, Indore. In this study sample comprised of 120 adolescent girls (60 from urban and 60 from rural college) between 16-19 years of age belonging to the selected urban and rural P.U colleges. Stratified random sampling procedure is used to select 120 adolescent girls as the sample for the present study from the selected urban (60) and rural (60) P.U colleges. Two main strata were made and from those two each sub strata were made and then the students were divided into six strata according to their optional subjects. The ten adolescent girls from each stratum by simple random sampling were selected. The t test was used to compare the knowledge regarding PCOS between the adolescent girls of the selected urban and rural In Table 1 It is evident from the table 9 that t value computed between the knowledge scores of the adolescent girls of the selected urban and rural college was statistically significant (t (118) =12.074, p<0.05, tabled value 1.98). Hence the null hypothesis is rejected and the research hypothesis is accepted, that is, there is significant difference between the mean knowledge scores of adolescent girls studying in selected urban and rural colleges Table 2: Area wise mean, SD, mean percentage of knowledge scores of adolescent girls of selected urban and rural colleges regarding PCOS n = 60 + 60 colleges and association of the selected baseline characteristics (age, stream, religion, education of the father and mother ) with the knowledge score were assessed using the chisquare test. III. Results The data were analysed based on the objectives and hypotheses using descriptive and inferential statistics. The level of significance chosen was 0.05. Table 1: Mean, SD, and t value of the knowledge scores of adolescent girls of selected urban and rural colleges + 60 Variable Knowled ge Grou p Urba n Mea n 18.7 5 Rural 11.9 2 S.D 1.85 6 3.97 1 t (118) =12.074; p<0.05 * Significant n = 60 t value 12.07 * t (118) =12.074, *significant The data presented in table 2 shows that the knowledge scores of the of the adolescent girls in the selected urban college was computed as 76%,68.24%, 62.50% and 70% in regard to ovary and cyst, PCOS, causes and symptom, diagnosis and prevention respectively.the knowledge scores of the adolescent girls in the selected rural college was computed as 53.33%, 41.96%, 38.33% and 45%, in regard to ovary and cyst, PCOS, causes and symptom, diagnosis and prevention respectively. Table 3: Association between knowledge scores and selected baseline characteristics of the adolescent girls of the selected urban P.U College
health programmes. They should plan these programmes for empowerment of women. Nursing education At present the health care system gives more emphasize on preventive rather than curative aspect. The study findings reveal that there is lack of knowledge among the adolescent girls regarding PCOS. To provide more knowledge to them nurses should have enough knowledge regarding PCOS and how to educate the adolescent girls. The nursing curriculum should lay more emphasize regarding PCOS. The nursing curriculum should incorporate activities like preparation of booklets, handouts, pamphlets and selflearning materials. Nursing research The results in the table 3 depicts that there is no association computed between knowledge score of the adolescent girls from the selected urban college and the baseline characteristics such as age, religion, education of the father and mother. Nursing practice IV. Nursing implications Nurses play a vital role in the health care delivery system. The expanded role of the professional nurse emphasizes those activities which promote health and preventive behavior among people than the curative aspect. The one of the important aspect of PCOS is the adolescent reproductive health, and today s adolescent girls are considered as the good and healthy mothers of tomorrow. It s very important that one has to give more important to their reproductive health. Most of the adolescent girls lack knowledge in PCOS. So it is the responsibility of the community health nurse as well as nurses who work in the hospital in educating people. The community health nurses and school health nurses should participate in assessing the health needs of these adolescent girls and they should be involved in planning, organizing, administering and monitoring the various related reproductive There is an extensive need to develop information materials based on adolescents reproductive health needs. Nurses being the largest groups in the health care delivery system and being more close to the patients and family should take initiative to conduct further research regarding PCOS. The present study is just a initial attempt to assess the knowledge and compare it among the adolescent girls of the urban and rural colleges and it will encourage and motivate health personnel s to do many more research studies. Nursing administration Nurse administrators are the backbone for providing facilities to improve the knowledge of the adolescent girls regarding PCOS. In the present world the health care delivery system demands quality health care. It requires the nurse administrators to have insight of the problems of the special population group and should update their knowledge about it. Nursing administrators can contact with women s organizations and also the authority of the educational institute in order to conduct the teaching programmes and workshops regarding PCOS. There should be health education materials, administrative support
and adequate funds provided to conduct the programmes. V. Conclusion The mean knowledge score regarding PCOS was comparatively higher in the adolescent girls (69.44%) of the selected urban college than in the adolescent girls (44.14%) of the selected rural college. There was significant difference between knowledge scores of the adolescent girls studying in the selected urban and rural college. The the selected urban and rural colleges was influenced by friends/peers. The knowledge of the adolescent girls studying in the selected rural college was not influenced by age, stream, religion, education of the father and mother. The study result proved that the the selected rural P.U College is comparatively less than the selected urban college adolescent girls. By providing the needed information to the adolescent girls one can improve their reproductive health. References 1. Hurlock EB. Developmental Psychology A Life-Span Approach. 5 th ed. New Delhi: Tata McGraw Hill Publishing Company Ltd; 1996. 2. Knochenhauer E. Prevalence of the polycystic ovary syndrome in unselected black and white women of the south eastern United States: a prospective study. J Clin Endocrinol Metab 1998; 83(9):3078-82. 3. Rogol AD. Growth and Development. Current Opinion in Endocrinology and Diabetes 2002; 9(1):11-2. 4. Driscoll DA, Ann NY. Polycystic Ovary Syndrome in Adolescence. Acad. Sci 2003; 997:49-55. 5. Arslanian S, Witchel SF. Polycystic ovary syndrome in adolescents: is there an epidemic? Current Opinion in Endocrinology & Diabetes 2005 Feb; 9(1):32-42.