early ambulation

1. DESERTATION
PRESENTATION
PRESENTED BY
DIMPLE
OBSTETRICS AND GYNECOLOGICAL NURSING

2. STATEMENT OF PROBLEM
“A study to assess the effect of educational intervention on knowledge
and attitude regarding prevention cervical cancer among women at
selected hospitals Hisar.”

3. OBJECTIVES OF THE STUDY
1.To assess the knowledge and attitude regarding the prevention of cervical cancer among
women in experimental and control group.
2.To determine the effectiveness of educational intervention on prevention of cervical
cancer among women in experimental group
3.To compare the post test level of knowledge and attitude score on prevention of cervical
cancer among women in experimental and control group.
4.To correlate the Pre test and Post test knowledge and attitude score on prevention of
cervical cancer among women in experimental and control group.
5.To associate the post test knowledge and attitude on prevention of cervical cancer with
their selected demographic variables in experimental and control group.

4. INTRODUCTION
“Bravery Is Not The Absence Of Fear But Action In The Face Of Fear.”
‘Mark Messier’
Cancer affects everyone the young, old, rich, poor, men, women and children and
represents a tremendous burden to patients, families and societies. Yet many of these deaths
can be avoided if detected early and treated promptly. Cancer is a group of diseases
characterized by the uncontrolled growth and spread of abnormal cells. If the spread is not
controlled, it can result in death. Cervical cancer is one of the leading causes of cancer in
women worldwide. One way by which the incidence of this malignant disease can be
minimized is by imparting knowledge through health education.

5. NEED FOR STUDY
On a global brand, breast cancer and cervical cancer are the two most common female
malignancies. Cervical cancer is a second most common type in women worldwide after
breast cancer. The incidence of cervical cancer is on the higher side in the developing
nations as compared to the developed countries ( Capalash N. et.al., 2010)
Every year cervical cancer is diagnosed in about 5,00,000 women globally and is
responsible for more than 2,80,000 death annually. There is a wide variation in the
incidence of cervical cancer across the globe. In the last 8 years in the United States, the
pap smear test have reduced the deaths related to cervical cancer by three-quarters.

6. RESEARCH HYPOTHESIS:
• H1: There will be a significant difference between pre and post test knowledge and
attitude score on prevention of cervical cancer among women in experimental and
control group.
• H2: There will be a significant correlation between Knowledge and attitude on
cervical cancer among women in experimental and control group.
• H3: There will be a significant association between the knowledge on prevention of
cervical cancer and demographic variables among women.
• H4: There will be a significant association between the attitude on prevention of
cervical cancer and demographic variables among women.

7. ASSUMPTION
• 1. It is assumed that women may have inadequate information on prevention of
cervical cancer.
• 2. Women would be co-operative and willing to express their knowledge
regarding prevention of cervical cancer.

8. Perception
-Learning need of
prevention of cervical
cancer
Interaction
-Administration of
knowledge questionnaire and
rating scale.
-Educational intervention
-Administration of same
questionnaire and rating scale
schedule on the 7th day.
Action
-Preparation of
questionnaire and
rating scale
-Preparation of
educational
intervention
-Validity
-Plan for
administration of
intervention
Transaction
Women will improve
knowledge and attitude
regarding prevention of
cervical cancer
- Women had no
improvement in knowledge
and attitude regarding
prevention of cervical
cancer
Investigator
Mutual goal setting to
improve knowledge and
attitude regarding
prevention of cervical
cancer
Interaction
-Respond to knowledge
questionnaire and rating scale
by answering the question.
-Participating Health teaching on
prevention of cervical cancer
-Respond to self reported
questions and rating scale on 7th
day.
Perception
-Lack of knowledge
and attitude regarding
prevention of cervical
cancer.
Action
-Consent
-Corporation of
women
-Acceptance of
suggestion
Women
Feedback
Fig-1 Conceptual framework on effect of educational intervention on knowledge and attitude regarding prevention cervical cancer among women based
on Imogene King’s goal attainment theory
Feedback

9. REVIEW OF LITERATURE
Review of literature in this study is organized under the following headings-
• 1. Review of literature related to incidence of cervical cancer.
• 2. Review of literature related to knowledge on cervical cancer.
• 3. Review of literature related to knowledge and attitude on cervical cancer.
• 4. Review of literature related to cervical cancer screening.

