KNOWLEDGE REGARDING MENSTRUAL CUP AMONG NURSING

STUDENTS OF SELECTED NURSING CAMPUS, BIRGUNJ

BY
ANITA KHADKA

Research Report Submitted for Partial Fulfillment of the Requirement of

Bachelor of Science in Nursing Program from National Medical College
Nursing Campus Affiliated To Tribhuvan University
 TABLE OF CONTENTS

CONTENTS
PAGE
CHAPTER I: INTRODUCTION
1.1 Background of the Study
1.2 Need of the Study
1.4 Significance of the Study
1.5 Conceptual Framework
1.6 Research Question
1.7 Research Variables
1.8 Operational Definitions
CHAPTER II: REVIEW OF LITERATURE
2.1 Introduction
2.2 Review of Literature
2.3 Summary of Literature Reviewed
CHAPTER III: RESEARCH METHODOLOGY
3.1 Research Design
3.2 Research Setting and Population
3.3 Sampling
3.4 Research Instrumentation
3.5 Validity and Reliability
3.6 Data Collection Procedure
3.7 Data Analysis Procedure
Budget Plan
References
Appendices
Appendix A-Workplan
Appendix B-Consent form
Appendix C-Research Instrument
 LIST OF FIGURES

SN FIGURE PAGE NO.

1. Conceptual framework
 CHAPTER I
INTRODUCTION

1.1Background of the study

Menstrual cup is an alternative to sanitary pads, which has received attention in relatively small-
scale studies in high income, and low- and middle-income countries, including among
schoolgirls. Made of high-grade medical grade silicone (biodegradable) have the advantage of
reuse, and can potentially last up to 10 years. Objective of this study was to assess and analyse
the awareness regarding menstrual cup among of reproductive age group. (Ballal &
Bhandary ,2020)

A menstrual cup is a menstrual hygiene device which is inserted into the vagina during
menstruation. Its purpose is to collect menstrual fluid. (Singh and Devnath ,2022)

Menstrual cup is one of the menstrual management products available throughout the world. This
product is flexible and reusable, made of silicone and used to collect menstrual blood vaginally. .
The willingness to use these cups is increasing, which is mainly due to the public's desire to use
the eco-friendly period products. Menstrual cups can protect the environment by preventing from
discarding millions of sanitary pads and tampons and improve the quality of life of women,
especially athletes and working women, due to longer protection periods, leakage prevention,
compatibility with activity and limiting the risk of toxic shock syndrome. This device can fill a
major gap in menstrual hygiene products and women's reproductive health around the world,
consequently empowering women in menstrual management. (Gharacheh et al., 2021)

Menstrual cups are inserted into the vagina, but the blood is collected in the receptacle, which
can hold 10–38 mL of blood. The menstrual cup should be emptied every 4–12 hours, depending
on menstrual flow and type of cup. Two types of cup are available, a vaginal cup, which is
generally bell-shaped and placed in the vagina, and a cervical cup, which, like a diaphragm for
contraception ,is placed around the cervix high in the vagina. Menstrual cups are made of
medical-grade silicone, rubber, latex, or elastomer and can last up to 10 years; disposable single
use menstrual cups also exist. ( van Eijk et.al, 2019)
The menstrual cup is an internally worn device with a pliable rim 70 mm in diameter and a thin-
walled reservoir to collect and hold the menstrual fluid. Once inserted, it opens to an oval shape,
positioned between the posterior fornix and the notch behind the pubic bone, covering the cervix.
Because the cup is aligned along the long axis of the vagina, intercourse can take place below the
cup, avoiding contact with the rim and minimizing risk of displacement. Removal is
accomplished by hooking a finger over the rim behind the pubic bone. The cup was first
marketed in the United States as an approved 510K device in 1996 (North & Oldham, 2011).

