RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGLORE, KARNATAKA
A COMPARATIVE STUDY TO ASSESS THE BEHAVIOUR RESPONSE AMONG PRIMIGRAVIDA MOTHERS ADMITTED IN THE ANTENATAL WARD WITH AND WITHOUT SUPPORT FROM CARE GIVERS IN A SELECTED HOSPITAL AT BANGLORE
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
GURUMAYUM MARTINA DEVI
ADARSHA COLLEGE OF NURSING
BANGALORE
RAJIV GHANDHI UNIVERSITY OF HEALTH
SCIENCES,KARNATAKA BANGALORE
PERFORMA SYNOPSIS FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
1. / NAME OF CANDIDATE AND ADDRESS(IN BLOCK LETTERS) / GURUMAYUM MARTINA DEVI1ST YEAR MSc NURSING.
ADARSHA COLLEGE OF NURSING.
2. / NAME OF THE INSTITUTE / ADARSHA COLLEGE OF NURSING
3. / COURSE OF THE STUDY AND SUBJECT / MASTER DEGREE NURSING WITH OBSTETRIC AND GYNAECOLOGY
4. / DATE OF ADMISSION TO COURSE / 28 - 06- 2008
5. / TITLE OF THE TOPIC / “A COMPARATIVE STUDY TO ASSESS THE BEHAVIOUR RESPONSE AMONG PRIMIGRAVIDA MOTHERS ADDMITTED IN A ANTANATAL WARD WITH AND WITHOUT SUPPORT FROM CARE GIVERS IN A SELECTED HOSPITAL AT BANGALORE”
6. BRIEF RESUME OF THE INTENDED WORK:
INTRODUCTION
‘A PERSON WHO HAS NEVER BEEN LOVED AND CARED IS SELDOM HAPPY’
The human being is capable of behaviour and therefore, is a living organism. The individual is in active relation with the environment and its influences.
Fear is the feeling aroused by accurate perception of a genuine external danger and anxiety on the other hand is not objectively realistic. It is an unexplained discomfort. Anxiety is produced by any situation that threatens the individual’s identity or self esteem or causes him to feel helpless, isolated and insecure.1
Development in medical care during the past 75 years has altered childbirth remarkably, drastically changing routines and customs that had evolved over centuries. However, pregnancy and giving birth are also fragile processes that requires more than just medical care. The women needs emotional and physical support and guidance to help her to take control of her body.
Every pregnant mothers need support and understanding both from her significant others and from professionals especially during the early stage of pregnancy. They have their physical as well as mental needs.
Primigravida mothers are those who conceived for the first time. Thus, they need extra care and special attention, acceptance of their behaviour, sincere praise and encouragement and protection which will ease them most disruptive behaviour for a healthy outcome.2
The importance of support from the care givers to the primigravida mothers cannot.be underestimated. All women remember their pregnancy and childbirth experience for the rest of their lives. The support must be individualised and tailored to the women's changing needs in pregnancy and labour
The goal of prenatal support is to help women achieve her wishes throughout her pregnancy and labour as well through offering companionship, attention to her emotional needs and helping hands.
Family is an institution which provide the most intimate and dearest support for the pregment mothers. Mothers with the support from the family built up a strong feeling to over come the stressful event of pregnancy and labour.7
The nurse instill confidence in the pregnant women to make them reduce their anxiety and stress during their pregnancy and childbirth. The hesitant, shy and fearful primigravida mothers are encouraged to ventilate their feelings with the care and support from the care givers.3
6.1. NEED FOR STUDY :
For most mothers, the pregnancy period and child birth is significant, though stressful event.
Throughout her pregnancy women may be anxious and apprehensive about what is going to happen to her baby and herself in labour. Here, care givers can reassure them and adequately prepare them for labour and encourage some significant others to provide support during child birth experience.
Antenatal care is the care of the women during pregnancy. The primary aim of antenatal care is to achieve at the end of the pregnancy a healthy mother and a healthy baby. Ideally this care should begin soon after the conception and continue throughout pregnancy.4
The antenatal care are to:
- promote, protect and maintain the health of the mother during pregnancy.
- Detect high risk cases and give them special attention.
- Foresee complication and prevent them.
- Teach the mothers elements of child care, nutrition, personal hygiene and environmental sanitation.
Women experience a safe childbirth as well as an experience that is positive and satisfying. A woman who is able to feel more satisfied with her experience.
