Kgmu Thesis 19.06 PDF

“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND
ITS MANAGEMENT AMONG ADOLESCENT GIRLS IN SELECTED
SCHOOL OF LUCKNOW WITH A VIEW TO DEVELOP AN
INFORMATION BOOKLET, LUCKNOW U. P.”
BY
YASHIKA MISHRA
Dissertation submitted to the
King George’s Medical University
Lucknow, Uttar Pradesh
In partial fulfillment of the requirement for the degree of
MASTER OF SCIENCE
In
CHILD HEALTH NURSING
UNDER THE GUIDANCE OF
Mrs. Rina Kumari
(CON- KGMU)
Department of Child Health Nursing
Vivekananda College Of Nursing
Lucknow
2019
King George’s Medical University, Lucknow, Uttar Pradesh

DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation/thesis titled “A study to assess the

knowledge regarding anemia and its management among adolescent girls in
selected school of Lucknow with a view to develop an information booklet,
Lucknow, U.P.” is a bonafide and genuine research work carried out by me under the
guidance of Mrs. Rina Kumari, Faculty of Nursing K.G.M.U, Department of
Child Health Nursing.
Date: Signature of the Candidate
Place: Lucknow
i
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A study to assess the

selected school of Lucknow with a view to develop an information booklet
Lucknow U.P.” is a bonafide research work done by Mrs. Yashika Mishra in partial
fulfillment of the requirement for the degree of Master of Science in Nursing
(Department of Child Health Nursing).
Co-Guide Signature of the Guide
Mrs. Anjali Chaturvedi Mrs. Rina Kumari
Department of Child Health Nursing Faculty of Nursing, KGMU
Vivekananda College of Nursing Department of Child Health Nursing
Lucknow College of Nursing, KGMU
K.G.M.U
Date:
Place:
ii
ENDORSEMENT BY THE HOD/PRINCIPAL
This is to certify that the dissertation entitled “A study to assess the

selected school of Lucknow with a view to develop an information booklet
Lucknow U.P.” is a bonafide research work done by Mrs. Yashika Mishra under the
guidance of Mrs. Rina Kumari, Faculty of Nursing, KGMU, Department of Child
Health Nursing and Co-guidance of Mrs. Anjali Chaturvedi, Department of
Child Health Nursing, Vivekananda College of Nursing.
Seal and signature of the Principal
Prof. Chandini Tiagi
Principal
Community Health Nursing
Vivekananda College of Nursing
Lucknow
Date:
Place:
©King George Medical University, Lucknow
iii
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that Vivekananda College of nursing affiliated to king George

medical university, Lucknow shall have the rights to preserve, use and disseminate
this dissertation in print or electronic format for academic/research purpose.
Date: Signature of the Candidate
Place:
©King George Medical University, Lucknow

iv
ACKNOWLEDGEMENT
“Acknowledgement and celebration are essential to fueling passion, making people

feel valid and valuable and giving the team a real sense of progress that makes it all
worthwhile”
-Dwight Frindt
Any piece of work that has proved its way remains incomplete if the sense of
gratitude and respect is not being deemed to those who have proved to be supportive
during its development period. Though these words are not enough, they can at least
pave way to help understanding the feeling of respect and admirance. I have for those
helped the way through.
Foremost, I express my gratitude to almighty God, the God creator of Heaven and
Earth for this abundant blessing and grace throughout the study.
I would like to acknowledge and thank the following people who have supported me,
not during the course of this thesis, but throughout my master’s degree.
I express my gratitude and heartiest thanks to reverend Swami Muktinathnanda Ji
Maharaj, Secretary, Vivekananda Polyclinic and Institute of Medical Sciences for
giving me an opportunity to undertake this research.
It is my pleasure and privilege to express deepest appreciation towards Prof. Mrs.
Chandini Tiagi, Principal, Vivekananda College of Nursing for allowing me to take
this opportunity and extending support to accomplish this research project. Not only
that, she is my mentor and heartfelt thanks for her encouragement, timely support and
assistance rendered throughout this research project.
My respectable gratitude to Professor R. Sutha, Vice Principal, Vivekananda College
of Nursing for infusing confidence through her encouragement and inspiring guidance
and valuable suggestions during the course of my work.
This study has been conducted under the expert guidance and supervision of Guide
Mrs. Rina Kumari, Faculty of Nursing KGMU. Department of Child Health
Nursing. I express my deep sense of gratitude for her continuous guidance, support,
elating encouragement and constructive criticism throughout this research study. Her
prompt inspirations, timely suggestions, enthusiasm and dynamism have enabled me
to complete my thesis. In fact, words cannot express my gratitude towards her.
v
I am extremely grateful to my Co-guide Mrs. Anjali Chaturvedi, Department of
Child Health Nursing, Vivekananda College of Nursing for timely guidance with
kindness, valuable ideas and suggestion and encouragement to leave the research
work successfully.
My sincere thanks to Dr. Neeta Bhargava, Dr. Niranjan and Dr. Puneet for their
constant encouragement, productive guidance, and timely help during the research
work.
It gives me great pleasure to thank all my M.Sc. (N) faculty of Vivekananda College
of Nursing, for their constant inspiration, guidance and encouragement for the
completion of this study.
I express my sincere thanks to all the experts for giving their precious time in
validating my tool and content. There valuable suggestions were successfully
incorporated in my research study.
I express my gratitude to Mr. Manoj Pandey statistician for his support, guidance in
connecting with analysis of data.
I extend my gratitude to the Principal, Shia girls college, Lucknow for granting me
permission to conduct the study.
I extend my sincere thanks to all students of Shia girls college, Lucknow for their
cooperation and support during the period of data collection.
I express my deep gratitude to Librarian Mr. Vinay Asthana and Mrs. Shilpi Mishra,
Assistant Librarian, for helping me through invaluable treasures and providing library
facilities.
I extend my heartfelt thanks to my family members my father Mr. Surendra Mishra,
my mother Mrs. Rajeshwari Mishra, my sisters and my brother for their immense
support, blessings and prayer.
I express my gratitude to my husband Mr. Naynish Pandey for his support, guidance
in connecting with the analysis of data.
I thankful to all my classmates for making me successful in all encounters and
difficulties faced during the study.
With a grateful heart.....
MS. YASHIKA MISHRA
Date:
Place: Lucknow
vi
LIST OF ABBREVIATIONS
df: Degree of freedom

et.al: And others
n: Number of samples
Η0 : Null Hypothesis
H1 : Research Hypothesis
χ2: Chi square
p Value: Level of Significance
<: Less than
>: Greater than
%: Percentage.
DV: Demographic Variables
vii
RESEARCH ABSTRACT
STATEMENT OF PROBLEM
“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND

ITS MANAGEMENT AMONG ADOLESCENT GIRLS IN SELECTED
SCHOOLS OF LUCKNOW WITH A VIEW TO DEVELOP AN
INFORMATION BOOKLET LUCKNOW U.P."
Ms. Yashika Mishra* Mrs. Rina Kumari** Mrs. Anjali Chaturvedi***
*M.Sc. (N) II Year student, **Faculty of Nursing, ***Department of Child Health

Nursing
Background- Adolescence is a critical stage in the life cycle, when the health of
females is affected due to growth spurt, beginning of menstruation, poor intake of iron
due to poor dietary habits and gender bias. Iron deficiency anemia affects over 60%
of the adolescent girls in India. Anemia in adolescent girls has far-reaching
implications. The anemic adolescent girls grow into adult women with compromised
growth, both physical and mental. These women have low pre-pregnancy weight and
are more likely to die during childbirth and deliver low birth weight babies.
Objectives –The main objective was to assess the existing level of knowledge regarding
anemia and its management among adolescent girls. Method- A quantitative
research approach and a non-experimental descriptive research design was used. The
sample size of 135 adolescent girls were selected by using non-probability
convenience sampling technique. Initially the investigator got permission from
concerned authority of Shia girls College Lucknow. The written consent was obtained
from sample. The tools used were, Performa of demographic variables, structured
knowledge questionnaire. Assessment of preexisting level of knowledge done by
administering structured knowledge questionnaire after that information booklet was
distributed. Result- The result of the study revealed that there was majority of the
48.9% sample subjects had inadequate level of knowledge, 32.6% had moderate level
of knowledge and 18.5% had adequate level of knowledge. Conclusion- The study
concluded that adolescent girls have inadequate knowledge regarding anemia and its
management among adolescent girls and there is a strong need to improve the
knowledge level of adolescent girls regarding anemia and its management.
viii
Keywords- Anemia and its management, information booklet, anatomy and
physiology of blood.
“A study to assess the knowledge regarding anemia and its management among
adolescent girls in selected schools of Lucknow with a view to develop an
information booklet, Lucknow U.P.”
OBJECTIVES
1. To assess the existing level of knowledge regarding anemia and its management
among adolescent girls.
2. To find out the association between level of knowledge scores among adolescent
girls with their selected Socio demographic variables.
3. To develop and distribute information booklet regarding anemia and its
management.
RESEARCH HYPOTHESIS
H1- There is a significant association between level of knowledge scores

regarding anemia and its management among adolescent girls with their selected
socio demographic variables.
CONCEPTUAL FRAME WORK
The conceptual framework of the study was based on the Pender’s Health
Promotion Model 2008. The major components were Individual characteristics
and experiences, Behavior- specific cognitions and affect, Behavioral outcomes
and it provided the comprehensive framework for achieving the objectives of the
study.
ix
RESEARCH METHODOLGY
A quantitative research approach and a non-experimental descriptive research

design was used. The total sample size of 135 adolescent girls were selected by
using non-probability convenience sampling technique. Initially the investigator
got permission from concerned authority of Shia girls College Lucknow. The
written consent was obtained from sample. The tools used were, Performa of
demographic variables, self-structured questionnaire. Assessment of preexisting
level of knowledge done by administering structured knowledge questionnaire
after that information booklet was distributed.
MAJOR FINDINGS
1. Majority of subjects were in the age group of 15-16 years (54.81%) followed
by 17-18 years (40.75%) and only (4.44%) were in the age group of 19 - 20
years and no any adolescent girl belongs from above 20 years.
2. Majority of the sample subjects were in the 11th standard (83%) and only
(17%) sample subjects belongs to 12th standard respectively.
3. Majority of the sample subjects were Muslim (91.9%) followed by Hindu
(7.4%) and only (0.7%) belongs to other religion which belongs from
Christion religion.
4. Majority of the family belongs from joint family (62.2%) followed by nuclear
family (28.9%) and only (8.9%) belongs to extended family.
5. Majority of family income per month belongs from 10,000- 15000 (86.7%)
and (8.1%) were having monthly income 15,001-20,000 and (3.7%) were
having monthly income 20,001-25000 and 30001 only (1.5%) belongs from
monthly income 30001 and above.
6. Majority of sample subjects (77.78%) had previous information regarding
anemia and only (22.22%) samples had not previous information regarding
anemia. Among (78.00%) samples subjects who had previous information
regarding anemia in which (34.1%)had information from family members,
(31.1%) had information from books and articles, (10.4%) had information
from colleagues and only (2.2%) had information from mass media.
x
7. Majority of sample subjects (65.2%) had regular menstrual cycle, (25.9%) had
irregular menstrual cycle and only (8.9%) had heavy bleeding in their
menstrual cycle.
8. Majority of the sample subjects (64.4%) were having non-vegetarian dietary
pattern and rest (35.6%) were belongs from vegetarian dietary pattern.
9. Majority of samples (63.00%) were unhealthy and only (37.00%) were
healthy. Among (63.00%) sample subjects who were unhealthy in which
(31.9%) had anemia, (18.5%) had diabetes, (9.6%) had high blood pressure
and only (3.0%) had jaundice.
LIMITATION
The limitations of the study were -
 The sample size was limited to 135 only.

 Sample subjects were only selected from Shia PG girl’s college Lucknow.
 Some of the student was not co-operative and refused to participate in the
research study.
CONCLUSION
The overall finding of the study clearly shows that there was an inadequate level of
knowledge regarding anemia and its management among adolescent girls. Thus, a
strong need is to improve the level of knowledge of adolescent girls. Therefore, the
investigator distributed information booklet without any post intervention so as to
disseminate the information regarding anemia and its management.
xi
TABLE OF CONTENT
CHAPTER CONTENT PAGE NO.

I INTRODUCTION
Background of the study 1-8
Need for the study 9-11
II OBJECTIVES
Statement of the problem 12
Objectives 12
Hypothesis 12
Operational definition 12-13
Assumptions 13
Delimitations 14
Conceptual framework 15-20
III REVIEWS OF LITERATUTE 21-33
IV METHODOLOGY
Research approach 34
Research design 35-36
Variables 37
Research setting 37
Population and sample 38
Sampling size 39
Sampling technique 39
Criteria for sample selection 39
Description of tools 40
Reliability and validity 43
Ethical clearance 43
Pilot study 44
Data collection procedure 44
Plan for data analysis 45
V RESULT 46-65
VI DISCUSSION 66-69
VII CONCLUSION 70-72
VIII SUMMARY 73-75
IX BIBLIOGRAPHY 76-80
X ANNEXURES 81-115
xii
LIST OF TABLES
TABLE NO. DESCRIPTION PAGE NO.
Table No.4.1 Scored Interpretation of structured knowledge questionnaire 42
Table No.5.1.1 Frequency and percentage of adolescent girls according to their age in 48
year
Table No.5.1.2 Frequency and percentage of adolescent girls according to their 49
educational qualification
religion
Table No.5.1.4 Frequency and percentage of adolescent girls according to their type 51
of family
Table No.5.1.5 Frequency and percentage of adolescent girls according to their family 52
income per month
Table No.5.1.6.1 Frequency and percentage of adolescent girls according to their 53
previous information
Table No.5.1.6.2 Frequency and percentage of adolescent girls according to their 54
previous information. If yes,
menstrual cycle
dietary pattern
Table No.5.1.9.1 Frequency and percentage of adolescent girls according to their family 57
health status
Table No.5.1.9.2 Frequency and percentage of adolescent girls according to their family 58
health status. If unhealthy
Table No. 5.2.1 Frequency percentage distribution of sample subjects according to the 59
level of knowledge.
Table No. 5.2.2 Item wise analysis of correct and incorrect response regarding anemia 60-61
and its management.
Table No. 5.2.3 Mean, standard deviation and mean percentage on level of knowledge 62
regarding anemia and its management among adolescent girls
Table No. 5.3.1 Association between level of knowledge scores regarding anemia and 63-64
its management among adolescent girls with their demographic
variables
xiii
LIST OF FIGURES
PAGE
FIGURE NO. DESCRIPTION
NO.
Figure No.2.1 Conceptual framework 20
Figure No. 4.1 Schematic presentation 36
Figure No. 5.1.1 Bar graph showing percentage of sample subjects according 48
to their age group
Figure No. 5.1.2 Cone graph showing percentage of sample subjects according 49
to their educational qualification
Figure No. 5.1.3 Bar graph showing percentage of sample subjects according 50
to their religion
Figure No. 5.1.4 Bar graph showing percentage of adolescent girls based on 51
types of family which they belong
Figure No. 5.1.5 Bar graph showing percentage of adolescent girls according 52
to their family income per month
Figure No. 5.1.6.1 Pie graph showing percentage of adolescent girls based 53
knowledge of anemia
Figure No. 5.1.6.2 Doughnut graph showing percentage of adolescent girls 54
based on various methods to know about the anemia
Figure No. 5.1.7 Bar graph showing percentage of adolescent girls according 55
to their menstrual cycle
Figure No. 5.1.8 Cone graph showing percentage of adolescent girls according 56
to their dietary pattern
Figure No. 5.1.9.1 Doughnut graph showing percentage of adolescent girls 57
according to their family health status
Figure No. 5.1.9.2 Bar graph showing percentage of adolescent girls based on 58
type of disease in their family health
Figure No. 5.2.1 Bar graph showing the level of knowledge of adolescent girls 59
xiv
LIST OF ANNEXURES
ANNEXURE ANNEXURE PAGE

NO. NO.
ANNEXURE I Letter requesting permission to conduct the 81
pilot study
ANNEXURE II Letter requesting permission to conduct the 82
final study
ANNEXURE III Letter seeking consent to validate research 83
tool and information booklet
ANNEXURE IV Criteria checklist for demographic variable 84-86
validation
ANNEXURE V Content validity certificate 87
ANNEXURE VI List of experts who validated tool 88
ANNEXURE VII Certification of the statistician 89
ANNEXURE VIII Certificate by English editor 90
ANNEXURE IX Certificate by Hindi editor 91
ANNEXURE X Demographic variables and Structured 92-107
knowledge questionnaire
ANNEXURE XI Scoring key 108-109
ANNEXURE XII List of formulas 110-111
ANNEXURE XIII Master data sheet 112-115
xv
CHAPTER I
INTRODUCTION
BACKGROUND
“Children are the wealth of tomorrow. Take care of them if you wish to have strong
India. Every day to meet various challenges”
-Jawaharlal Nehru
Health is a fundamental human right and health is central to the concept of quality
of life (Sundar Lal, 2007).1 It is a general Condition of a person in all aspects and also it
is a resource for everyday life. Health is a positive concept Emphasizing social and
personal resources as well as physical capacities. Adolescent is a period of second decade
of life and constitute over one fifth of India’s population. Adolescence begins when the
secondary sex characteristics appear and ends when somatic growth is completed and the
individual is psychologically mature, capable of becoming a contributing member of
society.2
Adolescents is a stage of transition from childhood to adulthood and is marked by

the termination of the childhood at one end and the beginning of adulthood at the other
end. The adolescent is yet not free from the secure environment of the childhood yet
heading towards achieving adulthood which is unknown. The adolescent is neither down
the stairs nor up the stairs. It is in between and there is no specific status which may be a
source of problem if proper handling is not done and proper care is not given. 2
Since adolescence is a transitional stage between childhood and sociological

