INTRODUCTION:
According to WHO, adolescent girls faces nutritional problems like low Haemoglobin level in the prevalence of 40% in the age between 15 – 45 years.1 Low Haemoglobin levels can drain the colour from life, leaving adults feeling drained, Fatigued and breathless, as their bodies struggle to deliver oxygen’s vital spark. Home Remedies like natural resources can improve the Haemoglobin level and help to improve The lifestyle.2 Nature’s medicine cabinet offers a treasure trove of remedies for anaemia. Beetroot juice, with its deep crimson hue, seeps iron rich goodness in the bloodstream. Beetroot juice with Jaggery, a ruby – red duo that synergizes irons potency, as the earthy Sweetness of Jaggery enhances absorption, nurturing haemoglobin’s growth and Reviving vitality in anaemia’s gentle grasp.2
BACKGROUND OF THE PROBLEM
Anaemia among teenagers can be seriously almost entirely caused by a lack of substance iron, which is closely related to the level of severity of anaemia. The most Visible effect of anaemia is a decline in achievement studying in school. This article Briefly introduces anaemia, aetiology, pathophysiology, impact, and preventive Measures.3
Thus, while going through all the mentioned review available from various sources, and by referring various research and non – research review includes student’s and teacher feedback from college during health assessment and monthly check-ups on incidence of low Haemoglobin level in Nursing students, being nurse investigators, the investigators perceived the importance of Haemoglobin level in late adolescents. By considering the recommendations given by expert in the field of research and the investigators felt that it will be relevant to improve the level of Haemoglobin level in Adolescents.
NEED AND SIGNIFICANCE OF THE STUDY:
Anaemia is a condition in which the concentration of Haemoglobin falls below Normal threshold, reducing the bloods ability to transport oxygen effectively throughout the body.4 Haemoglobin is a protein found in red blood cells that carries oxygen from The lungs to all over the body.5
Globally, an estimated 24.3% of the population, or 1.92 billion people, were Affected by anaemia in 2021, according to a study published in The Lancet. This Prevalence has decreased slightly from 28.2% in 1990. The highest prevalence was Observed in western sub-Saharan Africa (47.4%), South Asia (43.0%), and central sub-Saharan Africa (35.7%). However, the proportion of anaemia attributable to iron Deficiency appears to vary according to geographic region, demographics, and anaemia Severity and infection burden. Many conditions associated with anaemia are known to Be more common among people in lower – and middle-income countries (LMICs), and particularly preschool children and women of reproductive age, meaning that anaemia. Affects these population groups disproportionately. In 2019, 1.76 billion people were Affected by anaemia worldwide (prevalence of 23.67%). The Global Burden of Disease 2019 found that anaemia was responsible for 50.3 million years lived with disability Representing 5.8%.6 The National Family Health Survey 5 (NFHS-5) conducted in 2019 - 21, revealed that 67.1% of children aged 6 – 59 months, 59.1% of adolescent girls, and 57.0% of women aged 15 – 49 years were anaemic.7
OBJECTIVES:
Primary Objectives:
1. To assess the level of Haemoglobin among Nursing students in Educational Institution.
2. To evaluate the effect of Beetroot juice with Jaggery in improving the level of Haemoglobin among Nursing students in Educational Institution.
Secondary Objective:
1. To find out the association between the pretest level of Haemoglobin among Nursing students with selected demographic variables
HYPOTHESES
HA1: There is a statistically significant difference in the mean pretest and posttest Level of Haemoglobin among Nursing student in selected Educational Institution.
H01: There is a no statistically significant difference in the mean pretest and Posttest levels of Haemoglobin among Nursing student in selected Educational Institution.
HA2: There is a statistically significant association between the pretest level of Haemoglobin among Nursing students with selected demographic variables.
H02: There is a no statistically significant association between the pretest level of Haemoglobin among Nursing students with selected demographic variables.
MATERIALS AND METHODS:
Research Approach:
In this study, a quantitative research approach was used to assess the effect of Beetroot juice with Jaggery in improving the level of Haemoglobin among Nursing students in educational institution at Kollam district.
