Thesis97

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation titled “A Study To Assess The

Effectiveness Of Video Assisted Teaching On Knowledge Regarding

Infertility Among Infertile Couple In Selected Hospitals At Haryana” Is a

bonafide and genuine research work carried out by me, for the partial

fulfillment of the requirement for the degree of M.Sc (OBG) under the

guidance of Prof. Mrs. Vishnupriya.K Principal Sophia college of nursing

Gwalior and Co Guided by Mrs.S. Rani Lecturer department of OBG

Sophia College of nursing Gwalior Madhya Pradesh.

Signature of the Candidate

II

Certificate by Guide and Co guide

This is to certify that this dissertation title “A Study To Assess The

Effectiveness Of Video Assisted Teaching On Knowledge Regarding Infertility

Among Infertile Couple In Selected Hospitals At Haryana” Is a bonafide and

genuine research work carried out by Ms Hem kumari for the partial fulfillment of

the requirement for the degree of M.S c in Nursing (OBG Specialty) under my

guidance.

Guide Co Guide

III

Certificate

This is to certify that this dissertation “ A study to assess the effective ness

of video assisted teaching on knowledge regarding infertility among infertile

couple in selected hospitals at Haryana” Is a bonafide and genuine research work

carried out by Ms Hem kumari for the partial fulfillment of the requirement for

the degree of M.S c in Nursing (OBG Specialty)

Internal Examiner External Examiner

PLACE

IV

ENDORSEMENT BY THE HEAD OF THE DEPARTMENT AND HEAD OF

THE INSTITUATION

This is to certify that this dissertation titled “A Study To Assess The Effectiveness Of

Video Assisted Teaching On Knowledge Regarding Infertility Among Infertile Couple In

Selected Hospitals At Haryana” Is a bonafide and genuine research work carried out by

Ms Hem kumari for the partial fulfillment of the requirement for the degree of M.S c in

Nursing (OBG Specialty).

Sign of HOD Seal & Sign of Principal

V

COPY RIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that the JIWAJI UNIVERSITY GWALIOR MADHYA

PRADESH shall have the rights to preserve, use and disseminate this

dissertation/thesis in print or electronic format for academic/research purpose.

Sign of candidate

VI

ABSTRACTS

STATEMENT OF THE PROBLEM:

A Study To Assess The Effectiveness Of Video Assisted Teaching On Knowledge

Regarding Infertility Among Infertile Couple In Selected Hospitals At Haryana.

BACKGROUND OF THE STUDY:

Reproduction is a phenomenon that has evolved for the survival of the living of

different species by producing continuous stream of new generation of that species.

Production of a new human being begins with fertilization .Failure to this process results

in Infertility. Though infertility does not claim an individual life, it inflicts devastating

emotional trauma on the individual for being unable to fulfill the biological role of

parenthood for no fault of his/her own.

WHO estimates that approximately 8-10% of couples experience some

form of infertility .On a worldwide scale, this mean that 50-80%million people suffer

from infertility with men and women in almost identical proportion. Infertility is

exclusively a female problem in 30-40% of cases and male in 10-30% of cases.

Most infertility cases (85-90%) are treated with medication or surgery.

Improvement in infertility treatment have made it possible for many women Whose male

partner is infertile to become pregnant .These new and advanced Technologies include ,

X

In vitro fertilization (IVF),Intra cystoplasmic sperm Injection (ICSI) and other similar

procedures

OBJECTIVES OF THE STUDY:

To assess the pre-test knowledge of infertile couples regarding infertility before

video assisted teaching.

To assess the post-test knowledge of infertile couples regarding

infertility after video assisted teaching.

. assess the post-test knowledge of infertile couples regarding infertility after

video assisted teaching.

To compare the pre-test and post knowledge of infertile couples.

To assess the effectiveness of Video Assisted Teaching on knowledge regarding

infertility among infertile couples.

To determine the association between the pre-test knowledge with selected

demographic variables

HYPOTHESES:

H1: There will be a significant difference between the pre-test mean and post-test mean

knowledge score of infertile couples.

H2: There will be a significance association at 0.05 level of significance between

knowledge scores with selected demographic variables of infertile couples.

XI

METHODS:

The conceptual framework of the study was developed based on ‘’General System

Theory ‘’by Bertanlanffy. A pre experimental one group pre-test and post-test design

was used for the study .Non- probability convenient sampling technique was used to

select the sample

A structured knowledge questionnaire and a video assisted teaching on infertility was

implemented as a tool for data collection. A scoring was developed to score the items of

analysis of data.

The content validity of the tool was established on the basis of correction given by

experts from the field of nursing and medical field. Reliability (r-0.93) of the tool was

tested by test-retest method and reliability co-efficient was calculated by using raw score

formula. A Pilot study was conducted with 10 subjects to find out the feasibility of

conducting the study.

The main study was conducted with samples at hospitals. The video teaching on

infertility was administering following pre-test. The post-test was after 7 days to assess

the effectiveness of video teaching.

RESULT:

The collected data was analyzed by using descriptive and inferential statistics.

XII

THE SIGNIFICANCE FINDINGS OF THE DATA WERE:

The mean pre-test knowledge score of infertile couple was 18.06 ( 45.15%) and the mean

post-test knowledge after administration of video assisted teaching was 32.24 (80.60%)

which revealed that significance 35.45% of improvement in couple’s knowledge

regarding infertility after administration of video teaching.

The calculated paired (t) test value 27.41 for knowledge is greater than table value and

found to be high statistical significant at the level of p<0.05. Hence research hypotheses

stated that there will be significant difference between pre-test and post-test knowledge

among infertile couples about infertility was accepted .Findings revealed that there was

statistically significant association between the pre-test knowledge scores with selected

Demographic variables was calculated by using chi-square test at p<0.05 level of the

subject .Hence the research hypotheses stated that there will be significant association

between pre-test K score with selected demographic variables was accepted.

CONCLUSION:

The overall findings of the study revealed that the administration of video teaching

programme facilitated the infertile couples to learn more about infertility which is evident

in the significantly improved pre-test K scores. The video teaching method was found

highly effective in improving knowledge of the couples regarding infertility.

XIII

TABLE OF CONTENT

CHAPTER CONTENT PAGE NO

CHAPTER-1 Introduction

Background Of the Study

Significance and Need for study

Problem Statement

Objectives

Operational Definitions

Assumptions

Research Hypothesis

Delimitations

Projected Outcome

Conceptual Framework

1

3

4

7

7

8

8

9

9

9

10

CHAPTER-2 Review of Literature 14

CHAPTER-3 Research Methodology

Research Approach

Research Design

Variables

Settings

Population

Sample Technique

Sampling Criteria

28

29

29

30

31

31

32

32

Development of the Tool

Scoring Key

Content Validity

Reliability

Pilot Study

Method For Data Collection

Plan for Data Analysis

Protection Of Human Subjects

34

36

37

37

38

39

39

40

CHAPTER-4 Data Analysis &Interpretation 42

CHAPTER-5 Discussion

Conclusion

Implication

Recommendation

Limitation

Summary

Bibliography

Annexure

56

60

60

65

65

66

69

75

XV

ACKNOWLEDGEMENT

“Give me a spirit of thankfulness, Lord;

For numberless blessing given,

Blessings that daily come to me,

Like dewdrops falling from heaven.”

“Man’s effort is always crowned by God’s grace and blessing”. Express my deep sense

of gratitude to the Lord Almighty for the blessings and mercy which enabled me to reach

up this step and complete my study.

The successful of this study comes through the valuable help, guidance contribution of

some of the teachers, seniors, friends and other well-wishers. Investigators recall their

kindness with a great full heart and are trying to express these gracious sentiments in a

few words flowing from within.

I express my gratitude and appreciation to Dr.Manjeet Kaur Bhalla Chairperson Sophia

College of Nursing Gwalior for providing me the opportunity to undertake the P.G course

in this esteemed institution and to conduct this study.

This study has been undertake and completed under the expert guidance of Prof. Mrs.

Vishnupriya.K Principal Sophia College of Nursing, Gwalior. I am grateful of her

constant help and guidance in shaping this project in to the present from her support,

encouragement and providing the required facilities for the successful completion of this

study. VII

My sincere thanks to co-guide Mrs. S. Rani Lecturer Deptt of Obstetric and

Gynecological Nursing Sophia College of Nursing Gwalior for her constant

encouragement, valuable guidance, supervision and timely help during the entire

course of this study.

It gives me a great pleasure to express my sincere thanks to all the head of

department, Lecturers and Asst. Lecturers for their constant encouragement,

guidance, valuable suggestions and their loving attitude which helped me in

completion of this study.

My sincere thanks go to all the participants who formed the core and basis of this

study for their whole hearted cooperation. I express my deep gratitude to librarian of

Sophia Nursing College for helping me through the invaluable treasures.

I cherish the friendship I had and take this opportunity to thank each one of them. My

friends have been an encouragement every time and their motivation my confidence that

had helped me reach here and I also thank for their constant support and whole hearted

solidarity. I use this opportunity to thank Mr. Prasanth.K and MS. Megha for helping

throughout the process of my study and also for this concern and enthusiastic support.

VIII

I am speechless! I can barely find words to express all the wisdom, love and support

given me for that I am eternally grateful to my beloved Husband Mr. Sukhpal Singh for

his endurance and encouragement and enthusiastic support throughout the course.

I would like to express motherly warm love towards my children Baby Hitashi and Baby

Vivaan, for their unconditional love and their support even they were left alone during

the period of my study.

Once again, I am grateful to all of them who have directly and indirectly helped me in

completion of this study, including those whom I may have in divergently failed to

mention.

Signature of the candidate

Ms. Hemkumari

IX

CHAPTER-I

INTRODUCTION

“Pain during labour is tolerable but emotional pain due to infertility is intolerable”

“The greatest work of art created first by god and then by man, is the creation of life.

This art takes two artists, man and woman, each bringing their own parts of a pallet to

create a work of art that not only has a piece of both artists but has a living, breathing,

ever-changing, piece of art with an identity of its own.”

Bethany Jane Andrews

Marriage is an event by which a male and female shares their life with each other.

Entry of a child changes a marriage, completely and permanently. It changes individuals

as a couple and also make changes in the way they think and act and relate to each other.

It adds beauty to life as if sweet scent to a beautiful flower.1

To become a mother and father is one of life’s greatest blessings. It changes their

heart, thoughts, and actions. It is a lifelong event that forever changes the couples.1

In our society, individuals are committed in relationships like marriage with the

goal of procreation. Both men and women are supposed to pass on their genetic and

generational traits .Failure by both men and women to fulfill their need for a child is

usually devastating, humiliating, and emotionally destructive .Thus it becomes a

1

Major life stressor, which can affect the well-adjusted couples. Even though tremendous

strides have been made in treating this relatively common condition, infertility is

typically not openly discussed.1

Infertility is defined as failure to conceive within one or more years of regular

unprotected coitus. Primary infertility denotes those patients who have never

conceived .Secondary infertility indicates previous pregnancy but failure to conceive

subsequently. Infertility is a heartbreaking condition that affects nine million couples in

the world each year. It causes tremendous stress, can trigger debilitating sadness and

depression, and can tear a marriage to shreds. It is shown that 1 in 6 couples are said to

have infertility in India .If the couples are more than 35 years, it increases as 1 in 3

couples. The males are responsible for 40 % while females are responsible for another 40

% and 10 % because of the problems within the both, 10 % is due to idiopathic reasons.2,3

A study conducted in rural areas of India on prevalence of female infertility among

232 couples, reported that 14.4% had the prevalence of infertility.4

The first step in obtaining infertility therapy is fertility testing. There are many reasons

why couples have trouble in conceiving, including low sperm count, low hormone levels,

and abnormalities in reproductive organs. Only comprehensive fertility testing can isolate

the problem and allow doctor to suggest appropriate courses of treatment.5

2

BACKGROUND OF THE STUDY

Reproduction is a phenomenon that has evolved for the survival of the living of

different species by producing continuous stream of new generation of that species.

