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A STUDY TO ASSESS THE INCIDENCE AND
KNOWLEDGE RELATED TO ANEMIA AMONG GIRLS OF
NURSING COLLEGE OF LUDHIANA, PUNJAB WITH A
VIEW TO DEVELOP INFORMATION BOOKLET
Research Project submitted for the partial fulfillment of
the requirement for the degree of
POST BACHELOR OF SCIENCE IN NURSING
Of
Baba Farid University of Health Science,
Faridkot, Punjab
2013
Group B
Guru Hargobind college Of Nursing , Rakot (Punjab)
A STUDY TO ASSESS THE INCIDENCE AND
KNOWLEDGE RELATED TO ANEMIA AMONG GIRLS OF
NURSING COLLEGE OF LUDHIANA, PUNJAB WITH A
VIEW TO DEVELOP INFORMATAION BOOKLET
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Research Project submitted for the partial fulfillment of the
requirement for the degree
of
POST BACHELOR OF SCIENCE IN NURSING
Of
Baba Farid University of Health Science,
Faridkot, Punjab
2013
Group B
Name & Signature of Supervisor
Mrs.Gursangeet kaur
Assisstant professor M.Sc (N)
Obstretric and Gynaecology
Name & Signature of Co-Supervisor
Mrs .Mandeep kaur
(Assisstant Professor M.Sc (N)
Obstretric andGynaecology
Guru Hargobind College Of Nursing, Raikot (Punjab)
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Certificate of the Supervisor and Principal
This is to certify that Group B (Paramjeet kaur Dhaliwal,Parmjeet kaurChahal,Ramandeep kaur grewal, Ramandeep kaur batth ,Ramandeep kaur
grewal,Rashpinder kaur Dhindsa,Ravinder kaur Dhillon,Sandeep kaur
Chahal,Veerpal kaur Mahli)has carried out the study titled , Astudy to assess the
incidence and knowledge related to anemia among girls of nursing college
Ludhiana,Punjab with a view to develop information booklet. It is the original work
of the above said Group conducted under guidance and supervision.
Supervisor Co- Supervisor
Mrs.Gursangeet kaur Mrs.Mandeep kaur
Assisstant professor Asssisstant professor
Obstetrics and Gynaecology Obstetrics and Gynaecology
PrincipalProfessor(Mrs) Shamim Sagar
Guru Hargobind College of Nursing,
Raikot, Ludhiana, Punjab.
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Acknowledgement
Your Name, O Transcendent Lord, is Ambrosial Nectar; whoever meditates on it,
lives.
We praise and thank Lord Almighty for His love and care that He showered on us
during our present study and we acknowledge that without which it would not have
been a possibility.
It is a sense of honor and pride for us to place on record, our sincere thanks to
honorable Mrs. Shamim Sagar, Principal, INE, GHG COLLEGE OF
NURSING,RAIKOT, Ludhiana for her valuable guidance and inspiration to
complete this research project
We express our heartfelt gratitude to our Guide MRS Gursangeeet kaur, Assistant
Professor, INE,and our Co-Guide GHG COLLEGE OF NURSING,RAIKOT, Mrs.
Mandeep Kaur, Assistant Professor INE, GHG COLLEGE OF
NURSING,RAIKOT,, Ludhiana for their , guidance, inspiration, support and
encouragement during the investigation and manuscript preparation throughout the
course of our research project.
We are also thankful to our beloved class teacher Mrs. Jaspreet kaur maan ,Clinical
instructor and Miss. Chamandeep kaur, Clinical instructor, INE, GHG COLLEGE
OF NURSING,RAIKOT, Ludhiana, for their guidance, inspiration, support and
encouragement during the investigation and manuscript preparation throughout the
course of our research project. It was not possible to complete the project without
their endless efforts and sincere guidance.
Words cannot express the gratitude and thanks we feel towards our research
coordinator Mr. Narendra kumar sumeriya, Associate Professor, GHG COLLEGE
OF NURSING,RAIKOT,, Ludhiana for this guidance, encouragement and for giving
us an opportunity to undertake this research project.
We are also our sincere thanks to honorable M.Sc experts Mrs. Asha
Emanual(Professor), Mrs. V.Shantha laxmi (Associate Professor), Mrs.Charlotte
Ranadive (Associate Professor), Mrs.Navneet kaur (Assistant Professor),
Mrs.kuldeep kaur (Assistant Professor), Mrs.Manveerpal kaur(Assistant
Professor)Mrs.Veena baksh(Assistant Professor), for their valuable suggestions and
guidance.
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Very deep appreciation for giving feedback valuable suggestions goes to faculty
members of INE, , GHG COLLEGE OF NURSING,RAIKOT, Ludhiana.
We also want to thank all our wonderful classmates, library staff and friends for
their encouragement and motivation
Word acknowledgment would remain incomplete if we do not express our sincere
and deep sense of indebtedness to our parents and loved ones and also to the study
subjects who helped us in gathering the data.
Above all we bow our heart before almighty GOD and our gratitude to him for his
abiding grace and for being the guiding for guiding for behind our task.
All may not be mentioned, but none is forgotten from the heart.
WITH BOUQUETS THANKS
MISS.Paramjit kaur Dhaliwal
MISS.Parmjeet kaur Chahal
MISS Ramandeep kaur Grewal
MISS.Ramandeep kaur Batth
MISS .Ramandeep kaur Grewal
MISS.Rashpinder kaur Dhindsa
MRS.Ravinder kaur Dhillon
MISS.Sandeep kaur Chahal
MISS.Veerpal kaur Malhi
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TABLE OF CONT
S.NO CHAPTER PAGE NO.
1 INTRODUCTIONIntroductionNeed of the studyStatement of problemObjectives
AssumptionsLimitationOperational definition Delimitations
2 REVIEW OF LITERATURE3 METHODOLOG
Resarch approachResearch designResearch SettingPopulationMethod of data collectionSampling techniqueSample sizeCriteria for selection of the sampleDevelopment and description of toolsValidity of the toolsPilot studyReliability of the toolsData collection procedure
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TABLE OF CONTENTS
S.NO CHAPTER PAGE NO.
