INTRODUCTION:

The birth of a newborn is one of the most awe-inspiring and emotional events that can occur in one’s lifetime. After nine months of anticipation and preparation, the neonate arrives to new and challenging environment for their healthy survival. The first four weeks of life constitutes the neonatal period, as we know, when a baby is born he/she has to adapt from fetal life to extra uterine life. All the body systems undergo changes in order to ensure healthy survival, minimize illness and maximize the growth and development.

It is desirable to keep the normal term babies with their mother rather than in a separate nursery. Rooming in promotes better emotional rapport between the mother and the baby, the mother can participate in the nursing care with the nursing personnel.

The health and survival of the newborn baby depends upon the health status of the mother and her awareness, on her baby. The best preparation is to have considered them and decided before and what procedures are desired to newborn. For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused. First time parents are often unaware that many of these routine procedures are not grounded in evidence based practice, but are rather the product of ease and access for staff.¹

Motherhood is a beautiful and joyous experience to women, the health of the mother during pregnancy is important to give birth to a healthy baby. The best and most precious gift the mother can give the baby is the gift of health. There is no indicator in Biology, which tells us so much about the past events and the future trajectory of life, as the care of newborn baby at the time of birth. The mother needs to know about the newborn care like breastfeeding, maintenance of warmth, baby bath, immunization and care of diaper etc. Breastfeeding is defined as feeding the baby exclusively by mother for a period of six month, baby bath is the procedure which is used to perform to clean the baby, improve the circulation and monitor for proper growth and development of newborn. Warmthness can be maintained by proper covering the baby from head to body except face, immunization helps the baby to prevent from infection, care of diaper is procedure which help to frequently change the diaper whenever it get soiled.²

The mother has a pivotal role to play in the life of her newborn baby. If mother fails to care, the children will be the sufferers. If the mother copes with life skillfully then she can safeguard the health of her child. In spite of lapses and failures the women should act as a corner stone of the family structure and remain as the chief guardian of child welfare. Thus the mother is presented as the custodian of child’s health. Hence the mother who is going to take care of her own baby should be well prepared to handle her baby during her antenatal visits itself, which helps mother and baby during their post natal period.

NEED FOR STUDY:

Today’s children are tomorrow’s citizens. The development and the prosperity of a nation depend on the health and development of children. The first month of a baby’s life is a most critical period. Over 80% of the new born babies require minimal care, which can be provided by the mother under the supervision. Mother is the primary health worker to provide newborn care.³

One of the greatest medical advances of the past decades has been scientific validation of the importance of newborn care. One of the most critical needs felt by the newborn’s parents, is the lack of their sense of sufficient knowledge. The global crude birth rate in 2005 is 20.5/1000. The crude birth rate ranged from 1.33/1000 in Germany, 15.33 in Niger, United States 14.14%/1000. According to world health statistics 2008 the total number of live newborn birth is about 15 births per 1000 people, among them likelihood is that around 500 of those 1000 population are males and 500 were females.³ Howard L Sobel, et.al. (2011) conducted a study to assess the effectiveness of immediate newborn care practices on delay thermoregulation and breastfeeding initiation, in selected 40 Hospitals at Philippines using a standardized tool to record practices and timing of immediate newborn care procedures. Among them drying, weighing, eye care, and vitamin K injection were performed in more than 90% of newborn, only 9.6% were allowed skin to skin contact, 68.2% were put to breast they were separated 2 min later, 2% developed sepsis and pneumonia.⁴

Alageswari A, et.al. (2019) conducted a study to evaluate the effectiveness of Prenatal Education Programme on postnatal and newborn care. The Quantitative pre-experimental one group pre and post-test research design was used. The sample size was 100 prenatal mothers, which were selected by using the purposive sampling technique who fulfilled the inclusion criteria at selected hospitals, Puducherry. Data was collected by using structured interview schedule method. The results depicts that prenatal education programme was more effective and it can be promoted in prenatally by nurse in their day to day activities in hospital setting.⁵

When the antenatal women become the post natal mother she lacks knowledge on caring her baby. When we see in the post natal wards of hospitals, majority of the babies were handled by the grand women and their family members or care takers. The women fails to take care of babies in many ways like limited handling skills, fear to touch, lack of previous experience in handling baby, lack of knowledge on breast feeding, importance of breast feeding especially feeding the colostrum, lack in covering the baby and maintaining their body temperature, not following in giving the immunization at right time interval for the baby, and leaving the babies with soiled diaper for prolong time and lack of maternal bonding. Most of the time 50% of mothers had limited knowledge regarding care of newborn. So the researcher was very much provoked to bring awareness during antenatal period itself among primi gravida women attending to antenatal OPD’s.

