A Study to Evaluate the Effectiveness of Structured Teaching Programme on Knowledge regarding Temporary Methods of Family Planning among Postnatal Mothers Attending in Government Hospital at Guntakal, Ananthapur District

Jyothi Kalabattula

Assistant Professor, Asram College of Nursing, Eluru, Andhra Pradesh, India.

*Corresponding Author E-mail: jyo5445@gmail.com

ABSTRACT:

Background: Family planning has far-reaching benefits for women and their families. A study reported that birth interval was indirectly proportional to infant and child mortality rates. Over 1,50,000 maternal deaths take place every year in India. This accounts for about 25% of the maternal deaths in the world. Most of these deaths are preventable by providing proper antenatal, intra natal and postnatal care services to pregnant women and mothers. Objectives:(1) To assess the existing level of knowledge regarding Importance of Temporary methods of Family planning among postnatal mothers.(2) To evaluate the effectiveness of structured teaching programme on knowledge regarding Importance of Temporary methods of family planning among postnatal mothers.(3) To find out the association between the posttest level of knowledge regarding importance of temporary methods of family planning of postnatal mothers with their selected demographic variables. Material and Methods: A quantitative research approach, pre-experimental, one group pre and posttest design was used for this study. Data was collected from 50 postnatal mothers of selected hospital. Purposive sampling was used for selecting the samples. The investigator developed structured teaching programme with regard to the family planning methods. Structured knowledge questionnaire was used for data collection. Results: In posttest 92% study participants had adequate knowledge, and 8% had moderately adequate knowledge. The overall analysis of knowledge that the pretest mean is 18.88 and that of posttest is 21.30. The calculated ‘t’ value is 38.13, which is higher than the table ‘t’ value 4.21at 98 df with 0.05 level of significance. There was extremely significant difference between pretest and posttest levels of knowledge among postnatal mothers regarding family planning methods. Conclusion: The study concludes that mothers had adequate knowledge after structured teaching programme on family planning methods. It also suggests importance of conducting health programmes to improve the awareness about the temporary family planning methods and practice. The nurses are playing a vital role to educate the postnatal mothers.

KEYWORDS: Structured Teaching Programme, Knowledge, Temporary Family Planning, Effectiveness.

INTRODUCTION:

“Delay the first, postpone the second and prevent the third”

Marriage is an important social institution. It is changing in its form according to the change in its culture. It is an institution, which permits or admits man and women for family life. It is more or less durable condition between male and female, beyond the mere acting of propagation (birth of off-spring). It is an in approved social institution where by two or more persons forms the family. There has been mutual attraction due to certain biological and psychological causes resulting in the establishment of intimate relationships. From the biological view point the sexual inter-course is necessary for physical satisfaction and the birth of the progeny. It also leads to mutual help in times of need, psychologically they have so many traits, which are mutually complementary.¹

In developing countries, especially in India where deep-rooted beliefs, customs and superstitions regarding pregnancy. Child birth, health and the role of the mother are still widely prevalent and women with poor socio-economic back ground are more vulnerable to the health risks associated with child bearing in quick succession. These contribute to high rates of maternal morbidity and mortality. Family planning plays a crucial role in safe guarding the health of women.²

Family planning is the way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitude and responsible decision made by individuals and couples in order to promote the health and welfare of family and community and thus contributes to the social development of the country.³

A study reported that birth interval was indirectly proportional to infant and child mortality rates. At birth intervals of <24 months the neonatal mortality rate was 71.5 and infant mortality rate was 109.5. However, when birth interval increased beyond 48 months neonatal mortality declined to 24.1 and infant mortality rate to 38.5.⁵

The reduction in women’s productivity also places an economic burden on their families, communities and societies. Improving the social and economic status of women, which greatly affect and are affected by poor reproductive health, is a vital concern. Increasing a woman’s educational level and control over financial resources can improve her status within the house hold, thereby increasing not only her role in decision making, knowledge about health and services available to her, that contribute to good health.⁷

Dutta D C. (2012) A study on contraceptive knowledge, practice and utilization of service in rural area of India was conducted among 1,17,465 eligible women from selected 28 districts, out of 1,17,465 eligible women 14,276 were using contraceptives and 17,082 were not using any family methods. Among contraceptive users only 26 percent of women were using spacing methods. Almost all women (98.8%) were using a contraceptive method with the knowledge of their husband and had their support for continuing the same. The most common reason given for not using any family planning method was ‘family not completed (34.6%), and fear of side effects (10%).

