INTRODUCTION:

Adolescence is a period of transition to adult life. It is a unique phase of life during which a child goes through tremendous physical, emotional and social changes and sexual maturation occurs. The present-day adolescent is considered to be more knowledgeable about world affairs. One fifth of the world’s population is represented by them. In today’s scenario both the parents are employed to fulfil the increasing demands to maintain the socio-economic status in society, the adolescents hardly receive the guidance of the elders which they need now more than at any other stage in their life. Unfortunately, schools and colleges do not impart a proper education about growing self to these adolescents. Hence, they depend mainly on their peers, magazines, internet and other networking sites for gaining knowledge about their biological changes and social values. With little or inaccurate knowledge, these young people engage in sexual activities, rendering themselves vulnerable to venereal diseases.¹

Adolescence is a transitional stage of physical and mental human development occurring between puberty and adulthood. It is characterized by beginning and ending teenage stage. Adolescence is a person between the age group of 13 and 19. Puberty is a period of rapid growth and psychological changes. Adolescent is a stage is very important in the life of the girl, because of physical, sexual, psychological changes takes place. The major landmark of puberty for females is Menarche, the onset of Menstruation which occurs the age of 12-13. There can be emotional and physical discomfort problems with puberty.²

Adolescence in girls has been recognized as a special period in their life cycle that requires specific attention. This period is marked with onset of menarche Adolescent girls constitute a vulnerable group, particularly in India where female child is discriminated in the society. Menstruation is still regarded as something unclean or dirty in India and the reaction to menstruation depends upon awareness knowledge about the subject. Most girls are ignorant about the physiology of menstruation and therefore the first experience of menstruation is of fear, shame and disgust.

A fear inculcates in the adolescent girls that they will sin if they breaks these taboos. For these reasons, girls’ attitudes and expectations about menstruation became very negative. Premenstrual syndrome is an array of symptoms that occurs during the second half of the menstrual cycle. The symptoms typically and include one or more of the following. Depression, tiredness, irritability, anxiety, headache, breast swelling, tenderness, craving for sweet or salty foods, constipation and skin acne. Good menstrual health encompasses personal hygiene, mental health, adequate nutrition and correct use of absorbents such as cloth or sanitary napkins. As health team members, nurses can make the adolescent girls aware about this. So that they will be in a better position to practice the hygienic ways.³

Adolescent is a difficult time; the physical changes constitute a spurt in growth, the size and shape of the body change. Their mental and physical development put great stress on them as well as on those around them. In adolescent period the puberty is the unavoidable event in both males and females but it is more important for female.⁴

Menstruation is a cyclic physiologic process and naturalpart of a woman’s life characterized by the flow of blood and endometrium from the uterine cavity This cyclic hormonal functioning is usually accompanied by changes in several physical and psychological aspects, which is described as premenstrual syndrome. Premenstrual syndrome (PMS) is defined as a collection of recurrent physical, cognitive, affective, and behavioral symptoms affecting women, occurring cyclically during the luteal phase of the menstrual cycle and resolving at or within a few days of the onset of menstruation Even if many women experience PMS symptoms, they do not perceive these symptoms as either distressing or debilitating.⁵

The physical influence in the girls during adolescent are significant and the changes occurs in the body, both internally and externally. Menstruation is a normal physiological process in girls and has monthly uterine bleeding for 3-5 days after every 28 days from puberty to menopause. A change in normal behaviour and appearance of abnormal symptoms often noticed in second half of the cycle, but these symptoms are severe enough to disturb life cycle of women and caused premenstrual syndrome. 9,10 Between the age group of 25-35 years up to 85% of menstruating woman reports that they are having one or more premenstrual syndrome. All the women who are all between the age group of 14-30 years were experiencing premenstrual syndrome.