1 INTRODUCTIONIntroductionNeed of the studyStatement of problemObjectivesAssumptionsLimitationOperational definition Delimitations
2 REVIEW OF LITERATURE3 METHODOLOG
Research approachResearch designResearch SettingPopulationMethod of data collectionSampling techniqueSample sizeCriteria for selection of the sampleDevelopment and description of toolsValidity of the toolsPilot studyReliability of the toolsData collection procedureEthical considerationPlan of data analysisSummary
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4 ANALYSIS AND INTERPRETATATIONOF DATA
Main Analysis and interpretationMajor findingDiscussionSummary
5 CONCLUSION , IMPLICATION AND SUMMARY6 BIBLOGRAPHY
7 ANNEXURES
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LIST OF TABLE
S.NO TABLES PAGE NO.
1 Frequency and Percentage distribution of
Demographic data of girls.
2 Frequency and percentage distribution of
knowledge Level regarding anemia among girls
3 Overall mean SD, mean percentage of knowledge
Score of girls regarding anemia .
4 Association between knowledge regarding anemia.
5 Incidence regarding anemia among girls.
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LIST OF FIGURES
S.NO TITLE PAGE NO.
1.1 Conceptual framework1.2 Research design2.1 Bar diagram showing the frequency
distribution of subjects according to
level of knowledge regarding anemia
4.1 Pia diagram showing the percentage
distribution of knowledge according to
girls age
4.2 Pia diagram showing the percentage
distribution of knowledge according to
area of parmenent residence
4. 3 Pia diagram showing the percentage
distribution of knowledge according to
type of family
4. 4 Pia diagram showing the percentage
distribution of knowledge according to
type of residence.
4.5 Pia diagram showing the percentage
distribution of knowledge according to
dietary habits
4.6 Pia diagram showing the percentage
distribution of knowledge according to
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monthly income.
4.7 Pia diagram showing the percentage
distribution of knowledge according to
source of information
5.1 bar diagram showing percentage distribution
according to incidence of anemia among girls
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LIST OF ANNEXURE
S.NO ANNEXURE PAGE NO.
1 Experts opinion for content validity
Of the tool.
2 Content validity certificate3 Letter requesting permission for
pilot study.
4 Letter requesting permission forfinal study
5 List of experts6 Structured interview schedule7 List of formulas
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CHAPTER1
INTRODUCTION
Anemia is a world-wide problem with the highest prevalence of developing countries. It is
found especially among child-bearing age and girls. In India the incidence of anemia is
highest among women and young children. Anemia can be classified according to thecauses i.e. Impaired production of RBCs and hemoglobin, Accelerated destruction of
RBCs ,Blood loss and also classified morphologically.1
Iron deficiency can arise either due to inadequate intake or poor bioavailability of dietary
iron or due to excessive losses of iron from the body. Although most habitual diets contain
seemingly adequate amounts of iron only a small amount is absorbed. This poor
bioavailability is considered to be a major reason for the widespread iron deficiency. Iron
deficiency anemia (IDA) is a formidable health challenge in developing countries and
remains persistently high despite national programs to control this deficiency. In the
period of later school age and early adolescence nutrient requirements are high2.
According to WORLD HEALTH ORGANISATION the hemoglobin level should be 12
gm/dl for girls . When the hemoglobin level less then 12 gm/dl is considered as iron
deficiency anemia . WHO graded the Hb level 10 gm/dl is considered as moderate iron
deficiency anemia and Hb less than 7 gm/dl is considered as severe iron deficiency anemia
3
The decreased dietary iron intake , poor absorption , warm infestation , increased body
demand , menstruation are the major causes of iron deficiency anemia among adolescent
girls.4
Iron deficiency anemia typically results when the intake of dietary iron is inadequate for
hemoglobin synthesis. The body can store about one fourth to one third of its iron, and it is
not until those stores are depleted that iron deficiency anemia actually begins to develop.
Iron deficiency anemia is the most common type of anemia in all age groups, and it is the
most common anemia in the world more than 500 million people are affected more
commonly in underdeveloped countries where inadequate iron stores can result from
inadequate intake of iron. Iron deficiency is also common in the United States5.
Anemia is a sign, which can present at any age. It is important to investigate the cause of
anemia exclude a serious under laying aliment. Anemia is present when the hemoglobin
level in the blood is two standard deviations below the mean for the particular age and sex
being evaluated. The physiologic definition of anemia is a condition in which tissue
hypoxia occurs due to inadequate oxygen carrying capacity of blood6.
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Iron deficiency anemia occurs when there is a decrease in total body iron content, severe
enough to diminish erythropoietin and cause anemia. Diminished dietary iron absorption
in the proximal small intestine or excessive loss of body iron can result in iron deficiency.
Iron is essential for multiple metabolic processes, including oxygen transport, DNA
synthesis and electron transport. In severe iron deficiency the iron containing enzymes are
low and this can affect immune and tissue function7.
Anemia in girls is one of the social health problems. Iron deficiency anemia leads to
weakness, reduced exercise capacity, slower physical growth, impaired cognitive
development, decreasing the ability to light infections, delayed wound healing, behavioral
abnormalities and also . Anemia may compromise pubert. It may also reduce physical
work capacity because the decrease in hemoglobin reduces the availability of oxygen to
the tissues which in turn affects the cardiac output. Further in iron deficiency changes in
brain iron content and distribution and in neurotransmitter function may affect cognition8
.
NEED OF THE STUDY
Anemia is one of the most prevalent common nutritional deficiencies in the world
especially among girls9.
High prevalence of iron deficiency anemia reflects their poor status of nutrition because of
their rapid growth combined with poor eating habits and menstruation10.
In world health report of World Health Organization (WHO) states that the world wide
morality rate of iron deficiency anemia is 60,404,000 in 2005
10
.In Victoria 1996, the incidence rate of iron deficiency anemia was 1,87,979 cases among
girls11.
In USA, the incidence rate of iron deficiency anemia was 1 in 24 cases or 4.12% or 11.2
million people12.
In Australia the incidence rate of iron deficiency anemia is 2,17,000 girls in 200413.
National Family Health survey in 2006 showed that 56% of girls are anemic in India14.
World health report of World Health Organization states that the mortality rate of iron
deficiency anemia is 13,704,953 cases in India 200515.
The study was conducted on Prevalence of iron deficiency anemia among girls in 16
districts of India in 2006. The survey showed that 90.1% of girls are having iron
deficiency anemia. In this 60.1% of girls were exposed to moderate iron deficiency
anemia and 7.1% of girls were exposed to severe iron deficiency anemia16.
