BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / MS. JOSHINA SUNNY
1st Year M.Sc Nursing
Rajiv Gandhi College of Nursing
IIT Campus
Near Meenakshi Temple
Bannerghatta Road
Bangalore - 76
2 / Name of the Instituition / RAJIV GANDHI COLLEGE OF NURSING
3 / Course of study and subject / degree of master ofNursing
OBSTETRIC & GYNAECOLOGY NURSING
4 / Date of Admission to course / 30-06-2008
5 / Title of the Topic / A study to assess the EFFECTIVENEESS OF PLANNED TEACHING PROGRAM ON mINOR DISORDERS OF PREGNANCY AND ITS MANAGEMENT AMONG III YEAR b.sC nURSING STUDENTS IN A SELECTED COLLEGE OF NURSING, BANGALORE, kARNATAKA
BRIEF RESUME FOR INTENDED WORK
6.1 INTRODUCTION:
Pregnancy is a long and very special journey for a woman. It is a journey of dramatic physical, psychological and social change, of becoming a mother, of redefining family relationship and taking on the long term responsibility for caring and cherishing a newborn child.
There are numerous physiological and psychological changes which occur during pregnancy. Other stressful conditions which may affect psychological adaptations during pregnancy include the inadequately named “Minor Disorders”, such as nausea, vomiting, constipation, pica, increased urinary frequency, backache, leg cramps etc
The majority of discomforts experienced during pregnancy can be related to either hormonal changes or physical changes related to the growing uterus and fetus. In most of the mothers who are pregnant for the first time, it is evident or there is increased rate of the appearance of these minor discomforts, because of the increased hormone secretion for the first time, which is needed for the normal pregnancy.
There are minor ailments, which may affect the pregnancy. They are not serious, but you would probably like to know how to get rid of these minor problems. Unfortunately, there are no magical cures for many of these ailments,
until your pregnancy is further advanced or over. But most of them can be reduced if you take a few simples measures
Happiness and security needs are more during pregnancy than at any other time. Using self discipline technique and cultivating optimistic attitude . This will help you personally and will react favorably on your developing fetus. Make some allowance for certain unavoidable discomforts and limitation and do not allow yourself to become fretful and apprehensive. Minor disorders are only minor in as much they are not life threatening. These can also occur due to some accommodation changes, metabolic changes or because of postural changes during pregnancy.
The midwife is the key person educating the women about these common disorders of pregnancy. The midwife should have adequate knowledge of these common disorders of pregnancy and recognition of them when they become a medical emergency, and should initiate adequate management in those situations to prevent those becoming fatal for both the mother and the growing fetus.
6.2 NEED FOR STUDY
Every pregnancy is a unique experience for that women and what she experiences will be new and entirely different. Pregnancy is a period of physical, hormonal, immunological, metabolic and vascular changes. To determine the problems into actual or potential such as the minor disorders, the health assistant or the midwife has to perform a thorough assessment and develop a meaningful plan of care.
If the minor disorders are not managed appropriately, it may become medical disorders or life-threatening abnormality, which will, leads to an increase in the perinatal mortality and morbidity. In India 1, 48,000 women die every year as a result of pregnancy. The ratio of mortality and morbidity is 1:15. The present maternal mortality is 540/lakhs live birth1.
Every minute, a women dies from complications related to pregnancy, that means 1600 death every day, more than a half million death every year world wide. Globally Africa ranks the first in the highest rates of maternal mortality. Next to that is the south central Asia which is having increased rates of maternal mortality. In India alone 136000 women die due to complications during pregnancy every year.
A midwife is a person who is alongside and supporting women during pregnancy .A midwife might need to act as a women’s advocate when the partners/friends/relatives actions are unlikely to enhance, or could harm, the health and safety of pregnant mother and child 2.
Women need to be cared for by midwives who exhibit respectful and caring
attitude to women and provide a holistic approach to care that recognize cultural and social diversity and different skills required to meet the needs of women using maternity services3.
Nursing professionals play a vital role in the caring of the women during their pregnancy period. The knowledge regarding the various aspects of the pregnancy period has to be clearly explained to them to prevent the occurrence of complications during pregnancy. The nurses need to have a thorough knowledge regarding the events that takes place, and also should have a insight about the complications which can occur due to careless management of the minor disorders.
So, the researcher finds the need of assessing the knowledge of the III B.Sc students regarding the occurrence of minor disorders and its management as they are coming up in nursing profession and are the future nurses.