10. RESEARCH METHODOLOGY RESEARCH DESIGN: Quasi- experimental
TARGET POPULATION
Women
ACCESSIBLE POPULATION
Women of age 21-60 years visiting in Jindal Institute of Medical
Sciences and Aadhar Health Institute at Hisar
SAMPLING TECHNIQUE: Convenient sampling
SAMPLE SIZE: 80
EXPERIMENTAL
GROUP (40)
CONTROL
GROUP (40)
PRETEST PRETEST
INTERVENTION NO INTERVENTION
ANALYSIS AND INTERPRETATION POST TEST

11. PILOT STUDY
• Pilot study was conducted to find out the reliability of the tool and feasibility
of conducting the study. Study was conducted for a period of one week from
12.4.2022 to 19.4.2022 at Jindal Institute of Medical Sciences and Aadhar
Health Institute at Hisar. Study was conducted with 8 samples. The sample
who met inclusion and exclusion criteria was selected by using convenient
sampling technique. Informed consent was obtained from each person. The
administration of the tool and intervention through education programme
were implemented for 30 minutes. Practicability of the tool was checked to
conduct the main study.

12. METHOD OF DATAANALYSIS
• The data was analyzed in terms of the objectives of the study using descriptive and
inferential statistics. The plan of data analysis was follows.
Organize the data in a master data sheet.
Frequency and percentage distribution were used to analyze the demographic
variable of women.
Frequency and percentage distribution were used to assess the level of knowledge
and attitude of women.
Mean, percentage, standard deviation, paired and unpaired ‘t’ were used to assess
and compare the pretest and posttest knowledge and attitude.
Karl Pearson correlation coefficient and chi square test also were used to analyze
correlation and association of the data.

13. ORGANIZATI ON OF FINDINGS
• Section-I Frequency and percentage distribution of demographic variables of women
• Section-II Frequency and percentage distribution of level of knowledge and attitude regarding prevention cervical cancer among women
• Part-1 Frequency and percentage distribution of pretest and posttest level of knowledge regarding prevention cervical cancer among women
• Part-2 Frequency and percentage distribution of pretest and posttest level of attitude regarding prevention cervical cancer among women
• Section-III Comparison of level of knowledge before and after educational intervention in experimental and control group of women using
paired ‘t’ test.
• Section-IV Comparison of post test level of knowledge in experimental and control group of women using Unpaired ‘t’ test.
• Section-V Comparison of attitude before and after educational intervention in experimental and control group of women using paired ‘t’
test.
• Section-VI Comparison of posttest attitude in experimental and control group of women using Unpaired ‘t’ test.
• Section-VII Correlation between level of knowledge and attitude regarding prevention cervical cancer among women in experimental and
control groups
• Section-VIII Association between selected demographic variables and posttest level of knowledge of women regarding prevention of
cervical cancer in experimental and control group
• Section-IX Association between selected demographic variables and posttest attitude of women regarding prevention of cervical cancer in
experimental and control group

14. Section-I
Frequency and percentage distribution of demographic variables of women
Demographic variables Experimental group (N=40) Control group (N=40)
F % F %
1. Age
a) 21-30 years 10 25% 11 27.5%
b) 31-40 years 14 35% 16 40%
c) 41-50 years 11 27.5% 9 22.5%
d) 51-60 years 5 12.5% 4 10%
2. Education
a) Primary education 1 2.5% 1 2.5%
b) School education 2 5% 5 12.5%
c) Graduation 29 72.5% 27 67.5%
d) Post-graduation 8 20% 7 17.5%
3. Marital status
a) Married 40 100% 40 100%
b) Divorced 0 0% 0 0%
c) Widow 0 0% 0 0%
4. Age at menarche
a) 10-12 years 2 5% 4 10%
b) 13-15 years 32 80% 29 72.5%