The prevalence of iron deficiency anemia among girls are consistently high. Nowadays
most of the girls are having an intension to maintain a slim structure. So they are eating
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very less quantity of food. An influence of Jung foods and fast foods was reduce the
intake of dietary iron rich foods17.
Changes in the educational system and improvement in the standards of education was
increase the workload of students. This was increase the stress among students. It was
leads to meal skipping and gives a way to develop iron deficiency anemia. Due to iron
deficiency the at girls may get impaired physical work, poor intelligent quotient,
decreased motor and cognitive function. So all girls should know about iron rich foods,
importance of iron intake and functions of iron in Human body18.
If the iron deficiency is prolonged, the functions of heartis also affected gradually, because
of an excessive oxygen demand. It was increase the extra workload of the heart, so it can
produce myocardial infarction and angina in the later years. Complications of iron
deficiency anemia should be prevented strictly, to create a healthy human being19
In order to tackle this public health problem a multi-prolonged 12 x 12 initiative has been
launched by Family and Community Health Department in India. The initiative is targeted
at all adolescents across the country with the aim for achieving hemoglobin level of 12
g/dl by the age of 12 years by 2012. The important elements of the initiative are as
follows:
Capacity building Health and nutrition education
Increasing iron intake Weekly supplementation of iron tablets Parasite control through periodic de-worming Appropriate immunization
This initiative has been launched with the support of Government of India, Indian Council
of Medical Research, World Health Organization, UNICEF, Federation of Obstetrics and
Gynecological Societies of India, Professional bodies and others20.
All the above mentioned information suggests that it is mostly the girls who are affected
with the iron deficiency anemia. In the journey of life the girls has various chances to
experiment with the pleasures of life. In this situation as health professionals it is our
responsibility to provide more awareness on this subject and prevent the coming
generation from indulging in such deficiency. Based on these information the researcher
feels that it is important to prevent the iron deficiency anemia among girls21
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Statement of Problem
A study to assess the incidence and knowledge related to anemia among girl s of selected
college of ludhiana, Punjab with a view to develop information booklet.
Objectives: To assess the knowledge related to anemia among girls . To assess the level of hemoglobin among girls of selected college. To find out the association of the knowledge related to anemia with the selected
demographic variables.
To develop information booklet related to anemia.
Assumptions: Girls do have less Knowledge related to anemia Most of the girls going to colleges are anemic due to less knowledge.
Operational definition:
Knowledge: - it is defined as the information, understanding and skills that onegains through education and experience. In this knowledge refers to the level of
information of girls related to anemia as evaluated through the structure knowledge
questionnaire. Anemia: - Anemia is decrease in the number of red blood cell or hemoglobin
resulting in lower ability for the blood to carry oxygen to body tissues. In the study
anemia refers to the lower levels of hb component as assessed by the estimation of
Hemoglobin.
Delimitations:
Studies limited to nursing students only. Studies limited to selected nursing college of Patiala The study was limited to sample of (60) girls
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CONCEPTUAL FRAMEWORK
A conceptual framework represents a less formal attempt of organizing phenomena than
theories.Conceptual models like theories,deal with abstractions that are assembled by
virtue of their relevance to a common theme.
(Denise f. Polit and Cheryl Beck,2006)
In this study , it is conceptualized that are many factors which influence the knowledge
regarding prevention of anemia.these factors include age, area of permanent residence,
type of residence , type of family, monthly income, source of information .Knowledge was
assessed regarding the prevention of anemia .Knowledge levels are categorized as five
areas like excellent, good, average, below average.
Thus, the investigator was conceptualized the interrelationship between knowledge and
selected demographic variables of subjects
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Chapter II
Review of Literature
A review of literature is an essential aspect of study; it involves the systematic,
identification, location, scrutiny and summary of written materials that contains
information on a research problem. It broadens the view of the investigator regarding theproblem under investigation, help in focusing on the issues specifically concerning the
study. The investigator has made an attempt to explore studies, publications and reports
related to the study21.
The review of literature in this study was carried out under the following headings:
Studies related to incidence and prevalence of anemia Studies related to knowledge of nursing student Studies related to prevention of anemia among girls
Studies related to incidence and prevalence of anemia :
Study was conducted to assess the Prevalence of anemia and determine serum The ferritin
status among 1120 healthy adolescent (12-18 years) girls in a rural school at Chandigarh
in India. The cross sectional study was conducted. The results were 23.9% of adolescent
girls having a high prevalence of iron deficiency anemia22.
The study was conducted on deleterious functional impact of anemia on young adolescent
school girls, Gujarat, India. A standard method was used among 9-14 years of adolescent
girls. The result was the prevalence of iron deficiency was 67%. It is a higher incidence
rate23.
The study was conducted on anemia among adolescent females in the urban area of
Nagpur, Maharashtra in India. A cross sectional survey was
conducted among 296 girls (10-19 years). The results were the prevalence of anemia
among adolescent females was found to be 35.1%. A higher prevalence was found17.
The study was conducted on effectiveness of weekly supplementation of iron to control
the iron deficiency anemia among adolescent girls of Nashik, Maharastra in India. The
cluster sampling technique was followed in each stratum 30 clusters were identified. 10
adolescent girls from each cluster were identified. The prevalence of iron deficiency
anemia came down significantly 54.3% from 65.3%24.
The study was conducted on risk factors for anemia in school children in Tanga region,
Tanzania. A total of 845 school children were randomly selected in a cross sectional
survey conducted. The prevalence of iron deficiency anemia was 79.6%25.
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The study was conducted on prevalence of iron deficiency anemia among adolescent
school girls from Kermanshah, West Iran. A cross sectional study was conducted to
determine the prevalence of Iron deficiency anemia. The result was 47 girls 12.2% with
iron deficiency anemia26.
The study was conducted on excess adiposity and iron deficiency anemia in female
adolescent. The cross section study was conducted to assess the iron status and excess
adiposity, menarche, diet, physical activity and poverty status included in the National
Health and Nutrition examination survey 2003-2004. The results were the heavier weight
girls had an increased prevalence of iron deficiency anemia compare to those with normal
weight27.
