Knowledge regarding
selected neonatal infections and their prevention among primigravida
mothers
Mrs. Sarika Yadav1*,
Ms. Sonia2
1Lecturer, Faculty of Nursing SGT University, Gurgaon, Haryana, India
2Assistant
Professor, Faculty of Nursing, SGT University, Gurgaon,
Haryana, India
*Corresponding Author’s Email: sarikayadav06@rediffmail.com
ABSTRACT:
Background and Objective: Among the almost 3.9 million newborn deaths that
occur worldwide, about 30% occur in India. Children are our future and utmost
precious resources. After birth the health of the child depends upon the health
care practice adopted by the family, especially by the mothers. Information
about neonatal infection
will help in reducing mortality and morbidity during the neonatal
period. This study was conducted to identify the knowledge of primi mothers with regard prevention of neonatal infection.
Materials and Methods: This descriptive study was carried out among the
mothers of primigravida mother in the Maternity Hospital ,Delhi. The
Pre-test was conducted after that The planned teaching programme
was conducted . After three days post-test was done using the same
questionnaire to evaluate the effectiveness of the planned teaching programme. Results:
Area-wise analysis of knowledge score was more (37.12%) in the area of
“Prevention of neonatal GIT infection” and least percentage (26.23%) was in the
area of “Neonatal infection in general”. The mean percentage of knowledge score
of primigravida mothers in the pre-test was 31.71%
with a mean ± SD of 10.48±0.91 which was increased after administering a
planned teaching programme with a mean percentage of
knowledge score in the post-test by 86.33% with a mean ± SD of 28.73± 0.84. Interpretation and Conclusion: Overall
findings of assessment of the level of knowledge of the primigravida
mothers revealed that 81.52% of the sample had average knowledge, 18.48 % had
poor knowledge and none of them had good knowledge regarding prevention of
neonatal infection. Quartile distribution of knowledge scores in pre-test and
post-test showed significant difference between the knowledge score of pre-test
and post-test. This reveals the increase in knowledge level after the
administration of PTP. A very high significant (p<0.001) difference was
observed between the pre-test and post-test knowledge scores of primigravida mothers regarding prevention of neonatal
infection
KEYWORDS: Common neonatal infection,
knowledge of primi mothers, neonatal, planned
teaching programme, Health care practice.
INTRODUCTION:
“Children’s health reflects the
national health and wealth”.
“Today’s children are tomorrow’s citizen, a well developed child
contributes to the national welfare and children are the precious resource of
the nation”. Children are the world’s most valuable asset and their wellbeing
indicates the standard of living of the country. They constitute about 40
percent of the total population. These most precious part
of the world are most delicate and highly susceptible for infections.
Among the almost 3.9 million newborn deaths that occur worldwide, about
30% occur in India. Children are our future and utmost precious resources.
After birth the health of the child depends upon the health care practice
adopted by the family, especially by the mothers. Information about neonatal
problems and newborn care practices will help in reducing mortality and
morbidity during the neonatal period. This study was conducted to identify the
knowledge of primi mothers with regard to the common
problems of normal neonates.
Although the global under-five mortality rate has declined over the past
few decades, neonatal mortality still remains high. Globally four million
deaths occur every year in the first month of life. Almost all (99%) neonatal
deaths occur in the low-income and middle-income countries. In India alone,
around one million babies die each year before they complete their first month
of life, contributing to one-fourth of the global burden. The neonatal
mortality rate in India was 32 per 1000 live births in the year 2010, a high
rate that has not declined much in the last decade. The report, released
recently at the National Conference on Child Survival and Development in New
Delhi, claims that of the roughly 26 million children born in India each year,
1.2 million die during the first four weeks, that is, 30% of the 3.9 million
global neonatal deaths.[2]
To reduce the neonatal mortality rate, home-based neonatal care should
be actively initiated through the National Rural Health (NRHM) and integrated
management of neonatal and childhood illness (IMNCI). An added capacity of
Auxiliary Nurse Midwives (ANMs) and accredited social health activists (ASHAs),
for careful tailoring of behavior change according to
the local context, will bring about positive change and significant
improvements in newborn care at home and neonatal mortality.