15. Cont….
5. Age at marriage
a) 18-20 years 4 10% 5 12.5%
b) 21-25 years 25 62.5% 22 55%
c) Above 25 years 11 27.5% 13 32.5%
6. Work type
a) Heavy 2 5% 3 7.5%
b) Moderate 5 12.5% 7 17.5%
c) Sedentary 33 82.5% 30 75%
7. No of children
a) 1 6 15% 12 30%
b) 2 31 77.5% 25 62.5%
c) 3 and above 2 5% 3 7.5%

16. Section-II
Part-1
Frequency and percentage distribution of pretest and posttest level of knowledge regarding
prevention cervical cancer among women
Level of
knowledge
Experimental group (N=40) Control group (N=40)
Pre test Post test Pre test Post test
F % F % F % F %
Inadequate 17 42.5% 1 2.5% 24 60% 10 25%
Moderate 23 57.5% 11 22% 16 40% 30 75%
Adequate 0 0% 28 70% 0 0% 0 0%
In experimental group, pre test majority (57.5%) of women had moderate knowledge, 42.5% had inadequate
knowledge and no one had adequate knowledge regarding cervical cancer. In post test 70% women had adequate
knowledge and 22% had moderate knowledge and 2.5% had inadequate knowledge.
In control group, pre test majority 60% had inadequate knowledge, 40% had moderate knowledge and 0% had
adequate knowledge. In post test 75% had moderate knowledge, 25% had inadequate knowledge and 0% had
adequate knowledge regarding cervical cancer.

17. Part-2
Frequency and percentage distribution of pretest and posttest level of attitude regarding prevention
cervical cancer among women
Level of
attitude
Experimental group (N=40) Control group (N=40)
Pre test Post test Pre test Post test
F % F % F % F %
Negative 4 10% 0 0% 3 7.5% 10 25%
Neutral 20 50% 9 22.5% 35 87.5% 30 75%
Positive 16 40% 31 77.5% 2 5% 0 0%
In experimental group, during pre test majority 50% of women had neutral attitude, 40% had positive attitude
and 10% had negative attitude regarding prevention of cervical cancer. During post test 77.5% women had
positive attitude and 22.5% had neutral attitude regarding prevention of cervical cancer.
In control group, during pre test majority 87.5% of women had neutral attitude, 7.5% had negative attitude
and 5% had positive attitude regarding prevention of cervical cancer. During post test 75% women had neutral
attitude and 25% had negative attitude regarding prevention of cervical cancer.

18. Section-III
Comparison of level of knowledge before and after educational intervention in experimental
and control group of women using paired ‘t’ test.
Group Pre-test Post-test Mean
difference
‘t’-value
Mean SD Mean SD
Experimental
group
13.65 3.07 20.5 2.69 6.85 14.56**
Control group 12.95 2.72 14.68 2.45 1.75 4.43**
***- P<0.001, Highly significant
H1: There will be a significant difference between pre and post test knowledge and attitude score on prevention of cervical cancer
among women in experimental and control group.
In experimental group, posttest mean score (20.5) of knowledge with SD 2.69 was higher than pre test mean score 13.65 of
knowledge with SD 3.07 having a mean difference of 6.85. The calculated ‘t’ value 14.56 was higher than the tabulated ‘t’ value at
df 39, and p<0.001.
In control group, posttest mean score (14.68) of knowledge with SD 2.45 was higher than pre test mean score 12.95 of
knowledge with SD 2.72 having a mean difference of 1.75. The calculated ‘t’ value 4.43 was higher than the table value at df 39,
and p<0.001.
Hence, hypothesis H1 was accepted.

