RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
A COMPARATIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING DIETARY PRACTICESOF ANAEMIC AND NON ANAEMIC ADOLESCENT GIRLS WITH A VIEW TO DEVELOP SELF INSTRUCTIONAL MODULE ON MANAGEMENT OF ANAEMIA IN ST.ANNYS HIGHER SECONDARY SCHOOL AT KOLAR DISTRICT, KARNATAKA
ASWANI BOSE
M.S.C(N) FIRST YEAR
AE & CS PAVAN COLLEGE OF NURSING
KOLAR, KARNATAKA
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Rajiv Gandhi University of Health Science, Bangalore, Karnataka
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE / ASWANI BOSE2. / NAME OF THE INSTITUTION / AE & CS COLLEGE OF NURSING
KOLAR(DIST) KARNATAKA
3. / COURSE OF THE STUDY AND SUBJECT / M.S.C NURSING
1ST YEAR
[ MEDICAL SURGERICAL NURSING]
4 / DATE OF ADMISSION / 25-10-2010
5. / TITLE OF THE TOPIC / A COMPARITIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING DIETARY PRACTICE OF ANAEMIC AND NON ANAEMIC ADILESCENT GIRLS WITH AVIEW TO DEVELOP SELF INSTRUCTIONAL MODULE ON MANAGEMENT OF ANAEMIA IN ST.ANNYS HIGHER SECONDARY SCHOOL AT KOLAR DIST.KARNATAKA.
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6. BREIF RESUME OF THE INTENTED WORK
6.1 INTRODUCTION
“Some food is medicine,
Some food is poison,
Some food is Tension,
Some food is Fear,
Some food is Lovely,
Some food is Bland,
Some food is Sweaty,
Some food is Spicy,
Some food is nothing,
Food is not only food.....
A good eatable medicine.....
At only some food..... some food.”
Otteri Selvakumar
The knowledge of human nutrition no longer entails merely prevention of deficiency disease like plague beriberi or severe anaemia etc. Nutrition now plays a major role in the prevention and management of many diseases. Indeed even more than this discovery of antibiotics one of the most important advances in modern medicine is the better understanding of basic requirements of fluids and electrolytes. This help in the management of serious medicine eases and is very vital in the successful outcome of the Surgery1.
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Qualitative studies conducted on women’s illness and health seeking behaviour in diverse socio-economical setting across in report weakness as one of the most common symptoms of ill health that they experience , and weakness (often attributed to poor diet and poverty by the women) is often rated at the top of illness that cause concern.
“Anaemia is a efficiency in the number of erythrocytes (RBC). The quantity of haemoglobin, and or in the volume of packed RBCs.” It is a prevalent condition with many disease causes such as blood less, impaired production of erythrocytes or increased distribution of erythrocytes disorder can lead to tissue hypoxia accidents for many of the sign s and symptoms of anaemia. Anaemia is not a not a specific disease, it is a manipulation of pathologic process. Anaemia is identified by a through history and physical examination and then classified by laboratory review of the complete blood count (CBC) reticulate count and peripheral blood smear once anaemia is identified further investigation is done to determine the cause2.
Anaemia can result from primary hematologic problem or can develop as a secondary consequence of defects in other body system. The various types of anaemia can be grouped according to either a morphologic (cellular characteristics) or an etiologic classification. Morphologic classification is based descriptive, objective laboratory information about erythrocyte size colour. Etiologic classification is related to the clinical condition causing the anaemia such as erythrocyte production blood loss or increased erythrocytes distribution. Although the morphologic system is the most accurate means of classify anaemia. It is easier to discuss patient care by focusing on the aetiology of the anaemia. Iron deficiency anaemia is one of the most common chronic hematologic disorders is found in up to 3%of the world’s population. In the United States it comes in about 5%-10% of people ore 45%. The most
susceptible to iron deficiency anaemia are the very young. Those on poor clients and women in their reproductive years3.
The complications of anaemia mild including these that occur as a result chronic disease nevertheless even mild anaemia can reduce oxygen transport in blood. Moderate and severe iron deficiency anaemia is known to reduce endurance. Complication of severe and prolonged anaemia leads to secondary organ dysfunction or damage including heart arrhythmias and congestive heart failure4.
