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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR REGISTRATION OF

SUBJECT FOR DISSERTATION

MRS.NEENU BABY

1st YEAR M.Sc., NURSING

OBSTETRICAL AND GYNECOLOGICAL NURSING

YEAR 2018 – 2019

CHINAI COLLEGE OF NURSING

#9, SAPTHAGIRI MANSION

BOMMANAHALLI

BANGALORE -560068

1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

MRS. NEENU BABY


1 NAME OF THE
CANDIDATE AND 1st YEAR M.Sc NURSING
ADDRESS
CHINAI COLLEGE OF NU RS ING

#9,SAPTHAGIRI MANSION, BOMMANAHALLI,


BANGALORE – 500 068.

CHINAI COLLEGE OF NU RS ING


2 NAME OF THE
INSTITUTE BANGALORE-68

3 COURSE OF THE
STUDY AND M.Sc. NURSING-1ST YEAR
SUBJECT
OBSTETRICAL AND GYNECOLOGICAL
NURS ING

4 DATE OF ADMISSION
30.10.2018
TO THE COURSE

TITLE OF THE A STUDY TO ASSESS THE EFFECTIVENESS


5
TOPIC OF STRUCTURED TEACHING PROGRAMME
ON KNOWLEDGE REGARDING
PREVENTION OF CARCINOMA OF CERVIX
AMONG MULTIPAROUS WOMEN IN
SELECTED HOSPITALS AT BANGALORE

2
6: BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

Women’s health Issues have become a focus for science and politics. Women’s

work roles, possible exposures to workplace hazards, social class, social roles, social

stress, access to health care, and health behaviors are the factors that act together to help

determine a women’s health and well – being1.

Carcinoma is a type of cancer that develops from epithelial cells.Specifically, a

carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the

body, and that arises from cells originating in the endodermal, mesodermal and ectodermal

germ layer. Carcinomas occur when the DNA of a cell is damaged or altered and the cell

begins to grow uncontrollably and become malignant. It is from the Greek,

καρκίνωμα, karkinoma, meaning sore, ulcer, or cancer.2

Cervical cancer is a disease that affects the cervix in the female reproductive

system. The cervix is the lower portion of the uterus that connects the upper vagina to the

uterus. It is about two inches in length. During childbirth, the cervix dilates, allowing the

baby to travel from the uterus to the vagina. In the early stages of cervical cancer, there are

no symptoms. Cervical cancer symptoms begin to appear as the disease advances,

invading deeper into the cervix and surrounding tissue. As the disease progresses, women

may experience abnormal vaginal bleeding, post-coital bleeding, dyspareunia, pelvic pain

and heavy vaginal discharge. The main risk factors of cervical cancer are due to infection

with the human papilloma virus (HPV) that is transmitted through sexual contact. Other

factors include having sex at an early age, smoking cigarettes, having multiple sexual

partners, and having a weakened immune system.3

3
The cervix is the narrow portion of the uterus where it joins with the top of the

vagina. Most cervical cancers are squamous cell carcinomas, arising in the squamous

(flattened) epithelial cell that line the cervix. Adenocarcinoma, arising in glandular

epithelial cells is the second most common type. Very rarely, cancer can arise in other

types of cells in the cervix.4

In most of the developed countries, however, cancer of the cervix is the second

most common cancer in women after cancer of breast. The relation breast carcinoma and

cervical cancer is 3:1. Major factor affecting the prevalence of carcinoma cervix in a

population are economic factor, sexual behaviour and degree of effective mass screening.5

Cervical cancer ranks as the most frequent cancer among women in India and

most frequent cancer among women between 15 and 44 years of age. [1] Cancer of the

cervix uteri is the second most common cancer among women worldwide, with an

estimated 529,409 new cases and 274,883 deaths in 2008. About 86% of the cases occur in

developing countries, representing 13% of female cancers. About 11,150 new cases of

invasive cervical cancer are expected to be diagnosed in 2017, with approximately 3670

cases resulting death.6

India accounts for one-fifth of the world burden of cervical cancer. There are no

organized or high-level opportunistic screening programmes for cervical cancer in any of

the provincial states. Data from population-based cancer registries in different regions

indicate a slow, but steady, decline in the incidence of cervical cancer. However, the rates

are still too high, particularly in the rural areas, and the absolute number of cases is on the

increase due to population growth. Also in two sub districts of western India where the

literacy among women is less than 20% there have been attempts to evaluate the role of

4
improved awareness in the early detection and control of cervical cancer.7

The main reasons for the higher incidence and mortality of cervical cancer in

developing countries are:

1. Lack of awareness of cervical cancer among the population, health care providers

and policy makers.

