Knowledge and attitude of primigravidae mothers regarding prenatal attachment

 

Ms. Maisnam Pritam Chanu

Faculty of Nursing, SGT University, Gurgaon

 

ABSTRACT:

A descriptive study was conducted to a Study to assess the knowledge and attitude of primigravidae mothers regarding prenatal attachment in selected Maternity Hospital, Bangalore. The objectives of the study is to assess the knowledge and attitude of primigravidae mothers regarding prenatal attachment, to correlate the knowledge and attitude of primigravidae mothers regarding prenatal attachment to associate the knowledge and attitude of primigravidae mothers regarding prenatal attachment with their selected demographic variables. Methods Non- experimental descriptive study design was used to assess the level of knowledge and attitude of primigravidae regarding prenatal attachment in selected Maternity Hospital, Bangalore. In view of the nature of the problem and to accomplish the objectives of the study, structured questionnaire was prepared focusing on the level of knowledge and attitude of primigravidae mothers. Reliability of the tool was tested and validity was ensured in consultation with guide and experts in the field of medicine and nursing.The study was conducted in Hosahalli Referral Hospital, Vijayanagar M.C layout, Bangalore and 60 primigravidae mothers were selected by Non-probability convenient sampling technique. Structured questionnaires were used to collect the needed data. Collected data was analyzed by using descriptive and inferential statistics. The conceptual framework used is Nola Pender’s Health Promotion Model. Results Majority of the primigravidae mothers had moderate knowledge (61.7%)  and favourable attitude (60.0% ) regarding prenatal attachment. A significant correlation between knowledge and attitude among primigravidae mothers regarding prenatal attachment” was accepted. This may point out that the Maternity Health nurse to educate pregnant mothers regarding prenatal attachment..A significant association of knowledge and attitude among primigravidae mother regarding prenatal attachment with their selected demographic variables” was accepted. This indicated that level of knowledge and attitude is influenced by some demographic variables.

 

 

INTRODUCTION:

The attachment between the pregnant woman and the fetus during pregnancy had been described as the first important relation to the baby and has strongly been associated with the following mother-child relation after the birth. The attachment to the fetus and later to the baby is developing successively. It starts in early pregnancy and increases during the pregnancy to the most intensive during the last trimester^1-3.

 

Appropriate antenatal care is one of the pillars of Safe Motherhood Initiatives, a world wide effort launched by the World Health Organization (WHO) and other collaborating agencies in 1987 aimed to reduce the number of deaths associated with pregnancy and childbirth^4. It highlights the care of antenatal mothers as an important element in maternal healthcare as appropriate care will lead to successful pregnancy outcome and healthy babies^5. All pregnant ladies are recommended to go for their first antenatal check-up in the first trimester to identify and manage any medical complication as well as to screen them for any risk factors that may affect the progress and outcome of their pregnancy^6-7. According to the Perinatal Care Manual recently edited by the Ministry of Health Malaysia, primigravida women are advised to go for a total of ten visits during their pregnancyand for multigravida women, the total recommended antenatal visit is seven sessions^8,9

 

NEED OF THE STUDY:

Mother is the responsible person for the well being of the fetus and its outcome. Whenever the brain is stimulated, new neuronal connection are being made. The more connections, the more neurons are integrated. This in turn determines intelligence, social, and emotional skills of the child. Health professional can both assess and encourage women’s affective relationship with their fetus^1,6.

 

Muller in her study (1992) concluded that maternal-fetal attachment was progressive and may take the whole gestation period to fully develop^7,10. The pregnant woman’s experiences of her fetus are gleaned from either the visceral sensations of fetal movement or from the use of technical apparatus to visualise the fetus or hear its heart-beat^8,11. She must use her imagination to conceptualise her fetus - she is in the process of falling in love but needs the physical reality of the baby in her arms to secure this process.^9,12,13

 

During the maternity posting of the investigator’s degree programme, while collecting history in the antenatal OPD, most of the women were unaware and had inadequate knowledge regarding prenatal attachment and its benefits^10,14,15. This enhances the investigator to do this study to assess the knowledge and attitude of primigravidae mothers regarding prenatal attachment

 

STATEMENT OF THE PROBLEM:

“A study to assess the knowledge and attitude of primigravidae mothers regarding prenatal attachment in selected Maternity Hospital, Bangalore.”

 

OBJECTIVES:

To assess the knowledge of primigravidae mothers regarding prenatal attachment.

 

To assess the level of attitude of primigravidae mothers regarding prenatal attachment.

 

To correlate the knowledge and attitude of primigravidae mothers regarding prenatal attachment.

 

To associate the knowledge and attitude of primigravidae mothers regarding prenatal attachment with their selected demographic variables.

