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Effectiveness of Structured Teaching Programme on Knowledge and Attitude

regarding Prevention of Cancer Cervix among Women in selected


Rural Community at Hyderabad in Telangana State

By

Mrs.V.Bhulaxmi

Government College of Nursing, Somajiguda, Hyderabad, Telangana


Kaloji Narayana Rao University of Health Sciences, Warangal,
Telangana.
2021
Certified that this is the Bonafide work done
By

Mrs. V. Bhulaxmi
At Government College of Nursing, Hyderabad, T.S.

Submitted to Kaloji Narayana Rao University of Health Sciences,


Warangal, in partial fulfillment of the Requirement for the Degree of M. Sc
(Nursing)

Regd. No. 19501400008


MSc (Nursing) IInd yr.

Prof. Mrs. D.R. Radha Rukmini


M.Sc(N)
Principal,
Government College of Nursing,
Hyderabad.
Effectiveness of Structured Teaching Programme on Knowledge and Attitude
Regarding Prevention of Cancer Cervix among Women in selected
Rural Community at Hyderabad in Telangana State

Submitted to

Kaloji Narayana Rao University of Health Sciences, Warangal,

Telangana,

In the Partial Fulfillment of the requirement

For the Degree of MSc. Nursing

2021

By

Mrs.V.Bhulaxmi

Mrs.G.Sudha Mrs.R.Hansli,
MSc (Nursing), MSc (Nursing),
Lecturer, AsstProfessor,
Government College of Nursing. Government College of Nursing.
ABSTRACT

Present study was conducted by Mrs.V.Bhulaxmi in partial fulfilment of


requirement for the award of the degree of Master of Science in Nursing
at Government College of Nursing, Somajiguda, Hyderabad under
K.N.R. University of Health Sciences, Warangal, Telangana, during the
years 2019-2021.
Objectives of the Study:
1. Assess the knowledge prevention of cancer cervix among women.
2. Plan and administer the structured teaching programme on prevention
of cancer cervix among women.
3. Effectiveness of structured teaching programme on prevention cancer
cervix among women.
4. Correlate the knowledge on prevention of cancer cervix with attitude.
5. Find out the association between knowledge and attitude on cancer
cervix among women with selected demographic variables.
Research design selected for the present study was Non- experimental,
Descriptive design. A Structured Questionnaire and Likert Scale were used
to collect data. The content validity of the tool was obtained from experts in
the field of Obstetrics and Gynaecology Nursing, Dept of Obstetrics and
Gynaecology, Psychology Department and Rehabilitation Psychologist. The
study was conducted at AT Chintal Basthi, Hyderabad, Telangana. The
population for the study was Women who were living rural community at
Hyderabad,Telangana. Convenient sampling technique was used for the
selection of sample. Total sample for the study was 10 the reliability of the
tool was tested by using Karl Pearson’s coefficient correlation method and
the tool was found to be reliable (Correlation=0.695, reliability=0.810).

Pilot study was conducted at Chintal Basthi, Hyderabad, Telangana State.


The study was found to be feasible, practicable and appropriate. The data
collection was done from 31st April 2021 to 3rd May2021 at Chintalbasthi,
after the study was proved to be reliable. The main study was conducted at
at Khairathabad, Hyderabad, Telangana State. The conceptual framework
of the study was based on health belief model it explains the knowledge
and attitude of women towards Cervix cancer and The perceptions in the
present study are previewed knowledge and attitude towards prevention of
cervix cancer. The main aim of this model was to assess the knowledge and
Attitude of women gain regarding a Structured Questionnaire and Attitude
Scale and integrating research findings. The study findings revealed that
the majority of the samples were 36.0% of women belong to 25 - 29
years,92.5% of women were Hindu religion,56.5% were studied inter and
above ,78.0% were Home maker,92.5% have Rs. 10,000- 19,999of family
monthly income,93.0 % of women were married, 59.0% ofwomen had two
deliveries.,68.5% of women having information from health
personnel,55.0% were following mixed diet,96.5% of women not having
previous history in the family. The chi-square(x2) values computed for the
Knowledge Scores, and selected demographic variables like Age (9.9),
Religion (3.5), Educational status of the Women (27.3),
Occupation(0.4),Income (0.9), Marital Status(2.3), number of
delivery’s(2.9), Where do you know from health information about Cancer
cervix(3.3), Dietary Pattern(10.2) and If history of cancer cervix in the
family(8.3). In Chi-square shows age, education, Dietary pattern were
significant and other demographic variables no significant association with
the selected demographic variables. The chi-square(x2) values computed
for the Attitude Scores and selected demographic variables like Age (5.0),
Religion (1.1), Educational status of the Women (12.2),
Occupation(4.6),Income (2.6), Marital Status(0.8), number of
delivery’s(1.5), Where do you know from health information about
Cancer cervix(10.5), Dietary Pattern(2.2) and If history of cancer cervix
in the family(0.2). In Chi-square shows education, Where do you know
from health information about Cancer cervix were significant and other
demographic variables no significant association with the selected
demographic variables.

Acknowledgement

The investigator expresses immense gratitude to the Almighty God


for His Omnipotent Presence throughout the study.
The investigator takes this opportunity to pen down her gratitude to
many people who have rendered a helping hand by providing guidance and
encouragement in accomplishment.
The investigator owes her deep sense of gratitude to our beloved
principal, I express my heartfelt thanks to Prof. Mrs. D. R. Radha
Rukmini, and Prof. Dr. B. Vidyullatha, Principal, Government College
of Nursing, Hyderabad, for her valuable suggestions, eminent guidance and
constant encouragement which has continually motivated the investigator
for the successful completion of the study.
The investigator sincerely extends a deep sense of gratitude to her
guide, Mrs. R Hansli, Asst. Professor, HOD of Obstetrics and
Gynecological Nursing Dept, Government College of Nursing, Hyderabad,
for the dedicated guiding spirit, constant encouragement, constructive
suggestions and cooperation, without which it is hard to imagine the
completion of study successfully.
The investigator is greatly indebted and express my heartiest
gratitude and sincere thanks to research guide, Mrs. G.Sudha, Lecturer,
Government College of Nursing, Hyderabad, for the constant support,
valuable constructive suggestions and cooperation in completion of the
study.
The investigator extends my deep gratitude and sincere thanks to
Faculty members of the Government College of Nursing, Hyderabad,who
had validated the tool for their kindness and priceless expertise.
The investigator extends my sincere thanks to Mr. Dr.E.Krishna Kishore,
Statistician, for their untiring efforts in data interpretation andstatistical analysis.

The investigator expresses her sincere thanks to the women in the


study for their whole hearted cooperation and without whom this study
would not have been possible.
With folded hands I extended my deep sense of gratitude to my
evolving Parents and my husband Mr. L.Raju, my daughter Mrs.
V.Brunda, my son Mr. L. Bharath and those whose hard work and
sacrifice made me to stand in this stage.
A special thanks to my friends for their cooperation in gathering
materials from different resources and supporting in times of needs.

My earnest thanks and gratitude to all those who directly or


indirectly helped in successful completing this study.

Mrs. V.Bhulaxmi
Table of Contents

Sl. No. List of Contents


Page No.

I Introduction 1 – 11

Introduction 1-4
Need for the study 4-6
Statement of the Problem 6
Objectives 6
Operational definition 7
Assumptions 7
Research Hypothesis 8
Limitations of the study 8
Conceptual Framework 8-11
Summary 11

II Review of Literature 12 - 24
Literature related
Epidemiology Of Cervical
Cancer

Literature related to knowledge attitudes


and Intentions in prevention of cervical cancer

Literature related to effects of educational methods


on the knowledge, in prevention of cervical cancer

III Methodology 25-32


Research approach 25
Research design 25-26
Study Variables 27
Variables 27
Setting of the study 27
Population 27
Target Population 27
Accessible Population 27

Sample 28
Sampling technique 28
Duration of the study 28
Sampling method 28
Criteria for sample selection 28
Tools of research 28-29
Content validity 30
Reliability 30
Scoring and Grading 30
Pilot study 31
Data collection procedure 31
Plan for data Collection 31
Ethical considerations 32
Summary 32

IV Data Analysis, Interpretation & Discussion 33-90

Analysis, Objectives and Research Hypothesis 33-36

Section A - Distribution of Frequency and 37 - 49

Percentage according to their demographic

Section B- Frequency and percentage distribution 50 - 55


of Women according to the knowledge
and attitude levels

Section C - Overall Mean and Standard deviation 56 - 61


of the knowledge and attitude scores

Section D- Association between the knowledge 62-87


and attitude scores with the selected
demographic variables

Section E - Correlation between knowledge 88


and attitude of women

Summary 88-90
V Summary and Conclusion 91-98
Objectives of the study 91

Hypothesis 91
Summary of the Study 92
Major findings of the study 93-95
Implications of the study 96
Implication in the Nursing Practice 96
Nursing Education 96
Implication in Nursing Administration 96
Implication for Nursing Research 97
Limitations 97
Recommendations 97-98
Conclusion 98

VI References 99-103

VII Appendices 104-180


LIST OF TABLES
Page
Sl.No Tables
No
1 Incidence rate of Cancer Cervix (Source of Google Search
(WHO 6

2 Frequency and Percentage distribution of Womenaccording


to their Age, Religion, Educational status, Occupation 37

3 Frequency and Percentage distribution of Women


according to their Income per month, Marital status, 42
Number of Delivery’s
4 Frequency and Percentage distribution of Women
according to their Where do you know from health
46
information about Cancer cervix, Diet pattern, If history of
cancer cervix
5 Frequency and Percentage of distribution of Women
according to Level of Overall Knowledge in Pre test and 50
Post test on Prevention of Cancer Cervix.
6 Frequency and Percentage of distribution of Women
according to Cancer Cervix and prevention of cancer 52
cervix of Level of Knowledge in Pre test and Post test.
7 Frequency and Percentage of distribution of Women
according to Level of Attitude in Pre test and Post test on 54
Prevention of Cancer Cervix.
8 Overall Knowledge Scores and Std.Deviation Paired T-
Test of Significance on Prevention of Cancer Cervix 56
among Women.
9 Pre Test and Post Test Mean of overall Knowledge Scores
and Paired T-Test of Significance on about Cancer Cervix 58
among Women.
10 Pre Test and Post Test Mean of Attitude Scores and Paired
T-Test of Significance on Prevention of Cancer Cervix 60
among Women.
11 Association between Post Test Knowledge Scores of
Women on Prevention of Cancer Cervix with Age, 62
Religion, Educational Status, Occupation.
12 Association between Post Test Knowledge Scores of
Women on Prevention of Cancer Cervix with Income per 67
month, Marital Status, Number of Delivery’s.
Sl.No Page
Tables No
13 Association between Post Test Knowledge Scores of
Women on Prevention of Cancer Cervix with Where do you 71
know from health information about Cancer cervix,
Dietary Pattern, If history of cancer cervix in the family.
14 Association between Post Test Attitude Scores of Women
on Prevention of Cancer Cervix with Age, Religion, 75
Educational Status, Occupation.
15 Association between Post Test Attitude Scores of Women
on Prevention of Cancer Cervix with Income per month, 80
Marital Status, Number of Delivery’s.
16 Association between Post Test Attitude Scores of Women
on Prevention of Cancer Cervix with Where do you know 84
from health information about Cancer cervix, Dietary
Pattern, If history of cancer cervix in the family.
17 To Test Correlation between Knowledge Score and
Attitude Score among Women regarding Prevention of 88
Cancer Cervix
LIST OF FIGURES
Sl.No Figure Page No
1 Conceptual Frame work of the study 10

2 Research Design 26
3 Pie Diagram Shows Frequency and Percentage distribution of 38
Women according to their Age
4 Bar diagram Shows Frequency and Percentage distribution of 39
Women according to their Religion
5 Doughnut diagram shows Frequency and Percentage distribution 40
of Women according to their Educational status
6 Cone diagram shows Frequency and Percentage distribution of 41
Women according to their Occupation
7 Pyramidal diagram shows Frequency and Percentage distribution 43
of Women according to their income per month
8 Cylinder diagram shows Frequency and Percentage distribution 44
of Women according to their Marital status
9 Pie diagram shows Frequency and Percentage distribution of 45
Women according to their Number of Delivery’s
10 Bar diagram shows Frequency and Percentage distribution of 47
Women according to their Where do you know from health
information about Cancer cervix
11 Doughnut diagram shows Frequency and Percentage distribution 48
of Women according to their diet pattern
12 Pie diagram shows Frequency and Percentage distribution of 49
Women according to their history of cancer cervix in the family
Sl.No Figure Page No
13 Bar diagram shows Frequency and Percentage distribution of 51
Women according to Overall knowledge level regarding
Prevention of Cancer Cervix
14 Bar diagram shows Frequency and Percentage distribution of 53
Women according to Section Wise knowledge level regarding
Prevention of Cancer Cervix
15 Cylinder diagram shows Frequency and Percentage distribution 55
of Women according to Attitude knowledge level regarding
Prevention of Cancer Cervix
16 Cylinder diagram shows mean and Std. deviation distribution of 57
Women according to Overall knowledge regarding Prevention of
Cancer Cervix
17 Bar diagram shows mean and Std. deviation distribution of 59
Women according to Section Wise Knowledge regarding
Prevention of Cancer Cervix
18 Bar diagram shows mean and Std. deviation distribution of 61
Women according to Attitude knowledge regarding Prevention
of Cancer Cervix
19 Bar diagram shows Association between Overall knowledge 63
Level and age in years regarding Prevention of Cancer Cervix
among Women
20 Cylinder diagram shows Association between Overall 64
knowledge Level and religion regarding Prevention of Cancer
Cervix among Women
21 Bar diagram shows Association between Overall knowledge 65
Level and educational status regarding Prevention of Cancer
Cervix among Women
Sl.No Figure Page No
22 Pyramidal diagram shows Association between Overall 66
knowledge Level and Occupation regarding Prevention of
Cancer Cervix among Women
23 Bar diagram shows Association between Overall knowledge 68
Level and income per month regarding Prevention of Cancer
Cervix among Women
24 Cylinder diagram shows Association between Overall 69
knowledge Level and marital status regarding Prevention of
Cancer Cervix among Women
25 Cone diagram shows Association between Overall knowledge 70
Level and number of delivery’s regarding Prevention of Cancer
Cervix among Women
26 Pyramidal diagram shows Association between Overall 72
knowledge Level and Where do you know from health
information about Cancer cervix regarding Prevention of Cancer
Cervix among Women
27 bar diagram shows Association between Overall knowledge 73
Level and diet pattern regarding Prevention of Cancer Cervix
among Women
28 Cylinder diagram shows Association between Overall knowledge 74
Level and history of cancer cervix in the family regarding
Prevention of Cancer Cervix among Women

29 Bar diagram shows Association between Attitude Level and 76


Age in years regarding Prevention of Cancer Cervix among
Women

i
Sl.No Figure Page No
30 Cylinder diagram shows Association between Attitude Level and 77
Religion regarding Prevention of Cancer Cervix among Women
31 Cone diagram shows Association between Attitude Level and 78
Educational Status regarding Prevention of Cancer Cervix
among Women
32 Pyramidal diagram shows Association between Attitude Level 79
and occupation regarding Prevention of Cancer Cervix among
Women
33 Bar diagram shows Association between Attitude Level and 81
income per month regarding Prevention of Cancer Cervix among
Women
34 Cylinder diagram shows Association between Attitude Level and 82
marital Status regarding Prevention of Cancer Cervix among
Women
35 Cone diagram shows Association between Attitude Level and 83
Number of delivery’s regarding Prevention of Cancer Cervix
among Women
36 Pyramidal diagram shows Association between Attitude Level 85
and Where do you know from health information about Cancer
cervix regarding Prevention of Cancer Cervix among Women
37 Bar diagram shows Association between Attitude Level and Diet 86
Pattern regarding Prevention of Cancer Cervix among Women
38 Cylinder diagram shows Association between Attitude Level and 87
history of Cancer cervix in the family regarding Prevention of
Cancer Cervix among Women

List of Appendices
ii
Sl. No. Appendices

A Letter Requesting Permission to Collect Incidence

B Letter Requesting Permission for Tool Validity

C Letter for Tool Validity

D Letter Requesting Opinion and Suggestions of Experts


validate the Tool

E Letter for Tool Validity in English

F Letter for Tool Validity in Telugu

G Letter Requesting Permission to Conduct Pilot Study

H Letter Requesting Permission for Data Collection

I Tool

J Key

K Lesson Plan

L Master Sheet

M List of Experts

iii
CHAPTER - І

INTRODUCTION

“Go to the doctor, get a checkup, and get Pap smears regularly. Cervical cancer
is very preventable, and if you catch it early, there are tons of ways to treat it as
well.” - Mandy Moore.

Women are considered the backbone of the society. Her


contributions towards the Society have been undisputable since ancient
times. The roles she disperses are Wide and varied. Owing to such
responsibility vested on their shoulders the care takers health is most often
neglected. They often ignore even the most probable Signs of any disease
or ill health. With no one coming forward to address the problems and after
several failed Attempts, governments of various democracies across the
world have come forward with the goal of “Maternal Health”. With the
focus shifting to the subject efforts were made to find the most common
causes of morbidity and mortality among Women. Cervical cancer is the
pioneering causes of morbidity and mortality of Women in India.

Cancer of cervix is the most common cancer among women in India.


Cervical cancer is the leading causes of death in women worldwide about
6,00,000 women were diagnosed with cervical cancer and more than
3,11,000 women die due to cervical cancer (WHO 2019).

Cervical cancer is unique among cancers in that it can largely be


prevented through screening and removal of precursor lesions. It is the
second most common cancer among women worldwide and is the most
common malignancy in developing countries, particularly in India.
Cervical cancer starts in the cervix, the lower part of uterus that opens at
the top of the vagina. The precancerous condition called dysplasia can be
detected by a pap smear and is 100% treatable. It can take years for pre-
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cancerous changes to turn to cervical cancer.
Cervical cancer is ranked as the most frequent cancer in women in India. In
India, the peak age for cervical cancer incidence is 55 – 59 years. Cancer of
the cervix is third in the list of the most prevalent cancers, with an
estimated 1 lakh cases in 2016 and a projected 1.04 lakh cases by 2024.

India has a population of approximately 365.71 million women


above 15 years of Age, who are at risk of developing cervical cancer. The
current estimates indicate Approximately 132,000 new cases diagnosed
and 74,000 deaths annually in India, Accounting to nearly 1/3rd of the
global cervical cancer deaths. Indian women face a 2.5% cumulative
lifetime risk and 1.4% cumulative death risk from cervical Cancer . Health
is a “state of complete physical, mental, and social well being, not merely
the absence of disease or infirmity” (WHO). It maintains his or her capacity
for optimal functioning, that has a four dimensions for positive influence
and support for one other. If health is disturbed, leads to ill health, which
affects women and in turn her family. Mainly affects on economical burden
may result in death. Today’s world is in grip of numerous ferocious
diseases of which is Cancer of cervix, the most common cancer among
women in India. Cervical cancer is the leading causes of death in women.
It is a disease caused by the loss of control over a cells reproduction
capacity. Cervical cancer is the most common cancer among Indian women
of reproduction age.

Unfortunately despite the evidence of methods for prevention most


of the women remain unscreened. The reported barriers to screening
include unawareness of risk factors symptoms and prevention stigma and
misconceptions about gynecological diseases and lack of knowledge about
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cancer cervix preventions. Cervical cancer begins when healthy cells on the
surface of the cervix change and grow out of control, forming a mass called
a tumor. A tumor can be cancerous or benign tumor. If it is not diagnosed
and not treated become a cancerous tumor is malignant, it can spread to
other parts of the body. The cervix is the lower cylindrical part of the uterus.
It is less mobile than body it is about 2.5cm long and is slightly wide in the
middle than at either end. The lower part of the cervix projects into the
anterior wall of the vagina which divides it into supra vaginal and vaginal
parts. Cervical cancer remains a significant source of morbidity and
mortality for women world width with more than 4,66,000 women being
diagnosed with invasive disease.

Approximately 200000 deaths one attributed to progressive disease and


concomitant complication yearly. HPV types 16 and 18 together causes
about 70 % of the cervical cancer. Caner rates are expected to decline
further with vaccines now being used for the prevention of HPV. It is the
second most common cancer among women worldwide and is the common
malignancy in developing countries particularly in India. The pre
cancerous condition called dysplasia can be detected bya papsmear and is
100 % treatable. It can take years for pre cancerous changes to turn to
cervical cancer. The initiating event in cervical dysplasia and
carcinogenesis acquires due to human papiloma virus. The awareness about
cervical cancer prevention, among educated as well as illiterate population
is extremely poor. As a result there is no demand to provide cervical cancer
screening services from potential beneficiaries. In India, 16% percent of the
total world cases of cervical cancer occur annually. A change in the cervix
is mostly caused by a virus known as human papiloma virus (HPV) which
is a sexually transmitted infection.

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Other risk factors include consumption of tobacco, poor nutrition,
weak immune system, sexual intercourse at early age, with more than one
sexual partner multiparty, prolonged intake of oral contraceptive pills and
any sexual transmitted infections. Often women may not show any early
signs and symptoms. In the advanced stage symptoms may present as
severe pelvic pain, back pain, heavy bleeding, during menstruation, loss of
weight, abnormality is seen in vaginal discharge and dyspareunia. The key
to reduce cervical cancer morbidity and mortality is early detection and
treatment of cervical pre cancerous lesions.
Globally about 5, 00,000 women were diagnosed with cervical cancer and
more than 2,70,000 women die due to cervical cancer (WHO 2010). Cancer
affects everyone the young, old, rich, poor, men, women and children and
represents a tremendous burden to patients, families and societies. Yet
many of these deaths can be avoided if detected early and treated promptly.
For too many people “Cancer means death” since the diagnosis is often
made at the late stage of the disease. Ignorance, fear and anxiety play an
important role in seeking medical advice at the early stage. It is believed
that 75% of cervical cancer could be prevented if primary prevention was
initiated against known causative factors. Prevention and early detection of
cancer cervix must be a high priority to further decrease in cancer morbidity
and morality rates (Ruth Dun Leavey, 2009). In the light of present
knowledge, advanced science and technologies, early detection and prompt
treatment of cancer and pre cancerous conditions provided the best
possible protection against cancer for the individual and for the community.

Nurses have a major role in encouraging the women to undergo


regular screening to detect and prevent cervical cancer from the early
stage. Total incidenceof cervical cancer in the world population around one
fifth is occurring in India. Cervical cancer is the most common cancer of
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the female genital tracts and accounts for about two hundred and fifty
thousand deaths yearly most of which occur in developing countries. A
significant drop in its incidence has been recorded in the developed
countries as a result of intensive program of cervical screening. The study
determines the level of knowledge and uptake of cervical screening in
Owerri, south eastern part of Nigeria. The most common reasons given for
not doing the test were lack of knowledge, feeling of no need to do the test
and fear of bad result. The study concludes that the level of knowledge of
cervical screening is low and work ( Ezem BU, 2010). Cancer develops in
several phases, depending on the type of tissue affected. Typically these
phases are dysphasia, cancer insitu, localized invasive cancer, regional
lymph node involvement and distant materials. Cancer in all forms causes
12 percent of death. In developing countries 80 percent cases are cured
because of early detection.(WHO 2005)

NEED FOR THE STUDY

On a global brand, breast cancer and cervical cancer are the two
most common female malignancies. Cervical cancer is a second most
common type in women worldwide after breast cancer. Cancer cervix is the
most common among women in India. Because of illiteracy, lack of
knowledge, child marriages and low socio-economic condition. Cervical
cancer is the leading causes of death in women, worldwide about 5, 00,000
women diagnosed with cervical cancer and more than 2, 70,000 women die
due to cancer cervix (WHO.2010).Unfortunately, despite the evidence of
methods for prevention, most of the women remaining unscreened.

