A Study to Determine the Effectiveness of Planned Teaching Programme on Knowledge regarding prevention of Urinary Tract Infection among Adolescent Girls at Selected Colleges in Gulbarga

 

Nasreen Banu

Lecturer, Maharashtra College of Nursing, Latur.

 

ABSTRACT:

Backgrouund of the study: Urinary tract infection is common disease affecting all age groups, from newborn to old age.⁶ Among adolescent girls acute uncomplicated urinary tract infection is more prevalevent. This is the fourth main reason for out patient visit among adolescent women. Objectives: 1. To assess knowledge regarding prevention of urinary tract infection among adolescent girls in experimental and control group before and after the administration of planned teaching programme. 2. To determine the effectiveness of planned teaching programme regarding prevention of urinary tract infection in terms of gain in knowledge scores of adolescent girls.3. To find the association of pre test level of knowledge of adolescent girls with their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere. Method: A Quasi Experimental study was conducted among Adolescent girls from selected colleges of Gulbarga, A total of 100 adolescent girls were chosen by Purposive sampling technique and wee divided into two groups as Experimental group and Control group (50 Each). Structured Knowledge questionnaire was used to collect the data from the samples on Knowledge regarding Urinary tract infection followed by Planned teaching Programme was conducted on7th day Post test was conducted. Results: The results of the studies revealed during Pre-test the knowledge of the Adolescent girls in Experimental group was 12.04 and in Control group was 11.38 and in Post-test the Experimental group was 23.52 and in Control group was 11.42. The Calculated Paired `t`- test was 27.14 at 0.05 level which was found to be significant implying Planned teaching programme was effective in enhancing Knowledge of Adolescent girls regarding Urinary tract infections.

 

 

 

INTRODUCTION:

According to WHO ‘health is a state of complete physical, mental and social well being not merely an absence of disease or infirmity.’ In recent years this statement has amplified to include the ability to lead socially and economically productive life.¹

 

Adolescence period is the time of transition from childhood to adulthood. The term adolescence literally means ‘to emerge’ or ‘to achieve identity’. During this period social, psychological and physical transformation and maturation occur in adolescence.²

 

People between 10 and 19 years of age are the fastest growing segment of world’s population.³ Adolescence occupies one- third of the world’s population and 84% of them residing in developing countries.² As per last census in 2001, total population in India was 1028.61 million. Karnataka is the eighth largest state in India having population of 52.85 million,⁴ with 26.89 million males and 25.95 million females.⁵ Urinary tract infection is common disease affecting all age groups, from newborn to old age.⁶ Among adolescent girls acute uncomplicated urinary tract infection is more prevalevent. This is the fourth main reason for outpatient visit among adolescent women.⁷

 

NEED FOR THE STUDY:

In healthy people, urine in the bladder is sterile.  However, any part of the urinarytract can become infected.  An infection anywhere along the urinary tract is called as urinary tract infection.⁸ Among bacterial infection, urinary tract infection is the second most common infection which is seen by health care providers.  This infection is affecting more than 8 million people per year. In 1997, National Ambulatory Medical Survey reported that, 7 million office visits as well as 1million emergency room visits and 100,000 hospitalizations occur due to urinary tract infection.⁹ Among adolescent girls, lower urinary tract inflections are very common. At leastone episode of urinary tract infection will occur in nearly 5-6% of girls during first grade to graduation from high school. Compare to boys, the recurrence rate is 50% greater in girls.¹⁰ Due to urinary tract infection every year nearly 6-7 million young women visits physicians.

 

OBJECTIVES:

1.     To assess knowledge regarding prevention of urinary tract infection among adolescent girls in experimental and control group before and after the administration of planned teaching programme.

2.     To determine the effectiveness of planned teaching programme regarding prevention of urinary tract infection in terms of gain in knowledge scores of adolescent girls.

3.     To find the association of pre test level of knowledge of adolescent girls with their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere.

 

HYPOTHESIS:

H₁: The mean post test knowledge scores of adolescent girls on prevention of urinary tract infection, who have undergone the planned teaching programme will be significantly higher than their mean pre-test knowledge scores.

