CHAPTER III
MATERIALS AND
METHODS
CHAPTER III
MATERIALS AND METHODS
NO. CONTENTS PAGE NO.
3.1. .INTRODUCTION 36
3.2. RESEARCH APPROACH 36
3.3. RESEARCH DESIGN 37
3.4. SETTING FOR THE STUDY 37
3.5. POPULATION 37
3.6. SAMPLE 38
3.7. DESCRIPTION OF THE SAMPLE 38
3.8. DURATION OF THE STUDY 38
3.9. EXCLUSION CRITERIA 38
3.10. TOOLS AND TECHNIQUE FOR THE
STUDY 38
3.11. PILOT STUDY 40
3.12. DATA COLLECTION PROCESS 40
3.13. PREPARATION OF THE
INSTRUCTIONAL MODULE 41
3.14. ANALYSIS OF DATA 42
3.15. EPILOGUE 44
3.1. INTRODUCTION
Girls in their teens have many questions and uncertainties regarding their
physical maturation. In many cases personal hygiene is insufficient, resulting from
lack of information and education in the family. The onset of menarche introduces
a new dimension of life to cope with. Competent advice is essential in these habit
forming years to correct misconceptions and lead to proper health care.
Basic knowledge about ones owns body is worthwhile for the
understanding of advisable attitudes in personal hygiene. Educational points
should play their role next to the humanistic value of cyclic bleeding in the female
self- assurance. Education for understanding of menstruation should stress that it
primarily expresses feminity and should avoid depicting menstrual bleeding as a
repetitive nuisance.
In order to accept menstruation as a normal physiological phenomenon the
girls must have ideal knowledge about the significance of menstruation and
development of secondary sexual characteristics, selection of a sanitary menstrual
absorbent and its proper disposal.
By identifying the existing knowledge on menstruation and the problems
faced by the adolescents and conducting an educational programme on
menstruation for the adolescents it is hoped that the knowledge on menstruation
will be improved and the girls will accept menstruation as a normal phenomena.
3.2. RESEARCH APPROACH
The present study is intended to assess the level of knowledge of adolescent
girls regarding menstrual problems and menstrual hygiene.
A quasi experimental approach was adopted. The level of knowledge on
menstrual hygiene and problems of menstruation was assessed by a pretest using a
structured questionnaire and based on that knowledge, an instructional module
was prepared and a class room teaching was conducted by the investigator and its
effectiveness was tested through a post test.
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3.3. RESEARCH DESIGN
The present study is a one group pre test post test design and it has three
steps as detailed in Fig. 3 .1 as a schematic representation of the research design.
3.3.1. First Step - Descriptive
Knowledge on menstrual problems and menstrual hygiene was assessed by
a structured questionnaire. Tolerance of menstrual problems faced by the girls and
menstrual hygiene practices followed by them were also assessed from those who
attained menarche by a second set of structured questionnaire.
3.3.2. Second Step - Quasi-Experimental
An intervention was administered to all the girls_ in the form of an
instructional module in addition to a teaching session. After two weeks, post test
was conducted by a blind rater using the same questionnaire to determine the
effect of the teaching programme.
3.3.3. Third Step - Follow up
After two months a survey was agam conducted in a sub sample, among
20% of the students who attained menarche in the present study to assess the
tolerance of menstrual problems faced by them and to evaluate whether the
students had accepted the minor problems as normal.
The diagramatic representation of one group pre-test post-test design is O1
-X-02
01 Pre-test
X Teaching and instructional module
02 Post-test
3.4. SETTING FOR THE STUDY
The study was conducted at Cotton Hill Girls Higher Secondary School
Trivandrum (Urban) and Girls Higher Secondary School, Malayinkil (Rural).
3.5. POPULATION
The population for the study was adolescent girls from ?1h to 10th standard.