The reported barriers to screening include unawareness of risk factors,


symptom and prevention stigma and miscarriage about gynecological
diseases and lack of knowledge about it.
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Globally, cervical cancer is the fourth most common cancer in
women, with an estimated 560,505 new cases and 284,923 deaths in 2015.
The vast majority, around 85% of cervical cancer cases and 87% of cervical
cancer deaths occur in the less developed regions. In these regions, cervical
cancer accounts for almost 12% of all female cancers and 10% of all female
cancer deaths because of poor access to screening and treatment services.
It is the second most common cancer and third most common cause of
cancer deaths among women in the less developed regions. In India,
cervical cancer is the second most common cancer, with an estimated
132,314 new cases and 73,337 deaths in the year 2015.

Cervical cancer begins when healthy cells on the surface of the


cervix change and grow out of control, forming a mass called a tumor; a
tumor can be cancerous or benign, (if not diagnosed and not treated.). A
cancerous tumor is malignant; it can spread to other parts of the body. In
the light of present knowledge, advanced science and technologies, early
detection and prompt treatment of cancer and pre cancerous conditions
provided the best possible protection against cancer for the individual and
to prevent cervical cancer.

In most of the developed countries however cancer cervix is the


second most common cancer, in women after cancer of breast. The relation
breast carcinoma and cervical cancer is 3:1.Major factors affecting the
prevalence of carcinoma cervix in a population are economic factor, sexual
behavior and degree of effective mass screening. About 11,150 new cases,
of invasive cervical cancer are expected to be diagnosed in 2011,
approximately 3, 0670 cases resulting death (according to WHO)

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Early detection of cancer of cervix by Pap smear at the age of 20
years is useful as regular screening by pap smear having brought down the
incidence of invasive disease and their problem in younger women.
Routine screening has decreased the incidence of invasive cervical cancer
in United States where approximately 13,000 cases of invasive cancer and
59,000 cases of cervical carcinoma in situ are diagnosed.

Investigator from the past experience found that most of the women do
not present themselves for early detection and they seek treatment only in
the advanced stage. So there is need to improve the knowledge by
teaching about prevention of cancer cervix, change the attitude of women
regarding seeking health facility of cancer cervix, which is possible
only by health education. So the investigator has decided to impart
structured teaching programme on early detection and prevention of
cancer cervix.

Table -1 Incidence rate of cervical cancer (Source of Google Search


(WHO)

Year Globally In India In Telangana


2015 Approximately 67,477 deaths & 2,70,000 deaths
2,66,000 deaths 122,844
diagnosed
2016 2,66,000 deaths 22.01/100,67,477 deaths 1,00,000 deaths
2017 13,170 deaths 96,922(8.4%) 9,164 deaths
2018 5,70,000 deaths 3,11,000 diagnosed 60,000 deaths
2019 2,88,000 deaths 96,922 diagnosed & 9000 cases per
60078 deaths annum deaths

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10
STATEMENT OF THE PROBLEM

Effectiveness Of Structured Teaching Programme On Knowledge


And Attitude Regarding Prevention Of Cancer Cervix Among Women In
Selected Rural Community At Hyderabad In Telangana State.”

OBJECTIVES: -

1. Assess the knowledge prevention of cancer cervix among women


2. Plan and administer the structured teaching programme on
prevention of cancer cervix among women.

3. Effectiveness of structured teaching programme on prevention cancer


cervix among women.

4. Correlate the knowledge on prevention of cancer cervix with attitude.

5. Find out the association between knowledge and attitude on cancer


cervix among women with selected demographic variables

Operational definitions
It refers to the extent to which the structured teaching programme in
women regarding cancer cervix has achieved the effect in improving the
knowledge, attitude of women.

Structured teaching Programme on prevention of cancer cervix

It refers to the information on prevention on cancer cervix by the women


regarding cancer cervix as measured by structured questionnaire.

Knowledge

The scores obtained by the women on the structured questionnaire


regarding prevention of cancer cervix, prepared by the investigator.

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11
Attitude

It refers to the beliefs of women regarding cervical cancer, can be


measured by their response to items in the attitude scale.

Women

It refers to women, who are of 25-45 years age residing in


selected rural community at Hyderabad in Telangana state.

Selected Rural Community

People who are residing rural area. For this study rural community at
Kairathabad, Hyderabad.

ASSUMPTIONS

Women will have inadequate knowledge about cancer cervix.

1. Women need education regarding cancer cervix.

2. Structured teaching programme will enrich their knowledge


regarding cancer cervix.

1.2 RESEARCH HYPOTHESIS

H1: There will be significant difference between mean pre-test and post-
test knowledge scores of women regarding prevention of cancer
cervix at 0.05 level of significance.

H2: There will be significant association between post-test knowledge


of women regarding prevention of carcinoma of cervix with
selected demographic variables at 0.05 level of significance.

H3: There will be significant association between the post test attitude
regarding prevention of cancer cervix and their selected variables
at 0.05 level of significance.

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12
H4: There will be Correlation between Knowledge Score and Attitude
score.

LIMITATION OF THE STUDY

1. The study was limited to women who are willing to participate.


2. Sample size was limited to hundred women.
3. The Women, who are able to read, write and understand English
or Telugu Language.
4. Women, who were present at the time of data collection at
selected rural community.

CONCEPTUAL FRAMEWORK OF THE STUDY

Conceptual models are made up of concepts, which are words describing


mental images of phenomena and preposition. A conceptual frame work
for a research study helps to organize the study and provide a context for
the interpretation of the study findings. The conceptual framework for this
study was derived from the general system theory with input, throughput,
output and feedback. This was first introduced by Ludwig Von Bertalanffy
in 1968. According to this theory, a system is a group of elements that
interact with one another in order to achieve the goal. An individual is a
system because she receives input from the environment. This input when
processed provides an output. All living systems are open. There is a
continual exchange of matter, energy information the system is cyclical in
nature and continues to be so long as the four parts input, and throughput,
output and feedback keep interacting with each other. If there are changes
in any of the parts, there will be alterations in all parts, feedback from within
the system or from the environment provides information, which helps the
system to determine its effectiveness.

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Input

The input includes learner’s background like age, education, occupation,


socio- economic status and existing knowledge about cancer cervix. The
input also includes administration of structured teaching programme
regarding cancer cervix among women, such as risk factors, etiology,
diagnostic evaluation, path physiology, signs and symptoms, treatment and
prevention of cancer cervix.

Throughput

The throughput is the transformation of knowledge by structured teaching


programme regarding cancer cervix among women with the use of audio-
visual aids.

Output The output is the result of changes in knowledge found among the
women regarding cancer cervix, interrupted as inadequate knowledge.

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PERCEPTION

It refers to person’s representation of reality. It is not observable but it is inferred here,


the investigators perception is needed for women regarding prevention of Cancer
Cervix at selected rural community.

JUDGEMENT

The investigator decided to provide education to women regarding prevention of


Cancer Cervix to improve and reinforce their knowledge levels and practical skills.

ACTION

It refers to mental or physical activity to be achieved by the researchers’ action to plan


for educational programme for women regarding prevention of Cancer Cervix to learn
and update their knowledge and attitude regarding prevention of cancer cervix and
Attitude’ skills.

INTERACTION

It refers to verbal and non verbal behavior between an individual and the environment
or between two or more individuals. It involves goal directed perception a
communication, here the investigator interacts with women by giving pre-test and
structured teaching.

TRANSACTION

It is dependent upon the achievement of the goal in this stage, the investigator re-
assesses the knowledge and attitude skills regarding prevention of Cancer Cervix by
giving post- test and analyzing the effectiveness of structured teaching programme.

SUMMARY:

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This Chapter deals with introduction, need for Study, statement of Problem, objectives,
operational definitions, conceptual frame work, hypothesis, assumptions and limitation
of the study.
After reviewing of various literature researchers decided under two headings
1) Study related to knowledge on prevention of cancer cervix.
2) Study related to attitude on prevention of cancer cervix.

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CHAPTER – ІІ
REVIEW OF LITERATURE
This review of literature is an essential step in the development of
research project. It helps the researcher to design the proposed study in a
scientific manner to as to achieve the desired result.

Knowledge on prevention of cancer cervix:


Cervical cancer is a preventable disease hence the knowledge awareness
about cervix cancer of women will definitely reduce the incidence of
cervical cancer. Attendance of a gynecology clinic, on HPV, cervix
cancer awareness and the knowledge and willingness to use HPV vaccine
for themselves or their children is very important to protect them from
cervical cancer. In Belgium, women who are childless or poorly educated
and especially young women should be the targets of campaigns that
motivate them to prevent HPV-induced cervix cancer

1) Study related to knowledge on prevention of cancer cervix

1) K. Nalini, Dr. C. Usha Kiran,And Mrs. K. Varalakshmi


(2020), Conducted A Study To Evaluate The Effectiveness Of Structured
Teaching Programme On Knowledge Regarding Pap Smear Among
Women At Kondavalasa Village, Srikakulam (District).The major finds of
the study was Pre-test results shows that 43(86%) rural women had
inadequate knowledge and only 7 (14%) had moderate knowledge with
mean 14.76 and standard deviation5.66 on cervical cancer . so the H1 which
that was stated as “There will be inadequate knowledge among rural
women on pap smear” has been accepted . post test results shows that
majority 41(82%) had adequate total knowledge and only 9(18%) had
moderate knowledge with mean 46.82 and standard deviation 3.88 after
structured teaching programme . In this study revealed that there was

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significant association between the pre-test knowledge and demographic
variables such as among rural women, age ,educational status women
,educational status of the husband, occupational status of the women ,
occupational status of the husband were significant at 0.01 level. The
association of post-test knowledge score of subjects with demographic
variables such as women age, occupational status of the women, monthly
income of the family , sources of information was significant at 0.01 level
and educational status of the women , Educational status of the husband
was significant at 0.05 level.

2) Renuka P Sonawane.et.al., (2020) conducted a study on


Effectiveness of Structured Teaching Programme on Knowledge
Regarding Prevention of Cervical Cancer among Women of Reproductive
Age Group at Selected Rural Community. This study is A Quasi
Experimental Design was used for the present study &50 women of
reproductive age group were selected using purposive sampling technique.
A structured questionnaire was used to assess the knowledge. The analysis
and the data were based on the objective and hypothesis. Both descriptive
and inferential statistics were used for data analysis. The Assessment of
post-test knowledge score of the women of reproductive age group on
prevention of cervical cancer shows that, Majority of women 34(68%) had
good knowledge (13.59±1.189), 12(24%) had excellent knowledge
(16.50±0.6742) and followed by 4(08%) having the average knowledge
(10±00).It implies that, Majority of women having good, average and
excellent knowledge in post test score after implementation of STP on
knowledge of the women of reproductive age group on prevention of
cervical cancer as compare to pre-test it shows that STP was effective
educational strategies to create awareness.

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3) Josephine Jacquline Mary N, Kundapur R and Dhanya Mol
KK,(2019)

Effectiveness of a Structured Teaching Programme on Knowledge Regarding


Cervical Cancer among Women in Selected Wards of Malampuzha Panchayat
at Palakkad District, Kerala. This study is aimed to assess the knowledge
regarding cervical cancer among women in selected wards of Malampuzha
Panchayat at Palakkad district, Kerala, with the objectives to assess the existing
knowledge of women regarding cervical cancer, to develop and implement a
structured teaching programme on cervical cancer, to assess the effect of
structured teaching programme on cervical cancer and to find out the
association between pre-test knowledge score on cervical cancer with selected
demographic variables. The study adopted an one group pre-test– post-test
design, and 60 samples were recruited by using a convenient sampling
technique, followed by a structured questionnaire was used to collect the data
prior to the structured teaching programme, given to the research participants
and the post test was done after a period of one week. The data collected were
analyzed using descriptive and inferential statistics. The findings of the study
reveals pre-test assessment shows that 51.67% respondents had poor knowledge
and 48.33% of the population had average knowledge. After education, Post-
test assessment shows that no subjects have poor knowledge, 48.33%have
average knowledge and 51.67% have good knowledge regarding cervical
cancer. The mean post-test knowledge score (22%)of the subjects was higher
than the mean pre-test knowledge score (9%) and the study was significant
(t=33.59 p< 0.05).

4) Jhansirani sidiharthara, et.al., (2019) The Investigator planned


to check the Effectiveness of Structured Teaching Programme on

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Knowledge regarding Prevention and Warning Signs of Cervical Cancer
among Women in Selected Areas of, Jalandhar, Punjab. Revealed result
that in experimental group there was significant difference between pre-
test and post test knowledge of the woman. Whereas in control group there
was no significant differences between pre-test and post test knowledge of
women. Most instance will be diagnosed in women who are between the
age 20 and 50.

5) O. Tapera & Hendricks et.al., (2019) conducted a study to


assess Cervical cancer knowledge, attitudes, beliefs and practices of
women. Sequential explanatory mixed methods approach consisting of
analytical cross sectional survey and a qualitative inquiry was used. Study
population consisted of women with cervical cancer, health workers and
other stakeholders who are involved in cancer control programmes. Patient
survey data were collected using validated structured questionnaire in
Survey to go software in an android tablet. Qualitative study used key
informant interviews to understand survey findings better. Data analyses
for the survey involved univariate and multivariate analyses using STATA
version 14.For qualitative study, themes in transcripts were
coded and analyzed using Dedoose software to generate evidence for
the study. Participants reported different levels of knowledge of causes
(23%), risk factors(71%), prevention (72%), screening (73%) and
treatment (80%) of cervical cancer. Knowledge of causes of cervical cancer
were negatively associated with: being aged 45 or more years (OR = 0.02;
p = 0.004), having no household income(OR = 0.02;p = 0.007), household
income <US$600 per month(OR = 0.02; p = 0.015), middle class wealth
(OR = 0.01;p = 0.032), watching TV daily (OR = 0.01;p = 0.007) and 1–6
times per week (OR = 0.02; p = 0.045).Knowledge of causes of cervical

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cancer were also positively associated with listening to radio daily
(OR = 394, CI: 11.02–1406) (p = 0.001) and 1–6 times a week (OR = 100,
CI: 2.95–3364) (p = 0.010). Knowledge of prevention was only positively
associated with listening to the radio daily (OR = 77, CI: 1.89–
3114)(p = 0.022) and 1–6 times a week (OR = 174, CI: 2.42–
1255) (p = 0.018). Major drivers of lack of knowledge for cervical cancer
were: limited awareness.

6) Ghufran, Huda et al., Bahrain (2018), Knowledge, attitudes,


and practices regarding cervical cancer and screening among women
visiting primary health care Centres. This was a cross-sectional study of
300 women attending primary healthcare centres in Bahrain. We used a
validated tool comprised of 45 items to collect data through face-to-face
interviews between December 2015 and February 2016.Descriptive data
are presented for demographic data, and frequency distributions with
percentages are presented for each item of the knowledge and attitude
questionnaire. The mean age ± SD of the participants was 37.24 ± 11.89
years, they were mostly married (221; 73.7%), and had a high school or
higher education (261; 87%). Over64% (194 participants) had never heard
of a Pap smear procedure and only 3.7%(11 participants) had heard about
the human papillomavirus (HPV) vaccine. Nearly64% (192 participants)
believed that a Pap smear was helpful in detecting pre- cancer and cancer
of the cervix, and 44.3% (133 participants) believed that they should have
a Pap smear at least every 3 years. Regarding the practice, only 40.7%(122
participants) had a Pap smear in their lifetime. The majority of participants
felt embarrassed when examined by a male doctor (250, 83.3%) and few
underwent a Pap smear screening if they were never married (69, 23.0%).

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7) Nidhi Dagar, et.al., (2018). Conducted a Study on knowledge, attitude
and practice related to cervical cancer and screening among Women of
Reproductive Age Group in Selected Rural Community of Delhi based
cross - sectional study. The research approach adopted for the study was
evaluative and educative with one group pre-test post-test design. The
population comprised of women residing in Tilang PurKotla New Delhi.
Convenient sampling technique was used to select a sample of kk60
women of reproductive age group. Percentage of women having adequate
knowledge increased from 0% to 63.34% after giving planned teaching
program. Whereas 18.33% population reported inadequate Knowledge
Post test and 18.33% population have moderate knowledge post test. Post
test knowledge score improved 38.46% after planned teaching program. T-
ratio was statistically significant as the obtained value (32.11) is higher
than the tabulated value (2.00) required for t-ratio to be significant at .05
level of confidence. Maximum of the participants got benefitted from the
planned teaching programme on changing their attitude towards
prevention of cervical cancer. There was a significant difference between
pre test and post test knowledge and attitude regarding prevention of
cervical cancer and between post test knowledge and post test attitude
regarding prevention of cervical cancer among women of reproductive age
group. Chi-square values of post test knowledge score with demographic
variables were age 11.09 which was significant whereas chi-square values
with other variables like educational qualification (4.2); occupation (1.4);
income group (3.1); marital status (0.9) and number of children (7.3) were
not significant. This indicates that H3 is partially accepted with age only.
Chi-square values of post test attitude score with demographic variables
age (4.86) educational qualification (6.3); occupation (4.6); income group
(1.5); marital status (1.7) and number of children (4.4) were not significant.

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Knowledge deficit and unfavorable attitude existed regarding prevention
of cervical cancer among women of reproductive age group. The planned
teaching program was found to be effective in increasing the knowledge
and developing favorable attitude of the women of reproductive age group.

8) K. Krishnaveni * , Pinki Roy and R. Sambathkumar , (2017);knowledge,


attitude and practice related to cervical cancer and screening among women:
community based cross - sectional study. To assess the level of knowledge,
attitude, and practices of women of reproductive age of 20 - 70 years on their
understanding of the risk factors of cervical cancer, its early detection, and
prevention. A cross- sectional study was conducted in rural areas of
Komarapalayam from August 2016to January 2017 by using pre-tested
modified questionnaire. The purpose of the questionnaire was to assess the
demographic data, exposure to risk factors, knowledge, attitude, and practice
of the participants toward cervical cancer. A total of 500 married women have
participated in this study. Majority 26.6% had the secondary education; most
common 34% age group being 31 - 40 years. 39% had first childbirth and 34.6%
were married between 19 to 22 years; 27.8% had abnormal uterine bleeding
were the most common prevalence of risk factors. Mostly 98.4% and 96.6%
were heard about cervical cancer and its screening. Many women 82.2% had
never undergone cervical cancer screening and 98.9% of the women had never
been vaccinated. The main sources of information were friends and relatives
(42.8%) and fear of procedure (30.4%) was the main barrier for not undergoing
cervical screening. The knowledge about risk factors, sign were very poor, but
the method of prevention was good about cervical cancer in the study
population. Most of the women had never undergone screening and vaccination
for cervical cancer. But their attitude is favourable for screening.

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9) Naregal et al.(2017), conducted a study on effectiveness of planned teaching
programme (PTP) on knowledge regarding cervical cancer among women at
selected urban area Karad. Evaluative research approach was used for the study
and conducted in urban area Koyana Vasahat, Karad, Maharashtra, India, using
one group pre-and post-test design. Systematic proportionate sampling
technique was used for selecting 60 women. On the 1stday, structured
knowledge questionnaire was used for collecting data, and PTP on knowledge
regarding cervical cancer was conducted, followed by posttest on the 7thday.
The study was conducted to assess the effectiveness of a PTP regarding cervical
cancer. It was aimed to improve the knowledge of women regarding child
abuse and neglect. The mean posttest score 11 (SD=1) was higher than the
mean pretest score 7 (SD=2) these scores indicate that the PTP was effective.
The significant difference between the two tests was tested using paired t-test
the level of significant was set at the computed t-value (p<0.001) indicated that
there was a significant difference in the knowledge of women on cervical
cancer.

10) Rosliza,et.al., (2017),This article reviews the global burden of cervical


cancer, and the distribution of the disease according to various regions.
Conducted an electronic literature search through Google Scholar and ProQuest
Central was undertaken to determine the best estimates on cervical cancer
incidence and mortality using recently compiled data from cancer and mortality
registries since 2008. Additional information was gathered from manual search
of relevant articles in the reference were used in this review. There were an
estimated 528,000 new cases of cervical cancer and 266,000 deaths in 2012. It
is the fourth most common cancer globally. The incidence of cervical cancer
varied widely among countries with world age-standardized rates (ASR)
ranging from 4.4 to 75.9 cancer deaths occur in the less developed regions.

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25
High-risk regions. New methodologies of cervical cancer prevention should be
made available and accessible for women of all over the country.

2) Study related to attitude regarding prevention of cancer cervix

11) Ritanjalisahoo (2017), conducted a study, to assess the


effectiveness of knowledge of patients on cervical cancer,50 patients were
selected from SCB Medical College &Hospital, Cuttack, Odisha; by using
convenience sampling method. One group pre-test & post test design was
used. After STP, patients knowledge scored were adequately increased to
88%. There was an improvement in the level of knowledge as tested by
paired “t” test. Results were found to be statistically significant (P<
0.05).This study demonstrated that STP on cervical cancer was effective in
improving the knowledge of patient.

12) Sonu A R et al.(2017), conducted a study Effectiveness of Knowledge


and Attitude Regarding Early Detection and Prevention of Cervical Cancer
among Women, The research approach used was quantitative approach and
research design was one group pretest post test design. A sample size of 50
was selected from the Gynaecology Out Patient Department of TMM
(Tiruvalla Medical Mission) Hospital. Data collection was for a period of 6
weeks using a checklist, questionnaire and attitude scale. Majority of the
respondents were 0% of women belonged to the group 41-50 years, 90%
were married and 50% belonged to nuclear family, 50% had education upto
high school. 74% of women were Christians. 42% had family income
between Rs 5000-10000 and 72% of women were unemployed. 28 women
were married at the age more than 20 years. The duration of married life of

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28 women was between 21-30 years. 27 women had not attained
menopause. None of them attained menopause below the age of 45 years.
45 women had no family history of cervical cancer. 20 women had heard
of cervical cancer of which 8 of them had their source of information from
friends and relatives who are not health professionals. In pre test 70% had
poor knowledge, 26% had average and 4% had good knowledge level with
standard deviation of 3.52and about 74% had positive attitude and only
26% had negative attitude with standard deviation of 3.15In post test
94% had good knowledge, 6% had average and none had poor knowledge
level with standard deviation of 1.41 and about all had positive attitude
with standard deviation of 1.6 There was a significant difference in the
mean pre test and post knowledge and attitude scores at 0.05 level of
significanceChi-square test was done to determine the association between
pre test scores and selected demographic variables.There was no
significant association between pre test knowledge level with demographic
variables like education and religion. There was significant association
between pre test knowledge level with family income. There was no
significant association between pre test attitude scores with demographic
variables like education, religion and family income.DISCUSSIONA
similar study done at Tamil Nadu, in 2009, to determine the effectiveness
of Structured Teaching Program on cervical cancer among women in
reproductive age, concluded that 70% of samples had inadequate
knowledge regarding cancer cervix and 76% of the samples had
moderately favourable attitude. Only 6% had adequate knowledge. The
overall mean post-test knowledge (17.7) and attitude score (44.68) was
significantly higher than the mean pre-test (10.83) and attitude score (34.2).
The study clearly indicated that structured teaching program was effective
in changing the subjects’ knowledge and attitude regarding cervical

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27
cancer. It also proved that there is a positive correlation (r=0.567) which
existed between knowledge and attitude.[9]In the present study it was
inferred that there was statistically no significant association between pre
test knowledge score and demographic variables like education, religion
(p>0.5). There was statistically no significant association between pre test
attitude and demographic variables like education religion and family
income. A study among American women to describe the relationship
between health literacy, ethnicity and cervical cancer screening practices
showed that literacy was the only factor independently associated with
knowledge related to cervical cancer screening.
13) S. Shakila, Dr. S. Rajasankar, Dr. N. Kokilavani, (2015), A study to
assess the Knowledge regarding Cervical Cancer among Women. This
study was conducted to assess the level of knowledge regarding cervical
cancer among women and to find out the association between knowledge
score regarding cervical cancer with selected demographic variables of
women. Univariant research designs were adopted for this study.

