Download RAJIV GANDHI UNIVERSITY OF SCIENCES

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPIS PROFORMA FOR REGISTRTION OF SUBJECT FOR
DISSERTATION
Smt. ANNAPURNA G
GANTISIDDAPPANAVAR
1st YEAR MSc NURSING
N.D.R.K. COLLEGE OF NURSING
B M ROAD, HASSAN,
KARNATAKA.
N.D.R.K. COLLEGE OF NURSING
B .M .ROAD, HASSAN,
KARNATAKA.
MASTER IN PSYCHIATRIC
NURSING.
1.
NAME AND ADDRESS OF
THE CANDIDATE
2.
NAME OF THE
INSTITUTION
3.
COURSE OF STUDY AND
SUBJECT
4.
DATE OF ADMISSION TO
THE COURSE
31/ 05/2008.
TITLE OF THE TOPIC
“BIO PSYCHO SOCIAL CHANGES
DURING PRE MENSTRUAL
PERIOD.”
5.
5.1 STATEMENT OF THE
PROBLEM
“A STUDY TO ASSESS THE
EFFICACY OF STP REGARDING
KNOWLEDGE OF BIO PSYCHO
SOCIAL CHANGES DURING PRE
MENSTRUAL PERIOD AMONG
ADOLOSCENT GIRLS IN
SELECTED PU COLLEGE AT
HASSAN.”
6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION:
“I maintain that cosmic religious feeling is the strongest and noblest
incitement to scientific research.”
Albert Einstein
A woman has to cope with many problems that start from her early age,
when she experience her first period her menarche itself is a cause of frustration,
anxiety and shock, if she is not aware of this earlier, some girls will develop
inferiority complex, because of physical and social restriction imposed on her,
without proper explanation of the reason that her menstruation is related to her
child bearing capacity rearing and lasting accept her menopause.
One of the important area related to menstrual cycle is premenstrual
syndrome that is related to last part of menstrual cycle started after ovulation,
increased its intensity 5 t o 3 days prior to the menstruation to first day of
menstrual flow is established, all girls has to under go similar hormonal changes
in her life, but some girls distress related to her physical change mood behavior
and changes in social adjustment.
How these changes cripples her life, need to be addressed properly as to
days girls are not house bound only, our changing society need her contribution
from labour work to aronautics , scientist and researcher have conducted many
studies on this problems, this problem signs, symptoms, physical changes and
effect of different drugs effect of several condition and environment.
6.1 NEED FOR THE STUDY:
“Health is a positive state of well-being, people are in a state of emotional,
physical and social well-being , fulfils their responsibilities, function effectively
in daily life and are satisfied with their interpersonal relationships and
themselves.” According to WHO.
The pre menstrual period is one of the crucial period in adolescent girls,
the reported prevalence of about 20-40 % shows that a significant group of
woman may be affected by premenstrual syndrome. Reports of premenstrual
syndrome among adolescents in western countries indicate a prevalence ranging
from 14 to 30 percent. Some of the premenstrual syndrome symptoms like mood
depression feeling of hopelessness lethargy and excessive fatigability may create
serious negative consequences for the adolescents, their families and their social
relationship including low self-esteem, low tolerance to stress and feeling of
inadequacy. The consequences necessitate the adolescents learning to control
their premenstrual symptoms. 1
A study revealed the following symptoms:
 marked depressive mood, feeling of hopelessness or self depreciation
thoughts -77.7%
 difficulty of concentration -65.8%

marked change in appetite ,over eating or specific food craving -82.8 %

affective labiality ,with sadness tearful and increased sensitivity to
rejection 65.8%

hypersomnia or insomnia 59.7%

lethargy, excessive fatigability -91.6%

breast tenderness ,swelling headache ,joint muscular pain and a sensation
of bloating and weight gain 81.9%