Menstrual hygiene management can be challenging in low-income settings and among school
aged girls due to traditional beliefs, lack of knowledge and information on best hygienic
practices, and limited access to appropriate and affordable menstrual hygiene products. An
alternative method for menstrual hygiene management, instead of sanitary pads or tampons, is
the vaginal menstrual cup. As evidence on the use of menstrual cups is relatively limited, this
study aimed to explore the acceptability and feasibility of using vaginal menstrual cups among
school-aged girls in Thokarpa, Sindupalchowk, Nepal. ( Pokhrel et al., 2021)

1.2 Need of the study

Menstrual cup is a device for menstrual flow management and is claimed to be a health and
environment friendly alternative to the conventional menstrual sanitary protections. Vaginal
devices have along and intriguing history. In the United States, the first device was patented in
1867. Early vaginal cups used specifically for menstrual collection have never achieved
widespread use, even though they have been available in developed countries for many decades.
(Kakani & Bhatt , 2017)

A female might be using 8000-10000 sanitary napkins in her life time and accumulation of these
chemicals in body can cause serious health issues like immune system damage, diabetes,
hormone dysfunction, PID, ovarian cancer, infertility, birth defects; scented pads cause, bacterial
and yeast infections. The menstrual cup is one potential cost-effective product. However,
provision of this insertable Menstrual Hygiene Management(MHM) product in schools in low-
income countries with challenging water, sanitation and hygiene (WASH) conditions, increases
the need for assurance of good hand hygiene. (Manson, 2015).
A study was conducted on 120 women who are in the age group of 18-45 years at Rural tertiary
care hospital, India. Among them 80% of the study participants were aware of the menstrual cup.
The main concern about the menstrual cup was found to be fear of leakage (51.7%), followed by
discomfort (26.7%). 65% of the participants said if a menstrual cup is made available they are
willing to use it. This study thus concluded that though many of the participants were aware of
the usage of the menstrual cup the acceptance of the cup is still not achieved. (Sreenivas and
Ethiraj 2021)

A cross-sectional standardized questionnaire based survey method was conducted to collect

information from a sample size of 500 people of reproductive aged group 15-44 years in
Nagpur, Maharashtra, India. 2.2% of sexually active women use menstrual cups. They reported
cups were more comfortable. However, 96.4% of sexually inactive women use sanitary napkins.
The reasons for them not using cups were found to be lack of knowledge about how to use, want
to use but afraid not available in local medical stores and cultural beliefs. Usage of cloth still
made it to 0.8%. (Agrawal & Ruprai,2020).

A cross-sectional study was conducted among 400 medical undergraduate female students were
given a questionnaire to assess knowledge about the menstrual cup. Among them 28(7%) of
them did not know what a menstrual cup was 262(70.4%) students were for usage of menstrual
cup in virgins. Among 372 students, none of them used a menstrual cup. All the students in the
study used sanitary pads, owing to its popularity and promotion. There was lack of knowledge
and awareness about the cup. It was concluded that menstrual cup needs promotion to boost the
adoption rate of menstrual cups among the youth.( Eti et al., 2019)

Menstrual Hygiene Management and Menstrual Cup: Many women and adolescent girls from
poor families cannot afford to buy sanitary towels, and resort to using strips of old cloth and
other unhygienic methods. The study assessed the cultural, practical and health-related
appropriateness and feasibility of the menstrual cup as a method for managing menstrual flow.
The only problem is assuring a high level of hygiene is needed for insertion and removal of the
cup (APHRC, 2010).

With the advancement of the science and technology various products are introduced in the
market for menstrual hygiene management. Menstrual cup is one of the product introduced for
the menstrual hygiene management. There are a few clinical studies proving the actual benefits
of menstrual cups and thus there is a lot to be proven and confirmed. Hence it leaves a scope for
study to evaluate the menstrual cup as an alternative for menstrual sanitary protections.

If there are so many advantages of menstrual cup over sanitary pads, then why is it still not been
so popular? Probably because of lack of knowledge and the menstrual cup not been promoted as
much as it should have been, especially in a country like Nepal. A menstrual cup is inserted into
the vagina, while a menstrual pad isn't. So, people think that using a cup in unmarried girls might
result in loss of virginity. Since we follow western culture, the idea of use/throw is becoming
more common. Due to the lack of promotion of menstrual cup and popularity of sanitary pads
even educated ones have inadequate knowledge about menstrual cup.

