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Thesis97
1. DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation titled “A Study To Assess The
Effectiveness Of Video Assisted Teaching On Knowledge Regarding
Infertility Among Infertile Couple In Selected Hospitals At Haryana” Is a
bonafide and genuine research work carried out by me, for the partial
fulfillment of the requirement for the degree of M.Sc (OBG) under the
guidance of Prof. Mrs. Vishnupriya.K Principal Sophia college of nursing
Gwalior and Co Guided by Mrs.S. Rani Lecturer department of OBG
Sophia College of nursing Gwalior Madhya Pradesh.
Signature of the Candidate
3. Certificate by Guide and Co guide
This is to certify that this dissertation title “A Study To Assess The
Effectiveness Of Video Assisted Teaching On Knowledge Regarding Infertility
Among Infertile Couple In Selected Hospitals At Haryana” Is a bonafide and
genuine research work carried out by Ms Hem kumari for the partial fulfillment of
the requirement for the degree of M.S c in Nursing (OBG Specialty) under my
guidance.
Guide
Co Guide
III
4. Certificate
This is to certify that this dissertation “ A study to assess the effective ness
of video assisted teaching on knowledge regarding infertility among infertile
couple in selected hospitals at Haryana” Is a bonafide and genuine research work
carried out by Ms Hem kumari for the partial fulfillment of the requirement for
the degree of M.S c in Nursing (OBG Specialty)
Internal Examiner
External Examiner
PLACE
IV
5. ENDORSEMENT BY THE HEAD OF THE DEPARTMENT AND HEAD OF
THE INSTITUATION
This is to certify that this dissertation titled “A Study To Assess The Effectiveness Of
Video Assisted Teaching On Knowledge Regarding Infertility Among Infertile Couple In
Selected Hospitals At Haryana” Is a bonafide and genuine research work carried out by
Ms Hem kumari for the partial fulfillment of the requirement for the degree of M.S c in
Nursing (OBG Specialty).
Sign of HOD
Seal & Sign of Principal
V
6. COPY RIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the JIWAJI UNIVERSITY GWALIOR MADHYA
PRADESH shall have the rights to preserve, use and disseminate this
dissertation/thesis in print or electronic format for academic/research purpose.
Sign of candidate
VI
7. ABSTRACTS
STATEMENT OF THE PROBLEM:
A Study To Assess The Effectiveness Of Video Assisted Teaching On Knowledge
Regarding Infertility Among Infertile Couple In Selected Hospitals At Haryana.
BACKGROUND OF THE STUDY:
Reproduction is a phenomenon that has evolved for the survival of the living of
different species by producing continuous stream of new generation of that species.
Production of a new human being begins with fertilization .Failure to this process results
in Infertility. Though infertility does not claim an individual life, it inflicts devastating
emotional trauma on the individual for being unable to fulfill the biological role of
parenthood for no fault of his/her own.
WHO estimates that approximately 8-10% of couples experience some
form of infertility .On a worldwide scale, this mean that 50-80%million people suffer
from infertility with men and women in almost identical proportion. Infertility is
exclusively a female problem in 30-40% of cases and male in 10-30% of cases.
Most infertility cases (85-90%) are treated with medication or surgery.
Improvement in infertility treatment have made it possible for many women Whose male
partner is infertile to become pregnant .These new and advanced Technologies include ,
X
8. In vitro fertilization (IVF),Intra cystoplasmic sperm Injection (ICSI) and other similar
procedures
OBJECTIVES OF THE STUDY:
•
To assess the pre-test knowledge of infertile couples regarding
infertility before video assisted teaching.
•
To assess the post-test knowledge of infertile couples regarding
infertility after video assisted teaching.
•
. assess the post-test knowledge of infertile couples regarding
infertility after video assisted teaching.
•
To compare the pre-test and post knowledge of infertile couples.
•
To assess the effectiveness of Video Assisted Teaching on knowledge regarding
infertility among infertile couples.
•
To determine the association between the pre-test knowledge with selected
demographic variables
HYPOTHESES:
H1: There will be a significant difference between the pre-test mean and post-test mean
knowledge score of infertile couples.
H2: There will be a significance association at 0.05 level of significance between
knowledge scores with selected demographic variables of infertile couples.
9. XI
METHODS:
The conceptual framework of the study was developed based on ‘’General System
Theory ‘’by Bertanlanffy. A pre experimental one group pre-test and post-test design
was used for the study .Non- probability convenient sampling technique was used to
select the sample
A structured knowledge questionnaire and a video assisted teaching on infertility was
implemented as a tool for data collection. A scoring was developed to score the items of
analysis of data.
The content validity of the tool was established on the basis of correction given by
experts from the field of nursing and medical field. Reliability (r-0.93) of the tool was
tested by test-retest method and reliability co-efficient was calculated by using raw score
formula. A Pilot study was conducted with 10 subjects to find out the feasibility of
conducting the study.
The main study was conducted with samples at hospitals. The video teaching on
infertility was administering following pre-test. The post-test was after 7 days to assess
the effectiveness of video teaching.
RESULT:
The collected data was analyzed by using descriptive and inferential statistics.
10. XII
THE SIGNIFICANCE FINDINGS OF THE DATA WERE:
The mean pre-test knowledge score of infertile couple was 18.06 ( 45.15%) and the mean
post-test knowledge after administration of video assisted teaching was 32.24 (80.60%)
which revealed that significance
35.45% of improvement in couple’s knowledge
regarding infertility after administration of video teaching.
The calculated paired (t) test value 27.41 for knowledge is greater than table value and
found to be high statistical significant at the level of p<0.05. Hence research hypotheses
stated that there will be significant difference between pre-test and post-test knowledge
among infertile couples about infertility was accepted .Findings revealed that there was
statistically significant association between the pre-test knowledge scores with selected
Demographic variables was calculated by using chi-square test at p<0.05 level of the
subject .Hence the research hypotheses stated that there will be significant association
between pre-test K score with selected demographic variables was accepted.
CONCLUSION:
The overall findings of the study revealed that the administration of video teaching
programme facilitated the infertile couples to learn more about infertility which is evident
in the significantly improved pre-test K scores. The video teaching method was found
highly effective in improving knowledge of the couples regarding infertility.
11. XIII
TABLE OF CONTENT
CHAPTER
CONTENT
CHAPTER-1 Introduction
PAGE NO
1
Background Of the Study
3
Significance and Need for study
4
Problem Statement
7
Objectives
7
Operational Definitions
8
Assumptions
8
Research Hypothesis
9
Delimitations
9
Projected Outcome
9
Conceptual Framework
10
CHAPTER-2 Review of Literature
14
CHAPTER-3 Research Methodology
28
Research Approach
29
Research Design
29
Variables
30
Settings
31
Population
31
Sample Technique
32
Sampling Criteria
32
12. Development of the Tool
34
Scoring Key
36
Content Validity
37
Reliability
37
Pilot Study
38
Method For Data Collection
39
Plan for Data Analysis
39
Protection Of Human Subjects
40
CHAPTER-4 Data Analysis &Interpretation
42
CHAPTER-5 Discussion
56
Conclusion
60
Implication
60
Recommendation
65
Limitation
65
Summary
66
Bibliography
69
Annexure
75
XV
ACKNOWLEDGEMENT
13. “Give me a spirit of thankfulness, Lord;
For numberless blessing given,
Blessings that daily come to me,
Like dewdrops falling from heaven.”
“Man’s effort is always crowned by God’s grace and blessing”. Express my deep sense
of gratitude to the Lord Almighty for the blessings and mercy which enabled me to reach
up this step and complete my study.
The successful of this study comes through the valuable help, guidance contribution of
some of the teachers, seniors, friends and other well-wishers. Investigators recall their
kindness with a great full heart and are trying to express these gracious sentiments in a
few words flowing from within.
I express my gratitude and appreciation to Dr.Manjeet Kaur Bhalla Chairperson Sophia
College of Nursing Gwalior for providing me the opportunity to undertake the P.G course
in this esteemed institution and to conduct this study.
This study has been undertake and completed under the expert guidance of Prof. Mrs.
Vishnupriya.K Principal Sophia College of Nursing, Gwalior. I am grateful of her
constant help and guidance in shaping this project in to the present from her support,
encouragement and providing the required facilities for the successful completion of this
study.
VII
14. My sincere thanks to co-guide Mrs. S. Rani Lecturer Deptt of Obstetric and
Gynecological Nursing Sophia College of Nursing Gwalior for her constant
encouragement, valuable guidance, supervision and timely help during the entire
course of this study.
It gives me a great pleasure to express my sincere thanks to all the head of
department, Lecturers and Asst. Lecturers for their constant encouragement,
guidance, valuable suggestions and their loving attitude which helped me in
completion of this study.
My sincere thanks go to all the participants who formed the core and basis of this
study for their whole hearted cooperation. I express my deep gratitude to librarian of
Sophia Nursing College for helping me through the invaluable treasures.
I cherish the friendship I had and take this opportunity to thank each one of them. My
friends have been an encouragement every time and their motivation my confidence that
had helped me reach here and I also thank for their constant support and whole hearted
solidarity. I use this opportunity to thank Mr. Prasanth.K and MS. Megha for helping
throughout the process of my study and also for this concern and enthusiastic support.
VIII
15. I am speechless! I can barely find words to express all the wisdom, love and support
given me for that I am eternally grateful to my beloved Husband Mr. Sukhpal Singh for
his endurance and encouragement and enthusiastic support throughout the course.
I would like to express motherly warm love towards my children Baby Hitashi and Baby
Vivaan, for their unconditional love and their support even they were left alone during
the period of my study.
Once again, I am grateful to all of them who have directly and indirectly helped me in
completion of this study, including those whom I may have in divergently failed to
mention.
Signature of the candidate
Ms. Hemkumari
IX
16. CHAPTER-I
INTRODUCTION
“Pain during labour is tolerable but emotional pain due to infertility is intolerable”
“The greatest work of art created first by god and then by man, is the creation of life.
This art takes two artists, man and woman, each bringing their own parts of a pallet to
create a work of art that not only has a piece of both artists but has a living, breathing,
ever-changing, piece of art with an identity of its own.”
Bethany Jane Andrews
Marriage is an event by which a male and female shares their life with each other.
Entry of a child changes a marriage, completely and permanently. It changes individuals
as a couple and also make changes in the way they think and act and relate to each other.
