INTRODUCTION:

Urinary incontinence, loss of bladder control, is a common and often embarrassing problem which may have a profound impact on quality of life. The severity of urinary incontinence ranges from occasionally leaking urine when coughing or sneezing to having an urge to urinate that is so sudden strong.

Women in their premenopausal period may find pelvic muscles are simply weaker than they were before. These muscles may not have enough strength to hold the sphincters close and may cause unwanted leakage of urine.

Pelvic floor exercises often also called Kegel exercises after their originator, Dr. Arnold Kegel are widely promoted as the starting point for building pelvic floor strength. Research has shown that with regular exercise, it is possible for women to reduce or completely overcome the symptoms of weak pelvic floor muscle. A regime of pelvic floor exercises, introduced earlier in life, will also prevent many of the problems associated with weak pelvic floor muscles emerging later. Estimates of prevalence of urinary incontinence in women vary between 10% – 40% in most studies. Data from what is probably the largest cross–sectional study of urinary incontinence in women suggest a gradual increase in prevalence with age to an early peak. Prevalence around midlife followed by a slight decline or stabilization until about 70 years of age when prevalence begins to rise steadily. However, the prospects of education yield better results when greater emphasis is laid on aspects of prevention.

MATERIALS AND METHODS:

Research Approach and Design:

In this present study quantitative approach and Quasi experimental design was adopted.

Sample and Setting of the Study:

40 premenopausal women who were admitted in female medical and surgical wards and maternity (general and private) wards of St. Martha’s Hospital, Bangalore.

Development of Instrument:

Self structured Questionnaire were used for data collection. The tool was developed after thorough Review of literature, Discussion with guide, Discussion and consultation with experts in the field of nursing and medicine.

Description, Scoring and Interpretation of the Instrument:

Part 1: It consists of Demographic variables and Clinical variables

a) Demographic Variable: Includes thedata of patients such as code number, age (in years), education, occupation, level of activity, place of residence and marital status.

b) Clinical Variables: Includes body mass index, parity, type of delivery, co-morbidities, history of abdomino-pelvic surgeries, medication history, history of smoking, excessive alcohol or caffeine intake and history of urinary incontinence.

Scoring and interpretation of demographic and clinical variables were done by frequency and percentage of subjects.

Part 2: It consists of

A Structured Questionnaire:

It includes 30 close ended multiple-choice questions on pelvis floor muscle exercise. Each item has four options in which three are distracters and one is the right answer. Each correct answer was scored as ‘1’ and wrong answer was scored as ‘0’. The pre-test and post-test scores are also interpreted by frequency and percentage. The comparison of both pre-test and post-test scores by student ‘t’ test and association of by Chi square test.

Part 3: It consists of Video Assisted Teaching Programme on Pelvic Floor Muscle Exercises.

Validation of Tool:

The constructed tool was given to 5 experts from the field of medicine and nursing to ascertain the content validity. Suggestions and recommendations were accepted and necessary corrections were made in the tool and it was finalized for the study.

Data Collection Procedure and Analysis:

Prior to data collection the formal administrative permission was obtained to conduct the study from the Principal College of Nursing, Nursing Superintendent of St. Martha’s hospital and respective ward in charges. A brief introduction of the study and its objectives were given following which written consent was obtained from the study subjects. The subjects were selected based on inclusion criteria and data was collected using the structured interview schedulefollowing which a Video Assisted Teaching Programme on Pelvic Floor Muscle Exercises was conducted. The participants’ knowledge was reassessed the next day by administering the same tool. The demographic and clinical variables were explained using frequency and percentage. The pretest and posttest knowledge scores were compared using student ‘t’ test. The association between the pretest knowledge score and selected demographic and clinical variables were assessed using Chi-square.

RESULTS:

Table 1: Frequency and Percentage Distribution of Demographic Variables. (N=40)

Demographic Variables	Frequency	Percentage
1. Age
a) 20-30 years	21	52.5
b) 31-40 years	8	20
c) 41-50 years	11	27.5
2. Educational status
a) Illiterate	4	10
b) Primary schooling	9	22.5
c) Secondary schooling	6	15
d) High schooling	8	20
e) Graduate/post graduate	13	32.5
3. Occupation
a) Unemployed	3	7.5
b) Unskilled	1	2.5
c) Skilled	2	5
d) Housewife	26	65
e) Professional	8	20
4. level of activity
a) Sedentary	7	17.5
b) Moderate	26	65
c) Heavy	7	17.5
5. Place of residence
a) Rural	5	12.5
b) Urban	35	87.5
6. Marital Status
a) Single	4	10
b) Married	36	90
c) Widowed/Divorced/ Separated	0	0