The previous study conducted are related to knowledge, practice, feasibility and effectiveness of
the menstrual cup among reproductive age group women and adolescent girls. To the
researcher’s knowledge, there are no any study conducted for the knowledge regarding the use of
menstrual cup in Nursing students of Nepal. Being the student of nursing field as well as female,
the researcher is encouraged and felt need to carryout study on knowledge regarding menstrual
cup among Nursing students.

1.3 Objectives of the Study

1.3.1 General objectives

The general objective of the study is to find out the knowledge regarding menstrual cup among
nursing students of National Medical College Nursing Campus, NMCNC.

1.3.2 Specific objectives

To identify the level of knowledge regarding menstrual cup among the nursing students.

To find out the association between selected socio-demographic variables and level of
knowledge regarding menstrual cup among nursing students.

1.4 Significance of the study

This study helps to assess the knowledge regarding menstrual cup among nursing students.
The findings of study will aware the students to use the menstrual cup in their daily life and will
serve as reference material for future researchers.

1.5 Conceptual Framework

Conceptual framework referred to the interrelated concepts or abstractions that are assembled
together in some rational scheme by virtue of their relevance to a common theme.

This framework showed that the dependent variable i.e. knowledge regarding menstrual cup
among nursing students will be directly or indirectly affected by various independent variables
such as socio-demographic characteristics ( age, marital status, religion, level of education,
sources of information).The level of knowledge will be categorized into adequate and
inadequate.

Socio-demographic
variables
Age Inadequate
Academic year of
study Knowledge regarding
Moderate
of menstrual cup
Religion
Marital status Adequate

Menstrual History
Sources of
information

Figure 1: Conceptual framework on knowledge regarding menstrual cup among nursing students
1.6 Research Variables

Dependent Variable

Knowledge regarding menstrual cup

Independent Variables

Socio-demographic related variables

Age

Academic year of study

Religion

Marital status

Age of menarche

Source of information

1.7 Operational Definitions

Knowledge

In this study knowledge refers to the correct responses about the menstrual cup as measured by
self-administered structured knowledge questionnaire and expressed in terms of knowledge
score.

The knowledge level is scored as:

Inadequate knowledge ≤50%

Moderate Knowledge=51-75%
Adequate Knowledge=76-100%

( Muhire ,2021)
Menstrual cup

Menstrual cup is device which is inserted into vagina during the menstruation.

Nursing Students

In this study nursing students referred to students who were studying nursing at the time of
study.

1.8 Research Question

What is the level of knowledge of Nursing Students regarding of menstrual cup?

1.9 Delimitation of the study

The study will be delimited to nursing students of National Medical College and Nursing
Campus, Birgunj , Parsa.
 CHAPTERII

LITERATURE REVIEW

2.1 Introduction

Literature review is a synopsis of previous studies on a specific topic which is carried out in
order to gain overview of existing research and debates relevant to the area of study. It helps to
identify gaps and conflict in previous work. It also provides justification to present study. This
chapter deals with the literatures which were searched through electronic as well as manual
sources such as books, articles and journals. The search engine like Google Scholar and
databases like PubMed and Medscape were used. Likewise, key words: Knowledge, Use ,
Menstrual cup, Nursing students , Awareness were used when searching for the related
literature. The reviewed literature are organized and presented as follows:

2.2 Review of literature

Literature review on knowledge regarding menstrual cup

Sreenivas and Ethiraj (2021) conducted a cross-sectional study among 120 reproductive aged
women of 18-45 years to assess the knowledge, attitude, and practices regarding menstrual cup
in a Rural Tertiary Care Hospital, India. The study findings shows that 80% of the study
participants were aware of the menstrual cup. 36.7% of the participants got information from
media, 26.7% from family, 20.8% from friends, and 14.2% from media personnel. The
maximum of participants was in the age group of 21 years to 30 years (58.33%). The educational
level of the participants was mostly in the undergraduate (35%) or post-graduate level
(25.8%).65% of the participants said if a menstrual cup is made available they are willing to use
it.48.3% of study participants reported they have adequate knowledge, 45.8% had poor
knowledge and only 5.8% had good knowledge about menstrual cup.