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Fig. 3.1. Schematic Representation of the Research Design
Step 1 Step 2 Step 3
Socio demographic Dependent Variable
variable Tool
Tool
Age, Religion, Post test Awareness regarding
Pretest Interventional Domicile, Education menstrual problems
Programme of students, Education Structured and menstrual
Structured of parents, Income of questionnaire hygiene
questions Classroom teaching - family and
Instructional module Availability of media
Reduction of minor
ailments related to
menstruation and
improvement in
menstrual hygiene
Adolescent girls in Trivandrum
practice
Sample Size 1000
Rural and Urban School
3.6. SAMPLE
The sample constituted of 1000 adolescent girls studying in 7th to 10th
standards. The sample included the students who had and had not attained
menarche. Out of the 1000 students, 693 students had attained menarche.
3.7. DESCRIPTION OF THE SAMPLE
• Students were selected from 7th to 10th standard.
• Those who had attained menarche as well as those who had not
attained menarche were included.
• The sampling technique was multi stage sampling. Two higher
secondary schools for girls in Trivandrum were selected in random
lottery method. The divisions were selected by random method. The
number of students was selected in proportion to the total number of
students.
3.8. DURATION OF THE STUDY
Seven years 2000 - 2007
3.9. EXCLUSION CRITERIA
• Students who were unable to read and write Malayalam.
• Students below 7th and above 1 o standard were not included.
th
3.10. TOOLS AND TECHNIQUE FOR THE STUDY
• Structured question
• Instructional module
• Classroom teaching
The structured questionnaire was developed in 10 sections.
A. Demographic Data
Section I A Demographic data of adolescent girls - 5 questions.
Section I B Demographic data of mother - 4 questions.
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Section IC Demographic data of father - 4 questions.
Section ID - Data related to family status - 5 questions.
Section II Data related to the general history regarding menarche
- 8 questions.
B. Knowledge Score
Section III Data related to adolescence- 4 questions.
Section IVA - Data related to menstruation -15 questions.
Section IV B - ·Data related to the knowledge on physical problems of
menstruation -13 questions.
Section IV C - Data related to the knowledge on psychological
problems of menstruation - 6 questions.
Section IV D - Data related to the knowledge on social problems of
menstruation - 4 questions.
Section IVE - Data related to menstrual hygiene - 6 questions.
C. Tolerance Score
Another set of questions related to the tolerance level of physical and
psycho social problems experienced by the girls and the hygienic practices
adopted by them during menstruation was also prepared for girls who had attained
menarche.
Section I A Data related to the tolerance level of physical problems
experienced by the girls related to menstruation - 20
questions.
Section I B Data related to the tolerance level of psychological
problems of menstruation experienced by the girls - 18
questions.
Sections IC Data related to the tolerance level of social problems
experienced by the girls during menstruation - 8
questions.
D. Menstrual Hygiene Practices
Section II - Data related to the menstrual hygiene practices
adopted by the girls during menstruation - 21
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questions.
An instructional module was prepared and a classroom teaching was
conducted after the pre-test.
3.11. PILOT STUDY
After obtaining permission from the concerned authority, a pilot study was
conducted in 50 adolescent girls from the 8th standard. Duration of the pilot study
was three weeks. The structured questionnaire was scrutinized for its content
validity by subject experts and statistician. After necessary modification, the final
tool consisted of 18 items in the demographic data (section I), 8 general questions
regarding menstrual history (section II), 4 questions regarding adolescence
(section III), 15 questions regarding menstruation (section IVA), 13 questions
regarding physical problems (section IV B), 6 questions regarding psychological
problems (section IVC), 4 questions regarding social problems (section IVD) and
6 questions regarding menstrual hygiene (section IVE).
Another set of questions to assess the tolerance of menstrual problems
faced by the girls and menstrual hygiene practices followed by them was also
used. 20 questions related to the tolerance of physical problems, 18 related to the
tolerance of psychological problems, 8 questions related to the tolerance of social
problems and 21 questions related to menstrual hygiene practices.
3.12. DATA COLLECTION PROCESS
The data collection period was 6 months. The investigator obtained prior
permission from the authorities of Cotton hill girls HSS and Girls HSS
Malayinkizhu. The investigator presented herself in the specified schools and
structured questionnaire was distributed. The students themselves gave their
response.