The study was conducted on iron deficiency anemia among adolescent girls in
Bangladesh. The sample size was 355 adolescent girls. The result was iron deficiency
anemia has 24.8% of adolescent girls28
.
Choudary et al., (2008) conducted a cross sectional study to assess anemia among
unmarried adolescent girls in South India, 100 adolescent girls, aged from 11 to 18 years
were selected as samples by purposive sampling method. Blood samples were collected
and haemoglobin test was done. The result showed that 29% of adolescent girls were
affected with severe anemia, rest of them had mild anemia 71% (P
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morbidity history, anthropometric measures, mental history, frequency of lemon
consumption with meals, consumption of locally available iron rich foods. The result
showed that 1.3% of girls were severely anemic and 58% of girls were moderately anemic
(P< 0.01) in the study population31.
Sunitha et al., 2009conducted a descriptive study to assess the prevalence of anemia
among adolescent girls in Jhirli. Random sampling technique was used and 105 school
adolescents were selected as samples. Blood samples were collected and analyzed and a
record of one-week dietary recall was maintained. The result showed that 82% of girls
were anemic based on their dietary intake (P= 0.15). The report was concluded that
anemia is an emerging problem among the world population, nearly 2000 million
adolescent girls are suffering from this iron deficiency anemia32.
Suman.k et.al (2008) conducted a cross sectional study to screen out the health pattern of
the adolescent girls in the age group of 10-14 years. A total of 110 healthy adolescents
were taken as samples by random sampling technique. Diet survey and serum
haemoglobin level were assessed. The result showed that less than 10% of the girls had
12gm/dl of haemoglobin and others were anemic with haemoglobin level in the range of 6
to 11.9 gm/dl (p
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Pawashe (2009) conducted a study regarding iron nutritional status of adolescent girls
belonging to an urban slum and rural areas. Overall anemia was observed in 25% of the
girls irrespective of their residence. A higher percentage of rural girls (37.5%) especially
below the age of 12 years showed evidence of anemia. Thereafter, the prevalence was
similar in both urban and rural girls who had not attained menarche. With increasing age,
urban girls who had attained menarche showed an increase in the prevalence of anemia.
The prevalence of iron deficiency (serum ferritin < 12 mcg /dl) showed a progressive
increase from 28% to 60% over 12 years especially in the girls (P= 0.03). Findings
suggested that distribution of iron and folate tablets to correct anemia to the vulnerable
groups is essential36.
Leenstra et al. (2008) conducted a cross sectional study by using multistage random
sampling design with a total of 648 adolescent school girls aged 12-18 years were
randomly selected. The prevalence of anemia (Hb
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compared to boys (p
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rural adolescent girls have mild to moderate anemia. Thus, awareness must be created and
nutritional supplements need to be provided42.
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Chapter III
METHODOLOGY
Research methods are the steps, procedures & strategies for gathering & analyzing the
data in research investigations. The chapter includes:
Research approach
Research design Selection & description of setting Population Delimitations Sample & sampling technique Development & description of the tool Reliability Content validity Pilot study Plan of data analysis Summary
RESEARCH APPROACH:
Descriptive survey approach was used for this study.
Research designA experimental research design was utilized to assess the knowledge regarding anemia
among girls
RESEARCH SETTING:
The study will be conducted in a swift institute of nursing Patiala.
POPULATION:The population of present study compose of an girls student of the
nursing college.
SAMPLING TECHNIQUE:
Purposive sampling technique.
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SAMPLE & SAMPLE SIZE:
The sample size were 60 girls.
INCLUSION CRITERIA:
Age group between 17 to 23 years.
Those who are willing to participate in this study.
Girls who understand , read & write English .
EXCLUSION CRITERIA:
Those who are sick at the time of data collection.
Those who are not present at the time of data collection
DEVELOPMENT AND DESCRIPTION OF TOOL:A questionnaire was developed after the review of literature to design the appropriate tool
for collection of data . Review of literature from books , journals& internet , experts
opinion and investigators own experience in the field area provided foundation for the
construction of the tools . A proposed draft was prepared comprising of (08) questions
related to demographic variables and (31) related to knowledge questions .
The tools was given to 09 experts and deletion , addition , and modification were done
according to experts opinion as follow :Number of item deleted = 2 in demographic variables and 10 in knowledge questionnaire
Number of items added =4 in knowledge questionnaire
Number of items modified= 02
After inclusion of experts opinion, tool consisted of item as follow :
Part 1 : Demographic variables = 08
Part 2: Knowledge questionnaire = 31
Description of tools : To accomplish the objective of the study , a structured questionnaire
was constructed to measure the knowledge respectively. The tool consisted of two parts :
Part 1 : This part consisted (08) item related to demographic data of females related to
their . Age of females , type of residence , type of family , dietery habit , monthly income ,
drug addiction and source of information.
Part 2 : this part consisted of (31) structured multiple choice questions having one correct
answer among the four option to assess the knowledge of females regarding anemia .
The total score is = 31
For correct answer score is =1
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For incorrect answer is= 0
Part 3 : Incidence of anemia through HB Estimation.
METHOD OF DATA COLLECTION:
The 31 structured questionnaires wasused to assess the knowledge regarding the
prevention of anemia among girls in swift institute of nursing Patiala (Punjab) .The datawas collected within two weeks.
Information booklet : information booklet was distribution and division after the
data collection.
ETHICAL CLEARANCE:
Ethical clearance was obtained from the research committee of College of Nursing. The
permission was obtained from Head of the Institution of swift institute of nursing and
consent was obtained from the . girls during the data collection.
VALIDITY OF TOOL:
The content validity was established in consultation with experts from various nursing
field.
PILOT STUDY: The pilot study was conducted in march to see the feasibility and
reliability of the study after obtaining the formal permission from the principal of swiftinstitute of science and technology. Oral consent was obtained from the participants after
explaining the purpose of the study. Females who met inclusion criteria were selected by
using convenient sampling technique. The subject were asked to complete the
questionnaire followed by discussion to identify questions the respondent were likely to
misinterpret . The time taken for the completion of questionnaire varied from 20-30
minutes . The purpose of the study was explained and the confidentiality of theirresponses
was assured . Subject were satisfied with the questionnaire . It was found feasible and
reliability to conduct main study.
