Knowledge regarding Pubertal Changes among Adolescent Girls of Rural and Slum Areas in Meerut U.P. India: A Comparative Study
Surat Ram Kudi1, Balamani S Bose1, Kunika Singh1, Jatin Jayant1, Vaishnavi Singh1,
Vishu Kumari Gond1, Kusum Lata2
1College of Nursing, LLRM Medical College, SVBP Hospital, Meerut, U.P, India.
2Ch. Kehar Singh Educational Trust Baraut, Baghpat, U.P, India.
*Corresponding Author Email: srjat789@gmail.com, balabosejeeva@gmail.com, singhkunika118@gmail.com, Jatinjayant321@gmail.com, singhvaishnavi033@gmail.com, vishukumari91553@gmail.com, kusum.bhardwaj.133@gmail.com
ABSTRACT:
Background: India has highest number of adolescent populations 253 million, every fifth person in India is adolescent. During puberty adolescent experience physical, emotional and hormonal changes and response to those changes varies person to person. Lack of knowledge regarding pubertal changes gives a thought of changed body image among females and further leads to depression and causes low self-esteem. Aim: Aim of the study was to compare the knowledge regarding pubertal changes among adolescent girls in the selected rural and slum areas. Material and methods: A comparative study was done to conduct this study. Total 100 adolescent girls between 10-19 years 50 from rural area and 50 from slum area of Meerut, Uttar Pradesh, India enrolled using convenient sampling technique. Self-developed knowledge questionnaire regarding pubertal changes among adolescent girls was used to assess the knowledge. Results: The mean age of the participants from rural area was 14.46±3.01 while slum area was 14.18±2.4. The mean knowledge score of adolescent girls from rural area was 15.80±1.90 while slum area girls was 11.64±2.8. Majority of participants from rural areas had adequate knowledge while among slum areas participants majority had moderately adequate knowledge level. A statistically significant difference was found between mean knowledge score of rural and slum areas (t=9.33, p<0.001). Conclusion: Awareness program should be organized in slum areas and emphasis should be done on improving knowledge level regarding pubertal changes, menstrual hygiene among female of all reproductive ages.
KEYWORDS: Adolescent girls, Pubertal changes, Knowledge, Rural area, Slum area.
INTRODUCTION:
Adolescence is the phase of rapid physical, cognitive and psychosocial growth. It lies between the age 10 to 19 years1. India has highest number of adolescent populations 253 million, every fifth person in India is adolescent2. During adolescence boys and girls undergoes in pubertal changes. During puberty adolescent experience physical, emotional and hormonal changes and response to those changes varies person to person. For girls’ puberty start around 8 years of life3. Breast budding is the first sign of the puberty followed by hair growth on vagina, arm pits, menstruation4.
Several studies had shown that adolescent females lack sufficient knowledge regarding pubertal changes5. Lack of knowledge regarding pubertal changes gives a thought of changed body image among females and further leads to depression and causes low self-esteem6. It is very important to educate the girls properly regarding pubertal changes so that they can pass through this transitional phase smoothly and can cope with the distress caused by those changes. Increasing awareness and imparting right knowledge in right time can help to resolve many pubertal issues7. Researchers were curious to know about the differences in the knowledge level between rural and slum areas. This motivated the researchers to conduct a comparative study to assess the knowledge regarding pubertal changes among adolescent girls in the selected rural and slum areas.
HYPOTHESIS:
H1: There will be significant difference in the knowledge level between the adolescent girls of selected rural and slum areas regarding pubertal changes at p<0.05 level of significance.
H1: There will be significant association between the knowledge level and selected demographic variables of the adolescent girls of selected rural and slum areas at p<0.05 level of significance.
MATERIAL AND METHODS:
A comparative study was done to conduct this study. Total 100 participants were chosen 50 participants from rural area and 50 from slum area of Meerut, Uttar Pradesh, India. Participants enrolled using Convenient sampling technique. Participants who were willing to participate were between the age 10-19 years and available during the period of data collection were selected. Participants who do not understand English or Hindi language, suffering from physical and mental illness were excluded.
Measuring Tools:
Tool A: Self developed structured Socio- demographic Tool:
Demographic variables include of adolescent girls consisting of age, religion, education, family type, parents’ education, parents’ occupation, birth order, place of living, previous source of information.
Tool B: Self developed knowledge questionnaire regarding pubertal changes among adolescent girls:
The knowledge questionnaire developed in English language for assessing the knowledge of adolescent girls regarding pubertal changes. Content validity of the knowledge questionnaire was obtained by 5 experts and the reliability of the tool was measured by split half method. The Pearson correlation coefficient was 0.84.
The knowledge questionnaire comprises 20 items, included questions from definition of puberty, onset of puberty, signs of pubertal changes among girls and management of the mood changes during pubertal time. Knowledge of girls from rural and slum areas measured using same knowledge questionnaire. Each correct answer was scored as 1 and incorrect as 0. Minimum score was 0 and maximum score was 20. Bloom’s criteria were used for the interpretation of knowledge questionnaire. Score between 16-20 was considered adequate knowledge, 12-15 as moderate knowledge and <12 as inadequate knowledge.