the most severe symptoms were fatigue and irritability---73.9% - 2
premenstrual syndrome which can occur 7 -14 days before the onset of
menstruation and subsides with the commencement of menstrual flow, affect
girls during her reproductive age and is associated with physical, psychological
and behavioral changes.
Investigator personally feels that a health education help in terms of
increasing adolescent girls knowledge, regarding premenstrual and menstrual
symptoms, and decreasing the incidence and severity of premenstrual and
menstrual symptoms , gaining knowledge has been regarded as an important
goal towards an improving individuals health status. A lack of knowledge can
contribute to a variety of responses including anxiety and self care deficit. The
STP will increase knowledge and help in coping with such problems and
reducing the symptoms of premenstrual syndrome.
6.2 REVIEW OF LITERATURE
Review of literature is a critical summary on a topic of interest generally
prepared to put a research problem in context to identify gaps and lacunae in
prior studies so as to justify new investigation.
An education program was developed to determine an efficacy in
increasing knowledge and decreasing the severity of symptoms of premenstrual
syndrome, 94 schoolgirls aged between 14 and 18years from four secondary
school in Hong Kong were participated, knowledge scores were measured by
using the premenstrual syndrome knowledge questionnaire, after the education
program experimental group had significantly increased knowledge after three
months following education program, Experimental group girls reported
significant reduction in total premenstrual syndrome score, subscale scores are
measured by a translated version of Abraham’s menstrual symptoms
questionnaire, the result showed there is no significant difference in pre test
between two groups. and in the post test premenstrual syndrome scores were
reduced in experimental group of young adolescent girls- 1.
A study was conducted to evaluate the prevalence of a potential
premenstrual dysporic disorder (PMDD) during menstrual cycle in a general
population of Casablanca, results found that marked depressive mood, feeling
of hopelessness, self depreciation thoughts is 77.7% difficulty of concentration
65% marked change in effective over eating or specific food craving 82.8%
marked affective labiality with sadness tearful and increased sensitivity to
rejection 65.8% hypersomnia or insomnia 59.7% lethargy, excessive fatigability
91.6% physical symptoms including breast tenderness, swelling, headache, joint
or muscular pain and a sensation of bloating weight gain 81.9% the most severe
symptoms were fatigue and irritability according to this literature the disorder is
common and has a bad impact on mental health and on quality of life of the
women -2.
A Comparative study was conducted to assess mood and performance
tasks in 29 normal cycling women, result showed that a significant increase in
dysphoric mood during the luteal phase in women with premenstrual Dyshporic
disorder. compare to their follicular phase. and compared to control women,
Further during the luteal phase. women with PMDD showed impaired
performance on the immediate and delayed word recall task. And delayed digit
recall task and the digit symbol substitution test. compared to control women,
women with PMDD also showed increased desire for food items high in fat
during luteal phase. compared to follicular phase. and women without PMDD.
Women with PMDD consumed more calories during the luteal phase, compared
to follicular phase-3.
A study was conducted to assess the prevalence profile of premenstrual
dysporic disorder in 87 healthy woman aged between 18-30 years were selected
from croatine students. And young university graduates .assessed the severity of
symptoms daily during two cycles according DSM-4.
5 out of
87 women
fulfilled premenstrual dysporic disorder criteria result found that significantly
higher prevalence of co-morbid disorder in their medical history compared to
non-premenstrual disorder group-4.
A study was done for evaluation of behavior changes with a 17 year old
female, result determined that. in premenstrual dysporic disorder the mood
disturbance occur during the late luteal phase of the menstrual cycle,
approximately 1 week before the onset of menstrual bleeding remains after the
onset of menses. The symptoms are more severe than that of premenstrual
syndrome and are associated with significant functional impairment-5
A study was conducted to assess the symptoms experienced during
menstruation. and attitude towards management of menstruation. in this study