2. Absence or poor quality of screening programmes for precursor lesions and early-

stage cancer. In women who have never been screened, cancer tends to be

diagnosed in its later stages, when it is less easily treatable;

3. Limited access to health care services; Lack of functional referral systems.(WHO

2015). 8

6.1. NEED FOR THE STUDY:

Carcinoma Cervix is the most common cancer affecting Indian women with an

estimated age-adjusted incidence of 30.7 per 1,00,000 women and 1,32,082 new cases in a

year. By 2025, the no. of new cervical cancer cases in India is projected to 2,26,084. India

accounts for one-third of global burden of cervical cancer deaths.9

Cervical cancer is treatable disease if identified at the early stage. Cancer of the

cervix is the second most common cancer among women worldwide, with an estimated

529,409 new cases and 274,883 deaths in 2008. About 86% of the cases occur in

developing countries, representing 13% of female cancers12.Globally it is estimated that

there are 6 million new cancer cases, of which 52% occur in developing countries. The

magnitude of the problem of cancer in the Indian sub-continent in terms of sheer number

is most alarming. The estimated new cases of cancer in India per year are nearly 6.5 lakhs

and at the start of the next millennium estimated to be 8.6 lakhs. The crude incidence of

5
cancer in India is approximately 100 per 100,000 populations. The Cancer in women in the

Indian Sub-continent constitutes more than 50% of the total cancer. The most common

cancer observed by Indian registries are those related to tobacco usage in males while

among females, the most common cancer are those of the Uterine Cervix, Breast and Oral

cavity. In Karnataka a state in the southern part of India, it is estimated that annually there

are about 35,000 new cases whereas, the prevalent cancer accounts to about 1, 50,000.10

Educating people regarding the disease will help drive away the fears and stigma

associated with the disease. Well- illustrated audio-visual educational materials are

extremely useful in literate as well as illiterate population.10Efforts to improve awareness

of the population have resulted in early detection of and survival from cervical cancer in

backward regions of India. Also, where the literacy among women is less than 20% there

have been attempts to evaluate the role of improved awareness in the early detection and

control of cervical cancer.11

India which accounts for one sixth of world’s population also bears one fifth of

the world’s burden of carcinoma cervix. There are approximately 130,000 new cases of

cervical cancer in India per year .and the disease is reported to be responsible for all most

20% of all female death. India’s cervical cancer age standardized incidence rate [30.7 per

100,000] and age standardized mortality rate [17.4 per 100,000] are highest in South

Central Asia. The Indian national AIDS control organization suggests that there is a strong

association between HIV &HPV infection. Each year there are approximately 465,000

new cases of invasive cancer of the cervix and more than 200,000 deaths from the disease.

In India approximately 100,000 new cases come in advanced stages (stageIII&stage

IV).Where as in developed countries 90% of the cases are diagnosed in the early stages

(stageI&stageII) and only 10% cases in advanced stages (stageIII& IV). “The number of

6
death due to cervical cancer in India is estimated to rise 79,000 by the year 2010 and the

high risk is seen among the age group of (35-64 years) according to a survey conducted in

Chennai.” In Karnataka a survey study was conducted and it reveals that out of 7846

women, carcinoma cervix made up 26%of all cancers, 40% of female malignancies and

