RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

MS. G. MALATHI

FIRST YEAR M.Sc (NURSING)

OBSTETRICS & GYNAECOLOGY NURSING

YEAR 2008-2010.

THE KARNATAKA COLLEGE OF NURSING

NO. 12, KOGILU MAIN ROAD,

YELAHANKA, BANGALORE - 560064

GANDHI UIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALAORE

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / G.MALATHI
Ist YEAR M.Sc., NURSING STUDENT, THE KARNATAKA COLLEGE OF NURSING , NO. 12, KOGILU MAIN ROAD, YELAHANKA, BANGALORE - 560064
2. / NAME OF THE INSTITUTION / THE KARNATAKA COLLEGE OF NURSING , NO. 12, KOGILU MAIN ROAD, YELAHANKA, BANGALORE - 560064
3. / COURSES OF STUDY / Ist year M.Sc (Nursing),
(OBSTETRICS & GYNAECOLOGY)
4. / DATE OF ADMISSION / 01-07-2008
5 / TITLE OF THE STUDY / A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING MINOR AILMENT DURING PREGNANCY AND THEIR HOME REMEDIES AS PRACTICED BY PRIMI GRAVIDA MOTHERS ATTENDING PRE – NATAL CARE FACILITIES FROM SELECTED COMMUNITY CENTRE IN YELAHANKA.

6. BRIEF RESUME OF THE INTENDED WORK:-

6.1. INTRODUCTION

Ghosh (1987) stated that it has been estimated that an average Indian woman become pregnant 8 times and gives birth to 6 -7 children out of which 4 – 5 survive . In between , she is breast feeding the babies, and so it seems that she spends 80% of her reproductive life in pregnancy and lactation

Mothers and children are the basic foundation of a society and its wealth. So, it is very important to take care of a woman during her pregnancy. Pregnancy is a crucial period where the Mother tends to take care of herself so as to prepare herself for safe delivery and to have a healthy baby.

During the course of pregnancy period many changes occur in a woman’s body as a result of hormonal influences and adaptation to the gestational process. Thereby, they experience a variety of physiological and psychological symptoms such as nausea, vomiting , backache , giddiness , heartburn and anxiety etc. These are termed as minor ailments or discomforts of pregnancy.

The expectant Mothers contribute further to family health, where she seeks guidance throughout the pregnancy and follows the advice of experienced personnel to overcome or treat these minor ailments of pregnancy. Most of the expectant mothers rely on home remedies or no remedies for the minor ailments of pregnancy thinking that they will be subsiding by the end of pregnancy.

India has a very ancient culture. People of different communities in India put faith in a particular system depending upon their culture, environment, education and familiarity with the system in dealing with their health problems. Pregnancy and child birth has a significant place in all cultures of our country. In India itself, there are endless beliefs regarding what is good or not good for he pregnant woman. In some regions it is customary to eat special sweets with a lot of ghee and nuts during pregnancy which in turns causes too much weight gain and few minor ailments.

Moreover, to reach the goal of Health For All by 2000 A.D. all useful methods will have to be employed and all possible resources are to be mobilized. One of eh most important methods are adopting indigenous health practices, therefore home e remedial measures for treating minor ailments play an important role in our country.

6.2. NEED FOR THE STUDY

Despite the fact most of the minor ailments seen in pregnancy are largely preventable and easily curable, minor ailments continues to be the common cause of maternal morbidity in India .Poverty, ignorance , repeated pregnancies, lack of antenatal facilities and socio – cultural aspects are most important branch of preventive and obstetrical medicine throughout the world.

In our clinical experience, investigators observed that antenatal mothers complains of flatulence, nausea, vomiting, blenching , epigastric distress, heartburn etc. due to certain foods.

A survey of current usage of medial plants in selected mainly industrialized countries is being undertaken by the world federation of proprietary medicine manufacturers on behalf of WHO. The findings indicate that the number of individual using medicinal plant remedies is large and increasing specially among young people. The proper use of medicinal plants is a necessity not a luxury. At the Alma – Ata Conferences on primary health care, governments were recommended to give high priority to traditional medicine and to make policies and regulations embracing proven traditional remedies.


In olden days there were joint families so the pregnant women were getting enough information from the old women folks. On the other hand, family structures changed i.e nuclear families are common. In developing countries there are only few opportunities for the pregnant woman to help them to form a positive self esteem and status of certain kind.