19. Section-IV
Comparison of post test level of knowledge in experimental and control group of women using
Unpaired ‘t’ test.
20.5
2.69
14.68
2.45
0
5
10
15
20
25
Mean SD
Comparision of posttest Knowledge
Experimental group
Control group
In experimental group, posttest mean score (20.5) of knowledge with SD 2.69 was higher than
control group, posttest mean score (14.68) of knowledge with SD 2.45 having a mean
difference of 5.825. The calculated ‘t’ value 10.10 was higher than tabulated ‘t’ value at df-79
and p<0.001.

20. Section-V
Comparison of attitude before and after educational intervention in experimental and control group
of women using paired ‘t’ test.
Group Pre-test Post-test Mean
difference
‘t’-value
mean SD Mean SD
Experimental
group
47.50 10.7 55.1 6.94 7.6 5.46**
Control group 45.53 6.95 47.1 7.21 1.57 4.95**
H1: There will be a significant difference between pre and post test knowledge and attitude score on
prevention of cervical cancer among women in experimental and control group.
In experimental group, posttest mean score (55.1) of attitude with SD 6.94 was higher than pre test mean
score 47.50 of attitude with SD 10.7 having a mean difference of 7.6. The calculated ‘t’ value 5.46 was
higher than the tabulated ‘t’ value at df 39, and p<0.001.
In experimental group, posttest mean score (47.1) of attitude with SD 7.21 was higher than pre test
mean score 45.53 of attitude with SD 6.95 having a mean difference of 1.57. The calculated ‘t’ value
4.95 was higher than the table value at df 39, and p<0.001. hence Hypothesis H1 was accepted.

21. Section-VI
Comparison of posttest attitude in experimental and control group of women using Unpaired ‘t’ test.
In experimental group, posttest mean score (55.1) of attitude with SD 6.94 was higher
than control group, posttest mean score (47.1) of attitude with SD 7.21 having a mean
difference of 12.275. The calculated ‘t’ 7.75 value was higher than the tabulated ‘t’ value
at df 79 and p<0.001.
55.1
6.94
47.1
7.21
0
10
20
30
40
50
60
Mean SD
Comparision of posttest attitude
Experimental group
Control group

22. Section-VII
Correlation between level of knowledge and attitude regarding prevention cervical cancer
among women in experimental and control groups
Group ‘r’ Value (Correlation)
Experimental group
Pre-test knowledge and attitude -0.103
Post-test knowledge and attitude 0.414**
Control group
Pre-test knowledge and attitude 0.131
Post-test knowledge and attitude 0.157
H2: There will be a significant correlation between Knowledge and attitude on cervical cancer among women
in experimental and control group.
The above table revealed that, in experimental group there was a correlation (r=0.414) between posttest
level of knowledge and level of attitude at P<0.001. It was inferred that there was a positive correlation
between posttest knowledge and attitude of prevention of cervical cancer. Hence, hypothesis H2 was accepted.

23. Section-VIII
Association between selected demographic variables and posttest level of knowledge of
women regarding prevention of cervical cancer in experimental and control group
• H3: There will be a significant association between the knowledge on prevention of cervical cancer
and demographic variables among women.
• In experimental group association of post test level of knowledge score with selected demographical
variables. The variables such as age, marital status, age at menarche, age at marriage, occupation, and
number of children does not show any association with posttest knowledge scores. There was a
significant association of selected demographic variables such as education with posttest knowledge
score scores. So, the hypothesis (H3) was accepted.
• In control group association of post test level of knowledge score with selected demographical
variables. The variables such as age, education, marital status, age at menarche, age at marriage,
occupation, and number of children does not show any association with posttest knowledge scores.
So, the hypothesis (H3) was rejected.

24. Section-IX
Association between selected demographic variables and posttest attitude of women
regarding prevention of cervical cancer in experimental and control group
• H4: There will be a significant association between the attitude on prevention of cervical
cancer and demographic variables among women.
• In experimental group association of post test level of knowledge score with selected
demographical variables. The variables such as education, marital status, age at menarche,
age at marriage, occupation, and number of children does not show any association with
posttest knowledge scores. There was a significant association of selected demographic
variables such as age with posttest knowledge score scores. So, the hypothesis (H4) was
accepted.
• In control group association of post test level of knowledge score with selected
demographical variables. The variables such as age, education, marital status, age at
menarche, age at marriage, occupation, and number of children does not show any
association with posttest knowledge scores. So, the hypothesis (H4) was rejected.

