file · Web viewThe most common cause of secondary dysmenorrhoea is endometriosis. Other causes...
Transcript of file · Web viewThe most common cause of secondary dysmenorrhoea is endometriosis. Other causes...
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DESSERTATION
1. Name of the candidate and address
Ms. RAMA DEVI PAHARI
1 year M.Sc.(N)
Faran College of Nursing
Bangalore
2. Name of the institution Faran College of Nursing
3. Course of study and subject M.Sc.Nursing
Community Health Nursing
4. Date of admission to course 29 June 2012
5. Title of the topic“A descriptive study to assess the
knowledge and attitude of unmarried young
women in age group of (18-20)years
regarding dysmenorrhoea, residing in a
selected urban community at Bangalore”
6. BRIEF RESUME OF THE INTENDED WORK1
INTRODUCTION
Unmarried young women is in a transition period from childhood to adulthood
and is characterized by a spurt in physical, endocrinal, emotional, and mental growth,
with a change from complete dependence to relative independence. The period of
adolescence for unmarried young women is a period of physical and psychological
preparation for safe motherhood. As the direct reproducers of future generations, the
health of an adolescent unmarried young woman influences not only their own health,
but also the health of the future population. Almost a quarter of India's population
comprises of unmarried young women below 20 years. One of the major physiological
changes that take place in adolescent unmarried young women is the onset of
menarche, which is often associated with problems of irregular menstruation,
excessive bleeding, and dysmenorrhea. Of these, dysmenorrhea is one of the common
problems experienced by many adolescent unmarried young women.1
Dysmenorrhoea is a gynecological medical condition of pain during menstruation
that interferes with daily activities. Dysmenorrhoea can be classified as either primary
or secondary based on the absence or presence of an underlying cause. Secondary
dysmenorrhoea is dysmenorrhoea which is associated with an existing condition. The
most common cause of secondary dysmenorrhoea is endometriosis. Other causes
include leiomyoma, adenomyosis, ovarian cysts, and pelvic congestions.
Dysmenorrhoea is a common health problem, having negative effects on the health
related quality of life which translates to poor academic performance of majority of
the female university students. Dysmenorrhoea is the leading cause of recurrent short-
term school absence in adolescent girls and a common problem in women of
reproductive age. About 15 percent of adolescent girls report severe dysmenorrhoea,
2
and it is the leading cause of recurrent short-term school absenteeism in adolescent
girls.2
The global library of women’s medicine dedicated to the enhancement of women’s
healthcare reported that more than 50% of post pubescent menstruating women are
affected by dysmenorrhea, with 10–12% of them having severe dysmenorrhea with
incapacitation for 1–3 days each month. Women who continue to work or to attend
classes have been shown to have lower work output or scores during their
dysmenorrhea. Dysmenorrhea is most common in women between the ages of 18 and
2o years, with most of the severe episodes occurring before 21 years of age. Primary
dysmenorrhea occurs more frequently in unmarried women than in married women
(61% vs. 51%), decreases with age, and does not appear to be related to the type of
occupation or physical condition of the woman. Exercise does not appear to have any
significant effect on the incidence of dysmenorrhea. Associated factors that increase
the risk duration and severity of dysmenorrhea include early menarche, long
menstrual periods, overweight Dysmenorrhea can feature different kinds of pain,
including sharp, throbbing, dull, nauseating, burning, or shooting pain.3
6.1 NEED FOR THE STUDY
Adolescent girls, almost always, silently suffer the pain by dysmenorrhea and the
discomfort associated with it due to lack of knowledge about reproductive health. It is
probable that this also affects their academic performance. Due to some cultural and
religious restrictions, many unmarried young women in this country lack appropriate
and sufficient information regarding dysmenorrhoea causing incorrect and unhealthy
behaviors during their menstrual period. This burden, unfortunately, has not been
taken seriously in terms of its social or hygienic aspects.
