This chapter presents a brief account of present study conclusion which is drawn from the findings. The implication is highlighted in various areas- nursing practice, nursing education, nursing administration and nursing research. And also it clarifies the limitations, suggestions and gives recommendation for future study.
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SUMMARY OF THE STUDY
The objective of the study was to evaluate the effectiveness of Planned Nursing Intervention on management of Pre Menstrual Syndrome (PMS) in terms of intensity of symptoms, knowledge and attitude among college girls in a selected educational institution, Salem”.
Rosenstoch’s Health Belief Model was selected as conceptual frame work for this study. An evaluative approach, pre experimental one group pre test, post-test was used for the study. Non probability purposive sampling technique was used to select the samples and the samples size was 30.
Tools were made from book references, net references and previous experiences of the researcher. Content validity obtained from 5 experts (3 nursing and 2 medical personnel) Reliability of the tool was estimated by split half method for knowledge questionnaire r’= 0.82, Likert’s scale by split half method r’= 0.82, it shows that the tool was reliable.
After which a pilot study was conducted among 3 samples. Following that actual data collection was done with the same tool. On day 1, the researcher screened 100 college girls with screening tool to know no. of them experiencing PMS. It revealed that out of 100, 64 of them had PMS, among them 30 of them were recruited as samples as majority of them had 5 or more than 5 symptoms (3 physical and 1emotional and 1 behavioural symptom). Following that from the recruited samples pre-test was done. Demographic data was collected by self report method and intensity of symptoms was assessed using (0-10) Numerical Rating Scale, knowledge was assessed with structure knowledge questionnaire and attitude of PMS was assessed using the 5 points Likert’s scale. On the same day researcher taught planned nursing intervention on management of PMS for about 20-30 minutes. A pamphlet was given emphasizing on specific measures of PMS management. Along with that a pocket dairy was given to each individual to specify the symptoms and their intensity during PMS for consecutive 3 cycles. On 15th day post-test was carried out using the same tools A concise data analysis was done using descriptive and inferential statistics.
MAJOR FINDINGS OF THE STUDY
I. Demographic Variables:
The analysis shows that 73.33% were in the age group of 21-25 years.
Based on family monthly income 53.3%were under the category of 2001 – 5000 rupees.
Those who attained menarche at the age group of 13-14 were 73.34%
In regards to food habits 76.67% were non vegetarian.
Regarding weight in kg about 73.34% were in the group of 41-60 kilogram
Among samples 56.67% of them reported that their sisters had family h/o PMS.
100% says that they don’t take own medications
During PMS 90%says that they don’t take any home remedies
II. Findings related to Effective Planned Nursing Intervention:
a) Intensity of symptoms:
Majority of symptoms experienced by samples were (Abdominal pain, pimples, tiredness, anger, inadequate sleep, anxiety, irritability, low back pain)Least experienced symptoms were (Diff in concentrating, joint pain, calf muscle pain, breast tenderness, headache, nausea, palpitation, mood swing, withdrawal from environment, food craving, swelling of extremities, fever). Description of each symptom which was experienced by more than 10 samples were discussed as follows
In pre-test abdominal pain was present for 25 samples among that 36.00% had mild pain, 28.00% had moderate pain, 28.00% had severe pain and 8.00% had intolerable pain. In I cycle abdominal pain was present for 23 samples among them 44.44% had mild pain, 44.44% had moderate pain, and 11.12% had severe pain. In II cycle 22 samples had abdominal pain, among them 45.45% had mild pain, 40.90% had moderate pain 13.64% had severe pain. In III cycle 76.19% had mild pain, 14.29% had moderate pain and 9.52% had severe pain.
In pre-test pimples were present for 21 samples among them 50.00% had mild, 35.00% had moderate and 15.00% had severe. In I cycle Pimples were present for 21 samples among them 61.90% had mild, 33.34% had moderate and 4.76% had severe. In II cycle 6.50% had mild, 25.00% had moderate, 5.00% had severe and 5.00% had Intolerable. In III cycle 19 samples had pimples among them 78.95% had mild, 15.78% had moderate and 5.27% had severe.
In pre-test tiredness were present for 20 samples among them 40.00% had mild, 60.00% had moderate. In I cycle tiredness were present for 18 samples among them 50.00% had mild, 50.00% had moderate. In II cycle 18 samples had tiredness in that 66.66% had mild, 33.34% had moderate. In III cycle 15 samples had tiredness in that 73.34% had mild, 26.66% had moderate.
In pre-test anger was present for 15 samples among them 53.33% had mild, 20.00% had moderate and 26.67% had severe anger. In I cycle anger was present for 13 samples among them 69.24% had mild, 23.07% had moderate and 7.69 had severe. In II cycle 11 samples had anger in that 63.34% had mild, 36.36% had moderate. In III cycle 8 samples had anger in that 50.00% had mild, 50.00% had moderate.
In pre-test inadequate sleep was present for 13 samples among them 53.85% had mild, 30.77% had moderate and 15.38% had severe. In I cycle inadequate sleep was present for 11 samples 54.55% had mild, 45.55% had moderate. In II cycle 11 samples had inadequate sleep, among them 54.55% had mild, 45.45% had moderate. In III cycle 100.00% had mild.