Divakar et al (2021) conducted cross sectional survey among 163 obstetricians and
gynecologists in the public and private practice in Bangalore, India on Menstrual health and
hygiene to study knowledge ,attitude and practices of obgyns on usage of menstrual cups. 93%
of the health care providers think that menstrual cups are more environment friendly than
sanitary pads. We found that only 59% think that they are the way forward for better menstrual
hygiene management. Only 57% of the health care providers actually advised young girls on the
usage of menstrual cups. Though fifty percent of the health care providers think that it is
appropriate to advice menstrual cups to young girls, only 35% pro-actively advocate menstrual
cups to young girls irrespective of their sexual activity. Most of the users had the internet and
peer group as their source of information, rather than the healthcare providers.

Ballal & Bhandary(2020) conducted a descriptive cross-sectional study in A. J. Institute

Mangalore, Karnataka, India on menstrual cup awareness among reproductive women over 1
month . The data was collected from the selected eligible participants using an interviewer
administered questionnaire. In this study 300 candidates were enrolled. Nearly 82% of the study
population had good awareness of menstrual cup, 65.75% had good knowledge and 43.67% are
willing to accept menstrual cup as sanitary hygiene aid during menstrual days but only 2.67%
were found to have used it.

Agrawal & Ruprai (2020).This study was projected to study menstrual practices and
acquaintance with menstrual cup among 500 people of reproductive aged group 15-44 years in
Nagpur, Maharashtra, India. 2.2% of sexually active women use menstrual cups. 3.7% of
them prefer to use sanitary napkins along with menstrual cups only for gym and
swimming. They reported cups were more comfortable. Other reasons for preference were they
are environment friendly and reusable. However, 96.4% of sexually inactive women use
sanitary napkins. The reasons for them not using cups were found to be lack of knowledge
about how to use, want to use but afraid not available in local medical stores and cultural beliefs.
Usage of cloth still made it to 0.8%.

Eti et al (2019)performed cross sectional study to assess the knowledge about menstrual cup
and its usage among medical students among 400 undergraduate medical students belonging to
second, third and final year MBBS of Rajarajeswari Medical College and Hospital ,India . Boys
were excluded from the study. Among 400 medical students, 28(7%) of them did not know what
a menstrual cup was 262(70.4%) students were for usage of menstrual cup in virgins. There was
no clear picture among students regarding material used in cup manufacture, its emptying time
and sterilization technique. Among 372 students, none of them used a menstrual cup.

Literature related to acceptability, adaptability and use of menstrual cup

Beksinska et al(2021) conducted cross sectional study to assess the acceptability of the
menstrual cup among 509 female students aged 18-24 years in 10 further education institutions
including 22 campus sites in KwaZulu-Natal, South Africa .Menstrual cups were offered after
receiving education and training in their use. The students were followed for up to 12 months to
assess menstrual cup acceptability, user experiences and continuation. Disposable pads were the
primary menstrual hygiene product used in the 3 months prior to the baseline interview (95.5%,
n = 486), and 8.1% (n = 41) of students reported that they had used toilet paper or newspapers.
463 (91%) students were interviewed at 1 month follow-up, 86% reported that they had tried to
use the menstrual cup. There was mixed reporting on ease of insertion and removal on first use.
Among those who attempted use, half (49.5%, n = 197) reported that inserting the menstrual cup
on first use was very easy or quite easy and other did not find it .The majority who had used the
cup (>90%) reported they would continue to use it at each follow-up visit.

van Eijk et al(2018).A longitudinal study was conducted to determine the use of menstrual cups
among 192 school girls between 14 to 16 years through cluster random sampling in 10 schools of
Nyanza Province, Western Kenya. Girls were provided with menstrual cups in addition to
training and guidance on use, puberty education, and instructions for menstrual hygiene. During
repeated individual visits with girls reported use of the menstrual cup. Girls were able to keep
their cups in good condition, with only 12 cups (6.3%) lost (dropped in toilet, lost or destroyed).
Verbally reported cup use increased from 84% in the first 3 months (n = 143) to 96% after 9
months (n = 74).