3
Dysmenorrhea is the most common gynecologic complaint and the leading cause
of recurrent short-term school or work absenteeism among unmarried young women.
Despite the high prevalence of dysmenorrhea in unmarried young women, they do not
seek medical advice or are under-treated. In one study, a majority (98%) of unmarried
young women used non pharmacologic methods such as heat, rest, or distraction to
treat dysmenorrhea, with perceived effectiveness of 40% or less. In other studies from
different populations, 30-70% of unmarried young women reported at least
occasionally self-medicating with over-the-counter (OTC) pain medications.7-9
However, 57% of those who self-medicated with OTC preparations used sub-
therapeutic. Only 54% of adolescents knew that certain medications could relieve
menstrual cramps, and 27% of girls are unable to recognize any of three non-steroidal
anti-inflammatory drugs (NSAID) listed as possible treatments for dysmenorrhea.4
A descriptive cross-sectional study was conducted to evaluate adolescents self-
reported knowledge of dysmenorrhea types, and symptoms, and to identify its
severity, factors that make pain worse and its negative academic impacts. The study
sample consisted of 289 participants selected by non-probability, convenience
sampling. The results revealed that majority (59.9%) of the participants were within the
age group of 18 – 22 years with Mean ± SD of 19.5 ± 3.1 years. Most (50.9%) of the
participants reported that they were suffering from primary dysmenorrhea while slightly
below one-half (45%) of the participants did not know the type of dysmenorrhea they
were suffering from, 129 participants experienced poor academic performance. The most
common reason for poor academic performance was inability to concentrate in class
(46.5%). The researchers concluded that, outstanding high number of female students did
not know the type of dysmenorrhea they were suffering from and dysmenorrhea impacts
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negatively on their academic performance, which may be as a result of inadequate
management among the studied participants.5
An explorative survey study with correlation approach was conducted on the
prevalence of dysmenorrhea and associated symptoms among adolescent girls in
Gwalior. The study sample consisted of 970 adolescent girls in the age group of 15-20
years. The results revealed that, the prevalence of dysmenorrhea in adolescent girls is
79.67%. Most of them, 37.96%, suffered regularly from dysmenorrhea severity. The
three most common symptoms present on both days, that is, day before and first day
of menstruation were lethargy and tiredness (first), depression (second) and inability
to concentrate in work (third), whereas the ranking of these symptoms on the day after
the stoppage of menstruation showed depression as the first common symptoms.
Negative correlation was found between dysmenorrhea and the General Health Status
as measured by the Body surface area1
A cross-sectional study was conducted to assess the knowledge and attitude of
urban adolescents. The study sample consisted of 169 subjects in age group of 15-20
years. The results revealed that, majority (84.3%) of the adolescents reported
menstrual disorder followed by dysmenorrhea (65%), abnormal cycle lengths
(13.2%), and excessive uterine bleeding (8.6%). Only 2% of teens reported about
receiving information about menstruation from their health care provider. Negative
expectations regarding menstruation were associated with higher rates of school
absenteeism and missed activities. The researchers concluded that, it is imperative
that health care provider’s should increase their anticipatory guidance to adolescence
regarding normal mesturation.6
5
From the available literature reviewed, it is evident that burden of dysmenorrhoea
is greater than any other gynecological complaint, and is associated with significant
impact. Social disadvantage, co-morbidity with other somatic syndromes and
reproductive factors are determinants of these complaints. Dysmenorrhea is a very
common problem among adolescent girls, and they experience a number of physical
and emotional symptoms associated with dysmenorrhea, and with the increased
intensity of pain in occurrence of dysmenorrhea the probability of experiencing these
symptoms. Since the available studies are few in the Indian scenario the researcher
found it relevant to assess the knowledge and attitude of unmarried young women in
the age group of 18 to 20 years regarding dysmenorrhoea residing in the selected
urban community at Bangalore.