Production of a new human being begins with fertilization. Failure to this process results

in Infertility. Infertility is a tragic condition. Though infertility does not claim an

individual life, it inflicts devastating emotional trauma on the individual for being unable

to fulfill the biological role of parenthood for no fault of his/her own.6

WHO estimates that approximately 8-10% of couples experience some form of

infertilit. On a worldwide scale, this means that 50-80% million people suffer from

infertility with men and women in almost identical proportion. Infertility is exclusively a

female problem in 30-40% of cases and male in 10-30% of cases.7

Most infertility cases (85-90%) are treated with medication or surgery.

Improvement in infertility treatment have made it possible for many women Whose male

partner is infertile to become pregnant .These new and advanced Technologies include ,

In vitro fertilization (IVF),Intra cystoplasmic sperm Injection (ICSI) and other similar

procedures 3

3

NEED FOR THE STUDY

Everyone has the goal of becoming a parent, but for those who are unable to

conceive a child, it is an exquisitely painful reality. Many of the people spend a portion of

the life attempting to avoid unplanned pregnancies, and assume that once they are ready

to conceive, it will happen with little difficulty. They tend to think that shifting gears

from preventing pregnancy to planning conception and childbirth will proceed in a

relatively smooth and orderly fashion.1

Infertility has come to be recognized as a significant social problem. There are

numerous infertility cases among many couples who try to conceive a child .A

multicounty study carried out by the world health organization and including India place

the incidence of infertility between 10% to 15%.It affects almost 13% to 15%

of couples of world wide .In the united kingdom it is estimated that one in six

couples would be companied of infertility. The prevalence varies widely, being less

in developed countries and more in developing countries.8

In India, due to influence of western culture and increasing urbanization, the view

of individuals towards marriage system has changed. Higher education, better career

opportunity and economical independence are the factors that cause young people to

delay marriage without realizing that their action could affect country’s

4

demography and health care system. Reproductive function declines as a women age,

particularly after the age of 35 years .Thus it places all women who are opting for a late

marriage at higher risk of infertility.9

Women with polycystic ovarian syndrome (PCOS) often are infertile because they

don’t ovulate. 40%-80% of women with PCOS have a problem with infertility. The

reason for this wide variation is that PCOS is a complex metabolic syndrome, with

multiple factors that can interfere with fertility10

The American society for reproductive medicine estimates that 5 million American

heterosexual couples report difficulties in achieving a viable pregnancy of which 1.3

million seek advice for the problem .The researcher also suggested that condition will be

worst in the coming world.11

A study conducted on knowledge and attitude of infertile couples about assisted

reproductive technology among 400 infertile couples reported that 41.7% have good

knowledge and 55.7% had poor knowledge. Even though 73% got information from ART

centers, only a small percentage have exhibited adequate knowledge .About 94.5% of

patients mentioned that Assisted Reproductive Technology expenses are not affordable to

them .12

A Study conducted in South Africa on knowledge and treatment – seeking

behaviors for childlessness among 120 women reported that, 58 % of the samples

5

had little knowledge regarding recent advancements in infertility management and only

45% have a positive attitude towards it ,45.8% did not have any concern regarding the

topic .13

From many reviews the student researcher found that incidence of infertility is

increasing day by day, mean while most of the infertile couples are not having adequate

knowledge regarding recent advancements in infertility management which is leading to

the reduced acceptance of these treatments among them. The prevalence of infertility will

be more devastating in the future with the upcoming concept of late marriages .So the

student researcher perceived the need for assessing updated knowledge regarding the

recent advancements among the infertile couples in order to make future informational

programmes and there by promoting them for the proper utilization of the services.

A significant number of couples complain that they are not told about the treatment

path and a lot of their questions remain unanswered. This information gap might lead to

anxiety. The goal of this study is to evaluate the impact of provision of training regarding

infertility on infertile couples.

6

STATEMENT OF THE PROBLEM:-

A study To Assess The Effectiveness Of Video Assisted Teaching Programme On The

Knowledge Regarding Infertility Among Infertile Couples In Selected Hospitals at

Haryana.

OBJECTIVES:-

To assess the pre-test knowledge of infertile couples regarding infertility

before video assisted teaching

To assess the post-test knowledge of infertile couples regarding infertility

after video assisted teaching

To compare the pre-test and post knowledge score of infertile couples.

To assess the effectiveness of Video Assisted Teaching on

knowledge regarding infertility among infertile couples.

To determine the association between the pre-test knowledge with

selected demographic variables.

7

OPERATIONAL DEFINITIONS:

A. ASSESS: It refers to the evaluation or estimation of knowledge level of infertile

couples regarding infertility.

B. EFFECTIVENESS: In this study it refers to the extent to which the video

teaching programme has achieved the desired effect as measured by gain in knowledge

level of infertile couples by a structured questionnaire

C.VIDEO ASSISTED TEACHING PROGRAMME: It is a planned teaching

material of lecture combined with video with duration of 45minutes.

D. KNOWLEDGE: The ability of infertile couples to respond towards the

questionnaire on the selected aspects of infertility.

E. INFERTILITY: The inability of a couple to achieve a pregnancy after repeated

intercourse without contraception for one year.

F. INFERTILE COUPLE: Any given couple who is infertile may be related to the

female partner, the male partner or the combination of both.

ASSUMPTIONS:

Most of the infertile couples are not having enough knowledge regarding

infertility.

Participatory care will improve self esteem towards the promotion of health.

8

RESEARCH HYPOTHESES

H1: There will be a significant difference between the mean pre-test and mean post-test

knowledge score of infertile couples.

H2: There will be a significance association at 0.05 level of significance between the pre-

test knowledge scores with demographic variables of infertile couples.

VARIABLES:

A. Independent Variables: Video teaching programme regarding infertility.

B .Dependent Variables: Knowledge level regarding infertility.

C .Demographic Variables: Age, Gender, Education, Occupation, Duration of treatment,

Previous Knowledge.

DELIMITATION:

Infertile couples who are available at the time of the study.

Infertile couples who are illiterate.

Sample size limited to 50 infertile couples.

Prescribed data collection is 4-6 weeks.

PROJECTED OUTCOMES

This study is proposed to determine the effectiveness of knowledge gain regarding

infertility among infertile couples through video assisted teaching.

9

CONCEPTUAL FRAMEWORK:

Conceptual framework refers as a background or foundation for a study .Concepts are

related in a logical manner by the researcher (ROSE MARIE NIESWIADOMY,2008).

Conceptual framework assists individual in organizing their thinking in order to select a

focus of study and interpreting the findings (MORSE JM , 1992).

Conceptual framework serves as a spring board for theory development. As this is

made up of concepts, which are mental images of a phenomenon, it provides for thinking

and interpreting what is seen. A model is used to denote symbolic representation of

concepts (Jacqueline Fawcett, 1987 ).

The modified conceptual framework for the present study has been developed from ''

General System Theory” by Ludwig Von Bertanlanffy (1968). He states that, an open

system is a system which continuously interacts with the environment. The interaction can

take the form of information, energy or material transfers in to or out of the system

boundary, depending on the discipline which defines the concept.

In this theory, focus is on the discrete parts and their interrelationship which makes up

and describes the whole. It defines system in a complex interaction which means that

system consists of two or more converted elements which form an organized and which

interact with other. All system must receive varying type of information from the

Environment. The system uses the input to maintain its homeostasis

10

The main concepts of the open system model are input, throughput, output and feedback.

INPUT:

'' Input” refers to any form of matter, energy, and information that enter in the system

through its boundary. In the present study,'' Input” refers to assessment of existing

knowledge of infertile couples regarding infertility in terms of pre-test knowledge and

administration of video assisted teaching on infertility.

THROUGHPUT:

''Throughput '' refers to process of the input .In the present study throughput refers to a

process of change in knowledge and understanding about the various aspects of infertility.

OUTPUT:

“Output” refers transfers matter, energy and information to the environment is an altered

state. In the present study, ' output ' refers to evaluation of change in knowledge of

infertile couples regarding infertility in terms of post -test knowledge after administration

of video assisted teaching on infertility.

FEEDBACK:

‘Feedback ' refers to information of environment responses to the system, output is used

by the system in adjustment, correction and accommodation to the interaction with the

environment. In the present study, 'Feedback' refers to effectiveness of video assisted

teaching on infertility by comparing pre-test and post -test knowledge and find out the

association between the pre-test knowledge with selected demographic variables of

infertile couples.

11

The model states that feedback loops are necessary to produce a mutually determined

plan of care and if the planned intervention is not effective, the determination is made

that further assessment is necessary. In the present study the investigator evaluates the

effectiveness of video assisted teaching on knowledge regarding infertility by comparing

pre and post- test knowledge score. The gain in knowledge depicts a positive outcome of

the programme while if no gain in knowledge is seen further assessment of the area of the

subject interest is necessary.

SUMMARY:

This chapter dealt with the Introduction, background of the study, significance and need

for the study, statement of the problem, objectives, operational definitions, assumption,

research hypotheses, variables, delimitation, projected outcomes and conceptual

framework of the study.

13

CHAPTER – II

REVIEW OF LITERATURE:-

It is the term of literature refers to the activities involved in identifying and searching for

information on a topic and developing a comprehensive picture of the state of knowledge

on the topic.

Review of literature helps the investigator to develop insight in the problem and gain

information about the problem and what has been done before. It provides basis for future

investigation, justifies the need for replication, throws light on the feasibility of the study,

constraints of data collection, and relates the findings from one study to another with a

hope to establish a comprehensive body of scientific knowledge and a professional

discipline from which valid and pertinent theories may be developed.

Based on the objectives of the study the literature from various sources had been

reviewed and arranged under following categories:

SECTION- A. Studies related to incidence and prevalence of infertility.

SECTION-B. Studies related to infertility knowledge assessment in infertile

couples.

SECTION- C. Studies related to treatment modalities.

SECTION- D. Studies related to video assisted teaching program.

14

SECTION- A. Studies related to incidence and prevalence of infertility.