The investigators took this study to draw some implications.The findings of the study will be useful for future students in dealing and understanding the various minor ailments experienced by pregnant women.

6.3 STATEMENT OF THE PROBLEM:-

A study to evaluate the effectiveness of structured teaching programme on the knowledge regarding minor ailments during pregnancy and their home remedies as practiced by primi gravida mothers attending pre – natal care facilities from selected Community Centre from Elanka

6.4 OBJECTIVES

·  To assess the knowledge among the primi gravida mothers in pre- test, regarding minor ailments in pregnancy and home remedies practiced by them.

·  To assess the knowledge among the primi gravida mothers in post – test, regarding minor ailments in pregnancy and home remedies practiced by them

·  Comparison of pre – test and post test knowledge among the primi gravida mothers to determine the effectiveness of structured teaching programme regarding minor ailments in pregnancy and home remedies practiced by them

·  To associate the knowledge of prim gravida mothers with demographic variables.

6.5. OPERATIONAL DEFINITIONS

EFFECTIVENESS

Refers to the outcome of structured teaching in terms of difference I per- test and post – test knowledge gained.

STRUCTURED TEACHING

It is a formal and specific teaching developed for the expectant mothers on the minor ailments of pregnancy and its home remedies.

PRIMI GRAVIDA MOTHER

Refers to mothers who are pregnant for the first time and are in the sixteen to thirty eight weeks of gestation

MINOR AILMENTS

They are minimum discomforts or illnesses of pregnancy that are usually the result of normal physiological changes due to pregnancy. They include morning sickness, frequency of micturition , ptyalism, giddiness, anorexia, indigestion, heart burn, edema of lower extremities, hemorrhoids, varicose veins, headache, backache , fatigue and leg cramps.

HOME REMEDIES

Remedial measures taken for the treatment of minor ailments during pregnancy, including herbal and home – made curses given by elder family members, elder women of the village, friends or taken by the expectant mother herself.


KNOWLEDGE

It is the antenatal mothers understanding and awareness to assess the question s about minor ailments during pregnancy.

6.6. ASSUMPTIONS

§  Primi gravida mothers will be experiencing some minor ailments during pregnancy.

§  Primi gravida mothers will be able to recall the minor ailments during pregnancy which they suffered from therir 1st, 2nd, and 3rd trimester.

§  Most of the expectant mothers will be practicing some remedies for the minor ailments.

§  They will be willing to participate in the study.

6.7 HYPOTHESIS

There is a significant difference between the pre – test and post – test knowledge of primi gravida mothers on ailment of pregnancy and home remedies.

6.8. REVIEW OF LITERATURE

Chou FH. Lin LL (2007 ) conducted a descriptive study to test the prevalence of nausea, vomiting and fatigue among pregnant mothers. The findings of the study reveals that 30 (26.5%) reported number 43(38.1%) occasional and 40 (35.4%) frequent nausea and vomiting . 4(3.5%) women reported no fatigue. 49(43.4%) occasional fatigue and 60 (53.1%) reported frequent fatigue.

Huxley (2006) conducted a prospective study to assess the positive effect of nausea and vomiting on pregnancy outcome, on a sample of 304 mothers. The findings were that there was a decrease risk of miscarriage, pre- term birth, low birth weight and perinatal death. Nausea and vomiting resulting form secretion of HCG and thyroxin, reduces maternal energy intake which stimulates early placental growth. Evidences also suggests that there may be a positive relationship between morning sickness and preconception body mass index, such that women who are underweight will experience less severe symptoms of morning sickness compared with women with normal preconception BMIs

Knudsen .A, et.al. (2002) conducted a study by obtaining self – administered questionnaire filled in daily by 180 women from 31st gestationa; week of delivery, to assess on the prevalence of well –being , heart burn, nausea, and vomiting related to gestational week, parity and age in the third trimester of the normal pregnancy. The study was completed by 120 women . the weekly prevalence of well – being decreased form 50% at the 31st gestational week to 24% at the 42nd gestational week. The weekly prevalence of heartburn (60%) nausea (16%) and vomiting (7%) was nearly constant throughout the study period. Well being was inversely related to parity, heart burn positively related to age. The study concludes that discomforts are customary in the third trimester of normal pregnancy

Lee RV(2006) in the epidemiologic studies conducted states that pregnancies accompanied by “morning sickness” have better outcomes than asymptomatic pregnancies. Study concludes that many pregnant patients note alterations in smell and taste which can precipitate “ morning sickness” symptoms that characterize early gestation. The intimate connection between immunogenetic identity, chemoidentity , and chemo communication by olfactory mechanisms suggests a relationship, between maternal symptoms and maternal accommodation of paternal antigens contained in the fetoplacental unit.