Premenstrual syndrome to physical and emotional symptoms occur about 5to 11 days before a woman starts her monthly menstrual cycle. The symptoms usually stops when the menstruation begins. premenstrual syndrome is a set of physical, behaviour and emotional symptoms. The common physical symptoms are, abdominal fullness, bloating of abdomen and headache. The common psychological symptoms are confusion difficulty in concentration, tension, anxiety, irritability, aggressive behaviour andmood swings. premenstrual symptoms can be relieved by leading a healthy lifestyle, reduction of caffeine, sugar, increase of fibre diet and adequate rest and sleep.⁶

NEED FOR THE STUDY:

Worldwide more than 1.2 billion are adolescents and about 21% of Indian population are adolescents (243 million). Young and growing children have poor knowledge and lack of awareness about physical and psychological changes that occurs during adolescence and the ill health affecting them. Premenstrual Syndrome is described as a collection of predictable physical, cognitive, affective, and behavioural symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolve quickly within a few days of the onset of menstruation.⁷

The typical symptoms of premenstrual syndrome normally involve the symptoms related to mood changes and physical conditions – like headache, fatigue, bloating, sleep disturbances, nausea, and breast tenderness. Premenstrual syndromes affect their educational performance, emotional well-being and daily activities.⁸

Today’s life style factors are also associated with the severity of premenstrual syndrome. Therefore, changing lifestyle, modifying diet, exercises, stress reduction and provision of services by health providers, can optimize Quality of life and overall health of women suffering from pre-Menstrual Syndrome. There are two methods for premenstrual syndrome management- pharmacological and nonpharmacological. Since non-pharmacological management has no side effect and from the available literature reviewed it is evident that it has a significant effect in minimizing the severity of premenstrual syndrome.⁹

Improper lifestyle among the adolescent girls causes a rise in the premenstrual syndrome cases; hence the study is of a particular interest of the researcher as the adolescent girls should be educated to manage the problem accordingly. This will also enlighten their hearts and minds towards prompt management.¹⁰

In India, the premenstrual syndrome is the second (60.5%) most prevalent syndrome among the adolescent girls. Psychiatric symptoms are predominant in adolescent girls suffering from premenstrual syndrome.¹¹

Premenstrual syndrome is a public health problem that affects more than half of reproductive age women globally, including in Ethiopia and studies have shown the prevalence of PMS varies from place to place and ranges between 5 and 90%. Previous studies showed that it prevalence was 7.1% in France University Hospital in Beirut Switzerland (91%), Iran (30.7%), Saudi Arabia (35.6%), Sistan and Baluchestan University (85.6%), Gujarat (18.4%), Thai (16.8%), Bahir Dar University, Ethiopia (72.8%), Debre Markos town, Ethiopia (81.3%), Mekelle University (83.2%) and Addis ketema preparatory school, Ethiopia was 86.1%).¹²

The need for safe and secure pre-menstrual syndrome and its management is universal. Premenstrual syndrome 67% and dysmenorrhea 33% were perceived by the study subjects as the most distressing problems associated with menstruation. The most common effect of menstrual problems on daily routine reported by the study subjects, was in the form of prolonged resting hours (54%) followed by inability to study (50%). More than half (52%) of the subjects discussed their problems with their mother and 60% of the study subjects opted for allopathic treatment for their menstrual problems.¹³

Education is one of the most important components for managing the menstrual problems. The adolescents form a significant proportion of the population of our country. In any country, adolescents represent a major potential human resource of the overall population. Pullon and Reimken, has conducted a survey on treatment of premenstrual symptoms. This revealed that 85% of women have taken some self-help measures during premenstrual symptoms.¹⁴

Adolescence itself is a period of growth and development and requires special attention to maintain and promote health and wellbeing. In India there is no specific adolescent development programme. Their healthcare needs are served through school health services. Here the community health nurse plays a vital role. She has a major responsibility towards health promotion and development. Considering the above factors, the investigation felt that there is a need of identifying the premenstrual problem experienced by the adolescent girls and the assess their knowledge regarding measure to reduce premenstrual syndrome, as it is important to develop the awareness and healthy attitude to reduce the severity of premenstrual problem among adolescent girls.¹⁵

OBJECTIVES OF THE STUDY:

· To assess the existing knowledge level among adolescent girls of selected schools of Sanjeli.

· To evaluate the effectiveness of structured teaching programme on knowledge regarding pre-menstrual syndrome and its management among adolescent’s girls in selected school of Sanjeli.

· To find out association between their selected demographic variable with their pre-test level of knowledge regarding pre-menstrual syndrome and its management.