120 student nurses from two schools of nursing in Ibdan Nigeria surveyed, result
showed that more participants experienced symptoms during premenstrual
period. than menstrual period. and 93 % had positive attitude towards
menstruation. 20 % consulted medical doctors whenever they experienced
menstrual symptoms. 70% the student used sanitary pad to manage their
menstruation- 6.
A study was conducted to describe the prevalence. Incidence 12 comorbidity factors. and correlates of threshold. and sub threshold premenstrual
dysporic disorder in the community of young women, results were found that.
baseline 12 month prevalence of DSM—4 Premenstrual dysporic disorder was
5.8 % concurrent major depression and dysthymia decreased slightly. An
additional 18.6 % were ‘near-threshold’ cases.
cumulative life time incidence
was 7.4%. PMDD syndrome was stable across 48 months with < 10% complete
remissions among baseline premenstrual dysporic disorder cases. the 12 month
life time co morbidity rates were high (anxiety disorders 47.4% mood disorders
20% somatoform 28.4%), 26.5% had no other mental disorder- 7.
A comparative study was conducted to evaluate the efficacy of a luteal
phase medication dosing, symptom data from the daily record of severity of
problems (DRSP) during first few days of menses. Results showed during the
luteal phase demonstrate reduction in DRSP total scores into the first few days of
menses regard less of whether active treatment was continuous throughout the
menstrual cycle or was discontinued at the onset of menses- 8.
A study was conducted to assess the experience of menstruation among
normal women. This study showed the importance of reducing bias in self
reports of menstrual symptoms, and illustrates the lag between hormonal
charges in the luteal phase and the peak of symptom severity at onset of menses.
Further research is needed to determine the nature and extent to which women
with a premenstrual disorders- 9.
A study was conducted to examine the association between psychosocial
stress and symptom severity, Stress mood physical symptoms.
Result showed
that there is no association between the severity of symptom. and the cumulative
daily stress reported during each cycle- 10.
6.3 OBJECTIVES OF THE STUDY :
1. To assess the knowledge of biopsychosocial changes during premenstrual
period among adolescent girls through pre-test and post test.
2. To find the efficacy of STP regarding knowledge of biopsychosocial
changes during premenstrual period among adolescent girls.
3. To find the association between socio demographic variables and
knowledge of biopsychosocial changes during premenstrual period
Among adolescents girls.
6.4 HYPOTHESIS
H0- Adolescent girls will not have any significant difference in the
knowledge of biopsychosocial changes during premenstrual period among
adolescent girls.
H1– The STP will significantly increases the knowledge of biopsychosocial
changes during premenstrual period among adolescent girls.
H2-There will be significant relationship between knowledge and socio
demographic variables.
6.5 OPERATIONAL DEFINITIONS :
1) Efficacy :
:In this study it refers to assess the
impact of STPregarding theknowledge
of bio psychosocial changes in
adolescent girls during premenstrual
period.
2) Structure teaching program
: It is a teaching method will develop by
theresearcher regarding biopsychosocial
changes during premenstrual period
Among adolescent girls.
3) knowledge :
:It refers to correct answers to the
knowledge items regarding
biopsychosocial changes during
premenstrual period among adolescent
girls.
4) Bio Psycho social changes
: Biopsychosocial changes that are seen
and experienced by a girl, Bio (with
reference to body)Psycho(with reference
to mind) Social (with reference to social
activities) changes.
5) Pre Menstrual Changes
:
Pre menstrual changes include
changes occur during pre menstrual
phase five days before and one day
after the onset of menstrual flow.
6 ) Adolescent Girls:
: The girls who are in the age between12 to 18
years.
6.6 ASSUMPTIONS
1) Adolescent girls will have little knowledge about biopsychosocial changes
during premenstrual period.
2) Structure technique teaching program will measure level of knowledge
regarding bio psycho social changes level of knowledge regarding
biopsychosocial changes during premenstrual period.
3) Socio demographical variable will have relationship with knowledge.
6.7 Delimitations of the study :
 The study period will be limited to 4 to 6 weeks.
 Sample size will be limited to 50 students.
 The study will be limited only to the adolescent girls studying in Pre
University College at Hassan.