It adds beauty to life as if sweet scent to a beautiful flower.1
To become a mother and father is one of life’s greatest blessings. It changes their
heart, thoughts, and actions. It is a lifelong event that forever changes the couples.1
In our society, individuals are committed in relationships like marriage with the
goal of procreation. Both men and women are supposed to pass on their genetic and
generational traits .Failure by both men and women to fulfill their need for a child is
usually devastating, humiliating, and emotionally destructive .Thus it becomes a
1
17. Major life stressor, which can affect the well-adjusted couples. Even though tremendous
strides have been made in treating this relatively common condition, infertility is
typically not openly discussed.1
Infertility is defined as failure to conceive within one or more years of regular
unprotected coitus. Primary infertility denotes those patients who have never
conceived .Secondary infertility indicates previous pregnancy but failure to conceive
subsequently. Infertility is a heartbreaking condition that affects nine million couples in
the world each year. It causes tremendous stress, can trigger debilitating sadness and
depression, and can tear a marriage to shreds. It is shown that 1 in 6 couples are said to
have infertility in India .If the couples are more than 35 years, it increases as 1 in 3
couples. The males are responsible for 40 % while females are responsible for another 40
% and 10 % because of the problems within the both, 10 % is due to idiopathic reasons.2,3
A study conducted in rural areas of India on prevalence of female infertility among
232 couples, reported that 14.4% had the prevalence of infertility.4
The first step in obtaining infertility therapy is fertility testing. There are many reasons
why couples have trouble in conceiving, including low sperm count, low hormone levels,
and abnormalities in reproductive organs. Only comprehensive fertility testing can isolate
the problem and allow doctor to suggest appropriate courses of treatment.5
2
18. BACKGROUND OF THE STUDY
Reproduction is a phenomenon that has evolved for the survival of the living of
different species by producing continuous stream of new generation of that species.
Production of a new human being begins with fertilization. Failure to this process results
in Infertility.
Infertility is a tragic condition. Though infertility does not claim an
individual life, it inflicts devastating emotional trauma on the individual for being unable
to fulfill the biological role of parenthood for no fault of his/her own.6
WHO estimates that approximately 8-10% of couples experience some form of
infertilit. On a worldwide scale, this means that 50-80% million people suffer from
infertility with men and women in almost identical proportion. Infertility is exclusively a
female problem in 30-40% of cases and male in 10-30% of cases.7
Most infertility cases (85-90%) are treated with medication or surgery.
Improvement in infertility treatment have made it possible for many women Whose male
partner is infertile to become pregnant .These new and advanced Technologies include ,
In vitro fertilization (IVF),Intra cystoplasmic sperm Injection (ICSI) and other similar
procedures 3
3
19. NEED FOR THE STUDY
Everyone has the goal of becoming a parent, but for those who are unable to
conceive a child, it is an exquisitely painful reality. Many of the people spend a portion of
the life attempting to avoid unplanned pregnancies, and assume that once they are ready
to conceive, it will happen with little difficulty. They tend to think that shifting gears
from preventing pregnancy to planning conception and childbirth will proceed in a
relatively smooth and orderly fashion.1
Infertility has come to be recognized as a significant social problem. There are
numerous infertility cases among many couples who try to conceive a child .A
multicounty study carried out by the world health organization and including India place
the incidence of infertility between 10% to 15%.It affects almost 13% to 15%
of couples of world wide .In the united kingdom it is estimated that one in six
couples would be companied of infertility. The prevalence varies widely, being less
in developed countries and more in developing countries.8
In India, due to influence of western culture and increasing urbanization, the view
of individuals towards marriage system has changed. Higher education, better career
opportunity and economical independence are the factors that cause young people to
delay marriage without realizing that their action could affect country’s
4
20. demography and health care system. Reproductive function declines as a women age,
particularly after the age of 35 years .Thus it places all women who are opting for a late
marriage at higher risk of infertility.9
Women with polycystic ovarian syndrome (PCOS) often are infertile because they
don’t ovulate. 40%-80% of women with PCOS have a problem with infertility. The
reason for this wide variation is that PCOS is a complex metabolic syndrome, with
multiple factors that can interfere with fertility10
The American society for reproductive medicine estimates that 5 million American
heterosexual couples report difficulties in achieving a viable pregnancy of which 1.3
million seek advice for the problem .The researcher also suggested that condition will be
worst in the coming world.11
A study conducted on knowledge and attitude of infertile couples about assisted
reproductive technology among 400 infertile couples reported that 41.7% have good
knowledge and 55.7% had poor knowledge. Even though 73% got information from ART
centers, only a small percentage have exhibited adequate knowledge .About 94.5% of
patients mentioned that Assisted Reproductive Technology expenses are not affordable to
them .12
A Study conducted in South Africa on knowledge and treatment – seeking
behaviors for childlessness among 120 women reported that, 58 % of the samples
5
21. had little knowledge regarding recent advancements in infertility management and only
45% have a positive attitude towards it ,45.8% did not have any concern regarding the
topic .13
From many reviews the student researcher found that incidence of infertility is
increasing day by day, mean while most of the infertile couples are not having adequate
knowledge regarding recent advancements in infertility management which is leading to
the reduced acceptance of these treatments among them. The prevalence of infertility will
be more devastating in the future with the upcoming concept of late marriages .So the
student researcher perceived the need for assessing updated knowledge regarding the
recent advancements among the infertile couples in order to make future informational
programmes and there by promoting them for the proper utilization of the services.
A significant number of couples complain that they are not told about the treatment
path and a lot of their questions remain unanswered. This information gap might lead to
anxiety. The goal of this study is to evaluate the impact of provision of training regarding
infertility on infertile couples.
6
22. STATEMENT OF THE PROBLEM:A study To Assess The Effectiveness Of Video Assisted Teaching Programme On The
Knowledge Regarding Infertility Among Infertile Couples In Selected Hospitals at
Haryana.
OBJECTIVES:• To assess the pre-test knowledge of infertile couples regarding infertility
before video assisted teaching
•
To assess the post-test knowledge of infertile couples regarding infertility
after video assisted teaching
•
•
To compare the pre-test and post knowledge score of infertile couples.
To assess the effectiveness of Video Assisted Teaching on
knowledge regarding infertility among infertile couples.
•
To determine the association between the pre-test knowledge with
selected demographic variables.
7
23. OPERATIONAL DEFINITIONS:
A. ASSESS: It refers to the evaluation or estimation of knowledge level of infertile
couples regarding infertility.
B. EFFECTIVENESS: In this study it refers to the extent to which the video
teaching programme has achieved the desired effect as measured by gain in knowledge
level of infertile couples by a structured questionnaire
C.VIDEO ASSISTED TEACHING PROGRAMME: It is a planned teaching
material of lecture combined with video with duration of 45minutes.
D. KNOWLEDGE: The ability of infertile couples to respond towards the
questionnaire on the selected aspects of infertility.
E. INFERTILITY: The inability of a couple to achieve a pregnancy after
repeated
intercourse without contraception for one year.
F. INFERTILE COUPLE: Any given couple who is infertile may be related to the
female partner, the male partner or the combination of both.
ASSUMPTIONS:
•
Most of the infertile couples are not having enough knowledge regarding
infertility.
• Participatory care will improve self esteem towards the promotion of health.
24. 8
RESEARCH HYPOTHESES
H1: There will be a significant difference between the mean pre-test and mean post-test
knowledge score of infertile couples.
H2: There will be a significance association at 0.05 level of significance between the pretest knowledge scores with demographic variables of infertile couples.
VARIABLES:
A. Independent Variables: Video teaching programme regarding infertility.
B .Dependent Variables: Knowledge level regarding infertility.
C .Demographic Variables: Age, Gender, Education, Occupation, Duration of treatment,
Previous Knowledge.
DELIMITATION:
•
•
Infertile couples who are illiterate.
•
•
Infertile couples who are available at the time of the study.
Sample size limited to 50 infertile couples.
Prescribed data collection is 4-6 weeks.
PROJECTED OUTCOMES
This study is proposed to determine the effectiveness of knowledge gain regarding
infertility among infertile couples through video assisted teaching.
25. 9
CONCEPTUAL FRAMEWORK:
Conceptual framework refers as a background or foundation for a study .Concepts are
related in a logical manner by the researcher (ROSE MARIE NIESWIADOMY,2008).
Conceptual framework assists individual in organizing their thinking in order to select a
focus of study and interpreting the findings (MORSE JM , 1992).
Conceptual framework serves as a spring board for theory development. As this is
made up of concepts, which are mental images of a phenomenon, it provides for thinking
and interpreting what is seen. A model is used to denote symbolic representation of
concepts (Jacqueline Fawcett, 1987 ).
The modified conceptual framework for the present study has been developed from ''
General System Theory” by Ludwig Von Bertanlanffy (1968). He states that, an open
system is a system which continuously interacts with the environment. The interaction can
take the form of information, energy or material transfers in to or out of the system
boundary, depending on the discipline which defines the concept.
In this theory, focus is on the discrete parts and their interrelationship which makes up
and describes the whole. It defines system in a complex interaction which means that
system consists of two or more converted elements which form an organized and which
interact with other. All system must receive varying type of information from the
26. Environment. The system uses the input to maintain its homeostasis
10
The main concepts of the open system model are input, throughput, output and feedback.
INPUT:
'' Input” refers to any form of matter, energy, and information that enter in the system
through its boundary. In the present study,'' Input” refers to assessment of existing
knowledge of infertile couples regarding infertility in terms of pre-test knowledge and
administration of video assisted teaching on infertility.
THROUGHPUT:
''Throughput '' refers to process of the input .In the present study throughput refers to a
process of change in knowledge and understanding about the various aspects of infertility.
OUTPUT:
“Output” refers transfers matter, energy and information to the environment is an altered
state. In the present study, ' output ' refers to evaluation of change in knowledge of
infertile couples regarding infertility in terms of post -test knowledge after administration
of video assisted teaching on infertility.
FEEDBACK:
‘Feedback ' refers to information of environment responses to the system, output is used
by the system in adjustment, correction and accommodation to the interaction with the
environment. In the present study, 'Feedback' refers to effectiveness of video assisted
teaching on infertility by comparing pre-test and post -test knowledge and find out the
association between the pre-test knowledge with selected demographic variables of
infertile couples.
27. 11
The model states that feedback loops are necessary to produce a mutually determined
plan of care and if the planned intervention is not effective, the determination is made
that further assessment is necessary. In the present study the investigator evaluates the
effectiveness of video assisted teaching on knowledge regarding infertility by comparing
pre and post- test knowledge score. The gain in knowledge depicts a positive outcome of
the programme while if no gain in knowledge is seen further assessment of the area of the
subject interest is necessary.
SUMMARY:
This chapter dealt with the Introduction, background of the study, significance and need
for the study, statement of the problem, objectives, operational definitions, assumption,
research hypotheses, variables, delimitation, projected outcomes and conceptual
framework of the study.
28. 13
CHAPTER – II
REVIEW OF LITERATURE:It is the term of literature refers to the activities involved in identifying and searching for
information on a topic and developing a comprehensive picture of the state of knowledge
on the topic.