6.2 REVIEW OF LITERATUR
Review of literature is a key step in research process. Review of literature refers to
an extensive, exhaustive and systematic examination of publication relevant to the
research project. Nursing research may be considered as a continuous process in
which knowledge gained from earlier studies are an integral part of research in
general. Literature review is concerned with review of related literature which
includes research and non-research reports, articles, documents, journals, books and
internet search. The aims of literature review are extension of knowledge and finding
out evidence, which support data, information and provide the basis from which
conclusions will be drawn in the study.
A cross-sectional study was conducted to determine patterns of menstrual cycles
among young girls and its related problems, discomfort and also to infer the extent of
awareness and sources of information regarding menstruation possessed by Indian
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girls before attaining puberty. The study sample consisted of 194 unmarried
adolescents studying in various institutions in Mysore city. The results revealed that,
the mean age of the subjects at menarche was 13.36 ± 1.25 years with the range being
10 to 17 years. Mean duration of menstrual flow was 4.77 ± 1.06 days. The most
prevalent menstrual symptoms were tiredness (47.9%), backache (38.3%), and anger
(34.5%). Prevalence of menstrual irregularity and dysmenorrhea was 11.9 and 78.2%.
About 6.7% of the participants had severe dysmenorrhea and 76.6% of the subjects
reported that their working ability was affected. About 60.4% of the girls were aware
of menstruation prior to menarche. Mothers and friends were the main sources of
information (47.8%).The researchers concluded that the prevalence of dysmenorrhea
and menstrual irregularity among young females are high. They suggested of
awareness programme to improve menstruation discomfort management.7
A descriptive, cross sectional study was conducted to assess the incidence of
dysmenorrhea and menstrual hygiene practices among adolescent girls from selected
nursing institutions. The study sample consisted of 160 students. The results revealed
a high prevalence (94.4%) and was categorized as (49.0%) for 1st degree of pain,
(34.4%) for second-degree and (16.6%) for third-degree. Measures taken to relieve
dysmenorrhea were found to be: intake of certain types of domestic hot drinks
(43.0%), taking analgesics (22.5%), and (66.2%) performed physical activities during
menstrual period to relieve pain. All students (100.0%) took complete hot baths
during menstruation. About one-fourth (26.9 %) of students just took rest and stayed
at home, who believed that physical activities will increase the menstrual pain and
increase feelings of exhaustion. On conclusion high prevalence of dysmenorrhea was
observed. However the necessity to adopt a healthy behavior, which includes:
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appropriate nutrition and appropriate use of medications based on a physician's
prescription was a very important issue.8
A cross sectional study was conducted to assess the perception regarding
menstruation and practices during menstrual cycles among selected high school
adolescent girls in resource limited settings around Bangalore city. The study sample
consisted of 506 adolescents. The results revealed that, the average age was 14.08
with Standard deviation of 1.06 and range between 12-16yrs. About 99.6% of the
students had heard of menstruation and 57.9% had acquired this knowledge even
before attaining menarche and 73.7% knew that menstruation was a normal
phenomenon, but only 28.7% had adeuate knowledge regarding menstruation. About
48.1% did not know that menstruation was related to pregnancy. Only 44.1% used
sanitary pads during the menstrual cycles. Among those who used cloth, only 31.3%
used soap and water to clean them, 56.8% used soap and water to clean their genital
organs and 88.8% of the girls took bath daily during menstruation. Regarding
perception about the word menstruation, many of the girls mentioned that they
experienced fear (44.1%) on attaining menarche, while some of them (26.1%) were
anxious. About 74.2% felt that menstrual cycle is a natural phenomenon while 17%
felt that menstruation occurred due to the curse of God. Majority of them (56.8%) felt
that menstruation poses a huge physical and psychological burden on them. On the
whole among the girls who had attained menarche only 43 (14.07%) showed a