Research Design:
For assessing the effect of Beetroot juice with Jaggery in improving the level of Haemoglobin among Nursing students in educational institution at Kollam district. The design used was pre-experimental one group pretest posttest design.
Variables:
Variables are concepts at different level of abstraction that are concisely defined to prompt the measurement or manipulation with in a study.
Independent Variable:
In this study, independent variable is Beetroot juice with Jaggery.
Dependent Variable
The dependent variable used in the study is Nursing students with low Haemoglobin level between the age group of 18 – 21 years.
Demographic Variables:
In the study, the demographic variables are age in years, religion, residence, type of family, socio economic status of the family as per the ration card, diet pattern, pattern of menstruation, treatment for any illness/infection, history of any illness/infection, Body Mass Index (BMI) and family history of anemia.
Setting of the Study:
In this study, the selected setting was Holy Cross College of Nursing Kottiyam, Kollam.
Population:
The population for this study comprised of Nursing students who are studying at Holy Cross College of Nursing Kottiyam, Kollam.
Sample and Sampling Technique:
Sample:
In this study, the sample comprised of Nursing students with low Haemoglobin level between the age group of 18 – 21 years who fulfilled the sample selection criteria.
Sample Size:
In this study, investigators selected 40 Nursing students with low Haemoglobin level in the age group of 18 – 21 years at Holy Cross College of Nursing Kottiyam, Kollam.
Sampling Technique:
In this study, Second, Fourth and Sixth Semester B.Sc. Nursing students were randomly selected by selection criteria.
Inclusion Criteria:
Nursing students who are,
· Adolescent girls between the age group of 18 – 21 years
· For moderate to severe anemia
· Not taking treatment for anemia
· Past history of anemia
Exclusion Criteria:
Nursing students who are,
· Menstruation during the study.
· Unavailability of the participants at the time of data collection
· Irregular menstruation
· History of any Illness/infection
Development/Selection of Tool
· Tool 1: Demographic Proforma
· Tool 2: Haemoglobin Estimation Scale
Tool 1: Demographic Variables:
Demographic variables are age in years, religion, residence, type of family, socio economic status of the family as per the ration card, diet pattern, pattern of menstruation, history of any illness/infection, treatment of infection/illness, Body Mass Index (BMI) and family history of anemia.
Tool 2: Haemoglobin Estimation Scale:
A Haemoglobinometer is an instrument used to determine the Haemoglobin content of the blood by spectrophotometric measurement. Portable Haemoglobinometer provide easy and convenient measurement, which is particularly useful in areas where no clinical laboratories are available. It is also useful in emergencies due to its ease-of use, accuracy, and fast delivery of results.
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Method of Haemoglobin Assessment |
Grade |
Scores |
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Normal value
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Men:13 – 18g/dl Female: 12 – 16g/dl |
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Haemo-globinometer |
Grade I: Mild |
11.0 – 11.9 g/dl |
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Grade II: Moderate |
8.0 – 10.9 g/dl |
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6.5 – 7.9 g/dl |
Data Collection Process:
The data collection process was identified of subjects and precise systematic gathering of information relevant to the research purpose, questions or hypothesis of the study.
Phase 1
Data collection is carried out to assess the Haemoglobin level by using a Haemoglobinometer, along with the Haemoglobin Estimation Scale and demographic variables. Pre-experimental one group pretest posttest was conducted and the investigator identified 40 adolescent girls with low Haemoglobin level between the age group of 18 – 21 years by selection criteria.
Phase II:
Following the preliminary test, Beetroot juice with Jaggery was administered to the Nursing students included in this study according to the investigators schedule. The intervention was administered for 15 consecutive days after pretest.
Phase III:
Posttest was conducted in 17th day after the intervention and the Haemoglobin levels were monitored.
RESULT:
Section A: Distribution of subjects based on demographic variables
· Out of 40 subjects, 22.5% of subjects belong to age group of 17 – 19 years and 77.5% belongs to age group of 20 – 22 years.
· Out of 40 subjects, 22.5% of subjects were Hindu, 75% of subjects were Christian and 2.5% of subjects belongs to Muslim.
· Regarding Residence, 27.5% of subjects were residing in urban areas and 72.5% of subjects were residing in rural areas.
