Background of the Study
Cervical cancer is the 4th most common cancer in women, with an estimated 5,60,505 new cases and 2,84,923 deaths in 2015, vast majority, approx. 85% of cervical cancer cases and 87% of cervical cancer deaths occur in the less developed regions. Cervical cancer records for roughly 12% of all female cancers and 10% of all female cancer death of poor to screening and treatment services. It is the 2nd most common cancer and third most common cause of cancer deaths among women in the less developed regions. In India, cervical cancer is the 2nd most common cancer.
Infection with high-risk human papilloma virus (HPV) and its persistence are necessary though not sufficient causes of cervical cancer. HPV is the most common viral infection of the reproductive tract. It is generally acquired by young women after the onset of sexual activity. The majority of HPV infections do not cause symptoms or disease and resolve spontaneously within 2 years. HPV inoculation and ordinary cervical screening is the best method to for estimate cervical cancer growth.1, 2, 3, 4, 5 Guardians/parental figures of youngster must be taught with respect to HPV inoculation before offering this chemoprophylaxis against cervical malignancy. Holes and obstructions to the entrance and conveyance of HPV immunization should be recognized, with the goal that logical and general well-being networks and common society can be activated to receive the inoculation policy.
Need For The Study
Cervical cancer growth deaths on the planet. Although the occurrence of carcinoma cervix has declined in the urban population, in the rural areas it continues to be highly prevalent. The usual 10-20 years of regular history of movement from gentle dysplasia to carcinoma cervix makes this cancer as moderately early preventable and gives the method of reasoning to screening Despite presence of national rules, the screening inclusion in India is shocking low. Carcinoma of the uterine cervix is a major medical issue faced by the Indian women, and consistently, around 120,000 women build up this infection India accounts 15.2 percent of the all-out cervical cancer growth deaths on the planet.6, 7, 8, 9, 10
Objectives
To assess the knowledge regarding early detection and prevention of cervical cancer among women from selected community areas of Madhya Pradesh before and after the administration of video-assisted teaching.
To determine the effectiveness of video – assisted teaching knowledge regarding early detection and prevention of cervical cancer among the women from selected community areas of Madhya Pradesh.
To find the association of the pre-test knowledge scores regarding early detection and prevention of cervical cancer among the women from selected community areas with their selected demographic variables.
Research Hypothesis
All the hypothesis of the study will be tested at 0.05 level of significance.
H1: There will be significant difference between the mean pretest and post test knowledge score regarding early detection and prevention of cervical cancer among women from selected community areas of M.P.at the level of p<0.05
H2: There will be significant association of the mean pretest knowledge scores regarding early detection and prevention of cervical cancer among women from selected community areas with their selected demographic variable.
Research Methodology
Research approach
Here the researcher aims to assess the effect of video assisted teaching programme on knowledge regarding early detection and prevention of cervical cancer among women from selected community areas of M.P. here the group was observed before and after introducing the independent variables.
Research design
One group pre-test – post-test design was adopted for the study. This study was intended to a certain gain in knowledge by the women residing in community areas. Here only one group was observed twice, i.e. before and after introducing the questionnaire.11, 12, 13, 14, 15, 16, 17, 18, 19
Variable sunder study
Independent variable: The independent variable is manipulated by the researcher. It is the intervention or treatment that the researcher performs to see the change in resulting change on the dependent variable. In this study independent variable is video assisted teaching on cervical cancer.
Dependent variable: The dependent variable usually is the variable that the researcher is interested in understanding explaining or predicting. It is the outcome variable which is measured or observed followed the instruction of independent variable. The present study gain in knowledge of women residing in community areas. In this study dependent variable is knowledge of women.
Setting of the study
The study was conducted in selected community areas of Madhya Pradesh.
Table 1
Comparison of mean pre-test and post-test knowledge score.
|
Group |
No. |
Knowledge Score Mean + SD |
t-value |
p value |
|
Pretest |
30 |
6.80+2.265 |
14.010 Df=29 |
p<0.05 |
|
Posttest |
30 |
17.73+4.323 |
Table 2
Distribution of women participants according to demographic variables
Table 0
Table 0
Population
Target population: Target population in the present study are the community areas in M P
Accessible population: 300 women from selected community areas of M.P. namely Awalda, Awaldi, Makadia, Jhalaria and Buranakhedi.
Sample: In this study, sample consists of women from selected from selected community areas of M.P.
