RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE.
1

NAME OF THE CANDIDATE

AND ADDRESS

A.MYTHILI
D/O A. GURUMOORTHY
D.NO :351
CHIPPILI
PONNUTI PALAM POST
MADANAPALLI
CHITTOR DISTRICT
ANDHRA PRADESH

NAME OF THE INSTITUTION

EAST WEST COLLEGE OF NURSING

2ND STAGE
RAJAJINAGAR
BANGALORE-560010

COURSE OF STUDY AND

SUBJECT

MSC NURSING
COMMUNITY HEALTH NURSING
DISSERTATION PROTOCOL

DATE OF ADMISSION COURSE 10-05-2007

TITLE OF THE TOPIC:

A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE REGARDING
MENSTRUAL HYGIENE AMONG ADOLESCENT GIRLS AT SELECTED
URBAN AND RURAL SCHOOLS IN BANGALORE WITH A VIEW TO
DEVELOP A SELF INSTRUCTIONAL MODULE.
PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION.

6 .BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

I Want to fly _ _ _ _ _ _ _ _ _ do not cut my wings.

[2004, UNFPRA PROGRAMME]
About 21% of total Population in India is adolescents. Adolescents belong to
vital age group not only because they are the entrant population to parenthood but
also because they are threshold between childhood and adulthood. As they attempt
to cross this threshold they face various physiological, psychological and
developmental changes. The word Adolescent is derived from the Latin word
adolescere which means to grow to maturity that indicate the defining features of
adolescence. During puberty the physical changes occur which transform the body
of child into that of an adult, changes in body size, changes in body proportions.

Adolescents are entitled to enjoy all basic human rights economic, social,
political and cultural, but their inability to exercise these rights, places on policy
makers and adults to implement separate measures to ensure their rights.
Adolescence marks a time of rapid and intense emotional and physical changes.
There is an increased value placed on peer acceptance and approval, and a
heightened attention to external influences and social messages about cultural
norms. Ideals and sub-sequent self-comparisons is strongly influenced by personal,
familial, and cultural factors.2
Menstruation is a physiological phenomenon which is unique to females that
begins in adolescence. The most striking change in adolescent girls is the onset of
menstruation, 3-5 days bleeding from the uterus once a month that will occur

throughout lifetime till the menopause. The first menses is called menarche.
Menarche is the signal that sexual maturation of the young female has occurred and
that the body is capable of supporting pregnancy.3
Menstruation occurs periodically throughout the child bearing years, except
during pregnancy and lactation. The ages of onset of menstruation differ form person
to person but seem to be affected by heredity, racial background and nutritional
status.4
Most of the girls receive their gynecological information from their mothers,
religious books, and older sister or a peer. However such information was generally
given after menarche rather than before A study conducted by (2006) using
qualitative research data and quantative survey that revealed, prior to menarche the
knowledge about menstruation was deficient among the respondents and ten
percent of woman respond ants reported various taboo-behavior related to
menstruation. Hence there is a need to provide healthy family life education to the
woman particularly the adolescent girls. Very few similar studies have been
conducted in India which has explored the knowledge and practice areas. But the
attitudinal aspects of menustration have not been studied specifically.5

6.1 NEED FOR STUDY:

Todays adolescents (21%) are tomorrows adults who are the strength of the
nation. Todays adolescent girls are our future homemakers. Most of the adolescents
tend to be extremely unaware of their own body their physical well being and
psychological change. Half of the adolescence age 12- 15 years residing in rural and
urban slum areas do not know about menstruation until its onset. 6
Menstrual cycle has come to occupy an increasingly important place in
discussions of womens health attention is again focusing on the impact of the onset
of menarche. Studies of girls response to menarche have determined that it is a
highly salient, intensely experience event and a turning point in female development
they also have demonstrated that more adequate preparation is associated with a

