RAJIV GANDHI UNIVERSITY ORF HEALTH SCIENCES

BANGALORE, KARANATAKA.

A STUDY TO ASESS THE EFFECTIVENESS OF VIDEO ASSISTED TEACHING ON KNOWLEDGE REGAEDING IRON AND FOLIC ACID DEFICIENCY ANEMIA AMONG ADOLESCENT GIRLS RESIDING IN

HOSTEL AT BANGALORE .

PEROFOMA FOR REGISTRATION OF SUBJECT FOR

DISEERTATION

MS NIDHI GULERIA.

1st YEAR M.Sc NURSING

OBSTETRICS AND GYNAECOLOGICAL NURSING

(2013-2014)

R.R.COLLEGE OF NURSING

RAJREDDY LAYOUT

CHIKKABAN

BANGALORE-

RAJIV GANDHI UNIVERSITY ORF HEALTH

SCIENCES

BANGALORE, KARANATAKA.

PEROFOMA FOR REGISTRATION OF SUBJECT FOR

DISEERTATION

1.NAME OF THE CANDIDATE

AND ADDRESS

MS NIDHI GULERIA

R.R.COLLEGE OF NURSING

BANGALORE-56090

2.NAME OF THE INSTITUTION R.R. COLLEGE OF NURSING

BANGALORE -560090

3. COURSE OF THE STUDY

SUBJECT

1st YEAR M.Sc NURSING

OBSTETRICS AND

GYNAECOLOGICAL NURSING4. DATE AND ADMISSION TO

COURSE

01 JUNE 2014

5.TITLE OF THE TOPIC

A STUDY TO ASSESS THE EFFECTIVENESS OF VIDEO ASSISTED

TEACHING ON KNOWLEDGE REGARDING IRON AND FOLIC ACID

DEFICIENCY ANEMIA AMONG ADOLESCENT GIRLS RESIDING IN

HOSTLE ,IN BANGALORE.

BRIEF RESUME OF THE INTENDED WORK

“ADOLESCENT WOULD BE THE BEST INVESTMENT FOR

FUTURE”

SUNDARLAL

6. INTRODUCTION

Adolescence is a transitional age of physical and psychological human development

generally between puberty and legal adulthood. Adolescence is a second phase of life. It is

“coming of age” as children grow into adult physically, mentally and socially. The adolescence

groups comes under 13yrs to 19yrs.1

Adolescence is considered as a nutritionally critical period of life. The pre-pregnancy nutritional

status of young girls is important as it impacts on the course and the outcome of their pregnancy.

India has the world’s highest prevalence of anemia among women, with 60 to 70 percent of the

adolescent girls being anemic. Anemia occurs when the hemoglobin concentration falls below

the normal range for the age and sex of the individual. True anemia arises when there is an

imbalance between red cell production and red cell destruction. Types of anemia are: Iron

deficiency anemia, sideroblastic anemia, megaloblastic anemia, hypo plastic anemia and

hemolytic anemia. The causes includes nutritional deficiency, mal absorption, blood loss etc.2

Among all these types of anemia the most prevalent is the iron deficit anemia and the folic acid

deficit anemia. Iron plays an important role in biology forming complexes with molecular

oxygen in hemoglobin and oxyglobin. Iron deficiency is one of the most common of the

nutritional deficiencies. Iron is present in all the cells in the human body and has several vital

functions and decrease in iron may lead to morbidity and death. Iron deficiency anemia can

cause shortened attention span, alertness and learning in adolescence.