Kakani & Bhatt ( 2017) conducted study on adaptability and efficacy of menstrual cup in
managing menstrual health and hygiene at Gujarat Medical Education and Research Society,
Medical College and Hospital, Dharpur, Patan, Gujarat, India among 158 participants aged
between ages of 20 to 50 years with regular menstrual cycle. Participants were provided
menstrual cups to be used for three consecutive menstrual cycles. They were given detailed
explanation/information about its usage. Feedback was obtained after every cycle for three
cycles using a structured questionnaire. The cup was preferred for comfort, dryness, and less
odor. Insertion was easy for 80% participants and 90%participants found removal easy. Problem
of leakage was encountered in 3-6%. There were few side effects like rashes, dryness or
infection.

Pokhrel et al (2021).A qualitative pilot study was conducted on acceptability and feasibility of
using vaginal menstrual cups among schoolgirls in rural village of Thokarpa, Sindupalchowk,
Nepal among four focus group discussions with a purposive sample of 28 schoolgirls between
13 and 19 years of age who were provided with vaginal menstrual cups. The data were collected
approximately three months after the distribution of the menstrual cup. Participants were
included in the study if they had started their menstruation and never given birth. The
participants found using the menstrual cup easy and convenient, and described economic and
environmental advantages of using it. Discomforts mentioned by the participants were pain when
inserting the menstrual cup, feeling the menstrual cup sticking out of the vagina, feeling a
constant urge to urinate and leakage. It concluded that use of vaginal menstrual cups for
menstrual hygiene management among schoolgirls appears feasible and acceptable, as it involves
practical, economic and environmental advantages.

Gharacheh et al(2021) conducted cross-sectional study among 515 eligible Iranian literate
women between the ages of 18 and 50 with regular menstrual periods who used menstrual cups
to manage menstruation for at least three consecutive cycles to assess the acceptability and
feasibility of menstrual cup. Snowball sampling technique was used. The mean score of the
overall satisfaction with the cup was 6.54 ± 0.76, and the leakage had the lowest mean score
among the satisfaction items (5.25 ± 1.63). About 83% of participants reported experiencing
menstrual cup leakage. Among the reported health risks, the highest mean score was for vaginal
pain during removal (23.9%). Most participants (83.9%) were familiar with the cup via social
networks and 98.6% recommended this product to other women.
Madziyire et al (2018) conducted prospective interventional study among 52 sexually active
women with poor socio-economic stratum from Epworth district in Zimbabwe, Africa to assess
the safety of menstrual cup after providing and training them to use menstrual cup for 12
month.At 12 months follow up ,94% were still using cup and 83% would recommend cup to
another women. There was no onset or worsening of dysmenorrhea in 83% , dyspareunia in
94% , pelvic pain in 92% and vaginal discharge in 92% of participants during 12 month of cup
use. This study shows that menstrual cup is acceptable, safe and a convenient menstrual care
management device which can be used by women of low socio-economic status in Zimbabwe.

Juma J et al (2017) conducted observational study to examine the safety of menstrual cups
against sanitary pads and usual practice among menstruating primary school girls aged 14-16
years of 30 primary schools in a health and demographic surveillance system in rural western
Kenya. Among 604 eligible girls tested, no adverse event or toxic shock syndrome was detected
over a median 10.9 months follow up. S. aureus prevalence was 10.8%, with no significant
difference over intervention time or between groups. Among them 65 were S.aureus positives at
first test, 49 girls were retested and 10 (20.4%) remained positive. Seven per cent of cups
required replacements for loss, damage, dropping in a latrine or a poor fit. Out of 30 used cups
processed for E. coli growth, 13 (37.1%, 95% CI 21.1% to 53.1%) had growth. E. coli growth
was greatest in newer compared with established users (53%vs22.2%, p=0.12). Thus, it was
concluded that among this feasibility sample no evidence emerged to indicate menstrual cups are
hazardous or cause health harms among rural Kenyan schoolgirls.