 

H₂: The mean post test knowledge scores of adolescent girls on prevention of urinary tract infection, who have undergone the planned teaching programme will be significantly higher than the mean post knowledge scores of adolescent girls who are not exposed to planned teaching programme.

 

H₃: The levels of knowledge and practices of adolescent girls regarding prevention of urinary tract infection will be significantly associated with their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere.

 

RESEARCH METHODOLOGY:

The present study was aimed at to determine the effectiveness of planned teaching programme on knowledge and practices regarding prevention of urinary tract infection among adolescent girls. The methodology of research indicates the general pattern for organizing, for gathering valid and reliable data for an investigation.

 

RESERCH APPROACH:

In view of the nature of problem and to accomplish the objectives of the study, an evaluative research approach was used for the present study, which is aimed to evaluate the effectiveness of planned teaching programme regarding prevention of urinary tract infection among adolescent girls at selected colleges.

R E O1 × O2

R C O1 − O2

 

KEY:

E- Experimental group

C- Control group

R- Random assignment of the sample

O1- Pre test

O2- Post test

 

Setting of the Study:

The study was conducted in the selected colleges at Gulbarga where adolescent girls were studying.

 

Population:

“Population refers to the entire aggregation of case that meet a designed set of criteria.” In the present study population was defined as the adolescent girls studying in selected colleges.

 

Sample and Sampling:

A sample is used in research, when it is not feasible to study the whole population from which it is drawn. The sample for the study consisted of 100 adolescent girls with 50 each in experimental and control group from selected colleges at Gulbarga.

 

Sampling Techinique:

Probability sampling technique; which involves the random selection of elements from the population was used for the study.

 

RESULTS:

Analysis and Interpretation of Data:

This section deals with the analysis and interpretation of the data collection to determine the effectiveness of the planned teaching programme on prevention of urinary tract infection among adolescent girls. The data were analyzed on the basis of the study objectives, using both descriptive and inferential statistics. Analysis is the process of organizing and synthesizing the data so as to answer research questions and test hypothesis.

 

Organization of Finding:

The data were collected and entered in the master sheet and the findings are presented under the following headings.

 

Section 1: Description of Selected Personal Variables:

A] Frequency and percentage distribution of adolescent girls in experimental and control group according to their Selected Personal Variables.

 

Section 2: Effectiveness of planned teaching programme:

a) Description of adolescent girls’ knowledge regarding prevention of urinary tract infection

b)    Significance of difference between pretest knowledge scores of adolescent girls among experimental and control group.

c) Gain in knowledge: comparing pretest and posttest scores

1. Significance of difference between pretest and posttest knowledge scores of experimental group.

2. Significance of difference between gains in posttest knowledge scores among experimental and control group.

 

Section 3: Findings related to association of knowledge scores of adolescent girls with their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere.

 

Section 1 Description of Selected Personal Variables:

A] Frequency and percentage distribution of adolescent girls in experimental and control group according to their Selected Personal Variables.

The study sample composed of 100 adolescent girls, 50 each in experimental and control groups. The selected personal variables are described under sub headings viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere as shown in Table 1, 2, 3, 4 and 5.

 

Table 1: Frequency and percentage distribution of subjects according to age and religion. N=100

Samples Characteristics	Experimental Group n=50		Control Group  n=50		Total N=100
	f	(%)	f	(%)	f / (%)
Age in Years
1. 15 - 16	28	56	21	52	49
2. 16 - 17	19	38	19	38	38
3. 17- 18	3	6	10	20	13
Religion
1.Christian	4	6	26	52	30
2. Hindu	39	78	11	22	50
3. Muslim	7	14	13	26	20

 

AGE:

The data presented in the Table 1 shows that, the age of sample varied from 15- 18 years. Both in the experimental (56%) and control group (52%) maximum samples were in the age group of 15 - 16 years.

 

Religion:

Table 1 shows that, in experimental group, maximum sample 39 (78%) were Hindus and rest 7 (14%) and 4 (08%) were Muslims and Christians respectively; where as in control group maximum sample 26 (52%) were Christians and rest 13 (26%) and 11 (22%) were Muslims and Hindus respectively.