mature adulthood, their rights and responsibilities are not very clear cut as it is in case of
children and adults, whereas children are fully depends-upon adults and adults fully
dependent upon themselves. 2
According to WHO the adolescent period is from the age of 10 years to 20 years
i.e. the second decade of life. It can be distinguished as early adolescence, age 10- 13
years, middle adolescence, age 14- 16 years & late adolescence age 17 to 20 years. 2
1
Adolescents are in the age group of 12 to 18 years. Girls begin to menstruate at
this age. The girl should have weight approximately 42-64 kg and height approximately
155-169 cm. Total nutrient requirements are increased during adolescence age to support
a period of dramatic growth and development. Eating right food at right time will prevent
the nutritional deficiencies especially Iron deficiency disorders (Dorothy et al., 2007).4
Adolescence is a critical stage in the life cycle, when the health of females is
affected due to growth spurt, beginning of menstruation, poor intake of iron due to poor
dietary habits and gender bias. Iron deficiency anemia affects over 60% of the adolescent
girls in India. Anemia in adolescent girls has far-reaching implications. The anemic
adolescent girls grow into adult women with compromised growth, both physical and
mental. These women have low pre-pregnancy weight and are more likely to die during
childbirth and deliver low birth weight babies (UNICEF, 2012).4
Adolescent is a period of second decade of life and constitute over one fifth of
India’s population. Adolescence begins when the secondary sex characteristics appear
and ends when somatic growth is completed and the individual is psychologically mature,
capable of becoming a contributing member of society. Adolescents are in the age group
of 12 to 18 years. Girls begin to menstruate at this age.4
In world health report of World Health Organization (WHO) states that the
worldwide mortality rate of iron deficiency anemia is 60,404,000 in 2005 (WHO, 2005).4
High prevalence of iron deficiency anemia reflects their poor status of nutrition
because of their rapid growth combined with poor eating habits and
menstruation (Wong’s, 2009).4
Adolescence is the most vulnerable phase of life associated with high iron
requirements for growth and development accompanied by expansion of blood volume,
muscle mass, natural loss of menstrual blood in girls and increased demands with the
onset of pregnancy.4
There does seem to be a trend towards a decrease in the age at menarche over the
decades both in the rural and urban situations, not only in the affluent upper classes but
2
also among the poor classes of urban and rural communities and making adolescent girls
susceptible to anemia.3
Anemia is common in poor class since intake of poor mainly due to non-
availability of healthy foods. In higher classes, personal likes and dislikes and food
taboos lead to anemia.3
Anemia is the most common form of malnutrition mostly due to iron deficiency
amongst adolescent today. It is of public health significance in our country anemia
prevalence being > 30 percent.4
Anemia is very common among women in India due to invariable reasons which
include malnutrition, infection especially hookworm infestation, repeated pregnancies,
abortions, antepartum and post-partum hemorrhage discriminatory treatment of women
etc. about 85 percent of the women during pregnancy are known to be anemic. Anemia in
pregnancy results in premature labor, low birth weight babies, post-partum hemorrhage
and perinatal mortality.2
Adolescent girls with accelerated growth and rapid skeletal development may
suffer from iron deficiency due to inadequate food intake. Low iron store throughout
childhood may result in a delayed menarche and impaired immune response (Verma,
2004).5
Anemia is widely prevalent in young adolescent girls. With the onset of

menarche, marriage, pregnancy, anemia and mal nutrition get increased. Some girls with
an obsession to become thin stop eating or eat less as a result of which they suffer from
many disorders. Pre-pregnancy nutrition and health are likely to affect fetal health,
therefore it is necessary to impart nutrition education and provide iron and folic acid
tablet to adolescent girls. Often anemia is due to get worsened by worm infestation.2
It is therefore essential to give deworming treatment and follow principle of

personal and environmental hygiene. Most of times girls are undernourished because they
are nutritionally neglected.2
Anemia is a pathological condition where hemoglobin or hematocrit becomes

abnormally low because of low essential nutrients like iron, folic acid, protein, vitamin
3
B12, and vitamin C etc. adolescent constitutes more than 20 percent of our population in
India and >50 percent suffer from iron deficiency anemia (Sushil Madan).4
Nutritional anemia is a global problem of immense health significance affecting

persons of all age and economic group. Anemia is one of the most common
hematological abnormalities found in children. It can be defined as the reduction in
oxygen-carrying capacity or as a reduction in the red cell mass of the body. Among the
various types of nutritional anemia, iron-deficiency anemia is the most common affecting
more than two billion people globally.6
In most populations anemia is primarily due to iron deficiency and is in fact the
late stage of a relatively long process of deterioration in iron stores. UNICEF/WHO
report indicates that there are approximately 2.5 cases of iron deficiency for each case of
anemia. Many more adolescents are in fact suffering from iron deficiency (ID) with its
adverse effects on health and physical stamina, than are frankly anemic. 6
Iron deficiency and iron deficiency anemia (IDA) in adolescence is a major public
health problem. Studies indicate that the incidence of anemia in adolescents tends to
increase with age and corresponds with the highest acceleration of growth during
adolescence. The highest prevalence is between the ages of 12-15 years when
requirements are at peak. Adolescents (age 10-19 years) are at high risk of iron
deficiency and anemia due to accelerated increase in requirements for iron, poor dietary
intake of iron, high rate of infection and worm infestation as well as the social norm of
early marriage and adolescent pregnancy.7
Iron deficiency anemia occurs because of lack of the mineral iron in the body.
Bone marrow in the center of the bone needs iron to make hemoglobin, the part of red
blood cell that transport oxygen to the body’s organs. Without adequate iron the body
cannot produce enough hemoglobin for red blood cells. The result in iron deficiency
anemia.5
This type of anemia can be caused by poor iron diet especially in infant and
children, teens, vegans, and vegetarians, menstruation, the metabolic demand of
pregnancy, breast feeding &frequent blood donation.5
4
The iron deficiency causes nutritional anemia in children. About 50 percent of
children have anemia. It is due to mal nutrition. It usually leads to various other problems
such as general weakness affecting work performance, reduced immunity and resistance
to infections resulting in increased morbidity and morbidity and mortality. It affects
physical and psychological behavior of the child. There is decrease in the concentration
of the hemoglobin and it is lower than the normal cut off point set up by WHO, which is
11 g/dl in children 6 month to 6 years.2
A level between 10 – 11 g/dl considered as the mild anemia and below 10 g/dl as
marked anemia. Anemia is aggravated by worm infestations and malarial parasites. It
may also be caused because of these infections. Another cause of anemia is folic acid
(folate) deficiency.7
Anemia in children can be prevented by preventing and controlling of anemia in

pregnant and nursing mothers by improvement in diet and prophylactic treatment by iron
folic acid, improvement of diet of children emphasizing on breast feeding, proper
weaning and supplementation etc., iron folic acid drops/tablets as prophylaxis, prevention
and treatment of worm infestation and malaria. Fortified salt with iron has been tried out
by national institute of nutrition to control anemia in regions with high prevalence of
anemia and is accepted by the government as a public health approach to prevent
anemia.2
National Family Health Survey (NFHS) estimates reveals presence of nutritional

anemia to be 70-80% in children, 70% in pregnant women and 24% in adult women.
With 40% prevalence of nutritional anemia in the world on an average for the general
population, the prevalence in the developing countries tends to be three to four times
higher than in the developed countries. In studies conducted in developing countries,
adolescent anemia was reported as the greatest nutritional problem. Adolescence is a
crucial phase of growth in the life cycle of an individual.4
Global data base by WHO (2000) on child growth and malnutrition and national
family health survey-2 (2000). In India, have suggested high prevalence of iron
5
deficiency anemia (56%) in school age children the average prevalence rates are: Asia
(58.4%), Africa and Asia (>40%), Indonesia (24-25 %).4
According to the World Health Organization (WHO), anemia is defined as

hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dl in men. However, normal
Hb distribution varies not only with sex but also with ethnicity and physiological status.
New lower limits of normal Hb values have been proposed, according to ethnicity,
gender and age. Anemia is a global public health problem affecting both developing and
developed countries at all ages.5
Anemia is often multifactorial and not an independent phenomenon. For the

classification and diagnosis of the hematologic parameters, the underlying pathological
mechanism and patient history should be taken into account. In this population, anemia;
recently defined by levels of Hb<12 g/dL in both sexes, is mostly of mild degree (10-12
g/dL).5
In India, the prevalence of anemia among adolescent girls were 56% and this
amount to an average 64 million girls at any point in time. Studies conducted in different
regions of India shown that the prevalence of anemia was 52.5% in Madhya Pradesh,
37% in Gujarat, 41.1% in Karnataka, 85.4% in Maharashtra, 21.5% in Shimla, 56.3% in
Uttar Pradesh, 77.33% in Andhra Pradesh, 58.4% in Tamil Nadu and in Kerala (19.13%
among college students and 96.5% in tribal area). The major risk factors identified from
the above studies were socio-economic status, blood loss during menstruation, nutritional
status, hand hygiene and worm infestation.8
Nutritional needs of girls during adolescent period are generally ignored leading
to stunting and poor health. One of the major consequences of the physiological changes
and the nutritional neglect which happens during this period is anemia. In a tropical
country like India helminthic infestation is very common which can lead to chronic blood
loss which in turn results in anemia.8
Anemia causes adverse consequences as the disease progress. It not only affects
the growth of adolescent girls but also affect their attentiveness, memory and school
performance and retention in school attendance. It also causes delay in onset of
6
menarche, affects immune system leading to infections. If the anemic adolescent girl
becomes pregnant, it may increase fetal morbidity and mortality, increase the perinatal
risk, increase the incidence of Low Birth Weight (LBW), and overall increase in Infant
Mortality Rate (IMR) and Maternal Mortality Rate (MMR). As growing pregnant
adolescents complete with the growing fetus for nutrients anemia in pregnancy will be
worse than in older women.8
This type of anemia can be caused by poor iron diet especially in infant and
children, teens, vegans, and vegetarians, menstruation, the metabolic demand of
pregnancy, breast feeding &frequent blood donation.5
The iron deficiency causes nutritional anemia in children. About 50 percent of

children have anemia. It is due to mal nutrition. It usually leads to various other problems
such as general weakness affecting work performance, reduced immunity and resistance
to infections resulting in increased morbidity and morbidity and mortality. It affects
physical and psychological behavior of the child. There is decrease in the concentration
of the hemoglobin and it is lower than the normal cut off point set up by WHO, which is
11 g/dl in children 6 month to 6 years.2
A level between 10 – 11 g/dl considered as the mild anemia and below 10 g/dl as
marked anemia. Anemia is aggravated by worm infestations and malarial parasites. It
may also be caused because of these infections. Another cause of anemia is folic acid
(folate) deficiency.7
Anemia in children can be prevented by preventing and controlling of anemia in

pregnant and nursing mothers by improvement in diet and prophylactic treatment by iron
folic acid, improvement of diet of children emphasizing on breast feeding, proper
weaning and supplementation etc, iron folic acid drops/tablets as prophylaxis, prevention
and treatment of worm infestation and malaria. Fortified salt with iron has been tried out
by national institute of nutrition to control anemia in regions with high prevalence of
anemia and is accepted by the government as a public health approach to prevent
anemia.2
7
Global data base by WHO (2000) on child growth and malnutrition and national
family health survey-2 (2000). In India, have suggested high prevalence of iron
deficiency anemia (56%) in school age children the average prevalence rates are: Asia
(58.4%), Africa and Asia (>40%), Indonesia (24-25 %).4
8
NEED FOR THE STUDY
“It is health that is real wealth and not pieces of gold and silver”
-Mahathma Gandhi
Adolescence is the time when many developments takes place both physically and
mentally. In this period more nutritious and healthy diet is needed. During adolescence
increased iron is needed for the body for the expansion of blood volume and increases
muscle mass. Adolescence gain 20% of adult weight and 30% adult height in the
adolescence period. Iron deficiency anaemia is the most common type of anaemia in all
age group and it is the most common type of anaemia in the world.9
-Brunet
Adolescents account for one fifth of the world’s population and have been on an
increasing trend. In India, they account for 22.8% of the population (as on 1st March
2000, according to the Planning Commission’s Population projections). This implies that
about 230 million Indians are adolescents in the age group of 10 to 19 years. The term
adolescent means ‘to emerge’ or ‘achieve identity’.6
The adolescent period offers a chance to acquire knowledge about optimal

nutrition during young adulthood that could prevent or delay adult onset diet related
illnesses later on. Anaemia reduces physical work capacity and cognitive function,
learning and scholastic performance in schoolgirls entering adolescence. Now-a-days due
to various to influence of various media such as magazines, televisions young girls are
skipping meals to make themselves thin and slender and due to this modernization many
of them tend to eat fast food or junk food. This all leads to deficiency of iron rich diet. 7
The adolescent may suffer from impaired physical work, poor intelligent quotient,
decreased motor and cognitive function due to iron deficiency. So, all adolescent girls
should know about the importance of iron rich foods, iron intake and functions of iron in
human body. It can be done by providing health and nutritional education, weekly
supplementation of iron tablets, provision of deworming tablets etc.6
9
As per WHO Iron deficiency is the most common and widespread nutritional
disorder in the world. The prevalence rate of iron deficiency anaemia among Children
between 5-15yrs is 5.9- 48.1%.8
According to the National family Health Survey report 2005-2006, 56% of

adolescent girls are anaemic, boys too are falling prey to the disease. The study was
conducted on Prevalence of iron deficiency anaemia among adolescent girls in 16
districts of India in 2006. The survey showed that 90.1% of adolescent girls are having
iron deficiency anaemia. Haemoglobin count in most of the adolescent girls in India is
less than the standard (12 g/dl) accepted worldwide.8
Standard method was used among school girls age 9 – 14 year in India to assess
the physical work capacity and cognition of anaemic school girls. The result showed that
the adverse effect of anaemia was present even after controlling for under nutrient. The
data revealed anaemia adversely affect physical work capacity and cognition among
young adult girls. Recent reports reveal that anemia prevalence in adolescent girls is very
high ranging from 50 % to >90%. In 2006, the overall prevalence of anemia has been
reported to be extremely high at 90.1% in adolescent girls 11-18 years old from 16
districts in 4 regions of India. The study also confirms that 85% of pregnant women are
anemic. The earlier study from Western India reports that in the low-income group 80-
90% had hemoglobin less than 12%.9
Iron deficiency is the most common and widespread nutritional disorder in the
world and effects a large number of children and women in developing countries, it is the
only nutrient deficiency which is also 23 significantly prevalent in industrialized
countries. The numbers are staggering 2 billion people i.e. over 30% of the world’s
population are anemic, many due to iron deficiency, and in resource-poor areas, this is
frequently exacerbated by infectious diseases. Iron deficiency affects more people than
any other condition, constituting a public health condition of epidemic proportions. More
subtle in its manifestations than, for example, protein-energy malnutrition, iron
deficiency exacts its heaviest overall toll in terms of ill health and premature death. Iron
deficiency and anemia reduce the work capacity of individuals and entire populations,
bringing serious economic consequences and obstacles to national development. Overall,
10
it is the most vulnerable, the poorest and the least educated that are affected by iron
deficiency (WHO, 2012).5
In a study of adolescent girls 10-19 years in urban slums of Southern India

Andhra Pradesh, anemia prevalence is reported to be 67.9%. Moderate anemia 37.05%,
mild anemia, 21.42% and 9.4% severe anemia, while another study from Ranga Reddy
district of Andhra Pradesh reports anemia prevalence in girls 13-15 years to be 83%.
Whereas under nutrition is reported (stunting) in one-third of adolescent population,
prevalence of anemia is almost universal. A similar high prevalence of anemia in rural
Rajasthan between 73.3% and 85.4% has been reported. About 62% of urban adolescent
girls from the lower socio economic group are estimated to be anemic. Anemia in
adolescent girls is now recognized to be a public health problem along with anemia in
other population groups such as young children and pregnant women. The primary cause
of iron deficiency and iron deficiency anemia (IDA) is attributed to lack of bioavailable
iron from the traditional cereal based diets and low consumption of foods rich in heme
iron.5
So, from the above finding, it is seen that the adolescent girls have less knowledge
regarding management of anaemia. Adolescents are at high risk of iron deficiency and
anemia due to accelerated increase in requirements for iron, poor dietary intake of iron,
high rate of infection and worm infestation as well as the social norm of early marriage
and adolescent pregnancy. Hence I felt that there is a need to conduct a study which can
significantly increase the knowledge of adolescent girls about deficiency anaemia and its
management.
11
CHAPTER II
“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND ITS

MANAGEMENT AMONG ADOLESCENT GIRLS IN SELECTED SCHOOL OF
LUCKNOW WITH A VIEW TO DEVELOP AN INFORMATION BOOKLET
LUCKNOW U.P.”.
OBJECTIVES
2. To find out the association between level of knowledge scores among adolescent girls
with their selected Socio demographic variables.
3. To develop and distribute information booklet regarding anemia and its management
RESEARCH HYPOTHESIS
Hypothesis is a tentative statement about the relationship, if any between two or

more variables.
Hypothesis will be tested at p < 0.05 significance level.
H1- There is a significant association between level of knowledge scores regarding

anemia and its management among adolescent girls with their selected socio
demographic variables.
OPERATIONAL DEFINITION
Assess:
It refers to determination of knowledge among adolescent girls regarding iron deficiency

anemia and its management through structured knowledge questionnaire.
12
Knowledge:
It refers to understanding of adolescent girls regarding iron deficiency anemia and its
management which will be measured by the structured knowledge questionnaire.
Anemia (Iron Deficiency Anemia)
Iron deficiency anemia is a common nutritional disorder seen among adolescents. It is a

decrease in the number of red blood cells in the blood caused by deficiency of iron.
Adolescent girls:
It refers to the girls between the age group of 15 - 20 year are studying at Shia girls inter
college, Lucknow, U.P.
Information booklet:
It refers to the systematically developed and organized information booklet designed to

give the knowledge regarding iron deficiency anemia its causes, sign and symptoms
diagnosis, prevention and management of iron deficiency anemia among adolescent girls.
ASSUMPTION OF THE STUDY
The study assumes that-
1. The adolescent girls will have some knowledge regarding iron deficiency anemia
and its management.
2. They would be willing to express their knowledge regarding iron deficiency
anemia and its management.
3. The responses to questionnaire will reflect their actual knowledge regarding iron
deficiency anemia and its management.
4. Information booklet will improve the knowledge regarding anemia and its
management.
13
DELIMITATIONS
This study is delimited to:
1. Adolescent girls who are present in the Shia girls inter college, at the time of data
collection.
2. Assessment of knowledge only once before the distribution of the information
booklet through the written responses obtained through a structured knowledge
questionnaire.
3. 135 adolescent girls only.
14
CONCEPTUAL FRAMEWORK
A conceptual frame work is an analogous to the frame of a house, just as the foundation
supports a house. A theoretical frame work provides a rationale for prediction about a
relationship among variables of a research study.
Conceptual frame work facilitates communication and provides the systematic approach
to nursing research, education, administration and nursing practice.
Conceptualization refers to the process of referring general or abstract ideas, which are
formulated by generalizing from particular manifestations of certain behavior or
characteristics. These abstracts are referred as concepts.
The conceptual frame work in the present study is based on Pender’s health promotion
model 2008.
The conceptual frame work of the study is based and designed on the concept of health
promotion model prepared by Nora J Pender, which focuses on explaining health
promoting behavior in the presence of cues to action.
According to Nora J Pender health promotion model is defined as activities directed

towards the development of resources that maintain or enhance an individual’s well-
being. Health promotion model focused more on achievement of higher level of well-
being and self-actualization.
Health promotion is defined as behavior motivated by the desire to increase well-being

and actualize human health potential. It is an approach to wellness. On the other hand
health promotion or illness prevention is described as behavior motivated desire to
actively avoid illness, detect it early or maintain functioning within the constraints of
illness.
It defines health as a positive dynamic state not merely in the absence of disease. Health
promotion is directed at increasing a client’s level of well-being. The health promotion
model describes the multi-dimensional nature of persons as they interact with their
environment to pursue health. The model focuses on following three areas:
15
 Individual characteristics and experience
 Behavior specific cognitions and affect.
 Behavioral outcomes.
The health promotion model notes that each person has unique personal characteristics
and experiences that affect subsequent action.
The set of variables for behavioral specific knowledge and affect have important
motivational significance.
Health promoting behavior is the desired behavioral outcome and is the end point in the
health promotion model. Health promoting behaviors should result in improved health
enhanced functional ability and better quality of life at all stages of development.
Health promoting behavior should result in improved health, enhanced functional ability
and better quality of life at all stages of development.
INDIVIDUAL CHARACTERISTICS AND EXPERIENCES
Personal factors
Personal factors categorized as biological, psychological and socio cultural. These