Shah C et al (2017) A study was conducted to establish the safety, efficacy, and adequacy of
menstrual cup among one hundred females aged 15-44 years in India .7% percent of the women
stated that they use tampons as their menstrual tool where as an astonishing 82% women use
sanitary pads both that are branded as well as locally made. While 11% of the females use both
tampons as well as sanitary pad. After watching a short awareness video and consulting with
doctor patients started using flow care menstrual cups. After 8 weeks the same subjects were
asked to complete the study and out of which 43% females rated the cup as better than pads,
tampons and cloth. 36% subjects rated cup as equal to pads or tampons whereas 21% thought
that they are not as good as pads and tampons. 57% females would consider using a menstrual
cup in future. Out of all the females who used menstrual cups 64% women found the insertion of
cup difficult for the first time, whereas almost all women had no issues removing the cup. It
concluded that menstrual cup is a better and safe alternative towards menses and also helps
reduce the environmental risk.

Shihata & Brody (2014).A study conducted on an innovative, reusable menstrual cup that
enhances the quality of women's lives during menstruation among 146 women of diverse cultural
and national background in UK to evaluate the acceptability of a unique, cost-effective,
reusable, and environmentally safe device i.e femmycycle for menstrual blood collection and to
enhance the quality of life for women during menstruation as an alternative to sanitary pads and
tampons. Women were instructed to use the femmycycle for three cycles, report any side effects
and compare their experiences using the femmycycle with other sanitary products. Among all
participants who used this new device for three cycles, 84% preferred the femmycycle over
previously-used methods and safer for the environment than pads and tampons. It concluded that
the device can protect the environment and enhance the quality of women’s lives during
menstruation due to the longer duration of protection, prevention of leakage, activity
compatibility, as well as elimination of the risk of Toxic Shock Syndrome.

Stewart et al (2010) performed study to assess the women’s experience of using mooncup
among 53 healthy volunteers of University of Nottingham Medical School student, UK. It was
aimed to determine whether the mooncup is tolerated by asking 53 healthy female volunteers to
record the frequency of changing sanitary protection and leakage over three menstrual cycles
with regular sanitary protection and three cycles with the mooncup. The frequency of leakage
and changing the Mooncup was measured along with acceptability of the moon cup. A total of
126 baseline cycles and 71 cycles with the mooncup were recorded. The moon cup leaked 0.5
times less frequently and required to be changed 2.8 times less frequently, on average, during
one menstrual period than regular sanitary protection. Of the participants, 55% will carry on
using the mooncup for sanitary protection. Thus, it was concluded that the moon cup is
acceptable for most women but could not be used for the objective measurement of menstrual
blood loss because of the leakage that did occur.

2.3 Summary of Literature Reviewed

From a literature reviewed it has been found that an average woman uses 10000 sanitary
products during her lifetime. Thus menstrual cups could have a significant environmental
advantage .A study previously conducted study shows that menstrual cup are the best alternatives
of tampons and sanitary pad. Most of the female who has been the part of the study found
menstrual cup very effective in terms of cost, comfort and adaptability as well. The previous
study conducted were related to knowledge, attitude, adaptability , feasibility and effectiveness
of the menstrual cup and the study population were school children, medical students and women
of reproductive age group. There are no any study conducted for the knowledge regarding the
use of menstrual cup in Nursing Students. Being the students of nursing field as well as female,
how much they are concerned about their menstrual health and modern menstrual products as
well as to identify the level of knowledge regarding menstrual cup. There is a need of study in
this area.

CHAPTER III

METHODOLOGY
3.1 Research Design

A descriptive cross sectional study design will be used to assess the level of knowledge regarding
menstrual cup among nursing students.

3.2 Research Setting and Population

Setting

This study will be conducted at National Medical College Nursing Campus , Birgunj , Parsa.

Population

The study population will be PCL nursing students studying in National Medical College and
Nursing Campus, Birgunj, Parsa.