The prevalence of infertile couples differs according to the definition of couple’s

infertility. If we accept the most commonly used definition, i.e. the lack of

pregnancy after 1 year of unprotected regular intercourse, infertile couples represent

about 10 to 15 %of all couples. According to the definition of the European society for

Human Reproduction and Embryology, i.e. the lack of pregnancy within 2 years by

regular coital exposure, the prevalence of infertile

couples in Europe and North America is approximately 5 to 6%.14

In a follow-up study of 1297 couples registered at a NOVA SCOTIA infertility

clinic with a complaint of infertility of at least 12 months duration, the cumulative

pregnancy rate at 36 months, with 95 % confidence limit was found to be 49.4%.The

predictors of pregnancy by univariate analysis were a favorable primary clinical,

diagnosis (p<0.001) ,a duration of infertility of less than 3 years (p<0.001) , a single

diagnosis for the infertility (p<0.001), a previous pregnancy in the partnership

(p=0.001),and a length of marriage of less than 4 years (p=0.002). Proportional hazard

analysis confirmed these variables as predictors of pregnancy. The highest cumulative

pregnancy rates after 12 and 36 months of follow- up were observed in case of ovulation

deficiency, and the lowest were seen in cases of tubal defects. However, before the

process of diagnosing infertility begins, useful prognostic information can be

15

determined from the length of marriage, the duration of infertility and the partnership’s

history of previous pregnancy.15

A study was conducted among 175 consecutive infertile couples were interviewed

together and individually in accordance with a 25 point questionnaires. Amongst the

males, premature ejaculations 66% was most common problem followed by erectile

dysfunction 15%, decreased libido 11% and orgasmic failure 8%. Amongst females

dyspareunia 58%, decreased libido 28%, and orgasmic failure 14% were most common

problems. Various types of misconceptions were also observed in the infertile couples.

Lack of sexual awareness and education formed an important part of observations.

Psychosexual dysfunction and infertility was found to occur, in a large number of

couples, together in association. Most common cause for this problems seems to be

ignorance and lack of sex education.16

A population survey was conducted to assess the prevalence of infertility and the

proportion of couples seeking help in more and less develop countries from 25 population

surveys sampled 172 to 413 women. The 12 month prevalence rate ranged from 3.5% to

16.7% in more developed nations and from 6.9% to 9.3% in less developed nations, with

an estimated overall median prevalence of 9%. In 17 studies, sampling 6410 women, the

proportion of couples seeking medical medical care was an average 56.1% range 42-

76.3% in more developed countries and 51.2% range 27-74.1% in less developed

16

Countries range 27-74.1% in less developed countries. The proportion of people actually

receiving care was substantially less, 22.4%. Based on these estimates and the current

world population, 72.4% million women are currently infertile, of these 405 million are

currently seeking infertility medical care.17

A survey was done about distribution of infertility those who were attending primary

infertility clinics in Israel. Infertility is one of the most prevalent health disorders in young

adults. About 2515 couples 37% and tubal damage 18%. Infertility factors were identified

in the women alone in 30.6% participated in the study. Out of these male factor 45%,

Oligo ovulate cases and the men among in 29.2%. To combine infertility factors were

found in 18%, the rate of unexplained infertility was 20.7%. The study was concluded by

saying that male factor accounts for almost half of all cases of infertility in couples.18

B. Studies related to infertility knowledge assessment in infertile couples:-

A descriptive study conducted found that, there is scarce Knowledge regarding the

impact of infertility on couples. The main objective of the study was to review the

findings on quality of life and health related quality of life among infertile

couples. .Among infertile subjects, women had lower scores in several QOL or HRQOL

domains in sample size comparison to men. So from this study, it is evidenced that there

is a scarcity of knowledge in infertile couples19.

17

A study conducted about knowledge and attitudes towards infertility held by

members of 2 countries councils in Sweden. For this study 182 samples were taken and

153 answered the questionnaire. The result of the study shows that different age groups

did not show different levels of knowledge; the committee members who were very

positive towards infertility treatment did not have any better knowledge of such treatment

than those who were less positive. At the time of survey displayed the same level of

knowledge as the other council members. The members showed very little familiarity

with the priority groups suggested in the report from the health care priority committee.20

A phenomenological study was conducted about couple’s experiences of. In his

study he focused on the improvement of knowledge of infertility among infertile couples

by the nurse. If nurses are to work effectively with families in contemporary societies,

their practice and activities must be appropriately informed. The purpose of this study

was to examine in-depth the experience of couples undergoing treatment for infertility.

He explains that all couples undergoing infertility treatment experienced life changes

which included life style changes, various physical and emotional changes, and changes

in the relationship of couples. Most of the couples reported feelings of social isolation

associated with being infertile. Findings from this study will add more knowledge based

on infertility among the infertile couples.21

A study conducted about the women’s and men’s perceptions of infertility

18

Their associations with psychological adjustment. The main objective of the study was to

extend the knowledge of the couples by examining the perception of infertility among

couples undergoing treatment. The study was cross-sectional and included two samples.

Sample 1 included 72 couples at their first visit to an infertility clinic and sample 2

included 49 couples at various stages of treatment. The result of the study shows that the

partners differed in their perceptions of infertility and their distresses.22

The descriptive cross-section study was conducted to evaluate the knowledge of

infertile couples about infertility at patient infertility clinics of University Hospital in

Tehran Iran. Data was collected from 400 infertile couples by a self administer structured

questionnaire. The study findings showed that 120 couples (30 %) had good knowledge

but 280 (70 %) had poor knowledge about infertility.23

A study report shows that there is a lack of infertility knowledge in the general

population. The aim of the current study was to asses people’s knowledge about

infertility, focusing on identifying the type of information needed to educate people about

the potential risks for infertility.24

A study report found that knowledge about infertility issues is a core motivator

behind engaging in the medical process for infertility problem. The results demonstrated

that the participants were knowledgeable about the risk factors for infertility but were not

as knowledgeable at recognizing factors that had no effect on fertility, and believed that

19

thesefactors actually increased a woman’s fertility.Fertility awareness campaigns need to

address false beliefs as they may give individuals a false sense of security about their

fertility.25

SECTION C:Studies related to treatment modalities:

A study was conducted about the epidemiological aspects of primary infertility in

Kashmir region of India. The main objective of this study is to assess the magnitude of

primary infertility and to study its etiological aspects in India. About 10,063 married

couples were interviewed to ascertain the prevalence of primary infertility. The result of

the study shows that 15%of the couples interviewed had primary infertility among which

4.66%had unresolved infertility at the time of survey. The etiology of infertility in250

consecutive couples revealed a female factor in 57.6%, a male factor 22.4%, combined

factor in5.2%and an undetermined cause in 14.8%.26

A study report shows that smokers have lower sperm counts and stopping smoking

increase sperm count. Smokers sperm count is on average 13 – 17 % lower than One half

of 1%of men was functionally sterile in 1938.Today it has reached between 8-12

%.Functionally sterile” is define as sperm counts below 20 million per ml of semen.27

A high number abnormal sperm heads is associated with decreased fertilization.

Some drugs such as sulphasalazine, used to treat inflammatory bowel disease can

drastically reduce semen quality.28

20

A study of 3 smokers who were followed for 5 – 15 months after stopping smoking

reported that their sperm count rouse 50 – 80 %, suggesting that chemicals in the smoke

are responsible and any reduction in sperm count is reversible.29

A study found that alcohol reduces fertilization success. A large 50% reduction in

experiments of test animals given intoxicating doses of alcohol 24 hours prior to mating.30

Ovulatory dysfunction can be suggested by late menarche, presence of premenstrual

syndrome, abnormal cycle length, amount of menstrual loss, premenstrual spotting, hot

flushes and excessive physical exercises and/or weight changes greater than 10%in the past

year. Systematic diseases such as diabetes mellitus and thyroid dysfunction that are not

adequately treated may also have adverse effects on fertility .Medical treatments may cause

temporary(sex steroids)or permanent (cytotoxic agents) damage to the Ovulatory function.31

8.4%o of women 15-44years had impaired ability to have children and about half of

these couples eventually conceive. These are statistics will vary greatly depending on the age

of the woman. Couple infertility rates are nearly double percentage since it then take

into account male infertility.32

38% of female non-smokers conceived in their 1st cycle of attempting pregnancy

compared to 28% of smokers. Smokers were also 3-4 times more likely than non smokers to

have taken greater than a year to conceive.33

21

A study of 1,909 women in Connecticut found the risk of not conceiving for 12

months (the usual definition of infertility), was 55% higher for women drinking 1 cup of

coffee per day -100% higher for women drinking more than 3 cups of coffee per day.34

Risk of infertility increased in females who reported exposures to textile dyes, dry

cleaning chemicals, noise, lead, mercury and cadmium. There was a significant risk of

increased time to conception among women exposed to anti-rust agents, welding, plastic

manufacturing, lead, mercury, cadmium, or anesthetic agents.35

Expensive fertility treatments resulted in only a 6percentage point improvement in

achieving pregnancy over “infertile” couples who just “kept trying. In a study of 1145

couples who had been diagnosed as infertile, only half of them were treated to help attain

pregnancy. After a two to seven-years follow up, pregnancies occurred in 41%of the

treated couples and 35% of untreated couples.36

Infertility by itself does not threaten physical health but has a strong impact on the

psychological and social well-being of couples. In the last 2 decades, progress in caring

for the infertile couple, in particular progress in the field of assisted reproduction and

micromanipulation, has provided significant hope for many couples for whom hope could

not have been offered in the past. This is especially true for bilateral tubal diseases and for

male factor infertility, as near all couples with male factor in fertility can now undergo

either one(or more)IVE or ICSI attempt (s).For couples with other causes of

22

Infertility, however, the differences in pregnancy rate often do not reach statistical

significance.37

A study was conducted in 32 couples in the age group of 21- 43 years, who had

primary infertility ranging from 1-12 years. The female partner was given eve care syrup at

a dose of 2 teaspoonfuls for 6 months. The male partner was given Spemann tablet at a

dose of 2 tablets, twice daily for the same periods. The female were advices during test to

detect human chorionic gonadotrophin if they had a missed period for duration of more

than 15 days after 3 months of treatments, 6 female tested positive, for tested positive after

4 months and for tested positive after 6 months of treatment. The pregnancies were later

confirmed with pelvic ultrasonography, which showed live fetus without any

abnormalities. Among the males, there was a marked improvement in the sperm count

especially in those males hoe has abnormal or low sperm counts. A complete analysis was

done at the end of 6 months and the final report showed that the fertility rate after eve care

and Spemann therapy was 43.75%.This was combine therapy could bring out a good out

come in infertile couples if the used Eve care and Spemann for at least 6 months.38

MSG (Monosodium glutamate), a common flavor enhancer added in foods, was found

to cause infertility problems in test animals. Male rats fed MSG before mating less

than a 50% success rate , where as male rats not fed MSG had over a 92%success

23

rate.Also the offspring of the MSG treated males showed shorter body length, reduced

testes weight and evidence of overweight at 25 days. MSG is found in ascend, flavored

potato chips, Doritos, meat seasoning and many packaged soups.39

The sexual history of the couple is very important. The frequency and timing of

intercourse and the use of lubricants should be assessed. It happens frequently that an

infertile couple abstains from intercourse and has only timed exposures in the middle of

the cycle, but there is no evidence that prolonged abstinence increases the change of

pregnancy; abstinence (7 to 8 days) should be reasonably recommended only if

oligozoospermia is present. Use of lubricants should be discouraged because of their

detrimental effects on semen quality.40

In a study conducted, clinical infertility is a prevalent problem with significant

financial and costs. Modifiable life style factors exists that may affect a Person’s time to

conception and there chance of having a healthy, live birth.A person’s time pregnancy and

their chance of having a healthy, live birth may be affected by factors such as weight ,

vitamin and iodine intake, alcohol and caffeine consumption, smoking, substance abuse,

stress, environmental pollutants vaccination and oxidative stress.41

A case control study was conducted to assess the differences in attitude towards

aspects of assisted reproductive technology between infertile and porous women a

university-based tertiary clinic of Kuopio. A sample of 392 women with fertility

24

problem and 200 porous women as control was selected on the basis of convenience

sampling technique. A questionnaire consisting of 46 questions on different aspects of ART

was administered to the sample. The study revealed that response rate in group of infertile

women was 48 %( 189/392). Porous women responded with a similar rate of

42%(82/200).The mean age (ISD) of parous women responded with a similar rate of 42

%(84/200).The mean age (ISD)of parous women was 35.0(+_5.0)years and it was 34.0

(+_6.1) years in women with fertility problem over 80% women and parous women would

set on upper age limit to the infertility treatment for women,66% of infertile women and

73% of parous women would set an upper age limit for men also. Two-third of infertile

women and 58% of parous women agreed to the question that is the duty of parents to tell a

child about the use of assisted reproductive technology .Infertility regarded an illness by

infertile women, but only 34% of the parous women .Thus the study conducted that split

attitude was influenced by the wish of infertile women to help childless couples and to the

recruit suitable /oocyte donors. Parous women were motivated by their concern for

children’s right.4

SECTION- D.Studies related to video assisted teaching programme.

