SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

SUBMITTED BY:
Ms. SONIYA. JOHN
Ist YEAR M.Sc. NURSING
OBSTETRICS AND GYNAECOLOGY NURSING
(2009-2011 BATCH)

VARALAKSHMI COLLEGE OF NURSING

No.19, KIADB ROAD
CHOKKASANDRA
T.DASARAHALLI
BANGALORE-560057

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE,KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION
SONIYA JOHN

1.

NAME OF THE CANDIDATE

I YEAR M.SC.NURSING

AND ADDRESS

VARALAKSHMI COLLEGE OF
NURSING
BANGALORE-560057
VARALAKSHMI COLLEGE OF

NAME OF THE INSTITUTION

NURSING
BANGALORE-560057
MASTERS DEGREE IN NURSING

COURSE OF STUDY AND SUBJECT

3
4
5

OBSTETRIC AND GYNAECOLOGY

NURSING

DATE OF ADMISSION TO COURSE

TITLE OF THE STUDY

15-06-2009
THE EFFECTIVENESS OF
STRUCTURED TEACHING
PROGRAMME REGARDING
POLYCYSTIC OVARIAN SYNDROME
AMONG ADOLESCENT GIRLS

6. BRIEF RESUME OF INTENDED WORK

INTRODUCTION:
"All any grown up expects of an adolescent is that he act like an adult and be
satisfied to be treated like a child.

John Gran

Adolescent phase starts from the onset of puberty and extends from till sexual
maturation is complete. During this period the individual becomes capable of
reproduction. The age at the onset of puberty and sexual maturation vary within a
wide range. The adolescent are prone to suffer from medical and health problems
peculiar to this age period.
Polycystic ovary syndrome is an endocrine disorder that affects approximately 5% of
all women. It occurs amongst all races and nationalities, is the most common
hormonal disorder among women of reproductive age and is a leading cause of
infertility.1
The principal features are obesity, anovulation (resulting in irregular menstruation),
acne, and excessive amounts or effects of androgenic (masculinizing) hormones. The
symptoms and severity of the syndrome vary greatly among women. While the causes
are unknown, insulin resistance, diabetes, and obesity are all strongly correlated with
Polycystic ovarian syndrome2.
Adolescent girls are often associated with Oligomenorrhea, amenorrhea irregular,
few, or absent menstrual periods, Hirsutism excessive and increased body hair,
typically in a male pattern affecting face, chest and legs. Hair loss appearing as
thinning hair on the top of the head Acne, oily skin, seborrhea. Obesity or weight
gain: one in two women with Polycystic ovarian syndrome are obese, depression and
deepening of voice. All these are due to immaturity of the hypothalamic pituitary
ovarian axis during the first years following menarche.3
For Adolescent no

surgical management is possible, before marriage, so that by

giving information regarding Polycystic ovarian syndrome is very useful. And our
main aim or goal is to lower insulin levels, restoration of fertility, treatment of

hirsutism or acne and restoration of regular menstruation, and prevention of

endometrial hyperplasia and endometrial cancer. During Adolescent period general
interventions like weight reduction, regular exercise &maintaining a healthy weight
can reduce hormonal imbalance, restore ovulation and fertility, and improve acne and
hirsutism4.

6.1 NEED FOR THE STUDY

Adolescent grow both rapidly and mature dramatically during this period. In a family
in which an adolescent is expected to begin working full time or to marry at an age
you may need to include factors such as effects of job, family, financial stress and
readiness for early child bearing also. Reproductive disorders in children range from
mild infections to serious anatomic malformations. All of these require prompt and
careful treatment so that we have to make them aware of normal reproductive health
and its abnormalities. Then only they can identify abnormalities & treat promptly5.
Polycystic ovarian syndrome is a common endocrine disorder which may lead to lot
of problems later in the age of an adolescent girls. As Polycystic ovarian syndrome is
an ovarian disorder marked by a lack of estrogen, Hyperandrogenaemia, obesity,
Hyper insulinaemia & starts early in the adolescent period. We should teach them
regarding the clinical features treatment & prevention6.
A comparative cross-sectional study found that women with polycystic ovary
syndrome are at a significantly higher risk of depression compared with non-PCOS
women. That may affect badly the adolescent girls6. In another study it is reported that
prevalence of Polycystic ovarian disease may be as high as 11.2% in women of
reproductive years of that age group adolescent girls make up 50% when dealing with
teenagers 98% of cyst in younger are benign7.
A study reviewed that polycystic ovarian syndrome is among the most common
endocrinologic disorders during adolescence, there is always a need to investigate all
new relevant data. Recent findings: The present review article, is occupied with apart from basic knowledge on polycystic ovarian syndrome - issues concerning

genetics, new trends in diagnosis, and data on metabolic and endocrine features of the
syndrome. Finally, emphasis is given to current therapeutic trends. Early recognition
and prompt treatment of polycystic ovarian syndrome in adolescents is important to
prevent long-term sequellae. More research is necessary in order to find answers to
many clinical and theoretical aspects of the syndrome.8
All these data provoked the researcher to take this initiation of conducting the study to
assess the knowledge regarding polycystic ovary and complications among
adolescents within 16-20 years including nature, meaning, dietary practice, exercise,
complications and administer the planned teaching programme and to investigate its
effect in terms of gain in knowledge among adolescent girls