STATEMENT OF THE PROBLEM:

A Study to Assess the Effectiveness of Video Assisted Teaching Programme on Knowledge regarding Newborn Care among Primi gravida Women.

OBJECTIVES:

1. To assess the pre test knowledge score regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

2. To assess the effectiveness of video assisted teaching programme regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

3. To assess the post test knowledge score regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

4. To compare the pre test and post test knowledge scores regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

5. To associate the post test knowledge score among primi gravida women regarding newborn care with their selected demographic variables at PESIMSR, Kuppam, A.P.

HYPOTHESIS:

H₀1: There will be no significant difference between pre test knowledge score and post test knowledge score among primi gravida women, after video assisted teaching programme.

H₀2: There will be no significant difference between post test knowledge score of primi gravida women, with their selected demographic variable.

METHODOLOGY:

A quasi experimental, one group pre test post test design was used to evaluate the effectiveness of video assisted teaching on newborn care among primi gravida women attending antenatal OPD’s at PESIMSR, Kuppam, A. P. The study was conducted in antenatal OPD at PESIMSR, Kuppam, A.P. The total sample size selected for this study was 60 primi gravida women by using probability simple random sampling technique. The tool consists of structured interview questionnaire, to assess the pre test knowledge score by selecting the sample individually and the same tool was used to assess the post test knowledge score of the same samples after an intervention with the video assisted teaching, by demonstrating selected newborn care procedures. It consists of two sections, Section-I consist of 8 questions about their demographic variables like age, religion, educational qualification, marital life, area of residency, occupation, income, gestational age and Section-II consist of 40 questions regarding newborn care under five aspects like breastfeeding, baby bath, maintenance of thermoregulation, immunization, and care of diaper. One mark for each corrects and zero for each wrong answer was given. Reliability of the tool was assessed by collecting the data from six primi gravida women. The samples were chosen according to the similar characteristics of the study, other than the samples selected for the main study. The tool after validation was tested for its reliability by using McNeMar chi square method. r=0.89, the tool was reliable. Content validity of the tool was done by experts from Dept. of Medical Pediatrics and Dept. Paediatric and Obstetrical Nursing from different colleges/ hospitals.

RESULTS:

The results were compared with the help of descriptive and inferential statistics. The data was organized into following sections,

Section I: Distribution of samples according to demographic variables

Section II: Comparison of pre-test and post- test knowledge scores of primi gravida women.

Section III: Association of post test knowledge level with their selected demographic variables.

Table1: Socio demographic distribution of subjects (N=60)

S. No.	Demographic Variable	Frequency	%
1.	Age in years
	Below 20 years	18	30
	21-25	29	48
	26-30	10	17
	31 and Above	03	05
2.	Religion
	Hindu	55	92
	Christian	02	03
	Muslim	03	05
	Others	-	-
3.	Educational Qualification
	Illiterate	10	17
	Primary School	12	20
	Secondary School	11	18
	Intermediate and more	27	45
4.	Marital Life
	1 Year	38	64
	2 Year	11	18
	3 Year	05	08
	4 Year and Above	06	10
5.	Area of Residency
	Tribal	04	6.66
	Rural	36	60
	Town	12	20
	Urban	08	13.33
5.	Income per Month
	Less than 3,000/-	13	22
	3,001-5,000/-	36	33
	5,001-7,000/-	12	27
	7,001 and Above	08	18
6.	Occupation
	Private Employee	19	32
	Government Employee	01	02
	Coolie	09	15
	House Wife	31	51
7.	Gestational Age in Months
	7 Months	-	-
	8 Months	10	25
	9 Months	17	42.5

Table 1 shows frequency and percentage distribution of demographic variables of primi gravida women, about 29(48%) belongs to 21 to 25 years age group, 55(92%) were Hindu’s, 27(45%) were educated up to intermediate and more, about 38(64%) were belongs to 1 year of marital life, 36(60%) were living in rural areas, 13(22%) women belongs to less than 3000 rupees of family income and 31(51%) were housewife’s, about 27(45%) belongs to 7 months of gestational age.

Table: 2. Categorization of knowledge scores of Primi Gravida Women (N=60)

Knowledge Level	Pre test		Post test
Knowledge Level	Frequency	%	Frequency	%
Inadequate	48	80	01	1.66
Moderate	11	18.33	37	61.66
Adequate	01	1.66	22	36.66

Table 2 shows that the present study found in pre - test out of 60 primi gravida women 48(80%) had inadequate knowledge, 11(18.33%) had moderate knowledge and 01 (1.66%) had adequate knowledge regarding. And in post-test out of 60primi gravida women 01(1.66%) had inadequate knowledge, 37(61.66%) had moderate knowledge and 22(36.66%) had adequate knowledge regarding newborn care.