positive attitude (scores=4) towards the process of menstruation.9
A cross sectional study was conducted to describe the prevalence and
determinants of dysmenorrhea among adolescents in Goa. The study sample
consisted of 2494 subjects. The results revealed that more than half of the samples
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reported dysmenorrhea. Moderate to severe dysmenorrhea was reported by 755
participants (33.4%, 95% CI 31.4–35.4). There was a linear association between
severity of pain and impact (medication and taking rest) and the onset of pain
(premenstrual onset associated with more severe pain). On multivariate analyses, the
risk of moderate–severe dysmenorrhoea was associated with the experience of
violence (OR 2.23, 95% CI 1.5–34); other somatic complaints (OR 3.67, 95% CI 2.7–
4.9 for highest somatoform symptom score category compared with the lowest);
gynecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI
1.3–2.3; dysuria: OR 1.98, 1.4–2.7. The researchers conducted that the burden of
dysmenorrhea is greater than any other gynecological complaints and is associated
with significant impact.10
A descriptive cross sectional study was conducted to assess knowledge, attitudes
and health-taking behaviors of adolescents in the age group of 15-18 years with
regard to dysmenorrhea and menstrual hygiene. The study sample consisted of 250
students. The results revealed that, about 77% of the subjects reported that they have
enough knowledge about dysmenorrhea from which only 32% follow appropriate
practices, such as taking a bath and using hygienic materials. About 33% of the
students avoided any physical activity or even mild exercise during menstrual period.
Over 67% of the girls reported to take palliative medicine for their menstrual pain
without prescription by a doctor. The prevalence of dysmenorrhea in this study was
71%. The main point achieved in this study was the necessity of educating female
students about the menstrual period health-taking behaviors, including: appropriate
nutrition, exercise and physical activity, personal hygiene, and appropriate use of
medication based on physician’s prescription.11
9
A comparative cross sectional study was conducted to identify different
epidemiological problems, perception socio economic loses of life and management
of dysmenorrhea in different setting. The study sample consisted of 101 girls from
urban area and 79 girls from rural area. The results revealed that, the prevalence of
dysmenorrhoea is 54% (53% in girls in urban areas and 56% in girls in rural areas)
(X2 df = 0.1, P = 0.05). Sickness absenteeism (28–48%), socio economic losses, and
perceived quality of life losses are more prevalent among girls in urban areas than in
girls in rural areas. Girls in rural areas resort to physical labour and other natural
methods to obtain relief while the girls in urban areas are mainly depending on
medications.12
A study was conducted on menstrual discomfort and its influence on daily academic
activity, and psychosocial relationship among female undergraduate students. The sample
consisted of 415 female adolescents. Results showed a high prevalence of dysmenorrhoea
(64%) among respondents within 3 months prior to this study. Dysmenorrhoea was significant
among female students who reported dizziness, headache, depression and irritation; and those
whose menstrual disorder ever called for medical attention (P<0.05). Similarly, menorrhagia
was less frequent (21%) than dysmenorrhoea (64%), but occurred more significantly with
dizziness, headache and depression. Menstrual disorder was experienced as an objective and
subjective reality among those interviewed. Both dysmenorrhoea and menorrhagia were
significant predictors of psychosocial relationship of the female students (P<0.05). 13
A cross-sectional study was conducted to determine the prevalence of
dysmenorrhea and to determine the health related quality of life among a group of
adolescents. The study sample consisted of 623 participants. The results revealed that,
prevalence of dysmenorrhea was found to be 72.7% and was significantly higher in
coffee consumer females with menstrual bleeding duration of >_ 7 days and those
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who had a positive family history of dysmenorrhea when compared to others (P<0.05,
for each one). By multivariate analysis, coffee consummation (OR-2.084) menstrual
bleeding duration >_ 7days (OR 1.590), and positive family history of dysmenorrhea,
(OR 3.043) were important risk factors for dysmenorrhea. Except for social