Iron deficient-anemia is nowadays the world’s most prevalent nutritional problem,

particularly during the pregnancy. And it is one of the most frequent complications related to

pregnancy. Anemia during pregnancy continues to be a common clinical problem with high

rates of prevalence (35 to 75%) in many developing countries. The major concern about the

adverse effects of anemia on pregnant woman is a greater risk of prenatal mortality and

morbidity for the population. Anemia was previously reported to contribute significantly to

maternal mortality and to both maternal and fetal morbidity. Furthermore, anemia during

pregnancy is a risk factor of iron deficiency anemia for infant.2

The body can store about one forth to one third of its iron, and it is not until those

store are depleted that iron deficiency anemia actually begins to develop. Iron deficiency anemia

is the most common type of anemia in all age group, and it is the most common type of anemia

in the world. Iron deficiency anemia occurs when insufficient quantity of iron is only available

for body’s requirement. 3

According to world health organization (WHO) the hemoglobin level should be

12 g/dl for adolescent girls. If it is less than 12 g/dl it is considered as iron deficiency anemia.

According to WHO if the hemoglobin level is 10 g/dl then it is considered as mild iron

deficiency anemia, if the hemoglobin is between 7 g/dl to 10 g/dl then it is considered as

moderate iron deficiency anemia and if the hemoglobin is less than 7 g/dl then it is considered as

severe iron deficiency anaemia.5

It is estimated that 2000 million people all over the world is suffering with anemia. More

than 500 million people are affected, more commonly in under developed countries, where

inadequate iron stores can result from inadequate intake of iron (seen with vegetarian diet ) or

from blood loss ( e.g. intestinal hookworm). In the United States of America adolescent girls are

10 times vulnerable to develop anemia than boys. 3

Average western diet contains 10 – 15 mg of iron per day and about 10% of this is

absorbed. In factors of iron deficiency anemia are low intake of meat, fish, iron fortified food,

frequent dieting, vegetarian eating style, meal skipping, heavy menstrual periods, intensive

physical training etc. 1

The iron deficiency anemia is usually correctable with oral supplements with ferrous

sulphate ( 200 mg t.d.s ) usually it is well tolerated. Therapy should be continued until the

anemia has resolved. To prevent anemia, diet naturally rich in iron should be provided. 3

According to the third National Health and Nutrition Examination Survey (NHANES

III) data, iron deficiency, defined by two or more abnormal measurements (serum ferreting,

transferring saturation and/or erythrocyte protoporphyrin ), continues to be relatively prevalent

in U.S. females, affecting 7.8 million adolescents and women of childbearing age. Iron

deficiency anaemia, a more severe stage of iron deficiency (defined as a low hemoglobin in

combination with iron deficiency), was found in 3.3 million females.3 the prevalence of iron

deficit anemia in adolescent girls based on 5th percentile for females ( 11-15 yrs ) is 2% and for

females (16-19 yrs) is 3%. 6

Bangladesh is a country where 22% of all newborns are low birth weight, 43% of <5

children are stunted (height-for-age <-2 z scores) and 17% of them are wasted (weight-for-height

<-2 z scores) (2). The majority of these children are anemic due to coexisting micronutrient

deficiencies. According to a national rural survey report, the prevalence of anemia is as high as

78% among infants aged 6-11 months and is 64% among young children aged 12- 23 months.

Another review of anemia in Bangladesh also found that its prevalence ranged from 49

to 81% with a suggestion that rural children have higher levels of anemia than urban children. A

representative survey of 14 rural districts of Bangladesh (7,764 people of 0-60 years of age)

identified an association of anemia with large families, poor sanitation, low socioeconomic

status, poor nutritional status and higher parasitic infection. Anemic children are therefore

exposed to several risk factors associated with poverty, and that in turn detrimentally affects their

development. Iron deficiency anemia is considered to be the main type of anaemia.13

Normal hemoglobin range in Newborn ( <1 week old) is 14-22mg/dl, 6 month old is

11-14mg/dl, children 91-15 yrs) is 11-15 mg/dl, adult men are 14-16mg/dl and women are 12-

16mg/dl. Normal RBC’s count in adult male has about 5.4 million red blood cells per micro liter

of blood and a healthy adult female has about 4.8 million. Whereas s packed cell volume also

known as hematocrit which is the integral part of a person’s complete blood count is45% in

males and 40 % for females.11

6.1. NEED FOR THE STUDY

Adolescence is a period of “Storm and Stress” and strain and strife. Adolescents are aged

between 13-19 years and they account for more than one-fifth of world’s population (i.e., 1-2

billion). In India, this age group forms 21.4% of the total population. According to the RGCC,

Government of India, about one-fifth of India’s population is the adolescent age-group.