6.2REVIEW OF LITERATURE
The present study has been organized under the following headings :
1. STUDIES RELATED TO KNOWLEDGE OF ADOLESCENT GIRLS
ABOUT
POLYCYSTIC OVARIAN SYNDROME.
2. STUDIES RELATED TO EFFECTIVENESS OF STP.
I :STUDIES RELATED TO KNOWLEDGE OF ADOLESCENT ABOUT
POLYCYSTIC OVARIAN SYNDROME.
. A cross-sectional study was conducted to determine the prevalence of clinical
polycystic ovary syndrome in 14- to 18-year-old high school girls in Isfahan, Iran
among 1,000 high school girls (14-18 years old) were selected by multi-stage random
sampling from different high schools in Isfahan. Following physical examination, a
single physician recorded the presence of hirsutism, severe acne, androgenic alopecia,
menstrual dysfunction and obesity using a validated questionnaire. Clinical Polycystic
ovarian

syndrome

was

diagnosed

if

menstrual

dysfunction

and

clinical

hyperandrogenism were detected. The study found that clinical Polycystic ovarian
syndrome was present in 30 (3%), hirsutism in 60 (6%), menstrual dysfunction in 74
(7.4%) and severe acne in 47 (4.7%) of the population studied. The prevalence of
clinical Polycystic ovarian syndrome in our study population was similar to those of

other studies; however, the prevalence could have been higher with hormonal
assessment. 9
A study estimated that the prevalence of the polycystic ovary syndrome in the
general population have ranged from 220%. population of 369 consecutive women
(174 White and 195 Black; aged 1845 years. Polycystic ovarian syndrome was
defined as 1) oligoovulation, 2) clinical hyperandrogenism (i.e. hirsutism) and/or
hyperandrogenemia, and 3) exclusion of other related disorders, such as
hyperprolactinemia, thyroid abnormalities, and nonclassic adrenal hyperplasia. In
conclusion, in our consecutive population of unselected women the prevalence of
hirsutism varied from 28% with no significant difference between White and Black
women. These data suggest that Polycystic ovarian syndrome may be one of most
common reproductive endocrinological disorders of women. 10
A study was conducted to determine the conversion risk and predictors for depression
in women with polycystic ovary syndrome as prospective longitudinal study at
University practice among patients with polycystic ovary syndrome through Primary
Care Evaluation of Mental Disorders Patient Health Questionnaire. A total of 60 of
103 subjects responded to the second survey. Mean time between the two surveys was
22 months (range 12-26 months). The overall prevalence of depression was 40%
(24/60). Of these, 10 women screened positive for major depressive disorder or other
depressive syndromes and 14 were receiving antidepressant medications. There were
11 new cases identified in the second survey (19% conversion). Total subjects with
mood disorders in this study were 34/60 (56.6%), including 11.6% with anxiety
syndromes and 23.3% with binge eating disorder. Difficulties with menstrual
function, fertility, and body image (weight, hirsutism, acne) were not significantly
different in women with and without depression. The study concluded that there is a
significant risk for mood disorders (defined by the Diagnostic and Statistical Manual
of Mental Disorders-IV) in women with polycystic ovary syndrome. 11
II STUDIES RELATED TO EFFECTIVENESS OF STP.
Singh Sunitha, conducted a study to assess the effectiveness of STP on knowledge and
practices related to hand washing technique among food handlers. descriptive
corelational study was adapted and 30 samples were taken through purposive
sampling technique. Interview technique was use to collect the data. After pretest data

collection a STP was administered with AV aids and demonstration..The main

findings of the study were pretest means knowledge scores was found to be 43.7%
and post test mean knowledge score was 83.1%.The above findings indicates that STP
has been significantly effective in increasing their knowledge and practice scoring.12
Meerah.R.conducted a study on the effectiveness of STP, on learning needs of
traditional birth attendance regarding prevention and control of AIDS.A descriptive
survey designed and randomly collected 60 samples were taken. The study was
conducted in two phases. In phase one learning needs are assessed and analyzed. In
phase two STP was developed, administered and evaluated for effectiveness.
Structured interview schedule was used for data collection reliability of the tool was
found to be high.(r=0.95).The study revealed that TBAS have inadequate knowledge
of every aspects of AIDS. The STP was found to be effective in increasing the
cognitive behavior of TBAS and found to be effective tool for providing information
regarding prevention and control of AIDS through statistical tests13.