3.3Sampling Procedure
Sample Size=83

The sample size is calculated based on proportion of good knowledge that was 5.8% conducted
by (Sreenivas and Ethiraj , 2020). According to the objectives of the study, PCL nursing student
from National Medical College Nursing Campus will be selected and by considering operational
definitions, inclusion and exclusion criteria, sample population is drawn. The sample size of the
study will be calculated by using Cochran’s formula.

n =z2pq/d2

Where, n = required sample size

z = 1.96 for 95% of Confidence interval

p = Prevalence of an event =5.8% = 0.058(Sreevinas and Ethiraj,2021)

q = Probability of failure = 1-p = (1-0.058) = 0.942

L= allowable/ permissible error 5%

So, the calculated sample size is: Sample size (n) = z2pq/L2

= (1.96)2 x 0.058 x 0.942 / (0.05)2

= 83

From the calculation, the sample size will be 83.

Sampling Method

The probability stratified proportionate random sampling technique will be used for the study.
Considering each year as strata, 28 each sample will be taken from 1st year and 3rd year and 27
sample will be taken from 2nd year by using random sampling technique (lottery method).

PCL Nursing No. of nursing Proportion Sample size

students

1st year 40 40/118=0.34 28

 2nd year 38 38/118=0.32 27

3rd year 40 40/118=0.34 28

Total 118 1 83

Inclusion Criteria

PCL nursing students of National Medical College and Nursing Campus, Birgunj, Parsa.

Those who are willing to participate in the study.

Those who can understand English.

3.4 Research Instrumentation

A self-administered structured questionnaire will be prepared for data collection after the review
of related literatures, consultation with research advisor and subject expertise.

A research tool will consists of two parts which are as follows;

Part I: Items related to Socio-demographic variables

Part II: Structured questionnaire to assess knowledge regarding menstrual cup

3.4.2 Validity and reliability of tool

Content Validity of the research instrument will be maintained by the consultation with experts
of the related field.

Pretesting of the instrument will be done in 10% of the total sample size (i.e. 8) among nursing
students of The Himal institute of Health Science to check the clarity, sequence of the tool.
Reliability of the tool will be done by Split half test.

3.5 Plan for Data Collection

Prior to data collection ethical approval will be taken from the institutional Review Committee of
National Medical College.
Formal administrative approval will be obtained from the respective nursing campuses of
Birgunj.

Informed written consent will be taken from the respondents prior to data collection and
respondents will be clearly explained that their participation is voluntarily and have freedom to
withdraw from study at any time.

The researcher will follow the standard protocol to prevent possible COVID-19 infection to
herself and the respondent.

Confidentiality of the collected data will be maintained by keeping the filled questionnaires
safely, maintaining non -disclosure and using only for research study purpose and data will be
collected within the given 2 weeks.

3.6 Plan for data analysis

After data collection, the collected data will be checked and reviewed for its completeness and
accuracy.
Then,the data will be coded, classified and entered into statistical package for social science
(SPSS) version 20.
Descriptive statistics like frequency, percentage, mean and standard deviation will be used for
the Descriptive analysis and chi square will be used to determine the association between
selected variables.
The analyzed data will be presented in tables.

Budget plan
SN ITEMS COST
1. Print and Photocopy 2000
2. Stationary articles 500
3. Internet 1000
4. Communication 100
5. Transportation 100
6. Miscellaneous 500

TOTAL 4200
 Work plan
S.N Activities
1st 2nd 3rd 4th 5th 6th 7th 8th 9th
week week week week week week week week week
1. Literature review
2. Research problem
Presentation
3. Research proposal
Development
4. Research proposal
Presentation
5. Finalization of
research
proposal
including tool
Development
6. Data collection
7. Data analysis and
Interpretation
8. Report writing
9. Research report
Presentation
References
 CONSENT FORM

Title of Research Project: “Knowledge Regarding Menstrual Cup among

Nursing Students of National Medical College Nursing Campus, Birgunj.”