A Study was conducted by Kumari Sathya K in 2005 to determine the effectiveness of

video assisted teaching vs. lecture method on knowledge of newborn assessment among

final year general nursing and midwifery students of selected Institutes, Bangalore

25

The sample consisted of 60, experimental Group 1-30 and Group-2-30.A structured

knowledge questionnaire on newborn assessment was developed by the investigator. The

major findings of the study were: mean difference between the lecture and video were

22.9 and 25.4 respectively. Video is slighter high than lecture. Findings of the study score

shows that Video assisted teaching was also an effective teaching strategy. Different

teaching strategies should be used in teaching to make students better understand, theory

as well as practical.43

A study was conducted to assess the effectiveness of video assisted nursing

intervention on lumbo-sacral pain and activities of daily living among antenatal primi

mothers at SRH. The study was conducted on 60 primi mothers and the post-test

knowledge of the mother regarding pain and daily living activities were higher than the

Pre-test scores after video assisted teaching. The findings indicates that 65.5% had good

knowledge ,while 15.45% had average knowledge and 19.09% had poor knowledge

before video assisted teaching program me. The study concluded that video assisted

teaching programme will improve the knowledge of the primi mothers and it will help in

regaining their activity level than those who did not participate in the study.44

A study was conducted to compare the efficacy of a video- assisted module versus

conventional module (lecture), regarding post exposure prophylaxis (PEP) among 58

dental students, in Shahid Behest University of Medical Sciences, Tehran, Iran. They

26

were asked to take a test about the principles of prior to being taught via lecture or the

video films. The test was repeated following conventional teaching module and the video

– assisted teaching module. The pre- teaching test results indicating low knowledge

among the students regarding PEP with a mean value of 8.98+ 2.99 which was

significantly different compared to post-teaching test results following the lecture-only

phase ( 11.30 ± 3.90) and the video- assisted teaching phase ( 17.32 ± 2.94).45

A study was performed to investigate the effects of video-based self assessment on

the ability of nursing students to accurately measures vital signs, their communication

skills, and their satisfaction. A quasi – experimental control- group, pretest- posttest of 40

second year student nurses were enrolled fundamental of nursing course in a college of

nursing. Results of the research indicate that there was a statistically significant

difference in exam scores for assessing long- term memory, in video rewiring group

demonstrating higher score (t=4.75,df=213,p,0.001).Students satisfaction was also

significantly higher in the video-review group than in the control group. These results

suggested that video-based self assessment is a beneficial and an effective instructional

method of training undergraduate nursing students to develop awareness of their strength

and weakness, to improve their clinical and communication skills.46

27

CHAPTER-3

RESEARCH METHODOLOGY

INTRODUCTION:

Research methodology is a way to solve the problem systematically. It is a

Procedure in which the research starts from initial identification of the problem to final

conclusion. It organize all the components of the study in a way that is most likely to lead

to valid answer to the problem that have been posed.(NANCY

BURNS and SUSAN K GROVE).

Research methodology provides a brief description of the method adopted by the

investigator in the study. It indicates the general pattern of organizing the procedure of

gathering valid is reliable data for an investigation .It includes research approaches,

research design, the setting, the population, sample, sample size, sampling technique, and

criteria for sample selection ,description of tools, validity and reliability of the tool,

intervention, pilot study and data gathering process, plan for data analysis and the

protection of human subjects The present study is aimed to assess the effectiveness of

video assisted teaching programme on knowledge regarding infertility among infertile

couples in selected hospitals at Haryana.

28

RESEARCH APPROACH:

Research approach is an umbrella that covers the basic procedure conducting

research (Kothari CR 2004)

According to (Denise F. Polit et al, 2001), experimental approach is to explore the

dimension of a phenomenon or to develop hypotheses about relationship between the

phenomena.

A pre experimental research approach was considered to be the most appropriate and

adopted to assess the effectiveness of video assisted teaching programme on knowledge

regarding infertility among infertile couples in selected hospital.

RESEARCH DESIGN:

The research design refers to the researcher’s overall plan for the obtaining answer to the

research questions and all spells out strategies that the researcher adopted to develop

information that is accurate ,objective and interpretation (Denise F. Polit et al,2001),

experimental. A pre experimental one group, pre-test, post-test research design has been

used to attain the objectives of the present study.

According to (Denise F. Polit et al, 2001) the schematic representation of pre-

experimental research design:

29

Pre-test(01 ) Intervention Post-test (02)

Pre assessment of

knowledge

Regarding infertility

among infertile couples

by structured

knowledge

questionnaire after

intervention.

Video assisted teaching

programme regarding

Knowledge on infertility

among infertile couples.

Post assessment of

knowledge regarding

infertility among

infertile couples by

structured knowledge

questionnaire after

intervention.

TABLE 1:- SCHEMATIC REPRESENTATION OF RESEARCH DESIGN

VARIABLES:

Variables are the measurable characteristics of a concept and consist of special group

attribute (Janice M .MORSE. and Peggy Anne Field, 2005)

Independent Variables:

An Independent variables is that which is believed to cause or influence the dependent

dependent variable, in experimental research by the manipulated (treatment) variables

(DENISE F POLLIT et al 2001)

In this study the independent variable refers to video assisted teaching on infertility

30

Dependent variables:

The variable is hypothesized to depend on or be caused by another variable, (the

independent variable) the outcome variable of interest (Kerlinger, and Freed In, 1983) In

the present study dependent variable refers to knowledge level of infertile couples

regarding infertility.

SETTING:

Setting refers to the area where the study is conducted. It is the physical location

and condition in which data collection takes place in a study (Denise F. Polit et al, 2001).

Based on the geographical proximity, feasibility and familiarity with the setting, the

investigator selected infertility clinics, at Haryana, to carry out the present study

POPULATION:

The population referred to as the target population, which represents the entire

group or all the elements like individuals or objects that meets certain criteria for the

inclusion in the study (Nancy Burns, and Susan K Grove, 2007).

The target population of the present study comprises of infertile couples who were

attending hospitals at Haryana.

31

SAMPLE:

Sample refers to the subset of a population that is selected by the investigator to

participate in a research project (Dorothy Y. Brockopp, and Marie T H).

Sample size of the present study consists of 60 infertile couples getting treatment from

the hospitals at Haryana.

SAMPLING TECHNIQUE:

Sampling defines the process of selecting a group of people or other elements with which

to conduct a study (Basavanthappa BT, 2007).

Non-probability sampling technique was adopted to select the samples for the present

study based on inclusion criteria.

SAMPLING CRITERIA:

The samples were selected with the following predetermined set of criteria.

INCLUSION CRITERIA: All the infertile couples who:

Attend the infertility clinics.

Are willing to participate in the study.

Can understand Hindi/ English.

EXCLUSION CRITERIA: All the infertile couples who:

Are associated with other obstetric complication.

Have other chronic illness.

Cannot understand Hindi.

32

DEVELOPMENT OF THE TOOL:

After the extensive review of literature discussion with the guide and the various experts

in the field of obstetric and gynecological nursing and medical field based on their

suggestion and recommendations, the tool was constructed in three parts consists of

demographic variables, self administered structured knowledge questionnaire and video

teaching regarding knowledge on infertility.

PREPARATION OF THE BLUE PRINT:

A blue print on the knowledge questionnaire consisting of five areas was prepared. It

depicted the distribution of items according to the content areas based on three domains

namely Knowledge, Comprehension, Analysis.

Table-2: DISTRIBUTION OF ITEMS ACCORDING TO THE THREE DOMAINS

IN THE BLUE PRINT:

DOMAINS NO OF ITEMS PERCENTAGE

KNOWLEDGE 14 35.00%

COMPREHENSION 5 12.50%

ANALYSIS 21 52.50%

TOTAL 40 100.00%

34

Table-3: DISTRIBUTION NUMBER OF ITEMS AND PERCENTAGE OF MARKS

ACCORDING TO THE AREAS.

ASPECTS NUMBER OF

QUESTIONS

PERCENTAGE OF

MARKS

Anatomy and Physiology 13 32.5%

Definition and Types 7 17.5%

Incidence of Infertility 3 7.5%

Causes of Infertility 6 15%

Investigations of Infertility 4 10%

Treatment of infertility 7 17.5%

TOTAL 40 100%

DESCRIPTION OF THE TOOL:

The tool was the standardized knowledge questionnaire regarding infertility. Tool

consists of two section-1consisted of baseline variables and section-2 had the knowledge

questionnaire on infertility. Total of 40 items were prepared and each carried one mark.

35

Part I: It consist of the following demographic variables.

DEMOGRAPHIC DATA:

Age

Gender

Education

Occupation

Duration of Treatment

Previous Knowledge

Part II: It consists of self administered structured knowledge questionnaire consisting 40

knowledge items related to infertility which dealing about:

Anatomy and physiology of reproductive organs

Definition and types of infertility

Incidence of infertility.

Causes of infertility.

Investigations of infertility.

Treatment of infertility.

Part III: It consists of video assisted teaching programme on infertility.

Scoring key:

Scoring Procedure: Scoring key is prepared for

Part I: By coding the demographic variables

Part II: By awarding score for the correct response

Score ‘1’ – correct response

Score ‘0’—wrong response

Maximum score – 40

36

Score interpretation:

To interpret the level of knowledge the scores subjected as

Inadequate 10% -- 40%

Moderate 41% --70%

Adequate >70

Content validity:

Validity is a measure of truth or accuracy of a claim and is an important concern

throughout the research process. It refers to whether an instrument accurately measures

Measures what it is supposed to measure. Content validity of tool was ascertained in

consultation with ten experts, seven experts were from the field of obstetric and

gynecological nursing, and other three experts were doctors. The experts were requested

to judge the items for accuracy, relevance and appropriateness. The tool was modified

accordingly and content validity index was found to be 0.8.

Reliability:

Reliability refers to stability and repeatability of the data collected instrument

(Jacqueline Rose Hott, and Wendy C. Budin, 2006).