The mother plays a key role in the prevention of infection in the
neonatal period. Care practices immediately after delivery play a major role in
causing neonatal morbidities and mortalities. The essential newborn care
practices outlined to decrease neonatal morbidity and mortality include clean
cord care, thermal care, and initiating breast feeding immediately after birth.
The purpose of this study is to assess the knowledge of primi
mothers with regard to neonatal ailments, their prevention, and management.
OBJECTIVES OF THE STUDY:
1. Determine the knowledge of primigravida
mothers regarding prevention of neonatal infections.
2. Conduct a planned teaching programme on prevention of neonatal
infection for primigravida mothers.
3. Find the effectiveness of the planned teaching programme on
prevention of neonatal infection for primigravida
mothers in terms of gain in knowledge.
HYPOTHESIS:
H1:- The mean post-test knowledge scores of primigravida
mothers regarding prevention of neonatal infections will be significantly
higher than the mean pre-test knowledge scores.
MATERIAL AND METHODS:
One group pre-test post-test design with pre-experimental approach was
used to evaluate the effectiveness of PTP on prevention of neonatal infection
for primigravida mothers..
The present study was conducted at maternity Hospitals The
hospital is a teaching hospital with bed strength of 200 with a daily average
of 180 in-patients. The out-patient department functions daily with an average
of 90 patients. In addition to the maternity and gynaecological services it has
a well developed neonatal unit.. The population
comprised primigravida who have completed 12 weeks of
gestation. The sample size was 40 mothers who met inclusion criteria. Purposive
Random Sampling Technique is a type of non-probability sampling approach
adopted for present study.
SAMPLING CRITERIA:
Primigravida who have completed 12 weeks
of gestation in maternity hospital who are willing to participate in the study
and knows Hindi / English are included . While Mothers who are
not available during the period of data collection. Mothers who are not willing
to participate were excluded.
Data collection tools and technique tools are given as under.
Tool-1 - Demographic Data
Tool -2 - Knowledge Questionnaires
The tool was prepared after extensive review of literature. Tool 2 had
40 statements covering the knowledge items. The area included were Knowledge
related to neonatal infection, Knowledge related to prevention of neonatal skin
infection ,Knowledge related to prevention of cord
infection, Knowledge related to prevention of gastrointestinal tract infection
The tool was sent to 05 experts were selected on the basis of their
qualification, experience and interest in the problem area. Reliability was
tested by split-half method. To establish the reliability, the questionnaire
was administered to seven primigravida mothers other
than study sample. The test was first divided into two equivalent halves and
correlation was found using Karl Pearson’s correlation coefficient formula. The
correlation for the half test was found to be significant (
r½ = .718, P<0.001). The reliability coefficient of the
whole test was then estimated by Spearman Brown prophecy formula. The tool was
found reliable (r=0.84).
Prior permission was obtained from the concerned authority of the
selected maternity hospital. Consent was obtained from the participants. The
researcher herself has collected data from the sample after obtaining their
consent.
The Pre-test was conducted on n 1st day. The planned teaching
programme was conducted on the same dates respectively. The duration of each
session was one hour. After the sessions, different questions were raised by
the group and appropriate explanations were given. After three days of
pre-test, post-test was done
using the same questionnaire to evaluate the effectiveness of the
planned teaching programme.
DATA ANALYSIS:
Data analyzed using
descriptive statistics.
Distribution of subjects with respect to demographic variables will be
represented using frequencies and percentages. Mean standard deviation and mean
percentage will be used to describe the knowledge of primigravida
mothers regarding prevention of neonatal infections. Level of knowledge score
will be grouped into four categories, very good (above 30), good (20-30),
average (10-20), poor (0-10).
One group pre test and post-test (x) design will be used to evaluate the
effectiveness of the PTP. Further statistical significance of the effectiveness
of PTP will be analyzed by paired‘t’ test. Data will
be presented in tables, graphs and diagrams.
