A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF STAFF NURSES REGARDING SELECTED ALTERNATIVE AND CONTEMPORARY MODALITIES OF PAIN RELIEF DURING FIRST STAGE OF LABOUR IN SELECTED MATERNITY HOSPITALS, BANGALORE
By
SHANTI SONU SAM
Dissertation Submitted to
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SCIENCE
IN
OBSTETRICS AND GYNAECOLOGICAL NURSING
Under the guidance of
Mrs. Gowri Sayee
Associate Professor & HOD
Department of Obstetrics and Gynaecological Nursing
FORTIS INSTITUTE OF NURSING
20/5, Yelachenahalli, Kanakapura road, Bangalore-560078
YEAR
2010-2012
Rajiv Gandhi University Of Health Sciences, Bangalore, Karnataka.
DECLARATION BY THE CANDIDATE
I hereby declare that this thesis entitled “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF STAFF NURSES REGARDING SELECTED ALTERNATIVE AND CONTEMPORARY MODALITIES OF PAIN RELIEF DURING FIRST STAGE OF LABOUR IN SELECTED MATERNITY HOSPITALS, BANGALORE.” is a bonafide and genuine research work carried out by me under the guidance of Mrs. Gowri Sayee, Associate professor and HOD, Department of obstetrics and gynaecology, Fortis institute of nursing, Bangalore.
Signature of Candidate
SHANTI SONU SAM
Date:
Bangalore:
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation titled “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF STAFF NURSES REGARDING SELECTED ALTERNATIVE AND CONTEMPORARY MODALITIES OF PAIN RELIEF DURING FIRST STAGE OF LABOUR IN SELECTED MATERNITY HOSPITALS, BANGALORE.” is a bonafide research work done by Ms. Shanti Sonu Sam in partial fulfilment of the requirement for the degree of Masters of Science in Nursing (Obstetrics and Gynaecology).
Signature of Guide:
Mrs. Gowri Sayee
Associate professor& HOD
Obstetrics and gynaecological nursing
Fortis institute of nursing
Bangalore- 560078
Date:
Bangalore
ENDORSEMENT BY THE
HOD, PRINCIPAL/ HOD OF THE INSTITUTION.
This is to certify that the dissertation entitled “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF STAFF NURSES REGARDING SELECTED ALTERNATIVE AND CONTEMPORARY MODALITIES OF PAIN RELIEF DURING FIRST STAGE OF LABOUR IN SELECTED MATERNITY HOSPITALS, BANGALORE.” is a bonafide research work done by Ms. Shanti Sonu Sam under the guidance of Mrs. Gowri Sayee, Department of Obstetrics and Gynaecological Nursing, Fortis institute of nursing, Bangalore.
Signature of the HOD Signature of the Principal
Mrs. GOWRI SAYEE Prof. SRIDHAR K.V
Associate Professor
Date: Date:
Bangalore Bangalore
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of Health Sciences, Karnataka shall have the right to preserve, use and disseminate this dissertation thesis in print or electronic format for academic or research purposes.
Signature of the candidate:
Shanti Sonu Sam
Date:
Bangalore
© Rajiv Gandhi University of Health Sciences, Karnataka
ACKNOWLEDGEMENTS
“Every good thing given and every perfect gift is from above, coming down from the Father of lights, with whom there is no variation or shifting shadow”.
(James 1: 17)
First and foremost I would like to thank the supreme teacher of all: God. I know that I am here and that I am able to write all of this for a reason. I will do my best in never forgetting what a great fortune I have had in just being here, and that it comes with a lesson and a responsibility. I hope I am doing the work you have planned me to do.
I extend my heartfelt thanks to my respected teacher and guide Mrs. Gowri Sayee Associate professor, HOD, Department of Obstetrics and gynecological nursing, Fortis Institute of Nursing, Bangalore. Her appropriate guidance, even support, encouragement, priceless suggestions and co-operation has continually motivated me for the successful achievement of this dissertation.
I express my profound and sincere thanks to our beloved principal Prof. Shridhar K.V, Principal, HOD, Department of Medical Surgical Nursing, Fortis Institute of Nursing, Bangalore. His encouragement, guidance, valuable suggestions and untiring effort which has motivated me throughout the study. His personal interest, endless patience, love and blessing have been the foundation of this study.
I owe my earnest gratitude and sincere thanks to my teacher and co-guide Mrs. Sabitha Sibbala Associate professor, Department of Obstetrics and gynecological nursing, Fortis Institute of Nursing, Bangalore. I am thankful for her valued guidance, kind support and judicious help which enabled me to complete my study successfully.