Maternal anxiety is a common feature of pregnancy and childbirth. Animal and human studies have shown that condition which arouse anxiety can have a deleterious effect on the fetus.
One of the most imported contribution to a healthy pregnancy is care and support given to the pregnant mothers throughout their pregnancy.
Globally, there are approximately 240 million pregnancies annually, these pregnancies results in 134 million births and 50 millions abortions, 20millions of which are performed under unsafe conditions. India accounts for more than 20% of the global maternal and child deaths and approximately 30million women in India experience pregnancy annually, 27 million have live births. Of these, nearly 1,36,000 maternal deaths occur annually, most of which can be prevented.5
Fatigue is a frequent symptoms which may occur early in pregnancy. With the care and support from care givers the primigravida mothers overcome from this physical stress. It is the care givers who provide the most and intimate and dearest relationship for all the pregnant mothers.
Amenorrhoea, morning sickness, frequency of micturition and breast discomfort are the presumptive symptoms of early month of pregnancy. Primigravida mothers who are experiencing all these symptoms for the first time increases their level of anxiety and fear. With the care and support they received they can easily overcome all this changes. But without the support they can undergo trauma which will be risk factor for both mothers and babies.6
Of all health professional, nurses have the most contact with the couple experiencing pregnancy and childbirth, and they are in a position to shape the perceived outcome of the event (Bryanton, Davey and Sullivan,1993).
. Midwives hold an important key to positive care around the time of childbirth that will contribute to good start for the baby and parents during this critical period of human life.8
6.2 REVIEW OF LITERATURE
Review of literature is a key step in research process. The literature is review to summarize knowledge or assess the behaviour to use in a practice or to provide basis for conducting a study. The major goal of review of literature are to develop a strong knowledge base to carry out research and non-research scholarly activity.
Wing Cheung, Yim Ip and Dominic Chan(2006) conducted a study on maternal anxiety and feelings of control during labour. The objectives of this study is to explore the relationship between maternal anxiety and feelings. A conveniences sample of 90 Hong Kong Chinese first time mothers was selected for the study. As conclusion the study showed a significant negative relationship between maternal anxiety and feeling of control during labour.9
Zafer, Ahmed A, Ehiri, John E, Anyanwu, Ebere C(2003) conducted a study on Antenatal services in Kampung Diatrict, Combodia. The aim of this study was to assess factors that influence use of antenatal care services with both quantitative and qualitative designs. The study was conducted with a vonlunteer sample of 260 posnatal mothers. The results showed that first.10
PHC Rondo, Rf Ferreira, F. Noguira , MCN Ribura, H. Lobert and R Antes (2002) conducted a study on maternal psychological stress and distress as predictors of low birth weight, prematurity and intra uterine growth retardation. Its objective is to evaluate the associations between maternal psychological distress and low birth weight, prematurity and intra uterine growth retardation and the prevalence of stress and distress in pregnancy. For the study 865 pregnant women in antenatal care unit is selected. The study is associated with both birth weight and gestational age.11
A.Waters CNM, RNC, MS and Kathryn A.Lee RN, PhD.(1999), consucted a study on Difference between primigravidae and multigravidae mothers in sleep disturbance, fatigue and function status. The purpose of this study was to describe the differences between primigravidae and multigravidae women in their experience and behaviour pattern. A convenience sample of 31 pregnant women was used. In cloclution it was found that multigravidae women are more confident about their pregnancy, less fatigue and sleep well compared to primigravidae women.12
Wilson EK(1995) conducted a study on acculturation and changes in the likelihood of pregnancy and feelings about pregnancy among women of Mexican origin aiming to explore the changes that occur will acculturation in the likelihood that women of Mexican origin in the United States get pregnant, that they considered their pregnancies. Data were collected from 924 women of Mexican origin in1995 National Survey of Family growth.13
Bester MB, Nolte AG conducted a study on knowledge and expectation of childbirth in primigravidas. The aim of the atudy was to determined the knowledge and expectations the primigravidas has of their childbirth. An exploratory, descriptive design was used within the context of an Academic hoapital in Johanneberg. From the research it is clear that a large gap exists in the primigravida's preparation of childbirth.14