Table 1
Area-wise mean, SD and mean
percentage of knowledge scores of primigravida mothers regarding prevention of neonatal infection.
|
Knowledge Area |
Max Score |
Mean |
SD |
Mean % |
|
Neonatal Infection in General |
7 |
2.73 |
0.80 |
29.62 |
|
Prevention of NeonatalSkin Infection |
9 |
2.3 |
0.87 |
26.23 |
|
Prevention of cord Infection |
12 |
2.42 |
0.54 |
34.13 |
|
Prevention of GI Infection |
12 |
2.97 |
0.72 |
37.12 |
|
|
40 |
10.48 |
0.91 |
31.71 |
The mean percentage of the total knowledge scores was 31.71%, with mean
and SD of 10.48 ± 0.91. Area-wise mean percentage of knowledge score was 29.62%
in the area of “Neonatal infection in general” with mean and SD 2.73 ± 0.80. In
the area of “Prevention of neonatal skin infections” the mean percentage was
26.23% with mean and SD 2.3 ± 0.87. Area-wise mean percentage of knowledge
score in the area “Prevention of neonatal cord infection” was 34.13%with mean and SD of 2.42 ± 0.54.
In the area of ‘Prevention of neonatal GIT infections”, the mean percentage was
37.12% with the mean and SD 2.97 ± 0.72. This reveals that overall and
area-wise knowledge of primi gravida
mothers regarding prevention of neonatal infection was average and they needed
to be educated.
Table-2 : Area wise mean,
SD and mean percentage of the knowledge scores in pre-test and post-test.
|
AREA |
Max Score |
Pre Test x |
Post Test y |
Effectiveness (y-x) |
|||
|
|
|
Mean ±SD |
Mean % |
Mean ±SD |
Mean % |
Mean ±SD |
Mean % |
|
Neonatal Infection
in General |
7 |
2.73±0.80 |
29.62 |
7.24±0.5 |
80.44 |
4.51±0.3 |
54.21 |
|
Prevention of NeonatalSkin Infection |
9 |
2.36±0.87 |
26.23 |
7.19 ±0.52 |
89.88 |
4.83±0.35 |
55.75 |
|
Prevention of cord
Infection |
12 |
2.42±0.54 |
34.13 |
7.29±0.0.49 |
91.13 |
4.87±0.5 |
61.51 |
|
Prevention of GI
Infection |
12 |
2.97±0.72 |
37.12 |
6.77 ±0.52 |
84.63 |
3.8±0.2 |
47.51 |
|
|
40 |
10.48 ±0.91 |
31.71 |
2.73±0.84 |
86.33 |
18.01± 1.35 |
54.72 |
Comparison of mean percentage of the knowledge scores of the pre-test
and post-test reveals an increase of 54.72% in the mean knowledge of the primigravida mothers following the planned teaching
programme. Comparison of area-wise mean and SD of the knowledge scores in the
area of “Prevention of cord infections”, shows that the pre-test mean knowledge
score was (2.42 ± 0.54), with a mean percentage of 34.13%, where as post-test
mean percentage score was 91.13% with a mean and SD of (7.29 ± 0.49). This
shows an increase of 61.51% in the mean knowledge scores of the primigravida mothers.
A more or less similar percentage of effectiveness of planned teaching
programme was observed in the areas of “Neonatal infection in general” (54.21%),
and “Prevention of neonatal skin infections” (55.75%).
Comparison of area-wise mean and SD of the knowledge scores showed that
in the area “Prevention of GIT infection” the pre-test mean percentage of
knowledge score was only 37.12 % where as post-test knowledge score was 84.63%,
indicating an increase of 47.51% in the mean percentage knowledge score of primigravida mothers.
However, overall findings reveal that the percentage of effectiveness of
Post-test knowledge score was more when compared to the pre-test knowledge
score. Hence, it is observed that the planned teaching programme was effective.
Table-3:
Significance Difference between the Pre test and Post Test knowledge score
regarding prevention of primigravida mothers
regarding prevention of neonatal infections n=40
|
Knowledge Area |
Mean Effectiveness |
t Value |
Table Value |
Level of significance |
|
|
SECTION A |
4.51 |
40.9 |
3.447 |
P<0.001 |
VHS |
|
SECTION B |
4.83 |
40.3 |
3.447 |
P<0.002 |
VHS |
|
SECTION C |
4.87 |
53.3 |
3.447 |
P<0.003 |
VHS |
|
SECTION D |
3.8 |
37 |
3.447 |
P<0.004 |
VHS |
|
TOTAL |
18.01 |
81.73 |
3.447 |
P<0.005 |
VHS |
VHS:
Very Highly Significant
The calculated t’ value was greater than the table value in all
sections. Therefore the null hypothesis was rejected and research hypothesis
was accepted. The gain in knowledge scores of primigravida
mothers was very highly significant in all the sections. Therefore it is
concluded that there is significant gain in knowledge of primigravida
mothers through planned teaching programme on prevention of neonatal
infections.