factors are predictive of a given behavior and shaped by the nature of the target behavior
being considered.
In this study, personal biological factors are demographic variables of adolescent girls
such as age, sex, educational qualification, religion, type of family, family income per
month, previous information regarding anemia and its management, menstrual cycle,
dietary pattern and family health status.
BEHAVIOR SPECIFIC COGNITION AND AFFECT
Perceived benefit of action
Anticipated positive outcomes that will occur from health behavior.
16
Perceived barrier to action
Anticipated, imagined or real blocks and personal cost of understanding a given

behavior.
In this study beliefs related eating practice such as Vegetarian or Non-vegetarian,

inability to get proper nutrition, Poor socio-economic status, lack of knowledge related to
foods, lack of interest towards some foods, lack of awareness, lack of time to take proper
food are some of the perceived barriers to action.
Perceived self-efficacy
Judgment of personal capability to organize and execute a health promoting

behavior.
In this study Perceived self-efficacy influences perceived barriers to action so higher

efficacy result in lowered perceptions of barriers to the performance of the behavior.
Activity related to affect:
Subjective positive or negative feeling that occur before, during and following
behavior based on the stimulus properties of the behavior itself.
Activity related affect influences perceived self- efficacy, which means the more positive
the subjective feeling, the greater feeling of efficacy. In turn, increased feeling of efficacy
can generate further positive affect.
In this study, activity related effect explain the ability to active participation from the
group, cooperation from the group and creative preparation of information booklet
regarding anemia and its management. Distributed by investigator after conducting the
pretest for increasing the knowledge level and active participation of group.
Interpersonal influences:
Cognition concerning behaviors, beliefs or attitudes of the others. Interpersonal

influences include: norms (expectations of significant others), social support
(instrumental and emotional encouragement) and modeling (various learning through
17
observing others engaged in a particular behavior). Primary source of interpersonal
influences are friends and health care providers.
In this study, it is influenced by level of understanding, cooperation between researcher

and student, sample and with environment.
Situational influences:
Personal perception and cognition of any given situation or context that can
facilitate or impede behavior. Include perceptions of options available, demand,
characteristics and aesthetic features of the environment in which given health promoting
is proposed to take place. Situational influences may have direct or indirect influences on
health behavior.
BEHAVIOURAL OUTCOME
Commitment to plan of action
The concept of intention and identification of a planned strategy leads to

implementation of health behavior.
In this study, it describes about formulation of a realistic plan to get knowledge by the
booklet regarding the anemia and its management which provided by the investigator.
Immediate competing demands and preferences
Competing demands are those alternative-behavior over which individuals have

low control because there are environmental contingencies such as work or family care
responsibilities.
In this study, immediate competing demands and preference of adolescent girls

are choices of junk food rather than the nutritious foods.
Health promoting behavior
Endpoint or action outcome directed toward attaining positive health outcome

such as optimal well-being, personal fulfillment and productive living.
18
In this study, it specifies about preparedness to have knowledge regarding anemia and its
management to adopt positive health promoting measures and helps to incorporating this
in to their nursing practice.
19
Behavior specific
cognitive and effect Behavioral
Individual outcomes
characteristics
and experiences
Perceived benefits of action
Judgment of personal ability to
organize health promoting behavior
this information booklet will
improve knowledge.
Prior related
behavior
Behavior of Perceived barriers to action
adolescent girls Lack of knowledge, poor
regarding anemia socioeconomic status, lack of interest
and its management towards the food
that they are having
les knowledge
regarding anemia Perceived self-efficacy
and its Lack of time, lack of awareness and
beliefs regarding nutritious food. Health
management.
promo
ting
Activity related effects behavi
Commi
Personal factors Information Booklet is distributed by or
tment
Age, educational investigator after conducting the pretest of plan Upgrad
qualification, for increasing the knowledge level and of e the
Religion, Type of active participation of group. action level of
Inform
family, family knowle
ation
income, previous dge
Interpersonal influence booklet
information on regardi
regarding anemia Peer and colleague groups, social ng
anemia
and its management, and health care providers support. anemia
and its
stream of education, Level of understanding. and its
manag
menstrual cycle, Language approach, confidence, manag
ement
dietary pattern, cooperation, confidence. ement
Situational influences
Cooperation between investigator and
adolescent girls.
SHIA GIRLS INTER COLLEGE, LUCKNOW
Figure No. 2.1 MODIFIED FROM REVISED PENDERS HEALTH PROMOTION
20
CHAPTER-III
REVIEW OF LITERATURE
A literature Review is a body of text that aims to review the critical point of knowledge
on a particular topic of research.
-ANA 2000
‘It is a written summary of journal articles, book and other documents that describes
that past and current state of information, organize the literature into topics and
documents a need for proposed study.’
Creswell, 2005
The review of literature is defined as a broad, comprehensive, in-depth, systematic and

critical review of scholarly publications, unpublished scholarly print materials,
audiovisual materials and personal communications. Review of literature is a key step in
research process.
Researchers often undertake a literature review to familiarize themselves with the

knowledge base. One of the function of the research literature review is to ascertain what
is already known in relation to a problem of interest. In this study, review of literature is
classified under the following headings:
This chapter deals with the literature which is reviewed and relevant to the present study.
 Review of literature related to assess the prevalence of iron deficiency anemia.

 Review of literature to assess the knowledge regarding Iron deficiency anemia.
21
 REVIEW OF LITERATURE RELATED TO ASSESS THE PREVALENCE OF
IRON DEFICIENCY ANEMIA.
Seema Rani et al. (2018), a descriptive Study was conducted to Assess the
Prevalence of Anemia and Identify Dietary Practices among Adolescent Girls in Selected
School of Moradabad, Uttar Pradesh. Quantitative approach with descriptive survey
design was used to achieve the objectives of the study. The sample consisted of 100
adolescent girls (11-17 years) from selected school of Moradabad. Convenient sampling
technique was used to select the sample. A structured questionnaire was developed to
identify dietary practices and to obtain demographic profile of adolescent girls and a
recording sheet was used to collect data regarding their haemoglobin level. The data was
collected and analyzed, interpreted using both descriptive and inferential statistics. The
study showed that 66% of the adolescents were anemic; out of which 31% were mild
anemic, 25% moderate and 10% were severely anemic. There was a significant
relationship between anemic statuses of the sample with their frequency of eating junk
food. A pamphlet on prevention and management of anemia among adolescent was
developed and disseminated to the adolescent girls. The point prevalence of anemia
among adolescent girls was found to be 66%. The high prevalence of anemia among
adolescents demands due emphasis on iron and folic acid supplementation, iron rich food
intake, health education regarding personal hygiene and periodical deworming to reduce
the burden of anemia among adolescent girls.16
Anil Kumar et al. (2018), a prospective study was conducted with 340 girls and
500 serving adults and prevalence of anemia was carried out with respect to different
prevailing factors. The prevalence of severe, moderate and mild anemia in girls was
0.5%, 10.6% and 27.9% respectively and in serving soldiers prevalence of anemia was
1.8%, 2.8% and 3.4 % respectively. In the present study, the prevalence of anemia was
found to be 39% in adolescent girls and 8% in serving soldiers. Strongest predictor to
anemia in adolescent girls was history of excessive menstrual bleeding and vegetarian
diet. Age group, age at menarche and BMI did not affect anemia prevalence.17
22
Amanda g. Cooke et. al. (2017), a retrospective cohort study was conducted in
children’s medical center in Dallas, Texas to assess the iron deficiency anemia in
adolescent who present with heavy menstrual bleeding. The researcher selected one
hundred seven patients with HMB and concomitant IDA who presented to the outpatient,
emergency department, and inpatient settings. The data depicts that the median
initial hemoglobin concentration for all patients (n = 107) was 7.4 g/dL, and most (74%,
n = 79) presented to the emergency department or via inpatient transfer. Symptomatic
IDA was treated with blood transfusion in 46 (43%, n = 46). Ferrous sulfate was the most
commonly prescribed oral iron therapy. Seven patients received intravenous iron therapy
either initially or after oral iron treatment failure. Combined oral contraceptives were
commonly prescribed for abnormal uterine bleeding, yet 10% of patients (n = 11)
received no hormonal therapy during their initial management. Evaluation for
underlying bleeding disorders was inconsistent.18
A.S. Ahankari et.al. (2017), a cross-sectional survey was conducted in rural

areas of Maharastra state of India among adolescent girls to assess the prevalence of iron
deficiency anemia and risk factors in 1010 adolescent girls. The study recruited 13- to 17-
year-old adolescent girls living in 34 village of Osmanabad district.
Data were collected on individual health, dietary, sociodemographic factors,
and anthropometric measurements were taken. Haemoglobin (Hb) levels were measured
using Sahli's haemometer. Logistic and linear regressions were used to identify risk
factors associated with IDA and Hb levels, respectively. The data depicts that among
1010 adolescent girls the mean Hb was 10.1gm/dl, and 87% had anaemia. the prevalence
of mild moderate and severe anemia was 17%, 65% and 5% respectively. The researcher
concluded that Anemia prevalence was extremely high among adolescent girls in rural
areas of Maharashtra. There is urgent need of comprehensive preventative interventions
for the whole adolescent girl population.19
Upadhye et al (2017), a cross-sectional survey was conducted in an urban area in

a school. A total of 300 girls (12-18 years) were included in this study. Statistical analysis
23
was done using percentage, standard error of proportion, Chi-square test and student’s t-
test. The prevalence of anemia was found to be 90%. A significant association of anemia
was found with socioeconomic status and literacy status of parents. Mean height and
weight of subjects with anemia was significantly less than subjects without anemia. A
high prevalence of anemia among adolescent females was found, among those whose
parents were less educated.20
P.M. Siva et al (2016), a cross-sectional study was conducted among 257

adolescent girls of ettumanoor panchayat, the field practice area of Government Medical
College, Kottayam. A pre-designed and pre-tested proforma was used to obtain data
regarding socio-demographic details and factors associated with anemia. Relevant
clinical examination of participants was done. Blood samples were analysed using an
auto-analyser and stool examination for ova or cyst was done under microscopy.
Diagnosis of anemia was established when haemoglobin was less than 12gm/dl. Data
analysis was done using SPSS 16.0. Association between Categorical variables was
tested with Chi-square test and continuous variables independent t-test was used. Logistic
regression was used to find out independent risk factors. The level of significance was
fixed at p-value of < 0.05. The prevalence of anemia was 21%. Risk factors associated
with anemia in the univariate analysis were presence of ova or cyst in stool (p = 0.003,
OR = 2.94) and number of pads per day during menstruation (p = 0.004). Protective
factors were hand washing after toileting (p = 0.021, OR = 0.311), hand washing before
food intake (p = 0.026, OR = 0.5), foot wear usage (p = 0.022, OR = 0.25) and jaggery
consumption (0.042). The factors which were significant in logistic regression were
worm infestation, number of pads per day, washing hands before food intake and foot
wear usage.21
Anurag Srivastava et al. (2016), a community based cross sectional study was
conducted among 604 unmarried adolescent girls in the age group of 13- 19 years in rural
areas of district amroha, Utter Pradesh using simple random sampling. A pre-tested and
post tested and predesigned schedule was used to collect the information. Chi square test
was applied to analyze data. Out of 604 subjects, 418(69.2%) subjects were anemic.
24
Majority 39.7 % have mild anemia while 28.3% have moderate anemia and 1.2% have
severe anemia. A high proportion 42.1% of the anemias were aged between 13-15 years
of significant association of anemia was found among belonging to the low socio-
economic status, increased family size and less parent’s education.22
Saroj Khatiwada et.al. (2015), a cross-sectional study was conducted in 2012 in

four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the
prevalence of anemia among the school children of eastern Nepal. Children aged 4–13
years were selected randomly from different schools of above districts and 618 venous
blood samples were collected. Hemoglobin level was estimated by using
cyanmethemoglobin method. The data depicts that the mean hemoglobin level was
12.2 ± 1.82 gm/dl. About 37.9% (n = 234) children were found anemic. Anemia
prevalence was 42.4% (n = 78), 31.6% (n = 60), 45.3% (n = 48) and 34.8% (n = 48)
among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively.
The study finds anemia as a significant health problem among the school children of
eastern Nepal.23
Deena Thomas et. al. (2015), a Cross-sectional hospital-based study was

conducted among 200 adolescents (10-18 y) with anemiato associate the severity of
nutritional anaemia with serum levels of ferritin, vitamin B12 and folate; and to
determine demographic, socio-economic and nutritional correlates for nutritional anemia
in adolescents. Dietary intake (24-h recall), and serum levels of folate, vitamin B12 and
ferritin were estimated. Iron, folate and vitamin B12 deficiency was present in 30.5%
79.5% and 50% of adolescents, respectively. Statistically significant association was
observed between severity of anemia and serum vitamin B12 levels, iron intake, folate
intake, Vitamin B12 intake, vegetarian diet, attainment of menarche and history of
worm infestation.24
Jayanta Saha (2015), a prospective study was conducted in Department of

Biochemistry, Chhattisgarh Institute of Medical Sciences, Bilaspur (CG). A total 112
female students participated in this cross-sectional study was age between 18-25 years.
25
Complete blood cell count and Serum iron, Ferritin, total iron binding capacity were used
to assess the status of iron deficiency and iron deficiency anaemia. Results: We found
significant (P<0.001) decrease level of Serum Iron and Ferritin and significant (P<0.001)
increased level of TIBC in ID as well as IDA as compared to Normal. In this study, the
prevalence rates of ID and IDA in female university students aged 18–25 years were
55.35% and 10.7%, respectively.25
Tesfaye M et al (2015), a cross-sectional study was conducted among 408 school

adolescents Anemia and iron deficiency among school adolescents: burden, severity, and
determinant factors in southwest Ethiopia Bonga Town, from March 15, 2014 to May 25,
2014. An interviewer-administered questionnaire was used to collect socio demographic
and other data. A total of 7 mL of venous blood and 4 g of stool samples were collected
from each study participant. Blood and stool samples were analyzed for hematological
and parasitological analyses, respectively. This study showed that anemia was a mild
public health problem in this population. School-based interventions on identified
associated factors are important to reduce the burden of anemia among school
adolescents.26
Tanvi Twara, Sanskriti Upasna, Ritu Dubey et al. (2015), a study was
conducted to assess the nutritional status of adolescent girls and to find out the prevalence
of anemia in adolescent girls Bihar. The purpose of selection of this town for the field
study is the rapid change in its population, lifestyle and food pattern. A total number of
100 adolescent girls were selected in age groups of 13 to 18 years. The study population
comprised of 100 samples of adolescent girls from semi-urban areas. Result shows 66
percent prevalence rate of anemia among adolescent girls. Mean height and weight of
adolescent girls were compared with respective NCHS standards and only mean weight
shows a significant difference between them. BMI shows 56 percent girls were
underweight. Clinical signs and symptoms of anemia were seen in 45 percent adolescent
girls.27
Kumar B. Shill et. al. (2014), a cross-sectional study was conducted to estimate,
the prevalence of iron-deficiency anemia among the university students of Noakhali
26
region, Bangladesh. The study included 300 graduation-level students aged 17-25 years
(150 male and 150 female), with different socioeconomic backgrounds, from 7
departments. In this study, 55.3% students were anaemic, of whom 63.3% were female;
thus, anemia was found to be much more common among females than males. Females
are prone to anemia because of menstruation and due to social customs; they get a diet of
inferior quality compared to males. The researcher concluded that Iron-deficiency anemia
is predominant among a large number of people, especially rural women and children in
Bangladesh. In most of the cases, it occurs due to the lack of iron-rich food in daily diet
and, sometimes, excess menstrual blood loss for women. The present study indicates that,
besides the rural women, the majority of university students, especially female, are
affected by iron-deficiency anemia.28
Mohan Joshi & Raghvendra Gumashta (2013), a randomized control trial

study was conducted in adolescent girls suffering from iron deficiency anemia visiting
Urban health and training centre situated in urban slum area during the study period June,
2011 to October, 2012. The 120 anemic (Haemoglobin< 12 gm%) adolescent girls (10-19
years) were distributed randomly by block randomization in, two groups; one receiving
daily Iron and Folic Acid supplementation and in other group receiving weekly Iron and
Folic Acid supplementation for 3 months. All the study subjects were given de-worming
(Albendazole 400 mg) and required health education separately. The data depicts that the
mean age of study subjects in ‘Daily Iron and Folic Acid Supplementation’ and ‘Weekly
Iron and Folic Acid Supplementation’ group was 13.48 and 13.55 years respectively.
Their mean pre-intervention Haemoglobin was 10.1±1.1 gm/dl and 10.4±1.1 gm/dl
respectively. The mean rise in Haemoglobin after lean period of 1 month in respective
groups was almost equal i.e. 1.0±0.7 gm/dl and 1.0±0.8 gm/dl. Adverse Drug Reactions
were 8.3% in weekly regime as compared to 13.35% in daily regime, abdominal pain
being the commonest adverse drug reaction seen. The compliance calculated as mean of
unconsumed ‘Iron and Folic Acid’ tablets was 6.1±10.98 in ‘Daily Iron Folic Acid
Supplementation’ group, while it was 1.3±3.15 in ‘Weekly Iron Folic Acid
Supplementation’ group (p=0.0012), making weekly regime more promising than daily
regime with better treatment compliance. So the study concluded that weekly
27
supplementation of ‘Iron and Folic Acid’ in ‘Iron Deficiency Anaemia’ patients is as
good as daily supplementation with added benefits of less adverse reactions and better
compliance.29
Sachin Pandey (2013), across sectional study was conducted on 1st January,
2009 to 28th February, 2009 among 3rd year MBBS Students between the ages of 20 to
25 years studying at Chhattisgarh Institute of Medical Science (CIMS), Bilaspur. A total
of 96 students age ranging 20 to 25 years out of 100 students enrolled in the batch were
studied. A structured questionnaire, which include general information, sign and
symptoms regarding anemia, dietary habit, BMI, general physical examination, systemic
examination and a tallqvist strip for Hemoglobin estimation were carried out. Anemia
prevalence was 30.20% among medical students. Out of total 96 students 29 students
were found anemic out of which 11 (19%) male students were anemic. And 18 (47.4%)
female students were found anemic. The cutoff hemoglobin level below 12.0 gm% was
considered anemia.30
Monika Jain (2012), a quasi-experimental study was conducted to investigate the

relationship between iron deficiency and cognitive test scores among school aged girls.
Quasi random experimental research design was used. School girls aged 8 to 11 years
from Banasthali residential school were selected purposively. The prevalence of anemia
(Hb< 11.5 g/dl) was 77.5% in the study population; 46.0% subjects had mild anemia
(n=51) and 31.5% had moderate anemia (n=35). Mean Hb of mildly and moderately
anemic was 10.4 and 9.3 g/dl respectively (table 1). Non anemic subjects’ (n=25) mean
was 12.1 g/dl. Mean MCV, MCH and MCHC of anemic subjects were 73.0 fl, 27.6 pg
and 31.3% respectively. The means of same indices in non anemic group were 88.0 fl,
28.8 pg and 32.8% respectively. Serum iron and TIBC mean values were 55.5 and 776.9
µg/dl in moderately anemic subjects; 86.8 and 663.9 µg/dl in mildly anemic subjects;
151.5 and 594.2 µg/dl in non-anemic subjects.31
Premlatha et al. (2012), a study was conducted to estimate prevalence of iron

deficiency anemia among adolescent schoolgirls in the age group 13-17 years in Chennai
and to study the associated factors. A cross sectional survey was carried out among 400
28
school students. The prevalence e of anemia was found to be 78.75% among school girls.
The results of the study show that the factors such as age, literacy status of mother, types
of family, community, weight, diet, frequency Review of Literature 57 of intake of green
leafy vegetables and fruits, menstrual discharge and deworming are the factors
contributing to the prevalence of anemia.31
Shilpa S Biradar at el (2012), a cross-sectional study was conducted for a period

of one year from Jan 2008 – Dec 2008 at villages which were under Vantamuri PHC, a
field practice area of J.N Medical College, Belgaum to assess the Prevalence of Anemia
among Adolescent Girls. A total of 840 adolescent girls (10-19 years of age) were
included in the study. A pre-designed and pre-tested proforma was used to obtain the
details of the socio-demographic variables. A relevant clinical examination of the
participants was done. Following this, 2ml of blood was obtained by venipuncture. The
blood samples were analyzed by using an automated cell counter. The diagnosis was
established as anemia when the hemoglobin level was less than 12gm/dl. The prevalence
of anemia was 41.1% (with that of severe anemia being 0.6%, that of moderate anemia
being 6.3% and that of mild anemia being 34.6%. It was observed that the prevalence of
anemia was high in late adolescents (15- 19yrs) as compared to that in the early
adolescents (10-14yrs). A majority of the girls had mild anaemia. The prevalence of
anemia was considerably high among the girls who belonged to the low socio-economic
status.32
Siddharam et al. (2011), a study was conducted to estimate the prevalence of

anemia among adolescent girls and to study the socio-demographic factors associated
with anemia. A cross sectional survey was conducted in selected Anganwadi centers of
rural area of Hassan district.314 adolescent girls (10-19 years) were included in the study.
The study was conducted from February to April 2011 (3 months). Data analysis was
done by using proportions and chi-square test. Prevalence of anemia was found to be
45.2%, a statically significant association was found with iron deficiency anemia, weight
loss and anemia; pallor and anemia. In the present study, it was seen that among the
45.2% of anemic adolescent girls 40.1% had mild anemia, 54.92% had moderate anemia
and 4.92% had severe anemia. A high prevalence of anemia among adolescent girls was
29
found, which was higher in low economic strata. It was seen that anemia affects overall
nutritional status of adolescent girls.33
Ajgonkar et al. (2010), a study was conducted on prevalence of Iron Deficiency