Review of literature helps the investigator to develop insight in the problem and gain
information about the problem and what has been done before. It provides basis for future
investigation, justifies the need for replication, throws light on the feasibility of the study,
constraints of data collection, and relates the findings from one study to another with a
hope to establish a comprehensive body of scientific knowledge and a professional
discipline from which valid and pertinent theories may be developed.
Based on the objectives of the study the literature from various sources had been
reviewed and arranged under following categories:
SECTION- A. Studies related to incidence and prevalence of infertility.
SECTION-B. Studies related to infertility knowledge assessment in infertile
couples.
SECTION- C. Studies related to treatment modalities.
29. SECTION- D. Studies related to video assisted teaching program.
14
SECTION- A. Studies related to incidence and prevalence of infertility.
The prevalence of infertile couples differs according to the definition of couple’s
infertility. If we accept the most commonly used definition, i.e. the lack of
pregnancy after 1 year of unprotected regular intercourse, infertile couples represent
about 10 to 15 %of all couples. According to the definition of the European society for
Human Reproduction and Embryology, i.e. the lack of pregnancy within 2 years by
regular
coital
exposure,
the
prevalence
of
infertile
couples in Europe and North America is approximately 5 to 6%.14
In a follow-up study of 1297 couples registered at a NOVA SCOTIA infertility
clinic with a complaint of infertility of at least 12 months duration, the cumulative
pregnancy rate at 36 months, with 95 % confidence limit was found to be 49.4%.The
predictors of pregnancy by univariate analysis were a favorable primary clinical,
diagnosis (p<0.001) ,a duration of infertility of less than 3 years (p<0.001) , a single
diagnosis for the infertility (p<0.001), a previous pregnancy in the partnership
(p=0.001),and a length of marriage of less than 4 years (p=0.002). Proportional hazard
analysis confirmed these variables as predictors of pregnancy. The highest cumulative
pregnancy rates after 12 and 36 months of follow- up were observed in case of ovulation
30. deficiency, and the lowest were seen in cases of tubal defects. However, before the
process of diagnosing infertility begins, useful prognostic information can be
15
determined from the length of marriage, the duration of infertility and the partnership’s
history of previous pregnancy.15
A study was conducted among 175 consecutive infertile couples were interviewed
together and individually in accordance with a 25 point questionnaires. Amongst the
males, premature ejaculations 66% was most common problem followed by erectile
dysfunction 15%, decreased libido 11% and orgasmic failure 8%. Amongst females
dyspareunia 58%, decreased libido 28%, and orgasmic failure 14% were most common
problems. Various types of misconceptions were also observed in the infertile couples.
Lack of sexual awareness and education formed an important part of observations.
Psychosexual dysfunction and infertility was found to occur, in a large number of
couples, together in association. Most common cause for this problems seems to be
ignorance and lack of sex education.16
A population survey was conducted to assess the prevalence of infertility and the
proportion of couples seeking help in more and less develop countries from 25 population
surveys sampled 172 to 413 women. The 12 month prevalence rate ranged from 3.5% to
16.7% in more developed nations and from 6.9% to 9.3% in less developed nations, with
an estimated overall median prevalence of 9%. In 17 studies, sampling 6410 women, the
31. proportion of couples seeking medical medical care was an average 56.1% range 4276.3% in more developed countries and 51.2% range 27-74.1% in less developed
16
Countries range 27-74.1% in less developed countries. The proportion of people actually
receiving care was substantially less, 22.4%. Based on these estimates and the current
world population, 72.4% million women are currently infertile, of these 405 million are
currently seeking infertility medical care.17
A survey was done about distribution of infertility those who were attending primary
infertility clinics in Israel. Infertility is one of the most prevalent health disorders in young
adults. About 2515 couples 37% and tubal damage 18%. Infertility factors were identified
in the women alone in 30.6% participated in the study. Out of these male factor 45%,
Oligo ovulate cases and the men among in 29.2%. To combine infertility factors were
found in 18%, the rate of unexplained infertility was 20.7%. The study was concluded by
saying that male factor accounts for almost half of all cases of infertility in couples.18
B. Studies related to infertility knowledge assessment in infertile couples:A descriptive study conducted found that, there is scarce Knowledge regarding the
impact of infertility on couples. The main objective of the study was to review the
findings on quality of life and health related quality of life among infertile couples.
.Among infertile subjects, women had lower scores in several QOL or HRQOL domains
32. in sample size comparison to men. So from this study, it is evidenced that there is a
scarcity of knowledge in infertile couples19.
17
A study conducted about knowledge and attitudes towards infertility held by
members of 2 countries councils in Sweden. For this study 182 samples were taken and
153 answered the questionnaire. The result of the study shows that different age groups
did not show different levels of knowledge; the committee members who were very
positive towards infertility treatment did not have any better knowledge of such treatment
than those who were less positive. At the time of survey displayed the same level of
knowledge as the other council members. The members showed very little familiarity
with the priority groups suggested in the report from the health care priority committee.20
A phenomenological study was conducted about couple’s experiences of. In his
study he focused on the improvement of knowledge of infertility among infertile couples
by the nurse. If nurses are to work effectively with families in contemporary societies,
their practice and activities must be appropriately informed. The purpose of this study
was to examine in-depth the experience of couples undergoing treatment for infertility.
He explains that all couples undergoing infertility treatment experienced life changes
which included life style changes, various physical and emotional changes, and changes
in the relationship of couples. Most of the couples reported feelings of social isolation
33. associated with being infertile. Findings from this study will add more knowledge based
on infertility among the infertile couples.21
A study conducted about the women’s and men’s perceptions of infertility
18
Their associations with psychological adjustment. The main objective of the study was to
extend the knowledge of the couples by examining the perception of infertility among
couples undergoing treatment. The study was cross-sectional and included two samples.
Sample 1 included 72 couples at their first visit to an infertility clinic and sample 2
included 49 couples at various stages of treatment. The result of the study shows that the
partners differed in their perceptions of infertility and their distresses.22
The descriptive cross-section study was conducted to evaluate the knowledge of
infertile couples about infertility at patient infertility clinics of University Hospital in
Tehran Iran. Data was collected from 400 infertile couples by a self administer structured
questionnaire. The study findings showed that 120 couples (30 %) had good knowledge
but 280 (70 %) had poor knowledge about infertility.23
A study report shows that there is a lack of infertility knowledge in the general
population. The aim of the current study was to asses people’s knowledge about
infertility, focusing on identifying the type of information needed to educate people about
the potential risks for infertility.24
34. A study report found that knowledge about infertility issues is a core motivator
behind engaging in the medical process for infertility problem. The results demonstrated
that the participants were knowledgeable about the risk factors for infertility but were not
as knowledgeable at recognizing factors that had no effect on fertility, and believed that
19
thesefactors actually increased a woman’s fertility.Fertility awareness campaigns need to
address false beliefs as they may give individuals a false sense of security about their
fertility.25
SECTION C:Studies related to treatment modalities:
A study was conducted about the epidemiological aspects of primary infertility in
Kashmir region of India. The main objective of this study is to assess the magnitude of
primary infertility and to study its etiological aspects in India. About 10,063 married
couples were interviewed to ascertain the prevalence of primary infertility. The result of
the study shows that 15%of the couples interviewed had primary infertility among which
4.66%had unresolved infertility at the time of survey. The etiology of infertility in250
consecutive couples revealed a female factor in 57.6%, a male factor 22.4%, combined
factor in5.2%and an undetermined cause in 14.8%.26
A study report shows that smokers have lower sperm counts and stopping smoking
increase sperm count. Smokers sperm count is on average 13 – 17 % lower than One half
35. of 1%of men was functionally sterile in 1938.Today it has reached between 8-12
%.Functionally sterile” is define as sperm counts below 20 million per ml of semen. 27
A high number abnormal sperm heads is associated with decreased fertilization.