Table 3: shows that the mean post-test knowledge score (29.41) was higher than the mean pre-test knowledge score (16.3). McNeMar chi square was used to assess the pre test and post test knowledge comparison, the p-value was 0.042 hence the intervention was effective.

Table: 3: Mean and Standard Deviation of pre-test and post-test knowledge scores of primi gravida women (N=60)

S. No.	Knowledge regarding newborn care	Mean	S.D.	McNeMar chi square
1.	Pre Test	16.3	5.88	0.442
2.	Post Test	29.41	3.77

Table 4: Association between Post test Knowledge level of Primi Gravida Women with their Socio Demographic Variables. (N=60)

S. No	Demographic Variables	Knowledge Level						Chi-Square
		Inadequate		Moderate		Adequate		p value	Result
		F	%	F	%	F	%	0.444	NS
1.	Age
	< 20 years	00	00	16	26.6	03	05
	21-25 years	00	00	14	23.33	14	23.33
	26-30 years	00	00	06	10	04	6.66
	> 30 years	01	1.66	01	1.66	01	1.66
2.	Religion
	Hindu	01	1.66	34	56.66	19	31.66	0.329	NS
	Christian	00	00	00	00	02	3.33
	Muslim	00	00	03	05	01	1.66
3.	Educational Qualification
	Illiterate	00	00	08	13.33	02	3.33	0.267	NS
	Primary	00	00	09	15	03	05
	Secondary	01	1.66	06	10	04	6.66
	Intermediate and Above	00	00	14	23.33	13	21.66
4.	Marital Life
	1 year	00	00	23	38.33	15	25	0.325	NS
	2 years	01	1.66	04	6.66	05	8.33
	3 years	00	00	04	6.66	01	1.66
5.	Area of Residency
	Tribal	00	00	06	10	01	1.66	0.396	NS
	Rural	01	1.66	18	30	15	25
	Town	00	00	09	15	02	3.33
	Urban	00	00	04	6.66	04	6.66
6.	Income per Month
	< 3000	00	00	09	15	04	6.66	0.160	NS
	3001- 5000	01	1.66	12	20	04	6.66
	5001-7000	00	00	12	20	06	10
	7001 and above	00	00	04	6.66	08	13.33
7.	Occupation
	Private Employee	00	00	09	15	10	16.66	0.052	NS
	Government Employee	00	00	00	00	01	1.66
	Coolie	01	1.66	07	11.66	01	1.66
	House wife	00	00	21	35	10	16.66
8.	Gestational Age in Months
	7 months	00	00	17	28.33	12	20	0.475	NS
	8 months	01	1.66	07	11.66	04	6.66
	9 months	00	00	13	21.66	06	10

Table 4 shows, no significant association between post test knowledge scores with selected socio demographic variables of primi gravida women.

DISCUSSION:

The first objective of the study was to assess the pre test knowledge scores regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

The pre test knowledge score among 60 primi gravida women were as follows, 48(80%) had inadequate knowledge, 11(18.33%) had moderate knowledge and 01(1.66%) had adequate knowledge.

The second objective of the study was to assess the effectiveness of video assisted teaching programme regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

In this study video tape demonstration regarding newborn care like breast feeding, baby bath, immunization, maintenance of warmth, and care of diaper was projected for 30 minutes in antenatal OPD’s for all 60 selected primi gravida women.

The third objective of the study was to assess the post test knowledge scores regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

The post test knowledge scores among 60 primi gravida women were as follows, 01(1.66%) had inadequate knowledge, 37(61.66%) had moderate knowledge and 22 (36.66%) had adequate knowledge.

The fourth objective of the study was to compare the pretest and post test knowledge scores regarding newborn care among primi gravida women at PESIMSR, Kuppam, A.P.

To find the difference in knowledge levels chi square test was used to test the result and the p-value which was 0.042 and hence it was proved that video assisting teaching was effective. There was a significant increased level of knowledge of primi gravida women at PESIMSR, Kuppam, A.P. Hence the corresponding hypothesis H₀1 was rejected.

The fifth objective of the study was to associate the post test knowledge scores among primi gravida women regarding newborn care with their selected socio demographic variables.

There is no significant association between post test knowledge scores of primi gravida women with their selected demographic variables. Hence the corresponding hypothesis H₀2was accepted.