El-Sherbini AF, El-Torky MA,Ashmawy AA, Abdulhamid HS conducted a study on Assessment of Knowledge, attitudes and practices of expectant mothers in relation to antenatal care. This study aims to assess the knowledge, attitudes and practices of expectant mothers in relation to ante-natal care in Assiutt and to find out factors affecting their knowledge. Fifty women were selected from three Maternal and child health centers in Assiut. The findings of the present study revealed that most of the primigravida (88.2%) women werw more likely to have poor knowledge in relation to ante-natal care compared to others(11.8%) whose gravidity was less than 5.15
Heins HC Jr, Nance NW, Ferguson JE conducted a study on social support in improving perinatal outcome. This study aims at improving prenatal outcome with social support. The study was conducted on 565 matched pairs(case/control) of rural teenage primigravidas with single pregnancies with and without the social support of the resource mothers. The conclusion shows that there were significantly more patients with adequate prenatal care in the program group (p less than .000001). The frequency of low birth weight infants was significantly less ( p = .006), as was the small - for - gestation - age rate ( p = .002).16
K. Ellis, C. Chang, S.Bhandhari, L. Bullock, E. Geden conducted a study on rural mother experiencing the stress of intimate partner violence. They aim of the study was to rule out the level of stress of the abused mothers with childbirth concern. 616 women were classified as abused and non abused for the study as the samples. The study shows the elevation of stress significantly. To the abused mothers which in turns affect the child birth.17
6.3 STATEMENT OF THE PROBLEM
'A comparative study to assess the behaviour response among primigravida mothers admitted n the antenatal ward with and without support from care givers in a selected hospital at Bangalore'
6.4 OBJECTIVES OF THE STUDY
1. To assess the behavior response of primigravida mothers admitted in the antenatal ward with support from care givers.
2. To assess the behavior of primigravida mothers admitted in the antenatal ward without support from care givers.
3.To compare the behaviour response of primigravida mothers admitted in the antenatal ward with and without support from care givers
.
4.To find out the association between the selected demographic variables with behaviour response of prime mothers with support from care givers.
6.5 OPERATIONAL DEFINITION
1.Comparative:
It refers to the behaviour response of primi mothers mesasured or judged by comparing with and without support from care givers.
2.Assess:
It refers to judged the anxiety and stress among the primigravida mothers.
3.Behaviour response :
It refers to the answers or response given by the primigrsvida mothers
.
4.Primi-gravid mother:
It refers to pregnant women who conceived for the first time.
5.Care givers:
It refers to the persons showing concerned or interested to the primigravida mothers who are in need of care and support.
6.6 ASSUMPTION
Primigravida mothers may reduce stress and anxiety with the support from care givers.
6.7 DELIMITATIONS
1.The study is limited to those primigravida mothers who are admitted in the antenatal ward.
2.The study is limited to only those who are willing to participate in the study.
3. The study is limited to those primigravida mothers who are present at the time of data collection.
7. MATERIALS AND METHODS
Source of data: Primigravida mothers who are admitted in antenatal ward of K.C.General Hospital ,Bangalore.
7.1 METHODS OF DATA COLLECTION
RESEARCH METHOD: Descriptive method
RESEARCH APPROACH: Non experimental
RESEARCH DESIGN: Descriptive survey approach
SAMPLING TECHNIQUE: Simple random sampling technique using lottery method.
SAMPLE SIZE: 60 Primi mothers.
POPULATION: The population of the study comprises of primigravida mothers admitted in the antenatal ward in KCG hospital,Bangalore.
SETTING OF THE STUDY: The study will be conducted in KCG Hospital,Bangalore
7.2.8 DURATION OF THE STUDY: Data will be collected from the sample for a period of 4weeks after obtaining permission from authorities and subjects.
7.2 CRITERIA FOR SELECTION OF SAMPLE
Incusion criteria
Primi mothers who are :
- admitted in antenatal ward.
- present at the time of data collection.
- able to communicate in cannada, hindi and English.
- willing to participate in the study.
Exclusion criteria
Primi mothers who are-
- not willing to participate .
- who are not present at the time of data collection.
7.3 DATA COLLECTION TOOL
The investigation will developed an interview schedule to collect the data:
PART 1: Demographic characteristics i.e. age, religion, type of family, income, education, occupation, place of residence, source of information, family history (obstetrical history)
PART 11: Structure interview schedule of the behaviour response of primigravida mothers.
7.4 MEHODS OF DATA ANALYSIS
Data will be analysed using descriptive and inferential statistics. Descriptive like mean, median, standard deviation, frequency and percentage distribution will be used for assessing demographic characteristic of behaviour response of primigravida mothers.