functioning role emotional and mental health domains the SF-36 points received from
other domains were higher in family with dysmenorrhea (for each on P>_0.05).14
A cross sectional study was carried out to determined the prevalence of
dysmenorrhea among adolescent girls. The study sample consisted of 404 adolescent
girls. Data were collected by self administered questionnaire including information on
demographic variables, prevalence of dysmenorrhea severity, its impact and treatment
used. The study results revealed that 94% (n = 380) of the participants had
dysmenorrhea. It was mild in 27% (n = 104), moderate in 41% (n = 155) and severe in
32% (n = 121). Dysmenorrhea was the cause of limited sports activities in 81%,
decreased class room concentration in 75%, restricted home work in 50%, school
absenteeism in 45%, limited social activities in 25% and decreased academic
performance in 8% of the affected student. Only 3% (n = 10) had consulted a
physician, 21% (n = 80) self medicated and 55% (n= 210) took no action. The
commonest drug used were paracetamol (n = 60, 16%) ibuprofen (n= 9, 8%) and
mefenemic acid (n =12, 3%). There was no statistically significant correlation
between dysmenorrhea and demographic and menstrual characteristics.15
A study was conducted to determine the prevalence of dysmenorrhea among
female adolescents and its impact on academic performance, school attendance and
social activities and its management. The study sample consisted of 706 female
adolescents. The results revealed that among participants who had a period in the
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previous 3 month 85% reported dysmenorrhea, of these 38% reported missing classes
due to dysmenorrhea, during 3 months prior to the study and 33% reported missing
individual classes. Activities affected by dysmenorrhea included class concentration
(59%), sports (51%), class participation (50%), socialization (46%), homework
(35%), test-taking skills (36%), and grades (29%). Treatment taken for dysmenorrhea
included rest (58%), medications (52%), heating pads (26%), tea (20%), exercise
(15%), and herbs (7%). About 14% consulted a physician and 49% saw a school nurse
for seeking help with the symptom management. Menstrual pain was significantly
associated with school absenteeism, decreased accademic performance, sport
participation and socialization with peers (P<01).16
6.3 STATEMENT OF THE PROBLEM:
“A descriptive study to assess the knowledge and attitude of unmarried young
women in the age group of (18- 20) years regarding dysmenorrhoea residing in a
selected urban community at Bangalore.”
6.4 OBJECTIVES OF THE STUDY:
The objectives of the study are to:
assess the knowledge of unmarried young women in the age group of 18 to 20
years regarding dysmenorrhoea.
assess the attitude of unmarried young women in the age group of 18 to 20
years regarding dysmenorrhoea.
find out correlation between knowledge and attitude of the unmarried young
women in the age group of 18-20 years regarding dysmenorrhoea.
12
determine an association between the knowledge of unmarried young women
in the age group of 18- 20years regarding dysmenorrhoea and their selected
socio demographic variables.
determine an association between attitude of unmarried young women in the
age group of 18-20 years regarding dysmenorrhoea and their selected socio
demographic variables.
6.5 HYPOTHESIS
The following hypothesis will be tested at 0.05 level of significance:
H1: There is a significant relationship between the knowledge and attitude of
unmarried young women in age group of 18-20 years regarding
dysmenorrhoea.
H2: There is a significant association between the knowledge of unmarried young
women in age group of 18-20 years regarding dysmenorrhoea and their
selected socio demographic variables.
H3: There is a significant association between the attitude of unmarried young
women in the age group of 18- 20 years regarding dysmenorrhoea and their
selected socio demographic variables.
6.6 OPERATIONAL DEFENITION OF TERMS:
13
Assess
In this study, it refers to identifying the knowledge and attitude by the
organized and continuous process of data collection regarding
dysmenorrhoea among unmarried young women in age group of (18-20)
years.
Knowledge
It denotes the awareness or information that the unmarried young women
in age group of (18-20) years possess regarding dysmenorrhea which will
be collected through the interview schedule.
Attitude
In this study, it refers to an expressed opinion regarding the way in which
the unmarried young women look at dysmenorrhoea.