Anemia (IDA) among adolescent girls (11-21 years) residing in urban slum areas of
Dharavi, Mumbai. Iron deficiency anemia which is a widespread condition in adolescents
of developing countries. The rapid rate of linear growth, increase in blood volume and
onset of menarche during adolescence all increases the need for iron. Adolescent iron
requirements are even higher in developing countries because of infectious disease and
parasitic infestations that cause iron loss. Therefore, an attempt has been made to report
the prevalence of IDA among adolescent girls residing in urban slum areas of Dharavi, at
Mumbai. To determine the prevalence of IDA in adolescent girls (11-21 years) residing
in urban slum areas of Dharavi, Mumbai. The study was carried out in the 100 adolescent
girls (11-21 years) who are the beneficiaries of ICDS and Kishori project from slum areas
of Dharavi, Mumbai using purposive sampling technique. Standardized questionnaire
was used to determine the eating habits of the subjects. Anemia detection was done by
estimation of complete blood count using mythic – 18, an automated blood cell counter.
The prevalence of IDA was found to be 50 %, despite majority of the subjects (42%)
being non-vegetarians. The highest frequency was found among the Hindu (24%) and
Muslim (21%) community. One of the reasons for the same could be that none of the
subjects had undergone deworming so far. It was also seen that consumption of
micronutrient rich foods was less, there by emphasizing the need for creating awareness
of personal hygiene and providing nutrition education for the participants. 34
Avashia (2010), a study was conducted on anemia prevalence. Anemia is more

commonly prevalent among adolescents, preschool children, pregnant and lactating
mothers. Anemia among adolescent have gained more importance as they are the most
crucial segment of the population whose wellbeing influences the future generation as
today young girls are future mothers. Micronutrient deficiency, especially iron deficiency
in adolescent girls can seriously affect their health. 8% of adolescent girls of 10-19 years
of age are suffering from iron deficiency anemia. Food based approaches have higher
potential for achieving and reaching and long lasting benefits for the control of iron and
30
other micronutrient deficiency. Hence the research was undertaken to develop an iron
rich health drink which was made up with locally available ingredients, evaluates its
acceptability and its efficacy by supplementing the drink to selected anemic adolescent
girls.
 REVIEW OF LITERATURE TO ASSESS THE KNOWLEDGE REGARDING

IRON DEFICIENCY ANEMIA.
D Divya, B Kokilamma, P Sudharani and M Sreelatha (2017), a study was

conducted to assess the knowledge regarding measures to improve hemoglobin levels
among adolescent girls at selected colleges Tirupati Non experimental approach to
achieve the objectives of the study, a descriptive study involving 100 adolescent girls at
Sree padmavathi junior college for women. Data were collected by using structure
questionnaire. Data regarding demographic characteristics and multiple choice question
related to measures to improve hemoglobin. Data were analyzed with cronbach’s Alpha,
correlation co efficient. Hypothesis H01 states there is a no significant association
between measures to improve hemoglobin with selected demographic variables was
accepted. Out of 100 adolescent girls majority (57%) were inadequate knowledge, more
than 1/4th (36%) of Adolescent girls were having moderate knowledge and few (7%)
participants having adequate knowledge regarding measures to improve hemoglobin
levels among adolescent girls.35
Niba Johnson, Noufeena D. Y. et. al. (2016), a study was conducted on

knowledge regarding prevention of iron deficiency anemia among adolescent girls in
selected pre-university colleges of Mangaluru. The study was carried out to determine the
knowledge regarding prevention of iron deficiency anemia among adolescent girls and to
find the association between knowledge scores and selected demographic variables. A
descriptive survey approach was used in the study, non-probability purposive sampling
technique was used to select 100 adolescent girls and data was gathered using the
structured knowledge questionnaire on iron deficiency anemia. Data was analyzed by
using descriptive and inferential statistics. The study result showed that majority (84%)
of study sample had moderately adequate knowledge, 11% had inadequate knowledge
31
and 5% had adequate knowledge on prevention of iron deficiency anaemia. There was no
significant association found between knowledge scores and the selected demographic
variables of the adolescent girls (p>0.05). This study concluded that majority (84%) of
the study sample had moderately adequate knowledge on prevention of iron deficiency
anemia so it is advisable to provide educational programs for the adolescent girls
regarding iron deficiency anemia.36
Mr. Chandrasekhar M et al. (2016), a descriptive study was conducted in

Mysore to assess the knowledge regarding iron deficiency anemia among adolescent
girls. 100 samples from selected rural areas of Mysore were selected using non-
probability convenient sampling. Data collection tool consisted of a personal profile and
a structured questionnaire to assess the knowledge regarding prevention of iron
deficiency anemia among adolescent girls. Collected data was analyzed using descriptive
and inferential statistics. The findings of the study revealed that maximum number of
adolescent girls is having average knowledge regarding the prevention of iron deficiency
anemia. It is found that the association between the level of knowledge of adolescent girls
regarding the prevention of iron deficiency anemia is statistically not significant with
their age, education, education of the parents, dietary pattern, previous information, type
of family, religion and number of children in the family but there is an association
between the family income and knowledge of adolescent girls. It can be interpreted that
majority of adolescent girl's knowledge regarding prevention of iron deficiency anemia is
nearly average. This study found that there is a necessity to improve knowledge, so the
information booklet given.37
C. Maruthanayagam R. Mahalakshmi (2015), a study was conducted on

anemia and anemic related knowledge among 152 college girl students of Musiritaluk,
Trichy district, Tamil Nadu. A questionnaire has been prepared to collect the
demographic profile of the subjects, food habits of the subjects and food frequency
questionnaire (FFQ) was used. Most of the subjects were within the age range of 18- 21
years, living in nuclear family, having non-vegetarian food habits and belong to middle
income group. Most of the subjects were having faulty food habits; 60% of subjects eat
32
out once a week followed by 23% subjects eat out twice a week and most of them
preferred to eat fast foods and carbonated beverages. Only 25% of the subjects were
having good knowledge about anemia. The results show that the nutrition education
intervention is required for the teenage girls to create awareness and to disseminate the
knowledge related to the prevention and control of anemia.38
Savita et al. (2013), a study was conducted to assess the impact of education
intervention on nutritional knowledge of iron deficiency anemia among 207 post-
adolescent girls of 18-25 years of age in Bangalore. The prevalence of anemia observed
that 53.14 % were found to be moderately anemic, 42.51 % were found to be mildly
anemic and 2.89 % were to be found severely anemic and only 1.44 % had normal
haemoglobin level. The prevalence of anemia in the study population was very high
i.e.98.66%.39
33
CHAPTER IV
RESEARCH METHODOLOGY
“Research methodology is a systematic way to solve a problem systematically. It may be

understood as science of studying how research is to be carried out systematically”.
-According to Polit & Beck
“Research methodology is a method to analytically explain the research problem. It may

be described as a science of analysis how research is done systematically. In this
investigate the various stages that are generally implemented by a scholar in studying his
problem of research in conjunction with the reason behind them”.
-According to Kothari (2004)
“Research methods are the tools and techniques for doing research. Research is a term
used liberally for any kind of investigation that is intended to uncover interesting or new
facts”.
- Walliman (2011)
This chapter includes research approach, research design, sampling procedure,

development of tool, description of tool, validity, reliability, data collection procedure
and plan for data analysis. Present study aimed at assessment of knowledge regarding
iron deficiency anemia and its management among adolescent girls in selected school of
Lucknow with a view to develop an information booklet, Lucknow U.P.
RESEARCH APPROACH
Research approach refers to the researcher’s overall plan for obtaining answers to the
research questions or for testing the research hypothesis. It is the basic strategy that the
researcher adopts to develop information that is accurate and interpretable.
- According to Polite and Hungler (1999)
34
The Research approach is a plan and procedure that consists of the steps of broad
assumptions to detailed method of data collection, analysis and interpretation. It is
therefore based on the nature of the research problem being addressed.
Research approach tells the researcher from whom to collect the data and how to analyze
it. It also suggests possible conclusion to be drawn from the data and helps the researcher
in answering specific research question in most accurate and efficient way.
In view of the nature of the problem selected for the study and the objective to be
accomplished a quantitative research approach was considered to be the most
appropriate approach in order to assess the knowledge regarding anemia and its
management among adolescent girls in selected school of Lucknow with view to develop
an information booklet Lucknow U.P.
RESEARCH DESIGN
Research design means drawing an outline or planning or arranging details. It refers as “a

master plan specifying the methods and procedures for data collection, processing and
analyzing needed information”.
- (William Zikmund, 1988)
Research design can be defined as a blue print to conduct a research study, which
involves the description of the research approach, study setting, sampling size, sampling
technique, tools and method of data collection and analysis to answer specific questions
or for testing research hypothesis.
In this study, non-experimental descriptive research design was adopted to attain the
objectives of the present study.
O1 X
KEY,
O1 –Pre-test
X – Information booklet
35
SCHEMATIC REPRESENTATION OF RESEARCH DESIGN
TARGET POPULATION
450 ADOLESCENT GIRLS FROM 11TH AND 12TH STANDARD STUDYING IN
SHIA GIRLS INTER COLLEGE
ACCESSIBLE POPULATION
135 ADOLESCENT GIRLS FROM 11TH AND 12TH STANDARD BELONGS
FROM ART SECTION
SAMPLING TECHNIQUE
NON PROBABILITY CONVENIENCE SAMPLING
TECHNIQUE
SAMPLE
135 ADOLESCENT GIRLS FROM 11TH AND 12TH STANDARD
DATA COLLECTION
STRUCTURED KNOWLEDGE QUESTIONNAIRE
DATA ANALYSIS AND INTERPRETATION
DESCRIPTIVE INFERENTIAL
STATISTICS STATISTICS
Figure No. 4.1 Schematic Presentation
36
VARIABLES
Chinn and Karamer, stated that variables are concepts at different level of
abstractions that are concisely defined to promote their measurement or manipulation
within study.
Variables are qualities, properties or characteristics of person, things or situations that

change or vary.41
Variables includes in the present study are:
Demographic variables
In this study demographic variables are age, educational qualification, religion of the
participant, type of family and family income per month, previous information, menstrual
cycle, dietary pattern and family health status.
Research variable
In this study knowledge of adolescent girls on anemia and its management is research
variable.
RESEARCH SETTING
According Polit and Hungler “The researcher needs to decide where the
intervention will be implemented and where the data will be collected”.
Setting refers to the area where the study is conducted. It may be natural or a laboratory
setting depending on the type of study and choice of the researcher.
Setting is the location for conducting research
This study was conducted in selected school Shia girls inter college which is situated in
Chaupatiyan, Chauk, Lucknow U.P.
In this school, the classes have been conducted from 8th standard to 12th standard. The
distance from Vivekananda college of Nursing to Shia Girls inter college is 4.8 km.
37
POPULATION
The entire set of individuals or objects having some common characteristic

referred to selected for a research study; sometimes referred to as the universe of the
research study.
According to Best and Khan (1992), “A population is any group or individuals that
have one more characteristics in common and are of interest to the researcher”.
Population is the aggregation of all the units in which a researcher is interested.
Target population: It is the aggregate of cases that confirm to designated criteria and are
also accessible as subjects for a study.41
In this study the target population is 450 adolescent girls from 11th and 12th standard.
Accessible population: A target population consists of the total number of people or

objects which are meeting the designated set of criteria.41
In this study the accessible population is 135 adolescent girls which are from the art
section.
SAMPLE CRITERIA
SAMPLE
According to Polit and Beck (2006) “Sample is the subset of population,

selected to participate in a study”. It is used in the research, when it is not feasible to
study the whole population from which it is drawn.
Sample may be defined as a representative unit of a target population, which is to be

worked upon by researchers during their study. In other word sample consists of a subset
of units which comprise the population selected by investigators or researchers to
participate in their research project.41
In this study, the sample consisted of adolescent girls from Shia girls inter college
Lucknow, belongs from art group, 11th and 12th standard.
38
SAMPLE SIZE
Sample size means number of subjects, events, behaviors or situations that are
examined in a study. In other word sample size refers to a decision on how many items
from the universe are to be subjected for data collection.
The investigator selected 135 adolescent girls who fulfill the criteria of selection and
studying in Shia girls inter college Lucknow, U.P.
SAMPLING TECHNIQUE
According to Denise F. Polit (2011) “Sampling technique is the process of

selection of the sample with which to conduct the study”.
In this study “Non-Probability convenience sampling technique” was used. Non-

probability sampling is a technique where in the samples are gathered in a process that
does not give all the individuals in the population equal chance of being selected in the
sample. In other word every subject does not have equal chance to be selected because
elements are chosen by choice not by chance through non random sampling technique.41
Convenience sampling is a probably the most common of all sampling technique because
it is fast in expensive easy and the subjects are readily available.41
CRITERIA FOR SAMPLE SELECTION
According to Polite and Hungler, Eligibility criteria are the characteristics that
delimit the population of interest. Sampling criteria is that which specifies the
characteristics that the sample in the population must possess.
The sampling frame structured by the investigator included the following criteria.
INCLUSIVE CRITERIA
Inclusion criteria are characteristics that the prospective subjects must have if they are to
be included in the study.
39
In present study, inclusive criteria will be-
1. Adolescent girls (15 -20 years)

2. Who understand English or Hindi
3. Who are available at the time of data collection
EXCLUSIVE CRITERIA
Exclusive criteria are those characteristics that disqualify subjects from inclusion in the
study.
In present study exclusion criteria will be-
1. Adolescent girls less than 15 & more than 20 year.

2. Who are not willing to participate.
RESEARCH TOOL
According to Polit and Beck (2008), “A tool is the formal procedure that the
researcher develops to guide the collection of data in a standardized fashion in most
quantitative studies.”
A structured instrument with close ended items is efficient and easy to administer and
analyze.
Research tool is a device which is used to collect the data. The present study aim to
enhance the knowledge regarding iron deficiency anemia and its management by
assessing the knowledge of adolescent girls with structured knowledge questionnaire in
selected school Shia girls inter college Lucknow U.P.
TOOL FOR DATA COLLECTION
In this study, structured knowledge questionnaire was used as a research tool.
DESCRIPTION OF TOOLS
The most important aspect of any investigation is the appropriate information which
provides necessary data to answer the question raised in the study. For this study,
40
structured knowledge questionnaire was prepared for the data collection. Following steps
were taken to develop the tools: review of literature, opinion and suggestion from the
guides and experts and investigator own experience about the topic.
In this study tool consist of two parts:
Section A: Demographic Variables
Section B: Structured Knowledge Questionnaire
SECTION A: Demographic Variables
Socio demographic variables were developed by the researcher to collect base line
information of samples. Information on demographic data was collected from adolescent
girls. Master data sheet was prepared for demographic variables. This part consists of
socio demographic variables such as;
Age, religion, education, qualification, previous knowledge regarding anemia

and its management.
SECTION B: Structured Knowledge Questionnaire
Structured knowledge questionnaire was developed by the researcher to assess the

knowledge regarding anemia and its management among adolescent girls. This tool
consists of 30 multiple choice questions have four options. Out of four choices only one
was correct.
SCORE INTERPRETATION
For the structured Knowledge Questionnaire item score 1 was awarded for each correct
answer and 0 for wrong answer in all items. Thus a total 30 scores were allotted under
knowledge aspect and to interpret the level of knowledge, scores were distributed as
follows:-
41
Table No. 4.1 Scored Interpretation of Structured Knowledge Questionnaire
S. NO. SCORE LEVEL PERCENTAGE (%) OF LEVEL OF

SCORE KNOWLEDGE
1. 0-10 0-33.3% Inadequate

2. 11-20 33.4 - 66.7% Moderate
3. 21-30 66.8 -100% Adequate
DEVELOPMENT OF INFORMATION BOOKLET
The information booklet was prepared based on the title of the topic and objective
selected for the study. The following steps were adapted to develop the information
booklet-
 Development of the content

 Preparation of information booklet
 Content validity of information booklet
 Distribution of information booklet
DESCRIPTION OF INFORMATION BOOKLET
An information booklet was developed on the basis of review of the existing literature on
anemia and its management. Guidance from experts was taken in the development of the
information booklet. The information booklet comprises of following topics:
 Introduction on anemia
 Terminology related to anemia
 Definition of anemia
 Iron deficiency anemia
 Causes of anemia
 Sign and symptoms of anemia
 Management of anemia
42
CONTENT VALIDITY OF TOOL
Polit and Beck (2008) defined validity as “the degree to which an instrument
measures what it is intended to measure”.
The constructed tools along with objectives, blue print and criterion checklist was
submitted to 7 experts. The selection of experts was done based on their experience and
clinical experience. The experts were requested to give their opinions regarding
relevancy, accuracy and appropriateness of the items for further. Experts were selected
from the field of medical sciences, child health nursing. The suggestions from them were
incorporated into the tool. Validity of the tool was established by consultation with guide
and experts. Hence the tool was considered appropriate for pilot study.
RELIABILITY OF TOOL
“Reliability is the degree of consistency or dependability with which an

instrument measures the attributes it is designed to be measure”
The tool was tested for the reliability on 12/1/19 by split half method on 10 adolescent
girls in which Karl Pearson’s formula was used. The reliability of coefficient as 0.8.
Hence the structured knowledge questionnaire was found reliable.
ETHICAL CLEARANCE
 Written permission was taken from the research committee of Vivekananda