 

Table 2: Frequency and percentage distribution of subjects according to occupation of their parents, education of father and mother and place of residence N=100

Samples Characteristics	Experimental Group n=50		Control Group n= 50		Total n=100
	f	(%)	f	(%)	f / (%)
Occupation of Parents
1.Agriculture	3	6	8	16	11
2. Business	25	50	19	38	44
3. Coolie	2	4	16	32	18
4.Health care sector	2	4	2	4	4
5. Others	18	36	5	10	23
Education of Father
1. ≤ Lower primary school	2	4	20	40	22
2. High school	12	24	17	34	29
3. PUC	2	4	7	14	9
4. ≥ Diploma and Degree	34	68	6	12	40
Education of Mother
1. ≤ Lower primary school	1	2	20	40	21
2. High school	16	32	24	48	40
4. PUC	13	26	5	10	18
4. ≥ Diploma and Degree	20	40	1	2	21
Place of Residence
1.Rural	7	14	10	20	17
2. Semi urban	15	30	16	32	31
3. urban	28	56	24	48	52
Parents Income Per Month
1. Below 4000/-	2	4	21	42	23
2. 4001- 8000/-	10	20	23	46	33
3. 8001- 12000/-	21	42	4	8	25
4. 12001 and above	17	34	2	4	19
Presence of Female Senior Siblings
1. Yes	11	22	05	10	16
2. No	39	78	45	90	84
Educational Status of Female Senior Siblings N= 16
Degree	10	62.5	05	100	93.75
Post graduate	01	37.5	--------		6.25
Exposure to Mass Media
1. Yes	24	48	32	64	56
2. No	26	52	18	18	44
Previously Suffered from Sign and Symptoms of Urinary Tract Infection
Burning Sensation on Urination
1.Yes	10	20	13	26	23
2. No	40	80	37	74	77
Cloudy Appearance of Urine
1. Yes	--	---	---	---	--
2. No	50	100	50	100	100
Increased Frequency of Micturiation
1. Yes	3	6	---	---	3
2. No	47	94	50	100	97
Flank Pain Associated with The Fever, Chills, And Nausea
1. Yes	---	---	4	8	4
2. No	50	100	46	92	96
Flank Pain Associated with The Fever, Chills, and Nausea
1. Yes	---	---	4	8	4
2. No	50	100	46	92	96
Educative seminar on prevention of UTI attended previously at school or elsewhere.
1. Yes	---	---	2	4	2
2. No	50	100	48	96	98

 

OCCUPATION OF PARENTS:

It is evident from Table 2 that, in experimental group majority of adolescent girls’ 25 (50%) parents occupation was in business where as in control group it was only 19 (32%). Only 2 (4%) members’ parents was working in health care sector both in experimental and control group.

 

Education of Father:

In the category of education of father, in experimental group majority 34 (68%) were educated upto ≥ Diploma and Degree, 12 (24%) were educated upto High school, 2(4%) were educated upto PUC and another 2(4%) were having ≤ Lower primary school education, where as in control group maximum 20 (40%) had education ≤ Lower primary school, 17 (34%) were educated upto High school 7 (14%) were educated upto PUC, 6 (12%) were educated upto ≥ Diploma and Degree. (Figure 4 and Table 3)

 

Education of Mother:

Table 2 reveals that, in the category of education of mother, in experimental group, maximum 20 (40%) were educated upto ≥ Diploma and Degree, 16 (32%) were educated upto High school, 13 (26%) had educated upto PUC and only 1 (2%) was having education ≤ Lower primary school. Where as in control group, 24 (48%) were having education ≤ Lower primary school, 5 (10%) were educated upto PUC and only 1 (2%) was educated upto ≥ Diploma and Degree.

 

Place of Residence:

With regards to place of residence, Table 2 shows that, maximum members both in experimental group 28 (56%) and control group 24 (48%) were residing in urban area, followed by 15 (30%) in experimental group and 16 (32%) in control were residing in semi urban,7(14%) in experimental group and 10 (20%) in control group were residing in rural area.

