A Study to assess the Knowledge and Attitude regarding Antenatal Care among Spouse of Primi Gravid Mothers Attending Antenatal OPD, PIMS, Puducherry

 

Mrs. Catherine. R¹, Dr. Rebecca Samson², Mrs. Jayasankari³, Ms. Keerthika. C⁴,

Ms. Divya Roopa. C⁴, Ms. Mathumitha. A⁴, Ms. Priyadharshini. A⁴, Ms. Sherline Chitra. A⁴, Ms. Sivasankari. S⁴, Ms. Vinodhini. P⁴, Dr. Ravichandran⁴

¹Assistant Professor, College of Nursing, Pondicherry Institute of Medical Sciences, Puducherry, Pin – 605014, India

²Research Guide and Dean, College of Nursing, PIMS, Puducherry, India

³Vice Dean and HOD, Dept. of OBG, College of Nursing PIMS, Puducherry, India.

⁴ Lecturer / Biostatistician, PIMS, Puducherry, India.

 

ABSTRACT:

Antenatal care is the care provided to the women during pregnancy. ANC reduces maternal and perinatal morbidity and mortality both directly, through detection and treatment of pregnancy-related complications, and indirectly, through the identification of women at increased risk of developing complications during labor and delivery, thus ensuring referral to an appropriate level of care. Objectives: To assess the level of knowledge and attitude regarding antenatal care among spouse of primi gravid mothers. To find out the correlation between the level of knowledge and attitude on antenatal care among spouse of primi gravid mothers. Setting: Antenatal OPD, Pondicherry Institute of Medical Sciences, Puducherry, India. Methods: Data was collected over a period of one week in March 2019. The researcher obtained formal permission from the concerned authorities. Non experimental descriptive design was adopted to select the samples based on the inclusion criteria. The sample size was 90. Informed consent was obtained from the study participants. The data was collected using structured interview schedule for assessment of knowledge and five point Likert scale for attitude. Each participant was allotted 20 minutes. Around 10 to 20 spouses were interviewed per day.   At the end of the session pamphlets on antenatal care was provided to the spouse. Results: Out of 90 samples, majority of them 48.9% had moderately adequate knowledge, 45.6% had inadequate knowledge and 5.5% of them had adequate knowledge and 50% had favorable attitude, 45.6% had moderately favorable attitude and 4.4% of them had unfavorable attitude. The findings revealed that spouse of primigravid mothers had moderately adequate knowledge and favorable attitude and there is a need to improve it with the help of health education programme and pamphlets distribution.

 

 

 

 

 

INTRODUCTION:

Pregnancy, labor and childbirth are important milestones in a couple’s life. It is perhaps the most emotional and dramatic experience not only in a woman’s life but indeed in the life of her family members^[1]. Pregnant mothers contribute to major vulnerable and priority group in community^[2] Antenatal care (ANC) can be defined as the care provided by skilled health-care professionals to pregnant women in order to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases, health education and health promotion^[3].

 

The maternal mortality ratio in developing countries in 2015 is 239 per 100 000 live births versus 12 per 100 000 live births in developed countries^[4]. According to 2011 census, maternal mortality rate has increased in India, the reason being lack of proper antenatal care coverage and lack of awareness among mothers particularly from rural part of India, contributing the major population about the need of early registration and compliance with regular and proper antenatal checkup^[5].

 

The partner’s main role in pregnancy is to nurture and respond to the pregnant woman’s feelings of vulnerability. In recent years leaders in child birth education have recognized the vital role of the partner in pregnancy and child birth^[6]. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. Proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units to secure a better male involvement in maternal health care^[7]

 

By creating awareness among spouse of antenatal mothers regarding the importance of antenatal care, it can reduce the maternal, perinatal, neonatal mortality and morbidity and there by achieving the Sustainable Development Goal (SDG).

 

OBJECTIVES:

1    To assess the level of knowledge and attitude on antenatal care among spouse of Primigravid mothers.

2    To find out the correlation between the level of knowledge and attitude among spouse of Primigravid mothers.

 

MATERIAL AND METHODS:

Research Approach:

Quantitative research approach.

 

Research Design:

Non experimental descriptive research design.

 

 

 

Setting of the Study:

Antenatal OPD, Pondicherry Institute of Medical Sciences, Puducherry,

 

Population:  

Spouse of Primigravid mothers

 

Sample:

Spouse of Primigravid mothers attending antenatal OPD at PIMS.

 

Sample size:

90 spouses

 

Sampling Technique:

Convenience sampling technique.