Result:
Assessment of the level of knowledge of the primigravida
mothers revealed that 81.52% of the sample had average knowledge, 18.48 % had
poor knowledge and none of them had good knowledge regarding prevention of
neonatal infection.
Area-wise analysis of knowledge score was more (37.12%) in the area of
“Prevention of neonatal GIT infection” and least percentage (26.23%) was in the
area of “Neonatal infection in general”. The mean percentage of knowledge score
of primigravida mothers in the pre-test was 31.71%
with a mean ± SD of 10.48±0.91 which was increased after administering a
planned teaching programme with a mean percentage of knowledge score in the
post-test by 86.33% with a mean ± SD of 28.73± 0.84.
Very high significant difference was found between pre-test and
post-test knowledge scores of the primigravida
mothers on prevention of neonatal infection in all the areas. The study showed
that PTP was very highly effective in improving the knowledge of primigravida mothers on prevention of neonatal infection.
RECOMMENDATION:
A similar study
can be undertaken with a control group design.
Similar study can
be replicated on a large sample to generalize the findings An experimental
study can be conducted to compare two groups of primigravida
mothers from urban and rural community area.
A comparative
study can be conducted on primigravida mothers and multigravida mothers regarding prevention of neonatal
infection.
IMPLICATION:
From the findings of the study the following implications are stated.
o Present study would help to understand the
level of knowledge of primigravida mothers regarding
prevention of neonatal infections.
o The study findings would help the nurses
in the field of obstetrics and gynecology to develop
an insight into the importance of prevention of neonatal infections.
o A public awareness programme can be
carried out regarding prevention of neonatal infections in both urban and rural
community setting.
o The planned teaching programme gives
adequate knowledge to the mothers regarding preventive measures of neonatal
infections.
o Educational programs on prevention of
neonatal infections can be propagated through the use of mass media.
REFERENCES:
1.
K.Park. Text Book of Preventive and Social Medicine.18th
Edition. Jabalpur: Banarsidas
Bhanut Publisher; 2005.
2.
Tomris Turmen. Safe motherhood and Newborn Care.
Paediatric 2001.
3.
Mrs. Tumbulwadkar.
Paediatric Nursing. 2nd Edition. Bombay: Vora
Medical Publication; 1999.
4.
Leela Visaria, John Simons, Peter Berman. Maternal
educational and child survival pathways and evidence. 1st ed. Vikas Publication; 1997.
5.
Marja-Terttu, Pekka Laippalia.
Social support provided by public health nurse and the coping of first time
mothers with newborn care. Public Health Nurse 1999;
6.
Anil Narag,
Srinivas Murki. Research in
Neonatology. Indian Pediatr 2002.
7.
Kounteya Sinha. The Times of India. “In India, a child
dies every 15 seconds.”Report. Bangalore: 6th October 2009.
8.
Antony KR. Enabling mothers
to ensure health of newborns. Health action 2002.
9.
Dipak K. Guha. Neonatalogy
Principle and Practice 1Ed Vikas Publication 1995.
10.
Bordman BS Parental knowledge in prevention of neonatal infection. Journal of
Paediatric Infectious Disease 1998;
11.
Molly Babu.
A study of postnatal and neonatal health problem and home remedies used during puerperium in an urban community in Delhi. The Indian
Journal of Nursing and Midwifery. 1998.
12.
Bhahar L, Sharma VK. Parental education in prevention of neonatal infections.
Indian Pediatrics 1996;
13.
Ghai O P, Piyush Gupta, “Ghai’s
Essential Paediatrics” 6th edition. CBC Publishers and Distributors,
New Delhi.
14.
Christenson J. Paula Kenny
Janet W. Nursing process application of conceptual model, Tornoto.
The C.V. Mosby Company 1990;
15.
Kerlinger KN, Foundation of behavioural research. New York: Hold Rinehort and Winston Inc 1993
Received on 08.07.2015 Modified
on 27.07.2015
Accepted on 19.10.2015
© A&V Publication all right reserved
Int.
J. Adv. Nur. Management.
2016; 4(2): 97-101.
DOI:
10.5958/2454-2652.2016.00021.4