more positive initial response .Despite a sense of being prepared and even excited
about impending event, however, most girls still find menarche mildly stressful. 7
A study was conducted by (2005), due to lack of information on this natural
phenomenon and culturally divergent beliefs and practices, rural adolescent girls in
India often manage menstruation in an unsafe manner that leads to reproductive
tract infections and other reproductive health problems. 8
Almost all girls viewed themselves as prepared for menarche and claimed
they had discussed it with their mothers, their explanations of menstruation reflected
at best incomplete knowledge and more typically a variety of misconceptions or
ignorance.9
The girls should be educated about significance of menstruation and
development of secondary sexual characteristics,selection of sanitary menstrual
absorbent and its proper disposal. So that she does not develop psychological upset
and received education would indirectly wipe away the age-old wrong ideas and
make her feel free to discuss menstrual matters without any inhibitions. 10
Menstruation and puberty hygiene is rarely discussed at home as well as
schools, especially in the regions the current study was conducted. Due to some
cultural and religious restrictions many young girls in this country lack appropriate
and suffiicient information regarding menstrual hygiene causing incorrect and
unhealthy behavior during their menstrual period. 11
A study was conducted by (1997) on, assessed the knowledge and practice
of menstrual hygiene in Punjab. The main finding of the study was that adolescent
school girls as a whole had an inadequate knowledge on menstrual hygiene. 12
A study was conducted by (1995), on Understanding of menstruation in early
adolescent girls. Their explanation for menstruation reflected at best incomplete
knowledge and more typically a variety of misconception or ignorance. 13
A study was conducted by (1997), on Knowledge attitude of adolescent girls
regarding menstruation showed that the emotional response of the majority of girls
(60%) at the onset of menstruation.14
The above studies and personal views of the investigator and her exposure to
the surroundings in the form of relatives, neighbourhood ends who faced certain

problems in the aspect of menstruation and its crisis situation created an insight to
conduct a study to assess the knowledge and attitude towards menstrual hygiene
among adolescent girls with a view to develop a self instructional module.
6.2 REVIEW OF LITERATURE
Literature review was done for the present study and presented under the
following headings:
Section A: General information regarding menstruation and menstrual
hygiene.
Menstrual hygiene deals with a womans special health care needs and
requirements during her monthly menstruation or menstrual cycles. These areas of
special concern include choosing the best period protection or femine hygienic
products, bathing care of her vulva and vagina. 15
A study on, experiences in relation to menstruation. Showed that most of the
girls talked about how their menstrual bleeding makes them feel dirty and unclean
and reported feelings of embarrassment and shame. During menstruation one was
completely shocked, another reported that she was not allowed to enter in the
temple and kitchen. Such prohibitions do induce feelings of isolation and shame in
young girls. 16
A study on, adolescence has been identified as a period with particular
importance for understanding depression. This belief inexistence of linkages
between adolescent and menstrual cycles. It is state in which adolescent under goes
a range of emotions such as restlessness, low mood, irritability, poor concentration
and fatigue.17
Section B: Knowledge and attitude of adolescent girls related to menstrual
hygiene.
A study was conducted on, Menstrual knowledge and practices among
secondary schools girls in Nigeria. The menstrual knowledge and practices of 353
randomly selected healthy Nigerian schoolgirls were studied.

187 (53.1%) had

attained menarche, 40% of the subjects were deficient knowledge about

menstruation.18

A study on, knowledge and practices of menstrual hygiene. Major findings

of the study were adolescent girls on the whole had inadequate knowledge on
menstrual hygiene but the private school girls had higher knowledge than the central
school girls.19
A study on, Menstrual hygiene among rural adolescent girls. Almost all 64
girls received advice regarding menstrual hygiene from different sources. Some of
their practices were unhygienic. This showed that the mothers of these girls were
lacking right knowledge and same thing was transferred to their off springs. 20
A study was conducted on, Reproductive tract infections, sexually
transmitted infections and other useful knowledge. Some of this knowledge is
spreading in the adolescent population but the dissemination is slow and uncertain.
Sanitary napkins for menstruation are now advertised in television and the use of
commercially available pads have increased

Community groups and other such

channels are likely to be more effective means of transmitting important health

messages and advice to young women entering puberty.21
A study was conducted on, Menstrual hygiene practices and reproductive
morbidity. Majority of the women (60.8%) dealt menstruation unhygienically.
Symptoms suggestive of reproductive tract infections were reported 36.1% of the
women. Skin problems related to sanitary protection were reported by 45.8% of the
women. In resource poor contexts, where women do not have access to basic
facilities like water, bathroom and privacy, the standard of the hygiene one can
maintain is severely compromised. This inturn renders them vulnerable to
reproductive tract infections.22
A study on, Possibility of contributing factors related to poor genital hygiene
has also been suggested patterns of menstrual hygiene that are developed in
adolescence are likely to persist into adult life.23
A study on, Teaching adolescent girls about menstrual hygiene by.
administering a planned teaching program a multistage sampling technique was
adopted

for 9th standard girls, who had attained menarche.

