RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCESBANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTFOR DISSERTATION

1. NAME OF THE CANDIDATE : Mr. ANOOP.T.

AND ADDRESS I YEAR M.SC NURSING

NO-9, SAPTHAGIRI MANSION

BHANU NURSING HOME

ROAD BOMMANAHALLI

BANGALORE-560 068.

2. NAME OF THE INSTITUTION : CHINAI COLLEGE OF

NURSING, BOMMANAHALLI,

BANGALORE-68.

3. COURSE OF STUDY AND : MASTER DEGREE OF NURSING

SUBJECT PEADIATRIC NURSING

4. DATE OF ADMISSION TO : 15.06.2009

COURSE

5. TITLE OF THE TOPIC : “A STUDY TO ASSESS THE

EFFECTIVENESS OF SELF

INSTRUCTIONAL MODULE ON

NEONATAL CARE AMONG

PRIMI MOTHERS IN

SELECTED RURAL

COMMUNITY AREA,

BANGALORE

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6. INTRODUCTION :

“THE NATION WALKS ON THE FEET OF LITTLE CHILDREN”

“Children are the wealth of tomorrow take care them, if you wish to have a

Strong India, ever ready to meet various challenges “ Jawaharlal Nehru.

Health in the word of our late Prime Minister Indira Gandhi, is the starting

point of all welfare and health of nation depends on the health of individuals

(clccly d. ctal , 1997) .

The Mother has an important role to play in the life of her infant .To

Appreciate the place of the mother in rearing her child, the Word of Sir. Johnson

Spencer , the Author of Famous - “ One Thousand Families Survey “ are worth

recalling . He said “In the study of these families and attempting to correlate their

environment with the Health of the Children, there emerged one dominating

factor. The Capacity of mother, if she failed, her children suffer. If she coped with

life skill fully and with pluck, she was safeguard to their health, so the mother

presented as the custodian of the Child Health.

“Rooming in Technique” is the recent technique used to increase the child

Survival, Mother Plays a key role in identifying minor developmental deviations

and early evidence of disease process because she is constantly and closely

watching her baby, so she needs the basic knowledge and skills pertaining to child

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nutrition, immunization, environmental sanitation, personal hygiene and other

common problems in children (Singh Maharban 1991 )

Jawaharlal Nehru once said “The nation walks on feet of little children

“The Child of today ought to have sound of health in order to build a healthy

Nation. Gandhiji Stated that there is no school equal to a decent home and no

teacher equivalent to honest virtuous parents in any society. It is the mother who

is held totally responsible for caring of the her child (Isbester clare 1973)

Nearly 50 % of all infant deaths occur during the neonatal period, half of

these deaths occurs in the first 7 days due to pre maturity neonatal tetanus, birth

asphyxia , and infections which can be prevented by proper and timely care of

new born (CSSM and family welfare - 2005)

6.1. NEED FOR THE STUDY :

Three neonates die every minute in India. The overall neonatal mortality

rate (NMR) PER 1000 live birth, of 76 in rural areas and 39 in urban areas, in our

country is exceeding high when compared with figures or less than 9.0 and as low

as 4.2 in developed countries. There is a wide variation of NMR among different

states ranging from 11 in Kerala, to around 60 in Orissa, Madhya Pradesh and

Bihar. To achieve further reduction in neonatal mortality, it is mandatory to

enhance neonatal survival by specific programs and strategies.

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Every fourth baby in India is a low birth weight (<2500 gm) baby accounting for a

high load of morbidity and mortality. Every year 8 million low birth weight

babies, 2.7 million pre term babies, (<37 weeks gestation) and over 1 million very

low birth weight babies (<1500 gm) are born in India.

The neonatal mortality rate in our country is 2-3 times higher as compared

to that of developed nations. The NMR has been forming an increasing proportion

of NMR over the years and currently account for more than 60 % of Infant death

(Guhadipak 1995).

The Analysis of Community shows that birth Asphyxia, respiratory

distress, Infection and congenital malformation are the leading cause of death

among new born.

During the data collection the investigator observed that the average

neonatal death rate of 2-5 per month in selected community , the common cause

of death is prematurity .

The Government of India launched the CSSM in 1992. In this programmed

the new born has been given a separate special status with emphasis on clean and

safe delivery, prevention and management of Asphyxia, provision of warmth and

adequate feeding (Guha Deepak 1995).

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Moloni (1994) has observed that primary source of knowledge of neonatal

care was the nurse during Hospitalization; Hence it is felt that Assessment of the

Knowledge of the mothers on neonate care in this Community will help to prevent

the neonatal death.

During community posting the investigator identified that, the primi mothers have

less knowledge about Neonatal care, therefore the Investigator plan to conduct a

study to improve the knowledge of mother’s about neonatal care.

6.2. Review of Literature :

A Review related literature gives an insight into the various aspects

related to the study , which in turn develops the link between the Previously

existing knowledge and current study , and enables to study the various problems

encountered during the course of the study and helps by its direction in finding

ways to increase the effectiveness of data analysis and interpretation .