 

SAMPLING CRITERIA:

Inclusion criteria:

Spouse of Primigravid mothers attending antenatal OPD

 

DEVELOPMENT AND DESCRIPTION OF THE TOOL:

A structured interview schedule for assessment of knowledge and five point Likert scale for attitude on antenatal care among spouse of primigravid mothers. The final tool consist of 3 sections:

 

Section A:

Socio demographic variables:

It includes demographic characteristics of spouse (age, religion, education, occupation, sources of information) and characteristics of Primigravid Mothers (gestational age, age, years of marriage, education, type of family, occupation)

 

Section B:

Structured interview schedule to assess the knowledge regarding antenatal care among the spouse of Primigravid Mothers attending OPD. It consists of 20 items related to knowledge regarding antenatal care among spouse of primigravid mothers. The structured interview schedule was based on the selected aspects of antenatal care i.e. antenatal visits -17 and antenatal diet -3. 1 score was allotted to each correct answer and 0 score for wrong answer. Maximum score is 20. The score graded as

·       Adequate knowledge (>75% of score)

·       Moderately adequate knowledge (50-75% of score)

·       Inadequate knowledge (<50% of score)

 

Section C:

Five point Likert scale towards the attitude regarding Antenatal care among the spouse of primigravid mothers attending OPD at PIMS:

A five point Likert scale was used to assess level attitude regarding antenatal care among spouse of Primigravid Mothers. It consists of 10 statements. The score graded as

·       Favorable (>75% of score)

·       Moderately favorable (50-75% of score)

·       Unfavorable (<50% of score)

 

VALIDITY OF THE TOOL:

The tool was validated by 4 experts including 1 Medical officer and 3 Nursing faculty. The suggestions and minor corrections recommended by the experts were incorporated in the final preparation of demographic, knowledge and attitude questionnaire.

 

ETHICAL CONSIDERATION:

The proposed study was conducted after the approval of Institutional Review Board and the researchers got permission from the Director Principal, Medical superintendent, Nursing superintendent, HOD of obstetrics and gynecology department and OPD In-charge at Pondicherry Institute of medical sciences, Puducherry to conduct the study. Informed consent was obtained from the participant. Reassurance and confidentiality was maintained throughout the study. But it was informed that the result of the study will be discussed in the scientific society session

 

PILOT STUDY:

Formal permission was obtained from the Dean, CON, PIMS. The pilot study was conducted on 1.3.2019 The pilot study was conducted for 10 participants who fulfilled the inclusion criteria. Convenience sampling technique was adopted to select the participants. Structured interview schedule was used to assess knowledge and 5 point Likert scale towards attitude on antenatal care among spouse of primigravid mothers. The investigators did not find any difficulty during the pilot study. The study was found to be feasible and practical.

 

RELIABILITY OF THE TOOL:

The reliability of tool was established by split half method and the internal consistency of tool was found to be reliable (r =0.7)

 

DATA COLLECTION PROCESS:

Data collection was done at Antenatal OPD for period of one week from 4.3.2019 to 12.3.2019. Got prior permission from Director Principal, Medical superintendent, Nursing superintendent, HOD of Obstetrics and Gynecology department and OPD in-charge. After obtaining formal permission spouse of Primigravid mothers were informed about the objective of the study. Spouse who fulfilled the inclusion criteria was selected by convenience sampling technique. Nature and purpose of the study was explained to the participant and informed consent was also obtained. Data was collected using structured interview schedule on knowledge and 5 point Likert scale on attitude regarding antenatal care over a period of 20 minutes. At the end of the session pamphlets on antenatal care was provided to the spouse. After the data obtained from the study participants it was compiled for the data analysis.

 

DATA ANALYSIS:

Frequency, Mean and Standard Deviation was used to describe the Socio demographic variables, level of knowledge and attitude and Spearman correlation coefficient was used to determine the correlation between the level of knowledge and attitude regarding antenatal care among the spouse of Primigravid mothers.

 

MAJOR FINDINGS OF THE STUDY AND DISCUSSION:

The data obtained has been analyzed and presented under the following headings

Section-A:

Distribution of spouse and antenatal mothers according to socio demographic variables

 

Section-B:

Level of knowledge and attitude on antenatal care among the spouse of Primigravid mothers.

 

Section-C:

Correlation between the level of knowledge and attitude on antenatal care among the spouse of Primigravid mothers

 

Section-A: Distribution of Spouse and Antenatal Mothers according to Socio Demographic Variables

 

Percentage Distribution of Spouse according to Socio Demographic Variables:

Most of the spouses (61.1%) were in age group of less than 30 years. Majority (83.3%) of the participants belongs to Hindu. Nearly half of them (51.1%) were graduate holders. Most of them (46.7%) work as private employees. Majority of the spouse (56.7%) have idea on antenatal care.

 

Percentage Distribution of Antenatal mothers according to Socio Demographic Variables:

Nearly half of them (47.8%) fall under III trimester. Most of the antenatal mothers (93.3%) were in age group of less than 30 years. Majority (61.1%) of the antenatal mothers belongs to less than 24 months of marriage.  Most of them (53.3%) were graduate holders. Most of the mothers (64.4%) belong to joint family. Most of them (81.1%) come under the category of house wives.