 

HYPOTHESIS:

H1:  There is a significant correlation between knowledge and attitude among primigravidae mothers regarding prenatal attachment.

 

H2:  There is a significant association of knowledge and attitude among primigravidae mothers regarding prenatal attachment with their selected demographic variables.

 

CONCEPTUAL FRAMEWORK:

Modified Conceptual Frame Work Based on Nola Pender’s Health Promotion Model.

 

 

 

Figure 1: Modified Conceptual Frame Work Based on Nola Pender’s Health Promotion Model (1982; 1996 revised)

 

METHODOLOGY:

Fig 2: Schematic outline of research plan of the study.

RESULTS:

 

 

Fig. 3:  Schematic outline of research analysis

 

Major findings of the study were

Ø  The maximum number of primigravidae mothers 48.3% were in  the age group of 18- 23 years.

Ø  The majority of respondents 28.3% were belong to 24^th to 27^th weeks of gestation.

Ø  Most of the subjects 33.3% were Hindu.

Ø  Majority of the mothers 76.7% were house wife.

Ø  Maximum number of subject 71.3% were living in nuclear family.

Ø  Most of the respondents 48.3% got family income between Rs 10001- 15000/-.

Ø  The 53.3% of the respondents had no previous source of information.

Ø  Majority of the respondents 43.3% got information from neighbor.

Ø  Maximum of the respondents 78.3% got support from spouse.

 

Fig:4:  Mean, SD and range and mean percentage  regarding prenatal attachment among primigravidae mothers.

 

 

Assessment level of knowledge of mothers reveals the mean for overall knowledge of primigravidae mothers was 14.45 (SD= 6.04). The highest mean knowledge was for benefits of prenatal attachment 5.57(1.63) and the lowest Mean was for factors influencing prenatal attachment 2.65(SD= 0.98).

 

 

 

Table -1

Mean, SD and range of attitude regarding prenatal attachment among primigravidae mothers.   N=60

 

The assessment of attitude of primigravidae mothers revealed that the mean score of overall attitude was 45.38(SD= 6.04).

 

Fig.5.Correlation between knowledge and attitude of primigravidae mothers regarding prenatal attachment.

 

 

There was statistical significant association between level of knowledge and their selected demographic variables such as gestational age in weeks, Religion, educational status, occupation and Family income. Hence, the Hypothesis H2: “There is a significant association of knowledge among primigravidae mothers regarding prenatal attachment with their selected demographic variables” is accepted.

 

There was statistical significant association between level of attitude and their selected demographic variable such as age, education and previous source of information. Hence, H2:  “There is a significant association of attitude among primigravidae mothers regarding prenatal attachment with their selected demographic variables” is accepted.

 

CONCLUSION:

The study assessed the knowledge and attitude of primigravidae mothers regarding prenatal attachment. The results revealed that majority 61.7% of the subjects had moderate knowledge and 60.0% of them had favourable attitude, 38.3% had inadequate knowledge and 0.00%  has adequate knowledge. Majority 60.0% of them had favourable attitude, 38.3% of them had moderately favourable attitude and 1(1.7%) of them had  unfavourable attitude regarding prenatal attachment. There was a positive correlation between level of knowledge and attitude of primigravidae mothers regarding prenatal attachment. The study showed that there was a significant association of knowledge with selected demographic variables of primigravidae mothers such as gestational age in weeks, Religion, educational status, occupation and Family income.

 

IMPLICATIONS OF THE STUDY:

Nursing practice

Health education is an important function of the health personnel. Nurses as a resource person working in hospital and community setting should impart education especially on factors, strategies and benefits of prenatal attachment that enhance the good health outcome of the baby and mother. Current study helps the nurse to give correct information to the primigravidae mothers regarding prenatal attachment and the nurses can use this pamphlet to improve the knowledge and attitude of primigravidae mothers.

 

Nursing education

The nursing curriculum should lay more emphasis on the factors, strategies and benefits of prenatal attachment. Current study helps the nurse educator to provide correct information about prenatal attachment, so that she can educate student nurses about these aspects. The pamphlet prepared by the investigator could be given to the students to bring awareness regarding prenatal attachment. The student nurse can use this pamphlet to conduct periodical health education program in Hospital and Community as a part of curriculum to improve the knowledge and attitude of pregnant mothers regarding prenatal attachment.

 

Nursing administration

The nurse administrator should formulate policies, protocol, guidelines and systems of care in collaboration with the multidisciplinary team. The nurse administrator can use the pamphlet to educate the nurses and also conduct staff development program to improve the nurse’s knowledge and also to encourage them to provide these pamphlet for pregnant mothers during their antenatal visits. Nurse administrator ensures professional practice and research based and which is clinically effective. Nurse administrator should facilitate funding to have adequate number of books and journal in library related to prenatal attachment both in Hospital and College. So this will help the staffs and students to enforce and enhance their knowledge on prenatal attachment.