(Moran Ac, Choudasy N) 2008, a study on quantitative base line survey

was conducted in six urban slum areas in Bangaladesh to measure neonatal care

practice among primi mothers (n=1256) Thirty – Six in – depth Semi-structured

interviews were conducted to explore neonatal care practice among currently

pregnant women (n=18) and women who had at least one delivery (n=18); in the

base line survey the majority of women gave birth at home (84%) most women

reported having knowledge about drying baby (64%) wrapping the baby after birth

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(59%) and cord care (46%). Program in urban slum areas should also consider

interventions to improve social support for women, especially primi mothers.

Phar – B mowlah – G (2007) A cross Sectional study was contacted

in Public maternity Hospital , Dhaka ,Bangladesh on 316 pregnant Woman and

their new born , the study found that the mean birth weight of babies of primi

para was 107 g less than those of Multiparma, the study revealed that about 15%

of babies were LBW. The mean birth weight to be 2889 +/- 468 g. The low Birth

Weight was common in younger, the least time antenatal visit found to be 191 g

heavier than those who had less than two to visit.

(Kesteroton A.J, Cleland) 2007. A study carried out in rural Karnataka,

India. It uses quantitative data from a prospective survey following mothers

through their experience of pregnancy and the postnatal period and qualitative data

from in depth. Interviews and focus group discussions with mother’s and birth

attendants. It explores local newborn care practice and beliefs, analysis their

harmful or beneficial characteristics and elucidates areas of potential resistance to

behavior change and implementation of essential new born are package.

Richard et.al.(2006) conducted a study regarding acute stress disorder

among parents of infants in the neonatal ICU. The study was conducted among 40

parents. Parents completed self report measures of ASD, parenteral stress, family

environment and coping style. 28% of parents developed symptoms of ASD.

Result revealed that potential interventions help to minimize psychological distress

in parents.

John Snow Inc (2005). A study was to determine the feasibility of

improved meternal neonatal care seeking and house hold practice using an

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approach scalable under Nepal’s primary health care services, for the study 30

samples collected with 30 Respondents. The intervention consisted primarly of

community based antenatal counseling and dispensing and an early postnatal home

visit, most activities were carried out of community based health volunteers.

There were notable improvements in most house hold practice and services

utilization indicator.

Priti.V.(2004) a study in Jhabva district in which 5% village of each tehsil

selected Random sampling, information was obtained from 430 house hold of 67

villages on infant child mortality, death occurred during neonatal period.

Diflorio (2000) conducted study on mothers knowledge related to care of

the new born. The study reveals that significant differences among mothers are

the age and the level of education. The mother who were 30 years or older, also

had more then high school education demonstrated the work on knowledge on the

care of New born.

STATEMENT OF THE PROBLEM :

“ A STUDY TO ASSESS THE EFFECTIVENESS OF SELF

INSTRUCTIONAL MODULE ON NEONATAL CARE AMONG PRIMI

MOTHERS IN SELECTED RURAL COMMUNITY AREA,

BANGALORE .“

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6.3. OBJECTIVES OF THE STUDY:

To Assess the Knowledge of Primi, mothers regarding neonatal care.

To Assess the practice of primi mothers regarding neonatal care.

To associate knowledge on neonatal care with selected demographic

Variables.

To associate practice on neonatal care with selected demographic

variables.

6.4. HYPOTHESIS OF THE STUDY :

The Mean Post test Knowledge score of primi mothers regarding neonatal

care will be significantly higher than mean pre test knowledge score .

There will be significant association between pre test and post test

knowledge with selected demographic variables.

6.5. OPERATIONAL DEFINITIONS

1. Effectiveness :

It refers to the significant gain in knowledge as measured by the

Instrument and shown by post test Knowledge Score.

2. Neonatal :

It refers to the period of child after birth to one month.

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3. Care :

Refers to essential care provider to the baby by care giver Or mother

on Warmth, feeding, personal hygiene, care of cord, Immunization.

4. Self Instructional Module:

It is a booklet in English developed by researcher with contains

information on neonatal care.

5. Primi Mother :

It refers to the mother who had undergone delivery for the First time.

6.6. VARIABLES :

Research variables are the concepts at various levels of abstraction

that are entered Manipulated and collected in a study .

1. Independent variable :

Self Instructional Module on Neonatal care.

2. Dependent variable :

Knowledge and practice regarding Neonatal care.

3. Extraneous variable:

Age, Education, Occupation, Family Income, Type Of family,

Locality and Food Pattern.

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6.7. ASSUMPTION

1. The mother can gain knowledge regarding neonatal care.

2. Neonates are protected from infections through self instructional

module to the mother regarding neonatal care.

6.8. DELIMINATION

The Study is delimited to primi mothers.

The data collection period is delimited to 6 weeks.