PLAN FOR ANALYSIS:
The collected data will be planned and analyzed in the form of descriptive statistics and
inferential statistics. The analyzed data will be presented in the form of tables and figures
by using mean, percentage, standard deviation, X2 test .
Does the study require any investigation or intervention to be collected on patients or
other human or animals? If any please describe briefly.
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SUMMARY:This chapter deal with the research approach, research design , research
setting, target population , sample , sample size, technique , development and description
of tool, criterion measure , content validity , ethical consideration , pilot study , reliability
of the tool, data collection procedure and plan of the data analysis.
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Chapter-IV
ANALYSIS & INTERPRETATION
The chapter deals with analysis and interpretation of
the data collected from 60 girls regarding the knowledge of
anemia. The data thus obtained was analysis and
interpretation in accordance with the objectives by using
descriptive and inferential
In descriptive statistics, mean, mean, mean percentage
and degree of freedom, chi-square test was used for analyzing
the distribution of knowledge and attitude of girls.
OBJECTIVES
1. To assess the knowledge related to anemia among girls.2. To asses the level of hemoglobin among girls of
selected college.
3. To find out the association of the knowledge related to
anemia with the selected demographic variabls.
4. To develop information booklet related to anemia.
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Section A: Distribution of demographic data of girls
Table -1
Frequency and percentage distribution of demographic data of girls.
Demographic data f %
1. Age of girls in year
17-18 year 3 5
19-20year 25 42
21-22year 25 4223 above 7 11
2. Area of the permanent
Residence
Rural 22 37
Urban 32 52
Semi urban 02 03
Semi rural 04 08
3. Type of residence
Hostler 13 13
Day scholar 47 78
4. Type of family
Joint family 15 27
Nuclear family 45 73
Extended 00 00
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5. Dietary habits
Vegetarian 51 85
Non vegetarian 09 15
6. Monthly incomeRs 15000 26 44
7. Drug addictionNone 60 100
Smoking 00 00
Alcohol 00 00
Both alcohol & smoking 00 00
Other drug (if any special) 00 00
8. source of information
Print media 49 81
Multi media 10 17
Family member 00 00
Health care worker 01 02
Table 1: reveal that (42%) of girls were 21-22 year and (42%) 19-20 year
of age followed by (11%) 23 above ,(05%) 17-18 year respectively.
Major no. girls (52%) were permanent residence urban area followed by
(37%) rural area, (08%) semi rural ,(03%) semi urban area .
Major no. of girls (78%) day scholar followed by (13%) hostler.
Major (73%) no. of girls belonged to nuclear family followed by (27%)
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joint family .
Major (85%) no. of girls were vegetarian followed monthaly incone Rs
>15000 and information from print media.by (15%) non vegetarian.
Major (26%) no. girls belonged to monthly income Rs >15000 followed
by (16%) girls from Rs 10000-15000 , (15%) girls from Rs 5001-10000 ,
and (03%) Rs
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Section (b)
Objective 1 :To assess the knowledge regarding anemia among girls.
TABLE 2
Frequency and Percentage distribution of knowledge
regarding anemia among girls
Knowledge score
Level of knowledge score f %
Excellent 7 0 0
Table 1: illustrate that highest number 36(60%) of girls had good knowledge
followed by 12(20% ) excellent knowledge and 12(20%) average knowledge
score regarding anemia .
Thus was deduced that girls had good knowledge regarding anemia.
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Level of knowledge
Fig 2.1: frequency distribution of subjects according to level of knowledge
regarding prevention of anemia.
12
36
12
00
5
10
15
20
25
30
35
40
excellent good average below average
frequency
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Table :3
Overall mean, sd and mean percentage of knowledge score of subjects
regarding assess the knowledge among anemia.
Area Maximum
score
Knowledge score
mean Standard
deviation
Mean
persentage
Knowlegedge
And
incidence
regarding
anemia
among girls
31 19.33 70.9 62.3
Table: 3 reveals that mean knowledge score obtained by subjects is
19.33 ,sd 70.9 which is 62.3 of total score . The shows that the
subjects had average knowledge regarding prevention of anemia
among girls.
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Table :4
Association between knowledge regarding anemia among girls
Demograph
ic
variable
frequency df x2
(calculated
value)
Table
value
Level of
significant
Excelle-nt Good Aver-
age
Age of
year
12 37 10 6 9.13 12.59 Not
significant
Area of
Permanent
residence
14 37 09 6 7.82 12.59 Not
significant
Area of
residence
12 38 10 2 1.73 5.99 Not
significant
Type of
family
12 38 09 2 0.34 5.99 Not
significant
Dietary
habit
17 34 09 2 7.25 5.99 significant
Monthly
income
10 40 10 6 9.9 12.59 Not
significant
Source
Of
information
08 44 08 4 8.98 9.48 Not
significant
Objective 3:
To find out association between knowledge regarding anemia among girls
and selected demographic variables i.e. age of girls area of present residence
, type of family , monthly income , dietary habits , source of information
regarding anemia .
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Table -4 (a)
Association between knowledge regarding anemia with age of girls(in year)
N=60
Knowledge level
Age of Excellent Good Average Total Df x2
Girls(
In year)
f f f
17-18 0 01 2 0319-20 3 18 4 25 06 9.13
21-22 8 14 3 25
Above 23 1 05 1 07
Total 12 38 10 60
= non significant
Table 3(a) delineate that highest (8) girls were with excellent knowledge about
anemia in age group 21-22 year followed by (3) 19-20 year , (1) above 23 year
respectively.
Girls who had good knowledge belong to age group (18) 19-20 year, followed
by (14) 21-22 year, (5) above 23 and(1) 17-18 year respectively.
The average knowledge score was highest (4) 19-20 year followed by (3) 21-
22 year (2) 17-18 year and (1) above 23 year.
The x2 value was found statistically non significant between age of girl (in
year) and knowledge.
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Fig: 4.1 percentage distribution of knowledge acorroding to age of
girls of (in year)
5%
41%
42%
12%
Age of girls
17-18 year 19-20 year 21-20 year 23 year above
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Table 4(b)
Association between knowledge regarding anemia with area of permanent
residence
N=60
Knowledge level
Area of Excellent Good Average Total Df x
permanent
Residence
f f f
Rural 8 09 5 22
Urban 6 22 4 32
Semi urban 0 02 0 02 06 7.82
Semi rural 0 04 0 04
Total 14 37 9 60
= non significant
Table 4(b) delineate that highest (8) girls were with excellent knowledge
about anemia area of permanent residence in rural area followed by (6) in
urban area.