In order to establish reliability of the tool the technique called test and retest method

was used and reliability co-efficient was calculated by using the raw formula the

calculated value of ‘r’ was 0.09.The developed tool was found to be highly reliable.

37

INTERVENTION:-

The intervention in this study was a video assisted teaching regarding knowledge on

infertility. The topic was introduction, anatomy and physiology of reproductive organ,

definition, incidence, types, causes, investigation and treatment. At the end of the teaching

40 question were included for infertile couples self assessment. The questions were

validated by the experts. The duration of the video assisted teaching was 45 minutes.

PILOT STUDY:

Pilot study is a small scale version or trial run done in preparation for a major study.

(Denise f. polit et al 2001).

The refined tools were used for pilot study to test feasibility and practicability. After

obtaining formal permission from the director, of Sarvodaya hospital at Haryana. Pilot

study was conducted. Among 10 infertile couples selected by non- probability

convenient sampling technique. The investigator given self introduction, explain the

purpose of the study and subject’s willingness to participate in the study we ascertained.

The subjects are assured anonymity and confidentiality of the information provided by

them and written informed consent was obtained. The pretest was conducted by

administering the structured knowledge questionnaire followed by video assisted

teaching on infertility .On the 8th day post test was conducted by using the same.

38

Method of data collection:

The data were collected from the subjected after obtaining formal permission from the

doctors and NS of Sarvodaya hospital at Haryana. The main study was conducted

among 60 subjects. The subjects are selected by non-probability convenient sampling

technique. The investigator given self introduction explained the purpose of the study and

subject’s willingness to participate in the study was ascertained. The subjects are assured

anonymity and confidentiality of the information provided by then and written informed

consent was obtained. The pre test was conducted by administering the structured

knowledge questionnaire followed by video assisted teaching on infertility. On the 8 th

day post test was conducted by using the same tool. Each subject took 45 minutes to

complete the structured knowledge questionnaire.

PLAN FOR DATA ANALYSIS:

The data analysis plan included descriptive and inferential statistics.

DESCRIPTIVE STATISTICS:

Percentage and frequency to analyze demographic variables.

39

INFERENTIAL STATISTICS:-

Paired‘t’ test was used to compare the pre test and post test.

Mean and standard deviation to analyze t and post test level of knowledge

scores regarding infertility.

Chi square test was used to associate the pre test level of knowledge of score

regarding infertility with selected demographic variables of infertile couples. he

pre and post test level to knowledge regarding infertility.

PROTECTION OF HUMAN SUBJECTS:-

This research study was conducted was with full consideration for the rights of

human subjects .Only infertile couples were included. The proposed study was conducted

after the approval of hospital authority. The research procedure was explained to the

subjects and written consent was obtained before intervention. Assurance was given to

the study participants regarding the confidentiality of the data collected from them.

SUMMARY:-

This chapter deal with the description of research approach, research design, setting,

variables, population, sample, sampling technique, development and description of the

tool. Validity and reliability of the tool, pilot study, procedure for data collection and the

plan for data analysis.

40

CHAPTER-IV

DATA ANALYSIS AND INTERPRETATION

INTRODUCTION:-

This chapter deals with analysis and interpretation of the data collected to assess the

effectiveness of video assisted teaching in improving knowledge regarding infertility

among infertile couples and its interpretation.

The analysis and interpretation of information are based on data collected through

administration of video teaching to the study group. The result were computed using

descriptive and inferential statistics based on the objectives of the study.

PRESENTATION OF DATA:-

The data obtained were entered in a master data sheet for tabulation and statistical

processing. The analysis of data is organized and presented under the following sections:

SECTION-A: Analysis of sample characteristics-baseline variables.

SECTION-B: Knowledge of infertile couples regarding infertility in pre-test and post-

test.

SECTION-C: Effectiveness of video assisted teaching on knowledge regarding infertility

by comparing pre-test and post-test knowledge score among infertile couples.

SECTION-D: Association between the level of pre-test knowledge score with their


41

SECTION-A ANALYSIS OF SAPLE CHARACTERISTICS-BASELINE VARIABLES

TABLE-4: Description of baseline characteristics.

Frequency and Percentage distribution of Demographic Variables of Infertility

Demographic Variables Frequency Percentage

Age

20 – 24

25 - 29

30 - 3435and above

2420115

40.0%33.3%18.3%8.4%

GenderMaleFemale

3030

50%50%

EducationPrimarySecondarySenior SecondaryGraduate

1519206

25%31.7%33.3%10%

Occupation

EmployedUn-Employed

4515

75%25%

Duration of treatment

Below one yearOne yearAbove one year

30219

50%34.8%14.2%

Previous knowledge

YesNo

654

10%90%

42

Fig-1: Distribution of subjects according to age in years

(No =60)

Age in years

Fig-1: Depicts that out of 60 subjects 40% were in the age group of 20-24

years, 33.30% in between 25-29 years, 18.30% in 30-35 years and 8.40% were

in the age group of 35 and above.

43

Fig-2: Distribution of subjects according to gender

(No =60)

Fig-2: Depicts that there 50% were male participants and 50% were female

participants.

44

Fig-3: Distribution of study participants according to education

(No =60)

Fig-3: Depicts that out of 60 subjects none were illiterate, 25% were primary

, 31.70% were secondary, 33.30% were senior secondary, and 105 were

graduate and above.

45

Fig-4: Distribution of study participants according to occupation

(No =60)

Fig-

4: Depicts that out of 60 subjects 25% were unemployed and 75% were

employed.

46

Fig-5: Distribution of subjects according to duration of treatment

(No =60

Fig-5: Depicts that out of 60 subjects 50% were taking treatment below one

year, 34.80% s, 18.30% were taking treatment from one year, and 14.2 %

were taking treatment above one year.

47

Fig-6: Distribution of subjects according to previous knowledge

(No =60)

Fig-6: Depicts that out of 60 subjects 10% 0f infertile couples had knowledge on

infertility and 90% infertile couples had no knowledge on infertility.

48

SECTION-B: KNOWLEDGE OF INFERTILE COUPLES REGARDING

INFERTILITY IN PRE-TEST AND POST-TEST

TABLE-5: DISTRIBUTION OF KNOWLEDGE LEVEL REGARDING

INFERTILITY AMONG INFERTILE COUPLES IN THE PRE-TEST

Knowledge on

infertility

Inadequate 10-40% Moderate 41-70% Adequate >70%

Pre test 31 51.7 29 48.3 0 0

Table-5: depict that among the 60 subjects, 31(51.7%) subjects had inadequate

knowledge and 29 (48.3%) subjects had moderate knowledge regarding infertility.

TABLE-6: DISTRIBUTION OF KNOWLEDGE LEVEL REGARDING

INFERTILITY AMONG INFERTILE COUPLES IN THE POST-TEST

Knowledge on

infertility

Inadequate 10-40% Moderate 41-70% Adequate >70%

Post test 0 0% 6 10% 54 90%

Table-6: depict that among the 60 subjects, 6( 10%) subjects had moderate

knowledge and 54 (90%) subjects had adequate knowledge regarding infertility

49

Fig-7: DISTRIBUTION OF KNOWLEDGE LEVEL REGARDING INFERTILITY

AMONG INFERTILE COUPLES IN PRE-TEST AND POST-TEST

Fig-7: Depicts the knowledge level regarding infertility among infertile couples in

pre-test and post-test.

50

SECTION-C: EFFECTIVENESS OF VIDEO ASSISTED TEACHING ON

KNOWLEDGE REGARDING INFERTILITY BY COMPARING PRE-TEST AND

POST KNOWLEDGE SCORES AMONG INFERTILE COUPLES

TABLE-7: COMPARISON OF MEAN AND STANDARD DEVIATION OF

KNOWLEDGE SCORES REGARDING INFERTILITY IN PRE-TEST AND

POST-TEST

Fig-8: Depicts that out of 60 subjects 10% 0f infertile couples had knowledge on

infertility and 90% infertile couples had no knowledge on infertility.

51

TABLE-8: PAIRED t TEST VALUE OF KNOWLEDGE SCORES REGARDING

INFERTILITY

KNOWLEDGE

ON

INFERTILITY

MEAN S.D D.F Paired t

VALUE

TABLE

VALUE

INFERENCE

PRE-TEST

POST-TEST

14.18 3.65 49 27.41 2.010 SIGNIFICANT

(p < o.o5)

The table 8- indicates that, the calculated paired t test value 27.41 of pre and post

test knowledge score of infertile couples regarding infertility. Life supporties greater

than table value and found to be high statistical significant at the level of

p<0.05 .Hence research hypotheses stated that there will be significant difference

between pre and post test knowledge among infertile couples about infertility. Was

accepted.

52

SECTION D:ASSOCIATION BETWEEN PRE-TEST KNOWLEDGE SCORES

WITH SELECTED DEMOGRAPHIC VARIABLES OF INFERTILE COUPLES.

TABLE 9: ASSOCIATION BETWEEN THE PRE-TEST KNOWLEDGE SCORES

WITH SELECTED DEMOGRAPHIC VARIABLES OF INFERTILE COUPLES.

Demographic Variable

Below Mean

Above Mean

Degree of Freedom

Chi Square Value

Table Value

Inference

AGE 23 37 2 0.096 5.99 SIGNIFICANT

GENDER 27 33 1 3.91 3.84 SIGNIFICANT

EDUCATION 37 33 1 6.9 3.84 SIGNIFICANT

OCCUPATION 29 31 4 12.48 9.49 SIGNIFICANT

DURATION OF TREATMENT

32 28 3 7.82 7.82 SIGNIFICANT

PREVIOUS KNOWLEDGE

21 39 3 9.74 7.82 SIGNIFICANT

From the above table 9 findings revealed that there was statistically significant association

between the pre-test knowledge scores with selected demographic variables of the infertile

couples. Like age gender education, occupation, duration of treatment, previous knowledge

at the level of p<0.05 by using chi square test. Hence the research hypotheses stated that

there will be significant association between the pre-test knowledge score with selected

demographic variables was accepted.

53

SUMMARY:

This chapter dealt with analysis and interpretation of data using descriptive and

inferential statistics. The data gathered were summarized in the master sheet and both

descriptive and inferential statistics were used for analysis. Findings revealed that the

mean pretest knowledge score of infertile couples was 18.06 and the mean posttest

knowledge score was 32.24. Paired ‘t’ test was used to analyze the effectiveness of video

assisted teaching. Findings show a gain in knowledge which was significant at 0.01level

of significance in infertile couples, who had received the video teaching on knowledge

regarding infertility.

54

CHAPTER-V

DISCUSSION, CONCLUSION, IMPLICATION AND RECOMMENDATION

AND SUMMARY

This chapter deals with the discussion of the result obtained from statistical analysis

based on the collected data, objectives, hypotheses and review of literature selected for

the study, summary, conclusion, limitation,implication,and recommendation of the study

for future nursing education, nursing practice, nursing administration and nursing

research.

The purpose of the study was To Assess the Effectiveness of Video Assisted Teaching on

Knowledge Regarding Infertility among Infertile Couple in Selected Hospitals at

Haryana.

DISCUSSION:

The findings of the study were discussed in this chapter with reference to objectives of the

study under the following headings.