Sample size: 300 women from selected community areas of M.P. i.e is Awalda, Awaldi, Makadia, Jhalaria and Buranakhedi. (60 from each village.)
Description of The Final tool
The final tool comprised of 2 parts
Part I: Demographic data: It consisted of 11 items like age, Religion,. Marital status, Age of the woman at her marriage, No. of times you have conceived. Methods of contraception used, Educational status, Occupation Any kind of Addictions, Family income, History of cancer in family, History of recurrent infections, Previous information about Cervical Cancer, Have you ever done pap test.
Part II: Structured knowledge questionnaire: Structured knowledge questionnaire consisted of 32 questions covering early detection and prevention of cervical cancer. The items were of multiple-choice type with one correct answer. Each correct response carried a weightage of one score. Thus the maximum score was 32 and the minimum score was zero.
Development of Video Assisted Teaching
One of the objectives of the study was to prepare and validate video assisted teaching program. It was prepared based on.
The Video Assisted Teaching was developed according to the objectives of the study. The investigator prepared overall plan of (VAT), which covered all areas dealt in the questionnaire.20, 21
Pilot study
The investigator obtained formal consent from sarpanch of Begamkhedi, Indore for. The purpose of this study and confidentiality was explained to the women. The investigator selected 30 women as per the inclusion criteria for the pilot study. They were selected by convenient sampling technique. Group was assessed for the knowledge of early detection and prevention of cervical cancer. The video assisted teaching programme was implemented and post-test was done on the seventh day. The analysis revealed that the overall pre-test mean was 6.80 and post-test mean was 17.73. Thet value was found to be 14.010 which was statistically significant.
The participants showed positive response towards the intervention and the pilot study helped the investigator to make modifications in the tool to precede it for the main study. In the knowledge questionnaire the number of items was reduced to 36 from 40 as the questions were difficult to answer for the participants.
Pilot study aided the investigator to check the feasibility of conducting the main study, to determine the method of statistical analysis and to assess the time required for data collection.
Method of Data Collection
The data collection was scheduled and prior permission was obtained from sarpanch from selected community areas. The investigator visited the rural areas on the given date and was introduced to the women. The purpose of the study was explained to the women. The confidentiality of their identity and responses was assured in order to ensure their cooperation and prompt response. After obtaining the consent for the study, the tool was administered to the group. The pre-test was conducted and video assisted teaching programme was administered, the average time taken to conduct pre-test was 60 minutes. Post-test was performed on the 7th day using the same structured knowledge questionnaire. The respondents co-operated well with the investigator. At the end of data collection the investigator thanked the respondents for their co-operation. The investigator faced no problems during the data collection procedure.
Plan for data analysis
Data analysis is the systematic organization and synthesis of research data and testing of research hypothes is using those data. The data obtained in this study would be entered into a Master data sheet prepared by the investigator to analyze the data. The data would be analyzed in terms of descriptive (frequency, percentage, mean, range, median and standard deviation) and inferential (‘t’ test and X2 test)statistics
Result
There were 70 (23.3%) women in the age group 21-30 years, 100 (33.3%) women were in the age group 31-40 years, 80 (26.7%) women were in the age group 41-50 years and 50 (16.7%) women were in the age group 51 years and above. Majority of the women were in the age group 31-40 years. 140 (46.6%) women belonged to Hindu religion, 90 (30.0%) women belonged to Muslim religion, 50 (16.7%) women belonged to Sikh religion and 20 (6.7%) women belonged to other religions. Majority of the women belonged to Hindu religion. 180 (60.0%) women were married, 20 (6.7%) women were unmarried, 20 (6.7%) women were widow and 80 (26.6%) women were separated. 230 (76.7%) women were of age 10-15 years at marriage, 40 (13.3%) women were of age 15-20 years at marriage and 30 (10.0%) women were of age 25-30 years at marriage. Majority of the women participants were in the 10-15 years of age at marriage. 30 (10.0%) women participants had never conceived, 180 (60.0%) women had conceived one time, 70 (23.3%) women had conceived two times and 20 (6.7%) women had conceived three and more than three times. Majority of the women had conceived one time. 70 (23.3%) women were using oral contraceptive pills, 40 (13.3%) were using condoms as contraception, 90 (30.0%) women were using Copper-T, 70 (23.3%) women had undergone tubectomy and 30 (10.0%) women were not using any contraceptive method. 