Girls who had good knowledge belong about anemia (22) resides in urban
are followed by (9) in rural are ,(4) semi rural and (2) in semi urban
respectively.
The average knowledge score was highest (5) in rural area and (4) urban
area.
The x2
value was found statistically non significant between area of
permanent residence.
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Fig: 4.2 percentage distribution of knowledge according to area of
permanent
5%
80%
5%10%
Area of permanent residence
Rural Urban Semi urban semi rural
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Table 4 (c)
Association between knowledge regarding anemia with type of family
Knowledge level
Type of Excellent Good Average Total Df x2
family
f f f
Joint 05 07 3 15
Nuclear 07 32 6 45 02 3.4
Total 12 39 9 60
non significant
Table 4(c) explicit that excellent knowledge was highest (7) among girls of nuclear
family followed by (5) joint familyMost of (32) girls have good knowledge were from nuclear family followed by (7)
from joint family
The average knowledge score was highest (45) in nuclear family followed by 15 joint
family.
The association between type of family and knowledge of girl was found non
significant.
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Fig: 4.3percentage distribution of knowledge acorroding to type of
family
25%
75%
0%
Type of family
joint family nuclear family extended
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Table 4 (d)
Association between knowledge regarding anemia with type of residence
Knowledge level
Type of Excellent Good Average Total Df x2
Residence
f f f
Hostler m 01 09 3 13
Day scholar 11 29 7 47 02 1.73
Total 12 38 10 60
non significant
Table 4(d) depicts that highest excellent knowledge is (11) in days scholar and (1) in
hostler.And good knowledge (29) in days scholar. Average knowledge in highest (7) in days
scholar and (3) in hostler.
The x2
value was statistically non significant between type of residence.
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Fig: 4.4 percentage distribution of knowledge acorroding to type of
residence
22%
78%
Type of residence
hostler dayscholer
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Table 4(e)
Association between knowledge regarding anemia with dietary habits
Knowledge level
Diet habit Excellent Good Average Total Df x2
f f f
Vegetarian 15 31 5 51
Non vegetarian 02 03 4 09 02 7.25
Total 17 34 9 60
non significant
Table 4(e) depict that excellent knowledge was highest(15) in vegetarianfollowed by(2) in non vegetarian. Good knowledge is highest (31) in
vegetarian followed by (3) in non vegetarian. Average highest knowledge
(5) in vegetarian followed by (4) in non vegetarian.
The x2
value statistically significant between dietary habit and
knowledge of girls.
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Fig:4.6 percentage distribution of knowledge acorroding to diet habits
85%
15%
Dietary habits
vegetarian non vegitarian
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Table -4(f)
Association between knowledge regarding anemia with monthly income
Knowledge level
Monthly Excellent Good Average Total Df x2
Income
f f f
15000 4 21 1 26
Total 10 40 10 60
non significant
.
Table 4(f) depicts that excellent knowledge was highest (4) among income group
>15000 followed by (3) among income group 5000-10000, (2) income group 10000-
15000
And (1) among income group 15000 followed by (9) income group
5000-10000 , (8) in income group 10000-15000 and (2) in income group 15000.
The x2
value statistically no significant between monthly income and knowledge of
girls
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Fig: 4.7percentage distribution of knowledge according to monthly income
5%
25%
27%
43%
monthly income
Rs15000
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Table -4(g)
Association between knowledge regarding anemia with source of information
Knowledge level
Source of Excellent Good Average Total Df x2
Information
f f f
Print media 5 40 4 49
Multimedia 2 4 4 10
Health care 1 0 0 1
Worker
Total 8 44 8 60
Not significant
Table 4(g) depict that excellent knowledge was highest(5) getting
information regarding anemia from print media followed by (2) from
multimedia and (1) from health care.
Highest good knowledge (40) obtain information from print media
followed by (4) obtain information from multimedia.
Average knowledge obtain by girls is equal from print media and
multimedia.
The x2
value statistically no significant between source of information
and knowledge of girls
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Fig: 4.8 percentage distribution of knowledge according source of
information media
82%
17%
0% 1%
source of information
print media multi media family member health care worker
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Table : 5
Incidence regarding anemia among girls
Objective 4: To determination of frequency and percentage of
anemia among girls.
Hemoglobin level Frequency Percentage
Normal 04 7%
Anemic 32 53%
Moderate 23 38%
Severe 01 2%
Table 2 depict that out of 60 girls 32(53%) were anemic girls
23(38%)has moderate level of hemoglobin 4(7%) girls hav
normal level of hemoglobin and 1(2%)girl has severe level
hemoglobin.
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Fig :5.1Percentage distribution according to incidence of anemia
among girls
0
10
20
30
40
50
60
Normal Anemic Moderate Severe
Percantage
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CHAPTER 5
DISCUSSION, MAJOR FINDING, IMPLICATIONS
RECOMMENDATION
This chapter deal with a brief summary of the study undertaken , including discussion
major finding , implication of the study and recommendation for future research.
Discussion :
A descriptive was used to collect data from 60 subject who studied in swift institute of
nursing to assess their knowledge regarding anemia . The collected data was analyzed
using descriptive and inferential statistics.
In this section , the investigator interpretatively discuses the result of the study in the
discussion ; the researcher ties together all the looses end of the study . The finding of the
present study have been discussed in accordance with the objectives of the research and
literature review.
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LIST OF REFERENCE:
REFERENCES
Wongs , essential of pediatric nursing , 8th
edition published by
Mosby publishers , published in India 2009 , page no
915-917
WHO statistics for iron deficiency anemia 2005 from
www.pubmed.com
BT Basavanthappa , nursing research , published by JAYPEE
BROTHERS , page no 49www.WHO.comDorothy , R.Morlow text book of pediatric , 6
thedition
published by ELESEVIER PUBLISHER , published in
new Delhi in 2007 page no 1133-1136
SundarLal, Text book of Community Medicine, published by
CBS publisher, published in New Delhi 2007, Page No. 115-
130.
Dorothy, R.Morlow Text book of Paediatrics, 6th edition,
published by Elesevier publisher, published in New Delhi
2007, Page No. 1133-1136.
