An Experimental study to Evaluate the Effectiveness of Pudhina Extract in reducing dysmenorrhea among Adolescent Girls in Selected Schools at Madurai

Rose, K (2012) An Experimental study to Evaluate the Effectiveness of Pudhina Extract in reducing dysmenorrhea among Adolescent Girls in Selected Schools at Madurai. Doctoral thesis, The Tamilnadu Dr. M.G.R. Medical University, Chennai.

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Abstract

STATEMENT OF THE PROBLEM: An experimental study to evaluate the effectiveness of pudhina extract in reducing dysmenorrhea among adolescent girls in selected schools at Madurai. OBJECTIVES: 1. To assess the socio demographic and clinical variables among the adolescents with dysmenorrhea in the experimental and control group. 2. To assess the pretest extent of pain during dysmenorrhea using a standardized numerical scale and in terms of sensory and affective symptoms among adolescent girls of the experimental and control group. 3. To find out the pretest hemoglobin status, percentage of school attendance, perceived stress level and self assessed academic performance related to dysmenorrhea among adolescents of the experimental and control group. 4. To assess the post test extent of pain during dysmenorrhea using a standardized numerical scale and in terms of sensory and affective symptoms among adolescents of the experimental and control group. 5. To find out the post test hemoglobin status, percentage of school attendance, perceived stress level and self assessed academic performance related to dysmenorrhea among adolescents of the experimental and control group. 6. To compare the effectiveness of pudina extract on dysmenorrhea in reducing the extent of pain, perceived stress, self assessed academic performance among the adolescents of experimental and control group. 7. To find out the association between the pretest and post test extent of dysmenorrhea to selected demographic and clinical variables among the adolescents in the experimental and control group. HYPOTHESES: H01: There will be no significant difference in the pretest and post test level of pain during dysmenorrhea and the related sensory and affective symptoms among adolescents of the experimental and control group. H02 : There will be no significant difference between the pretest and post test hemoglobin status, percentage of school attendance related to dysmenorrhea among the adolescents of the experimental and control group. H03 : There will be no significant difference in the pretest and post test perceived stress among adolescents of the experimental and control group. H04 : There will be no significant difference in the pretest and post test self assessed academic performance during dysmenorrhea among adolescents of the experimental and control group. H05 : There will be no significant difference between pretest and post test scores of pain to selected demographic and clinical variables among the adolescents of the experimental and control group. The related literature review was done on menstrual cycle and dysmenorrhea, studies related to dysmenorrhea, review of literature related to alternative therapy, review of literature related to pudhina, studies related to pudhina leaves on dysmenorrhea. The conceptual framework used in this study was based on Ida Jean Orlando’s theory of deliberative nursing process (1972). RESEARCH METHODOLOGY: Research approach: A true experimental approach was adopted in this study. Research design: Pretest-posttest, control group design was used in this study. Research setting: The present study was conducted at selected schools at Madurai. Population: The accessible population included adolescent girls within 14-17years of age with dysmenorrhea studying in selected schools at Madurai, available during the study period. Sampling Technique: Adolescents were selected by simple random sampling technique from the selected schools. The study included 700 adolescent girls. The samples include 350 adolescents from the experimental group and 350 adolescents from the control group. The samples were selected based on the inclusion criteria. Description of the Tool The tool for the study was constructed after an extensive literature review, consultation with guides and experts. The tool was translated into Tamil. The certification for content was got from experts in the fields of gynecology, pediatrics, pediatric nursing, statistician and research. The scoring procedure was also concluded based on the expert suggestion. Section I : Proforma for socio demographic variables. Section II: Clinical variables and Standardized numerical pain rating scale. Section III: Menstrual distress questionnaire including sensory and affective symptoms. Section IV: Scale on perceived stress related to dysmenorrhea. Section V: Self assessment on academic performance during dysmenorrhea. Data Collection Permission was sought from five schools. The investigator created a good rapport with the adolescents. Confidentiality was assured. The purpose of the study was explained to them. Individual written consent was received from the participants. Adolescents were made sure that they had no allergy to pudhina consumption. The adolescent girls with dysmenorrhea were identified from the selected schools using a menstrual distress questionnaire. The