Therefore it can be considered as one huge segment of the total population which needs

attention.9

Adolescence is the time when much development 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 anemia is the most common type of anemia in all age group and it is the most

common type of anemia in the world.5

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.

Anemia 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 it modernization many of them tend to eat fast food or junk food. This

all leads to deficiency of healthy rich iron diet.4

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 deforming tablets etc. 6

As per WHO Iron deficiency is the most common and widespread nutritional disorder in

the world. The prevalence rate of iron deficiency anemia among Children between 5-15yrs is

5.9- 48.1%. According the latest National family Health Survey report 2005-2006, 56% of

adolescent girls are anemic, boys too are falling prey to the disease. The study was conducted on

Prevalence of iron deficiency anemia among adolescent girls in 16 districts of India in 2006. The

survey showed that 90.1% of adolescent girls are having iron deficiency anemia. Hemoglobin

count in most of the adolescent girls in India is less than the standard (12 g/dl) accepted

worldwide. 3

India has among the worst malnutrition and micro-nutrition deficiency rates in the world.

Iron deficiency anemia in India is a major public health problem. Respectively.. In USA, the

incidence rate of iron deficiency anemia was 1 in 24 cases or 4.12% or 11.2 million people. 3

A cross sectional study was carried out in Dhaka among 65 adolescent college girls who

were chosen randomly to investigate the dietary pattern. The result showed that there was a

deficit of 437 kcal/day in energy and prevalence of anemia was 23% among the participants.

73.8% of the participants were not aware of the source of iron rich foods. The result concluded

that the overall nutritional status of the urban adolescent college girls in Bangladesh as a whole

was poor.6

A cross –sectional study was done for one year from Jan 2008- Dec 2009 according to which

the prevalence of anemia was 41% (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 adolescent (15-19yrs). A majority of girls had mild anemia. The

prevalence of anemia was considered high among the girls who belonged to the low socio-

economic status.8

Standard method was used among school girls age 9 – 14 yrs in India to assess the

physical work capacity and cognition of anemic school girls. The result showed that the adverse

effect of anemia was present even after controlling for under nutrient. The data revealed anemia

adversely affect physical work capacity and cognition among young adult girls.7

From the above finding, it is seen that the adolescent girls have less knowledge

regarding management of iron deficiency anemia. Moreover the researcher also felt that the

adolescent girls living in hostel face many problem in aspect to diet, mental tensions low intake

of meat, fish, iron fortified food, frequent dieting, vegetarian eating style, meal skipping, heavy

menstrual periods, intensive physical training etc. 1

Folic acid ( vit B9) is essential for numerous bodily functions. Humans cannot synthesize this so

foliate has to be provided through diet to meet their daily requirements. Hallalberg et al. (1993)

stated that the prevalence of iron and folic acid deficiency was determined in Göteborg, Sweden,

in a sample of 15-16 year old girls (n = 220) and boys (n = 207) using serum ferreting (SF). In a

this study of women regarding the relationship between SF and stainable bone marrow iron, it

was established that at a cut off value for SF of < 16 micrograms/L in 75% of women with no

iron stores SF concentration was below this value (sensitivity 75%), whereas in 98% of iron-

replete women it was above this cut off value (specificity 98%). Thus the study showed that in

40% of the girls and 15% of the boys SF was below the cut off value, indicating iron and folic

acid deficiency. 7

According to a study reported prevalence of folic acid and iron deficit anemia is

78.75%. It is more in public school participants (43.5%) than that of private school respondents

(35%). A similar result was reported in a study conducted in Haryana-India during 2009. The mean

prevalence of folic acid deficit and iron deficit anemia in the studies conducted during the past 3

years (2008-2011) was 72.9%. The average prevalence from 2006-2008 was 71.3 %. On comparing

its prevalence with current study, it was elucidated that there is high level rise which indicates a

major health problem that requires a solution to decrease increasing trends. This rings an alarm

where intervention targeting individual’s benefit to be focused. A study was conducted to determine

the effectiveness of Weekly iron and folic acid supplementation with counseling in reducing anemia

in adolescent girls in Uttar Pradesh. The project provided weekly iron-folic acid tablets, family life

education, and deforming tablets every 6 months to 150,700 adolescent school girls and non-

schoolgirls. In 4 years, the overall prevalence of anemia was reduced from 73.3% to 25.4%.