Procedure:
Ethical Permission was obtained from LLRM Medical college Meerut to conduct this study. Permission has been obtained from respective locality in charge of selected rural and slum area and parents of each participant and participants themselves.
Before collecting the data, the investigator has informed about the importance of this study and ascertained the willingness of the participants. The data collection was be done for a period of one month July 2023. The samples were informed by the investigator about the nature and purpose of the study and they were asked to withdraw from study anytime without having any kind of fear. Written informed consent was taken and code numbers were allocated to each participant.
About 100 adolescents who met with inclusion criteria were selected by using non probability Purposive sampling technique from rural and slum areas (50 participants each) of Meerut. The investigator established good rapport with person through an informative talk about the purpose of the study was explained to the persons of the study to ensure their cooperation. Researcher filled demographic sheet and then structured knowledge questionnaire to assess the knowledge regarding secondary characteristics of puberty from participants themselves. All the subject were very much co-operative and investigator expressed her gratitude for their co-operation.
Data Analysis:
Data were analyzed using SPSS version 20, and Stata 11.1. Appropriate descriptive and inferential statistics was used for data analysis. For statistical significance p-value of <.05 was considered. The mean score of knowledge was compared using independent t-test. Chi square test was used to find association between knowledge level and sociodemographic variables.
Table 1 Frequency and percentage distribution of Socio- demographic characteristics of the participants rural and slum areas (N=100)
|
Socio-demographic characteristics |
Rural Areas |
Slum areas |
|||
|
Mean |
SD |
Mean |
SD |
||
|
Age |
14.46 |
3.01 |
14.18 |
2.4 |
|
|
|
Frequency |
Percentage |
Frequency |
Percentage |
|
|
Educational Status of participants |
No formal education |
0 |
0 |
20 |
40.0 |
|
Secondary Education |
22 |
44.0% |
27 |
54.0% |
|
|
Senior Secondary Education |
18 |
36.0% |
3 |
6.0% |
|
|
Graduation |
10 |
20.0% |
0 |
0 |
|
|
Education of mother |
No formal education |
2 |
4.0% |
47 |
94.0% |
|
Primary |
6 |
12.0% |
3 |
6.0% |
|
|
Secondary Education |
23 |
46.0% |
0 |
0 |
|
|
Graduation |
19 |
38.0% |
0 |
0 |
|
|
Education of father |
No formal education |
0 |
0 |
42 |
84% |
|
Primary |
8 |
16% |
8 |
16% |
|
|
Secondary Education |
23 |
46% |
0 |
0 |
|
|
Graduation |
19 |
38% |
0 |
0 |
|
|
Monthly family income (INR) |
<10000 Rs. |
0 |
0 |
42 |
84% |
|
Rs. 10001-20,000 |
4 |
8% |
8 |
16% |
|
|
Rs. 20001-30000 |
22 |
44% |
0 |
0 |
|
|
>30000 |
24 |
48% |
0 |
0 |
|
|
Religion |
Hindu |
45 |
90.0% |
37 |
74.0% |
|
Muslim |
5 |
10.0% |
13 |
26.0% |
|
Table 1 depicts the socio-demographic characteristics of the adolescent girls of rural and slum areas. The mean age of the participants from rural area was 14.46±3.01 while slum area was 14.18±2.4. Majority of the participants (44%) have education status till secondary level, 36% had senior secondary education, 20% doing graduation from rural area while majority of the participants (54%) have education status till secondary level, 6% had senior secondary education, 40% lacks formal education in slum area. Nearly half (46%) of participants mother have education status till secondary education, 38% participants mother were graduated, 12% educated till primary level and 4% had no formal education in rural area while majority of participants mothers (94%) lacks formal education, only 6% participants mothers studied till primary level among slum areas. Nearly half (46%) of participants father have education status till secondary education, 38% participants father were graduated, 16% educated till primary level and None lacks formal education among participants from rural area while among slum area participants majority of participants fathers (84%) lacks formal education, only 16% participants fathers studied till primary level. Nearly half (48%) of the participants family monthly income was >30,000, 44% have income 20001-30000 and 8% had between 10,000-20,000 from rural areas while in slum area majority of participants (84%) have monthly income <10,000, 16% have monthly family income 10001-20000. Majority (90%) participants were Hindu, 10% were Muslim from rural areas while in slum areas 74% participants were Hindu, 26% were Muslim.
Table 2: Mean knowledge score regarding pubertal changes among adolescent girls (N=100)
|
Variable |
Mean |
SD |
Minimum |
Maximum |
|
Rural areas |
15.80 |
1.9 |
11 |
19 |
|
Slum areas |
11.64 |
2.8 |
7 |
15 |
Table 2 depicts the mean knowledge score regarding pubertal changes among adolescent girls of rural and slum areas of Meerut. The mean knowledge score of adolescent girls of rural areas were 15.80±1.90. The mean knowledge score of slum areas girls was 11.64±2.8.