K. Park, Text book of Preventive and Social Medicine, 18th
Edition, published by Bhanot, published in Jabalpur 2007,
Page No. 449-450.
Wongs, Essentials of Paediatric Nursing, 8th Edition published
by Mosby publisher, published in India 2009, Page No.
915-917.
Dr. U.N.Panda, Hand book of Paediatrics, published by CBS
publisher, published in New Delhi, 2007, Page No. 115-130.
http://www.pubmed.com/http://www.pubmed.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.pubmed.com/ -
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IndianAcademy of Paediatrics, Text book of Paediatrics, 4th
Edition, Volume 1, published by Jaypee brothers,
published in New Delhi 2007, Page No. 101-103.
Suraj Gupta, Text book of paediatrics, 11th
edition, published by
Jaypee brothers, published in New Delhi 2009, Page No.
212-214.
Dr. M. Swaminathan, Advanced Text book on Food and
Nutrition,
Volume 1, published by Bappco Publisher, published in
Bangalore2008, Page No. 392-394.
World Health Organization (WHO) statistics for iron
deficiency anemia 2005, fromwww.pubmed.com.
Dr. Huntleys Diagnosis checklist, Health statistics,
www.wrongdiagnosis.com
Centers for disease control and Prevention, Anemia Statistics
(Iron deficiency anemia) MMWR MORB MORTAL
WKLYREP. 2002, Page No. 897-899.
Jeteja G.S. Singh, Prevalence of Anemia among Adolescent
Girls, Journal of Food and Nutrition bulletin 2006,
December Page No. 311-315.
Department of Family and Community Health, National Family
Health Servey-3 (2005-2006), www.indiastat.com.
BT, Basavanthappa, Nursing Research, published by Jaypee
brothers, published in New Delhi 1998, Page No 49.
SabithaBasu, Prevalence of Anemia among AdolescentSchool
going Girls at Chandigarh in India, published in Journal
http://www.pubmed.com/http://www.pubmed.com/http://www.pubmed.com/http://www.pubmed.com/ -
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of Indian Paediatrics, Volume 42, June 17, 2005, Page No.
593-597.
Sen A Deleterious Functional Impact of Anemia among
Adolescent School Girls, published in the Journal of
Indian Paediatrics, Volume 43, March 2006, Page No. 219-
226.
Chaudhry SM, A study of Anemia among Adolescent
Females in the urban area of Nagpur inIndia,published in
the Journal of Community Medicine, Volume 33, October
2008, Page No. 243-245.
Deshmuk P.R, Effectiveness of Weekly Supplementation of
Iron to Control Anemia among Adolescent Girls,
published in the Journal of Health Population and
Nutrition, Volume 26, March 2008, Page No. 74-78.
Tatala SR, Risk Factors for Anemia in School Children in
Tanga region, Tanzania, published in the Tanzan Journal
of Health Volume 10, October 2008, Page No. 189-202.
A. Kramipour R, Prevalence of Iron Deficiency Anemia
among Adolescent School Girls form Kermanshah,
western Iran, published in the Journal of Haematology,
Volume 13, December 2008, Page No. 352-355.
Tussing-Humphreys LM, Excess Adiposity and Iron
Deficiency Anemia in Female Adolescents,published in
the Journal of American Dietary Association, Volume 109,
February 2009, Page No. 297-302.
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Other research
www.pubmed.com
www.wrongdiagnosis.com
www.indiastat.com
www.WHO.com
http://www.pubmed.com/http://www.pubmed.com/http://www.wrongdiagnosis.com/http://www.wrongdiagnosis.com/http://www.indiastat.com/http://www.indiastat.com/http://www.who.com/http://www.who.com/http://www.who.com/http://www.indiastat.com/http://www.wrongdiagnosis.com/http://www.pubmed.com/ -
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Code no: _____
INSTRUCTIONS:-
The information is purely for research purpose. No information will be revealed or disclosed. Encircle in front of the right answer.
SECTIONADemographic Profile
1. Age of girls in years:-a) 17-18yearsb) 19-20yearsc) 21-22yearsd) 23 and above
2. Area of the permanent residence :-a) Ruralb) Urbanc) Semi urband) Semi rural
3. Type of residence:-a) Hostlerb) Day scholer
4. Type of the family :-a) Joint familyb)
Nuclear familyc) Extended family
5. Monthly income of family :-a) Rs < 5000b) Rs 5,001-10,000c) Rs 10,001-15,000d) Rs > 15,000
6. Dietary habits :-a) Vegetarianb) Non-vegetarian
7. Drug addiction :-a) Noneb) Smokingc) Alcohold) Both alcohol and smokinge) Other drug (if any) specify
8. Sources of information regarding anemia :-a) Print Mediab) Multi mediac) Family membersd) Health care worker
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SECTION B
KNOWLEDGE QUESTIONNAIRE
1. Anemia is :-a) Decreased Thrombocyteb) Increased Erythrocytec)
Decreased oxygen carrying capacity of bloodd) Increased Leukocyte
2. Normal level of hemoglobin in females is :-a) 8 - 10 mg/dlb) 1012 mg/dlc) 1214 mg/dld) 1216 mg/dl
3. The average life span of RBC s is :-a) 120 daysb) 140 daysc) 160 daysd) 180 days4. Anemia may effect:-a) Adolescent
b) Older
c) Children
d) All of above
5. Hemoglobin level is measured with the instrument known as :-a) Glucometerb) Thermometerc) Sphygmomanometerd) Hemoglobin meter
6. Sample required for Hb estimation is :-a) Blood sampleb) Urine samplec) Sputum sampled) Skin sample
7. The blood test done for anemia is :-
a) TLCb) DLCc) VDRLd) Hb Estimation
8. Risk factor for anemia is:-
a) Infectionb) Continuous skipping of meal to lose weightc) Low iron dietd) All of above
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9 .The main cause/causes of anemia among adolescent girls are/is :-
a) Excessive bleeding during menstruationb) Over eatingc) Low dietd)
All of above10.Type/types of anemia is /are:-
a) Iron deficiency anemiab) Sickle cell anemiac) Pernicious anemiad) All of above
11.Most common type of anemia which occur in girls is :-
a) Iron deficiency anemiab) Sickle cell anemiac) Pernicious anemiad) Thalassemia