Good nutrition is essential for good health and important for physical growth and development, good body composition and mental development peoples nutritional state can protect them or predispose them towards chronic disease. Medical treatment for many diseases includes diet therapy nutrition is thus both a preventive and therapeutic scienceN . nutrition is the science of food and its relation to people. The human body evolved for adapting to a wide variety of diets. Although survival is possible on an inferior diet, optimal health is not. Nutrition is vital to optimal health care team to promote health and treat many diseases5.
Nutrition is the science of food and its relationship to health. Nutrition plays an important role in the promotion and maintenance of health and prevention of human disease. Especially the nutrition deficiency disease, like malnutrition and anaemia.
Iron deficiency is the most common nutritional disorder, which affects about 20% of the world population. This disorder is not limited to developing countries, and is the main cause of anaemia in the USA. Iron deficiency is a systematic condition, which has many non- haematological consequences, compares physical endurance, work capacity, infant growth and development, and depresses immune function. Anaemia among adolescent girls and pregnant women continue to be a major problem in the state despite the state good net indicators6.
6.2 Need For Study
It is reported that 2170 million people are affected by nutritional anaemia out of these 90%, live in developing countries. Among these developing countries South East Asia has the highest prevalence of anaemia. The prevalent of iron deficiency anaemia high in women of reproductive age, 47% across developing countries and it worse to 57% during pregnancy. The prevalence of anaemia among rural adolescent to both sex was 42%.
In 2002 World Health Organisation global estimates of anaemia prevalent averaged 56%with a range of 55-75% depending on geographic location world health organisation 2002 (utto 1992) Prevalence of anaemia in south Asia is among the highest is the world overall high rates of malnutrition7.
This research brief explores and evaluates communication strategies developed to address India’s high prevalence of iron-deficiency anaemia among women, between 60%&70% of Indian adolescent girls are anaemic, a condition that can result in adverse pregnancy outcome or even material death , as well reduced work productivity and impaired physical capabilities.8
In this context, the institute of health management parched (IHMP),in collaboration with the international centre for research on women (ICRW), conducted a 3-year community intervention trial in Maharashtra, India among unmarried adolescent girls aged 10-19. Baseline data indicated that anaemia is significantly more likely among girls who eats two or fewer meals in a day have been side in the past year, and consume few iron-rich foods. Thus the invention focused on changed dietary behaviour.
The future of adolescent girls in the country seems dismal with a vicious cycle of underweight adolescence, child marriage and mental mortality. More than half of them are anaemic and 43% are married of before the age of 18. India also displays very glancing gender disparities. While 30% of boys between the age of 15 and 19 years are anaemic, 56% girls in the same age group suffer from the condition. This is of concern as anaemic girls is being undernourished are the first to drop out of school and are married off early.Economic inequities also distinguish the 300 million adolescent in India from their counter parts the world over.9
A community based cross sectional study was conducted to determine the prevalence of anaemia among unmarried, adolescent south Indian girls in an urban slum setting. A total of 100 apparently healthy girls between the ages of 11& 18 years . This socio economic dietary and anthropometric information was collected, and blood haemoglobin (H b) was estimated. The prevalence of anaemia (H b<129%) was 29%. Most had mild anaemia, severe anaemia was not seen. Two-thirds of those with anaemia and low socio economic status, religion and reporting infrequent or non consumption of meat. Only meat consumption is related to haemoglobin by multiple regression analysis. Anaemia is a common problem among adolescent girls in this setting, through severe anaemia is rare. There is a need to improve their haemoglobin status through dietary modification along with preventive supplementation and nutrition education.10
In Karnataka, the haemoglobin level was tested for 94% of the women compared with 88% in India as a wide. Overall 45% of women had some degree of anaemia 27% of women were mildly anaemia 13% were more moderately anaemia and 2% have severely anaemic. In prevalence is high in adolescent girls from rural women and illiterate scheduled caste or tribe.11
Dr.DS Ranu was conducted study in prevalence of anaemia in the school going children’s age group(12-18years) at kolar.it showed that over all prevalence of anaemia was25.9%.Girls significantly higher prevalence of anaemia than boys. The prevalence of anaemia in vegetarian group of 50% and it is in 25.4% in the mixed group. Anaemia was seen in14% of males and 39.2%in females.