88.47% of gynaecological malignancies.12

An experimental study was conducted to assess the effectiveness of HPV

screening for cervical carcinoma in rural India. The samples were collected by cluster

method and 131,746 healthy women between ages of 30& 59 years were selected. The

result reveals that 127 subjects were diagnosed with carcinoma cervix. The study was

concluded that in a low resource setting, a single round of HPV testing was associated

with a significant reduction in the number of advanced cervical carcinoma and death from

cervical cancer. 13

According to (WHO 2017) report the majority of women in developing countries

still do not have access to cervical cancer prevention programmes. Cervical cancer is not

detected until it is too late to be cured. An effort is required if this situation is to be

corrected. Health promotion, including education and counselling of women and men,

should be an integral understand that cervical cancer control programmes. Health

education should aim to ensure that women, their families and the community at last

should understand that cervical cancer is preventable.14

A study conducted by the New England Journal of Medicine reveals that about

1.3 lakh new cases of cervical cancer are reported every year, in India and about a quarter

of the five lakh cases globally.“Even the educated class are not aware of cervical cancer

and often link it with the neck. We have to explain to them that cervical cancer is caused

in the lower part of the body," says gynaecologist, In the hospital based cancer registries

7
(HBCRs), the leading site for cervical cancer is Bangalore and Chennai, the second

leading site in Mumbai and Thiruvananthapuram and the third leading site in Dibrugarh.

The percentage of cervical cancer constitutes 11.4% in Thiruvananthapuram, 30.7% in

Chennai, 40% in Bangalore respectively. In spite of having had a diagnosis of cervical

cancer in Chennai, Trivandrum and Bangalore it has been reported that they didn’t receive

active treatment.15

Researcher in her experience, identified that multiparous women are lacking


knowledge on prevention of cancer of cervix. A planned teaching programme for
mothers will help them to improve their knowledge and reduce the further
complications on this basis.

6.2 REVIEW OF LITERATURE:

Review of literature plays a vital role in research project. It highlights what was

previously done, what were the methods that have been used by the previous researchers

and how we can combine the previous research results to improve knowledge. Review of

literature relevant to the study helps the investigator to develop insight on what had done

in the past. Literature review is based on extensive survey of books, journals and internet

search on the related topics of research study. Review of literature is a systematic

identification, location, scrutiny and summary of written materials that contain information

on research problem.16

An extensive review of literature relevant to the research study topic was done to

gain information and insight and to build the foundation of the study. The literature

reviewed for the present study is organized and presented under following sections;

Section I: Review related to incidence of carcinoma of cervix

Section II: Review related to knowledge of prevention of carcinoma of cervix

8
6.2.1 Section I: Review related to incidence of carcinoma of cervix

A descriptive retrospective study was conducted to assess the participation rate

and results of cytological assessment in the context of cervical cancer screening activities.

The subjects included women less than or equal to 14 years of age living in two districts of

Barcelona [n =129327] between the year 2001& 2006. the results shows that the

participation of women aged 20-34 years [63.8%] is higher than those among 50-64 years

[36.0%] and the rate of pathological results increased from 11.4/1000 in 2001to 29.0 /1000

in 2006 and this increase was high among young women ,due to an increase in the rate of

atypical squamous cells of undetermined significance.[ASCUS] and low grade squamous

intra epithelial leisions[LSIL].The study was concluded that a low rate of participation in

the public cervical cancer screening programmes and an increase in the number of

pathological results during the study period17.

An experimental study was conducted to estimate the prevalence of cervical

human papillomavirus and cytological abnormalities in association with reproductive

factors of rural Nigerian women through cervical screening programmes.The obstetrics

and gynaecology team collected demographics of 231 patients and 199 Thin prepared pap

smears, which were analyzed cytologically for the presence of HPV DNA.The results

shows that of 231 patients of mean age 32.2, 76% had seen physician four times or less

and from 199 pap smears performed,21.6% consists of both high risk and low risk

HPV,16.6% of women had high risk HPV,6.5% of abnormal pap smears of which 4.5%

had atypical squamous cells of undetermined significance, .5% had atypical glandular

cells,1% had low grade squamous intraepithelial lesions and .5% had high grade squamous

intraepithelial leisions.Other findings were 9% had Trichomonas Vaginalis and 13.5% had

Candida. The study was concluded that improved access to health care and cervical cancer