Table 2: Frequency and Percentage Distribution of Clinical Variables. (N=40)

Clinical Variables	Frequency	Percentage
1. Parity
a) Primipara	7	17.5
b) Multipara	26	65
c) Nullipara/Not Applicable	7	17.5
2. Type of delivery
a) Vaginal delivery	21	52.5
b) Caesarian Section	11	27.5
c) Not Applicable	8	20
3. Co-morbidities
a) Diabetes mellitus	8	21.95
b) Urinary Tract infection	2	4.87
c) Constipation / Hemorrhoids	1	2.43
d) Genitourinary prolapse	0	0
e) Genito urinary diseases	2	4.87
f) Neurological conditions	0	0
g) Hyperthyroidism	0	0
h) Gynecological diseases	4	9.76
i) Psychiatric conditions	0	0
j) Chronic cough	1	2.43
k) Intra-abdominal tumors	0	0
4. Abdomino pelvic surgery
a) Yes	16	39.03
b) No	24	60.97
5. History of smoking
a) Yes	0	0
b) No	40	100
6. History of alcohol intake
a) Yes	0	0
b) No	40	100
7. History of excessive caffeine intake
a) Yes	0	0
b) No	40	100
8. Sexual function
a) Satisfactory	34	85.36
b) Not satisfactory	0	0
c) Not applicable	6	14.64
9. History of urinary incontinence
a) Yes	19	47.5
b) No	21	52.5

Figure 1: Distribution of Knowledge scores of premenopausal women on pelvic floor muscle exercises

Table 3: Association between demographic variable and knowledge scores: (N=40)

Demographic Variables	Above median	Below median	Chi-Square	t Value	Inference
1. Parity
d) Primipara	13	8	0.686	7.82	No Association
e) Multipara	3	5
f) Nullipara/Not Applicable	5	6
2. Educational status
a) Illiterate	1	3	6.94	11.87	No Association
b) Primary schooling	1	8
c) Secondary schooling	4	2
d) High schooling	6	2
e) Graduate/post graduate	9	4
3. Place of residence
a) Rural	3	2	0.127	5.41	No Association
b) Urban	18	17	0.127	5.41	No Association

Table 4: Association between Clinical variable and knowledge scores: (N=40)

Clinical Variables	Above median	Below median	Chi-Square	T Value	Inference
1. Age
a) 20-30 years	2	5	1.181	7.28	No Association
b) 31-40 years	14	12
c) 41-50 years	5	2
2. Type of delivery
a) Vaginal delivery	10	12	0.195	7.82	No Association
b) Caesarian Section	6	5
c) Not Applicable	5	3

SUMMARY:

Out of 40 Premenopausal women;

· Majority of them 52.5% belong to the age group between 20-30 years and a minimum number of participants 20% belong to age group of 31-40 years and 27.5% belong 41-50 years respectively.

· Less than half of them 32.5% were graduates, 20% of participants have done high school education, 22.5% of participants have completed primary schooling.

· More than half of them 65% were multiparous and 17.5% were primigravida.

· The mean of pretest was 13.02 with standard deviation of 4.02 whereas the post test mean score was 19.22 with the standard deviation of 3.62.

CONCLUSION:

The present study concluded there is an improvement in the knowledge level after the administration of Video Assisted teaching programme on pelvic floor muscle exercises and the study also revealed there is no association between the knowledge scores and the selected demographic variables (age, educational status and place of residence) and clinical variables (parity, type of delivery and urinary incontinence).

ACKNOWLEDGEMENT:

Thanks be to Lord Almighty… Our sincere thanks and heartfelt gratitude to our, Our Principal Sr. Shanty Chacko and Guide Ms. Jasmine Koshy and all the Faculties of our College for their constant support and guidance. We extend our Thanks to all the Participants for their kind cooperation throughout the data collection. This acknowledgement would be incomplete without thanking our Team Members who were enthusiastic and dedicated and worked with us to make study a success.

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Received on 01.09.2020 Modified on 27.11.2020

Asian J. Nursing Education and Research. 2021; 11(3):307-310.

DOI: 10.52711/2349-2996.2021.00074