The study was conducted in Melmaruvathur Adhiparasakthi Institute


of Medical Sciences and Research. Kanchipuram district.50 women who
fulfill the inclusion criteria were selected as sample. The study design was
uni variant research design was used for the study. The convenient
sampling technique was used to select the fifty samples. The data were
collected by administering the structured knowledge questionnaire on
cervical cancer to assess the level of knowledge among women. The study
finding revealed that the women had 35(70%) inadequate knowledge and
15(30%) had moderate knowledge regarding cervical cancer .Some of the
demographic variables like educational status, religion and source of

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information are significantly association at (p&lt;0.05) with knowledge
score of women.

14) Jhansi Rani sidhartha (2014) Conducted a cross sectional


survey of women attending Gynecology Out-Patient Department (OPD) in
a tertiary care hospital in Puducherry was conducted. Information about
their knowledge of cervical cancer, awareness of its prevention and their
socio demographic characters were collected.Mean age of the study
population was 40.45 ± 12 years. Less than half of the study population
(178, 44.5%) knew about cervical cancer. Less than one-fourth of the
population knew about screening services for prevention of cervical cancer,
and majority (389, 97.2%) were not aware of vaccination as prevention for
cervical cancer. Our study population shows poor knowledge about
cervical cancer and is unaware of the concept of prevention. Hence
extensive health education to the public is needed regarding cervical cancer
and its prevention.

15) Harsha Kumar, (2014), Conducted a questionnaire based on cross-


sectional study conducted among the women attending the outpatient
departments of teaching hospitals attached to Kasturba Medical College,
Mangalore. A sample size of 83 was calculated. A semi-structured
questionnaire was developed. After obtaining permission from
Institutional Ethics Committee, the questionnaire was administered to the
women in the language of their preference. Women were educated after the
data collection and a hand-out was provided. Data was analyzed using
SPSS Version 10. Student's independent ‘T’ test was used to compare
mean knowledge scores across socio-demographic groups. Majority of the

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women have poor knowledge about cervical cancer (81.9% [68/83]) and
it's screening (85.5% [71/83]). Only 6 out of 83 women had undergone
screening. Though women had come into contact with doctors earlier, they
were neither educated about cervical cancer nor were they told about the
screening. Whatever little knowledge the women had was obtained from
mass media. socio-demographic groups. Majority of the women have poor
knowledge about cervical cancer (81.9% [68/83]) and it's screening (85.5%
[71/83]). Only 6 out of 83 women had undergone screening. Though
women had come into contact with doctors earlier, they were neither
educated about cervical cancer nor were they told about the screening.
Whatever little knowledge the women had was obtained from mass media.
16) Neevan DR Dsouza et.al., (2013) , conducted a study on Projection of
cancer incidence is essential for planning cancer control actions, health
care and allocation of resources. Here the project the cancer burden at the
National and State level to understand the magnitude of cancer problem for
the various calendar years from 2011 to 2026 at 5-yearly intervals. The age,
sex and site-wise cancer incidence data along with populations covered by
the registries were obtained from the report of National Cancer Registry
Programme published by Indian Council of Medical Research for the
period 2001-2004. Pooled age sex specific cancer incidence rates were
obtained by taking weighted averages of these seventeen registries with
respective registry populations as weights. The pooled incidence rates were
assumed to represent the country’s incidence rates. Populations of the
country according to age and sex exposed to the risk of development of
cancer in different calendar years were obtained from the report of Registrar
General of India providing population projections for the country for the
years from 2001 to 2026. Population forecasts were combined with the
pooled incidence rates to estimate the projected number of cancer cases by

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30
age, sex and site of cancer at various 5-yearly periods Viz. 2011, 2016,
2021 and 2026. The projections were carried out for the various leading
sites as well as for ‘all sites’ of cancer. In India, in 2011, nearly 1,193,000
new cancer cases were estimated; a higher load among females (603,500)
than males (589,800) was noted. It is estimated that the total number of new
cases in males will increased from 0.589 million in 2011 to 0.934 million
by the year 2026. In females the new cases of cancer increased from 0.603
to 0.935 million. Three top most occurring cancers namely those of tobacco
related cancers in sexes, breast and cervical cancers in women account for
over 50 to 60 percent of all cancers. When adjustments for increasing
tobacco habits and increasing trends in many cancers are made, the
estimates may further increase. The leading sites of cancers in males are
lung, oesophagus, larynx, mouth, tongue and in females breast and cervix
uteri. The main factors contributing to high burden of cancer over the years
are increase in the population size as well as increase in proportion of
elderly population, urbanization, and globalization. The cancer incidence
results show an urgent need for strengthening and augmenting the existing
diagnostic/treatment facilities, which are inadequate even to tackle the
present load.
17) Shah V, Vyas, Singh A, Shivastava M (2012), conducted a study to
assess the Awareness and Knowledge of cervical cancer and its prevention
among the nursing staff of a tertiary health institute in Ahmedabad,
Gujarat, India. A cross- sectional study was carried out among the nursing
staff of a tertiary health institute in Ahmedabad, India. The duration for the
study was from March to June, 2006. A total of 620 nursing staff were
enrolled under the institute at the time of study. 15% of staff were randomly
selected using a table of random numbers after department-wise
stratification. The calculated sample size was 93 but practically a total of

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31
100 nurses were selected for the study. Verbal-informed consent was
sought from the study subjects. A 15-item structured questionnaire was
designed. However, provision for inclusion of open-ended responses was
also made in the format. The selected nurses were interviewed by the
investigator for seeking information about the socio- demographic profile
of the respondents, their knowledge about symptoms, risk factors and
prevention, their attitude and utilization of Pap smear as a screening device
for carcinoma cervix. Pre-testing of the questionnaire was done on 10
respondents; after which necessary changes were made, and the
questionnaire was re-administered. Data entry was done, and SPSS
statistical software was used to generate statistical parameters like
proportion, mean, standard deviation, etc. Z test was used as a test of
significance, and P value of <0.05 was considered as level of significance.
The major findings were Out of 100 staff nurses, 52% belonged to the age
group of 41–50 years. The mean age of the study population was 46 years.
The majority of respondents (89%) were married . 69% of respondents had
some knowledge of cervical carcinoma. As per information regarding
knowledge of the symptoms of cervical cancer, 65 (94.2%) respondents
stated vaginal discharge as one of the symptoms. The percentages of
respondents who mentioned menstrual abnormality and pain as symptoms
were 86.9 and 66.6, respectively. Only eight (11.5%) respondents were
aware of multiple sexual partners as one of the risk factors of cervical
carcinoma. Out of 69 respondents who had some knowledge regarding
cervical carcinoma, (88.4%) had knowledge regarding Pap test as one of
the preventive measures. Out of 61 staff nurses who knew about Pap test,
only five (8%) had undergone Pap test.

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32
18) Capalash N. et.al., (2010) Every year cervical cancer is diagnosed in
about 5,00,000 women globally and is responsible for more than 2,80,000
death annually. There is a wide variation in the incidence of cervical cancer
across the globe. In the last 8 years in the United States, the pap smear test
have reduced the deaths related to cervical cancer by three-quarters. At one
time cervical cancer was one of the most dreaded cancer and the leading
causes of death in women in the US. But now it is the eighth most common
disease. 80% of the new cervical cancer occurs in developing countries,
which reports approximately one fourth of the world’s cases of cervical
cancer estimated in the year (2010).

Cancer cells develop in several phases, depending on the type of tissue


affected. Typically these phases are dysphasia, cancer regional lymph
nodes involvement and distant organs. Cancer is uncontrolled cell growth;
Mutations in genes can cause cancer. By accelerating cell division rates or
inhibiting normal controls on the system, such as cell cycle arrest or re-
programming of old cells. It forms as a tumor like structure, and epithelial
cells that line bodily cavities. Sarcomas are cancer that arises in blood
vessels, and other tissues. Cancer develops when the body normal control
mechanism stops working. Old cells do not die, and instead grow out of
control, forming new abnormal cells. These extra cells may form a mass of
tissue, called a tumor.

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CHAPTER - ІІІ

METHODOLOGY

Research methodology deals with the method of investigation to be


adapted by the investigator. This chapter deals with research design,
variables, settings, criteria for sample selection, sample size, sampling
technique, development and description of tool, content validity, pilot
study, data collection procedure and plan for data analysis.

Kothari C.R. (2002)

Research Approach

The research approach refers to a General set of orderly disciplined


procedures used to acquire dependable and useful information.

(Polit and Hungers)

It is basic procedure for collecting data; research approach selected


for this study was quantitative approach method. The research approach
adopted for this study was descriptive in nature. The approach is a
descriptive of research design has chosen by the investigator as an
appropriate method for which the investigator gathers the information about
on prevention of cervix cancer among women.

Research Design

Research design is a design of researcher’s overall plan for addressing


a research questions, including specification for enhancing the study’s
integrity.

(Polit and Hungler 1999)

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Research design is a plan for obtaining answers to research
questions. The research design will be one group pre test and post test. The
accessible population of this study was on Knowledge Regarding
Prevention of Cervical Cancer among Women at Selected Rural
Community.”

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35
Research approach Quantitative

Research design One group pre-test and post-test

Setting of the study Rural community, Hyderabad.

population Women residing in rural community

sample Women between 25 – 45 years

Sample size 200 women

Sample technique Convenient sampling technique

Method of data Knowledge Questionnaire and attitude scale


collection

Data analysis Descriptive and inferential

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36
Study Variables

 Knowledge on Prevention of Cervical Cancer among Women

at Selected Rural Community.


 Attitude on Prevention of Cervical Cancer among Women at

Selected Rural Community.

Variables

Independent variables:

An independent variable is a variable that represents a quantity that


is being manipulated in an experiment. We have taken knowledge
and attitude among Prevention of Cervical Cancer.

Dependent Variables:

A dependent variable is a variable that represents a quantity who


value depends on how the independent variable is that is being
manipulated.

Setting of the Study:

The setting of the present study has been conducted in selected rural
community in Kairathabad. The investigator planned to conduct
study at Hyderabad, in Telangana.

Population:

Population is the number of people live together in the same place. The present
study conducted in rural community in Kairathabad.

Sample:

The sample in present study consist of women age between 25-45


years.
Sample size: 200 members of women.
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37
Sampling Technique:

Purposive sampling technique has been used for the present study to
select the samples at rural community Hyderabad, Telangana.

Criteria for sample selection:

Inclusive criteria
1. women who are willing to participate.
2. The Women, who are able to read, write and understand English or Telugu
Language.
3. Women, who were present at the time of data collection at selected rural
community.
4. Women who are of age 25-45 years.
TOOLS OF RESEARCH
The investigator used a structured questionnaire tool to assess the
level of knowledge

Likert scale asses the attitude regarding Prevention of Cervical


Cancer among Women.

Development of Data Collection Tool

The tools were developed for data collection. For the present study,
data collected with structured questionnaire for the knowledge attitude with
the help of likert scale.
Questionnaires
The questions comprised of demographic data,
knowledge and Attitude and based questions.

PART-A:

Description of sample characteristics according to bio-socio

demographical variables which includes Age, Religion, Educational status,

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38
Occupation, Income per month, Marital status, Number of Deliveries,

Where do you know from health information about Cancer cervix, Diet

pattern, If history of cancer cervix in the family with the help of frequency

and percentage distributions.

PART-B:

A structured knowledge questionnaire used to assess the


knowledge among women regarding about knowledge of Cancer Cervix.
PART-C:

A structured knowledge questionnaire used to assess the


knowledge among women regarding about knowledge of Prevention of
Cancer Cervix.
Content Validity

Validity refers to the degree to which an instrument measures what it is


intended to measure

(Polit, 2001)
The content validity of the tool was obtained on the opinions of
specialist in Obstetrics and Gynecological Nursing, Dept. of Obstetrics and
Gynecology, Dept. of Psychology, Rehabilitation Psychologist.
Tool was modified with the suggestions and advices were incorporated.

Reliability:
“Reliability refers to the accuracy and consistency of
information obtained in a study”.
Pilot and Beck (2008)
The Co- Relation Coefficient was computed using Karl Pearson’s
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39
Formula which showed “correlation” value 0.695 for Correlation between
Knowledge & attitude of women, the “reliability” value 0.81 for
Correlation between Knowledge & Attitude which indicated that the tool
was reliable.
Pilot Study

A pilot study is a small-scale version or trial run designed to test the


methods to be used in a larger, more rigorous study, which is sometimes
referred to as the parent study.
(Polit and Beck, 2008)

Permission obtained from the concerned authority the study was


conducted among 20 samples of the pilot study was done at Kairathabad
rural community chinthalbasthi, Hyderabad, Telangana State, in 30-04-
2021 to 03-05-2021 to test the feasibility of the tool and practicability
of the designed methodology. There was no modification made in the
tool after the pilot study, the women selected for the pilot study were not
included in the main study.
Data Collection Procedure
Data collection was done from 11-05-2021 to 16-05-2021 at
Khairthabad rural community Hyderabad, Telangana State. Before
conducting the study, formal permission was obtained from the Hospital
director. The subject was selected by Non-probability purposive
sampling technique. Data collection was four weeks. The purpose of the
study was explained to all the subjects and written consent was obtained.
The investigator assessed the level of knowledge, Attitude regarding
prevention of Cancer Cervix among women by using questionnaire.
Data collection was analyzed by descriptive statistics.

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40
Plan for Data Collection
It was planned to analyze the collected data by using descriptive statistics.

Descriptive Statistics
Frequency and percentage distribution used to analyze the
demographic variables and level of knowledge, Attitude regarding
prevention of Cancer Cervix among women.

Mean and standard deviation used to assess the Knowledge, Attitude prevention
of Cancer Cervix among women. The association will be used to assess the level of
knowledge and attitude, regarding prevention of Cancer Cervix among women.

ETHICAL CONSIDERATIONS

The study was conducted after the approval of ethical committee of


the Government College of Nursing, Osmania University Hyderabad.
Permission was sought from the Corporator of the rural community,
Khairthabad, Hyderabad and confidentiality maintained. Informed consent
obtained from each participant. Study purpose was explained to each
participant.

SUMMARY:
This chapter deals with the research approach, setting of the study.
Sample size, population, criteria for selection of sample, description of
tool, variables, validity of tool and pilot study data analysis.

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41
CHAPTER –IV

ANALYSIS & INTERPRETATION

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42
CHAPTER – IV

ANALYSIS AND INTERPRETATION

Kerlinger defines analysis as the categorizing, ordering, manipulating


and summarizing of the data to obtain answer to research question. The
purpose analysis is to reduce data to an intelligible and interpretable form,
so that the relation of research problems can be studied and tested, the data
themselves do not provide as with answer to our research questions.
Ordinarily, the amount of data collected in a study is extensive to be
reliably described by mere perusal. In order to answer the research
questions, the data must be presented and analyzed in some orderly
manner, so that relationship can be described.

This chapter deals with the analysis and interpretation of the data
related to “Effectiveness of Structured Teaching Program on Knowledge
and Attitude Regarding Prevention of Cervical Cancer among Women at
Selected Rural Community”. Data was collected from 200 Women
regarding knowledge regarding Prevention of Cervical Cancer. The data
collected was organized tabulated, analyzed and interpreted by using
descriptive and inferential statistics. The analysis and interpretation was
based on the data collected through structured questionnaire.

Descriptive statistics such as frequencies, percentage distribution,


mean, median, mode, and standard deviation were utilized to know
Effectiveness of Structured Teaching Program on Knowledge and
Attitude Regarding Prevention of Cervical Cancer among Women at
Selected Rural Community, Hyderabad.
Inferential statistics such as paired t-test was used to test the
significance effectiveness of, Effectiveness of Structured Teaching
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43
Program on Knowledge and Attitude Regarding Prevention of Cervical
Cancer among Women at Selected Rural Community and selected
demographic variables such as Age, Religion, Educational status,
Occupation, Income per month, Marital status, Number of Deliveries,
Where do you know from health information about Cancer cervix, Diet
pattern, If history of cancer cervix regarding Prevention of Cervical
Cancer.

OBJECTIVES OF THE STUDY

1. Assess the knowledge prevention of cancer cervix among women


2. Plan and administer the structured teaching programme on

prevention of cancer cervix among women.


3. Effectiveness of structured teaching programme on prevention
cancer cervix among women.
4. Correlate the knowledge on prevention of cancer cervix with attitude.
5. Find the association between knowledge and attitude on cancer

cervix among women with selected demographic variables

Data was presented in following headings.


Section A: Frequency and percentage distribution of Women
according to their selected demographic variables.
Section B: Frequency and percentage of knowledge scores of women
on knowledge and attitude regarding prevention of cervical
cancer according to the level of knowledge scores in pre test
and post test.
Section C: Paired t test of significance for knowledge and Attitude
scores of women on knowledge regarding prevention of
cervical cancer in pre test and post test and comparing pre
test and post test knowledge scores.
Section D: Association between Post test knowledge scores and

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44
Attitude scores among women regarding Prevention of
cervical Cancer in accordance with selected demographic
variables.
Section E: Correlation Between knowledge scores and Attitude
scores among women regarding Prevention of cervical
Cancer.

SECTION-A
DISTRIBUTION OF FREQUENCY AND PERCENTAGE
ACCORDING TO THEIR DEMOGRAPHIC VARIABLES

Section I deals with the Demographic data of the sample includes


Age, Religion, Educational status, Occupation, Income per month, Marital
status, Number of Deliveries, Where do you know from health
information about Cancer cervix, Diet pattern, If history of cancer cervix
regarding Prevention of Cervical Cancer. The data collected with the help
of structured questionnaire and presented in the following tables.

Page |
45
TABLE-1

Frequency and Percentage distribution of Women according to their


Age, Religion, Educational status, Occupation

N=200

Demographic variables Frequen Percent


cy
25-29 yrs 72 36.0
30-34 yrs 51 25.5
Age in 35-39 yrs 21 10.5
years 40-45 yrs 56 28.0
Total 200 100.0
Hindu 185 92.5
Muslim 8 4.0
Religion Christian 7 3.5
Others 0 0.0
Total 200 100.0
Illiterate 28 14.0
Primary
Education 30 15.0
Education Secondary
al Education 29 14.5
Status Inter and above 113 56.5
Total 200 100.0
Home maker 156 78.0
Daily Labour 21 10.5
Occupatio Private 20 10.0
n Employee
Govt.Employe 3 1.5
e
Total 200 100.0

From the above table explains that frequency and percentage


distribution of Women according to their Age, Religion, Educational
status, Occupation.

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46
According to the age in years table shows that, 72(36.0%) were
belonged to 25-29 yrs, 51(25.5%) were 30-34 yrs, 21(10.5%) were 35-39
yrs and 56(28.0%) were
40-45 yrs.

From the above table, we observed that majority were 25-29 yrs
and least was 35-39 yrs.

Age in years

28%
36%

25-29 yrs
30-34 yrs
11%
35-39 yrs
40-45 yrs
25%

Fig.No-1 Pie Diagram Shows Frequency and Percentagedistribution of


Women according to their Age

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47
100.0 92.5

90.0

80.0

70.0

60.0

50.0

40.0

30.0

20.0

10.0 4.0 3.5


0.0
0.0
Hindu Muslim Christian Others
Religion

Fig.No-2Bar diagram Shows Frequency and Percentage


distribution of Women according to their
Religion

As shown above table religion shows that, majority of the women


185(92.5%) were belonged to Hindu, 8(4.0%) were Muslim, 7(3.5%) were
Christian and least was others were nil.

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48
Educational Status

14%

Illiterate
15%
Primary Education
Secondary Education
56%
Inter and above

15%

Fig.No-3 Doughnut diagram shows Frequency and


Percentage distribution of Women according to their
Educational status

As shown above table shows that educational status reveals that,


28(14.0%) were illiterate, 30(15.0%) were primary education, 29(14.5%)
were secondary education and 113(56.5%) were inter and above.

From the above analysis clearly shows that majority were studied
inter and above and least was Illiterate.

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49
78.0
80.0

70.0

60.0

50.0

40.0
Percent
30.0

20.0 10.5 10.0

10.0 1.5

0.0
Home maker Daily Labour Private Employee Govt.Employee

Occupation

Fig.No-4 Cone diagram shows Frequency and Percentage


distribution of Women according to their
Occupation

From the occupation table shows that, majority of women


156(78.0%) were home maker, 21(10.5%) were daily labour, 20(10.0%)
were private employee and least was 3(1.5%) Govt. Employee.

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50
TABLE-2

Frequency and Percentage distribution of Women according to their


Income per month, Marital status, Number of Deliveries

N=200

Demographic variables Frequen Percen


cy t
10,000- 185 92.5
19,999
20,000- 10 5.0
Income 29,999
per 30,000- 2 1.0
39,999
month Above 3 1.5
40,000
Total 200 100.0
Married 186 93.0
Marit Unmarried 10 5.0
al Widow 4 2.0
status Total 200 100.0
One 36 18.0
Number Two 118 59.0
of Three or 46 23.0
above
Deliveri Total 200 100.0
es

The above table shows that the frequency and percentage


distribution of Women according to their Income per month, Marital status,
Number of Deliveries.

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51
100.0 92.5

90.0

80.0

70.0

60.0 10,000-19,999
20,000-29,999
50.0
Percent

30,000-39,999
40.0 Above 40,000
30.0

20.0
5.0
10.0 1.0 1.5

0.0
10,000-19,999 20,000-29,999 30,000-39,999 Above 40,000

Income Per month

Fig.No-5 Pyramidal diagram shows Frequency and Percentage


distribution of Women according to their
Educational status

From the Income per month reveals that, majority of the women
having 10,000-19,999, i.e.,185(92.5%), 10(5.0%) were having 20,000-
29,999, 2(1.0%) were
30,000-39,999 and 3(1.5%) were having above 40,000.

From the above table we observed that majority of the income


was10,000- 19,999 and least is 30,000-39,999.

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52
100.0 93.0

90.0
80.0
70.0
60.0

Percent50.0
40.0
30.0
20.0
5.0
10.0 2.0

0.0
Married Unmarried Widow
Marital status

Fig.No-6 Cylinder diagram shows Frequency and Percentage


distribution of Women according to their Marital
status

As shown above marital status explains that, majority of women


were married, i.e., 186(93.0%), 10(5.0%) were unmarried, least was
4(2.0%) were widow.

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53
Number of Deliverys

23% 18%

One
Two
Three or above
59%

Fig.No-7 Pie diagram shows Frequency and Percentage


distribution of Women according to their Number
of Deliveries

According to number of Deliveries shows that, 36(18.0%) were


one delivery, 118(59.0%0 are two Deliveries and 46(23.0%) are having 3
or above Deliveries.

From the above table we observed that, majority was two


deliveries and least was one delivery.

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54
TABLE-3

Frequency and Percentage distribution of Women according to their


how do you know from health information about Cancer cervix, Diet
pattern, If history of cancer cervix

N=200

Demographic variables Frequen Percen


cy t

Health 137 68.5


how do you Personal
Television 30 15.0
know from
News paper 13 6.5
health
Neighbours 20 10.0
information Total 200 100.0
about Cancer
cervix
Vegetarian 32 16.0
Non 58 29.0
Diet pattern vegetarian
Mixed 110 55.0
Total 200 100.0
history of Yes 7 3.5
cancer cervix No 193 96.5
Total 200 100.0
in the
family

The above table shows that the frequency and percentage


distribution of Women according to their how do you know from health
information about Cancer cervix, Diet pattern, history of cancer cervix.