6.3 REVIEW OF LITERATURE:
A study was conducted on nausea and vomiting in pregnancy. An evolutionary hypothesis at New york, nausea and vomiting in pregnancy ‘morning sickness’ is a common contemporary complaint. Many pregnant patients note alternations in smell and taste, which can precipitate “morning sickness” symptoms, that characterize early gestation. Epidemiological studies suggest a relationship between maternal symptoms and maternal accommodation. Parental antigen contained in the feto placental unit4
A study conducted on patient oriented assessment of back pain in pregnancy in which 76 women in their 8th and 9th month were studied. The study found that 31% of pregnant women had no back pain, 40% scored from 1-4, 21% scored from 5-10 and 8% scored more than 10. Results shows that, back pain was
not associated with having gone through pregnancies nor was the Roland score related to the weight before pregnancy or to increment of weight during pregnancy5.
A descriptive study of signs and symptoms of 870 patients in primary care related to pelvic pain during pregnancy reveals that pain during pregnancy is common with incidence rates of 48% to 56%. In total 870 women were included, in which the average score of the overall severity of the complaints was 7.8 (scale 0-15). Main complaints were located around the sacroiliac joints (76.6%) and the symphysis pubic (57.2%). Pregnant patient with pelvic pain show a considerable level of complaints6.
A study was conducted on heartburn during pregnancy with the risk of gastro esophageal reflux disease, in which 1180 randomly selected women aged between 18-49 years who had given birth at least once. The mean live delivery rat was 2+/-1 (range, 1-10). The prevalence of GERD was 7.4%. Where as the prevalence of GERD for women with history of one delivery was 1.5%, more than 2 deliveries accompanied with risk of 15.1% (p<. 001). In the group with no heartburn during pregnancy only 5.5% had GERD (p<. 00001.) 7
A A study was conducted on diet, physical inactivity and the prevalence of constipation through out and after pregnancy in which it revealed that constipated women consumed statistically significant less water in the first trimester (p=0.04) when compared to the non-constipated pregnant women during pregnancy. The study demonstrates that dietary factors
may play a role in terms of preventing or alleviating bowel habits throughout and after pregnancy8.
A study is to determining the prevalence of gastrointestinal symptoms among healthy pregnant women attending antenatal clinic at the university of Maiduguri Teaching Hospital.370 pregnant women were interviewed. Heartburn, easy fullness and nausea were the commonest gastrointestinal symptoms in 45%, 40.2% and 39.9% of cases respectively. Primigravida had significantly more symptoms than multipara. There were also significantly more gastrointestinal symptoms in the first trimester of pregnancy9.
A study on gastro esophageal reflux disease in pregnancy explained the high incidence of the problem in pregnant women for the majority of patients life style modifications are helpful but are not sufficient to control the symptoms and medication is required. In patients without prior history of reflux, symptom usually abates after delivery10.
A study conducted on change in bowel function during pregnancy, the purpose of this study was to provide new baseline data for a range of bowel habits for parameters. Sensations of incomplete evacuation and time spent defecation were significantly increased during all three trimester of pregnancy compared with after birth11.
A study conducted on 33-year-old pregnant women with nausea, itching
and fatigue, it occurs in third trimester or in early postpartum period. The occurrence of these problems during the third trimester was found out because of elevated liver enzymes and low platelets12.
A Prospective, Observational study on ano rectal symptoms in multiparous women during ante partum period are straining to defecate 28-59%, lumpy stools 48-59%. Constipation symptoms where reported more frequently in first trimester (p=0.031)13
6.4 STATEMENT OF PROBLEM:
A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED TEACHING PROGRAMME ON MINOR DISORDERS OF PREGNANCY AND ITS MANAGEMENT AMONG III BSC NURSING STUDENTS IN SELECTED COLLEGE OF NURSING IN BANGALORE, KARNATAKA.
6.5 OBJECTIVES OF THE STUDY:
1.To determine the knowledge of nursing students regarding minor disorders of pregnancy and its management by using structured knowledge questionnaire.
2. To evaluate the effectiveness of planned teaching programme on minor disorders of pregnancy and its management among nursing students.
3. To develop booklet on minor disorders of pregnancy and its management.
4. To find out the opinion about the booklet on minor disorders of pregnancy and its management by using an opinionnaire.
6.6 OPERATIONAL DEFINITIONS:
EFFECTIVENESS: it refers to the extent to which the planned teaching programme has achieved the desired effect in improving the knowledge of students regarding minor disorders of pregnancy and its management.
KNOWLEDGE: It refers to the right responses given by the students to the questionnaire
on minor disorders of pregnancy and its management.
MINOR DISORDERS OF PREGNANCY: These are the problem which cause
Discomforts to the mother during pregnancy such as nausea, vomiting, pica, back pain,
constipation, varicose vein, leucorrhoea, increased urinary frequency, leg cramps, fatigue
etc.
PLANNED TEACHING PROGRAMME : It refers to systematically organized
and developed instruction and teaching aids designed for group of 3rd B.sc nursing
Students to enhance their knowledge regarding minor disorders of pregnancy and its
Management.