Table 3: Frequency and percentage distribution of knowledge level regarding secondary characteristics among adolescent girls (N=100)
|
Variable |
Inadequate |
Moderately Adequate |
Adequate |
|
Rural areas |
3 (6.0%) |
17 (34.0%) |
30 (60.0%) |
|
Slum areas |
17 (34.0%) |
33 (66.0%) |
0 |
Table 3 shows frequency and percentage distribution of knowledge level regarding pubertal changes among adolescent girls of rural and slum areas. Among adolescent girls from rural areas, majority of participants had adequate knowledge while among slum areas participants majority had moderately adequate knowledge level.
Table 4: Mean difference of knowledge score regarding secondary characteristics among adolescent girls of rural and slum areas (N=100)
|
Variable |
Mean Difference |
SD |
t test |
df |
Tabulated value |
p value |
|
Knowledge |
4.48 |
2.1 |
9.33 |
49 |
1.684 |
<0.001 |
Table 4 depicts mean difference of knowledge score regarding pubertal changes among adolescent girls of rural and slum areas. It interprets the difference between mean knowledge score of rural and slum areas. There was statistically significant difference between knowledge score of rural and slum areas adolescents which is calculated by independent t test. It was found to be statistically significant at p<0.001. Hence Hypothesis HO1 is rejected.
A statistically significant association was found between knowledge regarding pubertal changes and education status of the participants at p<0.05. While no association was found with other demographic variable of govt and private school participants.
DISCUSSION:
The mean age of the participants from rural area was 14.46±3.01 while slum area was 14.18±2.4. The mean knowledge score of adolescent girls from rural area was 15.80±1.90 while slum area adolescent girl mean score was 11.64±2.8.
Among adolescent girls from rural areas was majority (60%) of participants had adequate knowledge level, 34% had moderately adequate and 6% had inadequate knowledge level regarding pubertal changes while majority (66%) participants from slum area had moderately adequate knowledge level, 34% had inadequate knowledge level regarding pubertal changes and no one had adequate knowledge level regarding pubertal changes. In one study adolescent girls had inadequate knowledge with mean and SD 6.57±2.27, 23% had moderately adequate knowledge with mean & SD 12.24±1.05 and the least 6% had adequate knowledge with mean and SD 16.83±0.77 on pubertal changes5. Coast et. Al in their systematic review found that majority of the adolescent girls had inadequate knowledge about menstruation8. While in one study contradicts with our study findings, they found 85.1% of the participants had high knowledge about puberty9. Sandhya et.al found 16% adolescents had very good level of awareness, 47% had good level of awareness, 28% had average level of awareness and 9% had below average level of awareness regarding pubertal changes10. Gaferi et.al found more than two-thirds (66.3%) of the participants had inaccurate knowledge, while about one-third (33.7%) of them had correct knowledge regarding reproductive health11.
In our study we found statistically significant difference between knowledge score of adolescents from rural and slum areas at p<0.001. Jain et.al conducted a comparative study to compare the level of awareness about pubertal changes and reproductive health between tribal and urban adolescent girls and found mean awareness of urban adolescent girls about pubertal changes and reproductive health was significantly greater than tribal adolescent girls12.
There was huge knowledge gap between rural and slum areas adolescent girls. The reason for good knowledge of the adolescent girls in the rural areas could be due to access to information resources such as internet and media. Rural areas adolescent and their parents were well educated comparatively to slum area which might have further brought gap in their knowledge level.
In our study statistically significant association between knowledge level regarding secondary characteristics among pubertal changes and education status at p<0.05 level of significance. While no statistically significant association between knowledge level and demographic characteristics of private school adolescents’ girls. In one study there was a significant association between level of knowledge on pubertal changes with demographic variables such as age (X2=0.042), mother’s education (X2=0.023), mother’s occupation (X2=0.022) and religion (X2=0.002) of the adolescent girls5.
LIMITATION:
Firstly, this was a cross-sectional study which is weak research design. Secondly, we used convenient sampling technique to choose the participants. We had taken data only from one rural and one area which lacks generalizability of study findings. Sample size was very less to generalize the findings.
CONCLUSION:
The mean knowledge score adolescent girls of rural areas were 15.80±1.90. The mean knowledge score of slum areas girls was 11.64±2.8. 60% of adolescent girls had adequate knowledge level, 34% had moderately adequate and 6% had inadequate knowledge level regarding pubertal changes from rural areas while majority 66% participants from slum areas had moderately adequate knowledge level, 34% had inadequate knowledge level regarding pubertal changes and no one had adequate knowledge level. Awareness program should be organized in slum areas and emphasis should be done on improving knowledge level regarding pubertal changes, menstrual hygiene among female of all reproductive ages.
ACKNOWLEDGMENT:
We are grateful to the ethical committee of the LLRM Medical college to give us permission to conduct this study. We are thankful to all participants to cooperate during the period of data collection.
CONFLICTS OF INTEREST:
There are no conflicts of interest.
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Received on 19.06.2024 Revised on 11.09.2024 Accepted on 20.11.2024 Published on 12.12.2024 Available online on December 30, 2024 Asian J. Nursing Education and Research. 2024;14(4):268-272. DOI: 10.52711/2349-2996.2024.00053 ©A and V Publications All right reserved
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