9
screening programmes may help to decrease transmission of HPV and subsequent cervical

cancer in under privileged areas18

A cross sectional observational study was conducted to determine whether testing

of self collected vaginal swabs for HPV DNA can be used to screen for cervical disease in

women aged 35 years & older. The screening was performed in 1365 previously

unscreened black South African women aged 35-65 years. The result shows high grade

squamous intraepithelial lesions were identified in 47 of 1365 women and there were 9

cases of invasive cancer of women with high grade disease, 66.1% had high risk HPV

detected in self collected vaginal samples. The false positive rates for HPV DNA testing of

self collected vaginal samples was 17.1%.A high risk type of HPV DNA was detected in

83.9%of women with high grade disease and 15.5% of women with no evidence of

cervical disease using a clinician obtained cervical sample. The study concludes that HPV

testing of self collected vaginal swabs is less specific than a clinician obtained cervical

sample for detecting high grade cervical disease in women aged 35 years & older in

addition to this HPV testing offers an important new way to increase screening in settings

where cytology is not readily performed.19

An evaluative study was done for the detection of precancerous lesions and to

prevent cervical cancer on a screening programme using visual inspection of the cervix

with acetic acid and cryotherapy.The subjects were taken by cluster method and it

included 16 of 64 districts. The result shows that even though the level of resources is poor

visual inspection of cervix using acetic acid can be carried out by trained doctors, nurses

and paramedical workers and the women, their partners and families are not aware of the

disease and its consequences. The study concludes that cervical cancer can be identified

earlier by creating awareness about the disease among women and their families. (27)

10
A survey study was conducted to assess the need and potential for improving the

quality of cervical cancer prevention and treatment services. The result shows that the

policy makers, community members and clients were mostly unaware about carcinoma

cervix and its preventable nature although they express a strong interest in having services

available to women in their communities. The study concludes that a gap in services,

unmet needs, standards, policies and integrated interventions are the potential factors to

improve the quality of services for prevention of cervical cancer.20

An experimental study was conducted to confirm whether vinegar provides

simple cervical cancer screening test where pap smears not available, as it is a simple in

expensive method and can be used to detect cervical cancer in countries where women do

not have access to pap smears. The subjects included 49,311 women between the age

group of 30 & 59 years. The result shows that the group of women who underwent visual

inspection of cervix using acetic acid has a 25% reduction in cervical cancer incidence and

35% reduction in deaths when compared with control group who received existing care so

this method is effective as a method of cervical cancer screening. The study concluded that

in the developing countries the screening over multiple visits is often not possible and

vaccination against human papilloma virus is currently too expensive,” Visual inspection

of cervix using acetic acid screening because of its simplicity and cost, is an effective

method to prevent cervical cancer in developing countries”, in the presence of good

training and sustained quality assurance.21

A survey study was conducted to confirm the importance of genital hygiene in the

fight against cervical infections that have a role in the development of cervical dysplasia

and cancer. The results shows that most of the women in rural areas are not using sanitary

pads and the facilities for washing after coitus are unavailable. The survey concludes that

11
health education, satisfactory living standards and the empowerment of women are

prerequisites for reducing the incidence of cervical dysplasia22

6.2.2 Section II: Review related to knowledge of prevention of carcinoma of cervix

A descriptive and cross sectional study was conducted to assess the knowledge of

cervical cancer, one of the leading causes of cancer death is women, and current screening

practices among female student at the University of Ibadan, Nigeria. A multi - Stage

sampling technique was used to select. 350 respondents. Semi – structured questionnaires

were used. Nearly 2/3 (63%) of respondents have heard about cervical cancer. Knowledge

of predisposing factors for the disease was high for early exposure to sex (82%) and sex

with multiple partners (70.6%). Only 15.7% knew that abnormal menstrual bleeding is

symptomatic of cervical cancer; 14.9% perceived themselves for screened 2.6% for the

disease. The study revealed that Intense and integrated educational programs are urgently

needed for this group.23

A study was conducted at All Indian Institute of medical Sciences, India

during 1965 – 2005 on cervical cancer with emphasis on screening by pap smear and

other alternative methods. The predominant risk factor is persistent infection with human

papilloma virus (HPV). Conventionally, pap smear cytology is the only method for

screening, but recently various studies have been carried out to explore alternative

methods like Visual inspection methods could be more feasible for organized population

based screening in a low resource country. A study revealed that a need for initiating

screening programmes within the existing health system in India.24

A Study was conducted on oncogenic human papillomavirus (HPV) causes 99.7%

of all cervical cancers. HPV types 16 and 18 are responsible for approximately 77% of

cases and peak prevalence occurs in females younger than 25 years of age. The recent