 

Income Per Month:

As seen in Table 2, in experimental group, majority 21 (42%) of the adolescents were belonging to income group of 8001 – 12000/-, 17 (34%) were belonging to 12001 and above, 10 (20%) were belonging to 4001 – 8000/-, 2(4%) were belonging to below 4000/- where as in control group maximum 23 (46%) were belonging to 4001 – 8000/-, 21(42%) were belonging to 4000/-, 4(8%) were belongs to 8001 – 12000/-, 2 (4%) were belonging to 12001 and above.

 

Presence of Female Senior Siblings:

Table 2 shows that, in experimental group 11(22%) of adolescent girls have female senior siblings; where as in control group only 5 (10%) had senior siblings.

 

Educational Status of Female Senior Siblings:

Table 2 shows that, out of 11 female senior siblings in experimental group, maximum members 10(62.5%) had education upto Degree and 37.5% had education upto Post Graduation. On the contrary all had education upto Degree in control group.

 

Exposure to Mass Media:

Table 2 shows that, in experimental group, 24(48%) adolescent girls were exposed to mass media, where as in control group majority 32(64%) were exposed to mass media.

 

Burning Sensation on Urination:

It is evident from the Table 2 that, only 10 (20%) adolescent girls experienced having suffered from burning sensation in experimental group, where as in control group this number was 13 (26%).

 

Cloudy Appearance of Urine:

None of the sample had experienced presence of cloudy experience of urine. (Table 2)

 

Increased Frequency of Micturation:

Table 2 reveals that, increased frequency of micturation was present in 3(6%) members of experimental group, but none of the members in control group had this experience.

 

Flank Pain Associated with the Fever, Chills, And Nausea:

Table 2 shows that, in control group 4(8%) of members had suffered from flank pain associated with the fever, chills, and nausea, where as no one in experimental group none suffered.

 

Educative seminar on prevention of UTI attended previously at school or elsewhere:

Table 2 shows that, only 2(4%) in control group had attended some educative seminar on prevention of UTI.

 

Section 2: Effectiveness of Planned Teaching Programme:

a) Description of adolescent girls’ knowledge regarding prevention of urinary tract infection.

 

The pretest and posttest knowledge scores obtained by the subjects were tabulated to a master sheet and the total scores obtained by each adolescent girls in the pretest and posttests were tabulated. Mean, standard deviation, median and range of pretest and posttest were computed. The findings were presented in the Table 3.

 

Table 3: Mean, Standard Deviation, Median, and Range of Pre Test and Post Test Knowledge Scores of Adolescent Girls In Experimental And Control Group On Prevention Of Urinary Tract Infection. N= 100

Group	Pre Test Scores				Post Test Scores
	Mean	SD	Median	Range	Mean	SD	Median	Range
Experimental  Group n=50 Control group  n=50	12.04 11.38	±3.29 ±3.28	12 11	6-20 5-20	23.52 11.42	± 3.64 ±3.32	24 12	16-30 6-18

 

The data presented in Table 3 shows that the pretest knowledge scores ranged from 6-20 in experimental group and 5- 20 in control group as against possible range of 0- 30. The mean pretest knowledge score is 12.04 with standard deviation ±3.29 in experimental and 11.38 with standard deviation ±3.28 in control group. The median score is 12 in experimental and 11 in control group. The posttest knowledge scores ranged from 16-30 in experimental group and between 6-18 in control group group as against possible range of 0- 30. The mean of posttest 1 knowledge scores is 23.52 with standard deviation ±3.64 and median of 24 in experimental group and 11.42 with standard deviation ±4.02 and median of 12 in control group.

 

Significance of difference between pretest knowledge scores of adolescent girls among experimental and control group:

In order to find out the significance of differences in the mean pretest knowledge scores of both experimental and control group, the independent‘t’ test was computed. The data are presented in the TABLE 4

 

Table 4: Mean, mean difference, Standard deviation, Standard deviation difference, SEMD, and independent‘t’ test for pretest knowledge scores of the adolescent girls among experimental and control groups. n=50

Group	Mean	Mean difference	SD difference	SEMD	Independent ‘t’ test
Experimental Control	12.04 11.38	.68	±3.32	.66	0.971

‘t’ (98) = 1.967 p>0.05

 

The data presented in the Table 4 shows that the mean difference between pretest knowledge scores of adolescent girls in experimental and control group is 0.68. To find the significance of difference in mean knowledge scores among experimental and control group, an independent ‘t’ test was computed and obtained value of independent ‘t’(98) = 0.971 p>0.05 is found to be not significant. Hence, it is inferred that there is no difference between pretest knowledge scores of adolescent girls among experimental and control groups before intervention and both the group started from an equivalent baseline.