SECTION-A: Analysis of sample characteristics-baseline variables.

SECTION-B: Asses the existing Knowledge of infertile couples regarding infertility

in terms of pre-test knowledge score.

SECTION-C: Knowledge of infertile couples regarding infertility after

administering of the video assisted teaching in terms of post-test knowledge score.

55

SECTION-D: Determination of Effectiveness of video assisted teaching on

knowledge regarding infertility by comparing pre-test and post-test knowledge

score.

SECTION-E: Association between the level of pre-test knowledge score with their


SECTION-A: Analysis of sample characteristics-baseline variables:

Distribution of infertile couples according to age( Fig-1) majority of subjects were in the

age group of 20-24 years, and only few subjects were in the age group of 35 and above.

Distribution of infertile couples to gender( Fig-2) female and male were in equal number

in both groups. Distribution of infertile couples according to education ( Fig-3) shows

that out of 60 subjects only 15 were educated at graduation level and above . Distribution

of infertile couples according to occupation ( Fig-4) shows that out of 60 subjects

majority (75%) were employed. According to duration of treatment distribution of

infertile couples ( Fig-5) out of 60 subjects half of them were taking treatment below one

year, and 14.2 % were taking treatment above one year. Distribution of infertile couples

according to previous knowledge ( Fig-6) 90% of infertile couples had no previous

knowledge on infertility.

56

SECTION-B: Assess the existing Knowledge of infertile couples regarding infertility

in terms of pre-test knowledge score.

From the analysis it was found that among the 60 infertile couples 31(51.7% ) subjects had

inadequate knowledge , 29( 48.3%) had moderate knowledge and the overall mean

knowledge score obtained by the subjects was 18.06 with standard deviation 3.83

regarding knowledge of infertility in pre-test.

SECTION-C: Knowledge of infertile couples regarding infertility after

administering of the video assisted teaching in terms of post-test knowledge score.

In post-test analysis revealed that majority of the subjects 54 (90%) had adequate

knowledge and only 6 (10%) had inadequate knowledge and overall mean knowledge score

obtained by the subjects was 32.24 with standard deviation 2.83 regarding knowledge of

infertility in post-test.

SECTION-D: Determination of Effectiveness of video assisted teaching on

knowledge regarding infertility by comparing pre-test and post-test knowledge

score.

The comparison of pre-test and post-test knowledge regarding infertility revealed that the

calculated‘t’ value of 27.41 which showed high statistical significance at p< 0.5 level.

Hence the research hypotheses state that there will be significant difference in pre and

post-test level of knowledge among infertile couples was retained.

57

SECTION-E: Association between the level of pre-test knowledge score with their


OBJECTIVE-5:- To determine the association between the pre-test knowledge with


H2- There will be a significance association at 0.05 level of significance between the pre-

test knowledge scores with demographic variables at 0.05 level of significance.

Chi-square was used to assess the association between pre-test knowledge and selected

variables such as age, gender, education, occupation, duration of treatment, previous

knowledge and values found was 0.096, 3.91,6.9,12.48,7.82 and 9.74 respectively and

table value found was 5.99,3.84,3.84,9.49,7.82,7.82 respectively hence it is concluded

that there is no association between the baseline variables and knowledge level and

hypothesesH2 is rejected.

There was no association shown between the baseline variables and knowledge scores of

the participants in the study, hence it is concluded that there is no association between the

Knowledge level of the infertile couples with their age, gender, education, occupation,

duration of treatment and previous knowledge. Irrespective of all the baseline

characteristics infertile couples can be trained adequately to gain knowledge regarding

infertility.

58

CONCLUSION:

Analysis of the level of knowledge of infertile couples on infertility shown that in pre-test

that among the 60 subjects, 31(51.7%) subjects had inadequate knowledge and 29 (48.3%)

subjects had moderate knowledge regarding infertility. In post-test among the 60 subjects,

6( 10%) subjects had moderate knowledge and 54 (90%) subjects had adequate

knowledge regarding infertility. These shows there was a significant increase in the

knowledge level in the post-test when compared to pre-test.

Effectiveness of video assisted teaching assessed by doing paired t test. In the pre-test the

mean knowledge score was 18.06 and post-test mean knowledge score was 32.24

respectively. The paired t value calculated was 27.41with a SD of 3.65,the table value

was significant at level of 2.010 level of significance. Hence the hypotheses H1 was

accepted. Therefore it is concluded that there was a significant gain in knowledge

regarding infertility through video assisted teaching among infertile couples.

NURSING IMPLICATION S OF THE STUDY:

The investigator had drawn the following implications from the study which is of vital

concern to the field of nursing service, nursing education, nursing administration and

nursing research and nursing practice.

59

NURSING PRACTICE

The knowledge of infertility is very complex in nature and required to be explored

in all the aspects of phenomena as well as the factors influencing it. The present study was

helpful in identifying the causative factors and treatment modalities of infertility which

will help to design strategies to help the infertile couple face the crisis with confidence

and courage.

The study findings have opened several implications for nursing practice in the

reproductive health area.

Health education is an important function of the health personnel. Nurses as

resource persons working in community settings and hospitals should disseminate the

proper information especially on prevention aspects of infertility.

The infertile couples should be explained about the phases of menstrual cycle, sign

of ovulation and how to plan their sexual intercourse during the period of ovulation.

As most of the couples undergo various investigation and treatment procedures,

proper explanations, pre requisites, preparations required, cost involved and the outcomes

has to be adequately informed to infertile couples by the nurses and chances must be given

to clarify their doubts.

60

NURSING EDUCATION

The nursing curriculum can include video assisted teaching on infertility for better

understanding. The current curriculum in nursing education places much emphasis on

obstetrical care of patients.

The curriculum contains need to be revised their importance is also given care of

infertile couple and the advanced reproductive technologies, recognizing the increased in

the incidence of infertility. As the infertile couples have lack of knowledge regarding

infertility and they are very sensitive. The students must clarify their doubt and knowledge

should be provided.

Change in the people's unhealthy practices. The major goal of the nursing practices

is to import the knowledge and encourage the healthy practices.

The present study assessed the knowledge of infertile couples regarding

infertility .On the basis of findings of the study the following conclusion. The results

reveal that majority (55%) of the subjects had moderately adequate knowledge with

regards to infertility.

The study disclosed that there was a significant association found between the level

of knowledge of infertile couples with their variables.

Education enlightens the darkness of the life through the public awareness, increased

and brings demographic variables such as age, educational status, occupation, duration of

61

Married life, duration of treatment, previous knowledge

NURSING THEORIES:

The conceptual and theoretical models exclusively for the use of reproductive health

nursing practice are yet to be developed by the nursing theorists. The path analysis used to

provide knowledge to infertile couples is presented in the present study in the form of a

conceptual model which can be used to educate and guide the nurses in caring for infertile

couples.

NURSING ADMINISTRATION:

Nurse as an administrator plays an important role in educating the professionals such as

mass health education measures in the community as well as hospitals.

The nurse administrator should formulate policies, protocols, guidelines and systems

of care in collaborations with the multi-disciplinary team

Nurse administrator should take the initiate in organizing in-service and continuing

educational programs and short term courses to prepare the staff nurses get specialized in

caring for infertile couples.

Nurse administrator ensures professional practice which is research based and

which is clinically effective.

Nurse administrator should take into consideration about facilities and supplies of

all resources made available in the library related to infertility.

62

This will help the staff and student to reinforce and enhance their knowledge on

infertility.

NURSING RESEARCH

The essence of research is to build a body of knowledge in nursing. The finding of the

present study serves as the basis for the professional and students to conduct further

studies. Nursing research is the means by which nursing profession is growing.

Nursing research with regard to support of infertile couple is not well developed .Further

research in the area of knowledge regarding infertility among infertile couples are

required to identify specific interventions that would be useful in helping the infertile

couples to achieve their ultimate goal of becoming a parent.

The interventions which will increase marital adjustment, family support and decrease

stress of infertile couples are to be developed, tested through research and

recommended for practice.

Research on nurse's knowledge regarding infertility should be carried out continuously to

assess their knowledge and upgrade their knowledge and practices.

4.The video assisted teaching prgramme can be implemented to the infertile woman and

their families and its effectiveness in reducing the lack of knowledge in infertile woman

can be researched.

63

Discrimination of findings through conference, professional journals and internet

will make application of research findings to be effective.

RECOMMENDATIONS:

The study can be replicated in different settings.

The same study can be done on a larger population for a more valid

generalization.

The knowledge, attitude and practice of reproductive health nurses in

psychological intervention for infertile couples can be studied.

A comparative study can be conducted to evaluate the effectiveness of video

assisted teaching to assess the knowledge of infertile couples.

A similar study can be undertaken by adopting a true experimental design using

structured teaching program to improve the knowledge of infertile couple.

LIMITATIONS:

The study is limited to infertile couples of a hospital and is limited to 60 infertile couples.

64

SUMMARY

The primary aim of the study was to assess the effectiveness of video assisted teaching

regarding knowledge of infertility among infertile couples in selected hospital at

Haryana.

THE OBJECTIVES OF THE STUDY WERE

To assess the pre-test knowledge of infertile couples regarding infertility in select

To assess the post-test knowledge of infertile couples regarding infertility in

selected hospitals.

To compare the pre-test and post knowledge of infertile couples.

To assess the effectiveness of Video Assisted Teaching on knowledge regarding

infertility among infertile couples.

To determine the association between the pre-test knowledge with selected

demographic variables.

The study based on the assumption that:

Most of the infertile couples are not having enough knowledge regarding

infertility.

Participatory care will improve self esteem towards the promotion of health.

The research hypotheses formulated were:

H1: There will be a significant difference between the mean pre-test and mean

post-test knowledge score of infertile couples.

65

H2: There will be a significance association at 0.05 level of significance between

the pre-test knowledge scores with demographic variables of infertile couples.

The review of literature is discussed under 2 sections, infertility and studies related to

video teaching.

Conceptual framework adopted for the study was based on Bertalanffy’s General System

Theory.

The research approach adopted for this study was an evaluative approach. The quasi

experimental design was adopted for the present study and non-probability convenient

sampling technique was used to select the samples. The data was collected from 60

infertile couples by using a structured knowledgeable questionnaire followed by a video.

The content validity of the tool was done by 8 experts. The reliability of the tool was 0.08.

the obtained data was analyzed in terms of objectives and hypotheses using descriptive

and inferential statistics.

Among the 60 infertile couples 31(51.7%) subjects had inadequate knowledge,

29(48.3%) had moderate knowledge and the overall mean knowledge score obtained by the

subjects was 18.06 with standard deviation 3.83 regarding knowledge of infertility in pre-

test. In post-test analysis revealed that majority of the subjects 54 (90%) had adequate

knowledge and only 6 (10%) had inadequate knowledge and overall mean knowledge

score obtained by the subjects was 32.24 with standard deviation 2.83 regarding

66

Knowledge of infertility in post -test.

The comparison of pre-test and post-test knowledge regarding infertility revealed that

the calculated’ value of 27.41 which showed high statistical significance at p< 0.5 level.

Hence the research hypotheses state that there will be significant difference in pre and

post-test level of knowledge among infertile couples was retained. Therefore it is

concluded that there was a significant gain in knowledge regarding infertility through

video assisted teaching among infertile couples.