12
implementation of HPV vaccination provides females with the opportunity to prevent

infection. School nurses are advocates of student health and often a primary source of

information. Therefore, they can play a key role in promoting vaccination prior to sexual

debut. They can also promote regular cervical screening post vaccination, which may not

be apparent to many students and parents. To deal with such issues, greater understanding

of HPV disease and prevention among school nurses, students and parents may lead to

greater reductions in the burden.25

Cancer of the cervix is the second most common cancer in women worldwide and

is a leading cause of cancer-related death in women in underdeveloped countries.

Worldwide, approximately 500,000 cases of cervical cancer are diagnosed each year.

Routine screening has decreased the incidence of invasive cervical cancer in the United

States, where approximately 13,000 cases of invasive cervical cancer and 50,000 cases of

cervical carcinoma in situ are diagnosed yearly. Invasive cervical cancer is more common

in women middle aged and older and in women of poor socioeconomic status, who are less

likely to receive regular screening and early treatment. There is also a higher rate of

incidence among African American, Hispanic, and Native America women. (ACS 2007).26

Boer MA, etal 2008 Conducted a population based study on prevalence of human

papillomavirus in Indonesia: in the three regions. A sample of 2686 women, aged 15-70

years, in Jakarta, Tasikmalaya, and Bali, Indonesia. The overall HPV prevalence was

11.4%, age-standardized to the world standard population 11.6%. The most prevalent

types found were HPV 52, HPV 16, HPV 18, and HPV 39, respectively, 23.2, 18.0, 16.1,

and 11.8% of the high-risk HPV types. In 20.7% of infections, multiple types were

involved. Different age-specific prevalence patterns were seen. HPV 52 was the most

prevalent type in the general population.27

13
Dr. RangaswamySankaranarayananetal (2007) conducted study on “Effect of visual

screening on cervical cancer incidence and mortality in Tamil Nadu, India: a cluster-

randomized trial” They assessed the effect of screening using visual inspection with 4%

acetic acid (VIA) on cervical cancer incidence and mortality in a cluster randomized

controlled trail. 114 study clusters in Dindigul district, 57 were randomized to one round

of VIA by trained nurses, and 57 to a control group. Healthy women aged 30 to 59 years

were eligible for the study. The primary outcome measures were cervical cancer incidence

and mortality. 49311 eligible women in the intervention group, 31 343(63.6%) were

screened. 30 958 control women received the standard care. 3088 (9.9%) screened

positive, 3052 had colposcopy, and 2539 directed biopsy. Of the 1874 women with

precancerous lesions in the intervention group, 72% received treatment. In the intervention

group, 274 430 person years, 167 cervical cancer cases, and 83 cervical cancer deaths

were accrued compared with 178 781 person-years, 158 cases, and 92 deaths and in the

control group during 2000-06 ( includes hazard ration 0.75 [ 95% CI 0.55-0.95] and

mortality hazard ration [0.47 – 0.89])28

Rao Rsetal (2007) conducted a cross-sectional study on “Downstaging for cervical

cancer in rural areas of Udupi district, Karnataka, India”. Population included all married

women in the age group of 35-59 years in two villages of the field practice area. Two

ANMs were trained in history taking, visual inspection of the cervix, using of speculum

and collecting Papanicolaou smears. After training, they made home visits and identified

women with gynaecological symptoms suggestive of cervical cancer. These women were

asked to report to Rural Maternity and child Welfare homes where the ANMs did a visual

inspection of cervix and made a cervical smear. A total of 1402 women were registered of

the ANMs could identify 368 women (26%) with sumptoms. Only 192 (52.2%) of these

14
women reported for examinations. Chronic cervicitis accounted for the largest proportion

of the cases (48.8%) three cases were diagnosed as suspected cases of cancer cervix. And

three cases (1.5%) turned out to be malignant. When clinical findings of the ANM

compared with results of cytological examination, ahigh degree of sensitivity (78.4%) and

positive predictive value (97.1%) were observed in diagnosing abnormal cytological

findings.29

6.3 PROBLEM STATEMENT

A study to assess the effectiveness of structured teaching programme on prevention of


carcinoma of cervix among multiparous women in selected hospitals at Bangalore.