 

Nursing research

Nursing research can be focused on selected aspects of prenatal attachment, which could help the nurses to understand the knowledge and attitude of pregnant mothers which will help the nurses to provide adequate information about the prenatal attachment. Dissemination of findings through conference and professional journals will make application of research findings to be effective.

 

RECOMMENDATIONS:

On the basis of the finding of the study it is recommended that

1)          A study can be undertaken with large sample to generalized the findings.

2)          A comparative study can be conducted between primigravidae and multigravida women regarding prenatal attachment.

3)          An experimental study to assess the effectiveness of  Structured teaching programme can be conducted on the knowledge of prenatal attachment.

 

REFERENCES:

1.       Abeer Eswi and Amalkhalil. prenatal attachment and fetal health locus of control among low risk and high risk pregnant women. World applied sciences journal 2012; 18: 462-471.

2.       World Bank. Safe Motherhood- a review. The Safe Motherhood Initiatives.1987- 2005 World Bank Report. New York: Family Care International; 2007.             

3.       Ministry of Health Malaysia. Family Health Development Division. Perinatal care manual: antenatal care. (2nd ed). Ministry of Health Malaysia: Putrajaya; 2010.

4.       Bonding with your Baby During Pregnancy.  Available at: http://www.virtualmedicalcentre.com/healthandlifestyle/bonding-with-your-baby-during-pregnancy/232#c4

5.       Availableat:http://www.playtexmommyville.ca/mommyville/prenatal/preparation/bonding_with_your_baby.aspx  

6.       Bonding with your Baby During Pregnancy.  Available at: http://www.virtualmedicalcentre.com/healthandlifestyle/bonding-with-your-baby-during-pregnancy/232#c4

7.       S. Rajeswari, vijayalakshmi Ethiraj. Maternal-fetal attachment among primigravida, Nightingale Nursing Times. A window for Health in Action, May 12; 8:.24-26

8.       Rubin R. Attainment of the maternal role: Part I. Processes. Nursing Research. 1967a;16(3):237–245.

9.       Rubin R. Attainment of the maternal role: Part II. Models and referrants. Nursing Research. 1967b;16(4):342–346.

10.     Rubin R. Maternal tasks in pregnancy. Maternal Child Nursing Journal. 1975;4:143–153.

11.     Lumley JM. The development of maternal-foetal bonding in first pregnancy. Third International Congress, Psychosomatic Medicine in Obsetrics and Gynaecology;1972.

12.     Lumley JM. Through a glass darkly: Ultrasound and prenatal bonding. Birth. 1980; 17:214–217.

13.     Lumley JM. Attitudes to the fetus among primigravidae. Australian Pediatric Journal. 1982; 18:106–109.

14.     Availableat:https://docs.google.com/viewer?a=v&q=cache:4kdbk61ooloj:library.usask.ca/theses/available/etd-08232004-170804/unrestricted/turriffjonassonthesis.pdf+matenal+fetal+attachment,prenatal+emotional+attachment&hl=en&gl=in&pid=bl&srcid=adgeesi7kuhwdoshwvbxwzjphwnghhbn8g1rwsh0x9gyv_oe947flfllfshgyhb68obc4prfofelumwzaprd26au090fadsawbc8q1oxfmmvhbgx0mfe0dawxgtehgwvhhbelyilooda&sig=ahietbq23ncdkcogov2pcar0guuxpgq1aa

15.     Muller, M. E. A Critical Review of Prenatal Attachment Research. Scholarly Inquiry for Nursing Practice: An International Journal. 1992; 6(1): 5 – 22

16.     BT  Basavanthappa . Nursing Research.2^nded.New Delhi: Jitendar P Vij; 2007.

17.     Alhusen JL, Gross D, Hayat MJ, Woods AB, Sharps PW, The influence of maternal- fetal attachment and health practices on neonatal outcomes in low-income, urban women. Johns Hopkins University School of Nursing, Balitmore, MD 21205, USA. 2012 Apr;35(2):112-20

18.     Siddiqui A, Hägglöf B, Department of Clinical Sciences, Division of Child and Adolescent Psychiatry, Umeå University, S-901 85, Umeå, Sweden. anver.siddiqui@psychiat.umu.se, “Does maternal prenatal attachment predict postnatal mother-infant interaction?”, Available at: http://europepmc.org/abstract/MED/10962164/reload=0;jsessionid=JvPSAedMOCjogDvjlzGh.10

 

 

Received on 21.05.2015           Modified on 25.08.2015

Accepted on 12.09.2015     © A&V Publication all right reserved