My heartfelt gratitude to our class coordinator, Dr. Mrs. Thressiamma P.M, vice principal HOD, Department of Community health Nursing, Fortis Institute of Nursing, Bangalore. I am thankful for her venerated guidance and constant support which enabled me to complete my study successfully.
A word of thanks to Mr. Prabhuswamy A C, associate professor, Department of medical surgical nursing, Fortis Institute of Nursing, Bangalore, for his help in completing my study.
With great proud and privilege, I express my profound sense of
gratitude and heart full thanks to all my P.G. Faculty, Fortis Institute of
Nursing, Bangalore for the fathomless guidance, constant availability,
intuitive suggestions, motivation and support rendered throughout my
study.
I am deeply indebted to all the experts who contributed the time and effort towards validating and refining the tools used in the present study.
I owe my gratitude to all the subjects who enthusiastically participated in carrying out the research project.
I express my sincere thanks to the Nursing Superintendent, Fortis hospitals, Bangalore Mrs. Kavitha Biswas for giving me the authorization to conduct the study among staff nurses in their revered institution. I thank the nursing in-charges of LDRP ward and 6th level of Fortis hospital for their help in arranging the classes.
A word of acclamation is to Mr. Arun, Asst. Professor, Manjunath college of arts and science, a prominent statistician who has helped me in the analysis of data of my research study.
I pay my obliged salutations to my parents Rev. Fr K. P. Sam and Mrs. Anitha Sam for their prayers and blessings. I extend my love to my siblings Ms. Shalin mary sam and Mr. Alwin sam for their support and best wishes that helped me to carry out my study successfully.
There are many more people who have worked behind the screen in their own loving way to help me accomplish this task. Special word of thanks to my classmate and dear friend Mrs. Reena stephen for her sensible help and suggestions. I thank all my friends especially my friends Ms. Navreet Virk and Mrs. Bincy Thomas for their support and prayers.
There are many to whom I am yet to show gratitude because all those who have helped in time have become priceless charms.
Signature of the candidate
(Ms. Shanti Sonu Sam)
Date:
Bangalore.
LIST OF ABBREVIATIONS USED
GNM / GENERAL NURSING AND MIDWIFERYB.Sc / BACHELOR OF SCIENCE
STP / STRUCTURED TEACHING PROGRAMME
SD / STANDARD DEVIATION
S / SIGNIFICANT
NS / NON-SIGNIFICANT
df / DEGREES OF FREEDOM
PPT / POWER POINT PRESENTATION
ABSTRACT
“It is refreshing to know that for all the billions of times it has occurred, the birth of a child, like the wonder inspired by a sunset, can never be tarnished by repetition”
Background
Motherhood is one of life’s greatest blessings. It is a lifelong event that forever changes woman into a mother. But the mother also has to go through enormous pain during this process of transition from a woman to a mother. As an expectant mother reaches her due date, a concern that looms large in her mind is the pain that she will experience during labour. Childbirth is a significant, though stressful event. A woman who is able to cope with the stress of the labour tends to feel more satisfied with her experience; an experience that is positive and has satisfying perceptions of childbirth.
An ideal labour pain relief method should meet the following criteria: having the least possible side effects for mother and fetus, having permanent effect, could be administered easily, having appropriate sedative effect without intervening the uterine contractures. Alternative and contemporary modalities during delivery would lead to relaxation and consequently, a rapid and easy delivery.
Midwives are the primary care takers who are with the labouring woman throughout the process of labour. Hence they should be educated about these alternative modalities and it should be applied in our hospitals. A teaching programme on selected alternative modalities can promote the use of these modalities during first stage of labour.
Statement of the problem
“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF STAFF NURSES REGARDING SELECTED ALTERNATIVE AND CONTEMPORARY MODALITIES OF PAIN RELIEF DURING FIRST STAGE OF LABOUR IN SELECTED MATERNITY HOSPITALS, BANGALORE”
Objectives of the study
1. To assess the pre-test knowledge scores of staff nurses regarding alternative and contemporary modalities of pain relief during first stage of labour.
2. To find out the effectiveness of structured teaching programme regarding alternative and contemporary modalities of pain relief during first stage of labour by assessing post-test knowledge scores of staff nurses.
3. To find out the association between pre-test knowledge scores and selected demographic variables.
Methods
Conceptual framework of the study is based on Von Ludwig Bertalanaffy’s general system’s theory. Based on the problem selected and objective of the study quasi-experimental one group pre-test post-test design without control group was selected.