 

Section-B: Level of knowledge and attitude on antenatal care among the spouse of Primigravid mothers:

Out of 90 samples, majority of them 48.9% had moderately adequate knowledge, 45.6% had inadequate knowledge and 5.5% of them had adequate knowledge., majority of them 50% had favorable attitude, 45.6% had moderately favorable attitude and 4.4% of them had unfavorable attitude.

 

The mean and standard deviation of knowledge of spouse regarding antenatal care were 10.3 and 3.4 respectively with the minimum and maximum range of 4 and 18. The mean and standard deviation of attitude of spouse regarding antenatal care were 36.8 and 5.0 respectively with the minimum and maximum range of 21 and 45.

 

Fig 1: Level of knowledge regarding antenatal care among spouse of primigravid mothers          n=90

 

Fig 2: Level of attitude regarding antenatal care among spouse of primigravid mothers n=90

 

Section-C:

Correlation between the level of knowledge and attitude on antenatal care among the spouse of Primigravid mothers

 

Table 1: Correlation between knowledge and attitude on antenatal care among spouse of primigravid mothers n=90

Antenatal care	Correlation coefficient	Significance
Level of Knowledge	0.381**	0.000
Level of Attitude

** Correlation is significant at the 0.01level (2-tailed)

 

The above table (Spearman correlation coefficient) shows that there is significant correlation between knowledge and attitude at “r” value 0.01 level on antenatal care among spouse of primigravid mothers.

IMPLICATIONS:

The findings of the study have implication in the following areas of the Nursing profession. It is explained in the following headings like Nursing practice, Nursing Education, Nursing administration and Nursing research.

 

Nursing Practice:

·       There should be a printed self structured module available in different languages which will provide necessary information about antenatal care for the spouse of Primigravid mothers.

·       The nurses should be encouraged to assist the spouse of Primigravid mothers for understanding the benefits of antenatal care.

 

Nursing Education:

·       It will be good to conduct short term courses on antenatal care for nurses.

·       A hand book on antenatal care and its use can be made available for nurses.

·       In service education on antenatal care for nurses working in clinical areas periodically.

 

Nursing Administration:

·       Nurse administrators should ensure the periodical conduction of training program on antenatal care and its benefits among spouse of primigravid mothers.

·       The nurse administrators must make sure that educational and informational materials should have consistent information which can be displayed in outpatient department of the hospital.

 

Nursing Research:

·       Dissemination of findings through conferences and professional journals will make the application of research findings more effective.

·       The study helps the investigators to develop insight regarding knowledge and attitude on antenatal care.

 

RECOMMENDATIONS:

On the basis of study findings, the following recommendations were made for further research.

·       A Similar study can be replicated on a large sample to generalize the study findings.

·       A comparative study can be conducted between urban and rural spouse of primigravid mothers.

·       A comparative study between primigravid and multigravid Spouse of antenatal mothers.

·       An experimental study can be conducted with structured teaching programme

·       A similar study can be conducted among nursing students to assess their level of knowledge and attitude on antenatal care.

 

CONCLUSION:

The findings revealed that spouse of primigravid mothers had moderately adequate knowledge and favorable attitude and there is a need to improve it with the help of health education programme and pamphlets distribution.

 

REFERENCES:

1.      Haile A, Engueselassive F. Influence of women‟s autonomy on couples contraception use in limma town. Dec 2006 [cited 2019 Mar 3];20(3):pg.no145-151.Available from: https://www.ncbi.nlm.nih. gov> articles.

2.      Behee Milligan, Barbara K wingrove, Leslie Richards, Margaret Rodan, Lillie Monroe. Perception about prenatal care. 2002 [cited 2019 Mar 2];2(1):pg.no25.

3.      WHO.India has achieved groundbreaking success in reducing maternal mortality. Geneva: WHO;2019 [cited 2019 Jan 26]. Available from:http:// www.scaro.who.int/meiacentre/features/2018india

4.      WHO.Global, regional, and national levels and trends in maternal mortality between 1991and 2015, with scenario based projection to 2030. Geneva: WHO;2016 Jan [cited 2019 Jan 18]. Available from:https:// www.ncbi.nih.gov/m/pubmed

5.      Redshaw M, henerson J. Fathers Engagement in pregnancy and child birth evidence from a national survey.2013[cited 2019 Mar11];13(1):pg.no70.

6.      Ghimire S. Maternal Mortality: sharing experiencefrom nobal medical college teaching hospital.2012[cited 2019 Mar7];7(2):pg.no33-35.

7.      Kaye D, Kakaire O, Nakimuli A et al. Male involvement during pregnancy and childbirth men‟s perceptions, practice and experiences during care from women who developed childbirth complication.2014 [cited 2019 Mar 3];14(1): pg.no 14-54. Available from: https://bmcpregnacychilbirth .biomedcentral.com

 

 

 

 

Received on 18.07.2019         Modified on 08.08.2019

Accepted on 30.08.2019       ©A&V Publications All right reserved