Hiller JE, et al (2013) A study to determine the ‘attitude of a women towards contraceptive use’ among 500 participants was conducted. Information was collected through questionnaires Results revealed that as of current usage, condoms were the most commonly used method (10.8%) followed by IUDs (5.4%), Oral pills (4.4%) and sterilization (3.6%). Obstacles to their adoption of contraceptive methods were hesitation (59.6%), nonavailability of service providers (43.2), fear of side effect (36.6%), customs and disbelieves or external pressure (22%).⁴

Jenner F, et al (2013) A Randomized controlled trial was conducted, among 540 mothers and made four groups. A Structured baseline household questionnaire; 20 minute, one to one health education at birth given and three months later, study revealed that Mothers in groups A and B (received health education at birth) were slightly more likely to use contraception at six months after birth compared with mothers in groups C and D (no health education at birth) (odds ratio 1.62, 95% confidence interval 1.06 to 2.5). There were no other significant differences between groups with regards to infant feeding, infant care, or immunization. Study says that the recommended practice of individual health education for postnatal mothers in poor communities has no impact on infant feeding, care, or immunization, although uptake of family planning may be slightly enhanced.⁶ With the professional and personal experiences, the investigator felt that it is essential to bring awareness among the postnatal mothers about family planning method.

OBJECTIVES OF THE STUDY:

1. To assess the existing level of knowledge regarding importance of temporary family planning methods among postnatal mothers.

2. To evaluate the effectiveness of structured teaching programme on knowledge regarding importance of temporary family planning methods among postnatal id mothers.

3. To find out the association between the post-test level of knowledge regarding Importance of temporary family planning methods of postnatal mothers with their selected demographic variables.

HYPOTHESIS:

· H 1: There is a significant difference in knowledge of postnatal mothers on temporary family planning methods before and after structure teaching programme.

· H2: there is a significant association of selected demographic variables with the post-test level of the knowledge regarding temporary family planning methods among the postnatal mothers.

MATERIAL AND METHODS:

Research Approach:

A quantitative research approach was used for this study.

Research Design:

A pre-experimental, one group pre and post-test design was adopted for this study.

O1 x O2

Keys:

O1 = Pretest

x = Structured teaching programme on knowledge regarding temporary methods of family planning among postnatal mothers

O2 = Posttest

Variables:

Dependent variables:

Knowledge on temporary family planning methods among postnatal mothers

Independent variables:

Structured teaching Programme regarding temporary family planning methods among postnatal mothers.

Setting of the Study:

The study was conducted in government hospital Guntakal in Anantapur district. 50 postnatal mothers were selected for the study by adapting purposive sampling technique.

Population Target population:

The target population refers to postnatal mothers.

Accessible population:

In this study the accessible population was postnatal mothers aged 20-33 years, at government hospital Guntakal in Anantapur district.

Sample:

It refers to the postnatal mothers who fulfilled the inclusive criteria.

Sample Size:

A total of 50 postnatal mothers in the age group of 20-33 years and who had satisfied the inclusion criteria were selected for this study.

Sampling Technique:

The postnatal mothers were selected by purposive sampling technique.

Inclusion criteria:

· Postnatal mothers (age between 20 to 33)

· Residing in the selected hospital

· Postnatal mothers who give the verbal consent for the study

· Postnatal mothers who can read and understandTelugu

Exclusion criteria:

· Postnatal mothers who are not willing to participate.

· Postnatal mothers who are not able to read and understand Telugu.

Tools And Techniques:

PART I: Demographic variables included age, educational status, Occupational status, Family income, Dietary habit of the family, Birth order of children, Birth weight of children.

PART II: It consists of Structured Multiple-Choice Questionnaires related to the assessment of the level of knowledge regarding temporary methods of family planning among postnatal mothers during pre and post test. The questions were related to their knowledge regarding the meaning of temporary methods of family planning, incidence, uses, types, risk factors, investigation, complication.

Data Collection Procedure:

The data collection period was 4weeks. The researcher initially established rapport, with the mothers and the validation of the study was explained to them. Informed consent was obtained from postnatal mothers. During the data collection period the postnatal mothers who met the inclusion criteria were selected from 20-33 age groups by using purposive sampling technique. Totally 50 mothers were selected. These groups were divided in to four groups and each group consisted of approximately 13mothers. Every group were given structured teaching programme on the separate days.