Some drugs such as sulphasalazine, used to treat inflammatory bowel disease can
drastically reduce semen quality.28
20
A study of 3 smokers who were followed for 5 – 15 months after stopping smoking
reported that their sperm count rouse 50 – 80 %, suggesting that chemicals in the smoke
are responsible and any reduction in sperm count is reversible.29
A study found that alcohol reduces fertilization success. A large 50% reduction in
experiments of test animals given intoxicating doses of alcohol 24 hours prior to mating.30
Ovulatory dysfunction can be suggested by late menarche, presence of premenstrual
syndrome, abnormal cycle length, amount of menstrual loss, premenstrual spotting, hot
flushes and excessive physical exercises and/or weight changes greater than 10%in the past
year. Systematic diseases such as diabetes mellitus and thyroid dysfunction that are not
adequately treated may also have adverse effects on fertility .Medical treatments may cause
temporary(sex steroids)or permanent (cytotoxic agents) damage to the Ovulatory function.31
8.4%o of women 15-44years had impaired ability to have children and about half of
these couples eventually conceive. These are statistics will vary greatly depending on the age
of the woman. Couple infertility rates are nearly double percentage since it then take
36. into account male infertility.32
38% of female non-smokers conceived in their 1 st cycle of attempting pregnancy
compared to 28% of smokers. Smokers were also 3-4 times more likely than non smokers to
have taken greater than a year to conceive.33
21
A study of 1,909 women in Connecticut found the risk of not conceiving for 12
months (the usual definition of infertility), was 55% higher for women drinking 1 cup of
coffee per day -100% higher for women drinking more than 3 cups of coffee per day.34
Risk of infertility increased in females who reported exposures to textile dyes, dry
cleaning chemicals, noise, lead, mercury and cadmium. There was a significant risk of
increased time to conception among women exposed to anti-rust agents, welding, plastic
manufacturing, lead, mercury, cadmium, or anesthetic agents.35
Expensive fertility treatments resulted in only a 6percentage point improvement in
achieving pregnancy over “infertile” couples who just “kept trying. In a study of 1145
couples who had been diagnosed as infertile, only half of them were treated to help attain
pregnancy. After a two to seven-years follow up, pregnancies occurred in 41%of the
treated couples and 35% of untreated couples.36
Infertility by itself does not threaten physical health but has a strong impact on the
psychological and social well-being of couples. In the last 2 decades, progress in caring
37. for the infertile couple, in particular progress in the field of assisted reproduction and
micromanipulation, has provided significant hope for many couples for whom hope could
not have been offered in the past. This is especially true for bilateral tubal diseases and for
male factor infertility, as near all couples with male factor in fertility can now undergo
either one(or more)IVE or ICSI attempt (s).For couples with other causes of
22
Infertility, however, the differences in pregnancy rate often do not reach statistical
significance.37
A study was conducted in 32 couples in the age group of 21- 43 years, who had
primary infertility ranging from 1-12 years. The female partner was given eve care syrup at
a dose of 2 teaspoonfuls for 6 months. The male partner was given Spemann tablet at a
dose of 2 tablets, twice daily for the same periods. The female were advices during test to
detect human chorionic gonadotrophin if they had a missed period for duration of more
than 15 days after 3 months of treatments, 6 female tested positive, for tested positive after
4 months and for tested positive after 6 months of treatment. The pregnancies were later
confirmed with pelvic ultrasonography, which showed live fetus without any
abnormalities. Among the males, there was a marked improvement in the sperm count
especially in those males hoe has abnormal or low sperm counts. A complete analysis was
done at the end of 6 months and the final report showed that the fertility rate after eve care
38. and Spemann therapy was 43.75%.This was combine therapy could bring out a good out
come in infertile couples if the used Eve care and Spemann for at least 6 months.38
MSG (Monosodium glutamate), a common flavor enhancer added in foods, was found
to cause infertility problems in test animals. Male rats fed MSG before mating less
than a 50% success rate , where as male rats not fed MSG had over a 92%success
23
rate.Also the offspring of the MSG treated males showed shorter body length, reduced
testes weight and evidence of overweight at 25 days. MSG is found in ascend, flavored
potato chips, Doritos, meat seasoning and many packaged soups.39
The sexual history of the couple is very important. The frequency and timing of
intercourse and the use of lubricants should be assessed. It happens frequently that an
infertile couple abstains from intercourse and has only timed exposures in the middle of
the cycle, but there is no evidence that prolonged abstinence increases the change of
pregnancy; abstinence (7 to 8 days) should be reasonably recommended only if
oligozoospermia is present. Use of lubricants should be discouraged because of their
detrimental effects on semen quality.40
In a study conducted, clinical infertility is a prevalent problem with significant
financial and costs. Modifiable life style factors exists that may affect a Person’s time to
conception and there chance of having a healthy, live birth.A person’s time pregnancy and
39. their chance of having a healthy, live birth may be affected by factors such as weight ,
vitamin and iodine intake, alcohol and caffeine consumption, smoking, substance abuse,
stress, environmental pollutants vaccination and oxidative stress.41
A case control study was conducted to assess the differences in attitude towards
aspects of assisted reproductive technology between infertile and porous women a
university-based tertiary clinic of Kuopio. A sample of 392 women with fertility
24
problem and 200 porous women as control was selected on the basis of convenience
sampling technique. A questionnaire consisting of 46 questions on different aspects of ART
was administered to the sample. The study revealed that response rate in group of infertile
women was 48 %( 189/392). Porous
women responded with a similar rate of
42%(82/200).The mean age (ISD) of parous women responded with a similar rate of 42
%(84/200).The mean age (ISD)of parous women was 35.0(+_5.0)years and it was 34.0
(+_6.1) years in women with fertility problem over 80% women and parous women would
set on upper age limit to the infertility treatment for women,66% of infertile women and
73% of parous women would set an upper age limit for men also. Two-third of infertile
women and 58% of parous women agreed to the question that is the duty of parents to tell a
child about the use of assisted reproductive technology .Infertility regarded an illness by
infertile women, but only 34% of the parous women .Thus the study conducted that split
attitude was influenced by the wish of infertile women to help childless couples and to the
40. recruit suitable /oocyte donors. Parous women were motivated by their concern for
children’s right.4
SECTION- D.Studies related to video assisted teaching programme.
A Study was conducted by Kumari Sathya K in 2005 to determine the effectiveness of
video assisted teaching vs. lecture method on knowledge of newborn assessment among
final year general nursing and midwifery students of selected Institutes, Bangalore
25
The sample consisted of 60, experimental Group 1-30 and Group-2-30.A structured
knowledge questionnaire on newborn assessment was developed by the investigator. The
major findings of the study were: mean difference between the lecture and video were
22.9 and 25.4 respectively. Video is slighter high than lecture. Findings of the study score
shows that Video assisted teaching was also an effective teaching strategy. Different
teaching strategies should be used in teaching to make students better understand, theory
as well as practical.43
A study was conducted to assess the effectiveness of video assisted nursing
intervention on lumbo-sacral pain and activities of daily living among antenatal primi
mothers at SRH. The study was conducted on 60 primi mothers and the post-test
knowledge of the mother regarding pain and daily living activities were higher than the
Pre-test scores after video assisted teaching. The findings indicates that 65.5% had good
knowledge ,while 15.45% had average knowledge and 19.09% had poor knowledge
41. before video assisted teaching program me. The study concluded that video assisted
teaching programme will improve the knowledge of the primi mothers and it will help in
regaining their activity level than those who did not participate in the study.44
A study was conducted to compare the efficacy of a video- assisted module
versus conventional module (lecture), regarding post exposure prophylaxis (PEP) among
58 dental students, in Shahid Behest University of Medical Sciences, Tehran, Iran. They
26
were asked to take a test about the principles of prior to being taught via lecture or the
video films. The test was repeated following conventional teaching module and the video
– assisted teaching module. The pre- teaching test results indicating low knowledge
among the students regarding PEP with a mean value of 8.98+ 2.99 which was
significantly different compared to post-teaching test results following the lecture-only
phase ( 11.30 ± 3.90) and the video- assisted teaching phase ( 17.32 ± 2.94).45
A study was performed to investigate the effects of video-based self assessment on
the ability of nursing students to accurately measures vital signs, their communication
skills, and their satisfaction. A quasi – experimental control- group, pretest- posttest of 40
second year student nurses were enrolled fundamental of nursing course in a college of
nursing.
Results of the research indicate that there was a statistically significant
difference in exam scores for assessing long- term memory, in video rewiring group
demonstrating
higher score (t=4.75,df=213,p,0.001).Students satisfaction was also
42. significantly higher in the video-review group than in the control group. These results
suggested that video-based self assessment is a beneficial and an effective instructional
method of training undergraduate nursing students to develop awareness of their strength
and weakness, to improve their clinical and communication skills.46
27
CHAPTER-3
RESEARCH METHODOLOGY
INTRODUCTION:
Research methodology is a way to solve the problem systematically. It is a
Procedure in which the research starts from initial identification of the problem to final
conclusion. It organize all the components of the study in a way that is most likely to lead
to valid answer to the problem that have been posed.(NANCY
BURNS and SUSAN K GROVE).
Research methodology provides a brief description of the method
adopted by the
investigator in the study. It indicates the general pattern of organizing the procedure of
gathering valid is reliable data for an investigation .It includes research approaches,
research design, the setting, the population, sample, sample size, sampling technique, and
criteria for sample selection ,description of tools, validity and reliability of the tool,
43. intervention, pilot
study and data gathering process, plan for data analysis and the
protection of human subjects The present study is aimed to assess the effectiveness of
video assisted teaching programme on knowledge regarding infertility among infertile
couples in selected hospitals at Haryana.
28
RESEARCH APPROACH:
Research approach is an umbrella that covers the basic procedure
conducting
research (Kothari CR 2004)
According to (Denise F. Polit et al, 2001), experimental approach is to explore the
dimension of a phenomenon or to develop hypotheses about relationship between the
phenomena.
A pre experimental research approach was considered to be the most appropriate and
adopted to assess the effectiveness of video assisted teaching programme on knowledge
regarding infertility among infertile couples in selected hospital.
RESEARCH DESIGN:
The research design refers to the researcher’s overall plan for the obtaining answer to the
research questions and all spells out strategies that the researcher adopted to develop
44. information that is accurate ,objective and interpretation (Denise F. Polit et al,2001),
experimental. A pre experimental one group, pre-test, post-test research design has been
used to attain the objectives of the present study.
According to (Denise F. Polit et al, 2001) the schematic representation of preexperimental research design:
29
Pre-test(01 )
Pre
Intervention
assessment
Post-test (02)
of Video assisted teaching Post
knowledge
programme
assessment
regarding knowledge
regarding
Regarding infertility Knowledge on infertility infertility
among infertile couples among infertile couples.
infertile
by
among
structured
structured
knowledge
questionnaire
couples
questionnaire
after
of
by
knowledge
after
intervention.
intervention.
TABLE 1:- SCHEMATIC REPRESENTATION OF RESEARCH DESIGN
VARIABLES:
Variables are the measurable characteristics of a concept and consist of special group
attribute (Janice M .MORSE. and Peggy Anne Field, 2005)
Independent Variables:
45. An Independent variables is that which is believed to cause or influence the dependent
dependent variable, in experimental research by the manipulated (treatment) variables
(DENISE F POLLIT et al 2001)
In this study the independent variable refers to video assisted teaching on infertility
30
Dependent variables:
The variable is hypothesized to depend on or be caused by another variable, (the
independent variable) the outcome variable of interest (Kerlinger, and Freed In, 1983) In
the present study dependent variable refers to knowledge level of infertile
couples
regarding infertility.
SETTING:
Setting refers to the area where the study is conducted. It is the physical location
and condition in which data collection takes place in a study (Denise F. Polit et al, 2001).
Based on the geographical proximity, feasibility and familiarity with the setting, the
investigator selected infertility clinics, at Haryana, to carry out the present study
POPULATION:
46. The population referred to as the target population, which represents the entire
group or all the elements like individuals or objects that meets certain criteria for the
inclusion in the study (Nancy Burns, and Susan K Grove, 2007).
The target population of the present study comprises of infertile couples who were
attending hospitals at Haryana.
31
SAMPLE:
Sample refers to the subset of a population that is selected by the investigator to
participate in a research project (Dorothy Y. Brockopp, and Marie T H).
Sample size of the present study consists of 60 infertile couples getting treatment from
the hospitals at Haryana.
SAMPLING TECHNIQUE:
Sampling defines the process of selecting a group of people or other elements with which
to conduct a study (Basavanthappa BT, 2007).
Non-probability sampling technique was adopted to select the samples for the present
study based on inclusion criteria.
SAMPLING CRITERIA:
The samples were selected with the following predetermined set of criteria.
47. INCLUSION CRITERIA: All the infertile couples who:
•
Attend the infertility clinics.
•
Are willing to participate in the study.
•
Can understand Hindi/ English.
EXCLUSION CRITERIA: All the infertile couples who:
•
Are associated with other obstetric complication.
•
Have other chronic illness.
•
Cannot understand Hindi.
32
DEVELOPMENT OF THE TOOL:
After the extensive review of literature discussion with the guide and the various experts
in the field of obstetric and gynecological nursing and medical field based on their
suggestion and recommendations, the tool was constructed in three parts consists of
demographic variables, self administered structured knowledge questionnaire and video
teaching regarding knowledge on infertility.
PREPARATION OF THE BLUE PRINT:
A blue print on the knowledge questionnaire consisting of five areas was prepared. It
depicted the distribution of items according to the content areas based on three domains
namely Knowledge, Comprehension, Analysis.