 

b)    Gain in knowledge: comparing pretest and posttest scores

1.     Significance of difference between pretest and posttest knowledge scores.

In order to find out the significance of difference between means of pretest and posttest knowledge scores, paired ‘t’ value was computed. The data are presented in Table 05. To test statistical significance following null hypothesis was stated:

 

H₀₁: There will be no significant difference between the mean pre-test and post test knowledge scores of adolescent girls who have undergone the planned teaching programme on prevention of urinary tract infection.

 

 

Table 05: Mean, mean difference, SD difference, SEMD, and paired ‘t’ test of pretest and posttest knowledge scores of adolescent girls on prevention of urinary tract infection in experimental group n= 50

Knowledge score	Mean	Mean difference	SD difference	SEMD	Paired ‘t’ test	Level of significance
Pretest Post test	12.04 23.52	11.48	±2.86	0.405	27.12	S (p<0.05)

‘t’ (49) = I..991 p=0.05

 

The data presented in Table 05 shows that in experimental group the mean difference between the pretest and posttest knowledge mean scores is 11.48. This indicates an increase in knowledge scores after undergoing planned teaching programme. To find significance of the gain in knowledge paired ‘t’ test value was computed and the obtained value of ‘t’ (49) = 27.12 is found to be significant at 0.05 level of significance.

 

Hence, the null hypothesis is not supported and the research hypothesis is supported. This indicates that the gain in knowledge is not by chance and the adolescent girls who have undergone the planned teaching programme on prevention of urinary tract infection, significantly gained knowledge.

 

2.     Significance of difference between gains in posttest knowledge scores among experimental and control group.

In order to find out the significance of difference between posttest mean knowledge scores of experimental group and control group, independent ‘t’ value was computed. The data are presented in Table 6.

To test the statistical significance following null hypothesis was stated:

 

H_02: There will be no significant difference between the mean posttest knowledge scores of adolescent girls on prevention of urinary tract infection, who have undergone the planned teaching programme, than the mean post knowledge scores of adolescent girls who are not exposed to planned teaching programme.

 

Table 6: Modified mean gain score, mean difference, standard deviation of difference, standard error of the mean difference, and ‘t’ value of posttest knowledge scores of adolescent girls among experimental and control group on prevention of urinary tract infection N=100

Group	Modified mean gain	MD	SD Difference	SEMD	Independent ‘t’ test
Experimental group  n=50 Control Group  n=50	0.953     0.004	*95	±3.52	0.704	I7.18

‘t’ (98) = 1.967 P<0.05 * The modified mean score is multiplied by 100

 

The data presented in Table 9 shows that modified mean gain scores of experimental group is .953, which is apparently higher than the control group mean gain score 0.004. The difference between the modified mean gain score of the two groups is 95 with standard deviation of difference 3.52

The statistical significance of the difference was tested and the ‘t’(98) = 17.18 in posttest is found highly significant at 0.05 level of significance.

 

Therefore, the research hypothesis is supported and the null hypothesis is not supported. The mean gain in knowledge scores of the adolescent girls who undergone planned teaching programme on prevention of urinary tract infection is significantly higher than those not undergone planned teaching programme. Hence this indicates that the planned teaching programme was effective in improving the knowledge of the adolescent college girls regarding prevention of urinary tract infection

 

Section-4: Findings Related to Association of Knowledge Scores of Adolescent Girls with Their Selected Personal Variables:

To find out the association between the pretest knowledge and selected personal variables, chi-square was computed and the following null hypotheses was stated:.