Young women
It refers to the unmarried young females in age group of (18-20) years who
are residing in the selected urban community.
Dysmenorrhea
It refers to the pain or discomfort associated with menstruation experienced
by women, who have attained menarche.
Urban Community
14
It refers to a group of people who inhabit in a particular geographic area, who
are sharing some common traditions, customs, beliefs and practices.
6.7 ASSUMPTIONS
The study is based on the following assumptions:
Most measurable attitudes are held strongly enough to direct the behaviour .
The tool prepared for study will be sufficient to assess the knowledge and
attitude of unmarried young women regarding dysmenorrhoea.
Unmarried young women operate on the basis of the cognitive information
they posses regarding dysmenorrhoea.
6.8 DELIMITATIONS:
The study is delimited to:
assessment of knowledge and attitude only as correct responses made to the
items in the tool.
unmarried young women in the age group of 18 to 20 years from the selected
urban community at Bangalore.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
The data will be collected from unmarried young women age group of (18-20)
years residing in the selected urban community at Bangalore.
7.2 METHODS OF DATA COLLECTION:
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Research method : Non experimental Survey method
Research design : Descriptive survey design
Sampling technique : Purposive sampling
Sample size : 100 unmarried young women age group of
(18-20) years.
Setting of the study : Selected urban community at Bangalore,
namely K Narayanapura
7.2.1 CRITERIA FOR SELECTION OF SAMPLE
INCLUSION CRITERIA
The study includes “unmarried young women”;
residing in the selected urban community at Bangalore.
who attained menarche.
who are willing to participate.
who can understand Kannada and English.
who are in the age group of 18 to 20 years.
Exclusion criteria
The study excludes “unmarried young women”;
who are not available at the time of data collection.
who are below 18 years of age.
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who are above 21 years of age.
7.2.2 DATA COLLLECTION TOOL
A structured interview schedule will be prepared by the investigator to assess the
knowledge of unmarried young women regarding dysmenorrhoea. Attitude scale
which is a likert type of scale will also be prepared to assess the attitude of unmarried
young women regarding dysmenorrhoea.
Content validity of the tool will be ascertained in consultation with the guide and
experts in the field of community medicine, psychiatric nursing and community health
nursing. Reliability of the tool will be established by split half method.
Prior to the study, written permission will be obtained from the concerned
administrative authority of the setting to conduct the study. Further an informed
consent will be obtained from the participants regarding their willingness to
participate in the study. The proposed period of data collection will be in October
2013.
7.2.3. DATA ANALYSIS METHOD
Data analysis will be done by using descriptive and inferential statistics.
Frequency and percentage distribution will be done to analyze demographic variables.
The demographic variables will also be described descriptively by using column, bar
pie and cone diagrams.
Mean and standard deviation will be used to assess the level of knowledge and
attitude of unmarried young women in the age group of (18 – 20) years regarding
dysmenorrhea.
17
A coefficient of correlation ‘r’ wills the used to determine correlation between
knowledge and attitude of unmarried young women regarding dysmenorrhoea.
7.3: DOES THE STUDY REQUIRES ANY INVESTIGATIONS
OR INTERVENTIONS TO BE CONDUCTED ON THE PATIENT
OR HUMAN BEING OR ANIMAL?
YES,
Only a structured interview schedule and an attitude scale regarding
dysmenorrhoea will be used. No other interventions which cause any physical harm
will not be used in the study.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED?
YES
Confidentiality and anonymity of the subjects will be maintained.
Consent will be obtained from the participants before conducting the study.
A written permission from the concerned administrative authority will be
obtained prior to the study.
8. LIST OF REFERENCES
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1. Agarwal A. K, Agarwal A., A Study of Dysmenorrhea during Menstruation in
Adolescent Girls, Indian Journal Community Medicine. 2010 January; 35(1):
159–164.