48. Table-2: DISTRIBUTION OF ITEMS ACCORDING TO THE THREE DOMAINS
IN THE BLUE PRINT:
DOMAINS
NO OF ITEMS
PERCENTAGE
KNOWLEDGE
14
35.00%
COMPREHENSION
5
12.50%
ANALYSIS
21
52.50%
TOTAL
40
100.00%
34
Table-3: DISTRIBUTION NUMBER OF ITEMS AND PERCENTAGE OF MARKS
ACCORDING TO THE AREAS.
ASPECTS
NUMBER
OF PERCENTAGE
QUESTIONS
MARKS
Anatomy and Physiology
13
32.5%
Definition and Types
7
17.5%
Incidence of Infertility
3
7.5%
Causes of Infertility
6
15%
Investigations of Infertility 4
10%
Treatment of infertility
7
17.5%
TOTAL
40
100%
OF
49. DESCRIPTION OF THE TOOL:
The tool was the standardized knowledge questionnaire regarding infertility. Tool
consists of two section-1consisted of baseline variables and section-2 had the knowledge
questionnaire on infertility. Total of 40 items were prepared and each carried one mark.
35
Part I: It consist of the following demographic variables.
DEMOGRAPHIC DATA:
•
Age
• Gender
•
Education
•
Occupation
•
Duration of Treatment
•
Previous Knowledge
Part II: It consists of self administered structured knowledge questionnaire consisting 40
knowledge items related to infertility which dealing about:
•
Anatomy and physiology of reproductive organs
•
Definition and types of infertility
•
Incidence of infertility.
•
Causes of infertility.
•
Investigations of infertility.
•
Treatment of infertility.
50. Part III: It consists of video assisted teaching programme on infertility.
Scoring key:
Scoring Procedure: Scoring key is prepared for
Part I: By coding the demographic variables
Part II: By awarding score for the correct response
Score ‘1’ – correct response
Score ‘0’—wrong response
Maximum score – 40
36
Score interpretation:
To interpret the level of knowledge the scores subjected as
Inadequate
10% -- 40%
Moderate
41% --70%
Adequate
>70
Content validity:
Validity is a measure of truth or accuracy of a claim and is an important concern
throughout the research process. It refers to whether an instrument accurately measures
Measures what it is supposed to measure. Content validity of tool was ascertained in
consultation with ten experts, seven experts were from the field of obstetric and
gynecological nursing, and other three experts were doctors. The experts were requested
to judge the items for accuracy, relevance and appropriateness. The tool was modified
accordingly and content validity index was found to be 0.8.
51. Reliability:
Reliability refers to stability and repeatability of the data collected instrument
(Jacqueline Rose Hott, and Wendy C. Budin, 2006).
In order to establish reliability of the tool the technique called test and retest
method was used and reliability co-efficient was calculated by using the raw formula the
calculated value of ‘r’ was 0.09.The developed tool was found to be highly reliable.
37
INTERVENTION:The intervention in this study was a video assisted teaching regarding knowledge on
infertility. The topic was introduction, anatomy and physiology of reproductive organ,
definition, incidence, types, causes, investigation and treatment. At the end of the teaching
40 question were included for infertile couples self assessment. The questions were
validated by the experts. The duration of the video assisted teaching was 45 minutes.
PILOT STUDY:
Pilot study is a small scale version or trial run done in preparation for a major study.
(Denise f. polit et al 2001).
The refined tools were used for pilot study to test feasibility and practicability. After
obtaining formal permission from the director, of Sarvodaya hospital at Haryana. Pilot
study was conducted. Among 10 infertile couples selected by
convenient sampling technique. The investigator given self
non- probability
introduction, explain the
52. purpose of the study and subject’s willingness to participate in the study we ascertained.
The subjects are assured anonymity and confidentiality of the information provided by
them and written informed consent was obtained. The pretest was conducted by
administering the structured knowledge questionnaire followed by video assisted
teaching on infertility .On the 8th day post test was conducted by using the same.
38
Method of data collection:
The data were collected from the subjected after obtaining formal permission from the
doctors and NS of Sarvodaya hospital at Haryana. The main study was conducted
among 60 subjects. The subjects are selected by non-probability convenient sampling
technique. The investigator given self introduction explained the purpose of the study and
subject’s willingness to participate in the study was ascertained. The subjects are assured
anonymity and confidentiality of the information provided by then and written informed
consent was obtained. The pre test was conducted by administering the structured
knowledge questionnaire followed by video assisted teaching on infertility. On the 8 th
day post test was conducted by using the same tool. Each subject took 45 minutes to
complete the structured knowledge questionnaire.
PLAN FOR DATA ANALYSIS:
53. The data analysis plan included descriptive and inferential statistics.
DESCRIPTIVE STATISTICS:
• Percentage and frequency to analyze demographic variables.
39
INFERENTIAL STATISTICS:•
Paired‘t’ test was used to compare the pre test and post test.
•
Mean and standard deviation to analyze t and post test level of knowledge
scores regarding infertility.
•
Chi square test was used to associate the pre test level of knowledge of score
regarding infertility with selected demographic variables of infertile couples. he
pre and post test level to knowledge regarding infertility.
PROTECTION OF HUMAN SUBJECTS:This research study was conducted was with full consideration for the rights of
human subjects .Only infertile couples were included. The proposed study was conducted
after the approval of hospital authority. The research procedure was explained to the
subjects and written consent was obtained before intervention. Assurance was given to
the study participants regarding the confidentiality of the data collected from them.
54. SUMMARY:This chapter deal with the description of research approach, research design, setting,
variables, population, sample, sampling technique, development and description of the
tool. Validity and reliability of the tool, pilot study, procedure for data collection and the
plan for data analysis.
40
CHAPTER-IV
DATA ANALYSIS AND INTERPRETATION
INTRODUCTION:This chapter deals with analysis and interpretation of the data collected to assess the
effectiveness
of video assisted teaching in improving knowledge regarding infertility
among infertile couples and its interpretation.
The analysis and interpretation of information are based on data collected through
administration of video teaching to the study group. The result were computed using
descriptive and inferential statistics based on the objectives of the study.
PRESENTATION OF DATA:The data obtained were entered in a master data sheet for tabulation and statistical
processing. The analysis of data is organized and presented under the following sections:
SECTION-A: Analysis of sample characteristics-baseline variables.
55. SECTION-B: Knowledge of infertile couples regarding infertility in pre-test and posttest.
SECTION-C: Effectiveness of video assisted teaching on knowledge regarding infertility
by comparing pre-test and post-test knowledge score among infertile couples.
SECTION-D: Association between the level of pre-test knowledge score with their
selected demographic variables.
41
SECTION-A ANALYSIS OF SAPLE CHARACTERISTICS-BASELINE VARIABLES
TABLE-4: Description of baseline characteristics.
Frequency and Percentage distribution of Demographic Variables of Infertility
Demographic Variables
Frequency
Percentage
24
20
11
5
40.0%
33.3%
18.3%
8.4%
30
30
50%
50%
15
19
20
6
25%
31.7%
33.3%
10%
Age
20 – 24
25 - 29
30 - 34
35and above
Gender
Male
Female
Education
Primary
Secondary
Senior Secondary
Graduate
Occupation
75%
57. Fig-1: Depicts that out of 60 subjects 40% were in the age group of 20-24
years, 33.30% in between 25-29 years, 18.30% in 30-35 years and 8.40% were
in the age group of 35 and above.
43
Fig-2: Distribution of subjects according to gender
(No =60)
58. Fig-2: Depicts that there 50% were male participants and 50% were female
participants.
44
Fig-3: Distribution of study participants according to education
(No =60)
59. Fig-3: Depicts that out of 60 subjects none were illiterate, 25% were primary
, 31.70% were secondary, 33.30% were senior secondary, and 105 were
graduate and above.
45
Fig-4: Distribution of study participants according to occupation
60. (No =60)
Fig4: Depicts that out of 60 subjects 25% were unemployed and 75% were
employed.
61. 46
Fig-5: Distribution of subjects according to duration of treatment
(No =60
Fig-5: Depicts that out of 60 subjects 50% were taking treatment below one
year, 34.80% s, 18.30%
were taking treatment from one year, and 14.2 %
were taking treatment above one year.
62. 47
Fig-6: Distribution of subjects according to previous knowledge
(No =60)
Fig-6: Depicts that out of 60 subjects 10% 0f infertile couples had knowledge on
infertility and 90% infertile couples had no knowledge on infertility.
63. 48
SECTION-B:
KNOWLEDGE
OF
INFERTILE
COUPLES
REGARDING
INFERTILITY IN PRE-TEST AND POST-TEST
TABLE-5:
DISTRIBUTION
OF
KNOWLEDGE
LEVEL
REGARDING
INFERTILITY AMONG INFERTILE COUPLES IN THE PRE-TEST
Knowledge on
Inadequate 10-40%
Moderate 41-70%
Adequate >70%
infertility
Pre test
31
51.7
29
48.3
0
0
Table-5: depict that among the 60 subjects, 31(51.7%) subjects had inadequate
knowledge and 29 (48.3%) subjects had moderate knowledge regarding infertility.
TABLE-6:
DISTRIBUTION
OF
KNOWLEDGE
LEVEL
REGARDING
INFERTILITY AMONG INFERTILE COUPLES IN THE POST-TEST
Knowledge on
Inadequate 10-40%
Moderate 41-70%
Adequate >70%
infertility
Post test
0
0%
6
10%
54
90%
Table-6: depict that among the 60 subjects, 6( 10%) subjects had moderate
knowledge and 54 (90%) subjects had adequate knowledge regarding infertility
49
64. Fig-7: DISTRIBUTION OF KNOWLEDGE LEVEL REGARDING INFERTILITY
AMONG INFERTILE COUPLES IN PRE-TEST AND POST-TEST
Fig-7: Depicts the knowledge level regarding infertility among infertile couples in
pre-test and post-test.
50
65. SECTION-C: EFFECTIVENESS OF VIDEO ASSISTED TEACHING ON
KNOWLEDGE REGARDING INFERTILITY BY COMPARING PRE-TEST AND
POST KNOWLEDGE SCORES AMONG INFERTILE COUPLES
TABLE-7: COMPARISON OF MEAN AND STANDARD DEVIATION OF
KNOWLEDGE SCORES REGARDING INFERTILITY IN PRE-TEST AND
POST-TEST
Fig-8: Depicts that out of 60 subjects 10% 0f infertile couples had knowledge on
infertility and 90% infertile couples had no knowledge on infertility.