A sample of 60 staff nurses working in OBG department of Fortis hospital, Bangalore were selected by non-probability sampling technique. Data was collected by administering structured questionnaire before and after the implementation of structured teaching programme. Data were analysed using descriptive and inferential statistics and represented in graphs and tables.
Results
In the present study 86.7% of the respondents had inadequate knowledge regarding alternative and contemporary modalities before the implementation of structured teaching programme. But after the implementation of structured teaching programme 15% of them had moderately adequate knowledge and 85% of them had adequate knowledge
The mean pre-test scores of 40.42% was higher than the mean post-test scores of 80.50% which was significant at P-value of 0.001 level which showed significant increase in knowledge and thus it proves the effectiveness of the structured teaching programme.
In the preset study the knowledge scores of staff nurses were found to be non-significant with the demographic variables i.e. age, qualification, experience, religion. Hence it indicates that there is no association between the knowledge scores of nurses and the selected demographic variables.
Interpretation and conclusion
The study showed that there was a significant improvement in the knowledge scores after the administration of structured teaching programme. Hence it can be concluded that the structured teaching programme was effective in improving the knowledge of staff nurses on alternative and contemporary modalities of pain relief during first stage of labour.
KEY WORDS: Structured teaching programme, effectiveness, knowledge, alternative and contemporary modalities
TABLE OF CONTENTS
NO. / CHAPTER / PAGE1. / INTRODUCTION / 1-9
2. / OBJECTIVES / 10-15
3. / REVIEW OF LITERATURE / 16-24
4. / METHODOLOGY / 25-40
5. / RESULTS / 41-64
6. / DISCUSSION / 65-68
7. / CONCLUSION / 69-72
8. / SUMMARY / 73-77
9. / BIBLIOGRAPHIC REFERENCES / 78-81
10. / ANNEXURES / 82-137
LIST OF TABLES
TABLE NUMBER / TITLE OF TABLE / PAGE NUMBER1. / Design chosen for the study. / 26
2. / Distribution of respondents according to age. / 43
3. / Distribution of respondents according to qualification. / 45
4. / Distribution of respondents according to experience. / 47
5. / Distribution of respondents according to religion. / 49
6. / Distribution of respondents according to pre-test and post-test knowledge scores / 51
7. / Area wise distribution of mean, mean percentage and standard deviation of pre-test knowledge scores of the respondents. / 54
8. / Area wise distribution of mean, mean percentage and standard deviation of post-test knowledge scores of the respondents. / 57
9. / Paired ‘t’ test showing the significant difference between mean pre-test and mean post-test knowledge scores of the respondents / 60
10. / Association between pre-test knowledge scores of the respondents with selected demographic variables. / 63
LIST OF FIGURES
FIGURE NUMBER / TITLE OF FIGURE / PAGE NUMBER1. / Conceptual framework of the study / 15
2. / Schematic representation of research methodology / 28
3. / Cylindrical diagram showing distribution of respondents according to age. / 44
4. / Pie chart showing distribution of respondents according to qualification / 46
5. / Pyramid diagram showing distribution of respondents according to experience / 48
6. / Pie chart showing distribution of respondents according to religion / 50
7. / Cylindrical diagram showing distribution of staff nurse according to pre-test and post-test knowledge scores / 53
8. / Bar diagram showing area wise distribution of mean, mean percentage and standard deviation of pre-test knowledge scores of staff nurses. / 56
9. / Bar diagram showing area wise distribution of mean, mean percentage and standard deviation of post-test knowledge scores of staff nurses. / 59
10. / Cylindrical diagram showing the significant difference between mean pre-test and mean post-test knowledge scores of staff nurses / 62
LIST OF ANNEXURES
ANNEXURE NO. / TITLE OF ANNEXURE / PAGE NO.A / Ethical clearance certificate / 82
B / Letter seeking permission to conduct the study / 83
C / Letter requesting consent to validate the tool / 84
D / Acceptance form for tool validation / 86
E / Content validation certificate / 87
F / Letter to the participants requesting consent to participate in the study / 88
G / List of experts for tool validation / 90
H / Blue print of distribution of items / 92
I / Tool for data collection / 93
J / Structured teaching programme on alternative and contemporary modalities of pain relief during first stage of labour. / 109
1. INTRODUCTION
“To her who loves us before she meets.”
-An inscription in Mexico City.
The foundation for the whole humankind is the art of motherhood. Mother is the greatest gift to the world.1 Every woman is a mother and she should be respected. Childbirth is an intense event and strong emotions both positive and negative can be brought to the surface. Childbirth is a divine process and women should be supported during labor.2