Study design is limited to single group pretest post test design.
6.8 SIGNIFICANCE OF STUDY
The study signifies the importance of STP regarding biopsychosocial changes
during Premenstrual period, will enhance the knowledge of adolescent girls
related biopsychosocial changes and helps in increasing coping strategies and
preventing biological psychological social problems related to premenstrual
period.
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA :-
:data will be collected from
adolescent girls studying in
selected Pre University Cllege at
Hassan.
7.1.1 Research Design :
:Pre experimental design.
7.1.2 Conceptual frame work:
: General system theory.
7.3 METHOD OF COLLECTION OF DATA
Part – A - Socio demographic profile.
Part – B – Data regarding Bio Psychosocial changes during premenstrual period
will be collected from adolescent girls, though structured questionnaire by
multiple choice questions.
7.3.1 SAMPLING PROCEDURE
Population: Population consists of all the adolescent girls studying Pre
University College, at Hassan
Sample: The adolescent girls studying in Pre University College and who are
fulfilling the inclusion criteria
7.3.2 Criteria for selection of samples :
1. Inclusion criteria for sampling:
 Girls who will be present during data collection.
 Girls who are studying in PUC college.
 The age between 16 – 18 years.
 Those who are willing to participate.
2. Exclusion criteria for sampling:
 Those who are not willing to participating the study.
 Those who are having some health problems during the study.
 Those who are not available at the time of study.
Those who are not attained menarche.
Sample size: 50 adolescent girls studying in Pre University College
Sampling technique: Non probability convenient sampling technique.
Setting: The study will be conducted in selected Pre university College at
Hassan.
7.3.3 PILOT STUDY: Pilot study will be planned for 10% the sample to find
out the convenience and practical difficulties of the study.
7.3.4 VARIABLES:Independent Variable
: STP regarding bio psychosocial changes
during pre manestrul period among adolescent
girls
Dependent variable
: knowledge of the adolescent girls regarding
Bio psycho social changes.
7.3.5 PLAN FOR DATA ANALASYS :
Data will be analyzed by using appropriate statistical measures.
7.4 Does the study require any investigation or interventions to be
conducted on patients or other humans or animals? If so please describe
briefly
Yes.
STP is used as an intervention on adolescent girls of selected Pre University
College at Hassan
7.4.1 Has ethical clearance been obtained from you institution ?
Yes.
8. LIST OF REFERENCES
1) Janita P C, Chau and Anne. M , “effect of an educational programme on
adolescent with pre menstrual syndrome”, Journal of Adolescent Health,
Volume 18, Issue 4, April 2007. Pages 286,291.
2) Silber T J ,Valadez-Meltzer A, “Premenstrual dysphoric disorder in
adolescents case reports of treatment with fluoxetine and review of the
literature”. J Adolescent Health 2005 Dec;37(6):518-25.
3) Reed S C hevin F R Evans S M. “Changes in Mood Cognitive performance
and appetite in the late luteal and follicular phase of menstrual cycle in
women with and without PMDD”, in New York State Psychiatric
Institute and Department of Psychiatry in Columbio University in USA.
2007.
4) Rojnic Kuzmun M Hotujac L. “Premenstrual disporic disorder – a
neglected diagnosis?” Preliminary study on a sample of croatine student
in University Hospital centre Zagreb Coll Antropol.2007 Mar;31(1):131-7.
5) NUR M.M Romano M.E Siqueiru L.M. “Premenstrual dysphoric disorder
in an adolescent female”, J pediatr Adolesc Gynecol. 2007Jun;20(3):201-4.
6) Moronkola OA, Uzuegbu VU. “Menstruation symptoms management and
attitude of female Nursing student” in Ibdan NigiriaAfr J Repord
Health.2006 Dec;10(3):84-9
7) Wittchen H U Becker E Lied R “prevalence Incidence and stability of
premenstrual dysphoric disorder in the community” as per Article
psychological medicine. 32(1):119-132, January 2002
8) Yonkers K.A Pearlstein T, Fayyad R, “Luteal Phase treatment of
Premenstrual dysporic disorder improves symptoms that continue into
post menstrual phase”. Affect Disord.2005 Apr;85(3):317-21.
9) Meaden P M Hartlage Cook – Karr J. “Timing and severity of Symptoms
associated with the menstrual cycle in a community based sample” in the
Midwestern United states. Department of Psychiatry Rush University
Medical Centre in Chikago USA. Psychiatry Res.2005Mar 30;134(1):27-36.
9
10) Lorrine Beck PHD Richard Gevirtz PHD and Joseph F “the predictive Role
of Psycho social stress on symptoms severity in premenstrual syndrome”
as per Article Psychological Medicine 29(5):1043-1053 ,September 1999.
Signature of candidate
10
Remarks of the guide
11
Name & Designation of
(in block letters)
11.1 Guide
11.2 Signature
11.3 Co-Guide (if any)
11.4 Signature
11.5 Head of Department
11.6 Signature
12
12.1 Remarks of the chairman & Principal
12.2 Signature