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55
68.5
70.0

60.0

50.0

40.0
Percent

30.0

15.0
20.0
10.0
6.5
10.0

0.0
Health Television News paper Neighbours
perssonal
how do you know from health information about Cancer
cervix

Fig.No-8 Bar diagram shows Frequency and Percentage


distribution of Women according to their how do you know
from health information about Cancer cervix

As above mention table reveals that health information about Cancer


Cervix, 137(68.5%) were from health Personal, 30(15.0%) were from
television, 13(6.5%) from news paper and 20(10.0%) from neighbours.

From the above analysis, we observed that majority was health


personal and least was news paper.

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56
Diet pattern

16%

Vegetarian
Non vegetarian
55% Mixed
29%

Fig.No-9Doughnut diagram shows Frequency and Percentage distribution of Women


according to their diet pattern
As shown above table diet pattern of the women, out of 200 selected
women, 32(16.0%) were Vegetarian, 58(29.0%) were non-vegetarian and
110(55.0%) were mixed diet followed.

Majority of the women follows the mixed diet and least was vegetarian diet.

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57
If history of cancer cervix in the family

4%

Yes
No

96%

Fig.No-10 Pie diagram shows Frequency and Percentage


distribution of Women according to their history of
cancer cervix in the family

According to the above table history of cancer cervix in the family


explains that, out of 200 selected women, majority was saying No-
193(96.5%) and least was yes saying were 7(3.5%).

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58
SECTION - B

It dealt with the categorization of Women into three groups such as


Below average, Average and Above average based on the knowledge
scores obtained in pre test and post test.
TABLE - 4

Frequency and Percentage of distribution of Women according


to Level of Overall Knowledge in Pre test and Post test on
Prevention of Cancer Cervix.
N=200

Pre Post
Categorizatio test test
n Frequen Percenta Frequen Percenta
cy ge cy ge
Below Average 61 30.5% 0 0%
(<33.33%)
Average 139 69.5% 93 46.5%
(33.34%-
66.66%)
Above Average 0 0% 107 53.5%
(>66.67%)
Total 200 100.00% 200 100.00%
Calculated value=177.121, Table value=5.991 at df=2, p=0.000<0.05(S*)

The table no.4 shows that frequency and percentage based on


knowledge scores of the women about Prevention of cancer cervix. Below
Average (<33.33%) indicates the scores in between 0 to 8, Average (33.34-
66.6%) indicates the score between 9-16 and Above average (>66.67%)
indicates the scores between 17-25.
Table no.4 explains that, 61(30.5%) were under Below Average
knowledge level in pre test whereas in post test were found nil,139(69.5%)
were under Average knowledge level in pre test, whereas 93 (46.5%) were
Average knowledge level in post test, in Above average knowledge level
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59
in pre test were nil, whereas 107 (53.5%) were under Above Knowledge
level in post test. These differences indicate that Structured Teaching
programme was highly affected among women.

69.5%
70.0%

60.0%
53.5%

50.0% 46.5%

40.0%
Below Avg(<=33.3%)
Percent

30.5%
Avg(33.34%-66.6%)
30.0%
Above Avg(>66.67%)

20.0%

10.0%

0.0% 0.0%
0.0%
Pre Test Post test
Overall Knowledge Level

Fig.No-11Bar diagram shows Frequency and Percentage


distribution of Women according to Overall knowledge level
regarding Prevention of Cancer Cervix

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60
TABLE - 5

Frequency and Percentage distribution of Women according to


Cancer Cervix and prevention of cancer cervix of Level of Knowledge
in Pre test and Post test.
N=200

About Cancer Cervix Prevention of cancer


Categorizatio cervix
n Pre test Post test Pre test Post test
F % F % F % F %
Below Average 54 27.0% 7 3.5% 58 29.0% 24 12.0%
(<33.33%)
Average 144 72.0% 12 61.0% 13 66.0% 107 53.5%
(33.34%- 2 2
66.66%)
Above Average 2 1.0% 71 35.5% 10 5.0% 69 34.5%
(>66.67%)
Total 200 100.0 20 100.0 20 100.0 200 100.0
% 0 % 0 % %
Calculated 103.252(S*) 60.776(S
value *)
Table value=5.991 at df=2, p=0.000<0.05(S*)

Table no.5 explains that Knowledge about Cancer Cervix Level of


Knowledge in Pre-test and Post-test, In Pre-test, 54(27.0%) were under
Below Average knowledge level, 144(72.0%) were under Average
knowledge level and 2(1.0%) were Above average knowledge level,
whereas in Post-test, 7(3.5%) were under Below Average knowledge level,
122(61.0%) were under Average knowledge level and 71(35.5%) were
Above average knowledge level.

Table no.5 reveals that the prevention of Cancer Cervix Level of


Knowledge in Pre test and Post test, In Pre test, 58(29.0%) were under
Below Average knowledge level, 132(66.0%) were under Average
knowledge level and 10(5.0%) were Above average knowledge level,
whereas in Post test, 24(12.0%) were under Below Average knowledge
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61
level, 107(53.5%) were under Average knowledge level and 69(34.5%)
were Above average knowledge level.

80.0%
72.0%
70.0% 66.0%
61.0%
60.0% 53.5%

50.0%
Percent

40.0% 35.5% 34.5%


29.0%
27.0% Below Avg(<=33.3%)
30.0%
Avg(33.34%-66.6%)
Above Avg(>66.67%)
20.0%
12.0%
10.0% 3.5% 5.0%
1.0%
0.0%
Pre Test Post test Pre Test Post test
Knowledge Level of Knowledge Level
About Cancer Cervix Prevention about Cancer
Cervix
Section Wise Knowledge Level

Fig.No-12Bar diagram shows Frequency and Percentage distribution


of Women according to Section Wise knowledge level regarding
Prevention of Cancer Cervix

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62
TABLE -6

Frequency and Percentage distribution of Women according


to Level of Attitude in Pre test and Post test on Prevention of
Cancer Cervix.

N=200

Pre Post
Categorizatio test test
n Frequen Percenta Frequen Percenta
cy ge cy ge
Low (<33.33%) 88 44.0% 0 0%
Moderate 112 56.0% 104 52.0%
(33.34%-
66.66%)
High (>66.67%) 0 0% 96 48.0%
Total 200 100.00% 200 100.00%
Calculated value=184.296, Table value=5.991 at df=2, p=0.000<0.05(S*)

The table no.6 shows that frequency and percentage based on Attitude
scores of the women about Prevention of cancer cervix. Low (<33.33%)
indicates the scores in between 0 to 6, Moderate (33.34-66.6%) indicates
the score between 7-13 and High
(>66.67%) indicates the scores between 14-20.

Table no.6 explains that, 88(44.0%) were under low attitude level in
pre test whereas in post test were found nil,112(56.0%) were under
moderate attitude level in pre test, whereas 104 (52.0%) were moderate
level in post test, in high Attitude level knowledge level in pre test were
none of them, whereas 96 (48.0%) were high attitude level in post test.
These differences indicate that Structured Teaching programme was highly
affected among women.

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63
60.0% 56.0%
52.0%
48.0%
50.0%
44.0%

40.0%
Percent

Low (<=33.3%)
30.0%
Moderate (33.34%-66.6%)
High (>66.67%)
20.0%

10.0%

0.0% 0.0%
0.0%
Pre Test Post test
Attitude Level

Fig.No-13Cylinder diagram shows Frequency and Percentage


distribution of Women according to Attitude knowledge level
regarding Prevention of Cancer Cervix

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64
SECTION – C
It dealt with the mean knowledge and comparison of pre test and
post test mean knowledge scores by using paired t test and testing the
hypothesis of the present study.
TABLE - 7
Pre Test and Post Test Mean of overall Knowledge Scores and Paired T-
Test of Significance on Prevention of Cancer Cervix among Women.
N=200

Overall Knowledge Pre Post


scores test test
Mean 9.760 16.440
Mean% 39.040 65.760
Standard Deviation 2.204 3.035
Standard Error 0.156 0.214
Paired t-test 29.733**(
S)
199dF Table t-value 2.045 p=0.000<0.05

The table no. 8 shows that the pre test mean was 9.760(39.040) with
2.204 standard deviation and 0.156 Std. Error and that of post test was
16.440(65.760) with
3.035 standard deviation and 0.214Std. Error. The calculated ‘t’ value was
29.733, which is higher than the table ‘t’ value 2.045 at 199df with 0.05
level of significance. It shows that there is significant difference (p<0.001)
in pre test and post test knowledge scores.
Hence it concluded after structured teaching programme on prevention of
cancer cervix the knowledge scores of women have been increased. The
positive result gives a clear indication of effectiveness of structured
teaching programme on prevention of cancer cervix among women. Hence
reject the null hypothesis and accept H1.

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65
18.000 16.430

16.000

14.000

12.000
9.755
Percent

10.000
PRE TEST
8.000 POST TEST
6.000
3.043
4.000 2.204
2.000

0.000
Mean Std. Deviation
Overall Knowledge

Fig.No-14Cylinder diagram shows mean and Standard deviation


distribution of Women according to Overall knowledge regarding
Prevention of Cancer Cervix

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66
TABLE - 8

Pre Test and Post Test Mean of overall Knowledge Scores and
Paired T- Test of Significance on about Cancer Cervix
among Women.
N=200

Variables About Cancer Prevention of


Cervix Cancer
Cervix
Pre Post Pre Post
test test test test
Mean 5.235 8.860 4.515 7.585
Mean% 37.392 63.285 41.045 68.955
Standard 1.333 3.035 1.894 1.942
Deviation
Standard Error 0.094 0.214 0.134 0.137
Paired t-test 23.234**(S) 22.746**(S)
199dF Table t-value 2.045 p=0.000<0.05

The table no. 8 shows that, Knowledge regarding about Cancer


cervix of the pre test mean was 5.235(37.392) with 1.333standard
deviation and 0.094 Std. Error and that of post test was 8.860(63.285) with
3.035 standard deviation and 0.214 Std. Error. The calculated ‘t’ value
was 23.234, which is higher than the table ‘t’ value 2.045 at 199df with
0.05 level of significance. It shows that there is significant difference
(p<0.001) in pre test and post test knowledge scores.
Knowledge regarding prevention of Cancer cervix of the pre test mean was
4.515(41.045) with 1.894standard deviation and 0.134 Std. Error and that
of post test was 7.585(68.955) with 1.942 standard deviation and 0.137 Std.
Error. The calculated ‘t’ value was 22.746, which is higher than the table
‘t’ value 2.045 at 199df with 0.05 level of significance.

It shows that there is significant difference (p<0.001) in pre test and post test
Page |
67
knowledge scores.

Hence it concluded after structured teaching programme on prevention


of cancer cervix the knowledge scores of women have been increased. The
positive result gives a clear indication of effectiveness of structured
teaching programme on prevention of cancer cervix among women. Hence
reject the null hypothesis and accept H1

8.860
9.000

8.000 7.585

7.000

6.000
5.235
5.000 4.515
Percent

4.000 Mean

3.000 Std. Deviation


2.136 1.942
1.894
2.000 1.334

1.000

0.000
PRE TEST POST TEST PRE TEST POST TEST
Knowledge Level of About Knowledge Level Prevention
Cancer Cervix about Cancer Cervix
Section wise Knowledge

Fig.No-15Bar diagram shows mean and Std. deviation distribution


of Women according to Section Wise Knowledge regarding
Prevention of Cancer Cervix

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68
TABLE -9

Pre Test and Post Test Mean of Attitude Scores and Paired
T-Test of Significance on Prevention of Cancer Cervix
among Women.

(N=200)

Overall Knowledge Pre Post


scores test test
Mean 7.075 12.980
Mean% 35.375 64.900
Standard Deviation 2.601 3.272
Standard Error 0.184 0.231
Paired t-test 26.062**(
S)
199dF Table t-value 2.045 p=0.000<0.05

The table no. 9 shows that Attitude of women regarding prevention


of cancer cervix of the pre test mean was 7.075(35.375) with
2.601standard deviation and
0.184 Std. Error and that of post test was 12.980(64.900) with 3.272
standard deviation and 0.231 Std. Error. The calculated ‘t’ value was
26.062, which is higher than the table ‘t’ value 2.045 at 199df with 0.05
level of significance. It shows that there is significant difference (p<0.001)
in pre test and post test attitude scores.

Hence it concluded after structured teaching programme on prevention


of cancer cervix the knowledge scores of women have been increased. The
positive result gives a clear indication of effectiveness of structured
teaching programme on prevention of cancer cervix among women. Hence
reject the null hypothesis and accept H1.

Page |
69
14.000 12.980

12.000

10.000

8.000 7.075
Percent

Mean

6.000 Std. Deviation

4.000 3.272
2.601

2.000

0.000
PRE TEST POST TEST
ATTITUDE

Fig.No-16Bar diagram shows mean and Std. deviation distribution


of Women according to Attitude knowledge regarding
Prevention of Cancer Cervix

Page |
70
SECTION – D

Association between Post Test Knowledge Scores and Attitude


Scores of prevention of Cancer Cervix among Women in
Accordance With Selected Demographic Variables.
This part dealt with identifying the association between knowledge and
attitude of women on Cancer Cervix according to the selected demographic
variables by using the chi-square test.
Table No-10

Association between Post Test Knowledge Scores of Women on


Prevention of Cancer Cervix with Age, Religion, Educational Status,
Occupation.
N=200

Post test Knowledge Level


Below
Avg(33.34% Above Chi-
Demographic variables Avg(<=33.3 Table Inferenc
- 66.6%) Avg(>66.67%) Square
%) value e
value
F % F % F %
25-29 yrs 0 0.0% 43 59.7% 29 40.3%
30-34 yrs 0 0.0% 16 31.4% 35 68.6% 9.941 7.81
Age in p= 0.01 5 at S*
35-39 yrs 0 0.0% 9 42.9% 12 57.1%
years 9 df=3
40-45 yrs 0 0.0% 25 44.6% 31 55.4%
Total 0 0.0% 93 46.5% 107 53.5%
Hindu 0 0.0% 85 45.9% 100 54.1%
Muslim 0 0.0% 6 75.0% 2 25.0% 3.539, 5.991 Not
Religion p=0.170 at Signific
Christian 0 0.0% 2 28.6% 5 71.4%
df=2 ant
Others 0 0.0% 0 0.0% 0 0.0%
Total 0 0.0% 93 46.5% 107 53.5%
Illiterate 0 0.0% 23 82.1% 5 17.9%
Primary
0 0.0% 20 66.7% 10 33.3%
Education 27.329, 7.815
Educatio Signific
nal Secondary p=0.000 at ant*
0 0.0% 8 27.6% 21 72.4%
Status Education df=3
Inter and
0 0.0% 42 37.2% 71 62.8%
above
Total 0 0.0% 93 46.5% 107 53.5%

Home maker 0 0.0% 73 46.8% 83 53.2%

Daily Labour 0 0.0% 9 42.9% 12 57.1% 0.425, Not


Occupati p=0.935 7.815 Signific
on Private at ant
0 0.0% 10 50.0% 10 50.0%
Employee df=3

Govt
0 0.0% 1 33.3% 2 66.7%
Employee
Total 0 0.0% 93 46.5% 107 53.5%

Page |
71
The above table shows that Association between knowledge level
and selected demographic variables such as Age in years, religion,
Educational status, occupation by using Chi-Square test.

According to the above table reveals that the Chi square value
computed between knowledge level of the women and age in years
regarding prevention of Cancer Cervix, the post test Chi square value ᵡ2 =
9.941 at 3 degrees of freedom was greater than table value (7.815) at
p=0.019<0.05 level of significance. Hence conclude that rejects null
hypothesis and it is inferred that there is a significant association between
knowledge level and age in years.

68.6%
70%

59.7%
60% 57.1%
55.4%

50%
44.6%
42.9%
40.3%
40%
31.4% Below Avg(<=33.3%)
Percent

Avg(33.34%-66.6%)
30%
Above Avg(>66.67%)

20%

10%

0% 0% 0% 0%
0%
25-29 yrs 30-34 yrs 35-39 yrs 40-45 yrs
Knowledge Level * Age in years

Fig.No-17Bar diagram shows Association between Overall knowledge


Level and age in years regarding Prevention of Cancer Cervix among
Women

Page |
72
80% 75.0%
71.4%
70%

60% 54.1%

50% 45.9%
Percent

Below Avg(<=33.3%)
40%
Avg(33.34%-66.6%)
28.6%
30% 25.0% Above Avg(>66.67%)

20%

10%
0% 0% 0%
0%
Hindu Muslim Christian
Knowledge Level * Religion

Fig.No-18Cylinder diagram shows Association between Overall


knowledge Level and religion regarding Prevention of Cancer Cervix
among Women

As shown to the above table reflects the Chi square value computed
between knowledge level of the women and religion regarding prevention
of Cancer Cervix, the post test Chi square value ᵡ2 = 3.539 at 2 degrees of
freedom was less than table value (5.991) at p=0.170>0.05 level of
significance. Hence conclude that accepts null hypothesis and it is inferred
that there is no significant association between knowledge level and
religion.

Page |
73
90%
82.1%
80% 72.4%
66.7%
70% 62.8%
60%

50%
37.2% Below Avg(<=33.3%)
Percent

40% 33.3% Avg(33.34%-66.6%)


27.6% Above Avg(>66.67%)
30%
17.9%
20%

10%
0% 0% 0% 0%
0%
Illiterate Primary Secondary Inter and
Education Education above
Knowledge Level * Educational Status

Fig.No-19 Bar diagram shows Association between Overall


knowledge Level and educational status regarding Prevention of
Cancer Cervix among Women

As shown to the above table clearly explains that the Chi square
value computed between knowledge level of the women and educational
status regarding prevention of Cancer Cervix, the post test Chi square value
ᵡ2 = 27.329 at 3 degrees of freedom was greater than table value (7.815)
at p=0.000<0.05 level of significance. Hence conclude that rejects null
hypothesis and it is inferred that there is a significant association between
knowledge level and educational status.

Page |
74
70% 66.7%

60% 57.1%
53.2%

50% 46.8%
42.9%
Percent

40%
33.3% Below Avg(<=33.3%)
Avg(33.34%-66.6%)
30%
Above Avg(>66.67%)

20%

10%

0% 0% 0% 0%
0%
Home maker Daily Labour Private Employee Govt.Employee

Knowledge Level * Occupation

Fig.No-20Pyramidal diagram shows Association between Overall


knowledge Level and Occupation regarding Prevention of Cancer
Cervix among Women

From the above table shows that the Chi square value computed between
knowledge level of the women and occupation regarding prevention of Cancer
Cervix, the post test Chi square value ᵡ2 = 0.425 at 3 degrees of freedom was
less than table value (7.815) at p=0.935>0.05 level of significance. Hence
conclude that accepts null hypothesis and it is inferred that there is no significant
association between knowledge level and occupation.

Page |
75
Table No-11
Association between Post Test Knowledge Scores of Women on
Prevention of Cancer Cervix with Income per month, Marital Status,
Number of Deliveries. N=200

Post test Knowledge


Level
Below Avg(33.34 Above Chi-
Demograp %- Tabl Inferenc
Avg(<=33.3 Avg(>66.67 Squar
hic %) 66.6%) %) e e
e
F % F % F %
variables value valu
e
10,000-
0 0.0 85 45.9 100 54.1
19,999 % % %
20,000-
0 0.0 6 60.0 4 40.0 Not
29,999 0.974, 7.81
% % % Signific
Incom 30,000- 5
0 0.0 1 50.0 1 50.0 p=0.80
39,999 at ant
e per % % % 7
Above df=
month 0 0.0 1 33.3 2 66.7
40,000 % % % 3
Total 0 0.0 93 46.5 107 53.5
% % %
Married 0 0.0 84 45.2 102 54.8
% % % 5.99 Not
Marit 0 0.0 7 70.0 3 30.0 2.374, 1
Unmarri Signific
ed % % % p=0.30 at
al ant
Widow 0 0.0 2 50.0 2 50.0
statu % % % 5 df=
Total 0 0.0 93 46.5 107 53.5
s % % % 2
One 0 0.0 20 55.6 16 44.4
% % % 5.99 Not
Number Two 0 0.0 49 41.5 69 58.5 2.956, 1
% % % Signific
of at
Three or p=0.22
0 0.0 24 52.2 22 47.8 ant
Deliveri above % % % 8 df=
es Total 0
0.0 93 46.5 10 53.5 2
% % 7 %
As shown above table shows that association between Post Test Knowledge
Scores of Women on Prevention of Cancer Cervix with Income per month,
Marital Status, Number of Deliveries.

Page |
76
70% 66.7%

60.0%
60%
54.1%

50% 45.9%
40.0%
40%
33.3% Below Avg(<=33.3%)
Percent

Avg(33.34%-66.6%)
30%
Above Avg(>66.67%)

20%

10%

0%

Knowledge Level * Income per month

0% 0% 0% 0%
10,000- 20,000- 30,000- Above
19,999 29,999 39,999 40,000

Fig.No-21Bar diagram shows Association between Overall


knowledge Level and income per month regarding Prevention of
Cancer Cervix among Women
According to the above table reveals that the Chi square value
computed between knowledge level of the women and income per month
regarding prevention of Cancer Cervix, the post test Chi square value ᵡ2 =
0.974 at 3 degrees of freedom was less than table value (7.815) at
p=0.807>0.05 level of significance. Hence conclude that accepts null
hypothesis and it is inferred that there is no significant association between
knowledge level and religion.

Page |
77
80%
70.0%
70%

60% 54.8%

50% 45.2%
Percent

40% Below Avg(<=33.3%)


Avg(33.34%-66.6%)
30.0%
Above Avg(>66.67%)
30%

20%

10%
0% 0% 0%
0%
Married Unmarried Widow
Knowledge Level * Marital status

Fig.No-22Cylinder diagram shows Association between Overall


knowledge Level and marital status regarding Prevention of
Cancer Cervix among Women

From the above table explains that the Chi square value computed
between knowledge level of the women and marital status regarding
prevention of Cancer Cervix, the post test Chi square value ᵡ2 = 2.374 at 2
degrees of freedom was less than table value (5.991) at p=0.305>0.05
level of significance. Hence conclude that accepts null hypothesis and it is
inferred that there is no significant association between knowledge level
and marital status.

Page |
78
58.5%
60% 55.6%
52.2%
47.8%
50%
44.4%
41.5%
40%

30% Below Avg(<=33.3%)


Percent

Avg(33.34%-66.6%)
Above Avg(>66.67%)
20%

10%

0% 0% 0%
0%
One Two Three or above
Knowledge Level * Number of Delivery's

Fig.No-23Cone diagram shows Association between Overall


knowledge Level and number of Deliveries regarding Prevention of
Cancer Cervix among Women
From the above table reflects the Chi square value computed
between knowledge level of the women and number of deliveries
regarding prevention of Cancer Cervix, the post test Chi square value ᵡ2 =
2.956at 2 degrees of freedom was less than table value (5.991) at
p=0.228>0.05 level of significance. Hence conclude that accepts null
hypothesis and it is inferred that there is no significant association between
knowledge level and number of deliveries.

Page |
79
Table No-12

Association between Post Test Knowledge Scores of Women on


Prevention of Cancer Cervix with Where do you know from health
information about Cancer cervix, Dietary Pattern, If history of
cancer cervix in the family.

