Research Article (Open access) |
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SSR Inst. Int. J. Life Sci., 9(2):
3180-3185,
March 2023
Assessment of
Knowledge Regarding Osteoporosis among Pre-Menopausal Women residing in
Selected Rural Communities
Roopa Kattimani1, Deelip S
Natekar2, Utalbasha N Dhandargi3*
1Student, Department of
Community Health Nursing, Shri B.V.V.S Sajjalashree
Institute of Nursing Sciences, Bagalkot, Karnataka, India
2Principal, Department of
Community Health Nursing, Shri B.V.V.S Sajjalashree
Institute of Nursing Sciences, Bagalkot, Karnataka, India
3Professor & HOD,
Department of Community Health Nursing, Shri B.V.V.S Sajjalashree
Institute of Nursing Sciences, Bagalkot, Karnataka, India
*Address for Correspondence: Dr. Utalbasha N Dhandargi,
Professor & HOD, Department of Community Health Nursing, Shri B.V.V.S Sajjalashree Institute of Nursing Sciences, Bagalkot,
Karnataka, India
E-mail: roopakattimani8748@gmail.com
Background: As a woman approaches menopause there are
gradual changes in the physiology of her body. One of the prominent changes is
an increase in the fragility of bone due to calcium variation causing
Osteoporosis. A low level of estrogen, which occurs around the time of menopause
leads to increased bone loss. A woman can undergo either primary or secondary
osteoporosis. In most cases, the first 'symptom' of osteoporosis is broken
bone. As osteoporosis is an emerging health problem, that creates an economic
burden, it needs a special focus to promote healthy ageing. Knowledge is the
best contributor to reducing the risk of premenopausal women getting
osteoporosis.
Methods: Total 70 pre-menopausal women living in chosen rural communities in
Bagalkot were chosen with a convenient sampling technique. A structured
questionnaire developed by the researcher was used to gather information
concerning knowledge about osteoporosis. Chi-square analysis was used to uncover the relationship between
knowledge about osteoporosis with socio-demographic factors.
Results: Total 24.28% of women were having good knowledge, 54.28% were having
average knowledge, and 21.42% of women were having poor knowledge about
osteoporosis. A significant relationship was attained between knowledge
regarding osteoporosis and occupation (χ2=14.20, p<0.007)
and formal education (χ2=16.22, p<0.039) at the
position of the significance of 0.05.
Conclusion: After evaluation of knowledge on the
subject of osteoporosis among pre-menopausal women, it was found that most
women had average knowledge regarding osteoporosis.
Key Words: Premenopausal Women, Osteoporosis,
Estrogen, Rural Communities
INTRODUCTION- Osteoporosis is the mainly familiar bone-related complaint in
humans, especially in females. As it is not easy to treat, portrays a main
public health problem in India. It is widespread among Caucasians, women, and
elder citizens. Most women are not aware of osteoporosis. Osteoporosis
generally leads to frequent fractures just as hypertension is a threat factor
for stroke. Osteoporosis has an effect on a vast number of people, of both
gender and all ethnicities, and its occurrence will enhance as an individual
get older. [1] Over 50% of postmenopausal women are more prone to
getting osteoporotic-affiliated fractures. Only 33% of older women, who have a
hip fracture will be able to return to a normal lifestyle. [2] Osteoporosis is an
increasing public health problem. Menopause can raise a woman’s possibility of
getting osteoporosis. [3] Women may suffer either primary or secondary
osteoporosis; most postmenopausal women undergo primary osteoporosis. [4]
“Osteoporosis has been defined by the World Health
Organization (WHO) as 'low bone mass and microarchitectural weakening and
decaying of bone tissue, leading to intense bone fragility and resulting
increase in fracture'. The word osteoporosis means ‘spongy bones. Osteoporosis
is frequently called a 'silent disease' because without the appearance of
symptoms bone loss occurs.” [5] Osteoporosis is a multi-factorial
disease; it occurs due to several causes and it is a gradually rising universal
health problem. In India, women will develop osteoporosis at an early age as
compared to their western counterparts.
Osteoporosis is a most disastrous disease, making the patient stay in hospitals
for a longer time. Myocardial infarction and diabetes mellitus occur as
complications of osteoporosis. [6] There is a need for early case finding, detection
of vulnerable and high-risk women and prevention and treatment of osteoporosis
to protect women from further complications. [7]
As ‘prevention is better than cure’, it is proved that knowing osteoporosis will reduce the
chance of getting osteoporosis, and it will further act as major preventive behaviour. [8] Osteoporosis is not as much of
common in premenopausal women as compared to postmenopausal women. Osteoporosis
develops when a woman attains her postmenopausal period. However, both
osteoporotic-related fractures and reduced levels of bone mineral viscosity
used to occur in premenopausal women and young women with these abnormalities
must require specialized medical attention from personnel of the health
department. [9] “If the women are aware of osteoporosis and
measures of its prevention in the premenopausal stage then it will be easier
for them to prevent the occurrence of osteoporosis in their post-menopausal
period”.