College of nursing, Lucknow.
 Written permission was obtained from the authorities of Shia Girls Inter College,
Lucknow, where the study was scheduled to be conducted. The purpose of the
study explained to the concerned authorities and participants.
 Informed consent were obtained from the participants who were enrolled for the
study (adolescent girls) of Shia Girls Inter College, Lucknow.
43
PILOT STUDY
According to Burns and Grove 2007 “Pilot study is a small-scale version of trial
run designated to test the method to be used in a large mode rigorous study, which
sometime refer to as present study”
After validation of the tool the researcher had started the pilot study on 17/1/2019 in Soha
Fatima public girls inter college, Lucknow with 10% of total sample size that is 14
adolescent girls. Prior to the study, formal permission was taken from the Principal of
Soha Fatima girls inter College. The investigator had selected the students with the help
of convenience sampling technique. After taking consent from the students, investigator
collected socio-demographic data from the students and then conducted pre-test.
A concise analysis was done using the statistics. During the pilot study the investigator
did not face any problem and found that the study to be feasible. The pilot study also
helped the investigator to estimate the total time required to conduct main study including
the budget.
After conducting the pilot study, it was found that the study was feasible. The concerned
authority and the sample were found to be cooperative, the structured knowledge
Questionnaire were relevant and the time and cost of the study was within the limit.
DATA COLLECTION PROCEDURE
The data collection procedure refers to identification of subjects and the precise,
systematic gathering of information/data relevant to the research purpose or the specific
objectives, questions or hypothesis of a study.
• Written permission was taken from research and ethical committee of

Vivekananda College of Nursing, Lucknow.
• After obtaining a formal permission from the concerned authorities of Shia girls
inter college samples were selected by non-probability convenience sampling
technique.
• Written consent was obtaining from the participants after explaining the purpose
of study and confidentiality was assured to all samples.
44
• Data was collected on 22-01-2019.The investigator administered structured
knowledge questionnaire to obtain the pretest.
PLAN FOR DATA ANALYSIS

The data collected from the sample subjects was organized and tabulated. The data were
analyzed in terms of objectives of the study by using descriptive and inferential statistical
measure, which are necessary to provide substantial summary of results.
The data analysis was planned based on the objective of the study.
Frequency and percentage distribution was used to analyze the socio-

demographic variables and knowledge level of the adolescent girls.
Mean, mean percentage and standard deviation was used to assess the
knowledge of adolescent girls regarding anemia and its management.
Chi square test is used to find the association of knowledge with the selected
45
CHAPTER V
DATA ANALYSIS AND INTERPRETATION
RESULTS
This chapter deals with analysis and interpretation of the data collected to “assess the
knowledge regarding anemia and its management among adolescent girls in selected
school of Lucknow with a view to develop an information booklet Lucknow U.P.”
“Analysis is defined as categorizing, ordering, manipulating and summarizing of data to
reduce it to interpretation form so that, research problem can be studied and tested
including relationship between the variables”. “Analysis and interpretation is the process
in which researcher examine the result from the data analysis, form conclusion explores
the significance of finding, generalize the finding and suggest further studies”. Hence the
analysis and interpretation of the data was done based upon these following objectives:
OBECTIVES
HYPOTHESIS
The hypothesis will be tested at the 0.05 level of significance.

46
ORGANIZATION AND COLLECTION OF DATA
A structured knowledge questionnaire was prepared to assess the knowledge regarding

anemia and its management among adolescent girls in selected school of Lucknow with a
view to develop an information booklet Lucknow U.P. A sample of 135 adolescent girls
was drawn from Shia girls inter college. The data obtained were entered in a master data
sheet for tabulation and analysis by employing descriptive and inferential statistics.
The analysis of data is organized and presented under the following sections.
The findings are presented under the following sections on the basis of objectives and
hypothesis:-
Section I: - Distribution of samples subjects according to their demographic variables.

Demographic variables include age, educational qualification, religion of the participant,
type of family, and family income per month, previous information, menstrual cycle,
dietary pattern and family health status.
Section II: - Knowledge scores of adolescent girls regarding anemia and its management
a) Percentage wise distribution of sample subjects according to the level of knowledge

scores.
b) Item wise analysis of correct and incorrect response regarding anemia and its
management.
c) Mean, standard deviation and mean percentage level of knowledge regarding anemia
and its management.
Section III: - Testing hypothesis.

47
SECTION I
DISTRIBUTION OF SAMPLE SUBJECTS ACCORDING TO THEIR
DEMOGRAPHIC VARIABLES
Table 5.1.1: Frequency and percentage of adolescent girls according to
their Age in year n=135
S. NO. AGE IN YEAR FREQUENCY PERCENTAGE
1 15 -16 years 74 54.81
2 17- 18 years 55 40.75
3 19 -20 years 6 4.44
4 Above 20 years 0 0
Total 135 100
Figure no. 5.1.1: Bar graph showing the percentage of adolescent girls according to
the age group.
Bar graph in figure no 5.1.1 - Indicates that majority of subjects were in the age group of
15-16 year (54.81%) followed by 17-18 years (40.75%) and only (4.44%) were in the age
group of 19 - 20 year and there was no any adolescent girl belongs from the age group of
above 20 years.
48
their educational qualification.
S. NO. EDUCATIONAL QUALIFICATION FREQUENCY PERCENTAGE

1. 11th standard 112 83
2. 12th standard 23 17
Total 135 100
Figure no 5.1.2: Cone graph showing the percentage of adolescent girls’ educational
qualification
Cone graph in figure no 5.1.2 - Indicates that Majority of the sample subjects were in the
11th standard (83%) and only (17%) sample subjects belongs to 12th standard
respectively.
49
their religion
S. NO. RELIGION FREQUENCY PERCENTAGE

1. Hindu 10 7.4
2. Muslim 124 91.9
3. Others 1 0.7
Total 135 100
Figure no 5.1.3: Bar graph showing the percentage of adolescent girls’ according to
religion
Bar graph in figure no 5.1.3 - Indicates that Majority of the sample subjects were Muslim
(91.9%) followed by Hindu (7.4%) and only (0.7%) belongs to other religion which
belongs from Christian religion.
50
their type of family
S. NO. TYPE OF FAMILY FREQUENCY PERCENTAGE

1. Nuclear family 39 28.9
2. Joint family 84 62.2
3. Extended family 12 8.9
Total 135 100.0
Figure no 5.1.4: Bar graph showing the percentage of adolescent girls based on
types of family from which they belongs
Bar graph in figure 5.1.4 - Indicates that Majority of the family belongs from joint family
(62.2%) followed by nuclear family (28.9%) and only (8.9%) belongs from extended
family.
51
their family income per month.
S. NO. FAMILY INCOME PER MONTH FREQUENCY PERCENTAGE

1. Rs 10,000 – 15,000 117 86.7
2. Rs 15,001- 20,000 11 8.1
3. Rs 20,001- 25,000 5 3.7
4. Rs 25,001-30,000 2 1.5
5. Rs 30001 and above 0 0
Total 135 100
Figure no 5.1.5: Bar graph showing the percentage of adolescent girls according
to their family income per month
Bar graph in figure 5.1.5 – Indicates that Majority of family income per month of
adolescent girls belongs from 10,000- 15000 (86.7%) and (8.1%) were having monthly
income 15,001-20,000 and (3.7%) were having monthly income 20,001-25000 and
(1.5%) belongs from monthly income 25001- 30,000 and no one belongs from the family
income of 30001 and above.
52
Table 5.1.6.1: Frequency and percentage of adolescent girls according to
their previous information
S. NO PREVIOUS INFORMATION FREQUENCY PERCENTAGEAGE

1. Yes 105 77.78
2. No 30 22.22
Total 135 100.0
Figure no 5.1.6.1: Pie graph showing the percentage of adolescent girls based on
knowledge of anemia.
Pie graph showing in the figure 5.1.6.1 - Indicates that Majority of sample subjects
(77.78%) had previous information regarding anemia and only (22.22%) samples had not
previous information regarding anemia.
53
Table 5.1.6.2: Frequency and percentage of adolescent girls according
to their previous information. If yes,
S. NO. PREVIOUS INFORMATION FREQUENCY PERCENTAGE

1. Books, articles 42 31.1
2. Colleagues 14 10.4
3. Mass media 3 2.2
4. Family member 46 34.1
Total 105 78
Figure no 5.1.6.2: Doughnut graph showing the percentage of adolescent girls based
on various methods to know about the anemia.
Doughnut graph showing in the figure 5.1.6.2 - Indicates that among (78.00%) sample
subjects who had previous information regarding anemia in which (34.1%) had information
from family members, (31.1%) had information from books and articles, (10.4%) had
information from colleagues and only (2.2%) had information from mass media.
54
their menstrual cycle
S. NO. MENSTRUAL CYCLE FREQUENCY PERCENTAGE
1. Regular 88 65.2
2. Irregular 35 25.9
3. Heavy bleeding 12 8.9
Total 135 100
Figure no 5.1.7: Bar graph showing the percentage of adolescent girls according to
their menstrual cycle.
Bar graph showing in the figure 5.1.7 - Indicates that the majority of sample subjects
(65.2%) had regular menstrual cycle, (25.9%) had irregular menstrual cycle and only
(8.9%) had heavy bleeding in their menstrual cycle.
55
their dietary pattern
S. NO DIETARY PATTERN FREQUENCY PERCENTAGE

1. Vegetarian 48 35.6
2. Non vegetarian 87 64.4
Total 135 100.0
Figure no 5.1.8: Bar graph showing the percentage of adolescent girls according to
their dietary pattern
Bar graph showing in the figure 5.1.8 - indicates that the majority of the sample subjects
(64.4%) were having non-vegetarian dietary pattern and rest (35.6%) were belongs from
vegetarian dietary pattern.
56
their family health status
S.NO. FAMILY HEALTH STATUS FREQUENCY PERCENTAGE

1 Healthy 50 37
2 Unhealthy 85 63
Total 135 100
Figure no 5.1.9.1: Doughnut graph showing the percentage of adolescent girls

according to their family health status
Doughnut graph showing in the figure 5.1.9.1- Indicates that the majority of samples
(63%) were unhealthy and only (37%) were healthy.
57
their family health status. If unhealthy,
S. NO. FAMILY HEALTH STATUS FREQUENCY PERCENTAGE

1. Anemia 43 31.90
2. High blood pressure 13 9.60
3. Jaundice 4 3.0
4. Diabetes 25 18.50
Total 85 63
Figure no 5.1.9.2: Bar graph showing the percentage of adolescent girls based on
type of disease in their family health.
Bar graph showing in the figure 5.1.9.2 - Indicates that among (63.00%) sample subjects
who were unhealthy, (31.9%) had anemia, (18.5%) had diabetes, (9.6%) had high blood
pressure and only (3.0%) had jaundice.
58
SECTION II
KNOWLEDGE OF ADOLESCENT GIRLS REGARDING ANEMIA

AND ITS MANGEMENT
This section describes the frequency percentage distribution of sample subjects according
to the level of knowledge regarding anemia and its management. The knowledge scores
obtained through structured knowledge questionnaire which analyzed by using the
descriptive statistics.
Table 5.2.1
Frequency Percentage distribution of sample subjects according to the level of

knowledge.
S. NO. LEVEL OF KNOWLEDGE FREQUENCY PERCENTAGE

1 Inadequate 66 48.9
2 Moderate 44 32.6
3 Adequate 25 18.5
Total 135 100
Figure no. 5.2.1: Bar graph showing the level of knowledge of adolescent girls.
59
Figure no 5.2.1- Indicate majority of adolescent girls (48.9%) had inadequate knowledge
regarding anemia, (32.6%) had moderate knowledge and only (18.5%) had adequate
knowledge regarding anemia.
Table 5.2.2
ITEM WISE ANALYSIS OF CORRECT AND INCORRECT

RESPONSE REGARDING ANEMIA AND ITS MANAGEMENT
Question Structured knowledge Total Percentage Total Percentage %

(N=135) questionnaire corrected % incorrect
response response
Q.1 Common victim of anemia 93 68.89 42 31.11
Q.2 Hemoglobin is made up of 35 25.93 100 74.07
Q.3 Normal value of hemoglobin 17 12.59 118 87.41
in adolescent female
Q.4 Which unit is used to 77 57.04 58 42.96
measure hemoglobin
Q.5 Which instrument is used to 92 68.15 43 31.85
measure hemoglobin level
Q.6 What is the normal life span 27 20 108 80.00
of red blood cells
Q.7 What is the primary role of 40 29.63 95 70.37
iron in blood
Q.8 What is the definition of 80 59.26 55 40.74
anemia
Q.9 Anemia is regarded as severe 79 58.52 56 41.48
when the hemoglobin level is
Q.10 Which is the most common 85 62.96 50 37.04
sign of anemia
Q.11 Which is the most common 92 68.15 43 31.85
type of anemia in adolescent
girls
Q.12 What are the Clinical signs of 96 71.11 39 28.89
iron deficiency anemia
Q.13 What are the Symptoms of 73 54.07 62 45.93
iron deficiency anemia
Q.14 Where pallor color in the 73 54.07 62 45.93
body can be seen in anemia
Q.15 How Iron deficiency anemia 55 40.74 80 59.26
affects adolescent girls
Q.16 What is the daily iron 37 27.41 98 72.59
60
requirement in adolescent
girls
Q.17 What is the recommended 82 60.74 53 39.26
nutritional requirement in
adolescent period
Q.18 Which food is not rich in Iron 84 62.22 51 37.78
Q.19 Which Plant source is rich in 54 40 81 60.00
iron
Q.20 Which is the rich animal 36 26.67 99 73.33
source of iron
Q.21 Which one of the following is 43 31.85 92 68.15
the best home remedy to
increase the hemoglobin level
Q.22 Which one of the following 69 51.11 66 48.89
helps in absorption of iron
Q.23 What is the recommended 50 37.04 85 62.96
dose of iron and folic acid
among adolescent girls
Q.24 What is the treatment for 85 62.96 50 37.04
worm infestation
Q.25 When the transfusion of 85 62.96 50 37.04
blood should be started in
anemia
Q.26 Which is not true regarding 71 52.59 64 47.41
oral iron therapy
Q.27 What is the preventive 44 32.59 91 67.41
measure for iron deficiency
anemia in school children
Q.28 How Folic acid deficiency is 81 60 54 40.00
prevented
Q.29 Which national programme 78 57.78 57 42.22
helps in prevention of iron
deficiency anemia
Q.30 Which one of the following is 63 46.67 72 53.33
the side effect of oral iron
therapy
In this table, the majority of the sample is 118, (87.41%) was given incorrect
response/answer regarding anemia and its management and majority of sample is 96,
(71.1%) was given correct response for the same questions. So, the conclusion of this
table shows that the majority of respondent have inadequate knowledge regarding anemia
and its management.
61
Table no. 5.2.3
Mean, Standard Deviation and mean percentage on level of knowledge regarding

anemia and its management among adolescent girls. n = 135
Groups Mean Standard Deviation Mean Percentage

Level of 14.6370 5.46441 48.7901
Knowledge
The data represent in this table and figure indicates that the Mean, Standard Deviation
and mean percentage on level of knowledge regarding anemia and its management. The
mean knowledge score is 14.63, Standard deviations is 5.46 and mean percentage is
48.79.
62
SECTION III
This section is related to testing of hypothesis i.e. association between the level of
knowledge scores with their selected demographic variables.
In order to determine the association between the levels of knowledge scores with their
selected demographic variables, the following hypothesis was formulated-
H1: There will be a significant association between level of knowledge scores with their
selected demographic variables.
Table 5.3.1
Association between level of knowledge scores regarding anemia and its

management among adolescent girls with their selected demographic variables.
S. Variables Level of Knowledge Statistical Significance

No. Inadequate Moderate (n=44) Adequate df
(n=66) (n=25) p- Table
Val Value
Num Percent Numbe Percent Num Percent
ue (P<
ber age (%) r age (%) ber age (%)
0.05)
1 Age in Years
15-16 year 30 45.5% 29 65.9% 15 60.0% 7.1 4 0.1 9.49
17-18 year 32 48.5% 15 34.1% 8 32.0% 38 29
19- 20 year 4 6.1% 0 0.0% 2 8.0%
Above 20 0 0.0% 0 0.0% 0 0.0%
2 Educational Qualification
11th 50 75.8% 39 88.6% 23 92.0% 4.8 2 0.0 5.99
standard 71 88
12th 16 24.2% 5 11.4% 2 8.0%
standard
3 Religion of the Participant
Hindu 3 4.5% 3 6.8% 4 16.0% 4.4 4 0.3 9.49
Muslim 62 93.9% 41 93.2% 21 84.0% 95 43
Others 1 1.5% 0 0.0% 0 0.0%
4 Type of Family
Nuclear 20 30.3% 11 25.0% 8 32.0% 2.5 4 0.6 9.49
family 13 42
63
Joint family 38 57.6% 30 68.2% 16 64.0%
Extended 8 12.1% 3 6.8% 1 4.0%
family
5 Family Income per Month
Rs. 10,000- 53 80.3% 40 90.9% 24 96.0% 8.6 6 0.1 12.59
15000 88 92
Rs. 15,001- 9 13.6% 2 4.5% 0 0.0%
20,000
Rs. 20,001- 3 4.5% 2 4.5% 0 0.0%
25,000
Rs. 25,001- 1 1.5% 0 0.0% 1 4.0%
30,000
Rs. 30001 0 0.0% 0 0.0% 0 0.0%
and above
6 Previous Information Regarding Anemia and its Management
Books, 19 28.8% 17 38.6% 6 24.0% 4.2 8 0.8 15.51
articles 8 3
Colleagues 7 10.6% 4 9.1% 3 12.0%
Mass media 1 1.5% 1 2.3% 1 4.0%
Family 22 33.3% 16 36.4% 8 32.0%
member
No 17 25.8% 6 13.6% 7 28.0%
Information
7 Menstrual Cycle
Regular 37 56.1% 31 70.5% 20 80.0% 6.6 4 0.1 9.49
Irregular 21 31.8% 9 20.5% 5 20.0% 03 58
Heavy 8 12.1% 4 9.1% 0 0.0%
Bleeding
8 Dietary Pattern
Vegetarian 25 37.9% 12 27.3% 11 44.0% 2.2 2 0.3 5.99
Non 41 62.1% 32 72.7% 14 56.0% 51 25
Vegetarian
9 Family Health Status
Healthy 26 39.4% 15 34.1% 9 36.0% 9.1 8 0.3 15.51
Anemia 20 30.3% 11 25.0% 12 48.0% 81 27
High Blood 6 9.1% 7 15.9% 0 0.0%
Pressure
Jaundice 3 4.5% 1 2.3% 0 0.0%
Diabetes 11 16.7% 10 22.7% 4 16.0%
If others 0 0.0% 0 0% 0 0.0%
than specify
64
The data given in this table shows that Chi square test was used to find out significant
association between level of knowledge scores with their selected demographic variables.
The findings of chi square shows that there is no significant association between the level
of knowledge scores with demographic variables like: - Age in year Educational
Qualification, Religion of the Participant, Type of Family, Family Income per
Month, Previous Information Regarding Anemia and its Management, Menstrual
Cycle, Dietary Pattern, Family Health Status. Here the p- value in each case is greater
than 0.05 (level of significance).
Thus, it can be concluded that the research hypothesis is rejected, which means there is
no significant association between level of knowledge scores with their selected
CHAPTER VI
65
DISCUSSION
This chapter discusses about the objectives and their relation to the findings from the
results and review of the related studies. The present study was aimed to assess the
knowledge regarding anemia and its management among adolescent girls in selected
school of Lucknow with a view to develop an information booklet Lucknow, U.P. in
order to achieve the objectives of the study. Descriptive design was adopted and 135
adolescent girls were selected by using non-probability convenience sampling technique
that was fulfilling the inclusion and exclusion criteria. The subjects were evaluated
through structured knowledge questionnaire regarding anemia and its management. Data
collection and analysis were carried out based on the objective of the study. Findings of
the study were discussed in terms of objectives and hypothesis along with the findings of
other studies.
OBJECTIVES
RESEARCH HYPOTHESIS
Hypothesis is a tentative statement about the relationship, if any between two or