N=200
Post test Knowledge Level
Below Avg(33.34%- Above Chi-
Demographic variables Table Inference
Avg(<=33.3%) 66.6%) Avg(>66.67%) Square
value
F % F % F % value
Health
Where do 0 0.0% 61 44.5% 76 55.5%
personal
you know
Television 0 0.0% 14 46.7% 16 53.3% 3.304, 7.815 Not
from health
News p=0.347 at Significant
information
0 0.0% 5 38.5% 8 61.5%
paper df=3
about
Cancer Neighbour 0 0.0% 13 65.0% 7 35.0%
s
cervix
Total 0 0.0% 93 46.5% 107 53.5%

Vegetarian 0 0.0% 11 34.4% 21 65.6%


5.991
Diet Non 10.245,
0 0.0% 37 63.8% 21 36.2% at Significant*
pattern vegetarian p=0.006
df=2
Mixed 0 0.0% 45 40.9% 65 59.1%
Total 0 0.0% 93 46.5% 107 53.5%
If history Yes 0 0.0% 7 100.0% 0 0.0% 3.841
8.346, Not
of cancer No 0 0.0% 86 44.6% 107 55.4% at
p=0.004 Significant
cervix in
Total 0 0.0% 93 46.5% 107 53.5% df=1
the family

As shown above table shows that Association between Post Test


Knowledge Scores of Women on Prevention of Cancer Cervix with Where
do you know from health information about Cancer cervix, Dietary Pattern,
If history of cancer cervix in the family.

Page |
80
70% 65.0%
61.5%
60% 55.5%
53.3%

50% 46.7%
44.5%
38.5%
Percent

40% 35.0%

Below Avg(<=33.3%)
30%
Avg(33.34%-66.6%)
Above Avg(>66.67%)
20%

10%
0% 0% 0% 0%
0%
Health Television News paper Neighbours
perssonal
Knowledge Level * Where do you know from health information about
Cancer cervix

Fig.No-24Pyramidal diagram shows Association between Overall


knowledge Level and Where do you know from health
information about Cancer cervix regarding Prevention of Cancer
Cervix among Women

From the above table clearly shows that the Chi square value
computed between knowledge level of the women and Where do you know
from health information about Cancer cervix regarding prevention of
Cancer Cervix, the post test Chi square value ᵡ2 = 3.304 at 3 degrees of
freedom was less than table value (7.815) at p=0.347>0.05 level of
significance. Hence conclude that accepts null hypothesis and it is inferred
that there is no significant association between knowledge levels and where
do you know from health information about Cancer cervix.

Page |
81
70% 65.6%
63.8%
59.1%
60%

50%
40.9%
40% 36.2%
34.4%
Below Avg(<=33.3%)
Percent

30% Avg(33.34%-66.6%)
Above Avg(>66.67%)
20%

10%
0% 0% 0%
0%
Vegetarian Non vegetarian Mixed
Knowledge Level * Diet pattern

Fig.No-25bar diagram shows Association between Overall


knowledge Level and diet pattern regarding Prevention of
Cancer Cervix among Women

From the above table shows that the Chi square value computed between
knowledge level of the women and diet pattern regarding prevention of Cancer
Cervix, the post test Chi square value ᵡ2 = 10.245 at 2 degrees of freedom was
greater than table value (5.991) at p=0.006<0.05 level of significance. Hence
conclude that rejects null hypothesis and it is inferred that there is a significant
association between knowledge levels and diet pattern.

Page |
82
100.0%
100%
90%

80%

70%
55.4%
60%
44.6% Below Avg(<=33.3%)
Percent

50%
Avg(33.34%-66.6%)
40% Above Avg(>66.67%)

30%

20%

10% 0% 0.0% 0%
0%
Yes No
Knowledge Level * If history of cancer cervix in the family

Fig.No-26Cylinder diagram shows Association between Overall


knowledge Level and history of cancer cervix in the family regarding
Prevention of Cancer Cervix among Women

As shown the above table reflects the Chi square value computed between
knowledge level of the women and Where do you know from health
information about Cancer cervix regarding prevention of Cancer Cervix, the
post test Chi square value ᵡ2 = 8.346 at 1 degrees of freedom was greater than
table value (3.841) at p=0.004<0.05 level of significance. Hence conclude that
rejects null hypothesis and it is inferred that there is a significant association
between knowledge levels and history of cancer cervix in the family.

Page |
83
Table No-13
Association between Post Test Attitude Scores of Women on Prevention
of Cancer Cervix with Age, Religion, Educational Status, Occupation.

N=200
Post test Attitude Level
Moderate
Low High Chi- Table
(33.34%-
Demographic variables (<=33.3%) (>66.67%) Square Inference
value
66.6%)
value
F % F % F %
25-29 yrs 0 0.0% 31 43.1% 41 56.9%
7.815
Age in 30-34 yrs 0 0.0% 30 58.8% 21 41.2% 5.070 Not
at
years 35-39 yrs 0 0.0% 14 66.7% 7 33.3% p= 0.167 Significant
df=3
40-45 yrs 0 0.0% 29 51.8% 27 48.2%
Total 0 0.0% 104 52.0% 96 48.0%
Hindu 0 0.0% 95 51.4% 90 48.6%
5.991
Muslim 0 0.0% 4 50.0% 4 50.0% 1.103, Not
at
Religion
Christian 0 0.0% 5 71.4% 2 28.6% p=0.576 Significant
df=2
Others 0 0.0% 0 0.0% 0 0.0%
Total 0 0.0% 104 52.0% 96 48.0%
Illiterate 0 0.0% 7 25.0% 21 75.0%
Primary
0 0.0% 18 60.0% 12 40.0%
Education 7.81
Educational 12.293, Significant*
5 at
Status Secondary p=0.006
0 0.0% 20 69.0% 9 31.0% df=3
Education

Inter and above 0 0.0% 59 52.2% 54 47.8%

Total 0 0.0% 104 52.0% 96 48.0%

Home maker 0 0.0% 75 48.1% 81 51.9%

Daily Labour 0 0.0% 13 61.9% 8 38.1% 7.81


Occupation 4.642, Not
Private 5 at
0 0.0% 14 70.0% 6 30.0% p=0.200 Significant
df=3
Employee

Govt.Employee 0 0.0% 2 66.7% 1 33.3%

Total 0 0.0% 104 52.0% 96 48.0%

Page |
84
According to the above table shows that association between Post
Test Attitude Scores of Women on Prevention of Cancer Cervix with Age,
Religion, Educational Status, Occupation.

70% 66.7%

58.8%
60% 56.9%
51.8%
48.2%
50%
43.1%
41.2%
40%
Percent

33.3%
Low (<=33.3%)
Moderate (33.34%-66.6%)
30%
High (>66.67%)

20%

10%
0% 0% 0% 0%
0%
25-29 yrs 30-34 yrs 35-39 yrs 40-45 yrs
Attitude Level * Age in years

Fig.No-27Bar diagram shows Association between Attitude Level and


Age in years regarding Prevention of Cancer Cervix among Women

As shown the above table explains that the Chi square value
computed between attitude level of the women and age in years regarding
prevention of Cancer Cervix, the post test Chi square value ᵡ2 = 5.070 at 3
degrees of freedom was less than table value (7.815) at p=0.167>0.05 level
of significance. Hence conclude that accepts nullhypothesis and it is
inferred that there is no significant association between attitude levels and
age in years.

Page |
85
80%
71.4%
70%

60%
51.4%
48.6%
50%
Percent

40% Low (<=33.3%)


Moderate (33.34%-66.6%)
28.6% High (>66.67%)
30%

20%

10%
0% 0% 0%
0%
Hindu Muslim Christian
Attitude Level * Religion

Fig.No-28 Cylinder diagram shows Association between


Attitude Level and Religion regarding Prevention of Cancer
Cervix among Women

From the above table reflects the Chi square value computed between attitude
level of the women and religion regarding prevention of Cancer Cervix, the post
test Chi square value ᵡ2 = 1.103 at 2 degrees of freedom was less than table
value (5.991) at p=0.576>0.05 level of significance. Hence conclude that
accepts null hypothesis and it is inferred that there is no significant association
between attitude levels and religion.

Page |
86
80% 75.0%
69.0%
70%
60.0%
60%
52.2%
47.8%
50%
Percent

40.0%
40% Low (<=33.3%)
31.0%
Moderate (33.34%-66.6%)
30% 25.0%
High (>66.67%)

20%

10% 0% 0% 0% 0%
0%
Illiterate Primary Secondary Inter and
Education Education above
Attitude Level * Educational Status

Fig.No-29Cone diagram shows Association between Attitude


Level and Educational Status regarding Prevention of Cancer
Cervix among Women

According to the above table explains that the Chi square value computed
between attitude level of the women and educational status regarding prevention
of Cancer Cervix, the post test Chi square value ᵡ2 = 12.293 at 3 degrees of
freedom was greater than table value (7.815) at p=0.006<0.05 level of
significance. Hence conclude that rejects null hypothesis and it is inferred that
there is a significant association between attitude levels and educational status.

Page |
87
80%
70.0%
70% 66.7%
61.9%
60%
51.9%
48.1%
50%
Percent

38.1% Low (<=33.3%)


40% 33.3% Moderate (33.34%-66.6%)
30.0%
30% High (>66.67%)

20%

10%

0%
Home maker Daily Labour Private Employee Govt.Employee

Attitude Level * Occupation

Fig.No-30 Pyramidal diagram shows Association between


Attitude Level and occupation regarding Prevention of
Cancer Cervix among Women

As the above table reveals that the Chi square value computed
between attitude level of the women and occupation regarding prevention
of Cancer Cervix, the post test Chi square value ᵡ2 = 4.642 at 3 degrees of
freedom was less than table value (7.815) at p=0.200>0.05 level of
significance. Hence conclude that accepts null hypothesis and it is inferred
that there is no significant association between attitude levels and
occupation.

Page | 12
Table No-14

Association between Post Test Attitude Scores of Women on


Prevention of Cancer Cervix with Income per month, Marital
Status, Number of Deliveries.

N=200

Post test Attitude Level


Moderate
Low High Chi- Table
(33.34%-
Demographic variables (<=33.3%) (>66.67%) Square Inference
value
66.6%)
value
F % F % F %
10,000-
0 0.0% 96 51.9% 89 48.1%
19,999

20,000-
0 0.0% 4 40.0% 6 60.0% Not
Income 29,999 2.682, 7.815
Significant
per month p=0.443 at
30,000-
0 0.0% 2 100.0% 0 0.0% df=3
39,999

Above
0 0.0% 2 66.7% 1 33.3%
40,000

Total 0 0.0% 104 52.0% 96 48.0%


Married 0 0.0% 96 51.6% 90 48.4%
5.991 Not
Marital Unmarried 0 0.0% 5 50.0% 5 50.0% 0.875,
at Significant
status p=0.646
Widow 0 0.0% 3 75.0% 1 25.0% df=2

Total 0 0.0% 104 52.0% 96 48.0%


One 0 0.0% 22 61.1% 14 38.9%
Number of
Two 0 0.0% 60 50.8% 58 49.2% 1.581, 5.991 Not
Deliveries
Three or p=0.454 at Significant
0 0.0% 22 47.8% 24 52.2%
above df=2

Total 0 0.0% 104 52.0% 96 48.0%

From the above table explains that Association between Post Test Attitude
Scores of Women on Prevention of Cancer Cervix with Income per month,
Marital Status, Number of Deliveries. Page | 13
100.0%
100%

90%

80%
66.7%
70%
60.0%
60%
Percent

51.9%
48.1% Low (<=33.3%)
50%
40.0% Moderate (33.34%-66.6%)
40% 33.3% High (>66.67%)

30%

20%

10%

0%

Attitude Level * Income per month

Fig.No-31 Bar diagram shows Association between Attitude Level


and income per month regarding Prevention of Cancer
Cervix among Women
As shown the above table shows that the Chi square value computed
between attitude level of the women and income per month regarding
prevention of Cancer Cervix, the post test Chi square value ᵡ2 = 2.682 at 3
degrees of freedom was less than table value (7.815) at p=0.443>0.05 level
of significance. Hence conclude that accepts null hypothesis and it is
inferred that there is no significant association between attitude levels and
income per month.

Page | 14
80% 75.0%

70%

60%
51.6%
48.4%
50%
Percent

40% Low (<=33.3%)


Moderate (33.34%-66.6%)

30% 25.0% High (>66.67%)

20%

10%
0% 0% 0%
0%
Married Unmarried Widow
Attitude Level * Marital status

Fig.No-32Cylinder diagram shows Association between


Attitude Level and marital Status regarding Prevention of
Cancer Cervix among Women

As shown the above table shows that the Chi square value computed
between attitude level of the women and marital status regarding
prevention of Cancer Cervix, the post test Chi square value ᵡ2 = 0.875 at 2
degrees of freedom was less than table value (5.991) at p=0.646>0.05 level
of significance. Hence conclude that accepts null hypothesis and it is
inferred that there is no significant association between attitude levels and
marital status.

Page | 15
70%
61.1%
60%
50.8% 52.2%
49.2% 47.8%
50%

38.9%
Percent

40%
Low (<=33.3%)

Moderate (33.34%-66.6%)
30%
High (>66.67%)

20%

10%

0% 0% 0%
0%
One Two Three or above
Attitude Level * Number of Delivery's

Fig.No-33Cone diagram shows Association between Attitude Level


and Number of Deliveries regarding Prevention of Cancer
Cervix among Women

According to the above table clearly shows that the Chi square value computed
between attitude level of the women and number of Deliveries regarding
prevention of Cancer Cervix, the post test Chi square value ᵡ2 = 1.581 at 2
degrees of freedom was less than table value (5.991) at p=0.454>0.05 level of
significance. Hence conclude that accepts null hypothesis and it is inferred that
there is no significant association between attitude levels and number of
Deliveries.

Page | 16
Table No-15

Association between Post Test Attitude Scores of Women on


Prevention of Cancer Cervix with women. Where do you know
from health information about Cancer cervix, Dietary Pattern,
history of cancer cervix in the family.
N=200
Post test Attitude Level
Moderate
Low High Chi- Table
(33.34%-
Demographic variables (<=33.3%) (>66.67%) Square Inference
value
66.6%)
value
F % F % F %

Health
how do you 0 0.0% 62 45.3% 75 54.7%
personal
know from
health Television 0 0.0% 17 56.7% 13 43.3% 7.815 Significant
10.587,
information at
News p=0.014
about 0 0.0% 9 69.2% 4 30.8%
paper df=3
Cancer
cervix Neighbours 0 0.0% 16 80.0% 4 20.0%

Total 0 0.0% 104 52.0% 96 48.0%

Vegetarian 0 0.0% 19 59.4% 13 40.6%


5.991
2.239, Not Significant
Diet Non at
0 0.0% 33 56.9% 25 43.1% p=0.326
pattern vegetarian df=2

Mixed 0 0.0% 52 47.3% 58 52.7%


Total 0 0.0% 104 52.0% 96 48.0%
History of Yes 0 0.0% 3 42.9% 4 57.1% 0.243, 3.841 Not Significant
cancer No 0 0.0% 101 52.3% 92 47.7% p=0.622 at
cervix in df=1
the family Total 0 0.0% 104 52.0% 96 48.0%

As shown above table shows that association between Post Test Attitude
Scores of Women on Prevention of Cancer Cervix with Where do you
know from health information about Cancer cervix, Dietary Pattern, If
history of cancer cervix in the family. Page | 17
80.0%
80%
69.2%
70%

60% 56.7%
54.7%

50% 45.3%
43.3%

40%
Percent

Low (<=33.3%)
30.8% Moderate (33.34%-66.6%)
30% High (>66.67%)
20.0%
20%

10%
0% 0% 0% 0%
0%
Health perssonal Television News paper Neighbours

Attitude Level * Where do you know from health information


about Cancer cervix

Fig.No-34 Pyramidal diagram shows Association between


Attitude Level and * Where do you know from health
information about Cancer cervix regarding Prevention of
Cancer Cervix among Women

According to the above table clearly shows that the Chi


square value computed between attitude level of the women
and where do you know from health information about Cancer
cervix regarding prevention of Cancer Cervix, the post test Chi
square value ᵡ2 = 10.587 at 3 degrees of freedom was greater
than table value (7.815) at p=0.014<0.05 level of significance.
Hence conclude that rejects null hypothesis and it is inferred
that there is a significant association between attitude levels and
where do you know from health information about Cancer
cervix.
Page |
18
59.4%
60% 56.9%
52.7%

50% 47.3%
43.1%
40.6%
40%
Percent

30% Low (<=33.3%)


Moderate (33.34%-66.6%)
High (>66.67%)
20%

10%

0% 0% 0%
0%
Vegetarian Non vegetarian Mixed
Attitude Level * Diet pattern

Fig.No-35Bar diagram shows Association between Attitude Level and Diet


Pattern regarding Prevention of Cancer Cervix among Women

From the above table clearly shows that the Chi square
value computed between attitude level of the women and diet
pattern regarding prevention of Cancer Cervix, the post test Chi
square value ᵡ2 = 2.239 at 2 degrees of freedom was less than
table value (5.991) at p=0.326>0.05 level of significance.
Hence conclude that accepts null hypothesis and it is inferred
that there is no significant association between attitude levels
and diet pattern.

Page |
19
60% 57.1%
52.3%
47.7%
50%
42.9%

40%

Low (<=33.3%)
30%
Moderate (33.34%-66.6%)
Percent

High (>66.67%)

20%

10%

0% 0%
0%
Yes No

Attitude Level * If history of cancer cervix in the family

Fig.No-36Cylinder diagram shows Association between Attitude


Level and * history of Cancer cervix in the family regarding
Prevention of Cancer Cervix among Women

As shown the above table explains that the Chi square value
computed between attitude level of the women and history of Cancer cervix
in the family regarding prevention of Cancer Cervix, the post test Chi
square value ᵡ2 = 0.243 at 1degrees of freedom was less than table value
(3.841) at p=0.622>0.05 level of significance. Hence conclude that accepts
null hypothesis and it is inferred that there is no significant association
between attitude levels and history of Cancer cervix in the family.

Page |
20
SECTION-E

It deals with the Correlation between knowledge score


and attitude scores among Women regarding Prevention of
Cancer Cervix.

TABLE NO: 16

To Test Correlation between Knowledge Score and


Attitude Score among Women regarding Prevention of
Cancer Cervix

Correlation Attitude Score


r 0.501*
*
P- 0
value
Knowledge Score N 200

It is observe that relation between overall knowledge


scores and attitude score of the value is r=0.501,
p=0.000<0.05, hence it is significant at 1% level of significance
and conclude that there is50.1% positive and strong
significance correlation between knowledge score and attitude
score among the women regarding prevention of Cancer
Cervix.

Page |
21
Summary:
 Majority of the women were 25-29 yrs and least was 35-39 yrs.
 Majority of the women were belonged to Hindu and least was others.
 Majority were studied inter and above and least was Illiterate.
 Majority of women were home maker, and least was Govt. Employee.
 Majority of the income was 10,000-19,999 and least is 30,000-39,999.
 Majority of women were married, least was widow.
 Majority of the women were having two deliveries and least was one delivery.
 Majority was health personal and least was news paper.
 Majority of the women follows the mixed diet and least was

vegetarian diet. Majority of the women previous history of cancer


cervix in the family was saying No-and least was yes.
 In the pre test, 30.5% were under Below Average knowledge

level, 69.5% were under Average knowledge level and Above


Knowledge level were found nil,in post test, under Below Average
knowledge level were none of them,46.5% were Average knowledge
level and 53.5% were under Above Knowledge level in post test.
 In the knowledge regarding about Cancer cervix Section, In Pre test,

27.0% were under Below Average knowledge level,72.0% were


under Average knowledge level and 1.0% were Above average
knowledge level, whereas in Post test, 3.5% were under Below
Average knowledge level, 61.0%were under Average knowledge
level and 35.5% were Above average knowledge level.
 In the prevention of Cancer Cervix Level of Knowledge in Pre test

and Post test, In Pre test, 29.0% were under Below Average
knowledge level, 66.0% were under Average knowledge level and
5.0% were Above average knowledge level, whereas in Post test,
12.0%were under Below Average knowledge level, 53.5% were
Page |
22
under Average knowledge level and 34.5% were Above average
knowledge level.
 In Attitude level, 44.0% were under low attitude level in pre test

whereas in post test were found nil, 56.0% were under moderate
attitude level in pre test, whereas 52.0% were moderate level in post
test, in high Attitude level knowledge level in pre test were none of
them, whereas 48.0% were high attitude level in post test.
 In the overall knowledge, pre test mean was 9.760(39.040) with

2.204 standard deviation and 0.156 Std. Error and that of post test
was 16.440(65.760) with 3.035 standard deviation and 0.214 Std.
Error. The calculated ‘t’ value was 29.733, which is higher than the
table ‘t’ value 2.045 at 199df with 0.05 level of significance.
 Knowledge regarding about Cancer cervix of the pre test mean was

5.235(37.392) with 1.333 standard deviation and 0.094 Std. Error


and that of post test was 8.860(63.285) with 3.035 standard deviation
and 0.214 Std. Error. The calculated ‘t’ value was 23.234, which is
higher than the table ‘t’ value 2.045 at 199df with 0.05 level of
significance. It shows that there is significant difference (p<0.001) in
pre test and post test knowledge scores.
 Knowledge regarding prevention of Cancer cervix of the pre test

mean was 4.515(41.045) with 1.894 standard deviation and 0.134


Std. Error and that of post test was 7.585(68.955) with 1.942 standard
deviation and 0.137 Std. Error. The calculated ‘t’ value was 22.746,
which is higher than the table ‘t’ value 2.045 at 199df with 0.05 level
of significance.
 Attitude of women regarding prevention of cancer cervix of the pre

test mean was 7.075(35.375) with 2.601 standard deviation and 0.184
Std. Error and that of post test was 12.980(64.900) with 3.272
standard deviation and 0.231 Std. Error. The calculated ‘t’ value was

Page |
23
26.062, which is higher than the table ‘t’ value 2.045 at 199df with
0.05 level of significance.
 Association between Post Test Knowledge level is significant

relation with Selected Demographic Variables such as age in years,


educational status diet pattern and no other demographic variables
such as Religion, Occupation, Income per month, Marital status,
Number of Deliveries, Where do you know from health information
about Cancer cervix, If history of cancer cervix regarding Prevention
of Cervical Cancer are non-significant.
 Association between Post Test Attitude level is significant relation

with Selected Demographic Variables such as age in years,


educational status
,where do you know from health information about Cancer cervix
and no other demographic variables such as Religion, Occupation,
Income per month, Marital status, Number of Deliveries, Diet
pattern, If history of cancer cervix regarding Prevention of Cervical
Cancer are non-significant.

Page |
24
CHAPTER V
SUMMARY, FINDINGS DISSCUSSION, CONCLUSION,
IMPLICATIONS, LIMITATIONS AND
RECOMMENDATIONS

This chapter is divided into two Sections. Section - I deal


with summary of the study, findings, and conclusion. Section - II
deals with implication in various areas of nursing practice, nursing
education, nursing administration, and nursing research, limitations
and recommendations.

OBJECTIVES OF THE STUDY

1. Assess the knowledge prevention of cancer cervix among women


2. Plan and administer the structured teaching programme

on prevention of cancer cervix among women.


3. Effectiveness of structured teaching programme on

prevention cancer cervix among women.


4. Correlate the knowledge on prevention of cancer cervix with attitude.
5. Find out the association between knowledge and attitude

on cancer cervix among women with selected


demographic variables

HYPOTHESES

H1: There is no significant difference between mean pre-test and


post-test knowledge scores of women regarding prevention
of cancer cervix at 0.05 level of significance.

H2: There is no significant association between post-test


Page | 25
knowledge of women regarding prevention of carcinoma of
cervix with selected demographic variables at 0.05 level of
significance.

H3: There is no significant association between the post test


attitude regarding prevention of cancer cervix and their
selected variables at 0.05 level of significance.

H4: There is no Correlation between Knowledge Score and Attitude score.

SUMMARY OF THE STUDY

The objective of the study was to assess the level of


knowledge and practice expressed regarding Prevention of Cancer
Cervix among Women at Selected Rural Community.