25. DISCUSSION
This chapter deals with the discussion of the findings of present study in accordance with the
objectives of the research problem. The findings of the study have been discussed with reference to
the results in experimental group, posttest mean score (55.1) of attitude with SD 6.94 was higher
than pre test mean score 47.50 of attitude with SD 10.7 having a mean difference of 7.6. The
calculated ‘t’ value 5.46 was higher than the tabulated ‘t’ value at df 39, and p<0.001. In
experimental group, posttest mean score (47.1) of attitude with SD 7.21 was higher than pre test
mean score 45.53 of attitude with SD 6.95 having a mean difference of 1.57. The calculated ‘t’ value
4.95 was higher than the table value at df 39, and p<0.001. Hence Hypothesis H1 was accepted.
In experimental group there was a correlation (r=0.414) between posttest level of knowledge and
level of attitude at P<0.001. It was inferred that there was a positive correlation between posttest
knowledge and attitude of prevention of cervical cancer. Hence, hypothesis H2 was accepted.

26. CONCLUSION
 In the present study in experimental group, pre test majority (57.5%) of women had moderate knowledge,
42.5% had inadequate knowledge and no one had adequate knowledge regarding cervical cancer. In post test
70% women had adequate knowledge and 22% had moderate knowledge and 2.5% had inadequate
knowledge. In control group, pre test majority 60% had inadequate knowledge, 40% had moderate
knowledge and 0% had adequate knowledge. In post test 75% had moderate knowledge, 25% had inadequate
knowledge and 0% had adequate knowledge regarding cervical cancer.
 In experimental group, during pre test majority 50% of women had neutral attitude, 40% had positive attitude
and 10% had negative attitude regarding prevention of cervical cancer. During post test 77.5% women had
positive attitude and 22.5% had neutral attitude regarding prevention of cervical cancer. In control group,
during pre test majority 87.5% of women had neutral attitude, 7.5% had negative attitude and 5% had
positive attitude regarding prevention of cervical cancer. During post test 75% women had neutral attitude
and 25% had negative attitude regarding prevention of cervical cancer.

27. SUMMARY
The study design consisted of an evaluative approach with one group pre test and post test control group design. Study was conducted at
Jindal Institute of Medical Sciences and Aadhar Health Institute at Hisar. Study was conducted with 80 samples. The sample who met
inclusion and exclusion criteria was selected by using convenient sampling technique. Informed consent was obtained from each person. The
administration of the tool and intervention through education programme were implemented for 30 minutes. Practicability of the tool was
checked to conduct the main study.
Findings of the main study-
In experimental group, posttest mean score (20.5) of knowledge with SD 2.69 was higher than control group, posttest mean score
(14.68) of knowledge with SD 2.45 having a mean difference of 5.825. The calculated ‘t’ value 10.10 was higher than tabulated ‘t’ value at
df-79 and p<0.001.
In experimental group, posttest mean score (55.1) of attitude with SD 6.94 was higher than control group, posttest mean score (47.1) of
attitude with SD 7.21 having a mean difference of 12.275. The calculated ‘t’ 7.75 value was higher than the tabulated ‘t’ value at df 79 and
p<0.001.
In experimental group there was a correlation (r=0.414) between posttest level of knowledge and level of attitude at P<0.001. It was
inferred that there was a positive correlation between posttest knowledge and attitude of prevention of cervical cancer. Hence, hypothesis H2
was accepted.

28. RECOMMENDATION
1. A similar study can be conducted in large group of women.
2. A longer period of intervention can be used studied for more
reliability and effectiveness.
3. A true experimental study with experimental and control groups
can be conducted.

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