6.7 ASSUMPTIONS:
1. The Nursing students have some knowledge regarding minor disorders of pregnancy and its management.
2. The planned teaching programme improves the knowledge regarding minor
of pregnancy and its management among students nurses.
3. The Nursing students will have the ability to understand minor disorders of
Pregnancy and its management.
6.8 HYPOTHESES:
H1. There will be a significant increase in the level of knowledge on minor disorders of pregnancy and its management among nursing students after a planned teaching programme.
H2: the mean post test knowledge score of nursing students on minor disorders of pregnancy and management will be higher than mean pre test score
6.9. DELIMINATION:
The study is limited only to III year B.Sc nursing students in a selected college of nursing Bangalore.
7. MATERIAL AND METHOD:
7.1 SOURCE OF DATA:
The data will be collected from III B.Sc nursing students in aselected college of nursing, Bangalore. .
7.1.1 RESEARCH DESIGN:
The researcher design will be selected for this study is pre-experimental one group, pre test post test design
7.1.2 SETTING:
The study will be conducted in selected college of nursing, Bangalore, Karnataka.
7.1.3 POPULATION:
The population under study consisting of III year B.Sc Nursing students in a selected college of nursing.
7.2 METHOD OF DATA COLLECTION:
7.2.1 SAMPLING PROCEDURE:
Convenient sampling techniques.
7.2.2 SAMPLE SIZE:
The sample size will be 60 students
7.2.3 INCLUSIVE CRITERIA:
1. Students who are willing to participate in the study.
2. Students who are available during the period of data collection.
7.2.4 EXCLUSION CRITERIA:
1. Students who are not willing to participate in this study.
2. Students who are not available during the period of data collection.
7.2.5 INSTRUMENT INTENDED BE USED:
Structured knowledge questionnaire
7.2.6 DATA COLLECTION METHOD:
Data will be collected by administering the structured knowledge questionnaire
7.2.7 PLAN FOR DATA ANALYSIS:
DESCRIPTIVE: Mean, median, mode, standard deviation and percentage will be calculated on this study.
INFERENTIAL: Chi-square, t-test will be done to evaluate effectiveness of PTP on minor disorders of pregnancy and its management.
7.3 DOES THE STUDY REQIRE AND INVESTIGATION OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS, OTHERS HUMAN OR ANIMALS?
Yes, the investigation is done on group of III year B.Sc nursing students
7.4 HAS ETHICAL CLEARENCE OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?
Yes, the order has been obtained from the authorities of selected college of nursing.
LIST OF REFERANCE:
- WHO. Danger signals during pregnancy. Indian Journal of Nursing and
- Lewis G, Drife.J (eds), why mothers die .The fifth report of the confident enquires
- UKCC (united kingdom central council of nursing). Strengthening and supporting
- Lecru . Division of maternal and Adolescent medicine. University of New York.
- Pandu.I patient oriented assessment of back pain in pregnancy ..Eur.spine.
- Rost C.C Kaiser A, Kos B.W. et.al. Pelvic pain during pregnancy. spine (2004): 15:29(22): 2567-72.
- Richter J.E .The management of heart burn in pregnancy. Alignment pharmacology
- Derbyshire E,Davis.J et.al . Maternal child nutrition. July(2006) 2 (3): 127-34.
- Mustapha.SK. Niger journal of clinical practice. June (2006) (1); 1-6.
- Ali R.A, Egan L.J. Journal of Gastroentroal Clinical North America. March2007:
- Derbyshire E. J, Davis J, et.al. Changes in bowel function in pregnancy. Digestive Disease science; February (2007) ; 52(2):324-8.
- Lorentzen Roland M.C,et.al. Journal of published medicine.(2007); 23:127(16):2096-7.
- O’Boyle A.L, Rieg T.S et.al. Journal of reproductive medicine. March(2008);
- Basavantappa B.T. Text book of midwifery and reproductive health nursing. Jaypee Brother publisher; Page No. 210-220
- Dutta D.C . Text book of Obstetrics. 6th Edition Mosby’s Publisher; Page No. 50-63
- Myles. Textbook for Midwives. 14th Edition. Mosby’s publishers ; Page No. 217-219
9. / Remarks of the guide / This study is significant among nursing students since nurse play an important role in promoting antenatal period and safe pregnancy. By doing this study we are able to assess the knowledge and give relevant information to nurses. The booklet developed by the study can be used as a media for giving health information.
10. / Name and Designation (In Block Letters)
10.1 Guide / Mrs. P PADMAVATHY
LECTURER
10.2 Signature
11. / 11.1 Head of the department / Mrs. P PADMAVATHY
LECTURER
11.2 Signature
12. / 12.1 Remarks of the chairman and Principal / This study is relevant to be done among the student nurses, since they provide health promotion activities during the period of studies to the students nurse by giving teaching programme. They will be able to deal and manage minor disorders during pregnancy in an active manner.
12.2 Signature
1