STATEMENT OF THE PROBLEM :

THE EFFECTIVENESS OF STRUCTURED
REGARDING

POLYCYSTIC

OVARIAN

TEACHING PROGRAMME
SYNDROME

AMONG

ADOLESCENT GIRLS AT SELECTED HIGHER SECONDARY SCHOOL OF

BANGALORE SOUTH KARNATAKA .

6.3 OBJECTIVES:
1. To assess the existing knowledge on polycystic ovary syndrome among
adolescent girls in terms of pretest score.
2. To develop Structured teaching programme on polycystic ovary syndrome
among adolescent girls .
3. To assess effectiveness of STP by comparing the pre and post test scores
difference.
4. To determine the association between post test knowledge score and socio
demographic variables such as age, age of menarchae, obesity, menstrual
history, education, religion, type of family, socioeconomic status, source of
information.

6.4. RESEARCH HYPOTHESIS:

H1 : The mean post test knowledge score of adolescent girls regarding the
polycystic ovary

syndrome will be significantly higher than the mean pretest

knowledge score paired `t` test at 0.01 level.

H2: There will be a significant association between the selected demographic
variables-age, education, religion, type of family, socioeconomic status, age of
menarchae, menstrual history, obesity, source of information and the knowledge of
adolescent girls by chi-square at 0.05 level.

6.5. VARIABLES UNDER STUDY:

DEPENDANT VARIABLE: Knowledge level of adolescent girls regarding
Polycystic ovarian syndrome.
-INDEPENDENT VARIABLE: Structured teaching programme on Polycystic
ovarian syndrome.
EXTRANEOUS VARIABLE: Demographic variable such as age, ,education,
religion,
Age of menarchae,menstrual history, obesity, type of family, socioeconomic status,
source of information

6.6. OPERATIONAL DEFINITIONS:

KNOWLEDGE: In this study it refers to the awareness and correct responses of the
adolescents regarding polycystic ovary syndrome.
EFFECTIVENESS: Statistical measurement of difference between pre and post test
knowledge score.
STRUCTURED TEACHING PROGRAMME: It refers to a structured teaching
programme prepared in English and kannada regarding the Anatomy of reproductive
system, Physiology of reproductive system, clinical features, management and
prevention of Polycystic ovarian syndrome.
ADOLESCENT GIRLS: In this study it refers the girls within the age group of 1620 years.

POLYCYSTIC OVARY SYNDROME: It refers to a clinical condition in which the

ovaries are enlarged and affected with more than one cyst.

6.7. ASSUMPTIONS:
The study assumes that
A. The adolescent girls may not have adequate knowledge regarding Polycystic
ovarian syndrome.
B. Adolescent will have interest to know more about Polycystic ovarian syndrome.

6.8. DELIMITATIONS OF THE STUDY:

A. The study is limited to the students studying in a selected higher secondary public
school.
B. The study is limited to the adolescent who will be available during the time of data
collection.

7. MATERIALS AND METHODS OF THE STUDY

7.1. SOURCES OF DATA:
The adolescent girls who are studying in the selected Higher secondary school aged
between 16-20 yrs.

7.2 METHOD OF DATA COLLECTION

Structured questionnaire will be used to collect the data on polycystic ovary syndrome
among adolescent girls.

7.2.1 RESEARCH APPROACH

An Evaluative approach

7.2.2 RESEARCH DESIGN

Quasi experimental research design.

7.2.3. STUDY SETTING

Study will be conducted in selected Higher secondary school at Bangalore.

7.2.4. POPULATION:
The population of the present study comprises of the adolescent girls aged between
16-20yrs.

7.2.5. SAMPLE SIZE:

Sample consists of 60 (sixty) adolescent girls aged between 16-20yrs in selected
higher secondary schools of Bangalore.

7.2.6. SAMPLING TECHNIQUE

Non probability purposive sampling.

7.2.7. SAMPLING CRITERIA:

INCLUSION CRITERIA
1. Adolescent girls who are studying at the selected school aged between 16-20yrs.
2. Adolescent girls who can speak and understand English and Kannada..
EXCLUSION CRITERIA
1. Adolescent girls who are not willing to participate
2. Adolescent girls who are not available during the study.