· Regarding type of family, 85% of subjects belongs to nuclear family, 12.5 % of subjects belong to joint family and 2.5% of subjects belongs to extended family.
· Out of 40 subjects, 17.5% of subjects were having pink color ration card, 55% of subjects having blue color ration card and 27.5% of subjects were having white color ration card.
· Regarding food pattern, 100% were having mixed diet.
· Out of 40 subjects, 72.5% have regular pattern of menstruation and 27.5% subjects have irregular pattern of menstruation.
· Out of 40 subjects, 7.5% of subjects had the history of illness / infection and 92.5% of subjects had no history of illness / infection.
· Out of 40 subjects, 5% of subjects have treatment of illness/ infection and 95% of subjects have no treatment of illness / infection.
· Regarding Body Mass Index, 20% of subjects have < 18.4Kg / m2 and 80% of subjects have 18.5 – 24.9 Kg / m2 Body Mass Index.
· Regarding the family history of anemia, 67.5% of subjects had family history of anemia and 32.5% of subjects had no family history of anemia.
Section B: Distribution of subjects based on assessment scores and evaluation scores of Nursing students with low Haemoglobin level.
This section deals with the analysis and interpretation of data to determine assessment scores and evaluation scores of Nursing students with low Haemoglobin level. Out of 40 subjects 85% of the Nursing students had moderate anemia and 15% had severe anemia in the pretest. In the posttest, the Nursing students have normal Haemoglobin level, mild anemia and moderate anemia.
Section C: Effect of Beetroot juice with Jaggery in improving the level of Haemoglobin among Nursing students.
Table 1: Mean and Standard Deviation of pretest and posttest scores in Haemoglobin rating scale n = 40
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Assessment of Nursing students with Anemia |
Mean |
MD |
SD |
t value |
p value |
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Pretest |
9.965 |
0.812 |
1.38 |
4.28 |
0.000059* |
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Posttest |
10.777 |
1.55 |
* = Significant at 0.05 level; MD= Mean Difference; SD= Standard Deviation
An average pretest and posttest Haemoglobin Estimation Screening Scale Scores in the subjects were 9.965 and 10.777. Mean difference of pretest and posttest Haemoglobin Estimation Scale Score was 0.812. Pretest and posttest standard deviation was 1.38 and 1.55 respectively. The computed ‘t’ value of pretest – posttest Haemoglobin Estimation Scale Scores regarding the Beetroot Juice with Jaggery in improving the level of Haemoglobin was 4.28 and the P value was 0.000059. Since calculated P value was less than 0.05 (P<0.05), Null Hypothesis (H01) is rejected.
Section D: Association between pretest Haemoglobin Estimation Scale Scores and demographic variables:
DISCUSSION AND CONCLUSION:
The study was focused on the effect of Beetroot juice with Jaggery in improving Haemoglobin level among Nursing students in educational institution at Kollam district. For conducting pre-experimental study, we collect 40 Adolescent girls with anaemia and analyzed using descriptive and inferential statistics. The findings of the study have been discussed using objectives.
Objective 1: To assess the level of Haemoglobin among Nursing students in Educational Institution.
In this study, out of 40 subjects 85% of the Nursing students had moderate anaemia, 15% of the Nursing students had severe anaemia in the pretest.
Objective 2: To evaluate the effect of Beetroot juice with Jaggery in improving the level of Haemoglobin among Nursing students in Educational Institution.
An average pretest and posttest Haemoglobin rating scale were 9.965 and 10.777 respectively. Mean difference of pretest and posttest Haemoglobin rating scale score 0.812. Pretest and Posttest standard deviation was 1.38 and 1.55 respectively. The computed ‘t’ value of pretest- posttest Haemoglobin rating scale score effect Beetroot juice with Jaggery in improving the hemoglobin level was 4.28 and p value of 0.000059. Since calculated p value was less than 0.05 (P<0.05). So Null Hypothesis (H01) is rejected. Above mentioned that Haemoglobin rating scale score were reduced after the administration of Beetroot juice with Jaggery among Nursing students.
Objective 3: To find out the association between the pretest level of Haemoglobin among Nursing students with selected demographic variables.