Hemoglobin levels and anemia prevalence were influenced significantly at 6 months. Weekly iron-

folic acid supplementation combined with monthly education sessions and deforming every 6

months is cost-effective in reducing the prevalence of anemia in adolescent girls. Appropriate

counseling, irrespective of supervision, is critical for achieving positive outcomes.13

A cross sectional survey was conducted in selected Anganwadi centers of rural area of

Hassan district. Three and Fourteen adolescent's girls (10-19 yrs old) were included in the study.

The study was conducted from February to April 2011 (3 moths).Data analysis was done by

using proportions and Chi-square test. Results: Prevalence of anemia was found to be 45.2%.13

Video assisted teaching provides a big avenue for research on innovative methods of

creating awareness among the adolescents on Anemia. It helps in bringing out the positive

changes in the knowledge of adolescent girls on anemia and improves their health by improving

their dietary pattern.

Hence the researcher felt that there is a need to conduct a study which can significantly

increase the knowledge of adolescent girls about iron deficiency anemia and its management and

that too with a technique which would be more effectual i.e (video assisted teaching).

6.2. REVIEW OF LITERATURE:

Review of literature is defined as a broad, comprehensive in depth, systematic and critical

review of scholarly publications, unpublished scholarly print materials, audio visual materials

and personal communication.8

A review of related literature gives an insight into the various aspects of the problems under

study. The review serves as an integrated function that facilitates the accumulation of

knowledge. Hence, review of literature is important to a research in order to know what has

been established and documented.9

The literature review related to the present study is organized and presented

under the following sections.

Section-1 :- Studies related to video assisted teaching

Section-2:- Studies related to Anemia

Section-3:- Studies related to Adolescent girls

Section 1 :- Studies related to Video assisted teaching

Video assisted teaching is an effective instructional method using advanced technology in its

applications. It is a technique which creates interest in the learners with its 3 dimensional audio

and visual effects in the learner.10

According to a report published in the February 2008 issue of the Archive of dermatology

teen who read or watch a presentation about Acne quickly learn the facts about this common skin

condition, and the information sticks with them for a long time. Both the audio visual

presentation proved to be effective teaching tools. Researchers hope that by teaching teens more

about their skin, they will be more likely to stick with their Acne treatment, which will ultimately

improves their self-esteem, and emotional stability.10

A study was conducted to assess the effectiveness of nutritional education and Iron

supplementation on prevention of Anemia during pregnancy among antenatal mothers of

Columbia in 2003. A sample of 42 pregnant women was subjected to a nutritional education

programmed along with administration of a supplement consisting of 60 mg elemental iron, 400

micrograms of folic acid, and 70mg vitamin c and a video assisted teaching. The effect of the

educational programmed was measured by knowledge changes about how patient’s behavior

affect nutrient bio-availability via source foods intake, as well as recognition of the tolerance

limits of supplements and potential effect of no adherence. The physiological status of each

patient was measured by three hematologic variables hemoglobin, haematocrit, and ferret. The

results revealed that, 94.4% of women did not show Anemia at the end of pregnancy.12

KHz, Alder, and Sinclair (1999) conducted a study which taught grocery related sight words to 3

students with mental retardation through an interactive video program. Twenty-four aisle sign

words were videotaped within the context of the aisle signs with the camera zooming in on the