more variables.
Hypothesis will be tested at p < 0.05 significance level.
MAJOR FINDINGS
66
The major findings of the study are summarized as follows:
SECTION I
Findings related to the distribution of subjects according to their demographic variables.
1) Majority of subjects were in the age group of 15-16 years (54.81%) followed by 17-
18 years (40.75%) and only (4.44%) were in the age group of 19 - 20 years and no
any adolescent girl belongs from above 20 years.
2) Majority of the sample subjects were in the 11th standard (83%) and only (17%)
sample subjects belongs to 12th standard respectively.
3) Majority of the sample subjects were Muslim (91.9%) followed by Hindu (7.4%)
and only (0.7%) belongs to other religion which belongs from Christion religion.
4) Majority of the family belongs from joint family (62.2%) followed by nuclear family
(28.9%) and only (8.9%) belongs to extended family.
5) Majority of family income per month belongs from 10,000- 15000 (86.7%) and
(8.1%) were having monthly income 15,001-20,000 and (3.7%) were having
monthly income 20,001-25000 and 30001 only (1.5%) belongs from monthly
income 30001 and above.
6) Majority of sample subjects (77.78%) had previous information regarding anemia
and only (22.22%) samples had not previous information regarding anemia. Among
(78.00%) samples subjects who had previous information regarding anemia in which
(34.1%)had information from family members, (31.1%) had information from books
and articles, (10.4%) had information from colleagues and only (2.2%) had
information from mass media.
7) Majority of sample subjects (65.2%) had regular menstrual cycle, (25.9%) had
irregular menstrual cycle and only (8.9%) had heavy bleeding in their menstrual
cycle.
8) Majority of the sample subjects (64.4%) were having non-vegetarian dietary pattern
and rest (35.6%) were belongs from vegetarian dietary pattern.
9) Majority of samples (63.00%) were unhealthy and only (37.00%) were healthy.
Among (63.00%) sample subjects who were unhealthy in which (31.9%) had
67
anemia, (18.5%) had diabetes, (9.6%) had high blood pressure and only (3.0%) had
jaundice.
SECTION II
a) Percentage wise distribution of sample subjects according to the level of knowledge.
Findings related to the Frequency Percentage distribution of sample subjects

according to the level of knowledge scores.
In the present study, the level of knowledge scores was categorized into inadequate,
moderate and adequate level of knowledge. Knowledge scores among adolescent girls
depicts the majority of adolescent girls (48.9%) had inadequate knowledge regarding
anemia, (32.6%) had moderate knowledge and only (18.5%) had adequate knowledge
regarding anemia.
While comparing the other study findings of the other published researcher, findings of
this study is showed that majority (84%) of study sample had moderately adequate
knowledge, 11% had inadequate knowledge and (5%) had adequate knowledge on
prevention of iron deficiency anemia. There was no significant association found between
knowledge scores and the selected demographic variables of the adolescent girls
(p>0.05). This study concluded that majority (84%) of the study sample had moderately
adequate knowledge on prevention of iron deficiency anemia so it is advisable to provide
educational programs for the adolescent girls regarding iron deficiency anemia.
This section full fill the first objective of the study to assess the existing level of
knowledge regarding anemia and its management among adolescent girls.
b) Mean, standard deviation and mean percentage level of knowledge regarding anemia
and its management.
In this study the Mean, Standard Deviation and mean percentage on level of knowledge
regarding anemia and its management. The mean knowledge score is 14.63, Standard
deviation is 5.46 and mean percentage is 48.79.
68
SECTION III
Findings related to testing of hypothesis i.e. there is significant association between the
level of knowledge scores with their selected demographic variables
In this study Chi square test was used to find out significant association between level of
knowledge scores with their selected demographic variables. The findings of chi square
shows that there is no significant association between the level of knowledge scores with
demographic variables like: - Age in year Educational Qualification, Religion of the
Participant, Type of Family, Family Income per Month, Previous Information
Regarding Anemia and its Management, Menstrual Cycle, Dietary Pattern, Family
Health Status. Here the p- value in each case is greater than 0.05 (level of significance).
This section full fill the second objective of the study that was find out the
association of knowledge scores among adolescent girls regarding anemia and its
management with their selected demographic variables.
Thus, it can be concluded that research hypothesis is rejected, which means there is no
association between demographic variables.
CHAPTER VII
CONCLUSION
69
This chapter presents the conclusions drawn, implications, limitations,
suggestions and recommendations. The focus of this study was to assess the knowledge
regarding anemia and its management among adolescent girls. Descriptive research
design was used. 135 adolescent girls were selected which were from Shia girls inter
college through non-probability convenience sampling technique. The data was collected
by structured knowledge questionnaire. Data was analyzed and interpreted by applying
statistical methods. The findings reveal that maximum adolescent girls (48.9%) had
inadequate level of knowledge, (32.6%) had moderate level of knowledge and only
(18.5%) of the sample subjects had adequate knowledge regarding anemia and its
management. The study concluded that there was an inadequate level of knowledge
regarding anemia and its management is high. Thus, a strong need is to improve the level
of knowledge of the adolescent girls. Therefore, the investigator distributed information
booklet without any post intervention to disseminate the information regarding anemia
and its management. Among the demographic variables analyzed in the study there is no
no any significant association among demographic variables.
NURSING IMPLICATIONS
The result of the study proved that there is an inadequate level of knowledge among
adolescent girls and there is a need to improve the level of knowledge of the adolescent
girls. Hence the responsibility of the health personnel is to create awareness regarding
anemia and its management.
The findings of the study have several implications in nursing practice, nursing
education, nursing research, and public education.
NURSING PRACTICE
The expanded role of the professional nurse emphasizes those activities which promote
health promotion and prevention behavior among people.
NURSING EDUCATION
70
 Nursing curriculum at pediatric nursing areas should have more content on
anemia and its management
 The curriculum should be such that it will generate interest among nursing
students on anemia and its management
 Students nurses should apprise and guide the parents especially the vulnerable
groups for example pregnant women and their families for knowing and
incorporating anemia and its management.
 The nurse can work as a health educator and arrange classes or health education
programme by providing information regarding anemia and its management
 The nursing personnel can develop and provide information booklet/planned

teaching programme/self-instructional module/ pamphlets for awareness of
anemia and its management among adolescent girls.
NURSING ADMINISTRATION
 The nurse administrator can prepare modules, manuals, health programmes

regarding anemia and its management and use the findings and contents of the
study.
NURSING RESEARCH
 Based on the finding of the study nursing theories can be evolved, which will
strengthen the field of nursing research.
 The present study contributes to the body of knowledge regarding anemia and its
management among adolescent girls.
 The study may serve as a guideline for further research.
LIMITATIONS
The limitations of the study are:-
71
 The sample size was limited to 135 only.
 Samples were only selected from Shia girls inter college.
 Some of the adolescent girls are not available and some refused participate in the
research study.
RECOMMENDATIONS
On the basis of the findings of the study the following recommendations are made:-
 The same study can be replicated on a larger sample or different setting for longer
duration to validate the findings and broaden the generalization.
 A comparative study can be carried out to ascertain the knowledge and attitude
between.
 Rural and urban areas as a whole
 Private and government school
 Age limit criteria can be from 14 to 20 years.
CHAPTER VIII
SUMMARY
72
This chapter gives a brief summary of the study. The present study aimed to assess the
knowledge regarding anemia and its management among adolescent girls.
OBJECTIVE
2. To find out the association between level of knowledge scores among adolescent
girls with their selected Socio demographic variables.
3. To develop and distribute information booklet regarding anemia and its
management among adolescent girls.
HYPOTHESIS
H1: There is a significant association between level of knowledge scores with their
selected demographic variables.
CONCEPTUAL FRAME WORK ADOPTED FOR THE STUDY
The conceptual framework of the study was based on the Pender’s Health Promotion
Model 2008. The major components were Individual characteristics and experiences,
Behavior- specific cognitions and affect, Behavioral outcomes and it provided the
comprehensive framework for achieving the objectives of the study. In this study,
literature reviews were comprised of literature related to anemia and its management
among adolescent girls, literature related to prevalence of anemia. This literature
information enabled the investigator to study the extent of the selected problem, to
develop conceptual framework, data analysis and interpretation.
RESEARCH METHODOLOGY
The research approach used was quantitative research approach. The research design
chosen for the study was descriptive and this study was undertaken in Shia girls inter
college. The data was collected through the structured knowledge questionnaire tool
which was prepared by the investigator. The sample size consists of 135 adolescent girls.
The obtained data was analyzed and interpreted on the basis of the objectives of the
73
study. The collected data was summarized and tabulated by utilizing descriptive statistics
and inferential statistics.
DATA COLLECTION TOOL WERE
SECTION A: Demographic variables
SECTION B: Structured knowledge questionnaire
The following conclusions were drawn on the basis of findings of the study:-
1) Majority of subjects were in the age group of 15-16 years (54.81%) followed by 17-
18 years (40.75%) and only (4.44%) were in the age group of 19 - 20 years and no
any adolescent girl belongs from above 20 years.
2) Majority of the sample subjects were in the 11th standard (83%) and only (17%)
sample subjects belongs to 12th standard respectively.
3) Majority of the sample subjects were Muslim (91.9%) followed by Hindu (7.4%)
and only (0.7%) belongs to other religion which belongs from Christion religion.
4) Majority of the family belongs from joint family (62.2%) followed by nuclear family
(28.9%) and only (8.9%) belongs to extended family.
5) Majority of family income per month belongs from 10,000- 15000 (86.7%) and
(8.1%) were having monthly income 15,001-20,000 and (3.7%) were having
monthly income 20,001-25000 and 30001 only (1.5%) belongs from monthly
income 30001 and above.
6) Majority of sample subjects (77.78%) had previous information regarding anemia
and only (22.22%) samples had not previous information regarding anemia. Among
(78.00%) samples subjects who had previous information regarding anemia in which
(34.1%)had information from family members, (31.1%) had information from books
and articles, (10.4%) had information from colleagues and only (2.2%) had
information from mass media.
7) Majority of sample subjects (65.2%) had regular menstrual cycle, (25.9%) had
irregular menstrual cycle and only (8.9%) had heavy bleeding in their menstrual
cycle.
74
8) Majority of the sample subjects (64.4%) was having non-vegetarian dietary pattern
and rest (35.6%) were belongs from vegetarian dietary pattern.
9) Majority of samples (63.00%) were unhealthy and only (37.00%) were healthy.
Among (63.00%) sample subjects who were unhealthy in which (31.9%) had
anemia, (18.5%) had diabetes, (9.6%) had high blood pressure and only (3.0%) had
jaundice.
CHAPTER-IX
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75
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36. D Divya, B Kokilamma, P Sudharani and M Sreelatha. Conducted a study to

assess the knowledge regarding measures to improve hemoglobin levels among
adolescent girls at selected colleges Tirupati. International Journal of Applied
Research 2017;3(8):648-652
37. Niba Johnson, Noufeena D. Y. et. al. A study on knowledge regarding prevention
of iron deficiency anemia adolescent girls. International journal of current journal
and review (SCI journal ).2016;81(8).
38. Mr. Chandrasekhar M et al. (2016); “Mysore descriptive study was conducted to
assess the knowledge regarding iron deficiency anemia among adolescent girls.
79
100 samples from selected rural areas of Mysore” Asian journal of nursing
education & research.2016;6(1).
39. Savita et.al. impact of educational intervention on nutritional knowledge of iron

deficiency anemia. Asian journal dairy and food research.2013;32(3).214-219.
40. Polit D, Beck C. Nursing Research: Principles and Methods.7th ed. New Delhi:
Lippincott Williams and Wilkins Company; 2006.
41. Polit D.F. Hungler P.E. Nursing Research: Principles and Methods.5th ed.
Philadelphia: J.B. Lippincott Company; 1999.
42. Sharma Suresh k. Nursing Research and Statistics.5th edition.USA: Elsevier

publisher; 2012.5.
43. Basavanthappa B.T. Nursing Research.2nd edition. New Delhi: Jaypee Brothers;
1998.
CHAPTER X
80
ANNEXURE-I
LETTER REQUESTING PERMISSION TO CONDUCT PILOT
STUDY
ANNEXURE-II
81
LETTER REQUESTING PERMISSION TO CONDUCT FINAL
STUDY
ANNEXURE-III
82
LETTER SEEKING CONTENT TO VALIDATE RESEARCH TOOL
AND INFORMATION BOOKLET
To,
-------------------------------
-------------------------------
--------------------------------
Subject: Letter seeking expert’s opinion and suggestion for establishing validity of
research tool.
Respected Sir/Madam
With due respect Ms. Yashika Mishra, II year M.Sc. Nursing student of
Vivekananda College of Nursing have selected the following topic for my research
dissertation to be submitted to King George Medical University in partial fulfillment for
the requirement for award of Master of Sciences in Nursing.
Topic: “A study to assess the knowledge regarding Anemia and its Management
among adolescent girls in selected school of Lucknow with a view to develop an
information booklet Lucknow, U.P.”.
I have prepared the following tools for the purpose of data collection and I request
you to kindly go through the content of the following tool for relevancy and
appropriateness. Here with, I am enclosing the copy of statement of the problem,
objectives, hypothesis, operational definition, demographic variables, research tool,
instructional module, blue print, answer key and criteria checklist for content validity.
I humbly request you to go through the items and give your valuable suggestions
and opinions to develop the content validity of the tool. Kindly suggest modifications,
additions and deletions, if any, in the remark column.
Thanking you in anticipation,
Date: Yours faithfully

Place: Lucknow Ms. Yashika Mishra
M.Sc. Nursing II Year
Vivekananda College of Nursing
83
ANNEXURE-IV
CRITERIA CHECKLIST FOR THE DEMOGRAPHIC VARIABLE
VALIDATION
Respected Madam/sir,
Kindly go through the tool on demographic baseline data and please tick [] in
the column provided against each item in terms of relevance adequacy and accuracy of
each items. Kindly give your valuable comments and suggestions in the remarks column.
PART I: DEMOGRAPHIC VARIABLES
S. No. AGREE DISAGREE REMARKS
1.
2.
3.
4.
5.
6.
7.
8.
9.
Suggestion:
--------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------
-------------------
Full Name & Signature
84
STRUCTURED KNOWLEDGE QUESTIONNAIRE RELATED TO
ANEMIA AND ITS MANAGEMENT AMONG ADOLESCENT
GIRLS
Respected Madam/sir,
Kindly go through the tool on knowledge assessment questionnaire and please
tick [ ] in the column provided against each item in terms of relevance adequacy and
accuracy of each items. Kindly give your valuable comments and suggestions in the
remarks column.
S. No. AGREE DISAGREE REMARKS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
85
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Suggestion:
------------------------------------------------------------------------------------
------------------------------------------------------------------------------------
Full Name & Signature
86
ANNEXURE-V
CONTENT VALIDITY CERTIFICATE
This is to certify that the tool developed by Ms. Yashika Mishra M.Sc. Nursing
Final year student of Vivekananda College of Nursing, Lucknow. (Affiliated to King
George Medical University, Lucknow), undertaking a research on. “Topic- “A study to
assess the knowledge regarding anemia and its management among adolescent girls
in selected school of Lucknow with a view to develop an information booklet
Lucknow, U.P.” has been validated by the undersigned, can proceed with this tool and
conduct the main study for research.
Place: Name:
Date: Designation:
Signature
87
ANNEXURE -VI
LIST OF EXPERTS WHO VALIDATED TOOL
1. Dr. Neeta Bhargava
HOD & Senior Consultant
Department of Pediatrics & Neonatology
Vivekananda Polyclinic Institute of Medical Sciences, Lucknow
2. Dr. N. K. Singh
Senior Consultant
Department of Pediatrics & Neonatology
3. Mrs. Shalini Chaurasia
Head Dietician
4. Lt. Col. Aruna K. R.
Associate Professor
College of Nursing
Command Hospital, Lucknow
5. Mr. K. Halemani
Msc. M.Phil
College of Nursing
S.G.P.G.I.M.S. Lucknow
6. Prof. Sudhakar. A
Nursing Dean cum Principal
Popular Nursing & Paramedical Institute, Varanasi
7. Ms. Sabi Das
Assistant Professor
A.I.I.M.S. Bhopal Nursing College, Bhopal
88
ANNEXURE -VII
CERTIFICATION OF THE STATISTICIAN
89
ANNEXURE –VIII
CERTIFICATE BY ENGLSH EDITOR
90
ANNEXURE –IX
CERTIFICATE BY HINDI EDITOR
91
ANNEXURE –X
SECTION A
Instruction: This section consist of demographic variables. Kindly read the questions
carefully and tick () appropriate answer in the column provided against each item.
Q 1- Age in year
a) 15 -16 years [ ]
b) 17- 18 years [ ]
c) 19 -20 years [ ]
d) Above 20 years [ ]
Q 2- Educational Qualification
a) 11thstandard [ ]
th
b) 12 standard [ ]
Q 3 - Religion of the participant
a) Hindu [ ]
b) Muslim [ ]
c) Others [ ]
If others
1) Christian [ ]
2) Punjabi [ ]
Q 4- Type of family
a) Nuclear family [ ]
b) Joint family [ ]
c) Extended family [ ]
Q5- Family income per month
a) Rs 10,000 – 15,000 [ ]
b) Rs 15,001- 20,000 [ ]
c) Rs 20,001- 25,000 [ ]
d) Rs 25,001-30,000 [ ]
e) Rs 30001 and above [ ]
92
Q 6 - Previous information regarding Anemia and its management
a) Yes [ ]
b) No [ ]
If yes then specify source of information
1) Books, articles [ ]
2) Colleagues [ ]
3) Mass media [ ]
4) Family member [ ]
Q 7 - Menstrual cycle
a) Regular [ ]
b) Irregular [ ]
c) Heavy bleeding [ ]
Q 8 - Dietary pattern
a) Vegetarian [ ]
b) Non vegetarian [ ]
Q 9 - Family health status
a) Healthy [ ]
b) Unhealthy [ ]
If unhealthy then specify which condition
1) Anemia [ ]
2) High blood pressure [ ]
3) Jaundice [ ]
4) Diabetes [ ]
5) If Others then specify [ ]
93
SECTION B
Instruction: This section consist of structured knowledge questionnaire regarding
anemia and its management. Kindly read the questions carefully and tick () appropriate
answer in the column provided against each item.
1. Who are the common victim of anemia?