51
66. TABLE-8: PAIRED t TEST VALUE OF KNOWLEDGE SCORES REGARDING
INFERTILITY
KNOWLEDGE MEAN
S.D
D.F
ON
Paired
t TABLE
VALUE
VALUE
27.41
2.010
INFERENCE
INFERTILITY
PRE-TEST
14.18
3.65
49
SIGNIFICANT
POST-TEST
(p < o.o5)
The table 8- indicates that, the calculated paired t test value 27.41 of pre and post
test knowledge score of infertile couples regarding infertility. Life supporties greater
than table value and found to be high statistical significant at the level of p<0.05
.Hence research hypotheses stated that there will be significant difference between
pre and post test knowledge among infertile couples about infertility. Was accepted.
52
67. SECTION D:ASSOCIATION BETWEEN PRE-TEST KNOWLEDGE SCORES
WITH SELECTED DEMOGRAPHIC VARIABLES OF INFERTILE COUPLES.
TABLE 9: ASSOCIATION BETWEEN THE PRE-TEST KNOWLEDGE SCORES
WITH SELECTED DEMOGRAPHIC VARIABLES OF INFERTILE COUPLES.
Demographic
Variable
Below Above
Mean Mean
Degree of Chi
Freedom
Square
Value
Table
Value
Inference
AGE
23
37
2
0.096
5.99
SIGNIFICANT
GENDER
27
33
1
3.91
3.84
SIGNIFICANT
EDUCATION
37
33
1
6.9
3.84
SIGNIFICANT
OCCUPATION 29
31
4
12.48
9.49
SIGNIFICANT
DURATION
OF
TREATMENT
32
28
3
7.82
7.82
SIGNIFICANT
PREVIOUS
21
KNOWLEDGE
39
3
9.74
7.82
SIGNIFICANT
From the above table 9 findings revealed that there was statistically significant association
between the pre-test knowledge scores with selected demographic variables of the infertile
couples. Like age gender education, occupation, duration of treatment, previous knowledge
at the level of p<0.05 by using chi square test. Hence the research hypotheses stated that
there will be significant association between the pre-test knowledge score with selected
demographic variables was accepted.
53
68. SUMMARY:
This chapter dealt with analysis and interpretation of data using descriptive and
inferential statistics. The data gathered were summarized in the master sheet and both
descriptive and inferential statistics were used for analysis. Findings revealed that the
mean pretest knowledge score of infertile couples was 18.06 and the mean posttest
knowledge score was 32.24. Paired ‘t’ test was used to analyze the effectiveness of video
assisted teaching. Findings show a gain in knowledge which was significant at 0.01level
of significance in infertile couples, who had received the video teaching on knowledge
regarding infertility.
54
69. CHAPTER-V
DISCUSSION, CONCLUSION, IMPLICATION AND RECOMMENDATION
AND SUMMARY
This chapter deals with the discussion of the result obtained from statistical analysis
based on the collected data, objectives, hypotheses and review of literature selected for
the study, summary, conclusion, limitation,implication,and recommendation of the study
for future nursing education, nursing practice, nursing administration and nursing
research.
The purpose of the study was To Assess the Effectiveness of Video Assisted Teaching on
Knowledge Regarding Infertility among Infertile Couple in Selected Hospitals at
Haryana.
DISCUSSION:
The findings of the study were discussed in this chapter with reference to objectives of the
study under the following headings.
SECTION-A: Analysis of sample characteristics-baseline variables.
SECTION-B: Asses the existing Knowledge of infertile couples regarding infertility
in terms of pre-test knowledge score.
SECTION-C:
Knowledge of infertile couples regarding infertility after
administering of the video assisted teaching in terms of post-test knowledge score.
55
70. SECTION-D: Determination of Effectiveness of video assisted teaching on
knowledge regarding infertility by comparing pre-test and post-test knowledge
score.
SECTION-E: Association between the level of pre-test knowledge score with their
selected demographic variables.
SECTION-A: Analysis of sample characteristics-baseline variables:
Distribution of infertile couples according to age( Fig-1) majority of subjects were in the
age group of 20-24 years, and only few subjects were in the age group of 35 and above.
Distribution of infertile couples to gender( Fig-2) female and male were in equal number
in both groups. Distribution of infertile couples according to education ( Fig-3) shows
that out of 60 subjects only 15 were educated at graduation level and above . Distribution
of infertile couples according to occupation ( Fig-4) shows that out of 60 subjects
majority (75%)
were employed. According to duration of treatment distribution of
infertile couples ( Fig-5) out of 60 subjects half of them were taking treatment below one
year, and 14.2 % were taking treatment above one year. Distribution of infertile couples
according to previous knowledge ( Fig-6) 90% of infertile couples had no previous
knowledge on infertility.
56
71. SECTION-B: Assess the existing Knowledge of infertile couples regarding infertility
in terms of pre-test knowledge score.
From the analysis it was found that among the 60 infertile couples 31(51.7% ) subjects had
inadequate knowledge , 29( 48.3%) had moderate knowledge and the overall mean
knowledge score obtained by the subjects was 18.06 with standard deviation 3.83
regarding knowledge of infertility in pre-test.
SECTION-C:
Knowledge of infertile couples regarding infertility after
administering of the video assisted teaching in terms of post-test knowledge score.
In post-test analysis revealed that majority of the subjects 54 (90%) had adequate
knowledge and only 6 (10%) had inadequate knowledge and overall mean knowledge score
obtained by the subjects was 32.24 with standard deviation 2.83 regarding knowledge of
infertility in post-test.
SECTION-D: Determination of Effectiveness of video assisted teaching on
knowledge regarding infertility by comparing pre-test and post-test knowledge
score.
The comparison of pre-test and post-test knowledge regarding infertility revealed that the
calculated‘t’ value of 27.41 which showed high statistical significance at p< 0.5 level.
Hence the research hypotheses state that there will be significant difference in pre and
post-test level of knowledge among infertile couples was retained.
57
72. SECTION-E: Association between the level of pre-test knowledge score with their
selected demographic variables.
OBJECTIVE-5:- To determine the association between the pre-test knowledge with
selected demographic variables.
H2- There will be a significance association at 0.05 level of significance between the pretest knowledge scores with demographic variables at 0.05 level of significance.
Chi-square was used to assess the association between pre-test knowledge and selected
variables such as age, gender, education, occupation, duration of treatment, previous
knowledge and values found was 0.096, 3.91,6.9,12.48,7.82 and 9.74 respectively and
table value found was 5.99,3.84,3.84,9.49,7.82,7.82 respectively hence it is concluded
that there is no association between the baseline variables and knowledge level and
hypothesesH2 is rejected.
There was no association shown between the baseline variables and knowledge scores of
the participants in the study, hence it is concluded that there is no association between the
Knowledge level of the infertile couples with their age, gender, education, occupation,
duration of treatment and previous knowledge. Irrespective of all the baseline
characteristics infertile couples can be trained adequately to gain knowledge regarding
infertility.
58
73. CONCLUSION:
Analysis of the level of knowledge of infertile couples on infertility shown that in pre-test
that among the 60 subjects, 31(51.7%) subjects had inadequate knowledge and 29 (48.3%)
subjects had moderate knowledge regarding infertility. In post-test among the 60 subjects,
6( 10%) subjects had moderate knowledge and 54 (90%) subjects had adequate
knowledge regarding infertility. These shows there was a significant increase in the
knowledge level in the post-test when compared to pre-test.
Effectiveness of video assisted teaching assessed by doing paired t test. In the pre-test the
mean knowledge score was 18.06 and post-test mean knowledge score was 32.24
respectively. The paired t value calculated was 27.41with a SD of 3.65,the table value
was significant at level of 2.010 level of significance. Hence the hypotheses H1 was
accepted. Therefore it is concluded that there was a significant gain in knowledge
regarding infertility through video assisted teaching among infertile couples.
NURSING IMPLICATION S OF THE STUDY:
The investigator had drawn the following implications from the study which is of vital
concern to the field of nursing service, nursing education, nursing administration and
nursing research and nursing practice.
59
74. NURSING PRACTICE
•
The knowledge of infertility is very complex in nature and required to be explored
in all the aspects of phenomena as well as the factors influencing it. The present study was
helpful in identifying the causative factors and treatment modalities of infertility which
will help to design strategies to help the infertile couple face the crisis with confidence
and courage.
•
The study findings have opened several implications for nursing practice in the
reproductive health area.
•
Health education is an important function of the health personnel. Nurses as
resource persons working in community settings and hospitals should disseminate the
proper information especially on prevention aspects of infertility.
•
The infertile couples should be explained about the phases of menstrual cycle, sign
of ovulation and how to plan their sexual intercourse during the period of ovulation.
•
As most of the couples undergo various investigation and treatment procedures,
proper explanations, pre requisites, preparations required, cost involved and the outcomes
has to be adequately informed to infertile couples by the nurses and chances must be given
to clarify their doubts.
60
75. NURSING EDUCATION
•
The nursing curriculum can include video assisted teaching on infertility for better
understanding. The current curriculum in nursing education places much emphasis on
obstetrical care of patients.
•
The curriculum contains need to be revised their importance is also given care of
infertile couple and the advanced reproductive technologies, recognizing the increased in
the incidence of infertility. As the infertile couples have lack of knowledge regarding
infertility and they are very sensitive. The students must clarify their doubt and knowledge
should be provided.
•
Change in the people's unhealthy practices. The major goal of the nursing practices
is to import the knowledge and encourage the healthy practices.
•
The present study assessed the knowledge of infertile couples regarding infertility
.On the basis of findings of the study the following conclusion. The results reveal
that
majority (55%) of the subjects had moderately adequate knowledge with regards to
infertility.
•
The study disclosed that there was a significant association found between the level
of knowledge of infertile couples with their variables.
•
Education enlightens the darkness of the life through the public awareness, increased
and brings demographic variables such as age, educational status, occupation, duration of
61
76. Married life, duration of treatment, previous knowledge
NURSING THEORIES:
The conceptual and theoretical models exclusively for the use of reproductive health
nursing practice are yet to be developed by the nursing theorists. The path analysis used to
provide knowledge to infertile couples is presented in the present study in the form of a
conceptual model which can be used to educate and guide the nurses in caring for infertile
couples.
NURSING ADMINISTRATION:
Nurse as an administrator plays an important role in educating the professionals such as
mass health education measures in the community as well as hospitals.
•
The nurse administrator should formulate policies, protocols, guidelines and systems
of care in collaborations with the multi-disciplinary team
•
Nurse administrator should take the initiate in organizing in-service and continuing
educational programs and short term courses to prepare the staff nurses get specialized in
caring for infertile couples.
•
Nurse administrator ensures professional practice which is research based and
which is clinically effective.
•
Nurse administrator should take into consideration about facilities and supplies of
all resources made available in the library related to infertility.
62
77. • This will help the staff and student to reinforce and enhance their knowledge on
infertility.
NURSING RESEARCH
The essence of research is to build a body of knowledge in nursing. The finding of the
present study serves as the basis for the professional and students to conduct further
studies. Nursing research is the means by which nursing profession is growing.