MATERIALS
AND METHODS
Study
design- Considering the purpose of the study, a
descriptive research method was used and the study was held at; Timmasagar and Kelavadi villages, Taluka Guledagudda,
Bagalkot district. Timmasagar and Kelavadi villages
are at a distance of 18 kilometres from Bagalkot. The
population of Timmasagar is 15,020 and the population of Kelavadi
village is 16,126.
Participants- In
the present study, participants were women between the ages of 35-50 years. The
sample consisted of 70 pre-menopausal women selected by convenient sampling
technique.
By using Cochran's formula, data for calculating
sample size was used from the findings of the pilot study on outcome variables.
Sample
size =Z value2 × SD2/d2.
where,
Z
is the critical value at 5% level of significance, SD is the Standard
deviation, d is the margin of error.
Variable:
Knowledge regarding Osteoporosis, using the pilot study data on outcome
variables, the sample size was calculated, Z=1.96, SD=0.205, d=5% (0.05).
Sample
size (n) = 3.84 × 0.042 ÷ 0.0025= (1.96)2 × (0.205)2/
(0.05)2
The
calculated sample size was n=64. The desired size of the sample was found to be
64. Taking into consideration the 10% attrition in data the ultimate sample
size was increased to 70 premenopausal women.
Data collection- Data
collection was carried out from 14 July 2022 to 29 July 2022 in Timmasagar and Kelavadi, Guledagudda; Bagalkot,
India. Data was collected from pre-menopausal women through the self-report
method. Before enrolment of subjects and data collection, formal authorization
was obtained from the principal of the nursing institution and gram panchayats,
of concerned villages. The study was explained to prospective participants and
on paper, consent was taken from them. A structured questionnaire was given to
participants, who were able to read and write and to participants, who cannot
read or write English or Kannada, the researcher read questions and asked them
to mark their options. An information booklet was prepared according to lacunae
found in knowledge and it was distributed to all participants of the study.
Data collection instruments
Section
1: Socio-Demographic Performa- Comprised of 6
items to assess the socio-demographic factors of premenopausal women.
Section
2: Structured questionnaire to assess osteoporosis knowledge- It
comprised 20 items. Each item was followed with 4 options; one correct and
three distracters. '1' mark was given for selecting the correct option and '0'
mark was given for selecting the wrong option.
Variables
under study
Dependent
variable- Osteoporosis knowledge.
Research variables-
Age, Educational status, spousal status, monthly income of the family, type of
diet and occupation.
Inclusion and Exclusion criteria
The study included women who;
·
have not attained
menopause.
·
willing to participate
·
were present at the time
of information gathering
·
were know the convenient
language
Women excluded, who,
·
have undergone
hysterectomy
·
were diagnosed with
osteoporosis
·
mentally ill and not able
to cooperate
·
were deaf and dumb.
Statistical
Analysis- Information was analyzed using SPSS 18.
Data were entered in an MS excel sheet and then transferred to SPSS. Data was
organized and explained using descriptive and inferential analysis to find out
the association between variables.
Ethical
Clearance: A
certificate of ethical permission was obtained from the ethical
committee of the Department of Community Health Nursing, Shri B.V.V.S Sajjalashree Institute of Nursing
Sciences, Bagalkot, Karnataka, India.
RESULT
The
mean age of the sample was 40.01±2.64. The socio-demographic data obtained from
premenopausal women was organized using frequency distribution.
Distribution of
socio-demographic variables- The greater part of pre-menopausal
women was 38 years (15.71%) of age, 14.28% were 41 years old, and 11.42% were
between 37 to 43 years. A total of 30% of women did not have any formal
education, 28.57% of women completed their primary education, 20% of women
completed secondary education, 11.42% completed their degree and of them, 10%
completed their pre-university education.48.57% had a monthly income of family
of Rs 10,001-Rs 15,000, 18.57% Rs 5001-10,000, 17.14% were having between Rs
15,001-20,000, 10% were having Rs 20,001 and above and 5.71% were having ≤5,000
rupees per month. A total of 74.28% of pre-menopausal women were married, 5.71%
were unmarried, 11.42% were the widow and 8.57% were divorced & separated.
The majority of pre-menopausal women were working as labourers
(44.28%), 28.57% were housewives and 27.14% were working in other occupations.
Most pre-menopausal women were having mixed diet (61.42%), about 30% were
vegetarian and 8.57% were non-vegetarian.
Knowledge
on the subject of Osteoporosis- The mean score on
knowledge of premenopausal women about osteoporosis was 7.35±2.46. The
premenopausal women were divided into 3 categories based on their level of
scores.
Level
of knowledge on osteoporosis among premenopausal women (Table 1) depicts that
most of (54.28%) premenopausal women had average knowledge, 24.28% had good
knowledge and 21.42% women had poor knowledge regarding osteoporosis.