HYPOTHESES:

H1: The mean of post level of knowledge will be higher than the mean of pre-test level of knowledge regarding pre-menstrual syndrome and its management.

H2: There will be a significant association between their selected demographic variable and their pre-test knowledge regarding pre-menstrual syndrome and its management.

METHODOLOGY:

RESEARCH APPEOACH:

Quantitative research approach

RESEARCH DESIGN:

Pre-experimental, one group pre-test and post-test design.

POPULATION:

A population is a group whose members possess specific attributes that the researcher is interested in studying.

· Target Population: All the girls of age group of 10-19 years old at Madhyamik and Uchchmadhyamik school at Sanjali.

· Accessible Population: All the girls studying in Madhyamik and Uchchmadhyamik school at Sanjali.

SAMPLE:

A total of 60 adolescent girls of the age group between 10-19 years were selected selected schools at Sanjeli.

SAMPLE SIZE:

The sample for present study consists of 60 adolescent girls of selected school.

TECHNIQUE OF SAMPLE SELECTION:

Convenience nonprobability sampling technique.

DATA ANALYSIS PLAN:

The collected data was analyzed using both descriptive and inferential statistics.

RESULTS:

Major study findings include.

Findings related to demographic variables of the study

· According to the age distribution 22(36.67%) belong to 11-12 years, 17(28.33%) belong to 13-14 years, and 21(35%) belong to 15-16 years.

· According to the age of menarche distribution 19(31.67%) belong to 11 years, 15(25%) belong to 12years, 9(15%) belong to 13years and 17(28.33%) samples belong to 14 years.

· According to the religion distribution 44(73.33%) belong to Hindu, 9(15%) belong to Muslim, and 7(11.67%) belong Christian.

· According to the type of family distribution 22(36.67%) belong to nuclear family, and 38(63.33%) belong to joint family.

· According to the dietary pattern distribution 33(55%) belong to vegetarian, and 27(45%) belong to non-vegetarian.

· According to the menstruation related any problem distribution 23(38.33%) belong to have menstruation related problems, and 37(61.67%) belong to no any menstruation related problems.

· According to the frequency of menstruation cycle distribution 18(30%) belong to 26 days, 16(26.67%) belong to 26 days, and 5(43.33%) belong to 32 days.

· According to the area of residence distribution 39(65%) belong to rural, and 21(45%) belong to urban.

Study shows as the pretest level of knowledge of adolescents’ girls among selected 40 studying in selected school. The present study shows that the pretest score reveals that reported 52(86.67%) has inadequate knowledge, 8(13.33%) has moderate knowledge and there was nil reported on adequate knowledge. After administration of structured teaching programme post-test knowledge of Adolescents girls was 36(60%) has moderate knowledge, 18(30%) has adequate level of knowledge and there was reported 6(10%) of inadequate level of knowledge.

It reveals that there was significant improvement in level of knowledge. It revealed that pre-test mean was 14.25 and post-test mean was 20.5 and mean difference was 6.25, standard deviation of pre-test was 4.253, standard deviation of post-test was 2.17208 The obtained “t-test” value for the level of knowledge pre-menstrual syndrome and its management among adolescent girls 18.86 that was highly significance at p<0.05. Hence formulate H1 was accepted. This show that there is significant improvement in knowledge score on pre-menstrual syndrome and its management among adolescent girls after giving structured teaching programme.

CONCLUSION:

The main conclusion of this present study is that most of the adolescents girls of selected school had inadequate and moderately adequate level of knowledge in pretest and they improved to moderately adequate and adequate knowledge in posttest. This shows the imperative need to understand the purpose the Structured teaching programme regarding pre-menstrual syndrome and its management among adolescents girls of selected school at Sanjeli and it will improve the knowledge regarding pre-menstrual syndrome and its management.

It’s evident that structured teaching program was effective in enhancing the knowledge of adolescent girls. Nurse should act as facilitator to educate adolescent girls regarding non- pharmacological management of premenstrual syndrome in order to improve the health and wellbeing of the adolescent girls.

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Received on 22.02.2024 Modified on 09.03.2024

A and V Pub Int. J. of Nursing and Medical Res. 2024; 3(2):84-88.

DOI: 10.52711/ijnmr.2024.17