a) Men [ ]
b) Women [ ]
c) Both A & B [ ]
d) None of above [ ]
2. Hemoglobin is made up of?
a) Iron & oxygen [ ]
b) Iron & protein [ ]
c) Vitamin & iron [ ]
d) Vitamin & protein [ ]
3. What is the normal value of hemoglobin in adolescent female?
a) 10-14gMmol/L [ ]
b) 9-10 mg/dl [ ]
c) 12-18 mg/dl [ ]
d) 12.5-15.5gm/dl ` [ ]
4. Which of the following unit is used commonly to measure hemoglobin?
a) Mmol/L [ ]
b) Mg /dl [ ]
c) Gram /dl [ ]
d) Pg. [ ]
5. Which Instrument is used to measure hemoglobin level?
a) Glucometer [ ]
b) Sphygmomanometer [ ]
c) Hemoglobinometer [ ]
d) Pulse oximeter [ ]
94
6. What is the normal life span of red blood cells?
a) 60 days [ ]
b) 80 days [ ]
c) 120 days [ ]
d) 100 days [ ]
7. What is the Primary role of iron in blood?
a) CarryingO2 [ ]
b) CarryingCO2 [ ]
c) Carrying H2O [ ]
d) Carrying HCo3 [ ]
8. What is the definition of anemia?
a) Decrease in Red Blood Cells [ ]
b) Decrease in White Blood Cells [ ]
c) Thickness of blood [ ]
d) Increase in red blood cells [ ]
9. Anemia is regarded as severe when the hemoglobin level is?
a) Below 13g/dl [ ]
b) Below 11 g/dl [ ]
c) Below 12g/dl [ ]
d) Below 7 g/dl [ ]
10. Which is the most common sign of anemia?
a) Pallor [ ]
b) High blood pressure [ ]
c) Irritability [ ]
d) Loss of appetite [ ]
11. Which is the most common type of anemia in adolescent girls?
a) Pernicious anemia [ ]
b) Vitamin B deficiency anemia [ ]
c) Folic acid deficiency [ ]
d) Iron deficiency anemia [ ]
95
12. What are the Clinical signs of iron deficiency anemia?
a) Brittle nails& sore tongue [ ]
b) Dehydration [ ]
c) Vomiting [ ]
d) Fever [ ]
13. What are the Symptoms of iron deficiency anemia?
a) Palpitation [ ]
b) Fatigue [ ]
c) Vomiting [ ]
d) Both A & B [ ]
14. Where pallor color in the body can be seen in anemia?
a) Sole, chest, abdomen [ ]
b) Conjunctiva, chest & abdomen [ ]
c) Palm, chest, abdomen [ ]
d) Lower palpebral conjunctiva, palms of hand & sole [ ]
15. How Iron deficiency anemia affects adolescent girls?
a) Easily tiredness [ ]
b) Fever [ ]
c) Aggravate hyperactivity [ ]
d) Swelling [ ]
16. What is the daily iron requirement in adolescent girls?
a) 1-2 mg [ ]
b) 3mg [ ]
c) 4mg [ ]
d) 6mg [ ]
17. What is the recommended nutritional requirement in adolescent period?
a) Protein [ ]
b) Minerals & vitamins [ ]
c) Energy [ ]
d) All of above [ ]
96
18. Which food is not rich in Iron?
a) Green leafy vegetables [ ]
b) Sugar and candy [ ]
c) Soya beans [ ]
d) Read meat [ ]
19. Which Plant source is rich in iron?
a) Beet root [ ]
b) Cereals (rice, pulses) [ ]
c) Fruits [ ]
d) Lemon [ ]
20. Which is the rich animal source of iron?
a) Egg white [ ]
b) Cow milk [ ]
c) Meat [ ]
d) Paneer [ ]
21. Which one of the following is the best home remedy to increase the
hemoglobin level?
a) Jaggery & roasted chana [ ]
b) Fruits & nuts [ ]
c) Lemon [ ]
d) Sugar [ ]
22. Which one of the following helps in absorption of iron?
a) Egg [ ]
b) Orange juice, fruits [ ]
c) Tea [ ]
d) Calcium [ ]
23. What is the recommended dose of iron and folic acid among adolescent girls?
a) Tablets of 50 mg elemental iron and 600 mcg folic acid [ ]
b) Tablets of 100 mg elemental iron and 500 mcg of folic acid [ ]
c) Tablets of 45 mg elemental iron and 400 mcg of folic acid [ ]
d) Tablets of 30 mg elemental iron and 200 mcg folic acid [ ]
97
24. What is the treatment for worm infestation?
a) Antibiotic (Ceftriaxone) [ ]
b) Antiparacitic (Albendazole, Mebendazole) [ ]
c) Antifungal (Metrogyl) [ ]
d) Antispasmodic (Voveron) [ ]
25. When the transfusion of blood should be started in anemia?
a) Less than 4 – 5 g/dL [ ]
b) Less than 8 g/dL [ ]
c) Less than 11 g/dL [ ]
d) Less than 10 g/dL [ ]
26. Which is not true regarding oral iron therapy?
a) Black stool [ ]
b) Gastrointestinal upset [ ]
c) Intake with vitamin c to increase iron absorption [ ]
d) Should be taken with empty stomach [ ]
27. What is the preventive measure for iron deficiency anemia in school children?
a) Deworming& iron supplementation. [ ]
b) Calcium supplementation. [ ]
c) Administration of Intravenous fluid. [ ]
d) Vitamin c rich supplementation. [ ]
28. How Folic acid deficiency is prevented?
a) Dietary deficiency [ ]
b) Malabsorption from jejunum [ ]
c) Interference with folate metabolism [ ]
d) Eating foods rich in folic acid [ ]
29. Which national programme helps in prevention of iron deficiency anemia?
a) Integrated Child Development services [ ]
b) Mid-day meal programme [ ]
c) National nutritional anemia control programme [ ]
d) Vitamin A deficiency control programme [ ]
98
30. Which one of the following is the side effect of oral iron therapy?
a) Fever [ ]
b) Reduce in appetite [ ]
c) Black stool & constipation [ ]
d) Dehydration [ ]
99
खंड-अ
बहु जन सां यक य आँकड़ो का आंकलन करने के लए बहु वक पीय नावल -
सहभागी से नवेदन है क नावल को यानपू वक पढ़ और उ चत उ तर के सामने (√) का नशान

लगाएं।
1उ वष म
(अ)15-16 वष। ( )
(ब) 17-18 वष। ( )
(स) 19-20 वष। ( )
(द) 20 वष से अ धक। ( )
2 शै क यो यता
(अ)11 क ा। ( )
(ब) 12 क ा। ( )
3 तभागी का धम
(अ) ह दू। ( )
(ब) मु ि लम। ( )
(स) अ य। ( )
4 प रवार का कार
(अ)एकल प रवार। ( )
(ब) संयु त प रवार। ( )
(स) व तृ त प रवार। ( )
5 पा रवा रक आय मह ने म
(अ) . 10000-15000 ( )
(ब) . 15001-20000 ( )
(स) . 20001-25000 ( )
(द) . 25001-30000 ( )
(ग) . 30001 से अ धक। ( )
6 एनी मया और उसके बचाव के बारे म आपको पहले से जानकार है या?

(अ) हाँ। ( )
100
(ब) नह ं। ( )
य द हाँ, तो एनी मया एवं उसके बचाव के ोत या है ।
(अ)पु तक, लेख। ( )
(ब) साथ काम करने वाला। ( )
(स) मी डया। ( )
(द) प रवार के सद य। ( )
7 मा सक धम
(अ) नय मत। ( )
(ब) अ नय मत। ( )
(स) अ धक र त ाव। ( )
8 आहार
(अ)शाकाहार । ( )
(ब) मांसाहार । ( )
9 प रवार का वा य
(अ) व थ। ( )
(ब) अ व थ। ( )
य द अ व थ, तो कौन सी बीमार है ।
(अ)एनी मया(शर र मे खू न क कमी) ( )
(ब) उ च र तचाप। ( )
(स) पी लया। ( )
(द) मधु मेह। ( )
101
खंड-ब
इस भाग म 30 बहु क पीय न है, िजनके चार उ तर दए गए है िजसमे से केवल एक सह है । सह
उ तर के लए (1) अंक और गकत उ तर के लए शू य(0) अंक दया जाएगा। सहभागी से नवेदन

है क सभी न को यानपू वक पढ़ और न न ल खत न के उ तर द।
1 जो एनी मया से पी ड़त है
(अ)पु ष। ( )
(ब) म हला। ( )
(स) पु ष और म हला दोनो। ( )
2 ह मो लो बन कससे बना है
(अ)लोहा और ऑ सीजन। ( )
(ब) लोहा और ोट न। ( )
(स) वटा मन और लोहा। ( )
(द) वटा मन और ोट न। ( )
3 कशोर म हलाओं म ह मो लो बन का सामा य मू य या है

(अ)10-14 Mmol/l ( )
(ब) 9-10 mg/dl ( )
(स) 12-18 mg/dl ( )
(द) 12.5 -15.5 gm/dl। ( )
4 ह मो लो बन नापने के लए आमतौर पर न न म से कस इकाई का योग कया जाता है
(अ)Mmol/l ( )
(ब) mg/dl ( )
(स) gram/dl ( )
(द)Pq. ( )
5 ह मो लो बन नापने के लए कस उपकरण का योग कया जाता है

(अ) लू कोमीटर। ( )
(ब) र तदाबमपी ( )
(स) हमो लो बनोमेटर। ( )
(द) न ज ऑि स मटर। ( )
102
6 लाल र त को शकाओं का सामा य जीवनकाल या है
(अ)60 दन। ( )
(ब) 80 दन। ( )
(स) 120 दन। ( )
(द) 100 दन। ( )
7 र त म लोहे क ाथ मक भू मका या है
(अ)ऑ सीजन ले जाना। ( )
(ब) काबन डाइऑ साइड ले जाना। ( )
(स) जल ले जाना। ( )
(द) बाई काब नेट ले जाना। ( )
8 एनी मया क प रभाषा या है

(अ)लाल धर क णकाओं का कम होना। ( )
(ब) वेत धर क णकाओं का कम होना। ( )
(स) खू न का गाढ़ा होना। ( )
(द) लाल धर क णकाओं का बढ़ना। ( )
9 ह मो लो बन कस तर तक कम होने पर एनी मया को गंभीर माना जाता है
(अ)13 gm/dl से नीचे। ( )
(ब) 11 gm/dl से नीचे। ( )
(स) 12 gm/dl से नीचे। ( )
(द) 7 gm/dl से नीचे ( )
10 जो एनी मया का सबसे आम संकेत है

(अ)पीलापन। ( )
(ब) उ च र तचाप। ( )
(स) चड़ चड़ापन। ( )
(द) भू ख न लगना। ( )
11 कशोराव था क लड़ कय म एनी मया का सबसे आम कार है

(अ)घातक र ता पता एनी मया। ( )
(ब) वटा मन बी एनी मया। ( )
103
(स) फो लक ए सड क कमी ( )
(द) लोहा (आयरन) क कमी। ( )
12 लोहा क कमी के एनी मया के नैदा नक संकेत या है

(अ)भंगु र नाखू न और जीभ म छाले। ( )
(ब) नजल करण। ( )
(स) उ ट करना ( )
(द) वर। ( )
13 आयरन क कमी से एनी मया के ल ण या है

(अ)घबराहट। ( )
(ब) थकान। ( )
(स) उ ट । ( )
(द) थकान एवं घबराहट दोनो ( )
14 एनी मया म शर र मे पीला रं ग कहाँ दखाई दे ता है
(अ)तलवे, छाती, पेट। ( )
(ब) कंजंि टवा, छाती, पेट। ( )
(स) हथेल , छाती, पेट। ( )
(द) लोअर पैलेव ल कंजंि टवा। ( )
15 आयरन क कमी कशोर लड़ कय को कैसे भा वत करता है

(अ)ज द थकान। ( )
(ब) वर ( )
(स) अ तस यता। ( )
(द) सू जन। ( )
16 र त म लोहे (आयरन) क दै नक आव यकता या है
(अ)1-2 mg ( )
(ब) 3 mg ( )
(स) 4 mg ( )
(द) 6 mg ( )
104
17 कशोर अव ध म अनु शं षत पोषण संबंधी आव यकता या है
(अ) ोट न। ( )
(ब) ख नज और वटा मन। ( )
(स) ऊजा। ( )
(द) उपरो त सभी। ( )
18 कौन सा भोजन लोहे (आयरन) से समृ नह है
(अ) हर प तेदार सि जयां। ( )
(ब) सोयाबीन। ( )
(स) चीनी और टॉफ । ( )
(द) लाल मांस। ( )
19 कौन सा वन प त लोहे (आयरन) से समृ है

(अ)चु कंदर। ( )
(ब) दाल। ( )
(स) फल। ( )
(द) नींबू। ( )
20 कौन सा पशु ोत लोहे (आयरन) से समृ है
(अ)सफेद अंडा ( )
(ब) गाय का दू ध। ( )
(स) मांस। ( )
(द) पनीर। ( )
21 ह मो लो बन के स तर को बढ़ाने के लए सबसे अ छा घरे लू उपाय न न ल खत म से या है

(अ)गु ड़ और भु ना हु आ चना। ( )
(ब) फल एवं मेवा। ( )
(स) नींबू। ( )
(द) चीनी ( )
22 न न ल खत म कौन लोहे के अवशोषण म मदद करता है

(अ)अंडा ( )
(ब) संतरे का रस, फल। ( )
105
(स) चाय। ( )
(द) कैि शयम। ( )
23 कशोर लड़ कय म आयरन और फो लक ए सड क अनु शं षत खु राक या है
(अ)50 mg मौ लक आयरन और 600 mg फो लक ए सड क गो लयां ( )
(ब) 100 mg मौ लक आयरन और 500 mg फो लक ए सड क गो लयां ( )
(स) 45 mg मौ लक आयरन और 400 mg फो लक ए सड क गो लयां ( )
(द) 20 mg मौ लक आयरन और 200 mg फो लक ए सड क गो लयां ( )
24 कृ म सं मण का इलाज या है
(अ)अं त बयो टक। ( )
(ब) वरोधी परजीवी। ( )
(स) ए ट फंगल। ( )
(द) ए ट पजमो दक। ( )
25 एनी मया म र त का आधान कब शु कया जाना चा हए
(अ)4-5 g/dl से कम। ( )
(ब) 8 g/dl से कम। ( )
(स) 11 g/dl से कम। ( )
(द) 10 g/dl से कम। ( )
26 कौन सा ओरल आयरन थेरेपी के बारे म नह है

(अ)काला मल। ( )
(ब) जठरांत परे शानी। ( )
(स) आयरन के अवशोषण को बढ़ाने के लए वटा मन सी का सेवन ( )
(द) खाल पेट लेना चा हए। ( )
27 कू ल ब च म आयरन क कमी से होने वाले एनी मया के लए नवारक उपाय या है

(अ)दे वो मग एंड आयरन स ल मट। ( )
(ब) कैि शयम स ल मट। ( )
(स) अंतः शरा व का शासन। ( )
(द) वटा मन सी से भरपू र स ल मट। ( )
106
28 फो लक ए सड क कमी को कैसे रोका जाता है
(अ)आहार क कमी। ( )
(ब) जेजु नम म अवशोषण न होना। ( )
(स) फोलेट चयापचय के साथ ह त ेप। ( )
(द) फो लक ए सड से भरपू र भोजन करना। ( )
29 कौन सा रा य काय म एनी मया (लोहे क कमी) को रोकने म मदद करता है

(अ)एक कृ त बाल वकास सेवाएं। ( )
(ब) म या ह भोजन काय म। ( )
(स) रा य पोषण संबंधी एनी मया नयं ण काय म। ( )
(द) वटा मन ए क कमी नयं ण काय म। ( )
30 न न ल खत म से कौन सा ओरल आयरन थेरेपी का साइड इफ़े ट है

(अ) वर ( )
(ब) काला मल और क ज। ( )
(स) भू ख म कमी। ( )
(द) नजल करण। ( )
107
ANNEXURE-XI
SCORING KEY
QUESTION ANSWER QUESTION ANSWER
1 B 16 B
2 C 17 D
3 C 18 B
4 C 19 A
5 C 20 C
6 C 21 A
7 A 22 B
8 B 23 B
9 D 24 B
10 A 25 A
11 D 26 D
12 A 27 A
13 A 28 D
14 D 29 C
15 A 30 C
108
उ र पि का
न उ तर न उ तर
1 ब 16 ब
2 स 17 द
3 स 18 ब
4 स 19 अ
5 स 20 स
6 स 21 अ
7 अ 22 ब
8 ब 23 ब
9 द 24 ब
10 अ 25 अ
11 द 26 द
12 अ 27 अ
13 अ 28 द
14 द 29 स
15 अ 30 स
109
ANNEXURE-XII
LIST OF FORMULAS
The following Statistical formulas were used
1. Mean: To obtain the mean, the individual observations were first added together and
then divided by the number of observation. The operation of adding together or
summation is denoted by the sign Σ.
The individual observation is denoted by the sign X, number of observation denoted by n,
and the mean by
2. Standard Deviation: It is denoted by the Greek letter σ. If a sample is more than 30

then.
When sample is less than 30 then.
3. Chi square test
Where O = Observed frequency
E = Expected frequency
110
4. Level of significance: “p” is level of significance
p> 0.05 Not significant
p< 0.05 Significant
p <0.01 Highly significant
p <0.001 Very highly significant
111
ANNEXURES - XIII
MASTER DATA SHEET
FAMILY INCOME PER MONTH