24 target words. During instruction (using a 5-second delay) students also observed the video

and were told to: "Look at the word", "This word is” and answer the question, "What is this

word"? If a student was unable to identify a word within 5-seconds, the video was paused and

the instructor said the word. Words were acquired, generalized to the community, and

maintained over a 5-month period. Results support the use of video modeling for the acquisition

and generalization of skills to community stores; however it should be noted that instructor

feedback and correction were provided along with viewing the videotapes.14

A study was done to assess the effectiveness of video assisted teaching program on

knowledge regarding the side effects of antipsychotics among primary care givers of clients with

mental illness in mental health centers at Pondicherry. The research design adopted was one

group pre test- post test study design. Purposive sampling technique was adopted to select the

desired sample. The total sample obtained was 40. The data was collected by means of structured

interview method to assess the knowledge regarding the side effects of antipsychotics .The

collected data were analyzed by using descriptive and inferential statistical methods. The finding

of the study reveals that the obtained’ value was significant at p<0.05 level. It was concluded that

video assisted teaching was effective in gaining knowledge regarding the side effects of

antipsychotics among primary care givers of clients with mental illness16

SECTION-2: STUDIES RELATED TO IRON AND FOLIC ACID DEFICIT ANEMIA.

According to national health and nutrition survey 2006 a sample of 2447 adolescents

aged 12 to 19 years of age was taken in Mexico. The result revealed that the overall prevalence

of anemia was 11.8 and 4.6%. Female were more prone to have more mineral deficiencies.1

A cross sectional study was conducted to investigate risk factors for iron-deficiency anemia

with 1709 children and adolescents in Brazil, who were suffering from mild to moderate

intestinal helminthes infection. Data were collected regarding hemoglobin levels, dietary habits,

parasitic infections, sanitary conditions, housing conditions, income of the parents. The result

showed that 32.3% were anemic among the children and adolescents studied. The conclusion

was made that the group at greater risk should increase the consumption of iron rich food and

improves socio-environmental conditions.3

Anemia during adolescence affects the growth and development of girls, diminishes

their concentration in daily tasks, limits their learning ability, increases their vulnerability to

dropping out of school, causes loss of appetite resulting in reduced food intake and irregular

menstrual cycles, and reduces physical fitness and future work productivity. Moreover, anemia

during adolescence influences women’s entire life cycle since anemic girls will have lower pr e-

pregnancy iron stores. As pregnancy is too short a period to build the iron stores required to meet

the needs of the growing fetus, women who enter pregnancy anemic are at an increased risk of

giving birth to children with a low birth weight (below 2,500 grams), delivering pre-term

newborns, and/or dying while giving birth. Additionally, children born to anemic women are

more likely to die before the age of one year and be sick, undernourished and anemic, thus

perpetuating the intergenerational cycle of maternal and child under nutrition. Hence, investing

in preventing anemia during adolescence is critical for adolescent girls themselves as well as for

the survival, growth and development of their children later in life.15

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. Conclusion: A high prevalence of anemia among adolescent girls was found, which was

higher in low economic strata. It was seen that anemia affects overall nutritional status of

adolescent girls Anemia situation in Bangladesh. According to international criteria, anemia is a

severe public health concern (defined as a prevalence of 40% or more) in preschool age children

and pregnant women, and a moderate problem (defined as prevalence between 20-39%) in

Adolescent girls and non-pregnant women of reproductive age. According to BBS/UNICEF

(2004), anemia affects 46% of pregnant women, 64% of children aged 6-23 months, 42%

of children aged 24-59 months, 30% of adolescent girls and 33% of non-pregnant women. The

prevalence of anemia is particularly high among children aged 6-23 months and

Pregnant women because their nutritional requirements for growth and reproduction are

relatively much higher. The anemia prevalence survey also included urban samples which

Indicated marked anemia; however prevalence was lower than rural samples. The prevalence of

anemia in urban areas were 56% in <5 year old children, 29% and 17% in Adolescent. girls and

boys, respectively. In addition, 41% of pregnant and 33% of non-pregnant women were found to

be anemic.16

STATEMENT OF PROBLEM

“A study to assess the effectiveness of Video Assisted teaching on knowledge regarding iron

deficiency and folic acid anemia among adolescent girls residing in hostel at, Bangalore.”