Descriptive approach and research design was adopted for


this study. Non-probability purposive sampling technique was
used to select the samples and the samples size was 200.

The tool selected for the present study included questions for
demographic data and questionnaire tool for the assessment of level
knowledge and expressed attitude regarding Prevention of Cancer
Cervix among Women at Selected Rural Community.

The data collection was done for a period of six weeks .The
data collected for the study was compiled and analyzed as per the
objectives of the study. Descriptive statistics were used to analysis
Page | 26
the data, interpreted in terms of objectives of the study.

The study findings shows that the level of knowledge and


expressed attitude regarding Prevention of Cancer Cervix among
Women at Selected Rural Community.

MAJOR FINDINGS OF THE STUDY

I. Demographic variables

Majority of the Section icipants

 36.0% of women belong to 25 - 29 years.

 92.5% of women were Hindu religion.

 56.5% were studied inter and above .

 78.0% were Home maker.

 92.5% have Rs. 10,000-19,999of family monthly income.

 93.0 % of women were married.

 59.0% of women had two deliveries.

 68.5% of women having information from health personnel .

 55.0% were following mixed diet.

 96.5% of women not having previous history in the family.

Findings related to assess the level of knowledge and


expressed attitude regarding Prevention of Cancer Cervix
among Women at Selected Rural Community, the findings
Page | 27
shows that
 In Overall knowledge, in the pre test, 30.5% were under
Below Average knowledge level, 69.5% were under Average
knowledge level and Above Knowledge level was found nil.
In post test, under Below Average knowledge level were none
of them, 46.5% were Average knowledge level and 53.5%
were under Above Knowledge level. In Attitude level, 44.0%
were under low attitude level in pre test whereas in post test
were found nil, 56.0% were under moderate attitude level in
pre test, whereas 52.0% were moderate level in post test, in
high Attitude level knowledge level in pre test were none of
them, whereas 48.0% were high attitude level in post test.
Findings related to Plan and administer the structured
teaching programme on prevention of cancer cervix among
women, the findings shows that

 In the knowledge regarding about Cancer cervix Section, In


Pre test, 27.0% were under Below Average knowledge level,
72.0% were under Average knowledge level and 1.0% were
above average knowledge level, whereas in Post test, 3.5%
were under Below Average knowledge level, 61.0% were
under Average knowledge level and 35.5% were Above
average knowledge level.
 In the prevention of Cancer Cervix Level of Knowledge in Pre
test and Post test, In Pre test, 29.0% were under Below
Average knowledge level, 66.0% were under Average
knowledge level and 5.0% were Above average knowledge
Page | 28
level, whereas in Post test, 12.0% were under Below Average
knowledge level, 53.5% were under Average knowledge level
and 34.5% were Above average knowledge level.

Findings related to effectiveness of structured


teaching programme on prevention cancer cervix
among women, the finding shows that

The effectiveness of the women the overall knowledge, pre test mean was
9.760 ± 2.204 standard deviation and 0.156 Std. Error and that of post test
was 16.440± 3.035 standard deviation and 0.214 Std. Error. The
calculated ‘t’ value was 29.733, which is higher than the table ‘t’ value
2.045 at 199df with 0.05 level of significance

 The effectiveness of Attitude of women regarding prevention


of cancer cervix of the pre test mean was 7.075±2.601
standard deviation and 0.184 Std. Error and that of post test
was 12.980 ±3.272 standard deviation and 0.231 Std. Error.
The calculated ‘t’ value was 26.062, which is higher than the
table ‘t’ value 2.045 at 199df with 0.05 level of significance.
Findings related to Correlate the knowledge on prevention
of cancer cervix with attitude among the selected rural
community, the findings shows that,

 The relation between overall knowledge scores and attitude


score of the value is r=0.501, p=0.000<0.05, hence it is

Page | 29
significant at 1% level of significance and conclude that
there is 50.1% positive and strong significance correlation
between knowledge score and attitude score among the
women regarding prevention of Cancer Cervix.

Findings related to the association between the level of


knowledge and expressed attitude regarding prevention
of cancer cervix with attitude among the selected rural
community with selected demographic variables, shows
that,

Data findings revealed that there was a statistically


significant association found between the level of knowledge
with age in years, educational status, diet pattern, at p< 0.05
level of significance.

There was a statistically significant association found


between expressed attitude with the level of attitude with age
in years, educational status and where do you know from
health information about Cancer cervix at p< 0.05 level of
significance.

IMPLICATION OF THE STUDY

The findings of the study have implication in various areas of


nursing practice, nursing education, nursing administration, and
Page | 30
nursing research and recommendation for further study are
present.

IMPLICATION IN NURSING PRACTICE

 Community health members are the appropriate persons for


helping women to increases their knowledge prevention of
cancer cervix among women at the selected rural
community

 Community health workers can conduct health practice to


improve the attitude of women regarding prevention of
cancer cervix.

NURSING EDUCATION

 Nursing students must be able to recognize the


importance of knowledge of women regarding prevention
of cancer cervix.

 Nursing students can conduct educational programmes,


role play, workshops and campaign regarding prevention
of cancer cervix at selected community area and its
prevention in the community to educate community health
welfare.

IMPLICATION IN NURSING ADMINISTRATION

 This study suggests that nurse administrators should conduct

in service education for the nursing staff about prevention of


cancer cervix at selected rural community and its preventive
measures.
Page | 31
 These findings will help the administrator to implement

health education program on prevention of cancer cervix at


selected rural community among women.

 Administrators can plan and conduct in service education

program for health team members to update their knowledge.


 Facilities should be provided to the community in order to

render better care for women and for fast recovery.

IMPLICATION FOR NURSING RESEARCH

 The study can be published in journals to disseminated


knowledge about prevention of cancer cervix at selected
rural community.

 The nurse researcher should motivate the clinical nurse to


apply the research findings in practice.

LIMITATIONS
 Data collection period was 6 weeks only.

 Generalization will be better if large sample included.

 Due to time constraints, the researcher was unable to


take more than 200 samples for the study.

 Study was limited to one selected rural community.


 Findings could have avoided investigators bias.
 Contamination through discussion in the ward is beyond
the control of investigator
 As there are no standard tools available the investigator
Page | 32
developed the tools for the study.

RECOMMENDATIONS

 The study recommends the following research,

 A similar study can be conducted again on a large sample.

 A study can be conducted on two or more community areas to


strengthen the findings.
 A comparative study can be under taken to see the relationship
between knowledge and attitude of women regarding
prevention of cancer cervix at selected rural and urban
community.

 A similar study can be replicated on a large scale and for a


longer period of duration for assessing practices for more
reliability and effectiveness.

 A similar study can be done in all women of both urban and rural area.

 A similar study can be done in community health workers.

 A similar study can be done on a large population for better


generalization.

 A similar study can be done on prevention of cancer


cervix at selected rural and urban community.

 A similar can be done to find out the effectiveness of planned


teaching program on the rural and urban people to improve
the knowledge regarding Cancer Cervix and its prevention.

Page | 33
 A similar study can be replicated in different setting to strengthen the
findings.

 A similar study can be done on knowledge of practice related


to the prevention of cervical cancer.

 Various other intervention modalities, which may vary in


content and method, can be used to assess the effectiveness of
STP among women in community
CONCLUSION

 The purpose of this study was used to assess the knowledge


and expressed attitude among women who were living rural
community. From the above findings shows in the post test of
the women had above average level of knowledge, and
expressed attitude prevention of cancer cervix at selected rural
community.

 On the whole, carrying out the present study was really an


enriching experience to the investigator. It also helped a
great deal to explore and improve the knowledge of the
researcher and the respondents.

LIST OF REFERENCES:

1. O. Tapera &amp; Hendricks et.al., (2019) conducted a study to assess


Cervical cancer knowledge, attitudes, beliefs and practices of women.
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regarding cervical cancer and screening among women visiting primaryhealth
care Centres
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3. Ms Nidhi Dagar A Study to Assess the Effectiveness of Planned Teaching
Programme Regarding Prevention of Cervical Cancer in Terms of Knowledge
and Attitude among Women of Reproductive Age Group in Selected Rural
Community of Delhi International Journal of Health Sciences & Research
(www.ijhsr.org) 196 Vol.8; Issue: 8; August 2018
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8. Dsouza, N. D., Murthy, N. S., &Aras, R. Y. (2013). Projection of cancer
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A (2015) Epidemiology of cervical cancer with special focus on India.Int J
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WEBSITES

1. www.tamilnadunursingcouncil.com
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df
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cancer-government-strategy.pdf.

Page | 39
CONTENT VALIDATION CERTIFICATE

I hereby certify that I have validated the tool of Mrs


V.Bhulaxmi, II year M.Sc. (Obstetrical and Gynaecological
Nursing) Nursing student, Government College of Nursing who is
undertaking the following study:

“Effectiveness of Structured Teaching Program on


Knowledge and Attitude Regarding Prevention of Cancer Cervix
among Women at Selected Rural Community, Khairthabad,
Hyderabad, Telangana.”

Signature of the Expert

Date:

Place: Designation

Page | 40
APPENDIX A
GOVERNMENT OF Date: 11/05/2021
TELANGANA

No.ACAD /GCON/2021
From, To,

Page | 41
Prof. D.R. Radha Rukmini, The Medical Superintendent,
Principal, Modern Government Maternity Hospital,
Government College of Nursing, Khairthabad,
Somajiguda, Rajbhavan Road, Hyderabad,
Hyderabad, T.S. T.S.

Respected sir,
Sub: Government College of Nursing, Hyderabad -2 Year M.sc

(N)Course- Permission for Incidence Collection –

Requested-Reg

I have pleasure in introducing Mrs. V.Bhulaxmi IInd year MSc (N)


student of this college who is doing her project study in partial fulfilment
of herM.sc (N) post graduate course. The topic for the project is furnished
below:

“Effectiveness of Structured Teaching Program on Knowledge and


Attitude Regarding Prevention of Cancer Cervix among Women at
Selected Rural Community, Khairthabad, Hyderabad, Telangana.”
In this connection she needs Tool Validation from your Institute,

I request you to kindly give permission for the same and extend your
guidanceand co-operation in this matter.

Thanking you.

Page | 42
Appendix C
Letter for Tool Validity
Hyderabad Date:

To,

Sub: Request for Tool validity,

Respected Sir/Madam,

I, Mrs. V.BHULAXMI, M.Sc. (N) 2nd year student bring to your


kind notice that I am conducting a research on “Effectiveness of
Structured Teaching Program on Knowledge and Attitude Regarding
Prevention of Cancer Cervix among Women at Selected Rural
Community, Khairthabad, Hyderabad, Telangana.”

For the partial fulfilment of M.Sc.(N) Programme. I kindly request


you to validate my tool, content and give me your valuable suggestions.

Thanking you,

Yours obediently,

Mrs. V.BHULAXMI,
nd
M.Sc. (N) 2 year studentGovt. College of Nursing
Page | 43
Hyderabad, T.S
Appendix D

Letter Seeking the Opinion of the Experts on Content Validity of the


Tool

Hyderabad
Date:
To,

(Through the Principal, Govt. College of Nursing)


Sub:Requesting the Opinion and suggestions for establishing
content validity of the tool- regarding,
Respected Sir/Madam,
I, Mrs. V.Bhulaxmi, M.Sc. (N) 2nd year student bring to your kind
notice that I am conducting a research on “Effectiveness of Structured
Teaching Program on Knowledge and Attitude Regarding Prevention
of Cancer Cervix among Women at Selected Rural Community,
Khairthabad, Hyderabad, Telangana”
With regards to this, I request you to kindly validate the tool for its
accuracy, appropriateness and relevance. I also request you to kindly sign
the Certificate of Validation of the tool. Your kind cooperation and your
expert judgement will be very much appreciated.
First Guide:- Mrs, R Hansili, Asst. Professor
Second Guide:- Mrs. G.Sudha, Lecturer
Thanking you
Yours obediently,
Mrs. V.Bhulaxmi,
M.Sc. (N) 2nd year student
Govt. College of Nursing
Page | 44

Hyderabad, T.S
Appendix E

Letter for English Validity


Hyderabad

Date:

To,

Sub: Request for Hindi validity,

Respected Sir/Madam,

I, Mrs. V.Bhulaxmi, M.Sc. (N) 2nd year student bring to your kind
notice that I am conducting a research on “Effectiveness of Structured
Teaching Program on Knowledge and Attitude Regarding Prevention
of Cancer Cervix among Women at Selected Rural Community,
Khairthabad, Hyderabad, Telangana.”

For the partial fulfilment of M.Sc.(N) programme. I kindly request


you to validate my tool, content and give me your valuable suggestions.

Thanking you,
Yours obediently,
Mrs. V.Bhulaxmi,
M.Sc. (N) 2nd year student
Govt. College of Nursing
Page | 45
Hyderabad, T.S
Appendix F

Letter for Telugu Validity

Hyderabad

Date:

To,

Sub: Request for Telugu validity,

Respected Sir/Madam,

I, Mrs. V.Bhulaxmi, M.Sc. (N) 2nd year student bring to your kind
notice that I am conducting a research on “Effectiveness of Structured
Teaching Program on Knowledge and Attitude Regarding Prevention
of Cancer Cervix among Women at Selected Rural Community,
Khairthabad, Hyderabad, Telangana”

For the partial fulfilment of M.Sc.(N) programme. I kindly request


you to validate my tool, content and give me your valuable suggestions.

Thanking you,
Yours obediently,
Mrs. V.Bhulaxmi,
M.Sc. (N) 2nd year student
Govt. College of Nursing
Hyderabad, T.S

Page | 46
APPENDIX G

GOVERNMENT OF TELANGANA

No.ACAD /GCON/12021 Date:

From, To,
Prof .D.R.Radha Rukmini, The Medical Officer,
Principal,
Government College of Nursing,
Somajiguda, Rajbhavan Road, Hyderabad,
Hyderabad, T.S. T.S.

Respected Sir/Madam,
Sub: Course- Permission for Pilot Study – Requested-Regarding.
Government College of Nursing, Hyderabad M.sc (N) 2nd year

I have pleasure in introducing Mrs. V.Bhulaxmi II year MSc (N)


student of this college who is doing her project study in partial fulfilment
of her M.Sc (N) post graduate course. The topic for the project is furnished
below:

“Effectiveness of Structured Teaching Program on Knowledge and


Attitude Regarding Prevention of Cancer Cervix among Women at
Selected Rural Community, Khairthabad, Hyderabad, Telangana.”
In this connection she would like to visit your institution to conduct
Research Study, I request you to kindly accord permission for the same
and extend your guidance and co-operation in this matter.

Thanking you.

Yours sincerely

PRINCIPAL.

Page | 47
APPENDIX H

GOVERNMENT OF TELANGANA

No.ACAD /GCON/2021 Date:

From, To,
Prof. D.R.Radha Rukmini, The Medical Officer,
Principal,
Government College of Nursing,
Somajiguda, Rajbhavan Road, Hyderabad,
Hyderabad, T.S. T.S.

Respected Sir/Madam,
Sub: Course- Permission for Data Collection – Requested-Regarding.
Government College of Nursing, Hyderabad M.sc (N) 2nd year

I have pleasure in introducing Mrs. V.Bhulaxmi II year MSc (N)


student of this college who is doing her project study in partial fulfilment
of her M.Sc (N) post graduate course. The topic for the project is furnished
below:

“Effectiveness of Structured Teaching Program on Knowledge and


Attitude Regarding Prevention of Cancer Cervix among Women at
Selected Rural Community, Khairthabad, Hyderabad, Telangana”
In this connection she would like to visit your institution to conduct
Research Study, I request you to kindly accord permission for the same and
extend your guidance and co-operation in this matter.

Thanking you.

Yours sincerely

PRINCIPAL.

Page | 48
APPENDIX I

“Effectiveness of Structured Teaching Program on Knowledge


and Attitude Regarding Prevention of Cancer Cervix among Women
at Selected Rural Community, Khairthabad, Hyderabad, Telangana.”

Part 1

Structured Knowledge Questionnaire

Part-1: Demographic Variations

Code -------------- Date --------------


----

1. Age in years [ ]
1) 25-29

2) 30-34

3) 35-39

4) 40-45

2. Religion [ ]
1) Hindu

2) Muslim

3) Christian

4) Others

3. Educational status [ ]
1) Illiterate

2) Primary education

3) Existing secondary education

4) Inter and more

Page | 49
4. Occupation [ ]

1) Housewife

2) Daily laborer

3) Private employee

4) Government employee.

5. Monthly Income (in Rupees) [ ]

1) 10,000 - 19,999

2) 20,000 - 29,999

3) 30,000 - 39,999

4) Above 40,000

6. Marital status [ ]

1) Married

2) Unmarried

3)Widow

7) Number of deliveries [ ]
1) One

2) Two

3) More than three

8) Where did the health information about Cancer Cervixcome from

[ ]

1) Health staff

2) Television

3) Newspaper

4) Neighbours

Page | 50
9. Dietary Pattern [ ]

1) Vegetarian

2) Non-vegetarian

3) Mixed

10. If history of cancer cervix in the family [ ]

1) Yes

2) No

PART– II

Section A

Multiple choice question

To gain knowledge About Cancer Cervix Among Women

1. What is cancer? [ ]
1) benign tumor

2) cyst

3) Watts

4) Rapid growth of malignant cells

2. Where is the cervix? [ ]

1) The lower pole of the uterus.

2) The upper part of the uterus

3) Anterior part of the cervix

4) The posterior part of the cervix

3. What type of Cancer Cervixis cervical cancer? [ ]


1) Infectious disease

2) Non-communicative

3) Preventable
Page | 51
4) Not preventable

4. Women of the same age are more likely to get cervical cancer? [ ]
1) 15– 25 years.

2) 26 - 36 years.

3) 37 and above

4) Within 15 years

5. What is the long-term method of contraception that can cause


cervical cancer? [ ]
1) Copper “T”

2) Gel

3) Condom

4) Injection

6. What is the main symptom of cervical cancer? [ ]

1) Toothache

2) Headache

3) Postpartum haemorrhage

4) Abdominal pain

7. Which of the following is a warning sign of cervical cancer? [ ]

1) Abnormal vaginal bleeding

2) Bleeding from the mouth

3) Bleeding from the nose

4) Bleeding from the ear

8. What are Cancer Cervixdiagnostic tests? [ ]

1) Urine test

2) Pop smear test

Page | 52
3) Stool test

4) Moisture test

9. How often should a Cancer Cervixtest be done? [ ]


1) Once in 3 years

2) Once in 5 years

3) Once in 10 years

4) Every year

10. Which day after menstruation is best to perform Pap smear test?

[ ]

1) The first day of menstruation

2) The last day of menstruation

3) 14th day of menstruation

4) 21st day of menstruation

11. Which of the following treatment is available for cervical cancer?

[ ]

1) Physiotherapy, Psychotherapy

2) Radiation therapy, chemo therapy

3) Dialysis, physiotherapy

4) Oxygen therapy, psychotherapy

12. Who are the most common women suffering from cervical
cancer? [ ]

1) Women who have multiple sexual partners

2) Unmarried

3) Widows

4) Those who are married


Page | 53
13. What is the early sign of cervical cancer? [ ]

1) Menstrual irregularities

2) Back pain

3) Lack of appetite

4) Insomnia

14. Which test is available to the general public? [ ]


1) Pop smear

2) Ultrasound scanning

3) CT scan

4) MRI
Part II

Section B.

Knowledge of cancer cervical prevention

1. Which of the following methods can be used to prevent cervical


cancer? [ ]
1) Undergo full screening

2) Complete fat test

3) Complete urine test

4) Complete stool test

2. At what age can any vaccine prevent cervical cancer? [ ]

1) HPV vaccination from 18 years

2) HPV vaccination from 50 years

3) HPV vaccination from 9 years

4) HPV vaccination for 40 years

Page | 54
3. What kind of foods and ingredients to prevent Cancer
CervixHelp? [ ]
1) Meat works

2) Greens and fruits

3) Ingredients of fibre foods

4) Fatty substances

4. What kind of vitamins help in the prevention of cervical cancer?

1) Vitamin A & C [ ]

2) Vitamin K.

3) Vitamin b

4) Vitamin d

5. What are the health practices to be followed to prevent cervical


cancer? [ ]
1) Having sex with someone

2) Overeating

3) Excessive sleepiness

4) Excessive walking

6. Which of the following is the most important method to prevent


cervical cancer? [ ]

1) Regular walking

2) Regular smoking

3) Regular pan chewing

4) Regular medical examinations


7. What is the action to be taken to prevent cervical cancer? [ ]

1) Not getting much sleep

2) Not committing sexual activity with more people


Page | 55
3) Not talking to too many people

4) Due to not being overweight

8. At what age can getting married prevent Cancer Cervixto some


extent? [ ]
1) At the age of 5 years

2) At the age of 10 years

3) At the age of 15 years

4) At the age of 20 years

9. Which of the following family methods is used to prevent cervical


cancer? [ ]
1) Two children

2) Three children

3) Four children

4) Five children
10. Who should be contacted immediately after having an abnormal
menstruation? [ ]
1) Neighbours

2) The owner of the house

3) See a doctor nearby

4) Keep it secret

11. What is the first problem faced by women who get cervical
cancer? [ ]
1) Iron deficiency
2) Potassium deficiency

3) Calcium deficiency

4) Magnesium deficiency

Page | 56
PART III

ATTITUDE OF WOMEN TOWARDS

PREVENTION OF CANCER CERVIX

Read the sentences carefully and choose one from these three options

Items Agree Neutral 1 Disagree


2 0
1: cancer cervix is low prevalent in
India
2: do you believe that pap test can find
out the cancer cervix?
3: carcinoma of the cervix cannot be
from one person to another transmitted
4: cancer cervix is a curse
5: cancer cervix is caused due to multiple
sexual
partners
6: cancer cervix leads to death
7: if screening is free and causes no harm,
will you screen?
8: HP vaccine can prevent cancer cervix
9: screening helps in the prevention of
cancer of cervix
10: Does every woman get cervical
cancer?
1 వ భాగము

Page | 57
భా


స్


-

1

:
క్ డ్

చ మ్

ర్ గ్

డ్ ్

న్ ర

ల్ ఫ్

డ్ క్

జ్ వ

క్ <్

వ వి

ష ధ

ణ్ ్్్

ణ ల

యి ్

రర డ క్రడజ -------------- Page | 58


3
తేద్ -------------------
)
1. రటం వ్స రరలల్
క్
వయరటటం ట

[ స

] య

1)25-29 న్
2)30-34
3)35-39
4)40-45 4

2. )
మత

[

]

1)హªిి దూ
ి
2

)
ి

మ 3. విదా్
స్్ ్తి
ి
[
సిి
]
ి
1)నిరక్షరిసయ ి లు

2) ప్ిి థమిక విదు


Page | 59
3) ఉన్నమిధ్ి మిక విది 3)30,000 - 39,999

4)40,000 ప్పన్
4)ఇ టర్ మరియు అ తక టే
ఎక వ
6. వ<్వరహ్క్
స్్ తి

4.
వృతి్
[
[ ]
]
1)వివాహªతులు
1)గృహªణి
2) అవివాహªతులు
2) రోజువారీ కూలీ క్ిరిికడు
3) వితిి తి వి
ిర ిట్ ఉద్య ి గి
3)పవ
7) డెలివరీల
4)ప్ిభుతవ ఉద్య ి గి. ట
ర ం ా్

5. న<లక్్ [

ఆదాయ్ ]

(ర్ పర 1)ఒకటి

య్లల్ 2) రˇిి డు
)
3)మూడు అ తక టే ఎక వ

8) కర్నస ర్డ గరర్శయ


[
గ్ ర*్ చి ఆరోగ్

స్టమ్చార్ ఎక్కడ
] 1)10,000
న్ట్ డ్
- 19,999
2)20,000 - 29,999 గ్హ్్ చ్ర్
Page | 60
[ విభాగ A



] 1)ఆరోగు స్బ్ ్ ద్ి


2) టెలివిజన్

3)వారి ిప్ప్ర్ ిక ్
పి
క్
4)ప్ి రుగువారు
ప్

9. ఆహిర

విధిన్ిి

[ ]
జ్్ ఞన్న్నన పª ్ దట్న్నక్ మహిళల
1) శిఖాహిరిి మధ్్ కర్నస ర్డ రటరం *వక్ట గ్ ర*్ చి
2) మాిి సిహిరిి
1. కర్నస ర్డ అ్ ట్
3) రˇిి డు ఏమిట్?