These findings are supported by the following studies; Reza sharafi, et.al. (2013) conducted a cross-sectional study to assess the knowledge regarding neonatal care among postnatal mothers. The results showed that knowledge levels of 78.5% of mothers were moderate. So it is imperative to provide comprehensive training in the field of newborn and infant care for mothers.⁶ Anupam Sharma, Kawaljit Kaur, et.al. (2015) conducted a study to assess the effectiveness of structured teaching program on knowledge regarding new born care among post-natal mothers in Guru Nanak Dev Hospital, Amritsar by adopting pre experimental single group pre test - post test design. The objectives of the study were to assess the pre test- post test level of knowledge, to compare the pre test- post test level of knowledge among postnatal mothers regarding new born care and to find out the association between levels of post-test knowledge score of post-natal mother in relation to selected socio demographic variables. Sample size of 60 postnatal mothers was selected using purposive sampling technique. Findings of the study indicated that there was a significant improvement between pre and post-test knowledge at P>0.05 level in new born care among Primi Gravida Post Natal Mothers but the mean gain in knowledge scores among study subjects were not significantly (p> 0.05) related to their selected Socio demographic variables i.e. age, religion, educational status, occupation, family income, type of family, utilization of health services were not found statistically significant⁷.Manasa Godati, et.al. (2016) conducted a study to assess the level of knowledge and practice of postnatal mothers regarding essential newborn care by using one group pre-test post-test design. A sample of 200 postnatal mothers was selected by purposive sampling technique at selected community areas of Bheemunipatnam, Vishakapatnam. Structured teaching programme on essential new born care was conducted. Among 200 postnatal mothers, majority 176(88%), 164 (82%) had inadequate knowledge, 20(10%), 32(16%) had moderate knowledge and 4(2%), 4(2%) had adequate knowledge the pre assessment of level of knowledge and practice on essential new born care. After the administration of structured teaching programme, majority 16(8%), 20(10%) had inadequate knowledge, 104(52%), 100(50%) had moderate knowledge and 80(40%), 80(40%) had adequate knowledge in the post assessment of level of knowledge and practice on essential new born care. It represents that structured teaching programme was effective in improving knowledge on essential new born care among postnatal mothers. Other than education and parity, there was no statistically significant association found between post assessment of essential newborn care and the demographic variables such as age of the mother, education, religion, parity, type of delivery in that study.⁸

RECOMMENDATIONS:

1. A similar study may be conducted on a large sample size.

2. A similar study may be conducted by using true experimental design.

3. A similar study may be conducted to early postnatal mothers.

4. A similar study may be conducted to assess both knowledge and practice.

5. A comparative study may be conducted among rural and urban primi gravida women.

CONCLUSION:

New born care is one of the essential accepts of the nurse which has to be taught and educated to the women especially during antenatal period itself specifically for primi gravida women, when they attended for antenatal checkup’s, which helps the mother to prepare psychologically, physically and emotionally to handle, and care for their babies after birth. And also which helps the child to have good bonding with their mother and to stay healthy. The researcher concludes that the knowledge levels of primi gravida women in post test was more than the pre test level of knowledge. (P-value: 0.042 is highly significant) Therefore it was concluded that the video assisted teaching on newborn care was effective for the primi gravida women at PESIMSR, Kuppam, A.P. But there was no significant association found between post test levels of knowledge with their selected socio demographic variables.

REFERENCES:

1. Lowder Milk, Perry. Maternity Nursing. Seventh Edition. Mary Land: Mosby Elsevier publishers; 2007; 994-998

2. www.pubmed.com

3. www.populationsurvey.com

4. Howard L Sobel, et.al. Immediate newborn care practices delay thermoregulation and breastfeeding initiation. Acta Paediatrica. 2011; 100(8): 1127-1133.

5. Alageswari A, Dash MB, Felicia CA. Effectiveness of prenatal education programme on postnatal and newborn care. Obstetrical and Gynecology International Journal. 2019; 10(6): 383-388.

6. Reza Sharafi, Hassan Esmaeeli. Knowledge assessment of neonatal care among postnatal mothers. Iranian Journal of Neonataology. 2013; 4(1): 28-31.

7. Anupam Sharma, Kawaljit Kaur, et.al. A Study to Assess the Effectiveness of Structured Teaching Program on Knowledge among Postnatal Mothers regarding New Born care in Maternity Ward of Guru Nanak Dev Hospital, Amritsar. International Journal of Obstetrics, Perinatal and Neonatal. 2015; 1(1): 32-39.

8. Manasa Godati, et.al. Effectiveness of Structured Teaching Programme Knowledge and Practice of Post Natal Mothers Regarding Essential New Born Care. ARC Journal of Nursing and Healthcare. 2016; 2(3): 10-16.

Received on 16.03.2021 Modified on 14.04.2021

Int. J. of Advances in Nur. Management. 2021; 9(3):241-246.

DOI: 10.52711/2454-2652.2021.00055