adolescents with dysmenorrhea were randomly selected for the experimental and control group. Pretest was conducted for the adolescents of the experimental and control group, using the self administered questionnaire developed by the investigator. Hemoglobin status was analyzed for the adolescents in both experimental and control group, during the pre test. No intervention was done on the adolescents of the control group after the pretest. Pudina extract in the form of capsules, at a dose of 2 grams was given once a day for three months to the adolescents in the experimental group. After three months of pudina administration, post test was conducted for the adolescents in the experimental group. After three months of pretest, posttest was conducted for the adolescents in the control group. Hemoglobin status was analyzed for both groups during the post test. Validity of the tool: Content validity was established with the opinion of 18 experts. Their suggestions were included to finalize the tool. The contents of the tool were all found to be relevant. Reliability of the tool: The reliability of the instrument was determined by using split half technique. The Cronbach alpha computed was 0.94. It showed that the tool was highly reliable. MAJOR FINDINGS OF THE STUDY: In regard to the socio demographic variables, many (40.3%) of the adolescents of experimental group, were in the age group of 16-17 years and the rest were below 16 years. More than half, 53.7 % of the adolescents of control group were within 14- 15 years of age. Mostly 40.9 % and 42.3% of the adolescents were in second order of birth in the experimental group and control group respectively. A vast majority, 76% and 92% of the adolescents, were Hindus in the experimental group and control group respectively. Few of the adolescents, 1.1% and 0.6% were Muslims from both groups. The body mass index calculated showed that the adolescents of the both groups had adequate weight. For a vast majority, 71.3% of the experimental group and 57.0% of control group, mother was the source of information. The other source of information was peers to 16% and 25.4% for the adolescents. For, 1.1% of the experimental group, media was the source of information. The other sources of information for the adolescents in the experimental group and control group were Neighbour for (6.3%), (12.1%), Health personnel, (3.7%), (0.9%) and relatives (1.7%), (3.7%) respectively. With regard to clinical variables, majority of the adolescents 60.6%, and 63.4 % of the experimental group and control group had attained menarche within 12-14 years, respectively. As many as 25.4%, 16.9 % of control group and control group attained menarche within 14-16 years of age respectively. Few, 14% and 19.7% of experimental group and control group attained menarche before 12 years of age respectively. The number of days of menstrual flow of experimental group and control group were, one day (1.4%), (1.7%), two days (7.1%), (3.7%), three days (34.3%), (26.9%) and more than three days (51.7%), (67.7%) respectively. The number of pads used/day in the experimental group and control group were, for 1-2 days (31.7%), (35.1%), 3-4 days (23.7%), (27.7%) and for more than 4 days (2.6%) and (6.0%) respectively. Most of the adolescents of experimental group 44.6% and 50.9% of control group had pain during 24-36 hours of menstruation. As many as, 44% of experimental group adolescents and 41.4% of control group adolescents, had pain 24 hours before menstruation. Only 11.4% and 7.7% of control group had pain lasting for 48-72 hours of menstruation. A vast majority (80.6%) of the experimental group and 74.6% of control group did not seek any treatment for dysmenorrhea. As many as 64.7% and 34.8% of control group sought self treatment. Many, 35.3% experimental group and 65.2% control group adolescents, sought home remedies for dysmenorrhea, while majority (64.%) of the adolescents of the experimental group and 34.8 % control group did not seek any treatment for pain. Based on the pattern of pain, 48.9% of experimental group and 49.4% of control group had rhythmic, periodic pain, while 30.6% and 18.6% of experimental group and control group had continuous steady constant pain respectively. Rest of the adolescents of experimental group, 20.6% and 32% of control group had brief momentary transient pain. In regard to the intensity of pain expressed was, mild by 23.1% , 23.7%, moderate pain by 22.6%, 28.3%, horrible pain by 7.4%, 6.9% and excruciating pain by 7.7%, 9.1% respectively. The adolescents of experimental group and control group was relieved from pain by sleep (44.0%), (31.1%), lying down (19.4%), (18.3%), drinking coffee/cool drinks (10.0%), (20.6%), no movement (6.9%), (7.7%), applying pressure (5.1%), (4.3 %), back massage (3.7%), (3.1%), self treatment (3.4%), (2.6 %) and following distraction techniques (2.3%) and (3.7%) respectively. The pretest level of pain among adolescents as assessed on a numerical scale revealed that most of adolescents, (37.4%) in the experimental group and 32.9% of the control group had moderate level of pain. Those adolescents with worst level of pain, were 10.9% and 11.7% in the experimental and control group respectively. The posttest level of pain assessed among adolescents as assessed on a numerical scale