Several studies have shown that iron deficiency causes changes in behaviour and lowers development test scores, these include changes in brain content and distribution, and in neurotransmitter function. Body in stores, such as central nervous system iron, decrease before RBC production affected by iron deficiency. Changes in cognition and behaviour may be independent of haemoglobin concentration. Decreased brain iron stores may impair the activity of iron-dependent enzymes necessary for the synthetic function, and degradation of neurotransmitter such as dopamine, section and adrenaline. Adolescent girls and young women are still at high risk at developing is deficiency because of increased iron demand during puberty, mental losses, and invited dietary iron intake. Prevalence estimates of iron deficiency in adolescent girls range friend 9% to 40%, depending on the population studied and the criteria used to define iron deficiency.
6.3Review of Literature
A review of literature is an essential aspect of scientific research. It involves the systematic identification, location , scrutinizing and summary of the written material that contains information on research .12
Problem,
The researcher present there review under the following headings,
è Studies related to anaemia among adolescent girls
è Studies related to dietary practices of anaemia among adolescent girls
è Studies related a view to develop SIM on management of anaemia.
Literature related to Anaemia Among Adolescent Girls
Objectives to determine the prevalence of anaemia in a group of apparently healthy school adolescent selected from two distinct socio economic areas in Baghdad and to assess the importance of diet and some other factors which could be relevant in the epidemiology anaemia in adolescents.
A random study was carried out to study socio economic status correlates of anaemia among adolescent girls in rural wardha. A random sample size was 1051 adolescent more included in the present studies 46% of them were from a mansoor are of high socio economic area and 54% of them were from a hoary area for low socio economic area in Baghdad, Iraq. The primary school in the study were predesigned questionnaires .The data were analysed & interpreted by univeriable analysis. Collection of data was carried out during the period between November 1996 until the end of April 1997. Haemoglobin concentration & packed cell volume level were determined Dietary intake of iron , calcium, protein & were estimated. The result revealed that anaemia among adolescent girls was 12.9% compare with 17.6% in LESA. The conclusion of the study showed that the anaemia prevalence is high in low socio economic status.13
A descriptive study was carried out to assess prevalence of iron deficiencies anaemia and morbidity profile on school going adolescent girls aged 10-15 years in Katmandu Sample was randomly selected after taking consent from their percents. A structural questionnaire was developed and pretested on adolescent girls. The data were analysed using programme of the statistical package for social science (PC+) and mainly mean percentage
chi-square and F-test were computed and interpreted. Results revealed that 60% subject were anaemic out of which 57% were less anaemic and 3% were moderately anaemic. The study concluded that the anaemia prevalence is high in school going adolescent girls.14
A descriptive study was carried out during the period between Nov 1996 until April 1997. Healthy school made & female adolescent students were taken from 2 distinct socio economic areas in AL tearkh region Baghdad. HSEA AL mansoor the sample size is 1051 adjacent and the sampling are selected using multistage stratified random sampling method. Each boy and girl was directly prepare by fitted up for and separately. A questionnaire form will be prepared & filled up for each student. The data was entered and analysed in univariable are multivariable statistical method. The result reveals that a total of 1051 adolescents were included in the present still 487 adolescent (45%) were from (HSEA) & 564 adolescent girls from (54%).s taht concluded dyuts ehT ample 451 males & 600 females more the highest population of anaemic females from LSEA compare to HSEA.15
A cross sectional study was carried out to assess the prevalence of anaemia, conducted from Aug 2002 to Nov 2002. The sample size is 1180 students from three school between age group 12-18 years. A sample more collected for estimated of haemoglobin cygnet haemoglobin method. The data were collected from students by a questionnaire form. A stratified random sample of 2860adolescent girls aged 12-19 years from schools and Vadodara, District were selected. The sample consist of rural urban, tribal girls the sample size indicated 2635 girls. Intervention trial was adopted as the same population.
Both biochemical & virtual enquiry was employed to collect the data .Haemoglobin estimation was done by ABACUS cell counter and serum fertin was assessed using immolate. The statistical data were calculated to mean media & percentages were calculated. The result reveals that anaemia prevalence was record as 53.2% as compared to baseline anaemia prevalence of anaemia. The study concluded that the anaemia prevalence among adolescent girls in India. 16