Dear participants,
I am Anita Khadka, Bachelor of Science in Nursing (BSN) final year student of National
Medical College Nursing Campus. As a partial fulfillment of our course, I have to conduct
research and the selected problem is “Knowledge Regarding Menstrual Cup among Nursing
Students of National Medical College Nursing Campus, Birgunj.”
I would like to get some information about your Knowledge regarding menstrual cup through
structured questionnaires. The information will be kept confidential and will be used only for
study purpose. This is for your kind information and participation.
………………………….
Signature of Researcher

I am willing to participate in study and aware that information provided will be kept confidential
and used only for study purpose.
Date:
Place:
…………………………………
Signature of Participant
 PART I

SOCIO-DEMOGRAPHIC DATA

CODE NO: …….(For research purpose only) DATE:……………

Instructions: Following statement is related to the socio-demographic information of the

respondent. Kindly choose the appropriate option and fill up the space with factual answer and
put the tick mark ( √ ) in the given questions.

1) Age of respondents

a. >19 years

b. <19years

2) What is your academic year of study?

a. First year
b. Second year
c. Third year
3) Which religion do you belong to?
a. Hinduism
b. Islam
c. Buddhism
d. Christanity

4) What is your marital status?

a. Married
b. Unmarried
c. Divorced
d. Widow
5) What is your age of menarche?
a. 9-11 years
b. 12-14 years
c. 15-17 years
6) Have you heard about menstrual cup?
a. Yes
b. No
6.1) If yes, from where did you get information?
a. Television
b. Radio
c. Internet sources
d. Peer interaction
e. Family
f. other sources
g. Not heard
 PART II

Self-Administered structured knowledge questionnaire regarding menstrual

cup

Instruction: Read the question carefully and tick (√) the correct answer from provided option to
each question.
1) What is menstrual cup considered as?
a. Biodegradable and Reusable b. Unsafe
c. Costly d. Use and throw product
2) What is the function of menstrual cup?
a. Absorption b. Retention
c. Collection d. Consumption
3) Which material is used to make menstrual cup?
a. Rubber b. Silicon
c. Glass d. Fiber
4) What is the shape of menstrual cup?
a. Ball b. Triangle

c. Bell d. Square

5) What are the parts of menstrual cup?

a. Tip, Valve and Handle b. Rim, Body and Knob

c. Adhesive wings and absorbent layer d. Absorbent portion and string

6) Where is menstrual cup inserted?

a. Rectum b. Uterus

c. Urethra d. Vagina
7) What are the available size of menstrual cup?

a. Smaller, Medium and Larger b. Smaller only

c. Larger only d. Medium only

8) What is average holding capacity of menstrual cup in it?

a. 5-10 ml b. 12-14 ml

c. 16-18ml d. 20-30 ml

9) What is the duration of emptying menstrual cup during menstruation?

a. Every 4-12 hour b. Every 14-16 hour

c. Every 1-2 hour d. Every 18-24 hour

10) How many years menstrual cup can be used for?

a. Up to 5 years b. Up to 10 years

c. Up to 8 years d. Up to 6 years

11) Which is the best position for inserting menstrual cup?

a. Side lying b. Sitting

c. Squatting d. Standing

12) The size of menstrual cup depend on the factor?

a. Height of women b. Weight of women

c. Color of menstrual cup d. Age of women

13) What are steps of menstrual cup insertion?

a. Lubricate and insert b. Wash, fold and insert

c. Relax, pull and wash d. Wash , insert and fold

14) How can the menstrual cup be cleaned during menstruation?

a. Cleaning with soap b. Cleaning with tissue paper

c. Cleaning with running water d. Cleaning with distilled water

15) What is the method of sterilizing menstrual cup?

a. Boiling b. Heating

c. Using microwaves d. Autoclaving

16) What are the advantage of menstrual cup?

a. Tough to find right fit b. Removal can be messy

c. Chance of leakage d. Odor free and economical

17) What are the misconception about menstrual cup?

a. Females will lose their virginity b. Cannot be used while sleeping

c. Can get stuck d. All of the above

18) How should menstrual cup be stored?

a. Plastic bag b. Breathable pouches

c. Plastic container d. Glass container

 ANSWER KEY

Item Number Answer Item Number Answer

1 a 10 b

2 c 11 c

3 b 12 d

4 c 13 b

5 b 14 c

6 d 15 a

7 a 16 d

8 d 17 d

9 a 18 b