revealed that, as many as 33.7% of the experimental group did not have pain during the post test. Whereas none of the adolescents of the control group were without pain. Only 0.3 % of the experimental group had worst pain, while 11.7% of the control group adolescents had worst pain during the post test. At p value < 0.05, it can be stated that pudhina extract has contributed to a reduction in the pain during dysmenorrhea among the adolescents. Based on the sensory symptoms, as many as 44.0% of adolescents in the experimental group had presented with severe sensory symptoms during the pre test. As many as 24.6% of the adolescents of the control group presented severe level of menstrual distress in the pre test. In regard to the sensory symptoms in the experimental group, only 1.4% presented with severe symptoms during the post test. While 33.4% of the control group adolescents expressed severe distress during the post test. The statistical test reveals that at p<0.05 there was a significant association of pre test, post test scores of menstrual distress based on sensory symptoms in the experimental group. Based on affective symptoms in the pre test, as many as 44.3% of the experimental group adolescents were found to have severe distress In the control group, during the pre test, as many as 36.3% of the control group adolescents expressed severe distress. During the posttest, in the experimental group, only 2.6% expressed severe distress in the post test. While only 40.3% of the control group expressed severe distress in the post test. The p <0.05 value denotes that there was a significant association between the pre test and post test values of menstrual distress based on affective symptoms in the experimental group. The pre test hemoglobin values of the experimental group adolescents during the pre test, range was from 7.0 gm% to 12.0 gm%. Among the control group the hemoglobin range was from 7.0 gm% to 12.1 gm%. The post test reveals that the adolescents of the experimental group had a significant rise in hemoglobin compared to the adolescents of the control group. This rise in hemoglobin was seen after the administration of pudhina extract had an impact on the experimental group. The statistical test p <0.05 reveals that there is a significant association between the pretest and posttest values of hemoglobin values in the experimental group. During the pre test, majority of the adolescents 44.0% of the experimental group and 45.1% of the control group reported 90-100% school attendance were higher secondary students. During the post test, majority of the adolescents (68.6%) of the experimental group had 90 -100% school attendance during menstruation, whereas only, 42.6% of the control group had 90-100% attendance during menstruation. This increase in the attendance was found to be statistically significant to the administration of pudhina extract. In regard to the perceived level of stress related to dysmenorrhea, during the pre test, as many as 28.9% of the adolescents of the experimental group had severe stress. Among the control group adolescents 17.7%were found to have severe stress during the pre test. Only 0.6% of the adolescents of the experimental group had severe level of stress in the post test. While 32.3% of the control group adolescents had severe stress during the post test. At p <0.05 level there was a significant association between the pre test and post test perceived stress scores of the control group. The self assessed coping ability of the adolescents in their academic performance reveals that, during the pre test 23.4% the adolescents of the experimental group were able to cope. In the control group, 50% were found to be able to cope in the pre test. During the post test, 98% of the experimental group adolescents were found to cope with dysmenorrhea. Only 38.3% adolescents of the control group were found to cope with dysmenorrhea during the post test. The extent of pain was significantly associated to the demographic variables were discussed. At p<0.05 there was a significant association of pain during menstruation to age in years, educational status of the mothers and number of days of menstrual flow. There was no significant association to the pre test level of dysmenorrhea to the other demographic and clinical variables. At statistical value p<0.05 there was a significant assosociation of pain during menstruation to the posttest to the number of days of menstrual flow. There was no significant association to the other selected demographic and clinical variables and post test level of dysmenorrhea. CONCLUSION: The study findings revealed that primary dysmenorrhea and associated menstrual problems is prevalent among majority of the adolescent girls within 14-17 years of age. This problem definitely needs some form of intervention based on medical evidence. Menstrual problems can be managed by the adolescents themselves with the help of nature.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: Effectiveness, Pudhina Extract, dysmenorrhea, adolescent girls, Selected Schools, Madurai.
Subjects: NURSING > Paediatric Nursing
Depositing User: Subramani R
Date Deposited: 23 Jan 2022 12:55
Last Modified: 23 Jan 2022 12:55
URI: http://repository-tnmgrmu.ac.in/id/eprint/19067

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