RELIGION OF PARTICIPANT
PREVIOUS INFORMATION
FAMILY HEALTH STATUS

MENSTRUAL CYCLE
DIETARY PATTERN
QUALIFICATRION
TYPE OF FAMILY
EDUCATIONMAL
AGE IN YEAR
SAMPLE NO.
1 A a B A A a1 a B b4
2 A a B B A a1 a B b2
3 A a B B A a1 a B b2
4 C a B B A a4 a B b1
5 a a B A A a1 b B a
6 a a B B A a1 a B a
7 a a B C A a1 a B a
8 a a B B A a1 a A b2
9 b a B C A a4 a B a
10 a a B C A b a B a
11 b a B B A a4 a B a
12 b a A B A b b A a
13 b b A A A a4 b A b3
14 a a B A A a1 a B a
15 a a B A A a4 a B b1
16 a b B B A a1 a B b1
17 b a B B A a1 a B a
18 b a B B A a1 a A a
19 b a B A A a4 a B b4
20 a a B B C a1 a A b4
21 a a B C C a1 a A b2
22 c a B C A a1 a A b2
23 a a B B B a1 b B b2
24 a a B B A a1 b B a
112
25 b a B A A a4 b B b1
26 a a B B A a4 a B b1
27 a a B C A a1 a B b4
28 a a B B B a1 c B b4
29 a a B B A a1 a B b4
30 a a B B B a4 b B a
31 a a B A A a1 b B b4
32 a a B A A a1 b B b4
33 a a B B A b b B b2
34 a a B B A a3 b B b1
35 b a B B C b b B b1
36 b a B B A a4 b B b1
37 b a B B A a4 b b b4
38 b b B A A b a b a
39 a a B A A b a b a
40 a a B A A a4 a a b2
41 b a B A A a1 a a b1
42 a a A B A a1 a a b1
43 a a B B A a1 a a a
44 a a B B A a1 a b a
45 b a B B B a1 a b b1
46 b a A B B a4 a a b1
47 a a B B A b a a a
48 a a B B A b a b a
49 b a B B A a4 a b b4
52 b a B A A a3 a b a
53 c a B B A a2 a b b4
55 b a B A A a1 b b b1
56 a a B B A b a b b1
57 b a B A A a2 a b b1
59 b a A C A b b b a
60 b b A C A a2 a a a
61 b a B B B a2 a a a
62 b b B B B a1 a a b1
65 b a B B A a2 b b a
113
66 a a A B A b a a b2
67 a a a B A a4 a A b1
68 a a a B A a2 a B a
69 b a b B A a4 b A a
70 a a b B D a4 b B b4
71 a a b A A a2 c B a
72 a a b B A a2 a A b4
73 a a b B A a2 b B a
74 b a b B A a2 a A b1
75 b a b B A a4 b B a
76 b a b B A a4 b A b4
77 a a b A A b a B b1
78 a a b B A a4 a B b1
79 a a b A A b a B b1
80 a a b B A a4 a B a
81 a a b B A a4 a B b4
83 b b b A A a4 a B b1
84 b b b A A a4 a B b1
85 a b b A A a2 a B b1
86 b b b B B a4 b B b2
87 b b b C B a4 b A a
88 a a b C A b a A b4
89 a a a A A b a A a
90 a a b A B b b A a
91 a a b A A a4 a A a
92 a a b B A b a A a
94 b b b B A a2 a A a
96 a a b A A a1 a A b1
97 a a b A A a1 a A a
98 a a b A A b a A b1
99 a a b A A b b A a
102 b b b C A a4 a A b3
103 a a b A A a2 a A b4
104 b b b B A a4 a A b1
105 b a b A A b a B b1
106 b a b A A a1 a B b1
114
107 b a b B A a4 c b b1
108 b b b B A b b B a
109 b b b B A b c B a
110 b a b A C a4 b B b1
111 b b b C A a4 b B a
112 b a b A C b b B b3
113 a a b B A b b B b3
114 b b c A A a4 a B b4
115 c a b A A b a B b1
116 b b b B A b c B a
117 a a b A A b c B a
118 a a b A A b c B a
119 b b b B A a4 a A b4
120 b a b A A a4 b A b2
121 a a b B A a1 a B b2
122 b a b B A a1 b B b4
123 b a b B A a1 c B a
124 a a b B A a1 c B b1
125 a a b B A a1 c B b1
126 c b b B A a1 b A b1
127 b a b B A a1 a A b2
128 b a b B A a4 b A b4
129 a a b B A a4 a B b1
130 a a b B A a4 A B b1
131 a a b B B a4 A B b1
132 b b b B A a4 A A b1
133 c b b B A a1 C a b4
134 a a b B D a1 A b b4
135 b b b B A a1 C b b4
115
MASTER DATA
SHEET(VIVEKANANDA COLLEGE
OF NURSING)
SECTION (B) MULTIPLE CHOICE

QUESTIONS
SAMPLE NO.
TOTAL
Q.10
Q.11
Q.12
Q.13
Q.14
Q.15
Q.16
Q.17
Q.18
Q.19
Q.20
Q.21
Q.22
Q.23
Q.24
Q.25
Q.26
Q.27
Q.28
Q.29
Q.30
Q.1
Q.2
Q.3
Q.4
Q.5
Q.6
Q.7
Q.8
Q.9
1 1 0 0 1 0 1 0 1 1 1 1 1 1 0 1 0 1 1 1 0 0 1 0 1 1 0 0 1 1 0 18
2 1 0 0 1 0 1 1 1 0 0 1 1 0 0 1 0 1 0 1 1 0 1 0 1 1 1 1 1 1 0 18
3 1 0 0 1 0 1 1 1 0 0 1 1 0 0 1 0 1 1 1 1 0 1 0 1 1 0 1 1 1 1 19
4 0 1 1 1 1 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 10
5 1 0 0 1 1 1 0 1 1 1 0 1 1 1 1 0 1 1 0 0 1 1 0 1 1 1 0 0 1 0 19
6 1 0 1 1 1 0 0 1 1 1 0 1 1 1 1 0 1 1 0 0 0 1 1 1 1 1 0 1 1 0 20
7 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 1 1 0 1 0 1 1 1 1 1 0 1 0 0 20
8 1 0 0 1 1 0 1 0 1 1 1 1 1 1 0 1 0 1 0 0 1 1 1 1 1 1 0 1 0 0 19
9 1 1 0 1 1 1 0 0 1 1 1 1 0 1 1 0 1 1 1 0 1 1 0 1 0 1 0 1 1 0 20
10 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 9
11 0 1 1 1 1 1 1 0 0 1 1 1 0 1 1 0 1 0 1 0 0 1 1 0 1 1 0 1 0 1 19
12 1 0 1 1 1 0 1 1 0 1 1 1 1 1 0 0 1 1 0 0 1 1 1 1 0 0 0 1 0 0 18
13 1 0 0 1 1 0 1 0 0 1 1 1 1 1 0 0 1 1 0 0 1 1 1 1 1 1 0 1 1 0 19
14 1 0 0 1 1 0 1 1 1 0 1 1 1 1 1 0 0 1 1 1 0 1 0 1 1 1 1 1 0 1 21
15 1 0 1 1 1 0 1 1 0 1 1 1 1 1 0 0 1 1 0 0 0 1 0 1 1 1 0 0 1 1 19
16 1 0 0 1 1 0 1 1 0 1 1 1 0 1 1 0 1 1 0 0 1 1 0 1 1 1 1 1 1 0 20
17 1 0 0 0 1 1 1 1 0 0 1 1 0 1 0 1 1 0 0 1 1 0 1 1 1 0 1 1 0 1 18
18 1 0 0 0 1 0 1 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 8
19 1 0 0 1 1 0 1 0 0 1 0 1 1 1 1 1 1 1 0 0 1 0 1 1 0 1 0 1 1 0 18
20 1 0 0 1 1 0 1 1 0 1 0 1 1 1 1 0 0 1 0 1 0 0 1 0 1 0 1 1 1 1 18
21 1 0 0 1 1 0 1 1 1 0 1 0 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 0 19
22 1 0 0 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 10
23 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 1 1 0 0 0 1 0 0 0 0 1 0 1 9
24 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 9
25 1 0 0 1 0 0 0 0 0 1 0 1 1 0 1 0 0 1 1 0 0 0 1 0 0 0 0 0 0 1 10
26 1 0 0 1 0 0 0 1 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 9
27 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 0 0 0 1 0 1 0 1 0 0 1 0 0 10
28 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 1 0 0 9
29 1 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 1 0 0 10
30 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 1 0 1 1 1 0 1 0 0 9
31 1 0 0 1 0 0 1 0 1 1 1 1 1 0 1 0 1 1 0 0 0 1 0 1 1 1 0 1 1 1 18
32 1 0 0 1 0 0 0 0 1 1 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 1 0 0 10
33 0 0 0 1 1 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 10
34 1 1 0 1 1 0 0 1 1 0 1 1 1 0 1 1 1 0 0 1 1 0 1 1 1 1 0 1 0 1 20
35 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 1 8
36 0 0 0 0 0 0 1 0 0 1 0 1 0 1 1 0 0 1 0 1 0 0 0 0 0 0 1 0 1 0 9
37 1 0 0 1 1 0 1 1 1 0 1 0 1 1 0 1 1 1 1 0 0 1 0 1 1 1 0 1 1 1 20
38 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 10
39 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 1 0 0 1 1 0 1 0 0 1 0 1 10
116
40 1 0 0 1 1 0 0 1 1 1 0 1 1 0 0 1 1 1 1 0 1 0 1 1 1 1 0 1 1 1 20
41 1 1 0 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 1 0 1 0 1 1 1 1 0 1 1 1 23
42 1 0 0 1 1 0 1 1 1 1 1 1 1 0 0 1 1 1 1 0 1 0 1 1 1 1 0 1 1 1 22
43 1 0 0 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 24
44 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 1 0 0 1 0 9
45 1 0 0 1 1 0 0 1 1 0 1 1 0 1 1 0 0 1 1 0 1 1 1 1 1 1 0 1 1 1 20
46 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 1 1 0 1 0 1 0 0 1 0 1 0 9
47 1 0 0 1 1 1 0 1 1 0 1 1 1 1 1 0 1 1 1 0 1 1 0 1 1 1 0 1 1 0 21
48 1 0 0 0 1 1 0 0 1 1 0 1 1 1 1 1 0 1 1 1 0 0 1 0 1 1 1 0 0 1 18
49 1 1 0 0 1 0 0 1 1 1 1 1 1 1 1 0 1 1 1 0 0 1 0 1 1 1 0 0 1 1 20
50 1 1 0 0 1 0 0 1 1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 1 1 1 1 1 1 0 19
51 1 0 1 0 1 0 0 1 1 1 1 1 1 1 0 0 1 1 0 1 0 1 1 1 1 1 1 1 1 1 22
52 1 0 0 1 0 0 0 0 1 1 0 1 1 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 10
53 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 0 1 1 1 0 1 1 0 1 1 1 0 0 1 21
54 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 1 1 1 1 0 1 1 0 1 1 1 0 0 1 21
55 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 0 1 1 1 0 1 1 0 1 1 1 0 1 1 20
57 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 0 1 1 1 0 0 1 0 1 1 1 0 0 1 19
58 1 1 0 1 1 0 1 1 1 1 1 1 0 1 0 1 1 1 0 1 1 0 1 1 1 0 1 1 1 0 22
59 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 1 0 6
60 0 1 0 0 0 1 0 1 0 1 0 0 1 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 10
61 0 0 0 0 1 0 0 1 1 0 1 1 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 9
62 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 8
63 1 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 1 1 1 1 1 0 1 0 1 1 1 1 1 1 21
64 1 1 0 0 1 0 0 1 0 1 0 1 0 1 0 1 1 1 1 0 1 0 1 1 1 1 1 0 1 1 19
65 1 1 1 1 1 1 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 24
66 1 1 0 0 1 0 0 1 1 1 1 1 1 0 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1 1 18
67 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 0 0 1 1 1 1 1 1 22
68 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1 0 1 1 0 0 0 1 0 1 1 1 1 1 1 1 21
69 0 0 0 0 1 0 0 1 0 1 0 1 0 1 1 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 9
70 1 0 0 1 1 0 0 1 1 1 1 0 1 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 0 1 22
71 1 1 0 0 1 0 0 0 1 1 1 1 0 1 1 1 1 1 1 0 0 0 0 1 1 1 1 1 1 1 20
72 1 0 0 0 1 0 0 1 1 1 1 0 1 1 0 1 1 1 0 0 0 1 1 1 1 0 1 1 0 1 18
73 1 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 1 0 0 9
74 1 0 0 1 1 0 0 1 1 0 0 0 0 1 0 0 1 0 0 0 1 0 0 1 0 1 0 0 0 0 10
75 1 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 9
76 1 0 0 0 1 0 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 0 0 1 1 0 1 1 1 1 21
77 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 8
78 0 0 0 1 0 0 0 1 1 0 0 1 1 0 0 0 1 0 0 0 0 1 0 1 1 0 0 0 1 0 10
79 0 0 0 0 1 0 0 1 0 1 0 0 0 0 1 0 1 0 1 0 0 1 0 0 1 0 0 1 0 0 9
80 1 0 1 1 1 0 1 1 1 1 0 1 1 0 0 0 1 1 0 0 0 1 0 1 0 0 1 1 1 1 18
81 1 0 1 1 1 0 1 1 1 1 0 1 1 0 0 0 1 1 0 1 0 1 0 0 1 0 0 1 1 1 18
82 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1 0 0 9
83 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 7
84 1 0 0 1 0 0 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 21
85 1 0 0 1 0 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 1 0 9
86 0 0 0 0 0 0 0 1 1 1 1 1 0 1 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 0 10
87 0 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 9
88 1 0 0 1 1 1 1 0 1 1 1 1 1 0 1 0 1 1 0 1 0 1 0 1 1 0 1 1 1 1 21
89 1 0 1 1 1 0 0 1 1 1 1 1 0 1 0 0 1 1 1 0 1 1 1 1 1 1 0 1 1 1 22
90 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 10
91 1 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 0 9
92 1 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 10
93 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 0 0 8
94 1 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 9
95 0 0 0 1 0 1 0 1 0 0 0 1 0 1 0 0 1 0 1 0 0 0 0 0 1 0 0 1 1 0 10
96 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 1 1 0 1 1 0 0 1 1 0 10
97 0 1 1 1 0 0 0 0 1 0 0 0 0 1 0 1 1 0 1 0 0 0 0 1 0 0 0 0 1 0 10
98 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 0 1 0 0 1 0 1 0 1 1 0 1 22
99 1 1 1 0 1 1 0 1 0 1 1 1 1 1 1 0 1 1 0 0 1 1 0 1 0 1 1 0 1 1 21
100 1 0 0 0 1 1 0 1 1 1 1 1 0 0 1 0 1 1 0 0 0 1 1 1 1 1 0 0 1 1 18
117
101 1 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 1 0 1 0 1 0 0 1 0 9
102 0 0 0 0 1 1 0 1 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 10
103 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 1 9
104 1 0 0 0 0 1 1 1 1 1 1 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 19
105 0 0 0 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 1 0 1 0 0 1 0 1 1 1 1 1 21
106 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 1 0 1 0 0 1 1 1 1 1 1 1 21
107 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 1 0 1 0 0 9
108 1 0 0 1 0 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0 0 1 0 0 0 1 1 19
109 0 0 0 1 1 0 0 1 0 0 0 0 1 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 1 0 9
110 0 0 0 0 1 0 0 0 1 0 1 0 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 1 0 0 8
111 0 0 0 1 1 0 0 1 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 0 8
112 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 9
113 1 0 0 1 1 0 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 10
114 1 1 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 9
115 0 0 0 0 1 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 10
116 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 1 0 0 0 0 1 0 0 1 0 0 1 0 0 10
117 1 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1 1 0 0 0 0 1 0 0 1 0 0 1 1 1 18
118 0 1 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 10
119 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 0 0 1 0 1 1 0 0 1 1 0 18
120 1 0 0 1 1 0 1 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 8
121 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 1 0 0 1 0 1 0 1 1 0 0 0 1 1 18
123 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 10
124 1 1 0 1 1 0 0 0 0 0 1 1 0 1 0 0 1 0 1 0 1 1 0 1 1 1 0 1 1 1 17
125 1 1 0 1 1 0 0 1 0 1 1 1 1 1 0 0 1 0 0 0 1 0 1 1 1 0 1 1 1 1 19
126 1 0 1 1 1 1 0 0 1 1 1 1 1 0 1 1 1 0 1 1 0 0 1 1 0 1 0 1 1 1 21
127 1 1 0 1 1 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 9
128 1 1 0 1 1 0 0 1 1 0 1 1 1 1 0 0 1 0 0 0 1 1 0 1 1 1 0 1 1 1 19
129 0 1 1 1 0 0 1 1 1 1 1 1 1 0 0 1 1 1 0 0 1 0 0 0 1 0 1 1 0 1 18
130 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 0 1 1 1 0 1 1 0 0 1 1 0 1 1 21
131 1 0 1 1 1 0 0 1 1 1 1 1 1 1 0 0 1 1 1 0 0 1 0 0 1 1 0 1 0 0 18
132 0 0 0 0 1 0 1 1 0 1 1 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 9
133 0 0 0 0 1 0 1 0 0 1 0 0 1 0 0 0 0 1 0 0 1 0 0 1 0 0 0 1 1 1 10
134 0 0 0 1 1 1 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 10
135 0 0 0 0 1 1 0 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 9
118
MAIN RESEARCH STUDY
IMAGES
119
120
121
122
123

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Kgmu Thesis 19.06 PDF

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“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND

ITS MANAGEMENT AMONG ADOLESCENT GIRLS IN SELECTED

SCHOOL OF LUCKNOW WITH A VIEW TO DEVELOP AN

INFORMATION BOOKLET, LUCKNOW U. P.”

Dissertation submitted to the

King George’s Medical University

Lucknow, Uttar Pradesh

In partial fulfillment of the requirement for the degree of

CHILD HEALTH NURSING

UNDER THE GUIDANCE OF

Mrs. Rina Kumari

Department of Child Health Nursing

Vivekananda College Of Nursing

King George’s Medical University, Lucknow, Uttar Pradesh

I hereby declare that this dissertation/thesis titled “A study to assess the

Date: Signature of the Candidate

This is to certify that the dissertation entitled “A study to assess the

Co-Guide Signature of the Guide

Mrs. Anjali Chaturvedi Mrs. Rina Kumari

Department of Child Health Nursing Faculty of Nursing, KGMU

Vivekananda College of Nursing Department of Child Health Nursing

Lucknow College of Nursing, KGMU

This is to certify that the dissertation entitled “A study to assess the

Seal and signature of the Principal

Prof. Chandini Tiagi

Community Health Nursing

Vivekananda College of Nursing

©King George Medical University, Lucknow

DECLARATION BY THE CANDIDATE

I hereby declare that Vivekananda College of nursing affiliated to king George

Date: Signature of the Candidate

©King George Medical University, Lucknow

“Acknowledgement and celebration are essential to fueling passion, making people

df: Degree of freedom

“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND

Ms. Yashika Mishra* Mrs. Rina Kumari** Mrs. Anjali Chaturvedi***

*M.Sc. (N) II Year student, **Faculty of Nursing, ***Department of Child Health

H1- There is a significant association between level of knowledge scores

CONCEPTUAL FRAME WORK

A quantitative research approach and a non-experimental descriptive research

The limitations of the study were -

 The sample size was limited to 135 only.

CHAPTER CONTENT PAGE NO.

III REVIEWS OF LITERATUTE 21-33

VII CONCLUSION 70-72

VIII SUMMARY 73-75

ANNEXURE ANNEXURE PAGE

Adolescents is a stage of transition from childhood to adulthood and is marked by

Since adolescence is a transitional stage between childhood and sociological

Anemia is widely prevalent in young adolescent girls. With the onset of

It is therefore essential to give deworming treatment and follow principle of

Anemia is a pathological condition where hemoglobin or hematocrit becomes

Nutritional anemia is a global problem of immense health significance affecting

Anemia in children can be prevented by preventing and controlling of anemia in

National Family Health Survey (NFHS) estimates reveals presence of nutritional

According to the World Health Organization (WHO), anemia is defined as

Anemia is often multifactorial and not an independent phenomenon. For the

The iron deficiency causes nutritional anemia in children. About 50 percent of

Anemia in children can be prevented by preventing and controlling of anemia in

The adolescent period offers a chance to acquire knowledge about optimal

According to the National family Health Survey report 2005-2006, 56% of

In a study of adolescent girls 10-19 years in urban slums of Southern India

“A STUDY TO ASSESS THE KNOWLEDGE REGARDING ANEMIA AND ITS

Ms. Yashika Mishra* Mrs. Rina Kumari Mrs. Anjali Chaturvedi*

M.Sc. (N) II Year student, Faculty of Nursing, Department of Child Health