67

BIBLIOGRAPHY

1) Jessica Evert. Introduction to Infertility. Mental help net [serial online] 2007 Jan 2;

Available from: URL: http://mentalhelp.net

2) D C Dutta. Textbook of gynecology. 4th edition. Kolkata: new central agency; 2007.

212-213

3) US Census Bureau. Statistics by Country for Female infertility. Population Estimates

2004

4) D .Kumar. Prevalence of infertility. Journal of rural and remote health research [serial

online] 2007 May 8; 7. Available from: URL: http ://www.rrh.org.au

Siti Nurani Mohr Nor. New Reproductive Biotechnology Values and Society. Eubios

Journal of Asian and International Bioethics. [serial online] 1999; 9: 166-9. Available

from: URL: http://eubios.info/index.html

5) Kangar. Late marriages impacting demography. Journal of health care system 2009

Nov; 284-290.

6) M.B Wingate. Recent advances in investigation. Can med assoc J. [serial

online]1998Nov1; 43. Available from: URL:http//www.ncbi.nlm.nih.gov/pmc

http://mentalhelp.net/

http://eubios.info/index.html

7) Alice D. Domar. Conquering Infertility Mind/Body Guide to Enhancing Fertility and

Coping With Infertility .Human reproduction [serial online] 2002 Oct; 17(5): 1534-46.

Available From: URL: http://www.helium.com/

68

8) Kangar. Late marriages impacting demography. Journal of health care system

9 .Boivin J, Andersson L, Psychological reaction during in vitro fertilization: similar

response pattern in husbands and wives . J Human Repord. 1998, 13: 3262-3267.

10. Seif D, Albrzi S. The effect of emotional and demographic factors on life- satisfaction

of infertile women. InSfertility and Reproductive J. 2001,66: 71-74.

11. Infertility: Frequently asked question. National’ Women’s Health Information center.

http://www.womenshealth.gov/FAQ.cfm. Accessed April 30, 2009.

12.Brassard M., et al., Basic infertility including polycystic ovary syndrome. Medical

clinics of North America. 2008,,92:1163

13. Shushan A., Eisenberg V.H., Schenker JG. Subfertility in the era of assisted

reproduction: change and consequences, Fertil Steril, 1995, 64:459—469.

14. Crosignani P.G ,Rubin B., Guidelines to the prevelance , diagnosis, treatment and

management of infertility , Hum repord. I996,11: 1775-1807.

http://www.womenshealth.gov/FAQ.cfm.%20Accessed%20April%2030

http://www.helium.com/

15 .John A.C., Ying S., Wilson E.H., Can Med Assoc. J ., vol . 130, February 1, 1984:

269.

69

16. K Jain, G. Radhakrishnan ,P.garwal, Infertility and psychosexual

disorders:Relationship in infertile couples, Indian journal of medical sciences

200054(1)1-7.

17.Jacky Bovin,Laura Buntin, John A. Collins and Karl G.Nygren. Intrnational estimate

of infertility prevalence and treatment seeking : Potential need and demand for infertility

medical care. Human Reproduction 2007 22 (6) 1506-1512.

18. Farhi J,Ben-Haroush A. Distribution of causes of infertility in patients attending

primary fertility clinics in Israel. Isr Med Assoc J , 2011 JAN ;13(1): 51-4.

19. Chachamovich JR, Chachamovich E,Ezer H, Fleck MP, Knauth D,PassosEP.

Investigating quality of life and health related quality of life in infertility. 2010 Jan;

31(2):101-10

20.Kjellberg S, Sydsjo G, Glebe K. Sundelid M. Knowledge of and attitude towards

infertility held by members of two country councils in Sweden. Acta Obstet Gynecol

Scand 2000 Nov; 79 (11) : 1015-20

21.Imeson M, McMurry A. Phenomenological study of couples experiences 1of

infertility . J Adv Nurs 1996 Nov ; 24 (5): 1014-22.

70

22. Benyamini Y, Gozlan M, Kokia E, Women’s and men’s perception of infertility and

their association with psychological adjustment. Br J health psycho 2009 Feb; 14

(pt1):,1-16.

23.Suhrabrand F, Jafasabadi M. Knowledge and attitude of infertile couples assisted

reproductive technology . Iranian Journal of reproductive Medicine 2005;3(2) 90-4.

24.Parazzini F, Treatment for infertility and risk of invasive epitelialcancer Hum Repord

1997:12:2159-2167.

25.World Health Organization;towards more objectivity in diagnosis and management of

fertility .J.Andeol1997;7(suppl):1-53.

26. Zargar AH , Wani AI, Masoodi SR , Laway BA. Epidemiological aspects of primary

infertility in Kashmir. 1997 Oct.

27. Jacobson C., Reproductive genetics center Vienna, Virginia.

28. Skakkebaek N. E., Lancet, June 11, 1994: 1474.

29.Sachita Sahachoudhary, Fertilizing ability of human sperm. The nursing journal of

india 2006 Nov.

30.National Summary and Fertility clinic report, Atlanta:2008.

71

31 World Health Organization, Manual for the standardized investigation and diagnosis

of the infertile couple, Cambridge University Press.U.K, 1993.

32. Howard Jones, New England Journal of Medicine December 2,1993:1710.

33. Baird D., Journal of the, American Medical Association, 1985, 253:2979-8324.

34. Rivard C.I., Journal of the American Medical Association, December 22, 1993.

35. Bogus law, Environmental Health Perspectives 1993, 101(suppl 2):85.

36. Collins J.A., New England Journal of Medicine November 17, 1983.

37. Shushan A., Eisenberg V.H., Schenker JG. Sub fertility in the era of assisted

reproduction: change and consequences, Fertile Steril, 1995, 64:459—469.

38. Nalini B., Shenoy S.K., The Role of Herbal Drugs in Infertile Couples, Obs, &

Gynae., Today, 2003, 8 (5): ,281-287.

39. William J. P., et. Al., Neurobehavioral Toxicology, 1979, 2:1-4.

40. Cooper T.G., Keck C, Oberdieck U, Nieschlag E. Effects of multiple ejaculations

after extended periods of sexual abstinence on total, motile and normal sperm numbers,

as well as accessory gland secretions, from healthy normal and oligozoospermic men.

Hum Reprod, 1993, 89:1251-1258.

72

41. World Health Organisation ;Towards more objective in diagnosis and management of

fertility. J.Andeol 1997:7(suppl):1-53.

42. Iteikkela K, Lansimees E,Hippelainen M, Heinonen S. A suevey of the attitude of

infertile parous women towards the availability of assisted reproductive

technology.International journal of obstetrics 2004 Nov; 111:1229-35

43. Kumarisathya k. A study to determine the effectiveness of video assisted teaching Vs

lecture method on knowledge of newborn assessment,. India 2005.

URL:http://digitoollibrary.megill.ca/R/?func=dbm-,jump-full&objectid=23446&local

base GI:NO1

44. A study to assess the effectivenes of video assisted nursing intervention on

lumbosacral pain and activities of daily living among antenatal primi mother at SRH.

45 Maleki Z.Mahdian M. Assessment of efficacy of a video-assisted teaching programme

on the knowledge of undergraduate students .BMJ 2006 Oct ; 14(5): 682-689.

46 Yoo MS, et.all Video-based self – assessment: Implementation and evaluation in an

undergraduate nursing course. Nurse education today ,2009 Aug ; Volume 29 (6): 585-

590.

73

ANNEXURE-II

INFORMED CONSENT

I understand that I am being asked to participate in research study at Sarvodaya

hospital. This research study will evaluate “The effectiveness of video assisted

teaching programme on knowledge regarding infertility among infertile couple’’

If I agree to participate in the study, I will be attending a knowledge and a video

assisted teaching programme last for 45 minutes followed by a post test.

I realize that the knowledge gained from this study may help either me or other

patients and there are no known risks associated with this study.

I realize that my participation in this study is entirely voluntary, and I may

withdraw from the study at any time I wish. I understand that all study data will be

kept confidential.

The study has been explained to me .I has read and understands this consent

form, all of my questions have been answered, and I agree to participate.

Signature of subject Date

Signature of investigator Date

75

ANNUXRE-III

PART-1 (TOOL)

DEMOGRAPHIC DATA

Name S.NO ----1. Age

a.20 years --- 24 yearsb.25 years --- 29 yearsc.30 years --- 34 years

d.35 years and above

2.Gender a. Maleb. Female

3.Education a. Primary b.Secondary c.Senior secondary.

d.Graduate / post graduate

4. Occupation a Employment

b Unemployment

5.Duration of Treatment a.Below one year

b.One yearc.Above one year

6 Previous Knowledge a.Yes

b.No

76

SECTION –II

INSTRUCTION: Encircle the most appropriate option out of given choices.

1. What do you mean by fertilization?

a. Development of reproductive organ

b.Family planning methods

c.Any disease condition of reproductive organ.

d.Fusion of sperm and ovum

2. Which of the following are main reproductive organs of a female?

a.Kidney, Ureters ,Urethra

b.Vagina ,Ovaries, Fallopian tubes, uterus

c.Stomach, Uterus, Small intestine

d.Ovum, Fallopian tube, Pancreas

3. Which of the following are main reproductive organs of a male?

a.Liver, Gallbladder, Pancreas

b.Kidney, Ureter, Nephron

c.Scrotum, testes, prostate gland, penis

d.ovaries, testes, penis

4. Which of the following causes fertility in males?

a.Ovum

b.Bacteria

c.Sperms

d.Atoms

5. Which of the following causes fertility in female?

a. virus

b. Ovum

77

c. Moleculesd. Atoms

6. Which of the following reproductive organ produce spermatozoon?

a. Liver

b.Scrotum

c.Urethra

d.Fallopian tubes

7. Which female reproductive organ produce ovum?

a. Ovary

b.Uterus

c.Fallopian tubes

d.Liver

8. Which of the following contains sperms?

a.Urine

b.Bile

c. Seminal fluid

d. Acid

9. What is the amount of seminal fluid ejaculated by man after intercourse normally?a.1ml – 3 ml

b.2 m l– 5 ml

c.10 ml – 12 ml

d.40 ml-50 m

10. What is the normal count of sperms in an ejaculated seminal fluid?a.1 million/ mlb.5 million/ mlc.20 million/ mld.50 million/ ml 78

11.What is the age of menarche in a woman?

a.12 – 13 years

b.14 –15 years

c.16 – 17 years

d.18 – 19 years

12. How many times menstrual cycle occur in a month normally?

a.Four times

b.Three times

c.One time

d.Two times

13. What is the duration of menstrual cycle ?

a.1 – 2 days

c.4 – 5 days

d.8 – 9 days

d.10 – 12 days

14. What do you mean by Infertility?

a. Occurrence of menstrual cycle

b. Not birth of a male child after one year of marriage

c.Not development of reproductive organ

d. Failure to conceive within one or more years of regular unprotected sex

15. In which of the following infertility occurs?

a.Only in females

b.Only in males

c.males & females

d.None of the above

79

16. What is the incidence of infertility in male?

a.0 %

b.20%

c.40%

d.60%

17. Which of the following is incidence of infertility in female?

a.40%

b.60%c

c.80%

d.100%

18. Which shows the incidence of infertility in males and females?

a.10 – 20 %

b.30 –40%

c.50 - 60%

d.70 – 80%

19. Which of the following are types of infertility?

a. External, Internal.

b.Primary, secondary, tertiary.

c.Biological, physical.

d.Primary,Secondary, Unexplained

20. What do you mean by primary infertility?

a.No delivery of a male child.

b.Spontaneous miscarriages.

c.Who have never conceived?

d.Use of contraceptives.