7.0. MATERIALS AND METHOD

7.1. SOURCE OF DATA :

Data will be collected from primi mothers in selected rural

Community area.

7.2. METHOD OF COLLECTION OF DATA :

7.2.1. Research design

Quasi – Experimental Design

7.2.2. Research Approach

An Evaluative research approach

7.2.3. Setting of the Study

This Study will be conducted in selected rural community

Area at Bangalore.

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7.2.4. Population

The Population of the study Comprises primi mothers in

selected rural community area , Bangalore .

7.2.5. Sample Size

The Total sample of the Study Consists of 40 mothers in

selected rural community area.

7.2.6. Sampling technique :

The Researcher will use the Simple random sampling

technique to draw the sample.

7.2.7. Sampling Criteria :

Inclusion Criteria:

Primi Mothers who are willing to participate.

Primi Mothers who are available during the period

of data collection.

Primi Mothers who can able to speak and read

kannada.

Exclusion Criteria:

Primi Mothers who are not willing to participate.

Primi Mothers who are not available during the data

collection

Primi Mothers who are not able to communicate

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Multiparous women

TOOLS FOR DATA COLLECTION :

A Structured Questionnaire is drafted for the purpose and the

relevant data will be collected from the sample Units. The tool consists of 3

parts, part-1, part - 2 & part -3

Part –I :

Selected Demographic variable such as Age, Education, Religion,

Occupation, Type of family, Family Income and Food Pattern.

Part – II :

Knowledge Questions regarding new born care.

Part – III:-

Practice questions regarding neonatal care.

PROCEDURE FOR DATA COLLECTION :

The data will be collected within the Prescribed Time Period in

Selected Rural Community Area.

The Objectives of the Study Will be explained to the primi mothers

before starting the data collection.

7.2.9. Data Analysis Method:

The data analysis will be carried out through descriptive and

inferential statistics by using computer software package (SPSS).

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DESCRIPTIVE STATISTICS :

The basic Statistical Techniques such as mean frequency percentage

and standard Deviation, correlation range of described demographic

variables etc. will be computed and interpreted suitably.

INFERENTIAL STATISTICS :

1. Paired ‘ t ‘ test to compare pre and post test knowledge score.

2. Chi square test will be used to find out the association between

demographic variable and knowledge level of primi mothers.

7.3. DOES THE STUDY REQUIRED ANY INTERVENTION TO BE

CONDUCTED PATIENTS OR OTHER HUMANS OR ANIMALS?

NO

Education will be given to primi mothers on Neonatal care by self

instructional module.

7.4. ETHICAL CLEARANCE

Permission will be obtained from

The research Committee of Chinai College of Nursing

Authorities of selected Rural Area in Community

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8. LIST OF REFERENCES :

BOOK FOR REFERENCE

1. B.T.Basavanthappa, ‘ Nursing Research, 1st Edition,1998,

Jaypee Brothers Medical Publisher pvt.ltd.

2. Polit DF and Hungler P.B, ‘Nursing Research, Sixth Edition,

Philadelphia Lippin cott William Wilkins Publisher, pvt Ltd,

New York page 34-37.

3. Marlo R Dorthy, ‘Text Book of Paediatric Nursing, sixth Edition

2005, Philadelphia W.B.Sauders Company, page 163.

4. Gupta Suraj, ‘A Short Text Book of Paediatric, Nineth Edition, 2001,

Jaypee brothers Medical publisher pvt.ltd. page 168.

5. Piyush Gupta, ‘Essential Paediatric Nursing, Second Edition 2007,

CBSP publisher and distribution New Delhi, page 275

6. Polit D.E.Hungler (2003), ‘ Nursing Research, seventh Edition,

Lippincott, Company, Philadelphia, USA, Page 289-311.14

JOURNALS :

1. Paul.V.K. The newborn Health Agenda Need for a village level

midwife; Nat Med. J.India 2000, 13:281-283

2. Singh.M.The challenge of new born care in India perinatology, 2003

5(6)255-261

3. Seth.R.Education and information to improve the care of newborn

babies in the community J.Neonatal 2002, 16:62-65.

4. Singh.M.Care of Newborn babies in the Community Asian J 1997 1:2-

27.

5. Wolegebrial A : Mothers Knowledge and belief on breast feeding,

Ethiop medical journal 2002,oct 40 (4) page no 365.

6. Barton sj. Infant feeding practice of low income rural mothers - MCN

AMJ matern child nurse 2001 mr – ap 26 (2) 93-97

7. Saroj Sharma practice related to breast feeding and weaning the nursing

Journal of India 2008,8,179

8. Guptha Neeru 1997 neonatal morbidity and mortality in “ At – Rish”

and Normal term pregnancies Indian pediatrics 64:523-527

9. Bolognia J.L. at 1991 Sun Protection in new born of comparative of

educational methods American Journal Dis child 145.1125-29

NET REFERENCE:

1. www.pubmed.com

2. www.google.com 15

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