These girls were

systematically divided into two groups, one experimental group and controlled group.
Both groups had a high level of knowledge deficit. 24

STATEMENT OF THE PROBLEM:

A Study to assess the knowledge and attitude regarding menstrual
hygiene among adolescent girls at selected urban and rural schools in Bangalore
with a view to develop a self instructional module.
6.3 OBJECTIVES OF THE STUDY;
-To assess the knowledge regarding Menstrual hygiene among urban and rural
adolescents girls.
-To assess the attitude regarding menstrual hygiene among urban and rural
adolescent girls
- To compare the knowledge and Attitude regarding menstrual hygiene between
rural and urban adolescent girls.
-To find out correlation between knowledge and Attitude regarding menstrual
hygiene.
-To find association between knowledge and attitude selected demographic
variables.

6.4HYPOTHESIS:
Ho1: Rural adolescent girls knowledge and attitude regarding menstrual hygiene
is inadequate.
6.5 OPERATIONAL DEFINITION:
KNOWLEDGE: Refers to the verbal responses of the selected adolescents
regarding menstruation and menstrual hygiene as measured by the correct
responses to items of the knowledge questionnaire.

ATTITUDE: In this study it refers to the selected adolescent girls feeling and
tendency towards menstruation and menstrual hygiene as expressed by them on
a summated rating scale and measured by the scores obtained on the rating
scale.
MENSTRUAL HYGIENE: Includes all those measures taken by the individual to
keep the genital area clean and dry during the menstrual period.
ADOLESCENT GIRLS: Refers to t girls who had attained menarche
(premenarchea) between 13-14 years who are studying 8 th and 9th standards of
selected urban and rural schools.
SELF INSTRUCTIONAL MODULE: It is printed pamphlet, which contains all the
informations about menstrual hygiene among adolescent girls.
6.6:ASSUMPTION: Knolwedge and attitude of rural adolescent girls are lesser
copared to urban adolescent girls.
7.0 MATERIALS AND METHODS:
7.1. SOURCES OF DATA:
The data will be collected from adolescent girls who are residing at S.V.N
school in Gayathri Nagar,and ModelGovernment. School in Hesaraghatta.
7.2. METHODS OF DATA COLLECTION:
7.2.1 Type of study: Comparative Study.
7.2.2 Research Design: on-experimental design.
7.2.3 Variables Under Study:
Independent Variables: Self-instructional module regarding knowledge and
attitude regarding menstrual hygiene.
Dependent Variables: Adolescent girls knowledge and attitude regarding
menstrual hygiene.
SELECTED DEMOGRAPHICS VARIABLES:

Personal characteristics which include age, religion, education, income,

personal friends, family members.
7.2.4 SAMPLING TECHNIQUE: Convenient sampling technique.
7.2.5 SAMPLE SIZE:
50 students were taken at S.V.N school in Gayathrinagar as urban school and
50 students from Model Government school in Hesaraghatta was taken as
rural school were selected as samples.
7.2.6 COMPARISION PARAMETERS:
Comparison between knowledge and attitude among urban and rural
adolescent girls.
7.2.7 DURATION OF STUDY: 6 weeks.
7.2.8 INCLUSION AND EXCLUSION CRITERIA:
Inclusion of Criteria:
1. The adolescent girls between 13-14 years who are willing to participate
in the study.
2. As they are doing schools they may be well in speaking
and understanding knowledge.
Exclusion of Criteria:
1. The adolescent girls less than 13-14 years.
2. Who are not interesting to participate the study.
3. The adolescent girls who are not available at the time of the study.
7.2.9 INSTRUMENT:
Socio demographic profile consisting of items relating to age, religion,
educational status, occupation, friends, family members.
Structured Interview schedule to assess the knowledge of adolescent girls.

8.0 DATA COLLECTION PROCEDURE:

After getting formal permission from concerned authority as well as
.from the subjects, the investigator participant and explain the purpose of the study
to the subject and structured interview schedule will be conducted followed by the
self-instructional module.
8.1 STATISTICAL METHODS USED:
The data obtained will be analyzed in terms of the objectives of the
study using descriptive and inferential statistics. The plan of data analysis is as
follows.
8.2 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION
ON PATIENTS OR OTHER HUMAN/ANIMALS? IF SO PLEASE DESCRIBE
BRIEFLY?
Yes self-instructional module regarding knowledge and attitude regarding
menstrual hygiene among adolescent girls (13-14years) will be assessed by
investigator.
8.3 HAS ETHICAL CLEARANCE BEEN OBTAINED?
Yes Ethical clearance will be obtained from concerned authority, the ethical
-The permission is obtained from
-The research committee of East West College of Nursing
-Authorities of selected Schools
-Informed concerned will be taken from the samples who are willing to participate

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Journal of women health,1995.1-10.
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