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ABSTRACT

A quasi-experimental study to assess the effect of structured teaching

programme on knowledge and performance ability of breast self examination

among the women in selected urban communities of Ludhiana, Punjab.

The research project was undertaken by Pamila Verma in partial fulfillment

of the requirement for the degree of Master of science in Nursing of the Baba

Farid University of Health Sciences, Faridkot, Punjab, (India) June 2003.

Objective

1) To assess and compare the pre-teaching knowledge score of breast self

examination among experimental and control group of women in

communities.

2) To assess and compare the post-teaching knowledge score of breast self

examination among experimental and control group.

3) To assess and compare the pre-teaching breast self examination

performance ability score of experimental and control group.

4) To assess and compare the post-teaching breast self examination

performance ability score among experimental and control group.

5) To find out the relationship of pre-teaching knowledge score and post-

teaching knowledge score of breast self examination among women in

communities with selected variables i.e. age, education, occupation,

religion, marital status, number of children, type of family, and type of

residence.

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6) To find out the relationship of pre-teaching breast self examination and

post-teaching breast self examination performance ability score among

the women in communities with selected variables i.e. age, education,

occupation, religion, marital status, number of children, type of family and

type of residence.

Hypothesis

H1 The post-teaching knowledge score of BSE among the

experimental group with be significantly higher than those of the control

group of women as measured by questionnaire at 0.05 level.

Rationale: Each woman should be taught BSE by her practitioner; a

teaching programme that include support, reinforcement and evaluation

may further enhance woman’s confidence, knowledge, proficiency and

adherence to monthly BSE. Pool and Zudkins, (1990).

H2 The post-teaching performance ability score of BSE among the

experimental group will be significantly higher than the control group of

women as measured by checklist at 0.05 level.

Rationale: Appropriate breast models and the use of breast self

examination facilitation shield were found to promote teaching breast

palpation and in turn to increase sensitivity Leslie & Leight (1999).

The conceptual frame work of the study is based on Orem’s self

care deficit theory (1959). The study was conducted in a selected hospital of

Ludhiana, Punjab. A quasi-experimental study to assess the effect of

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structured teaching programme on knowledge and performance ability of

breast self examination among the women.

Purposive sampling technique was used for selection of the sample.

Total sample consisted of 40 women in community i.e. 20 experimental group

and 20 in control group. The tool was prepared to collect the data. It

comprises section I for obtaining personal information, section II to assess

structured questionnaire on knowledge and practice of BSE, section III was

checklist to assess performance ability of each woman and section IV was

structured teaching programme which is constructed in lesson plan form with

general and specific objectives, contents are based on knowledge related to

BSE significant of BSE and anatomy and physiology of breast, risk factors

signs and symptoms of breast cancer, steps and guideline of BSE. It also

included demonstration on manikin by the investigator.

Pre-test was done from experimental and control group. Structured

teaching was given to the experimental group with the help of lesson plan,

demonstration of manikin and flash cards. Soon after structured teaching,

pamphlet was distributed to every subject for reinforcement of pre-teaching.

Post-test was taken after 24 hours from both the groups. After exposure to

structured teaching programme the knowledge and performance ability of

BSE were improved in women of experimental group, were as it remained

almost similar in woman of control group. Hence structured teaching

programme was found to be an effective tool to increase the knowledge and

performance ability of BSE of women in community. The pilot study was

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conducted to confirm the feasibility of the study and to determine reliability

and validity of the tool. The data obtained was analyzed by descriptive and

inferential statistics in terms of means, standard deviation, ’t’ test and Chi-

square test and Co-efficient correlation. Bar diagram and pie diagrams were

prepared to depict the relevant data.

Major Findings

Maximum number of both experimental group (80%) and control group

(90%) belong to the age group of 25-35 years. Women in the age group of

36-45 years were (15%) in experimental group and (5%) in control group. All

the respondents of experimental group and control group were married.

Maximum number of subjects (55%) in experimental group was Hindus and

(40%) were Sikhs. In the control group maximum number of women (65%)

were Hindus and (35%) were Sikhs, most of the women (30%) from

experimental group were with 10+2 education followed by B.A. / B.Sc. (20%)

primary school (20%) and few (5%) were illiterate, where as in the control

group maximum (60%) were with 10+2 education followed by B.A / B.Sc.