7.2.8.DATA COLLECTION TOOL:

A structured tool will consist of two sections
Part 1-Selected demographic variables such as age, education, religion, occupation,
type of family, socioeconomic status, age of menarchae, pattern of menstruation,
obesity, source of information.
Part 2- Structured questionnaire consist of questions related to knowledge regarding
polycystic ovary syndrome.

7.2.9. DATA ANALYSIS METHOD:

The collected data will be analyzed by the descriptive and inferential analysis
A. DESCRIPTIVE STATISTICS:
Descriptive measures such as frequency, mean, mean percentage, standard
deviation of complete demographic variable.
B. INFERENTIAL STATISTICS:
Paired test to compare pre and post test knowledge scores at 0.01 level.
Non parametric chi-square test will be used to find out the relationship between
selected demographic variable & knowledge level of adolescent girls.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTION TO BE

CONDUCTED

ON

PATIENT

OR

OTHER HUMAN OR ANIMALS?

- YES -.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM

YOUR INSTITUTION?
A. Ethical clearance will be obtained from research committee of Varalakshmi
College Of Nursing.
B. Consent will be obtained from the authorities of selected public school a
Bangalore

8. LIST OF REFERENCES:

1. Barnard L,Ferriday D,Guenther N,Strauss B,Balen AH,Dye L. (2007).

"Quality of life and psychological well being in polycystic ovary syndrome".
Hum.Reprod. 22 (8): 22792286.
2. Christine Cortet-Rudelli, Didier Dewailly (Sep 21 2006). "Diagnosis of
Hyperandrogenism in Female Adolescents". Hyperandrogenism in Adolescent
Girls.

Armenian

Health

Network,

Health.am.

http://www.health.am/gyneco/more/diagnosis-of-hyperandrogenism-infemale/. Retrieved 2006-11-21.

3. Cocksedge KA, Li TC, Saravelos SH, Metwally MA. Reappraisal of the role
of polycystic ovary syndrome in recurrent miscarriage. Reprod Biomed
Online. 2008 Jul;17(1):151-60.
4. Adele

pillitteri(2007).MATERNAL

AND

CHILD

HEALTH

NURSING.Lippincott Publishers.1388,916.
5. Bhattacharya SM, Jha A.Prevalence and risk of depressive disorders in women
with polycystic ovary syndrome (PCOS). Fertil Steril. 2009 Nov 5. [Epub
ahead of print]
6. Creatsas, George; Deligeoroglou, Efthimios. Polycystic ovarian syndrome in
adolescents Adolescent and pediatric gynecology
7.http://www.ebmoline.org/article/Polycystic ovarian syndrome in adolescents.
8.Mahin Hashemipour, Sussan Faghihimani, Behzad Zolfaghary, Silva Hovsepian,
Fahimeh Ahmadi, Sassan Haghigh. Prevalence of Polycystic Ovary Syndrome in
Girls Aged 14-18 Years in Isfahan, Iran. Horm Res 2004;62:278-282.
9. E. S. Knochenhauer, T. J. Key, M. Kahsar-Miller, W. Waggoner, L. R. Boots
and R. Azziz.Prevalence of the Polycystic Ovary Syndrome in Unselected Black
and White Women of the Southeastern United States: A Prospective Study. The
Journal of Clinical Endocrinology & Metabolism Vol. 83, No. 9 3078-3082

10.E. Kousta, D.M. White, E. Cela, M.I. McCarthy and S. Franks .The prevalence
of

polycystic ovaries in women with infertility Human Reproduction, Vol. 14,

No. 11, 2720-2723, November 1999

11.Norman RJ, Davies MJ, Lord J, Moran LJ.The role of lifestyle modification in
polycystic ovary syndrome. Trends Endocrinol Metab. 2002 Aug;13(6):251-7.
12. Singh Sunitha,Effectiveness of STP on knowledge and attitudes related to
handwashing techniques among food handlers. Nursing Journal of India, June
2004,Pages 276-298.
13.Meerah R,Effectiveness of STP on learning needs of traditional birth attendants
regarding prevention and control of AIDS. Indian journal of Nursing And
Midwifery ,march 2006,Pages1232-1238.

SIGNATURE OF STUDENT:
REMARKS OF THE GUIDE

The topic selected by the

research is appropriate to
Improve the knowledge of the
adolescent girls regarding
polycystic ovarian syndrome

NAME AND DESIGNATION

OF THE GUIDE

MRS. D. Kavitha
Assoc Professor
Department of OBG
Varalakshmi College of Nursing
Bangalore

SIGNATURE

NAME OF THE HOD

SIGNATURE

REMARKS OF PRINCIPAL

SIGNATURE

MRS. D. Kavitha
Obstetrics and Gynecology
Nursing
Department of OBG
Varalakshmi College of Nursing
Bangalore

The investigator is selected

relevant topic for the present
situation