100 (33.4%) women had done their primary education, 120 (40.0%) women had done their secondary education, 40 (13.3%) women had done their higher secondary and above education and 40 (13.3%) women were illiterate. Majority of the women had done their secondary education. 90 (30.0%) women were housewives, 90 (30.0%) women were working as labourers, 50 (16.7%) women were working class and 70 (23.3%) women were household workers. 20 (6.7%) women were smoking, 18 (6.0%) women were addicted to alcohol, 160 (53.3%) women were addicted to chewing tobacco and 102 (34.0%) women were not addicted to any substance use. Majority of the women were tobacco chewers. 70 (23.3%) women were having a family income of below Rs. 10000, 120 (40.0%) women were having a family income between Rs. 10000 – Rs. 20000, 69 (23.0%) women were having a family income between Rs. 20000 – Rs. 30000 and 41 (13.7%) women were having a family income of Rs. 30000 and above. Majority of the women were having a family monthly income between Rs. 10000 – Rs. 20000. 96 (32.0%) women were having a family history of cancer, while 204 (68.0%) women were not having any such family history. Majority of the women were not having any family history of cancer. 140 (46.7%) women were having a history of recurrent infections, while 160 (53.3%) women were not having any such history of recurrent infections. Majority of women were not having any history of recurrent infections. 190 (63.3%) women were having previous information about cervical cancer, while 110 (36.7%) women were not having any previous information about cervical cancer. 190 (63.3%) women had under gone PAP test, while 110 (36.7%) women had never undergone PAP test. Majority of the women had undergone PAP test.
Table 3
Comparison of pretest and posttest knowledge score
Table 4
Comparison of mean pretest and posttest knowledge score
|
Group |
No. |
Knowledge Score [Mean ± SD] |
‘t’ value |
P value |
|
Pretest |
300 |
13.67 ± 7.66 |
-19.105, df=299 |
P<0.05 |
|
Posttest |
300 |
23.80 ± 5.53 |
Table 5
Association between age with pretest score. (N=300)
In the pretest, 120 (40.0%) women had obtained poor knowledge score, 30 (10.0%) women had obtained fair knowledge score, 120 (40.0%) women had obtained good knowledge score and 30 (10.0%) women had obtained excellent knowledge score. Then an intervention in the form of video assisted teaching programme was given to these women and again the same set of knowledge questionnaire was read ministered and evaluated. In the posttest, 50 (16.7%) women had obtained fair knowledge score, 70 (23.3%) women had obtained good knowledge score and 180 (60.0%) women had obtained excellent knowledge score. Thus, the video assisted teaching programme was very helpful in improving the knowledge score of the women.
The above table shows the comparison of pretest and posttest knowledge score.
The mean pretest knowledge score was 13.67 ± 7.66, while the posttest knowledge score was 23.80 ± 5.53. The difference was found to be statistically significant (p<0.05), showing a significantly higher posttest knowledge in comparison to the pretest knowledge score.
Thus, the intervention was helpful in improving the knowledge score of the women.
Section III: Association between the pre- test knowledge score of woman from community areas and their selected demographic variables.
Summary
Human papillomavirus infection (HPV) causes more than 90% of cases; most people who have had HPV infections, however, do not develop cervical cancer. Other risk factors include smoking, a weak immune system, birth control pills, starting sex at ayoung age, and having many sexual partners, but these are less important. Cervicalcancer typically develops from precancerous changes over 10 to 20 years. About 90% of cervical cancer cases are squamous cell carcinomas,10% areadeno carcinoma, and a small number are other types. Diagnosis is typically by cervical screening followed by biopsy. Medical imaging is the done to determine whether or not the cancer has spread
HPV vaccines protect against two to seven high-risk strains of this familyof viruses and may prevent up to 90% of cervical cancers. As a risk of cancer still exists, guidelines recommend continuing regular Paptests. Other methods of prevention include having few or no sexual partners and the use of condoms. Cervical cancer screening using the Pap test or acetic acid can identify precancerous changes,which when treated, can prevent the development of cancer.
Conclusion
The study concluded that video assisted teaching programme was effective in improving the knowledge of women regarding early detection and prevention of cervical cancer from selected community areas.The study recommended the utilization of video assisted teaching programme by community health nurses,nurse researchers, nurse administrators, nurse educators and health care professionals to improve knowledge of early detection of cervical cancer.