• Nursing research with regard to support of infertile couple is not well developed .Further
research in the area of knowledge regarding infertility among infertile couples are
required to identify specific interventions that would be useful in helping the infertile
couples to achieve their ultimate goal of becoming a parent.
• The interventions which will increase marital adjustment, family support and decrease
stress
of infertile couples are to be developed, tested through research and
recommended for practice.
• Research on nurse's knowledge regarding infertility should be carried out continuously to
assess their knowledge and upgrade their knowledge and practices.
4.The video assisted teaching prgramme can be implemented to the infertile woman and
their families and its effectiveness in reducing the lack of knowledge in infertile woman
can be researched.
63
78. • Discrimination of findings through conference, professional journals and internet
will make application of research findings to be effective.
RECOMMENDATIONS:
•
The study can be replicated in different settings.
•
The same study can be done on a larger population for
a more valid
generalization.
•
The knowledge, attitude and practice of reproductive health nurses in
psychological intervention for infertile couples can be studied.
•
A comparative study can be conducted to evaluate the effectiveness of video
assisted teaching to assess the knowledge of infertile couples.
•
A similar study can be undertaken by adopting a true experimental design using
structured teaching program to improve the knowledge of infertile couple.
LIMITATIONS:
The study is limited to infertile couples of a hospital and is limited to 60 infertile couples.
79. 64
SUMMARY
The primary aim of the study was to assess the effectiveness of video assisted teaching
regarding knowledge of infertility among infertile couples in selected hospital at
Haryana.
THE OBJECTIVES OF THE STUDY WERE
•
To assess the pre-test knowledge of infertile couples regarding infertility in select
•
To assess the post-test knowledge of infertile couples regarding infertility in
selected hospitals.
• To compare the pre-test and post knowledge of infertile couples.
•
To assess the effectiveness of Video Assisted Teaching on
knowledge regarding infertility among infertile couples.
•
To determine the association between the pre-test knowledge with
selected demographic variables.
The study based on the assumption that:
•
Most of the infertile couples are not having enough knowledge regarding
infertility.
•
Participatory care will improve self esteem towards the promotion of health.
80. The research hypotheses formulated were:
•
H1: There will be a significant difference between the mean pre-test and mean
post-test knowledge score of infertile couples.
65
•
H2: There will be a significance association at 0.05 level of significance between
the pre-test knowledge scores with demographic variables of infertile couples.
The review of literature is discussed under 2 sections, infertility and studies related to
video teaching.
Conceptual framework adopted for the study was based on Bertalanffy’s General System
Theory.
The research approach adopted for this study was an evaluative approach. The quasi
experimental design was adopted for the present study and non-probability convenient
sampling technique was used to select the samples. The data was collected from 60
infertile couples by using a structured knowledgeable questionnaire followed by a video.
The content validity of the tool was done by 8 experts. The reliability of the tool was 0.08.
the obtained data was analyzed in terms of objectives and hypotheses using descriptive
and inferential statistics.
Among the 60 infertile couples 31(51.7%) subjects had inadequate knowledge,
29(48.3%) had moderate knowledge and the overall mean knowledge score obtained by the
subjects was 18.06 with standard deviation 3.83 regarding knowledge of infertility in pre-
81. test. In post-test analysis revealed that majority of the subjects 54 (90%) had adequate
knowledge and only 6 (10%) had inadequate knowledge and overall mean knowledge
score obtained by the subjects was 32.24 with standard deviation 2.83 regarding
66
Knowledge of infertility in post -test.
The comparison of pre-test and post-test knowledge regarding infertility revealed that
the calculated’ value of 27.41 which showed high statistical significance at p< 0.5 level.
Hence the research hypotheses state that there will be significant difference in pre and
post-test level of knowledge among infertile couples was retained. Therefore it is
concluded that there was a significant gain in knowledge regarding infertility through
video assisted teaching among infertile couples.
82. 67
BIBLIOGRAPHY
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Available from: URL: http://mentalhelp.net
2) D C Dutta. Textbook of gynecology. 4th edition. Kolkata: new central agency; 2007.
212-213
3) US Census Bureau. Statistics by Country for Female infertility. Population Estimates
2004
4) D .Kumar. Prevalence of infertility. Journal of rural and remote health research [serial
online] 2007 May 8; 7. Available from: URL: http://www.rrh.org.au
Siti Nurani Mohr Nor. New Reproductive Biotechnology Values and Society. Eubios
Journal of Asian and International Bioethics. [serial online] 1999; 9: 166-9. Available
from: URL: http://eubios.info/index.html
5) Kangar. Late marriages impacting demography. Journal of health care system 2009
Nov; 284-290.
6) M.B Wingate. Recent advances in investigation. Can med assoc J. [serial
online]1998Nov1; 43. Available from: URL:http//www.ncbi.nlm.nih.gov/pmc
83. 7) Alice D. Domar. Conquering Infertility Mind/Body Guide to Enhancing Fertility and
Coping With Infertility .Human reproduction [serial online] 2002 Oct; 17(5): 1534-46.
Available From: URL: http://www.helium.com/
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8) Kangar. Late marriages impacting demography. Journal of health care system
9 .Boivin J, Andersson L, Psychological reaction during in vitro fertilization: similar
response pattern in husbands and wives . J Human Repord. 1998, 13: 3262-3267.
10. Seif D, Albrzi S. The effect of emotional and demographic factors on life- satisfaction
of infertile women. InSfertility and Reproductive J. 2001,66: 71-74.
11. Infertility: Frequently asked question. National’ Women’s Health Information center.
http://www.womenshealth.gov/FAQ.cfm. Accessed April 30, 2009.
12.Brassard M., et al., Basic infertility including polycystic ovary syndrome. Medical
clinics of North America. 2008,,92:1163
13. Shushan A., Eisenberg V.H., Schenker JG. Subfertility in the era of assisted
reproduction: change and consequences, Fertil Steril, 1995, 64:459—469.
14. Crosignani P.G ,Rubin B., Guidelines to the prevelance , diagnosis, treatment and
management of infertility , Hum repord. I996,11: 1775-1807.
84. 15 .John A.C., Ying S., Wilson E.H., Can Med Assoc. J ., vol . 130, February 1, 1984:
269.
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16.
K
Jain,
G.
Radhakrishnan
,P.garwal,
Infertility
and
psychosexual
disorders:Relationship in infertile couples, Indian journal of medical sciences
200054(1)1-7.
17.Jacky Bovin,Laura Buntin, John A. Collins and Karl G.Nygren. Intrnational estimate
of infertility prevalence and treatment seeking : Potential need and demand for infertility
medical care. Human Reproduction 2007 22 (6) 1506-1512.
18. Farhi J,Ben-Haroush A. Distribution of causes of infertility in patients attending
primary fertility clinics in Israel. Isr Med Assoc J , 2011 JAN ;13(1): 51-4.
19. Chachamovich JR, Chachamovich E,Ezer H, Fleck MP, Knauth D,PassosEP.
Investigating quality of life and health related quality of life in infertility. 2010 Jan;
31(2):101-10
20.Kjellberg S, Sydsjo G, Glebe K. Sundelid M. Knowledge of and attitude towards
infertility held by members of two country councils in Sweden. Acta Obstet Gynecol
Scand 2000 Nov; 79 (11) : 1015-20
85. 21.Imeson M, McMurry A.
Phenomenological study of couples experiences 1of
infertility . J Adv Nurs 1996 Nov ; 24 (5): 1014-22.
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22. Benyamini Y, Gozlan M, Kokia E, Women’s and men’s perception of infertility and
their association with psychological adjustment. Br
J health psycho 2009 Feb; 14
(pt1):,1-16.
23.Suhrabrand F, Jafasabadi M. Knowledge and attitude of infertile couples assisted
reproductive technology . Iranian Journal of reproductive Medicine 2005;3(2) 90-4.
24.Parazzini F, Treatment for infertility and risk of invasive epitelialcancer Hum Repord
1997:12:2159-2167.
25.World Health Organization;towards more objectivity in diagnosis and management of
fertility .J.Andeol1997;7(suppl):1-53.
26. Zargar AH , Wani AI, Masoodi SR , Laway BA. Epidemiological aspects of primary
infertility in Kashmir. 1997 Oct.
27. Jacobson C., Reproductive genetics center Vienna, Virginia.
28. Skakkebaek N. E., Lancet, June 11, 1994: 1474.
86. 29.Sachita Sahachoudhary, Fertilizing ability of human sperm. The nursing journal of
india 2006 Nov.
30.National Summary and Fertility clinic report, Atlanta:2008.
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31 World Health Organization, Manual for the standardized investigation and diagnosis
of the infertile couple, Cambridge University Press.U.K, 1993.
32. Howard Jones, New England Journal of Medicine December 2,1993:1710.
33. Baird D., Journal of the, American Medical Association, 1985, 253:2979-8324.
34. Rivard C.I., Journal of the American Medical Association, December 22, 1993.
35. Bogus law, Environmental Health Perspectives 1993, 101(suppl 2):85.
36. Collins J.A., New England Journal of Medicine November 17, 1983.
37. Shushan A., Eisenberg V.H., Schenker JG. Sub fertility in the era of assisted
reproduction: change and consequences, Fertile Steril, 1995, 64:459—469.
38. Nalini B., Shenoy S.K., The Role of Herbal Drugs in Infertile Couples, Obs, &
Gynae., Today, 2003, 8 (5): ,281-287.
39. William J. P., et. Al., Neurobehavioral Toxicology, 1979, 2:1-4.
87. 40. Cooper T.G., Keck C, Oberdieck U, Nieschlag E. Effects of multiple ejaculations
after extended periods of sexual abstinence on total, motile and normal sperm numbers,
as well as accessory gland secretions, from healthy normal and oligozoospermic men.
Hum Reprod, 1993, 89:1251-1258.
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41. World Health Organisation ;Towards more objective in diagnosis and management of
fertility. J.Andeol 1997:7(suppl):1-53.
42. Iteikkela K, Lansimees E,Hippelainen M, Heinonen S. A suevey of the attitude of
infertile
parous
women
towards
the
availability
of
assisted
reproductive
technology.International journal of obstetrics 2004 Nov; 111:1229-35
43. Kumarisathya k. A study to determine the effectiveness of video assisted teaching Vs
lecture method on knowledge of newborn assessment,. India 2005.
URL:http://digitoollibrary.megill.ca/R/?func=dbm-,jump-full&objectid=23446&local
base GI:NO1
44. A study to assess the effectivenes of video assisted nursing intervention on
lumbosacral pain and activities of daily living among antenatal primi mother at SRH.
45 Maleki Z.Mahdian M. Assessment of efficacy of a video-assisted teaching programme
on the knowledge of undergraduate students .BMJ 2006 Oct ; 14(5): 682-689.