After the brief self-introduction, demographic data was collected and followed by Pre-test was conducted for 13 samples per day by using structured multiple-choice questionnaire for assessing the level of knowledge among postnatal mothers from each sample. From the day of intervention, the researcher took 8 days ’ time to conduct post-test which was done by using the same tool for assessing the level of knowledge regarding temporary methods of family planning among postnatal mothers.

Data analysis:

Descriptive statistics like frequency, mean, SD, mean percentage was used for description of demographic characteristics and assessment of knowledge. Inferential statistics like paired t test was used to evaluate the effectiveness of STP and chi-square test was used to find out the association between knowledge with demographic variables.

RESULTS AND DISCUSSION:

Section-A

Description of socio demographic variables

Table1: Frequency and percentage distribution of demographic variables among postnatal mothers

S.No

Demographic variable

Frequency

Age of postnatal mothers

(in years)

a. 20-22

b. 23-25

c. 26-29

d. d. 30-33

Education

a. Primary

b. Secondary

c. Higher secondary

d. Graduate

Occupation of Mother

a. Home maker

b. Agriculture

c. Government Job

d. Business

family Income per month

a. Below Rs 3000

b. Rs 3001-Rs 4000

c. Rs4001-Rs 5000

d. Above Rs 5000

Birth order of children

a. One

b. Two

c. Three

d. Four and above

Dietary habit of the family

a. Vegetarian

b. Non-Vegetarian

c. Mixed diet

Table 1 depicts that 12 (24%), 22 (44%), 13 (26.0%), 3 (6%) study mothers were aged between 20-22, 23-25, 26-29, 30-33 years respectively. Regard to educational status of postnatal mothers out of 50 mothers only four (8%) mothers were graduate, 12 (24%) mothers had studied in higher secondary school, 22 (44%) mothers were studied secondary education, 12(24%) mothers were studied primary level of schooling only. Regarding occupational status of postnatal mothers,20 (40%) were Homemakers, 12 (24%) mothers were agriculture, 8 (16%) of mothers were working as a government employes, 10 (20%)mothers were intended in business and other works. Regarding the income of the family, it was found that 15 (30%) were below Rs.3000 per month, 12 (24%) were range between 3001-4000, 11 (22%) were range between 4001-5000, 12 (24%) were range between above rs.5000 per month. As per the birth order 20 (40%) children were first born, 20(40%) second with regard to their order of birth.The above table showing that dietary habits of the family was mixed diet 34 (68%), vegetarian 23 (46%) and remaining non- vegetarian.

Section B

Distribution of level of knowledge on temporary methods of family planning among postnatal mothers, in pre and post-test.

Figure:-1-Frequency and percentage distribution of level of knowledge on temporary family planning methods among postnatal mothers, in pre and post-test.

Figure 1 shows that 94 (94%) study participants had inadequate knowledge whereas 6 (6%) had moderately adequate knowledge in pre-test. But in post-test 92 (92%) study participants had adequate knowledge, and 8 (8%) had moderately adequate knowledge.

Section C:

Table 2: Effectiveness of structured teaching programme on knowledge regarding temporary family planning methods

N=50

S.no

Observation

Mean

Mean Difference

Paired ‘t’value

Pre test

18.88

3.69

-2.42

38.93

Posttest

21.30

1.69

Df-49, p<0.05, extremely significant

The above table depicts that there is a statistically extremely significant difference at p <0.05 between pre and post-test knowledge score on temporary family planning methods among postnatal mothers.

The study findings are supported by the study conducted by Edwin S. (2010) the findings revealed there was an improvement in the knowledge of the mothers in the post test. Out of 342 mothers 91% had inadequate knowledge in the pre-test whereas 97% had adequate knowledge in the post test. The investigator educated postnatal mothers which was very important to improve the knowledge about temporary methods of family planning.

Section D:

Association between posttest level of knowledge on temporary family planning methods among postnatal mothers with selected demographic variables:

Chi square test was used to find out the association between demographic variable and level of knowledge of postnatal mothers. It reveals that there is no statistically significant association between demographic variables and the level of knowledge on temporary family planning methods among the postnatal mothers at the level of p<0.05.

CONCLUSION:

When the postnatal mothers are educated their level of knowledge on temporary family planning methods is increased and these promotes their attitude and skills to practice the same at home. The above findings strongly proved that education of the postnatal mothers are vital. Thus it is the responsibility of the nurse to teach the postnatal mother regarding the importance and benefits of temporary family planning methods there by to reduce the mortality and morbidity.

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