(15%) and few (10%) were with primary school education. Maximum number

of respondents (50%) of experimental group were having two children

followed by one child (5%) three children (10%) more than three (10%) and

one pregnant (5%), where as in the control group maximum number of

women (50%) were having two children, followed by one child (25%), three

children (15%) and more than three children (10%) each. Most of the

respondents (70%) belong to the nuclear family and (30%) to the joint family

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in the experimental group, where as (50%) belongs to the nuclear family and

(15%) belong to the joint family in the control group. Most of the respondents

(60%) fall in the income group of 4001-5000 per month and (10%) of the

respondents fall in the income group of 2000-3000 per month in the

experimental group, where as in the control group maximum number of

respondents (55%) fall in the income group of 4001-5000 per month and

(20%) fall in the 3001-4000 per month. Test of association was applied and

level of significance was 0.05. It was found that there is no significant

difference between samples.

 Majority (72.23%) of respondents had poor knowledge score (< 40%)

and (27.77%) had average knowledge score (40-59%) in the pre-test.

 100% of the respondents had poor performance ability score (50-60%)

in pre-test.

 Maximum (62%) number of subjects had secured good knowledge

score (61-74%), (37%) of respondents secured excellent knowledge

score and very few (1%) got average knowledge score after the

structured teaching programme.

 Maximum (67%) number of subjects had secured average

performance ability score (61-74%), and rest (33%) of the respondents

secured good performance ability score after the structured teaching

programme.

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 There is no statistically significant different between pre-test BSE

knowledge score of experimental group (12.30) and control group

(13.65). (T=1.20NS).

 There was statistically significant increase in post-test knowledge BSE

score of experimental group (27.85) at 0.001 level. (t=16.52).

 There is no statistically significant different between pre-test BSE

performance ability score of experimental group (3.25) and control

group (2.85). (t=1.19NS)

 There was statistically significant increase in post-test BSE

performance ability score of experimental group (17.4) at 0.001 level.

(t=34.54).

 There is no statistically significant effect of age on pre-test BSE

knowledge and performance ability scores of total number of

respondent. (t=1.20,0.91,1.26,1.56).

 There is no statistically significant effect of education on pre-test BSE

knowledge and performance ability scores of total number of

respondent. (t=1.96,0.88,0.03,1.0,0.14,0.13,.1.01).

 There is no statistically significant effect of occupation on pre-test BSE

knowledge and performance ability scores of total number of

respondent. (t=1.20,1.19).

 There is no statistically significant effect of religion on pre-test BSE

knowledge and performance ability scores of total number of

respondent.(t=1.15,0.63,0.46,0.92)

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 There is no statistically significant effect of marital status on pre-test

BSE knowledge and performance ability scores of total number of

respondent. (t=1.20,1.20)

 There is no statistically significant effect of number of children on pre-

test BSE knowledge and performance ability scores of total number of

respondent. (t=1.22,0.10,1.38,2.05,0.76,0,0.26).

Recommendations

1. This study can be replicated on a large sample there by can be

generalized for a large population.

2. Similar study can be using other teaching strategies i.e. self

instructional or computer assisted instructions.

3. Comparative study may be conducted to evaluate the effectiveness of

structured teaching programme among the women of urban and rural

communities.

4. Similar study can be done including attitude of women in communities

towards BSE.

5. Similar study can be conducted in different setting and different targets

population, such as nursing personnel, nursing students, teachers,

college girls, office goers etc.

6. A true experimental study may be conducted to standardize the

structure programme teaching used in the present study.

Limitations

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The present study was limited to only one post-test, one observation and one

administration of planned teaching programme.

1. The study lacks randomization due to limited time. Purposive sampling

was done from the selected area in center, Ludhiana, which restricts the

generalizations of the sty.

2. The present study was limited to only one post-test, one observation and

one administration of planned teaching programme.

3. The study did not attempt to measure the attitude of women towards BSE.

4. The size of the sample was only 40 subjects (20) in experimental group

and (20) in control group. Hence it is difficult to make broad

generalization.

5. Individual BSE was not done by the investigator.