2. Wikipedia, the free encyclopedia, Dysmenorrhea.
3. Dawood, Y,Dysmenorrhea The Global Library of Women’s Medicine
Dedicine to the nhancement women’s healthcare.
4. Zeep Harel,Dysmenorrhea in adolescent and young adults: Etiology and
Management, Journal Pediatric adolescent gynecology (2006)19:363-371.
5. Okoro R. N, Malgwi H., 3Okoro G. O. Self- reported knowledge of
Dysmenorrhoea and its Negative Academic impacts among a group of female
students of University of Maiduguri, North Eastern Nigeria.Novel Science
International Journal of Medical Science (2012), 1(7): 220-225
6. Shanbhag D, Shilpa R, D.Souza N, Josephine P, Singh J, Goud BR,
Perceptions regarding menstruation and Practices during menstrual cycles
among high school going adolescent girls in resource limited settings around
Bangalore city, Karnataka,India.International Journal of Collaborative
Research on Internal Medicine & Public Health, (2012).Vol.4 No.7
7. Chiou MH, Wang HH, Yang YH. Menstrual pattern among unmarried women
from south India”, Journal of Natural Science Bio- Medical.2011 Dec; 2(2):
174–179
8. Neamat A., Mohamed M. S, Ahmed N H, Ahmed E R. Assessment of
Dysmenorrhea and Menstrual Hygiene Practices among Adolescent Girls in
Some Nursing Schools at EL-Minia Governorate, Egyp, Journal of American
Science, 2011;7(9)
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9. Houston A. M, Abraham A., Huang Z, Knowledge, Attitudes, and
Consequences of Menstrual Health in Urban Adolescent Female. Journal of
Pediatric Adolescence Gynecology (2006) 19:271-275
10. Patel V, Tanksale V, Sahasrabhojanee M, Gupte S, Nevrekar P, The burden
and determinants of dysmenorrhea. A population-based survey of 2262
women in Goa, India. February 2006.
11. Poureslamii M, Ashtiani F O, Assessing Knowledge, Attitudes, and Behavior
of Adolescent Girls in Suburban Districts of Tehran About Dysmenorrhea and
Menstrual Hygiene,
12. S. Dysmenorrhoea in Different Settings: Are the Rural and Urban Adolescent
Girls Perceiving and Managing the Dysmenorrhoea Problem Differently,
Indian Journal of Community Medicine. 2008 October; 33(4): 246–249.
13. Titilayo A. Agunbiade O.M,. Banj O, Lawani A. Menstrual discomfort and its
influence on daily academic activities and psychosocial relationship among
undergraduate female students in Nigeria, Tanzania Journal of Health
Research, October 2009:Vol. 11, No. 4.
14. Unsal A., Ayraanel U., Tozun M.,Prevalance of dysmenorrheal and its effect
on quality of life among a group of female university students, Journal sutan
caboose university medical, April 2010:
15. Rahana, A., Anbarin B. Prevalence and impact of dysmenorrhea among
Omani high school student. Published online. 2011-october: 11, 485-491.
16. Banikarlmc C, Kedar SH. Prevalence and impact of dysmenorrhea on
Hispanic female adolescents, Arch – Pediatric adolescence Medicine;
2000:154 (2); 1226-1229.
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9 SIGNATURE OF THE
CANDIDATE:Ms. RAMA DEVI PAHARI
10. REMARKS OF THE GUIDE : This is a feasible study
11. NAME & DESIGNATION OF:
11.1 GUIDE
11.2 SIGNATURE
Mrs. SHEELIA WHITE N
Associate Professor
Community Health Nursing
11.3 HEAD OF THE
DEPARTMENT:
11.4 SIGNATURE:
MRS. SHEELIA WHITE N
Associate Professor
12. 12.1 REMARKS OF THE
CHAIRMAN & PRINCIPAL
12.2 SIGNATURE:
This is a relevant study
Mrs. ASHA ANDREWS
PRINCIPAL
21