80

21. Which of the following is true about secondary infertility?

a.Have twins pregnancy.

b.Have previous pregnancy but failure to conceive subsequently

c.Have not conceived after two years of marriage

d.Have two female child

22. What do you mean by unexplained infertility?

a.Faults in both male and female detected in one year of married life.

b.Couple who have Hormonal deficiency

c.Couples who are infertile with no abnormality detected

d.Couple who have sexually transmitted diseases

23. Which of the following are main cause of infertility in male?

a. Oligospermia, Azoospermia, Impotency

b.Oligospermia, Heamaturia , Impotency

c.Haemrrhoids, Oligospermia,

d.Impotency, Oligospermia, Azoospermia

24. What factor can cause infertility in males ?

a.Working in hot atmosphere

b.Working in cold atmosphere

c.Working in dry atmosphere

d.Working in humid atmosphere

25. Which of the following are main cause of infertility in females ?

a. Anovulation, Blocked fallopian tubes

b.Leucorrhoea, Anovulation

c. Blocked fallopian tubes, Menorrhagia

d . Leucorrhoea, , Menorrhagia

81

26. What disease can cause infertility in females?a.Jaundiceb.Typhoid Fever

c.Chicken Pox

d.Fibroid uterus

27. Which of the following diseases cause infertility in males ?

a.Poliomyelitis

b.Renal calculi

c.Mumps occur in puberty

d.Measles

28. In which conditions sperms are not form in males?

a.Undescended testes

b.Any trauma of testes

c.tumor of testes

d.All of the above

29. What is the main investigation for male infertility?

a.Semen analysis

b.Chest X - ray

c.Stool examination

d.Sputum examination

30. In which conditions testicular biopsy is done?

a.Oligouria

b.Azoospermia

c.High amount of semen

d.Premature ejaculation

82

31. Which of the following female reproductive organs are investigated for infertility?a.Ovaries, fallopian tube, uterus

b.Ovum, Fallopian tube, Uterus

c.Stomach, rectum, vagina

d.lungs, intestine, femur

32. What are the investigations done to identify blocked fallopian tubes?

a.Inflation of fallopian tube

b.Biopsy of fallopian tube

c.MRI of fallopian tubes

d.surgery of fallopian tube

33. Which of the following should be adopted by infertile couples?

a.Avoid wearing of loose undergarments

b.Avoid eating of fresh vegetables

c.Avoid wearing of cotton undergarments

d.Avoid wearing of tight undergarment

34. What is the treatment for blocked fallopian tubes?

a.Through tubal ultrasound

b.Through tubal medicine

c.Through tubal surgery

d.Through tubal radiation

35 Which of the following is the treatment of unexplained infertility?

a.Assisted reproductive therapy

b.Assisted reproductive technology

c.Assisted reproductive treatment

d.Assisted reproductive terminology

83

36. Which statement is true regarding artificial insemination?

a.In this concentrated sperm is injected through a catheter within the uterine cavity

b.In this concentrated drug is injected through a catheter within the uterine cavity

c.In this concentrated dye is injected through a catheter within the uterine cavity

d.In this concentrated ovum is injected through a catheter within the uterine cavity

37. Which of the following is treated by Artificial Insemination Donor?

a.Hypospadiasis

b.Azoospermia

c.Undescended testes

d.Hydrocele

38. Which statement is true regarding artificial insemination donor?

a.Donor should be non-vegetarian and healthy.

b.Donor’s culture, race and religion should be matched with husband.

c.Donor’s family background and native place should be matched with husband.

d.Donor’s blood group, hair, skin & eye color should be matched with husband.

39. Which of the following technology is included in assisted reproductive technology?

a.IVF

b.MRI

c.EEG

d.ECG

40. What do you mean by Surrogacy?a.Child adoptionb.Surrogate motherc.In Vitro Fertilizationd.Twin pregnancy

84

ANSWER KEY

ITEM

NUMBER

ANSWER MARKS

ALLOTED

ITEM

NUMBER

ANSWER MARKS

ALLOTED

1 d 1 21 b 1

2 b 1 22 c 1

3 c 1 23 a 1

4 C 1 24 a 1

5 b 1 25 a 1

6 b 1 26 d 1

7 a 1 27 c 1

8 c 1 28 d 1

9 b 1 29 a 1

10 C 1 30 b 1

11 a 1 31 a 1

12 c 1 32 d 1

13 b 1 33 d 1

14 d 1 34 c 1

15 c 1 35 b 1

16 c 1 36 a 1

17 a 1 37 b 1

18 a 1 38 d 1

19 d 1 39 a 1

20 c 1 40 b 1

92

BLUE PRINT

QUESTION NUMBER

KNOWLEDGE COMPREHENSION ANALYSIS TOTAL,

1 1 1

2 1 1

3 1 1

4 1 1

5 1 1

6 1 1

7 1 1

8 1 1

9 1 1

10 1 1

11 1 1

12 1 1

13 1 1

14 1 1

15 1 1

16 1 1

17 1 1

18 1 1

19 1 1

20 1 1

21 1 1

22 1

93

23 1 1

24 1 1

25 1 1

26 1 1

27 1 1

28 1 1

29 1 1

30 1 1

31 1 1

32 1 1 1

33 1 1

34 1 1

35 1 1

36 1 1

37 1 1

38 1 1

39 1 1

40 1 1

TOTAL 14 6 20 40

PERCENTAGE 35% 15% 50% 100%

94

ANNUXRE-IV

LETTER REQUESTING OPINION AND SUGGESTION OF EXPERTS TO VALIDATE THE TOOL

From:

Ms: Hem kumari

2nd year M.Sc. Nursing

Sophia Nursing college

To,

Through the Principal

Sophia nursing college

Sub: Request for expert opinion and suggestions to establish content validity for research tool.

Respected Sir/Madam,

I Ms. Hem kumari 2nd year M.Sc Nursing (OBG Nursing)student of Sophia Nursing College have selected the following topic for my dissertation to be submitted to Jiwaji University in partial fulfillment for a Master of science in Nursing.

Topic: A study to assess the effectiveness of video-assisted teaching programme knowledge of infertility among infertile couples in selected hospitals of Haryana.

Herewith I have enclosed:

Statement of the problem, objectives of all study and operational definitions

Blue print of the tool

Tool containing baselines Performa, questionnaire

Criteria checks list

I request you to go through the items and give your valuable suggestions and opinion to develop the content validity of the tool. Kindly suggest modification, addition, deletions if any in the remark column.

, Thanking you,

Yours Sincerely,

95

ANNEXURE-V

CERTIFICATES FOR THE CONTENT VALIDITY

This is to certify that the tool developed by Ms Hemkumari M.Sc Nursing student of

Sophia College of Nursing Gwalior (affiliated to Jiwaji University) is validate by me. He

can proceed with this tool and can conduct the main study for dissertation entitled

“The effectiveness of video-assisted teaching programme knowledge of infertility

among infertile couples in selected hospitals of Haryana’’

Date Name

Place Signature

Desiginaton

96

LIST OF TABLES

S.NO TABLES PAGE NO

1 Schematic representation of research design 30

2 Distribution of items according to the content areas based on

tree domains in the blue print

34

3 Distribution of items and percentage of marks according to

the three aspects of area

35

4 Description of baseline variables 42

5 Distribution of knowledge level regarding infertility among

infertile couples in the pre-test

49

6 Distribution of knowledge level regarding infertility among infertile couples in the post-test

49

7 Comparison of mean and standard deviation of knowledge 51

score regarding infertility in pre-test and post-test

8 Paired t test value of pre-test and post-test knowledge score of infertile couples regarding infertility

52

9 Association between the pre-test knowledge score with selected demographic variables of infertile couples

53

XVI

LIST OF FIGURES

S.NO FIGURES PAGE

NO

1 Conceptual framework based on Ludwig Von Betanffy’s

general system theory

12

2 Plan of intervention 33

3 Distribution of subjects based on age in years 43

4 Distribution of subjects according to gender 44

5 Distribution of subjects according to education 45

6 Distribution of subjects according to occupation 46

7 Distribution of subjects according to duration of treatment 47

8 Distribution of subjects according to previous knowledge 48

9 Distribution of knowledge level regarding infertility

among infertile couples in pre-test and post-test

50

XVII

ANNUXRE-VI

Criteria for validation of questionnaire on knowledge regarding on infertility

among infertile couples

Kindly go through the items in the structured knowledge questionnaire regarding

accuracy, relevancy, and appropriateness of content. There are 4 response columns in the

scale, namely Not relevant, Somewhat relevant, Quite relevant, Highly relevant. Place a

tick mark ( ) in the specific column. If you disagree to any of the items place your

comments in the remark column.

Rating scale for base line variables

Item No Not relevant Somewhat relevant

Quite relevant

Highly relevant

Remarks

1234

56

Rating scale for knowledge questionnaire

Questionnaire on knowledge regarding infertilityItem No Not relevant Somewhat

relevantQuite relevant

Highly relevant

Remarks

1

2

3

4

97 56789101112131415161718192021222324

25262728293031323334353637383940 98

ANNUXRE- VII

LIST OF EXPERTS

1. Dr. Anjali Gupta

Sarvodaya Hospital

Faridabad

2. Dr. Seema Sharma

Sarvodaya Hospital

Faridabad

3. Dr. Manju Goyal

Sarvodaya Hospital

Faridabad

4. Mrs. Vishnupriya.K

Principal


Gwalior

5. Mrs. Vishnupriya.K

Associate Professor


Gwalior

99

6. Mrs. Vijaylaxmi

Principal

Lingaya’s Nursing College

Faridabad

.

7. Mrs. Manju Rajput

Associate professor

Florence Nursing College

Faridabad

.

8. Mrs. Lily basu

Associate professor

Ahilya Bai Nursing College

Delhi

100

LIST OF ANNUXRES

S.No ANNUXRES PAGE No

1 Permission letter for conducting the research study

2 Informed consent

3 Tool

Part-I Baseline variables

Part-II Knowledge questionnaire on infertility

4 Letter requesting opinion and suggestion of experts to validate the

tool

5 Certificate for the content validity

6 Criteria for validation of questionnaire

7 List of experts

8 Structured teaching program on Infertility

XVIII

“ A STUDY TO ASSESS THE EFFECTIVENESS OF VIDEO ASSISTED TEACHING ON KNOWLEDGE REGARDING INFERTILITY AMONG INFERTILE COUPLES IN SELECTED HOSPITALS AT HARYANA’’

BY

Ms. HEMKUMARI

Dissertation submitted to

Jiwaji University Gwalior Madhya Pradesh

In partial fulfillment of the requirement for the degree of

MASTER OF SCIENCE

In

OBSTETRIC AND GYNAECOLOGICAL NURSING

Under the guidance of

MRS. VISHNUPRIYA.K

PRINCIPAL

SOPHIA NURSING COLLEGE GWALIOR MADHYA PRADESH

I

Health & Medicine

Thesis97