10. కటcిి బ్ిి లో క్ిి నస ర్ [


గరాిశయ చరితా
ఉ టే ]

[ 1)నిరప్ియమˇిన్ కణిప్త

] 2

1) అవి న్య )
2) లిదయ

P త్
A
R ర
T
– త్
I
I Page | 61
రా ి

యొ

3 క

) ి

వా ప్

ట్ ర

స భా

4)ప్ిమిదకరమˇిన్ కణిలి గి
విగవిి త గి ప్ుగి ట
ి
2. గరరాశయ ముఖ్దావర ఎకక డ
ఉ ది? 3

[ )
]

1)గరిిశయిి యొకి ద్ిగువ
రిి
ధిియవిి .

2

)


ి ి
రిి
ి


యి
య Page | 62
భా 1)అి టc వా దిి

గి 2

ి )

4 స్ి

)
ి

భా
రిి
ష్ి

ి


వే
లే

ని
ి
ద్ి

3
భా
)
గి
ని
ి
వి

రిి
3. గరర్శయ్ ముఖ్ద్వర కర్నస ర్డ ఏ
రకమ <్న్
ి
వరాధ్్?


[

ద Page | 63
]
గి 3)37 మరియు అ తకిి టి
ఎకి ి వ
ని
4) 15 స్ిి వతసరాలు లోప్ి
ద్ి
5. గరర్శయ్ ముాద్వర
4
కరనస ర్డ క్ కరరణమ యియ్
) ధ్్రఘ కరలిక్ గర్న్నర్ధ్క్

ని ప్దధ తి
ఏది?
వి

రిి [

ి
]


1)రాగి “టి”

బి
2)జˇల్


3)కిి డయ మ్


4) స్ి ద్ి మి దయ

6. గరర్శయ్ ముాద్వర కరనస ర్డ ప్రధ్్న్


లక్షణ్్
5. ఏవయరటటం క్్ చ్్ దన్ స్్ ్ ల్
ఏది?
గరర్శయ ముఖ్దావర కర్నస ర్డ
వచ్చ అవకరశ్ చ్్ దన్ [
ఎక్్ కవగ్గ ఉ ది? [
] ]

1
1) 15– 25 స్ిి వతసరాలు.
)
2)26 - 36 స్ిి వతసరాలు.
Page | 64
ప్ి 2)నోటి నియ డి రకాసాి వి

ి 3) మి కి ి న్యిి డి రకి సిి


వి
టి
4) చెవి నియ డి రకాసాి వి

8. గరర్శయ్ ముాద్వర కరనస ర్డ రోగ


నొ న్నరధరరణ్ ప్ర్క్షల్
ఏమిట్?
ప్ి
[

]
2 1) మూతా ప్ీక్ష

) 2) ప్ిప్ స్ిర్ ప్ీక్ష

త 3) మలము ప్ీక్ష

ల 4) తెమడ ప్ీక్ష

నొ 9. గరర్శయ్

ప్ి ముాద్వర

3)స్ిి భిగిి తరవాత రకి సిి కర్నస ర్డ గ్ీక్షన్ట


వి
ఎ్ త ్్రచస గ్ర
4) ఉదరిి నొప్ి
చేయాల్?
7. క్్ దివరట్ల్ గరర్శయ్
ముాద్వర కర్న్టరర డ హ్చచ ర*క్ టర ం క్్్్
ఏద్?
[ [

1)అసాధారణ యోని రకాసాి వి ] 1)3


Page | 65
స్ిి వతసరిల

కిర ఒకసారి

2)5 స్ిి వతసరిలకిర ఒకసిరి


3) 10 స్ిి వతసరిలకిర ద్ చిక్్్ట ల్ ఏది అ్ దటబ్ట్ ల్
ఒకసిరి

4) ప్ిప్త స్ిి వతసరిి

10. పరప్ స్మ్రర డ ప్రీక్ష న్నరవహ్్ చాడనన క్


ర్ ్్్ ట్రరవ్ ్్రువరత ఏ రోజు ఉత్
మమ<్న్ద?
[ ]

1)రుతుసాి వి మొదటి రోజు

2)రుతుసాి వి చివరి రోజు

3)రుతుసాి వి 14 వ రోజు

4)రుతుసాి వి 21 వ రోజు

11. గరర్శయ్ ముాద్వర కర్నస ర్డ క్


ఈ క్్

ఉ ది? [ ]

1) ఫ్సియో థెరపి, ప్సక్ి థెరీ

2) రిడియేషన్ థెరపి, ఖీమో థిరీ

3) , థెరీ
డయిలసస్ ఫ్సయో
Page | 66
4) ఆప్కసజన్ థెరీ, ప్సక్ి థెరీ

12. గరర్శయ ముక్ద్వర కర్నస ర్డ క్ ్్రచస గ్ర గ్ రయియా మహిళల్ ఎవరు ?

[ ]

1) బ్హి ళ లˇరి గిక భాగసివమి లనియ కలిగి ఉనిన మహªళలు

2) వివాహిి

కిినివిరి

3)వితిి తువి లు

4)వివాహిి

అయన్విరి

13. గరర్శయ ముక్ద్వర కర్నస ర్డ పరరర్ భ టర ్ం క్్్్ ఏమిటి? [ ]

1) రుతు అవకతవకలు

2) వెనియననొప్ి

3)ఆకలి లికప్ి

వడిి

4)నిదాలేమి

14. స్రమ్నస ్లక్ అ్ దటబాట్ ల్ ఉన్న ప్రీషa ఏద్? [ ]

1)ప్ిప్ స్ిర్

Page | 67
2) ఆలాి సా నిిి గ్

3)ప్స్బ ి సా న్

4)ఎమ్.ఆర్.ఐ

పరర్డ్ II

విభాగ B.

కర్న్టరర డ గరర్శయ న్నవరరణ్క్్ రట్ం బ్ ధ్్్ చ్న్ జ్్ ఞన్్

Page | 68
15.గరర్శయ్ ముాద్వర కర్నస ర్డ నన న్నవరర*్ చ్టటక్్ ఈ క్్పరటి్ చ్వచ్టచ? [
]

1)ప్ి రాి సీరీనిిి గ్ చేయ చయక్ివాలి

2)ప్ి రాి క్ివువ ప్ీక్షా

3)ప్ి రాి మూతా ప్ీక్షా

4)ప్ి రాి మలి ప్ీక్షా


16. ఏ వయస్టట న్ట్ డ్ ఏ వరక్టన్ తీస్టటక్వడ్ వలన్ గరర్శయ
మ్ ఖ
ర ా్వరర కరనస రుననన వరర*్ చ్వచ్టచ? [ ]

1) 18 స్బస ి వతసరిల న్యిి డి hpv వాకిరసన్


2) 50 స్ిి వతసరిల న్యిి డి hpv వాకిరసన్
3) 9 స్ిి వతసరాల నియ డి hpv వాప్కసన్
4) 40 స్ిి వతసరిలన్యిి డి hpv వాకిరసన్

17. గరర్శయ ముఖ్ద్వరర కరన్టరర డ న్నవరరణ్ క< పరటి్ చ్వలస్్న్ చ్ర్ ఏద్? [ ]

1) ఎకి ి వ నిద్ిిిి చకప్ి వడిి

2)ఎకి ి వ మిి ద్ితి లˇరిి గిక చరుకి ప్ిలిడక ప్ి వడిి

3)ఎక వ మి ద్ితో మాటాడకప్ి వడి

4) ఎక వప్తనక ప్ి వడి వలన్

18. గరర్శయ్ ముాద్వర కర్నస ర్డ న్నవరర*్ చ్డ్న్నక్ ఏ రకమ <్న్


ఆహిరిలు ప్
ప్ ిా రాిలు [ ]

ట ం యపయ
ర య డ యి?

1)మి స్ కృతా ి లు

2) ఆకకూరలు మరయు Page | 69


ప్ిి డల ి 3)ీచయ ఆహిరిలి

ప్ప్ిా రాిలు 4)క్ివువ ప్ప్ిా రాిలు

18. గరర్శయ్ ముాద్వర కర్నస ర్డ న్నవరర*్ చ్డ్న్నక్ ఏ రకమ <్న్


ఆహిరిలు ప్ప్ిా రాిలు [ ]

ట ం యపయ
ర య డ యి?

1)మి స్ కృతా ి లు

2) ఆకకూరలు మరయు

ప్ిి డల ి 3)ీచయ ఆహిరిలి

ప్ప్ిా రాిలు 4)క్ివువ ప్ప్ిా రాిలు

19. గరర్శయ ముక్ద్వర కర్నస ర్డ న్నవరరణ్క ్ ఏ రకమ <్న్ విటమ్న్ ల్


రటయ
ం య రపయ
డ యి? [ ]

1) విటమిన్ ఎ &స్

2) విటమిన్

కిˇ3)విటమిన్

బి 4)విటమిన్

డి

20. గరర్శయ ముక్ద్వర కర్నస ర్డ నన నన వరర*్ చ్డ్న్నక్ అన్టరటరం *్ చాల్టన్


ఆర్గ్ రపధ
ా త్ లు ఏమిటి? [ ]

1)ఒకరితిని లˇరి గిక సిిి బ్ిి ధ్ిి కలిగి ఉి డడిి

2)అధిక గా ప్తనిడ
Page | 70
3) అధికిి గి న్దప
ిి వడిి

4)అధికి గి న్డవడిి

21. గరర్శయ ముక్ద్వర కర్నస ర్డ నన వరర*్ చ్డ్నన క్ క్్ ది వరట్ల్ ఏది ముఖ్్్ గ్ర
పరట్్ చ్వలట్న
్ ప్దద ్్? [ ]

1) రˇగు లర్ వాప్క గ్

2) రˇగు లర్ ధ్ి మప్ిన్ిి

3)రˇగి ి లర్ ప్ిన్ చి య గ్

4)రˇగు లర్ వెరదు ప్ీక్షలు

22. అగ్టధ్్రణ్ ర్ ్్్ ట్రరవ్ క్లిగ్*న్ వ<్ టన్ ఎవర*నన టర ం ప్రది చ్ల్? [ ]

1) ప్ి రుగువారి ని

2)ఇిి టి యజమిని ని
3)దగగరలో ఉనన వెరదయునిన

4)రహస్ి ిి గి ఉ చయతినయ

23. ఏ వయస్టటల్ వివరహ్ చేయడ్ వలన్ గరర్శయ ముక్దావర


కర్నస ర డ కª్ ్్వరక్్ నన వరర*్ చ్వచ్టచన్ట? [ ]

1) 5 స్ిి వతసరాల వయసయ లో

2) 10 స్ిి వతసరాల వయసయ లో

3) 15 స్ిి వతసరాల వయసయ లో

4) 20 స్ిి వతసరాల వయసయ లో

24. గరబహశయ మ్ ఖ్దావరర కరనస ర్డ నన వరర*్ చ్డ్న్నక్ ఈ క్్ ది వరట్ల్


ఏ క్్ టు్ బ ప్దధ తి పరట్స్్ రవ్ ? [ ] Page | 71
1) ఇదద రు ప్పల
ల లు

2) ముగగురు ప్పల
ల లు

3) ప్ులగురు ప్పల
ల లు

4) అయదయగురు ప్పల
ల లు

25. గరర్శయ మ్ ఖ
ర ా్వరర కరనస ర్డ వచ్చన్ మహ్ళలలో మ్దటిగ్ర
ఎదటరయియ్ రటమ
ం టం ఏ టి? [ ]

1) ఐరన్ లోప్ిి

2) ప్ి టిష్యిి లిప్ిి

3) క్ిలిియమ్ లోప్ిి

4) మˇగినషియ లోప్ిి

Page | 72
భాగ III

కర్నస ర్డ రటరం *వక్ట న్నవరరణ్ ప్టల మహిళల యొక్క ప్ర వర్ న్
వరకర్లన్ట జ్ఞగ్త్ గ్ర చ్దవ్ డ్ మర*య్ ఈ మ్ డ్
ఎ్ ప్క్ల న్ట్ డ్ ఒక్ద్న్నన
ఎ చస క డి

విషయ అ గ్్గ్క*్ అనన శచ చత అ గ్్గ్క*్ చేేద


్ చస ట
2 1
0
1: గరాిశయ ముకద్ివరక్ిి నస ర్
భారతద్ిశ లోతక వ ప్భా వి ఉ ద్ి

2: ప్ిప్ ప్ీక్షగరాిశయ ముకద్ివర క్ిి నస ర్


నికనయ గుిి టదని మీరు ుు ితునానరా??

3: ఒక వుక్రి నియ డి మరికరిక్రగరిిశయ


మి కద్ివర క్ిి నస రావాప్ చెిి దదయ

4: గరాిశయ ముకద్ివర క్ిి నస ర్ అనేద్ి


శాప్ిి
5: గరాిశయ ముకద్ివర క్ిి నస ర్ అధిక
మి ద్ి తో స్ిి భోగిి వలని వసియిి ద్ి.

6: :గరిిశయ మి కద్ివర కిిి న్సర్ వసత


మరణిసి ిరు
7: సీరీనిిి గి ఉచితిి మరియి హాని
కలిగిిి చకపిి తి, మిరు సీరీనిిి గ్
చేయ చయకి ిి టిరి?
8: హెచప్ వా ప్కసన్ గరాిశయ ముకద్ివర
క్ిి నస రిననివారిిి చగలదయ

9: గరిిశయ మి కద్ివర కిిి న్సర్


నివారణక సిరీనిిి గ్ ప్సాయయుడతుిి ద్ి
Page | 73
10: పిప్తి సి ిక్ి ర గరిిశయ మి కద్ివర
క్ిి న్సర్ వసియిి ద్ి?

Page | 74
LESSON PLANON
CANCER CERVIX

Submitted to: Submitted by:


Guide 1:Mrs. Hansli (Asst. prof) V. Bhulaxmi
M.sc 2nd year
Guide 2: Mrs. Dr. Sudha (lecturer) Govt. College of
Nursing
GENERAL OBJECTIVE:
At the end of the class women will be able acquire adequate knowledge regarding cancer cervix, its causes, types,
pathophysiology, clinical manifestation, diagnostic evaluation, management (medical, surgical, nursing). Cervical cancer
is the third most common cancer in the women worldwide therefore it is one of the most important topic to understand in
the rural area in order to reduce mortality rate and incidences among women. cancer cervix and their incidences. The
women would be able to apply this knowledge in rural area while providing structured teaching programme

SPECIFIC OBJECTIVE:
At the end of the class women will be able to-
 Meaning of cancer cervix
 Incidence of cancer cervix
 List out the causes
 Risk factors of cancer cervix
 Signs and symptoms
 Complications of cancer cervix
 Discuss the prevention of cancer cervix
 Bibliography
S.NO Time Specific Content Teaching learning Interaction
objectives activity with Audio- with women
Visual Aids
1. 5min To define CANCER CERVIX: Teacher activity:
cancer MEANING: “Cancer cervix is malignant To define cancer cervix
cervix. tumor of the cervix. The tumor may with the help of power
point.
develop from the surface epithelium of the
cervix or from epithelium lining of the Learner activity:
cervical canal.” Women are listing.

INCIDENCE:
Incidence rate of cervical cancer 13.1/ 1 lakh
women globally.
World wide: ¼ the of cervical cancer cases
deaths.
In India 23.7/ 1 lakh.
⚫ New cases - 130,000/year
⚫ Died from cervical cancer - 20,000
30,000/year
⚫ Telangana: 9.169/ 1 lakh

2. 5min To enlist ETIOLOGY AND RISK FACTOR: Teacher activity:


the Enlist the etiological and
etiological ETIOLOGY: risk factors of cancer
factors of Human papilloma virus- cervix
cancer Infection with the common human papilloma Learner activity:
cervix. virus (HPV) is a cause of approximately 90% of Women are reading.
all cervical cancers. About half of the sexually
transmitted HPV are associated with cervical
cancer.

RISK FACTOR:
⚫ Early sexual activity
⚫ Cigarette smoking
⚫ Oral contraceptives
⚫ Family history
⚫ Nutritional deficiency
(folate, carotene, vit. c)
⚫ Obesity
⚫ Poor immune system (HIV)
⚫ Age(30-39 & 60-69)
⚫ Diethylstilbestrol
3. 5min To CLINICAL MANIFESTATION: Teacher activity: lecture What is the
enumerate ⚫ Bleeding that occurs between regular Learner activity: clinical
the clinical menstrual periods Women are reading. manifestation of
manifestati ⚫ Bleeding after sexual intercourse, cancer cervix?
on of douching, or a pelvic exam
cancer ⚫ Menstrual periods that last longer and
cervix. heavier that before bleeding after going
through menopause
⚫ Increased vaginal discharge
⚫ Pelvic pain

4. 5min To explain . DIAGNOSTIC EVALUATION: Teacher activity:


the ⚫ PAP smear-Routine screening for cervical Explain the diagnostic
diagnostic cancer abnormalities can detect early evaluation with the help of
evaluation stage cancer and precanceraous condition powerpoint.
of cancer that could progress to invasive disease.The
cervix. processbegins with a pap test, also known Learner activity:
as a pap smear. Women are reading.
⚫ HPV DNA test- Like the pap test, theHPV
DNA test involves collecting cells for lab
testing.

5. COMPLICATION: List out complications


⚫ Low blood counts
⚫ Uteric pain due to pyelonephritis
⚫ Vesicovaginal fistula
⚫ Menorrhagia
⚫ Post-menopausal PV bleed
6. Prevention: Discus the prevention of
cancer cervix
 Regular screening early detection
 PAP test
 HPV Test
 Find early cancerous signs and symptoms
 avoid early marriages
 avoid early sexual contact before 18
years
 avoid smoking and drinking
 avoid repeated instrumental deliveries
 avoid too late pregnancies
 avoid to many pregnancies
 avoid multi sexual partners
 avoid unsafe sex
 avoid prolonged use of copper “T”
 avoid un hygienic prevaginal
examinations
 take early detection and treatment of STD
SUMMARY:
Cervical cancer is a cancer arising from the cervix it is due to the abnormal growth of cells that have the ability to
invade or spread to the other parts of the body its usual onset is over 10 to 20 years and caused by HPV infection, smoking,
weak immune system, birth control pills etc. Early on typically no symptoms are seen later symptoms may include abnormal
vaginal bleeding, pelvic pain, or pain during sexual intercourse.
Cervical screening followed by biopsy is the diagnostic method with regular cervical screening, HPV vaccine. As a
risk of cancer still exists, guide4lines recommend continuing regular PAP tests.

CONCLUSION:

Worldwide, cervical cancer is both the fourth most common cause of cancer and fourth most common cause of
death from cancer in women. PAP test screening every 3-5 years with appropriate follow-up can reduce the cervical
cancer incidence up to 80% and reduced the number of cases and mortality from cervical cancer.
As a nursing personnel, encouraging the women to get screened are effective at increasing the likelihood they
will do so. Educational material also help to increase awareness about cervical cancer.

REFERENCES:

1. D.C Dutta a ‘textbook of obstetrics and gynaecology’ ..8th edition 2015, published by jaypee publications.
2. Myles “ a textbook for midwives” sixteenth edition, published by Elsevier publications.
3. Polit & HD Hunger P.B(2008) “nursing research principles and methods”
4. www.tamilnadunursingcouncil.com
5. www.pubmed.com
6. Obstetric and gynaecological journal
BOOK:-

PHIPP’S, Medical Surgical Nursing, Health and Illness Perspective, 8th Edition, Page No.-1697-1707, Published
by Elsevier.
HAWKS, HOKANSON JANE, BLACK.M.JAYEE, Medical Surgical Nursing, Clinical Management For Positive
Outcomes, Page No.-927-928, 8th Edition, Published by Elsevier.
MOSBY’S, Comprehensive Rreview of Nursing for the NCLEX-RN Examination, 20th Edition, Published by
Elsevier, Page No.-310-312.
SUDDARTH’S & BRUNNERS, Textbook of Medical Surgical Nursing, 13th Edition, Published by Wolters
kluwer (INDIA) Pvt. Ltd, Page no.-1586-1588.
CHINTAMANI, LEVI’S medical surgical nursing, assessment and management of clinical problems, published
by Elsevier, Page no.- 1367- 1369.