OBJECTIVES OF THE STUDY

1. To assess the existing knowledge on iron and folic acid deficit anemia among adolescent

selected hostel in Bangalore.

2. To assess and evaluate the effectiveness of video assisted teaching programmed on iron

and folic acid deficit anemia among adolescents by post test score.

3. To compare the post test and pre test knowledge scores among adolescent girls on iron

and folic acid anemia.

4. To find out the association between knowledge score and demographic variables.

OPERATIONAL DEFINITION:-

Effectiveness

It refers to the extent to which the video assisted teaching on adolescent girls

( 18-19yrs) has improved their knowledge regarding their diet and life style to reduce anemia

incidences.

Video Assisted Teaching

System of recording and reproducing moving visual images using

magnetic tape are used to communicate with and see each other to a group of people. In this

study teaching with video shall be done upon Anemia and its management.

Knowledge

In study the knowledge refers to the awareness and familiarity about anemia among

adolescent.

Anemia

It refers to hemoglobin percentage less then 11gm/100ml among adolescent girls as per

WHO standard. It refers to decrease in the number of red cells carrying oxygen in the blood is

associated with impaired cognitive functioning, lower school achievement and most likely lower

physical work capacity among adolescent girls

Adolescent Girls

It refers to the girls of age group between 18yrs to 19yrs.

VARIABLES UNDER STUDY

Independent variable

Video assisted teaching

Dependent variable

Knowledge of participants

Extraneous variable

Age, education, diet, menstrual cycle , type of family ,religion.

HYPOTHESIS

H1- There will be significant difference between pre test and post test knowledge regarding

anemia among the adolescent girls.

H2- There will be significant association between mean pre test knowledge score with selected

demographic variable.

ASSUMPTIONS

The adolescent girls may have inadequate knowledge regarding anemia and its

management.

The video assisted teaching may improve the knowledge of adolescent girls on anemia .

6.8DELIMITATIONS

The study is limited to the adolescent girls in selected hostel at Bangalore.

6.9METHODS AND MATERIAL

7. SOURCE OF DATA

Data will be collected from adolescent girls staying in hostel at, Bangalore.

7.1METHOD OF COLLECTION OF DATA

7.1.1 RESEAECH DESIGN

Pre- experimental one group pre and post test design.

One group pre-test-post-test design with pre-experimental design:

7.1.2 RESEARCH APPROACH

An evaluate approach

7.1.3 SETTING OF THE STUDY

The study will be conducted on the adolescent girls staying in hostel at RR Institution,

Bangalore.

7.1.4 POPULATION

Adolescent girls staying in hostel at, Bangalore

7.1.5 SAMPLE SIZE

50 adolescent girls who attend the video assisted teaching in selected area at Bangalore.

7.1.6 SAMPLE TECHNIQUE

purposive

7.1.7 SAMPLING CRITERIA

Inclusive criteria

The studies include:

1. The adolescents who are in selected hostel at, Bangalore. The age between 17 to 19 years.

2. The adolescents who are willing to participate in study.

3. The adolescents who are present at the time of study.

Exclusion criteria

1. The adolescents who are (17 to 19 years) of age.

2. The adolescents who are not willing to participate in the study.

3. The adolescents who are not present at the time of study.

7.1.8 TOOL FOR DATA COLLECTION

Self administer questionnaire

7.1.9 DATA ANALYSIS METHOD

The data analysis will be analyzed through descriptive and inferential statistics.

Descriptive statistics

Frequency, mean, median, mode and standard deviation of descriptive

demographic variables.

Inferential statistics

Paired‘t’ test to compare pre and post test knowledge score of 0.01 level.

Non-parameter Chi- square (x2) test will be used to find out the association

between demographic variables and knowledge level of the adolescent.