Table 1: Categorization
of knowledge on the topic of osteoporosis among pre-menopausal women
Category |
Frequency |
Percentage (%) |
Poor |
15 |
21.42 |
Average |
37 |
54.28 |
Good |
18 |
24.28 |
Association
between knowledge with their research variables (Table 2) depicts that
knowledge (p=0.039) and occupation (p=0.007) had significant
association with knowledge and other research variables had no significant
association with knowledge.
Table
2: Association between knowledge scores of pre-menopausal women using their
research variables
Variables |
Df |
Chi-square
value |
Table value |
p-value |
|
1 |
Age |
4 |
2.30 |
9.48 |
0.68 |
2 |
Education |
8 |
16.22 |
15.50 |
0.039* |
3 |
The family income per
month |
8 |
7.82 |
15.50 |
0.45 |
4 |
Marital
status |
6 |
3.47 |
12.59 |
0.74 |
5 |
Occupation |
4 |
14.20 |
9.48 |
0.007* |
6 |
Type
of diet |
4 |
5.90 |
9.48 |
0.20 |
α
= 0.05; Df= Difference of freedom
DISCUSSION- The mean age of participants was 40.01 years+2.64 years.
The mean knowledge score regarding osteoporosis was 7.35±2.46. A study on
knowledge concerning forestalling of osteoporosis published by Rathod et al. [10]
led to the conclusion that the mean score and standard deviation of
12.16±2.96 and by Panta et
al. [11] with the conclusion that is taken as whole osteoporosis
responsiveness and perspective, mean scores were 9.39±2.93 and 146.18±11.58,
respectively.
Findings related to the
assessment of knowledge among premenopausal women revealed that 24.28% of
premenopausal women have good knowledge regarding osteoporosis, about 54.28% of
women have average knowledge and about 21.42% of premenopausal women have poor
knowledge regarding osteoporosis. A descriptive study published by Sofia [12] concluded with result that
the majority (28) of women have inadequate knowledge (93%), 2(7%) had
moderate knowledge and one of them have sufficient knowledge and study
conducted by Senthilraja et al. [13] showed
that 22.5% were having very poor knowledge, 38.1%-poor, 34.1%-average, and 5.3%
were having good knowledge and also
similar study investigated by Muhammad et al. [14]
revealed that only a few (8.0%) women had good knowledge about osteoporosis and
the greater part of the women (49.0%) had a poor knowledge and study published
by Saeed et
al. [15] revealed that
33.3% of participants had average knowledge and 32.6%) had good knowledge
regarding osteoporosis.
Findings regarding the association among
variables of pre-menopausal women showed that; an association between age and
knowledge (χ2=2.30) significant association was not found
between knowledge and age (p>0.05).
Association of education
and knowledge (χ2=16.22, p=0.039) showed, a significant
association was determined between
knowledge and education (p<0.05). A cross-sectional study published by Puttapitakpong et al.
[16] showed that
educational status (p<0.01) had a significant association with
knowledge and a study conducted by Husam et al. [17]
exposed that there was a considerable difference got between education with
knowledge as determined by one-way ANOVA (p<0.001) and a prospective
study conducted through Satha et al.
[18] showed that a
significant correlation was established between knowledge concerning
osteoporosis (p-value: 0.007) education and also similar to the study conducted
by Mangalaraj et al. [19] showed
that significance was established between knowledge and education (χ2=9.511,
p<0.05).
Association
between family income per month and knowledge (χ2=7.82)
shows, there was no association found between knowledge with family monthly
income (p>0.05). Association of type of diet with knowledge (χ2=5.90)
showed, there was no relationship established between knowledge with diet (p>0.05).
A quantitative experimental study conducted by Suchismita et al. [20]
concluded with result that a significant association was not determined
between knowledge with family monthly income (χ2=1.61) and type
of diet (χ2=0.20).
Association between
marital status and knowledge (χ2=3.47) showed the association
was not found between knowledge with marital status (p>0.05), an
association of occupation with knowledge (χ2=14.20, p=0.007)
showed, there was a significant association of knowledge with occupation (p<0.05).
CONCLUSIONS- The
study reveals; nearly everyone was found to be having average knowledge
regarding osteoporosis. Prior awareness as regards osteoporosis can make women
aware of potential health problems associated with ageing.
It is recommended that
future research can investigate risk factors associated with osteoporosis to
minimize the morbidity of osteoporosis and to focus on premenopausal women,
while visiting the community and should educate them regarding their lifestyle
and prevention of osteoporosis.
Research concept- Dr. Deelip S Natekar
Research
design- Dr. Deelip S Natekar
Supervision- Dr. Deelip S Natekar
Materials- Dr. Deelip S Natekar
Data
collection- Ms. Roopa Kattimani
Data
analysis and Interpretation- Dr. Utalbasha
N Dhandargi
Literature
search- Ms. Roopa Kattimani
Writing
article- Dr. Utalbasha N Dhandargi
Critical
review- Dr. Utalbasha N Dhandargi
Article
editing- Dr. Utalbasha N Dhandargi
Final
approval- Dr. Utalbasha N Dhandargi
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