6.4.OBJECTIVES OF THE STUDY

The objectives of the study are to:

1. To assess the pretest knowledge score regarding the prevention of carcinoma of

cervix among multiparous women.

2. To evaluate the effectiveness of structured teaching programme on

prevention of carcinoma of cervix.

3. To find association between pretest knowledge scores and demographic variables.

6.5.HYPOTHESIS:

H1- There will be significant difference between the pretest and posttest knowledge score
of multiparous women regarding carcinoma of cervix

H2- There will be a significant association between pretest knowledge of multiparous


women regarding prevention of carcinoma of cervix with selected demographic
variables

15
6.6. VARIABLES

 Independent variable :Structure teaching program


 Dependent variable: knowledge on prevention of carcinoma of cervix among
multiparous women.
 Demographic variable: Age, religion, place of residence, educational
qualification of multiparous women, witnessed or experienced on cervix
carcinoma, previous knowledge on carcinoma of cervix and sources of information
about carcinoma of cervix
6.7.OPERATIONAL DEFINITIONS

1. ASSESS: The process by which a multiparous women condition is appraised or


evaluated.
2. EFFECTIVENESS:It refers to the desired change brought about by the structured
teaching programme and measured in terms of significant knowledge gain in the
mean test scores.

3. STRUCTURED TEACHING PROGRAMME:-In this study it refers to the


systematically developed instructional teaching aids designed for multiparous
women to provide information regarding prevention of carcinoma of cervix.

4. KNOWLEDGE: It is a facts or information of skills acquired through experience


or education regarding incidence causes signs and symptoms treatment and
preventive measures of carcinoma of cervix.
5. PREVENTION: It meansserving to avert the occurrence of carcinoma of cervix.
6. CARCINOMA OF CERVIX: It is the malignant neoplasm of the cervix.
7. MULTIPAROUS WOMEN: It is having borne more than one child.
8. HOSPITAL: A hospital is a health care institution with an organized medical and
professional staff and with permanent facilities that include inpatient beds. Provide
medical, nursing and other health related services to patients.

6.8.ASSUMPTIONS:

The study assumes that;

 Multiparous women will have some knowledge regarding carcinoma of cervix.

16
 Structured teaching programme is an effective method to enhance the knowledge
of multiparous women regarding prevention of carcinoma of cervix.
 Multiparous women will be interested to learn about the prevention of carcinoma
of cervix.

6.9 DELIMITATIONS

 Multiparous women who are available in a selected hospital.


 Multiparous women who can read, write or understand either Kannada or English.
 Multiparous women between the age group of 30 to 45 years.

7.MATERIAL AND METHOD:

7.1 Source of data

Data will be collected from multiparous women who are admitted in the
gynecological ward.

7.1.1. Research approach: Evaluative research approach.

7.1.2 Research design:

The research design for the study will be quasi experimental one group pre-test
posttest design.

7.1.3 Settings:

The study will be conducted in OBG ward in selected hospitals at


Bangalore.

7.1.4 Sample size

In this study, sample would consist of 50 multiparous women in a selected


hospital at Bangalore.

7.1.5 Population:

Multiparous women who are admitted in a selected hospital at Bangalore

17
during the period of data collection.

7.2 METHOD OF DATA COLLECTION:

7.2.1 Sampling procedure

In this study non – probability purposive sampling technique would be adopted.

i. Inclusion Criteria:

 Multiparous women aged between 30 and 45 year.


 Multiparous women who are willing to participate in the study.
 Multiparous women who are admitted in gynecological ward in a
selectedhospital at Bangalore.
 Multiparous women who can read, write or understand English.
ii. Exclusion criteria
 Multiparous women who are not willing to participate in the study.
 Multiparous women whose age is less than 30 years and more than 45years.