12.Sign and symptoms of anemia are :-a) Headache, dizziness, weakness.b) Nausea, vomiting, diarrhoeac) Skin rashes and edemad) All of above
13.The color of the skin during anemia is :-
a) Whiteb) Blackc) Paled) Pink
14.Shape of nails in severe anemia becomes :-
a) Spoon shaped nailsb) Normalc) Round shapedd) Curved shaped
15.The color of sclera during anemia becomes :-
a) Redb) Whitec) Pinkd) Pale
16.Diet to be added in anemic patient diet is :-
a) High cholesterol dietb) Green leafy vegetablesc) Fast-foodd) Vitamin D
17.The restricted food for anemic patient is/are:-
a) Greenleafy vegetablesb) Fruitsc) Fried and spicy foodd) None of above
18.The source/sources of rich iron diet is/are :-
a)
Beetroot and pomegranateb) Milk and cheese
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c) Wheat and curdd) Milk and groundnuts
19.Anemia can be prevented by :-
a) Fatty and spicy foodb) Iron rich dietc) Calcium rich dietd) Potassium rich diet
20.Vitamin is helpful in reducing the risk of anemia is :-a) Vitamin Ab) Vitamin B12c) Vitamin Cd) Vitamin d
21.The instruction/instructions to be followed during anemia is :-
a) Do not skip mealb) Nutritious dietc) Proper treatment and follow upd) All of above
22.In anemia following is avoided :-
a) Pulsesb) Fruitsc) Vegetablesd) Alcohol and smoking
23. Combination of food to be avoided in anemia is :-
a) Spinach and cheese.b) Peas and potatoesc) Peas and mushroomd) None of above
24.Action to be taken in case of complication of anemia is :-
a) No action to be takenb) Take doctors advicec) Increased the dose of medicined) All of above
25. Complication of anemia is :-
a) Hypovolemic and cardiogenic shockb) deathc) weaknessd)jaundice
26.Supplementary nutrition to be taken to prevent anemia are:-
a.Amoxicillin
b. Calcium tabletsc.Pantoprazoled. Iron and folic acid tablets
27. Supplementary iron therapy includes :
a) Well balanced dietb) Tablets ferrous sulphate 200 mg with 1 mg folic acidc) Calciumd) All of above
28. Iron is best absorbed in the form of :-
a) In ferrous formb) In potassium formc)
In folic acid formd) In calcium form
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29.Folic acid is not absorbed with :-
a) Milkb) Lemon juicec) Waterd) Orange juice
30.The best absorption of folic acid with :-
a) Sugarcane juiceb)
Milkc) Orange juice
d) Water31.The program is started by government of India to control the iron-deficiency
anemia is:-
a)Mid-day meal programb) Iron supplementation programc) Vitamin A prophylaxis programd) Tuberculosis control program
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Answer KeyS.NO ANSWER1. C
2. C3. A
4. D5. D6. A
7. D8. D9. A
10. D11. A12. A13. C14. A15. B16. D17. B18. C19. A20. B21. B22. D
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23. D24. A25. B26. A27. D28. B29. A30.31.32.
ACB
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APPENDIX-l
EXPERT OPINION FOR CONTENT VALIDITY OF THE TOOL
From,
Group-
Post Basic Bsc(N)2nd
year
Guru Hargobind college of nursing,
Raikot,Ludhiana,punjab
To,
Subject: expert opinion for content validity of tool
Respected madam/sir,
We, the member of group-B, student of Post Basic Bsc(N)2nd
year, Guru Hargobind
college of Nursing, Raikot ,Ludhiana,Punjab have undertaken a research study on
the topic:
A study to assess the incidence and knowledge related to anemia among gir ls of
nursing college of ludhiana, Punjab with a view to develop information booklet
Objective of the study are:
1) To assess the knowledge related to anemia among girls .2) To assess the level of hemoglobin among girls of selected college.
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3) To find out the association of the knowledge related to anemia with the selecteddemographic variables.
4) To develop information booklet related to anemia.
We request you to go through our tool and give your valuable suggestion
regarding appropriateness of items in terms of content, language and
accuracy. Kindly grant your expert opinion and suggestion for the same.
Thanking You.
Yours sincerely,
Group-
Post Basic B.Sc.(N)2nd
year
APPENDIX-Vl
LIST OF EXPERTS
1. Head of Administration
Swift Group Of Colleges,
Patiala
2. Principal,Swift Group Of Colleges,
Patiala
3. Vice- Principal,
Swift Group Of Colleges,
Patiala
4. Associate Professor
Community Health Nursing
Swift Group Of Colleges,
Patiala
5. Assisst. Professor
Medical- surgical Nursing
Swift Group Of Colleges,
Patiala
6. Assisst. Professor
Child Health Nursing
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Swift Group Of Colleges,
Patiala
7. Lecturer
Community Health Nursing
Swift Group Of Colleges,
Patiala
8. Lecturer
Midwifery & obstetrical Nursing
Swift Group Of Colleges,
Patiala
9. Lecturer
Child Health nursing
Swift Group Of Colleges,
Patiala
10. Lecturer
Child health Nursing
Swift Group Of Colleges,
Patiala
11. Lecturer
Medical- Surgical Nursing
Swift Group Of Colleges,
Patiala
12. Lecturer
Midwifery & obstetrical Nursing
Swift Group Of Colleges,
Patiala
13. LecturerMedical Surgical Nursing
Swift Group Of Colleges,
Patiala
14. Lecturer
Medical- Surgical Nursing
Swift Group Of Colleges,
Patiala
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15. Lecturer
Mental Health Nursing
Swift Group Of Colleges,
Patiala
APPENDIX-V
LIST OF FORMULAE
Reliability = =xy-xy
{x2-(x)2/N}{ y2-(y)2/N}
Degree of freedom = ( C1 ) =( r1 )
Chi - square =
2
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APPENDIX VII
TO WHOM IT MAY CONCERN
This is to certify that I have edited this thesis by for the partial fulfillment of
requirement for the degree of Post bachelor of science in nursing of Baba Farid
University of health Sciences Faridkot, Punjab.
Topic:A study to assess the incidence and knowledge related to anemia among girls
of nursing college of ludhiana, Punjab with a view to develop information booklet .
Date : .