7.2 DOES THE STUDY REQUIRE ANY INTERVENTIONS TO BE CONDUCTED ON

PATIENTS OR ANY OTHER HUMAN BEING OR ANIMALS

7.4 ETHICAL CLEARENCE

Permission will be obtained from:

The research committee of the R.R College of Nursing.

Authorities of the selected hostel at R.R Institution ,Bangalore

8. LIST OF REFERENCES

1. Frith- Terhume AL, Cogswell HE, Khan LK, Will JC, Ramakrishna U AM J Clan Nut

2000 Oct 72 (4);963-68 Link.

2. .J2oyce M Black, Jane Hokinson Hawks “Med Surgical Nursing” edition , published by

Elsevier in main link Road, Lappet Nagar , New Delhi 2005 , pg 2285-2288.

3. Dr Huntley diagnosis checklist, Health statistic,

4. 7th 10.Mohamed afar- Iron & foliate supplementation, vole 69, New Delhi, Indian

Journal, 2001, 81-92. Helen Keller International, Iron Deficiency anaemia throughout the

lifecycle in rural Bangladesh; National vit A survey 1997-98 Dhaka; Helen Keller

International, 1998.

5. K.Park, Textbook of Prevention and social Medicine, 18th edition, published by Banat,

published in Jabalpur 2007, pg 449-450.

6. Al- Quiz JM Saudi Med J 2001 Jun 22(6) : 490-6

7. Brita LL, Barrett ML, Silva Rde C Assist AM, Reis MG, Par raga I, Blanton RE Rev

Panam Salvd Rublicea.2003 Dec; 14(60 :422-31.

8. Basavanthapa BT , Nursing research , 3rd edition, Jaypee Brothers New Delhi. 1998, pg

49-52.

9. 9.Pilot and Hungler “ Textbook of Research in nursing “ 3rd edition 2006, pg 102-130.

10. 10.Koch PE, Ryder HF Dziyra J Niji Kev , Anataya RJ “ Educatind Adoloscent about

Acne Vulgaris “ Archieving of Dermatologt 2008.

11. Mohamad Jafar- Iron and folate supplementation vol 69, New Delhi, Journal, 2001, 81-

92.

12. Dongle AR, Deshmukh PR, Gag BS Food and Nutrirtion.2011

13. Hellene Keller International, Iron Deficiency anaemia throughout the lifecycle in rural

Bangladesh; National vit A survey 1997-98 Dhaka; Helen Keller International, 1998

14. Husain MM, Baker M, Pugh RN, SHEEKH- Hussein M , Bin Shaq SA, Berg DB, et al.

The prevalence and correlation of anaemia among young children and women of

childbearing age in Al Ain, United Arab Emirates. Ann Troop Paediatrics 1995, 15 : 227-

35

15. http;//www lourdescollegeofnursing.in/research. Html. Accessed on 13.11.13

Vir SC, Singh N, Nigam AK, Jain R. et al Weekly iron and folic acid supplementation with

counselling reduces anaemia in adolescent girls: a large-scale effectiveness study in Uttar

Pradesh, India; Healt Leblanc CP, Roux FM. Iron deficiency Anaemia following prenatal

Nutrition Intervention Dongle AR, Deshmukh PR, Garg BS Food Nutr Bull. 2011

Dec;32(4):315-2

9.SIGNATURE OF THE STUDENT

10.REMARKS OF THE GUIDE The selected study may be feasible and useful

in creating awareness regarding iron and folic

acid deficiency anemia among adolescent girls.

NAME AND DESIGNATION OF

THE GUIDE

MRS VANI H.M.

ASSISTANT PROFESSIOR

Obstetrics And Gynecological Nursing.

R.R.College of Nursing, Bangalore

SIGNATURE

CO-GUIDE

SIGNATURE

HEAD OF THE DEPARTMENT Mrs. .VANI H.M.

Assistant PROFESSOR,

Obstetrics And Gynecological Nursing,

R.R. College of Nursing, Bangalore.

SIGNATURE

REMARKS OF THE CHAIRMAN

AND PRINCIPLE

SIGNATURE