The findings of present study revealed that there was a significant association between pretest Haemoglobin estimation scale scores and demographic variables such as religion (χ2 = 6.33, p value = 0.03), socio economic status (χ2 = 5.77, p value = 0.04), history of illness / infection (χ2 = 6.79, p value = 0.009) and family history of anemia (χ2 = 3.75, p value = 0.04).
Discussion of present study with other relevant studies reveals that administration of Beetroot juice with Jaggery is highly effective for improving Haemoglobin level.
NURSING IMPLICATIONS:
Nursing Practice:
· Now a days Anaemia and its associative symptoms are very common among adolescent girls. Anaemia significantly impact adolescent girl’s quality of life, causing physical and emotional distress.
· Effective management in nursing practice involves a multidisciplinary approach, incorporating pharmacological and non- pharmacological interventions.
· Adolescents girls and their families usually prefer to start non- pharmacological measures before considering pharmacological management.
· Nurses play a vital role in assessing pain providing education on lifestyle modification.
· Successful management reduces Anaemia and associated symptoms, improves daily functioning and enhances overall, well-being, enabling adolescent girls to manage their symptoms and resumes normal activities.
Nursing Education:
· Graduate in nursing degree prepares nurses for practicing roles, including management and delivery of primary health care, case management, education and administration.
· Student development programme need to be arranged for the welfare of the students. Nurse educators should take up the role of student counsellors at institutional level for the early identification of the Anaemia and to overcome those academic performances in their curriculum.
· Several alternative modalities including dietary management and vitamin supplements have to be implement through the curriculum to identify and manage Anaemia among the adolescent group of nursing students.
Nursing Administration:
· The nurse administrators should take great interest in formulating the policies and the procedures for the betterment of the student community since nursing is a demanding profession. may come in contact with many adolescent girls with Anaemia in her day-to-day life.
· The nurse administrator can coordinate her work with the teaching aspect among nursing students by administering Beetroot juice with Jaggery as a remedy for Anaemia.
· Nurse administrator can organize in service education programme regarding Anaemia, associated symptoms and the benefits of Beetroot juice with Jaggery for reducing Anaemia.
· The nurse administrator should give opportunity to the students to provide teaching sections regarding Anaemia and benefits of Beetroot juice with Jaggery.
Nursing Research:
· Research in nursing field helps in professional growth as well as personal growth. Professional organizations in Nursing are convinced by the importance of Nursing research on nurses and nursing students.
· Research can also be done in nursing institution among adolescent girls to identify dysmenorrhoea, symptoms and its effective management. Research can be done to identify the reason for recurrent absent of adolescent girls in the academic period.
· This study can be used to identify Anaemia and its associated symptoms and adequate management. Research can be conducted in adolescent population at various settings.
· The study will be a valuable reference and pathway for future researchers. The replication of the study can be done on a large sample with different research design.
RECOMMENDATIONS:
· A key finding of the study is that many adolescent girls was suffering from Anaemia and associated symptoms. Considering the management of Anaemia, it is important that effect of Beetroot juice with Jaggery to reduce Anaemia among adolescent girls.
· In the light of the above study findings the following recommendations were made.
· As a part of their orientation, students can be given instruction to report any complications during intervention to the co-ordinator.
· The same study can be replicated by using a true experimental research design which might yield more reliable results, to validate the findings and to make generalization.
· Replication of the study could be done with a larger sample to validate and generalize the findings.
· A similar study could be conducted with adolescent girls with Anaemia to find out the effect of Beetroot juice with Jaggery to reduce Anaemia.
· A similar study could be conducted for girls with all age group who were suffering from Anaemia.
CONFLICT OF INTEREST:
The authors declare no conflicts of interest.
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3. B.T. Basavanthappa, Text Book of Midwifery & Reproductive Health Nursing, 7th edition, Jaypee Brothers Medical Publishers: 302-306.
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Received on 14.11.2025 Revised on 24.12.2025 Accepted on 26.01.2026 Published on 26.02.2026 Available online from March 03, 2026 A and V Pub J. of Nursing and Medical Res. 2026;5(1):29-34. DOI: 10.52711/jnmr.2026.07 ©A and V Publications All right reserved
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