 

H₀₃: There will be no significant association between pretest level of knowledge of adolescent girls regarding prevention of urinary tract infection and their selected personal variables viz. age, religion, place of residence, occupation and education of their parents, female senior siblings and their education, exposure to mass media, previously suffered from urinary tract infection, related educative seminar attended previously at school or elsewhere.The data are presented in the Table 7, 8 and 9

 

Table 7: Chi-square between pretest level of knowledge of adolescent girls on prevention of urinary tract infection and their selected personal variables viz. age, place of residence, occupation of parents and religion. N =100

Variables	Knowledge scores		c2	d(f)	Level of significance
	Median and above Median	Below Median
Age (years)			0.486       28.916           3.037         2.572	2       2           4         2	NS       S (p<0.05)           NS         NS
1. 15- 16	27	22
2. 16- 17	21	17
3. 17- 18	6	7
Place of Residence
1.Rural	6	11
2.Semi urban	7	24
3.Town	41	11
Occupation of Parents
1.Agriculture	3	8
2. Business	25	19
3.Coolie	11	7
4.Health care sector	3	1
5. Other	12	11
Religion
1.Christian	14	16
2.Hindhu	30	20
3.Muslim	10	10

c² (2) = 5.99, (4) = 9.49 p =0.05 S = significant NS = Not significant

 

Table 09: Chi-square between pretest level of knowledge of adolescent girls on prevention of urinary tract infection and their selected personal variables viz. parents income per month, presence of female siblings and their educational status and education of parents. N =100

Variables	Knowledge scores		c2	d(f)	Level of significance
	Median and Above Median	Below Median
Parents Income Per Month			1.245     2.87       *177     13.949         2.118             4.033	1     1       1     3         3             3	NS     NS           S (p<0.05)     S (p<0.05)     NS       NS
1.Below 4000-8000	33	23
2.8001-12000andabove	21	23
Presence of Female Senior Siblings
1Yes	6	10
2.No	48	36
Educational Status of Female Senior Siblings  n=16
Degree	5	10
Post graduate	1	----
Expiosure To mass media
1.Yes	21	35
2.No	33	11
Education of Father
1.BelowL.P. School	9	13
2.High school	16	13
3.P.U. College	5	4
4.Diploma and above that	24	16
Education of Mother
1.BelowL.P. School	9	12
2.High school	20	20
3.P.U. College	10	8
4.Diploma and above that	15	6

 c² (1) = 3.84, (3) = 7.82 p= 0.05 NS = Not significant, S = Significant * Yates’ correction done

 

Table 10: Chi-square between pretest level of knowledge of adolescent girls on prevention of urinary tract infection and their selected personal variables viz. previously suffered from sign and symptoms of urinary tract infection and educative seminar on prevention of urinary tract infection attended previously at school or elsewhere. N =100

Variables	Knowledge scores		c2	d(f)	Level of significance
	Median Andabove Median	below Median
Previously Suffered from Sign and Symptoms of Urinary Tract Infection			2.658     ----     *0.004       *0.121           *0.0002	1     ---     1       1           1	NS     -----     NS       NS           NS
Burning Sensation on Urination
1.Yes	9	14
2. No	45	32
Cloudy Appearance of Urine
1. Yes	---	---
2. No	54	46
Increased Frequency of Micturiation
1. Yes	2	1
2. No	52	45
Flank Pain Associated with The Fever, Chills, and Nausea
1. Yes	2	2
2. No	52	44
Educative seminar on prevention of UTI attended previously at school or elsewhere
1. Yes	------	2
2. No	54	44

c² (1) = 3.84 p£ 0.05 , NS = Not significant, * Yates correction done

 

Table 08, 09 and 10 shows that, the computed Chi-square value for association between level of knowledge of adolescent girls regarding prevention of urinary tract infection and their selected personal variables were not found to be statistically significant at 0.05 level expect for place of residence , educational status of the female senior siblings and exposure to mass media. Therefore, the findings partially support the null hypothesis and the research hypothesis inferring that adolescent girls pretest level of knowledge regarding prevention of urinary tract infection are highly associated with place of residence , educational status of the female senior siblings and exposure to mass media.

 

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Received on 08.12.2022         Modified on 12.01.2023

Accepted on 05.02.2023       ©A&V Publications All right reserved