In pre-test anxiety was present for 12 samples among them 41.67% had mild, 41.67% had moderate and 16.66% had severe. In I cycle anxiety were present for 11 samples among them 36.66% had mild, 63.64% had moderate. In II cycle 36.66% had mild, 63.64% had moderate. In III cycle 9 samples had anxiety among them 22.22% had mild, 55.56% had moderate and 22.22% had severe.
In pre-test irritability was present for 11 samples among them 45.45% had mild, 36.37% had moderate and 18.18% had severe. In I cycle irritability was present for 12 samples among them 58.33% had mild, 33.33% had moderate and 8.34% had severe. In II cycle 11 samples had irritability in that 54.55% had mild, 45.45% had moderate. In III cycle 9 samples had irritability in that 88.88% had mild, 11.12% had moderate.
In pre-test low back pain was present for 10 samples among them40.00% had mild pain, 10.00% had moderate pain, 30.00% had severe pain and 20.00% had intolerable pain. In I cycle low back pain was present for 10 samples 40.00% had mild pain, 40.00% had moderate pain, and 20.00% had severe pain. In II cycle 10 samples had Low back pain, among them 50.00% had mild pain, 10.00% had Low back pain 40.00% had severe pain. In III cycle 44.44% had mild pain, 11.12% had moderate pain and 44.44% had severe pain.
There were significant differences between the pre-test and the post-test level of intensity. The following symptoms have significant difference from pre-test to I cycle; pre-test to III cycle. Hence the alternate hypothesis H1 was accepted.
b) Knowledge on management of PMS
In pre-test Knowledge scores was 53.34% had inadequate knowledge, 43.33% had moderate knowledge and 3.33% had adequate knowledge. In post-test Knowledge scores was 13.33% had moderate knowledge and 86.67% had adequate knowledge.
The overall mean pre-test knowledge was (50.50% with SD 2.49) and ranged 6-15. The overall mean post-test knowledge was (79.65% with SD 1.93) ranged 12-19.
The paired ‘t’ value was significantly higher than the (9.966> t29=2.045)at p<0.05
c) Attitude on PMS:
In pre-test attitude scores 93.34% had positive attitude, 6.66% had strongly positive attitude. In post-test attitude scores was 50.00% had positive attitude, 50.00% had strongly positive attitude.
The overall mean pre-test attitude (30.15% with SD 5.22) and ranged 1-21. The overall mean post-test attitude was (48.40% with SD 8.16) ranged 6-31.
The paired ‘t’ value was significantly higher than the (5.349 > t29=2.045)at p<0.05
III. Findings related to association between the pre-test knowledge score on management of PMS and their selected demographic variables:
The chi-square value of the pre-test knowledge level and their age at menarche was found to be not significant (I‡2=2.468 < table value 9.49 at p<0.05)
The chi-square value of the pre-test knowledge level and their family history of PMS was found to be not significant (I‡2=3.088< table value 9.49 at p<0.05)
The findings of the study have implication in various areas of nursing practice, nursing education, nursing administration and nursing research.
The study implicates the existing knowledge gap and the obvious felt need for the information on management of PMS among college girls. The findings clearly point out that Planned Nursing Intervention is effective in promoting the knowledge and attitude in management of PMS .So Nurse as a women and competent health professionals have a responsibility to promote the right information among girls and modify the existing attitude, which in directly helps to modify their practice.
Present study proved that Planned Nursing Intervention is effective in promoting knowledge and attitude on management of PMS .The causes, symptoms, management of PMS is already present in the curriculum with that the innovations in management of PMS and various treatment modalities should be included. Nurses should be equipped with up to date knowledge on management of PMS .So that they will be able to promote knowledge to others. This will help to promote positive attitude and change their myths and encourage them to practice in their day-to-day activity.
The administrative area of nursing to become more assertive in the formation and reviewing of their policies and practice related to PMS. Health personnel are playing a vital role in providing education to the adult. To impart knowledge nurses are in need of continuing nursing education programme regarding myths in adapting to the various treatment modalities of PMS. To avoid risk and problems the adults should have a clear idea about management of PMS. Graduate nurses and administrators should take up the initiative in organizing continuing nursing education programme on management of PMS.
The present study revealed that there is knowledge deficit on management of PMS. It emphasizes a great need for research in awareness and effectiveness of Planned Nursing Intervention towards specific management of PMS and to develop practice guide lines.
The same study can be replicated to a large sample to generalize the results.
A study can be conducted with experimental and control group.
A study can be conducted to find effectiveness of specific measures related to management of PMS (Reflexology, dietary modification, regular exercise)
A study can be conducted among teenage school girls to assess the knowledge and attitude on management of PMS.
No reinforcement teaching was given to samples those who had moderate knowledge
The compliance of various interventions was not assessed.
The present study indicated that Planned Nursing Intervention IS more effective in promoting the attitude and knowledge of management of PMS and also in reducing the intensity of the symptoms. PMS management are cost effective, simple and acceptable way to reduce the symptoms. The result shows that more duration of practice of management is needed for a complete resolution of the PMS.
This chapter dealt with summary, implications, recommendations and conclusion.