Fast A. et.al. (2005) conducted a polysomnographic study on 13 women in later stages of pregnancy to sasses to cause for nocturnal low back pain in pregnancy. Eight women (61%) complained of nocturnal back pain or discomfort . this pain group used to spend a longer time sleeping in the supine position. The study hypothesize that a prolonged stay in the supine position leads to obstruction of the venacave which causes inadequate collateral circulation , increased pressure and venostasis in combination with a decreased in basal oxygen saturation leading to hypoxemia compromise the metabolic supply of the neural structures and result in pain

Lagion P. et.al, (2006) conducted a prospective cohort study to assess pregnancy hormone levels in relation to nausea with or without vomiting.262 women at 16 and 27 weeks of gestation were the samples of the study. The study concluded that lower levels of prolactin and higher levels of estrodiol as contributing or correlataing factors with the occurrence of nausea with or without vomiting at any time during the pregnancy until the 27th gestational week.

Franklin ME, et.al, (2004) conducted a prospective study to determine if posture and back pain has a relationship from first to the third trimester of pregnancy . During the first and third trimesters, each subject had their standing posture and back pain assessed by a Metrecom skeletal analysis system and a 0 to 10 cm line pain scale, respectively. The study concludes that no significant relationship were found between magnitude of change in posture and back pain.

Ramasuseelamma G (2000) conducted a study to identify the occurrence of selected common ailments and their home remedies in a selected rural community in Andhra Pradesh. One of her objectives was to identify the home remedies and to give reasons and to give reasons and source of information for using home remedies for selected common ailments as expressed by rural women. The findings of the study revealed that all the age groups of rural people experienced common ailments. They practiced home remedies after the second day of occurrence,. A majority of the home remedies were found to be effective as reported by respondents.

Joseph EM (1999) conducted a study on the role of the nursing personnel in relation to the informational needs of primi gravida mothers and information they received at antenatal clinic in Lady Hardinge Medical College and Hospital , New Delhi. One of her objectives was to find out the areas in which mothers want information .she found that highest percentage of mothers wanted information regarding normal physiological changes occurring during pregnancy and a good percentage of mothers wanted information regarding minor ailments.

7. METHODS AND MATERIALS

7.1 SOURCES OF DATA

Data will be collected from the primi gravida mother attending prenatal care facilities from the selected community centre in Elanka.

7.2 METHODS OF DATA COLLECTION

I. RESEARCH DESIGN

An observation is made before and after the independent variable has been introduced to a group.

OK1 – Knowledge score in pre –test

X – Structured teaching programme

OK2 – Knowledge score in post – test

The research design selected for their study is pre – experimental , one group pre – test and post – test design.


Figure :- the schematic representation of study

Group / DAY-1 / DAY-6
PRE – TEST / Structured teaching programme / Post – test
Primi mothers at Community Centre in Elanka / Knowledge test / Structured teaching programme on minor ailments in pregnancy and home remedies / Knowledge test

The selection of the research design is the most important step it provides the frame work for study . The research design used in this is pre -experimental one group test and post – test design.

II. RESEARCH VARIABLE

Independent variables structure teaching programmes, dependent variables knowledge skill on primi gravida mothers

III.POPULATIONS

The population of the present study include primi gravida mothers in selected Antenatal O P D department in Community Centre in Elanka who fulfills the inclusive criteria

IV. SETTING

The study was conducted in Elanka, Community centre, Bangalore, Karnataka State. The rationale for selection of this setting availability of subject, feasibility of conducting study and familiarity of the investigator with the setting


V.SAMPLE

Sample size comprises of 50 primi gravida mothers.

VI. CRITERIA FOR SAMPLE SIZE

INCLUSIVE CRITERIA