NET INFORMATICS:-
https//www.slideshare.net/mobile/manalisolanki/cervical-cancer-ppt.
http//www.slideshare.net/mobile/joyawale5/cervical-cancer-presentation-73217007.
https//www.slideshare.net/mobile/tageyaja/cancer-of-cervix-29150685.
https//www.webmd.com/cancer/cervical-cancer.
https//en.m.wikipedia.org/wiki/cervical_cancer.
JOURNAL’S REFERENCES:-
Oncology &Cancer Case Reports, Journal of Tumor Diagnostic and Reports.
International journals of cancer research and prevention, oncology report, cancer cell.
Journal of clinical & experimental oncology, chemotherapy of cancer.
MASTERSHEET
DEMOGRAPHIC VARIABLES
DATA

Where do you If
Age Educatio Income Marit Number know from Diet history
Sn in Religi nal Occupati per al of health patte of
o year on Status on month statu Deliver information rn cancer
s s y’s about Cancer cervix
cervix in the
family
1 3 3 4 3 2 1 2 1 3 2
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10 4 1 3 3 1 3 2 1 2 2
11 2 1 4 1 1 1 2 1 3 2
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20 2 1 2 1 1 1 1 4 2 2
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29 1 1 2 1 1 1 3 3 3 2
30 2 1 4 1 1 1 2 1 3 2
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32 4 1 3 2 1 1 2 2 1 2
33 1 1 4 1 1 1 2 1 3 2
34 4 1 4 1 1 1 3 1 3 2
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38 4 1 4 1 1 1 3 1 3 2
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44 1 1 4 1 1 1 2 1 3 2
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46 2 1 4 1 1 1 2 1 3 2
47 1 1 4 1 1 1 2 1 2 2
48 4 1 3 2 1 1 2 2 1 2
49 1 1 4 1 1 1 2 1 3 2
50 4 1 4 1 1 1 3 1 3 2
51 2 1 4 1 1 1 2 1 3 2
52 1 1 4 1 1 1 2 1 2 2
53 4 1 3 2 1 1 2 2 1 2
54 1 1 4 1 1 1 2 1 3 2
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57 1 1 4 1 1 1 2 1 2 2
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92 2 1 2 1 1 1 1 4 2 2
93 4 1 1 3 3 1 2 3 2 2
94 2 1 4 1 1 1 1 2 2 1
95 2 1 2 1 1 1 1 4 2 2
96 2 1 3 1 1 1 2 2 3 2
97 4 3 2 1 1 1 3 3 3 2
98 3 1 4 1 2 1 3 1 3 1
99 3 1 4 3 1 1 1 1 3 2
10 2 1 4 3 1 2 3 2 2 2
0
10 2 1 4 1 1 1 2 1 3 2
1
10 1 1 4 1 1 1 2 1 2 2
2
10 4 1 3 2 1 1 2 2 1 2
3
10 2 1 4 1 1 1 2 1 3 2
4
10 1 1 4 1 1 1 2 1 2 2
5
10 4 1 3 2 1 1 2 2 1 2
6
10 1 1 4 1 1 1 2 1 3 2
7
10 4 1 4 1 1 1 3 1 3 2
8
10 2 1 4 1 1 1 2 1 3 2
9
11 1 1 4 1 1 1 2 1 2 2
0
11 4 1 3 2 1 1 2 2 1 2
1
11 1 1 4 1 1 1 2 1 3 2
2
11 4 1 4 1 1 1 3 1 3 2
3
11 2 1 4 1 1 1 2 1 3 2
4
11 1 1 4 1 1 1 2 1 2 2
5
11 4 1 3 2 1 1 2 2 1 2
6
11 1 1 4 1 1 1 2 1 3 2
7
11 4 1 4 1 1 1 3 1 3 2
8
11 3 1 4 1 1 1 2 1 3 2
9
12 2 1 3 1 1 3 2 4 2 2
0
12 4 1 2 3 1 1 1 1 1 2
1
12 4 1 3 1 1 1 3 1 3 2
2
12 1 1 4 3 1 1 1 1 3 2
3
12 3 1 3 1 1 2 4 2 2 2
4
12 1 1 2 1 1 1 2 1 3 2
5
12 3 1 1 1 1 1 2 4 3 2
6
12 4 1 2 1 1 1 3 4 1 2
7
12 1 1 4 1 1 1 1 1 3 2
8
12 4 1 3 1 1 1 2 4 3 2
9
13 4 1 2 3 1 1 2 1 3 2
0
13 2 1 4 3 1 1 1 1 3 2
1
13 4 1 3 1 1 3 3 1 1 2
2
13 3 1 2 1 2 1 3 1 1 2
3
13 2 1 2 1 1 1 1 1 2 2
4
13 2 1 4 1 2 1 2 1 2 2
5
13 1 2 1 1 1 1 3 3 3 2
6
13 1 2 1 1 1 2 3 1 2 2
7
13 4 1 1 1 2 2 2 1 2 2
8
13 1 2 1 4 1 1 3 1 2 2
9
14 1 1 4 1 1 1 1 1 1 2
0
14 1 1 4 3 1 1 1 3 1 2
1
14 2 1 2 1 1 1 3 1 2 2
2
14 2 1 4 1 1 1 2 1 3 2
3
14 3 1 4 1 1 1 2 1 1 2
4
14 2 1 4 1 1 1 2 1 3 2
5
14 2 1 1 1 1 1 2 1 3 2
6
14 4 3 1 1 1 1 1 4 1 2
7
14 2 1 4 1 2 1 2 1 3 2
8
14 1 1 1 1 1 1 2 4 2 2
9
15 4 3 1 2 1 1 3 1 2 2
0
15 1 1 2 1 1 1 1 4 3 2
1
15 4 1 4 1 1 1 3 3 2 2
2
15 2 1 4 1 4 1 2 3 2 2
3
15 1 1 2 1 1 1 1 1 3 2
4
15 1 1 2 2 1 1 2 1 3 2
5
15 1 1 1 1 1 1 2 4 3 2
6
15 4 1 1 1 1 2 3 1 3 2
7
15 3 1 4 3 1 1 3 1 2 2
8
15 3 1 1 2 1 1 3 1 2 2
9
16 2 1 1 1 1 1 1 3 2 2
0
16 2 1 4 1 2 1 2 1 3 2
1
16 4 1 2 1 1 2 3 1 3 2
2
16 1 1 1 1 1 1 2 2 3 2
3
16 4 1 1 1 1 1 2 1 3 2
4
16 2 1 4 1 1 1 2 1 3 2
5
16 1 1 4 1 1 1 2 1 2 2
6
16 4 1 3 2 1 1 2 2 1 2
7
16 1 1 4 1 1 1 2 1 3 2
8
16 4 1 4 1 1 1 3 1 3 2
9
17 3 1 4 1 1 1 2 1 3 2
0
17 1 1 1 1 1 1 2 2 3 2
1
17 1 1 1 1 1 1 2 2 3 2
2
17 3 1 4 1 1 1 2 1 3 2
3
17 1 1 1 1 1 1 2 2 3 2
4
17 1 1 1 1 1 1 2 2 2 2
5
17 1 1 4 1 1 1 2 1 3 2
6
17 4 1 4 1 1 1 3 1 3 2
7
17 3 1 4 1 1 1 2 1 3 2
8
17 1 1 1 1 1 1 2 2 3 2
9
18 1 1 4 1 1 1 1 1 3 2
0
18 2 1 4 1 1 1 2 1 1 2
1
18 1 1 4 1 1 1 2 1 1 2
2
18 4 1 4 1 1 1 3 1 1 2
3
18 1 1 2 1 1 1 1 1 2 2
4
18 1 1 1 1 1 1 1 1 2 2
5
18 2 1 4 3 1 1 2 1 2 2
6
18 4 1 3 3 1 3 2 1 2 2
7
18 1 1 4 3 1 1 2 1 2 2
8
18 1 1 4 1 1 1 3 1 1 2
9
19 2 1 1 1 1 1 3 1 3 2
0
19 1 1 1 1 1 1 1 2 1 2
1
19 1 1 4 1 1 1 2 1 2 2
2
19 1 1 4 1 1 1 1 1 3 2
3
19 2 1 4 1 1 1 1 1 3 2
4
19 4 1 4 3 1 1 2 1 2 2
5
19 2 1 2 1 1 1 2 4 2 2
6
19 1 1 4 1 1 1 1 1 3 2
7
19 1 1 1 2 2 1 2 1 2 2
8
19 3 1 2 1 4 1 1 1 2 2
9
20 1 1 1 1 1 1 2 2 3 2
0
KNOWLEDGE POST TEST
SCORES

S.N Q Q Q Q4 Q5 Q6 Q Q8 Q9 Q1 Q1 Q1 Q1 Q1 Q1 Q1 Q1 Q1 Q1 Q2 Q2 Q2 Q2 Q2 Q2
o 1 2 3 7 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5
1 1 1 0 1 0 1 1 1 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1
2 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0 1 0 0 1 1 0 0 1 1
3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1
4 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 0 1 0 1 0 1 0 0
5 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 1 1 0 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1
7 1 0 1 1 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1
8 1 1 0 1 0 0 0 0 1 0 0 0 1 0 1 0 0 1 1 0 1 1 1 0 1
9 1 0 1 1 0 0 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 1 1 0 0
10 1 0 0 1 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0
11 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
12 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
13 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
14 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
15 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
16 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
17 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
18 4 0 0 1 1 0 0 1 0 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 0
19 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
20 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
21 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0
22 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 1 1 1 0 1
23 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0
24 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
25 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
26 1 0 0 0 0 1 0 0 1 0 0 1 0 1 0 0 0 1 1 0 0 1 1 0 1
27 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1
28 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 1 0 0 1 1 1 0 1
29 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0
30 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
31 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
32 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
33 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
34 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
35 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
36 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
37 1 0 0 1 0 0 1 0 0 0 1 0 0 1 1 0 0 1 0 0 1 1 1 0 1
38 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1
39 1 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 0
40 1 0 1 1 0 0 0 1 1 0 0 0 1 1 0 0 1 0 0 0 1 1 1 0 1
41 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
42 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
43 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
44 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
45 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
46 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
47 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
48 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
49 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
50 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
51 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
52 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
53 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
54 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
55 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
56 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
57 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
58 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
59 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
60 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
61 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
62 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
63 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
64 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
65 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
66 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
67 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
68 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
69 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
70 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
71 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
72 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
73 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
74 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
75 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
76 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
77 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
78 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
79 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
80 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
81 1 1 1 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 1 0 0 0 1 0
82 0 1 1 0 0 1 1 1 0 0 0 0 1 1 1 0 1 1 0 0 1 1 0 0 0
83 0 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1
84 1 0 1 1 0 1 0 1 1 0 0 0 1 0 0 0 0 1 1 0 0 1 1 0 0
85 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
86 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0
87 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 1 1 1 1 1 1
88 1 0 1 1 0 1 0 1 1 0 0 0 1 0 0 0 0 1 1 0 0 1 1 0 0
89 1 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 1 0 0 0 1 0
90 1 1 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
91 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 1 1 1 1 1 1
92 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
93 0 0 1 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 1 0 1
94 4 1 0 1 0 1 0 1 0 0 1 0 1 0 0 0 0 1 0 0 1 1 0 0 0
95 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0
97 1 1 0 1 0 1 0 0 1 0 1 0 1 0 0 1 1 1 0 0 1 1 1 1 0
98 0 1 1 0 0 0 1 0 0 0 1 0 1 0 0 0 0 1 0 1 1 0 1 0 0
99 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 1 0 0 1 1 0 0 0
100 0 0 0 0 0 1 0 1 0 1 1 0 1 1 0 0 1 1 0 1 0 1 0 0 1
101 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
102 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
103 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
104 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
105 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
106 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
107 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
108 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
109 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
110 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
111 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
112 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
113 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
114 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
115 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
116 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
117 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
118 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
119 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
120 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 1 1 0 0
121 0 1 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
122 0 1 0 0 0 1 1 1 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 1
123 1 1 1 0 0 1 1 1 1 0 0 0 1 0 1 0 1 1 1 0 0 1 0 0 1
124 1 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
125 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 0 1 1 0 0 0 1 0 0
126 1 0 0 0 0 1 1 1 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 1
127 1 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
128 0 1 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
129 1 1 0 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
130 0 1 0 1 0 1 0 0 1 0 0 0 1 0 1 0 1 0 0 1 0 1 0 1 0
131 0 1 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
132 0 0 1 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0
133 0 1 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
134 1 1 0 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
135 0 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
136 0 0 1 1 0 1 1 0 1 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0
137 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 0
138 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0
139 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 1 0 1 1 1 1 1 0 0
140 1 1 0 0 0 1 1 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
141 0 1 1 0 1 0 1 0 1 0 1 0 0 0 1 1 1 0 0 0 0 1 0 0 1
142 0 0 1 1 0 1 0 1 1 0 0 0 0 1 0 1 0 1 0 0 0 1 0 1 0
143 0 1 0 1 0 0 0 0 1 0 1 0 1 0 1 0 0 0 0 1 0 1 1 0 0
144 1 1 0 1 0 0 1 0 1 0 1 0 0 0 1 1 1 0 0 0 0 1 0 0 1
145 0 1 0 1 1 0 1 0 1 0 1 0 1 0 1 0 0 0 0 1 0 1 0 0 1
146 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
147 1 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 0 1 1 0
148 1 0 1 0 1 0 0 0 0 0 1 1 0 1 0 0 0 1 1 0 0 0 1 1 0
149 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 1 0 1 1 0 0
150 0 0 0 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
151 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 1 0 1 1 0 0
152 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 0 0 1 1 0
153 0 0 1 1 0 1 0 1 1 0 0 0 0 1 0 1 0 1 0 0 0 1 0 1 0
154 0 0 0 1 0 1 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 1 0 1 1
155 0 0 0 1 0 1 0 0 1 0 0 0 1 0 1 0 1 0 0 1 0 1 0 1 0
156 1 0 0 1 1 0 1 0 0 1 0 1 0 1 0 0 0 1 1 0 0 0 1 1 0
157 0 0 1 0 0 1 0 1 0 0 0 0 1 0 0 1 0 1 0 0 0 1 0 1 0
158 0 0 1 1 0 0 1 0 1 0 0 1 0 0 1 0 0 1 0 0 1 1 1 0 0
159 0 1 0 1 0 1 0 1 1 0 1 0 1 0 1 0 1 0 0 1 0 1 0 1 0
160 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 0 0 0 1 0
161 1 0 0 1 0 1 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 1 0
162 0 0 1 0 0 1 1 1 1 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0
163 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
164 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0
165 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 1 0 1 1 1 0 0 1
166 4 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
167 1 0 0 1 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 1 1 1 1 0
168 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
169 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
170 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
171 0 0 0 1 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 0
172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
173 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
174 0 0 0 0 0 1 0 0 1 0 0 1 1 0 0 0 1 0 0 1 1 0 0 1 0
175 1 1 0 1 0 1 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 1 0
176 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0
177 1 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1
178 1 0 0 1 0 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 0
179 0 0 0 1 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 0
180 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 0 0 1 1 0 1 0 1 1 0 0 0 0 1 1 1 0 1 0 0 0 1 0 1 0
182 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
183 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 0 0 0 1 0
184 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
185 0 0 0 1 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 0
186 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 0
187 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 1 1 1 0 0
188 1 0 0 1 1 0 0 1 0 1 1 0 0 1 0 0 1 0 0 1 1 1 1 0 0
189 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
190 0 1 1 0 0 1 1 1 0 0 0 0 1 1 1 0 1 1 0 0 1 1 0 0 0
191 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 0
192 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0
193 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 0 1 0 1 0 1 0 0 1 0 0 0 1 0 1 0 1 0 0 1 0 1 0 1 0
195 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 1 0 1 1 0 0
196 1 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
197 1 1 0 1 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 1
198 0 0 0 0 0 0 0 1 0 0 1 1 0 1 1 0 1 0 1 1 1 1 1 0 0
199 0 0 0 1 0 0 1 0 1 0 1 0 0 0 1 1 1 0 0 0 0 1 0 0 1
200 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
ATTITUDE POST SCORES
Sno A A A A A A A7 A A A1
1 2 3 4 5 6 8 9 0
1 2 2 0 0 2 0 0 0 2 1
2 2 2 2 0 0 2 2 2 2 0
3 2 0 2 0 0 2 2 2 0 2
4 1 2 18 0 1 0 1 0 0 1 1
5 2 0 19 2 0 2 0 2 2 2 2
6 0 1 20 2 0 2 0 2 2 2 2
7 0 2 21 2 2 2 1 0 0 2 0
8 1 2 22 2 2 0 1 2 2 2 2
9 0 2 2 0 1 0 2 2 2 0
10 0 1 0 1 0 2 2 2 0 0
11 2 2 2 0 0 0 2 0 0 1
12 0 2 2 2 0 2 0 2 1 2
13 2 2 1 1 2 2 2 2 2 1
14 0 2 2 2 0 2 2 0 2 0
15 2 2 0 1 2 2 2 2 2 0
16 2 2 0 1 2 2 2 2 2 0
17 2 0 2 0 2 2 2 2 2 0
23 0 0 0 0 0 1 0 0 2 2
24 2 0 2 0 2 2 2 2 2 0
25 2 0 2 0 2 2 2 2 2 0
26 1 0 2 0 0 2 1 0 1 0
27 1 0 2 0 0 2 0 0 1 0
28 1 0 2 0 0 2 2 0 0 0
29 1 0 0 1 0 0 1 1 1 0
30 2 2 2 0 0 0 2 0 0 1
31 0 2 2 2 0 2 0 2 1 2
32 2 2 1 1 2 2 2 2 2 1
33 0 2 2 2 0 2 2 0 2 0
34 2 2 0 1 2 2 2 2 2 0
35 2 2 0 1 2 2 2 2 2 0
36 2 2 2 0 0 0 2 0 0 1
37 2 2 0 1 2 2 2 2 2 0
38 2 2 0 1 2 2 2 2 2 0
39 2 2 0 1 2 2 2 2 2 0
40 2 2 1 1 2 2 2 2 2 0
41 2 2 2 0 0 0 2 0 0 1
42 0 2 2 2 0 2 0 2 1 2
43 2 2 1 1 2 2 2 2 2 1
44 0 2 2 2 0 2 2 0 2 0
45 2 2 0 1 2 2 2 2 2 0
46 2 2 2 0 0 0 2 0 0 1
47 0 2 2 2 0 2 0 2 1 2
48 2 2 1 1 2 2 2 2 2 1
49 0 2 2 2 0 2 2 0 2 0
50 2 2 0 1 2 2 2 2 2 0
51 2 2 2 0 0 0 2 0 0 1
52 0 2 2 2 0 2 0 2 1 2
53 2 2 1 1 2 2 2 2 2 1
54 0 2 2 2 0 2 2 0 2 0
55 2 2 0 1 2 2 2 2 2 0
56 2 2 2 0 0 0 2 0 0 1
57 0 2 2 2 0 2 0 2 1 2
58 2 2 1 1 2 2 2 2 2 1
59 0 2 2 2 0 2 2 0 2 0
60 2 2 0 1 2 2 2 2 2 0
61 2 2 2 0 0 0 2 0 0 1
62 0 2 2 2 0 2 0 2 1 2
63 2 2 1 1 2 2 2 2 2 1
64 0 2 2 2 0 2 2 0 2 0
65 2 2 0 1 2 2 2 2 2 0
66 2 2 2 0 0 0 2 0 0 1
67 0 2 2 2 0 2 0 2 1 2
68 2 2 1 1 2 2 2 2 2 1
69 0 2 2 2 0 2 2 0 2 0
70 2 2 0 1 2 2 2 2 2 0
71 2 2 2 0 0 0 2 0 0 1
72 0 2 2 2 0 2 0 2 1 2
73 2 2 1 1 2 2 2 2 2 1
74 2 2 2 0 0 0 2 0 0 1
75 0 2 2 2 0 2 0 2 1 2
76 2 2 1 1 2 2 2 2 2 1
77 0 2 2 2 0 2 2 0 2 0
78 2 2 0 1 2 2 2 2 2 0
79 2 2 0 1 2 2 2 2 2 0
80 2 0 2 0 2 2 2 2 2 0
81 0 1 0 0 0 0 2 2 0 0
82 2 1 0 0 2 1 2 1 2 1
83 2 1 0 0 2 1 2 1 2 0
84 2 1 0 0 2 1 2 1 2 0
85 2 0 2 0 2 2 2 2 2 0
86 2 0 2 2 2 2 2 2 2 0
87 2 1 0 0 2 1 2 1 2 0
88 2 0 1 0 1 1 2 2 2 0
89 0 1 0 0 0 0 2 2 0 0
90 2 0 2 0 2 2 2 2 2 0
91 2 2 2 1 1 1 2 1 1 1
92 2 0 2 0 2 2 2 2 2 0
93 2 0 0 1 1 1 1 2 2 0
94 2 0 2 2 2 2 2 2 2 0
95 2 0 2 0 2 2 2 2 2 0
96 1 2 2 2 2 2 2 2 0 0
97 2 2 2 0 1 0 2 2 0 0
98 0 2 0 1 0 0 1 1 0 0
99 2 0 0 0 0 0 2 2 2 0
100 0 2 2 0 0 0 2 0 0 1
101 2 2 2 0 0 0 2 0 0 1
102 0 2 2 2 0 2 0 2 1 2
103 2 2 1 1 2 2 2 2 2 1
104 2 2 2 0 0 0 2 0 0 1
105 0 2 2 2 0 2 0 2 1 2
106 2 2 1 1 2 2 2 2 2 1
107 0 2 2 2 0 2 2 0 2 0
108 2 2 0 1 2 2 2 2 2 0
109 2 2 2 0 0 0 2 0 0 1
110 0 2 2 2 0 2 0 2 1 2
111 2 2 1 1 2 2 2 2 2 1
112 0 2 2 2 0 2 2 0 2 0
113 2 2 0 1 2 2 2 2 2 0
114 2 2 2 0 0 0 2 0 0 1
115 0 2 2 2 0 2 0 2 1 2
116 2 2 1 1 2 2 2 2 2 1
117 0 2 2 2 0 2 2 0 2 0
118 2 2 0 1 2 2 2 2 2 0
119 2 2 0 1 2 2 2 2 2 0
120 0 2 0 2 2 0 2 2 2 0
121 0 2 0 2 2 0 2 2 2 0
122 2 2 0 0 2 0 0 2 2 0
123 0 2 0 2 2 0 2 2 2 0
123 0 2 0 2 2 0 2 2 2 0
124 2 2 0 1 2 0 2 2 0 0
125 2 2 0 0 2 0 0 2 2 0
126 2 0 0 1 2 0 2 2 2 0
127 0 2 2 0 2 1 0 2 2 1
128 0 2 0 2 2 0 2 2 2 0
129 2 2 0 0 2 0 0 2 2 0
130 2 2 0 1 2 0 2 2 0 0
131 0 2 0 2 2 0 2 2 2 0
132 2 2 0 0 2 0 2 2 2 0
133 2 2 0 1 2 0 2 2 0 1
134 2 2 0 0 2 0 0 2 2 0
135 0 2 0 2 2 0 2 2 2 0
136 2 2 0 0 2 0 2 2 2 0
137 2 2 0 0 0 2 2 0 2 0
138 2 2 0 0 2 0 2 2 2 0
139 0 2 0 2 2 0 2 2 2 0
140 2 2 2 0 2 0 2 2 2 0
141 2 2 0 1 2 0 2 2 2 1
142 2 1 0 2 0 1 0 2 0 2
143 2 2 1 0 0 0 2 2 2 0
144 1 2 1 0 2 1 0 0 1 1
145 2 2 1 0 0 0 2 1 2 0
146 2 0 1 1 2 0 1 2 0 1
147 2 1 1 0 2 1 2 2 0 2
148 2 1 2 0 2 2 2 1 2 0
149 2 1 2 0 2 1 2 1 2 1
150 2 2 0 0 2 0 0 2 2 0
151 0 2 0 1 2 2 2 1 2 1
152 2 2 0 1 2 0 2 2 2 1
153 2 1 0 2 0 1 0 2 0 2
154 2 2 2 1 2 2 2 1 0 1
155 2 2 0 1 2 0 2 2 0 0
156 2 1 1 0 2 1 2 2 0 2
157 2 1 0 2 0 1 0 2 0 2
158 2 1 2 1 2 2 2 2 2 1
159 2 2 0 1 2 0 2 2 0 0
160 0 0 0 0 0 1 2 1 2 1
161 1 2 0 0 0 0 2 0 0 2
162 2 1 2 0 2 1 2 1 0 2
163 0 0 0 0 0 1 1 1 1 1
164 2 2 0 0 2 0 2 2 2 0
165 2 2 2 0 0 0 2 0 0 1
166 0 2 2 2 0 2 0 2 1 2
167 2 2 1 1 2 2 2 2 2 1
168 0 2 2 2 0 2 2 0 2 0
169 2 2 0 1 2 2 2 2 2 0
170 2 2 0 1 2 2 2 2 2 0
171 2 2 2 2 2 0 0 0 0 1
172 0 0 0 0 0 0 0 0 0 0
173 2 2 0 1 2 2 2 2 2 0
174 0 0 0 0 0 0 0 0 0 0
175 0 0 0 0 0 0 0 0 0 0
176 0 2 2 2 0 2 2 0 2 0
177 2 2 0 1 2 2 2 2 2 0
178 2 2 0 1 2 2 2 2 2 0
179 2 2 2 2 2 0 0 0 0 1
180 2 0 1 1 2 0 1 2 0 1
181 2 1 0 2 0 1 0 2 0 2
182 0 0 0 0 0 1 1 1 1 1
183 0 0 0 0 0 1 2 1 2 1
184 0 0 0 0 0 1 1 1 1 1
185 2 2 2 2 2 0 0 0 0 1
186 2 2 0 0 0 2 2 0 2 0
187 0 2 0 2 2 0 2 2 2 0
188 0 2 0 2 2 0 2 2 2 0
189 0 0 0 0 0 1 1 1 1 1
190 2 1 0 0 2 1 2 1 2 1
191 2 2 0 0 0 2 2 0 2 0
192 2 0 2 0 2 2 2 2 2 0
193 2 0 1 1 2 0 1 2 0 1
194 2 2 0 1 2 0 2 2 0 0
195 2 1 2 0 2 1 2 1 2 1
196 2 2 0 1 2 0 2 2 0 0
197 2 2 0 0 2 0 0 2 2 0
198 0 2 0 2 2 0 2 2 2 0
199 1 2 1 0 2 1 0 0 1 1
200 0 0 0 0 0 1 1 1 1 1

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