7.2.2. Instruments intended to be used

Part 1: The tool consists of demographic Performa.

Part 2: Questionnaire will be used to assess the knowledge.

Part3 : structured teaching programme regarding prevention of carcinoma of


cervix.

SCORING PROCEDURE

For knowledge assessment

For answers. If answer is yes 1

If answer is no 0

SCORING INTERPRETATION

Good :- 75-100%

Average :- 50-75%

Poor :- Below 50%

18
7.2.3.DATA COLLECTION METHOD

The multiparous women in the selected hospital will be selected for the study
using non-probability purposive sampling. Formal administrative permission will
be obtained from the hospital authority. The data will be collected from 50
multiparous women after obtaining their consent. The procedure will be
explained to them and confidentiality will be assured. Pre-test will be
conducted using questionnaire on carcinoma of cervix and the structuredteaching
will be administered on the same day and after 6 days the post test will be
conducted with the score knowledge questionnaire.

7.2.4. DATA ANALYSIS PLAN

The plan of data analysis are

 All data will be tested at 0.05 level of significance.


 Demographic data will be analysed using frequency, percentage and graph.
 Paired ‘t’ test will be used to find the effectiveness of the structured
teaching programme.
 Association between pre-test knowledge scores and demographic variable will
be found by using chi-square test.

7.3 Does the study require any investigations or interventions to be conducted on

patients, or other animals? If so please describe briefly.

Yes, a structured teaching programme on knowledge of multiparous women


regarding carcinoma of cervix will be given.

7.4. Has ethical clearance been obtained from your institution in case of 7.3?

Yes, ethical clearance will be obtained.

19
8. REFERENCES :

1. Jean Jenkins RN, MSN, OCN et al. The effects of cancer on women. Seminars in

Oncology Nursing. May 1995; 11 (2): 77.s

2. Lemoine, Nigel Kirkham, Nicholas R. (2001). Progress in pathology. London:

Greenwich Medical Media. p. 52. ISBN 9781841100500. Available from:

https://en.wikipedia.org/wiki/Carcinoma

3. Lisa Fayed, Former. Cervical cancer 101, what is cervical cancer?. 2007 Dec 20.

Available from: http://cervicalcancer.about.com/od/cervical/cancerbasics/a/what is

cervical.htm

4. Dutta D.C,” A Text book of Gynaecology’’,4th edition New Central Book Agency

Ltd,8/1Chintamoni Das Lane,Calcutta 700009 page no:316.

5. Jimmy wales,cancer of cervix;Wikipedia.Available from

en.wikipedia.org/wiki/cervical_cancer.

6. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information

Centre). Human Papillomavirus and Related Cancers in India. Summary Report

2010. [last ascessed on 23 october 2013].Available at www. who. int/ hpvcentre

7. N.R Saltmarish, Human papilomavirus,Smoking,Multiparity,may put women at

age risk of cervical cancer, Women,s Health Weekly 2001 May 31.

8. World Health Organization Report 2015 – 2016

9. Booz HA, Boiangiu I, Appleby H, French C, Coomber H, HumpheryPet al.

Sigmoid colon is an unexpected organ at risk in Brachytherapy for cervical cancer.

Journal of Egyptian Nat Cancer Inst. 2006; 18:156-160

10. Incidence of cancer worldwide :http://www.kidwai.kar.nic.ingeneral.htm accessed

10 june 2010

20
11. SankaranarayananR,Budukh AM, Rajamanickam R. Effective screening

programmes for cervical cancer in low-and middle- income developing countries.

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9 SIGNATURE OF THE CANDIDATE

10 REMARKS OF THE GUIDE

11 11.1 .NAME AND B.KARPUKKARASI

DESIGNATION OF GUIDE

11.2 . SIGNATURE

11.3 . CO-GUIDE -

11.4 . SIGNATURE -

11.5. HEAD OF THE DEPARTMENT B.KARPUKKARASI

11.6 .SIGNATURE

12 12.1 .REMARKS OF THE PRINCIPAL

12.2. SIGNATURE

24

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