The students who had attained menarche were given the menstrual problem
tolerance and menstrual hygiene practice identification inventory for their
response along with the questionnaire I. In the 2nd phase after the teaching
programme, the instructional module was distributed to the students. The post-test
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was conducted after two weeks by a blind rater to get the responses from the
students to assess the effect of the teaching programme.
After 2 months the menstrual problem tolerance and menstrual hygiene
practice identification inventory tool was again distributed to a sub sample of the
study group who had attained menarche for their response.
3.13. PREPARATION OF THE INSTRUCTIONAL MODULE
The instructional module for the present study was prepared after assessing
the knowledge level of adolescent girls regarding menstrual problems and
menstrual hygiene
The instructional module was prepared with a view to improve the
knowledge regarding the problems of menstruation and menstrual hygiene. The
information for the module was obtained by extensive literature review and
collection of expert opinion from those qualified in this field. The validity of the
instructional module was confirmed by professionally qualified experts in this
field.
The module covered the following aspects
• Affidavit
• Aims of the instructional module
• Introduction
• Anatomy and Physiology of female reproductive system
• Changes in puberty
• Menstruation
• Facts about menstruation
• Myths about menstruation
• Physiology of menstruation
• Problems associated with menstruation
• Menstrual hygiene.
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3.14. ANALYSIS OF DATA
The collected data were transformed into the master sheet and necessary
coding was done and the following statistical tests were done.
The kinds of average or statistical measures of central tendency were used -
the mode, median and mean.
3.14.1. Standard Deviation
The standard deviation indicates the average amount of deviation of values
from the mean.
SD
x2 (X-X)2
N Number of frequencies
3.14.2. Chi-Square Test
Comparison of demographic data of girls and parents was done by using X2
test. The Chi-Square statistics was applied to contingency of different proportions.
The Chi-Square was computed by comparing two sets of frequencies observed in
the data and expected frequencies. Expected frequencies were calculated on the
basis of observed total frequencies for the rows and columns of a contingency
table (Polit and Hungler, 1999).
x2 � (0-E)
E
0 Observed frequency
E = Expected frequency
It has been proved that if way of the cell frequency in contingency table of
order (2 x 2) is less than 5, the continuity of Chi-square distribution curve is not
maintained. So to remove discrepancy, Yates suggested a correction, which is
extensively used. He suggested to add 0.5 in the frequency which is lesser than 5
and subtract and add 0.5 to the remaining cell frequency in such a way that
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marginal total remains the same. Then calculate the value of X2 by formula. This
=
was applied in this study also.
x2 I [ I o-E I -1121
2
E
3.14.3. Student's 't' Test
In order to compare the scores of two groups Student 't' test was applied.
X1-X2
= Mean of Group I
= Mean of Group II
= Standard Deviation of Group I
S2 Standard Deviation of Group II
n = Sample size
3.14.4. Paired 't' Test
For assessing the effectiveness of intervention the scores before and after
the educational programme was analyzed by applying paired 't' test.
d
crd/--./n
d = Mean of difference between pre test and post test scores
(J d = Standard deviation of differences.
n Sample size
3.14.5. Kruskal-Walli's One Way ANOVA.
The assessment of the difference in knowledge level of the groups was
R one way ANOVA.
compared statistically by using the Kruskal-Walli's
U
j
2·
H = 12
nJ·J - 3(N+l)
N (N+l) Id=l
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3.14.6. Mann ... Whitney U Test
To find out the difference m knowledge between the groups Mann -
Whitney U test -was applied.
U- nl n2
2
nl x n2 (nl+n2+1)
12
= Number of cases in the j1h sample.
N nj = Total number of cases in all the groups taken together.
Rj = Sum of ranks in the j1h sample.
The diagrams and tables were included wherever necessary.
3.14.7. Duncan's Multiple Range Test
This test was performed to on the pre-test scores of the different groups of
girls to see whether any two or more groups of girls obtained a similar range of
scores in situations where there was significant variation in the values.
3.15. EPILOGUE
This chapter dealt with the research methodology under different heading
viz introduction, research approach, research design, setting for the study,
population, sample, description of sample, tool and technique, pilot study, data
collection process, preparation of the instructional module and data analysis. In the
next chapter the observations were discussed with relevance to the conclusions
obtained out of the study.
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