88. 46 Yoo MS, et.all Video-based self – assessment: Implementation and evaluation in an
undergraduate nursing course. Nurse education today ,2009 Aug ; Volume 29 (6): 585590.
73
89. ANNEXURE-II
INFORMED CONSENT
I understand that I am being asked to participate in research study at Sarvodaya
hospital. This research study will evaluate “The effectiveness of video assisted
teaching programme on knowledge regarding infertility among infertile couple’’
If I agree to participate in the study, I will be attending a knowledge and a video
assisted teaching programme last for 45 minutes followed by a post test.
I realize that the knowledge gained from this study may help either me or other
patients and there are no known risks associated with this study.
I realize that my participation in this study is entirely voluntary, and I may
withdraw from the study at any time I wish. I understand that all study data will be
kept confidential.
The study has been explained to me .I has read and understands this consent
form, all of my questions have been answered, and I agree to participate.
Signature of subject
Date
90. Signature of investigator
Date
75
ANNUXRE-III
PART-1 (TOOL)
DEMOGRAPHIC DATA
Name
1. Age
a.20 years --- 24 years
b.25 years --- 29 years
c.30 years --- 34 years
d.35 years and above
2.Gender
a. Male
b. Female
3.Education
a. Primary
b.Secondary
c.Senior secondary.
d.Graduate / post graduate
4. Occupation
a Employment
b Unemployment
5.Duration of Treatment
a.Below one year
b.One year
c.Above one year
S.NO ----
91. 6 Previous Knowledge
a.Yes
b.No
76
SECTION –II
INSTRUCTION: Encircle the most appropriate option out of given choices.
1. What do you mean by fertilization?
a. Development of reproductive organ
b.Family planning methods
c.Any disease condition of reproductive organ.
d.Fusion of sperm and ovum
2. Which of the following are main reproductive organs of a female?
a.Kidney, Ureters ,Urethra
b.Vagina ,Ovaries, Fallopian tubes, uterus
c.Stomach, Uterus, Small intestine
d.Ovum, Fallopian tube, Pancreas
3. Which of the following are main reproductive organs of a male?
a.Liver, Gallbladder, Pancreas
b.Kidney, Ureter, Nephron
c.Scrotum, testes, prostate gland, penis
d.ovaries, testes, penis
4. Which of the following causes fertility in males?
a.Ovum
b.Bacteria
c.Sperms
d.Atoms
92. 5. Which of the following causes fertility in female?
a. virus
b. Ovum
77
c. Molecules
d. Atoms
6. Which of the following reproductive organ produce spermatozoon?
a. Liver
b.Scrotum
c.Urethra
d.Fallopian tubes
7.
Which female reproductive organ produce ovum?
a. Ovary
b.Uterus
c.Fallopian tubes
d.Liver
8. Which of the following contains sperms?
a.Urine
b.Bile
c. Seminal fluid
d. Acid
9. What is the amount of seminal fluid ejaculated by man after intercourse normally?
a.1ml – 3 ml
b.2 m l– 5 ml
c.10 ml – 12 ml
d.40 ml-50 m
10. What is the normal count of sperms in an ejaculated seminal fluid?
a.1 million/ ml
93. b.5 million/ ml
c.20 million/ ml
d.50 million/ ml
78
11.What is the age of menarche in a woman?
a.12 – 13 years
b.14 –15 years
c.16 – 17 years
d.18 – 19 years
12. How many times menstrual cycle occur in a month normally?
a.Four times
b.Three times
c.One time
d.Two times
13. What is the duration of menstrual cycle ?
a.1 – 2 days
c.4 – 5 days
d.8 – 9 days
d.10 – 12 days
14. What do you mean by Infertility?
a. Occurrence of menstrual cycle
b. Not birth of a male child after one year of marriage
c.Not development of reproductive organ
d. Failure to conceive within one or more years of regular unprotected sex
15. In which of the following infertility occurs?
a.Only in females
94. b.Only in males
c.males & females
d.None of the above
79
16. What is the incidence of infertility in male?
a.0 %
b.20%
c.40%
d.60%
17. Which of the following is incidence of infertility in female?
a.40%
b.60%c
c.80%
d.100%
18. Which shows the incidence of infertility in males and females?
a.10 – 20 %
b.30 –40%
c.50 - 60%
d.70 – 80%
19. Which of the following are types of infertility?
a. External, Internal.
b.Primary, secondary, tertiary.
c.Biological, physical.
d.Primary,Secondary, Unexplained
20. What do you mean by primary infertility?
a.No delivery of a male child.
95. b.Spontaneous miscarriages.
c.Who have never conceived?
d.Use of contraceptives.
80
21. Which of the following is true about secondary infertility?
a.Have twins pregnancy.
b.Have previous pregnancy but failure to conceive subsequently
c.Have not conceived after two years of marriage
d.Have two female child
22. What do you mean by unexplained infertility?
a.Faults in both male and female detected in one year of married life.
b.Couple who have Hormonal deficiency
c.Couples who are infertile with no abnormality detected
d.Couple who have sexually transmitted diseases
23. Which of the following are main cause of infertility in male?
a. Oligospermia, Azoospermia, Impotency
b.Oligospermia, Heamaturia , Impotency
c.Haemrrhoids, Oligospermia,
d.Impotency, Oligospermia, Azoospermia
24. What factor can cause infertility in males ?
a.Working in hot atmosphere
b.Working in cold atmosphere
c.Working in dry atmosphere
d.Working in humid atmosphere
25. Which of the following are main cause of infertility in females ?
a. Anovulation, Blocked fallopian tubes
96. b.Leucorrhoea, Anovulation
c. Blocked fallopian tubes, Menorrhagia
d . Leucorrhoea, , Menorrhagia
81
26. What disease can cause infertility in females?
a.Jaundice
b.Typhoid Fever
c.Chicken Pox
d.Fibroid uterus
27. Which of the following diseases cause infertility in males ?
a.Poliomyelitis
b.Renal calculi
c.Mumps occur in puberty
d.Measles
28. In which conditions sperms are not form in males?
a.Undescended testes
b.Any trauma of testes
c.tumor of testes
d.All of the above
29. What is the main investigation for male infertility?
a.Semen analysis
b.Chest X - ray
c.Stool examination
d.Sputum examination
30. In which conditions testicular biopsy is done?
a.Oligouria
b.Azoospermia
97. c.High amount of semen
d.Premature ejaculation
82
31. Which of the following female reproductive organs are investigated for infertility?
a.Ovaries, fallopian tube, uterus
b.Ovum, Fallopian tube, Uterus
c.Stomach, rectum, vagina
d.lungs, intestine, femur
32. What are the investigations done to identify blocked fallopian tubes?
a.Inflation of fallopian tube
b.Biopsy of fallopian tube
c.MRI of fallopian tubes
d.surgery of fallopian tube
33. Which of the following should be adopted by infertile couples?
a.Avoid wearing of loose undergarments
b.Avoid eating of fresh vegetables
c.Avoid wearing of cotton undergarments
d.Avoid wearing of tight undergarment
34. What is the treatment for blocked fallopian tubes?
a.Through tubal ultrasound
b.Through tubal medicine
c.Through tubal surgery
d.Through tubal radiation
35 Which of the following is the treatment of unexplained infertility?
a.Assisted reproductive therapy
b.Assisted reproductive technology
98. c.Assisted reproductive treatment
d.Assisted reproductive terminology
83
36. Which statement is true regarding artificial insemination?
a.In this concentrated sperm is injected through a catheter within the uterine cavity
b.In this concentrated drug is injected through a catheter within the uterine cavity
c.In this concentrated dye is injected through a catheter within the uterine cavity
d.In this concentrated ovum is injected through a catheter within the uterine cavity
37. Which of the following is treated by Artificial Insemination Donor?
a.Hypospadiasis
b.Azoospermia
c.Undescended testes
d.Hydrocele
38. Which statement is true regarding artificial insemination donor?
a.Donor should be non-vegetarian and healthy.
b.Donor’s culture, race and religion should be matched with husband.
c.Donor’s family background and native place should be matched with husband.
d.Donor’s blood group, hair, skin & eye color should be matched with husband.
39. Which of the following technology is included in assisted reproductive technology?
a.IVF
b.MRI
c.EEG
d.ECG
40. What do you mean by Surrogacy?
a.Child adoption
b.Surrogate mother
99. c.In Vitro Fertilization
d.Twin pregnancy
84
ANSWER KEY
ITEM
ANSWER
NUMBER
MARKS
ITEM
ANSWER
ALLOTED NUMBER
MARKS
ALLOTED
1
d
1
21
b
1
2
b
1
22
c
1
3
c
1
23
a
1
4
C
1
24
a
1
5
b
1
25
a
1
6
b
1
26
d
1
7
a
1
27
c
1
8
c
1
28
d
1
9
b
1
29
a
1
10
C
1
30
b
1
11
a
1
31
a
1
12
c
1
32
d
1
13
b
1
33
d
1
14
d
1
34
c
1
15
c
1
35
b
1
16
c
1
36
a
1
17
a
1
37
b
1
18
a
1
38
d
1
102. 94
ANNUXRE-IV
LETTER REQUESTING OPINION AND SUGGESTION OF EXPERTS TO VALIDATE
THE TOOL
From:
Ms: Hem kumari
2nd year M.Sc. Nursing
Sophia Nursing college
To,
Through the Principal
Sophia nursing college
Sub: Request for expert opinion and suggestions to establish content validity for research tool.
Respected Sir/Madam,
I Ms. Hem kumari 2 nd year M.Sc Nursing (OBG Nursing)student of Sophia Nursing
College have selected the following topic for my dissertation to be submitted to Jiwaji University in
partial fulfillment for a Master of science in Nursing.
Topic: A study to assess the effectiveness of video-assisted teaching programme knowledge of infertility
among infertile couples in selected hospitals of Haryana.
Herewith I have enclosed:
•
Statement of the problem, objectives of all study and operational definitions
•
Blue print of the tool
•
Tool containing baselines Performa, questionnaire
•
Criteria checks list
I request you to go through the items and give your valuable suggestions and opinion to develop the
content validity of the tool. Kindly suggest modification, addition, deletions if any in the remark
column.
103. ,
Thanking you,
Yours Sincerely,
95
ANNEXURE-V
CERTIFICATES FOR THE CONTENT VALIDITY
This is to certify that the tool developed by Ms Hemkumari M.Sc Nursing student of
Sophia College of Nursing Gwalior (affiliated to Jiwaji University) is validate by me. He
can proceed with this tool and can conduct the main study for dissertation entitled
“The effectiveness of video-assisted teaching programme knowledge of infertility
among infertile couples in selected hospitals of Haryana’’
Date
Name
Place
Signature
Desiginaton