DISSERTATION

PRESENTATION
DALIYA JOSEPH
M.SC NURSING II YEAR
OBSTETRICAL AND
GYNECOLOGICAL NURSING
STATEMENT OF THE PROBLEM

A study to compare the knowledge and

practices of postnatal mothers regarding

neonatal care from selected urban and

rural settings of Bangalore with a view to

develop information booklet.

 INTRODUCTION
Healthy children are the greatest resource and
pride of a nation. Investment in child development
is an investment in the future of the nation.
Children ought to be healthy and happy to become
productive and contented adults of the future. To
give them a happy and healthy child hood, we
must safeguard their health right from the
beginning. While each newborn baby is perceived
as a precious gift to the family, it also brings with it
new responsibilities, changes in behaviors and
altered family dynamics.
 CONT…
The major task of a family with a newborn is the
healthy incorporation of the new
person into the existing family structure. After the
baby’s birth, the mother establishes a
realistic image of the newborn. The mother
absorbs the newborn into her every day world
and into the social system through an
acquaintance - attachment process. Through her,
the newborn gradually establishes a firm
relationship with other siblings and the rest of
the family members.
 NEED FOR THE STUDY
Newborn babies constitute the foundation of life.
Healthy and sturdy babies are likely to evolve as
physically strong and mentally alert adults with
enhanced quality of human resource development
of a country. Of 5 million world wide neonatal
deaths, around 96% of them occur in developing
countries. The highest neonatal mortality rates are
seen in countries of South Asia resulting in almost
2.0 million of newborn deaths in the region each
year. With India contributing 1.2 million,
accounting for 25% of global neonatal death
OBJECTIVES OF THE STUDY

To assess the knowledge of postnatal mothers regarding

the neonatal care.
To describe the practices followed in their family regarding
neonatal care
To determine the association between knowledge and
practices of neonatal care
To compare the knowledge and practices of mothers from
selected urban and rural settings of Bangalore.
To determine association of knowledge with selected
baseline variables
To determine association of practice with selected baseline
variables
 HYPOTHESIS

H1: There will be significant association between

the level of knowledge with selected demographic
variables of postnatal mothers.
H2: There will be significant association between
the practice and the selected demographic
variables of postnatal mothers.
H3: There will be significant correlation between
the level of knowledge and practice regarding
neonatal care among postnatal mothers from
selected rural and urban setting from bangalore.
CONCEPTUAL FRAMEWORK
The theory chosen for the study is “Arthur
Coomb’s humanistic learning theory.
According to Coomb learning is a change
in behaviour that repeatedly reinforced. A
learning theory is a systematic integrated
out look in regard to the nature of process.
It influences the people (in this study the
postnatal mothers) to relate to their
environment in such a way to enhance
their ability to use both themselves and
their environment more effectively.
REVIEW OF LITERATURE
The relevant literature reviewed has been
organized and presented under the following
headings. Review of literature is a broad
comprehensive in depth review of information’s
from previous studies systematically. It has
been divided into 2 sections.
Studies related to knowledge and practice
regarding breast feeding
Studies related to knowledge and practice
regarding maintanance of warmth, prevention
of infections and cord care.
 METHODOLOGY
Research design

The research design selected for the present study was

comparative descriptive design.

Setting:

This study was conducted in-

1.Roopena agrahara(urban setting)

2.Jigani (Rural setting)

 Cont…
SAMPLE
Sample for this study included the normal
postnatal mothers who are residing in rural and
urban areas, Bangalore.
Sample size:
• Seventy postnatal mothers from roopena
agrahara, urban area.
• Seventy postnatal mothers from jigani, rural
area.
Sampling procedure:
Postnatal mother were selected using purposive
sampling. Postnatal mothers who fulfilled the
inclusion criteria were selected for the study.
 INCLUSION CRITERIA:

Postnatal mothers who are willing to

participate in the study
Mothers who have a healthy full term
singleton baby within 10 days of
delivery.
 EXCLUSION CRITERIA
Postnatal mothers with any complication, which
would interferes with normal caring of the baby.
Cardiac dysfunction
Post partum hemorrhage
Preterm delivery (birth weight below 2.5 kgs) ¾
Severe PIH & eclampsia
Intra uterine & neonatal death
LSCS
Multiple delivery
Post partum psychosis
DESCRIPTION OF THE TOOL
The instruments consist of 4 sections.
Section I.
a. Demographic data of the mother which includes
• Setting
• Age
• Religion
• Educational status
• Occupation
• Woman’s monthly income
• Monthly income of the family
b. Type of family
• Parity index
• Date of delivery
• Obstetric data
• Sex of the baby
• Registration
 CONT…
Section II. Knowledge about normal neonate.
This section contains 5 questions to elicit the mother’s
knowledge about normal characteristics of the
neonates.
Section III. Knowledge about neonatal care.
a. Breast-feeding: This section has 10 questions on
different aspects of breast-feeding.
b. Cord care: This section has 4 questions on cord
care.
 CONT….
c. Prevention of infection: This section contains 6
questions on prevention of neonatal
infection.
d. Maintenance of warmth: This section has 5
questions on maintenance of warmth.

Section IV. Practices regarding neonatal care.

This section has 24 semi-structured questions on
above aspects of neonatal care. Mothers were
expected to describe their practices about the care
of their neonate
METHOD OF DATA COLLECTION

First demographic data were collected from the mothers after

getting permission from the mothers to be included in the study.
Then the knowledge questions were asked one after the other and
the mother’s responses were marked on the interview schedule by
the investigator. Following which the mothers were asked to
describe their practices regarding neonatal care. Assurance about
the confidentiality of the answers was provided. The data obtained
was analyzed in terms of the objectives of the study using
descriptive and inferential statistics.
 RESULTS
This chapter is organized and presented under the following broad headings

Section - I: To compare mothers from rural and urban setting in relation to their
baseline variables

Section - II: To compare the knowledge of postnatal mothers regarding

neonatal care from rural and urban setting

Section - III: To compare the practice of postnatal mothers regarding neonatal

care from rural and urban setting.

Section - IV: To assess the correlation between knowledge and practice of

postnatal mothers regarding neonatal care.

Section -V: To determine the association between postnatal mother’s

knowledge and selected baseline variables .
 DEMOGRAPHIC DATA
Majority of postnatal mothers from rural
(68.57%) and urban setting (57%) is in the
age group of between 20-25 yrs.

Majority of postnatal mothers from rural

(62.86%) and urban setting (58.28%) is
primi mothers. There was no significant
difference between the two groups in parity
status when x2 was computed
 CONT..

Major portion of mothers from rural

and urban setting belongs to Hindu
religion there was no significant
difference found between the
two groups
 CONT..
In rural setting 30% of the mother had
educational status up to high school and
34.29% of mother from urban setting
educated up to high school level very few
mothers from rural setting (2.86% &1.43%)
completed secondary school & under
graduation, where as 17.14% of mothers
from urban setting completed secondary
school & 31.43% of mothers are graduates.
majority of mothers from rural and urban
setting was housewives. No significant
difference was observed between the two
groups in relation to their occupation.
majority of postnatal mothers from rural
setting came from extended family, 21.43%
are from nuclear family. But extended
family pattern and nuclear family pattern
are equally distributed among mother from
urban setting 44.29%
& 44.29%
KNOWLEDGE AND PRACTICE
REGARDING NEONATAL CARE
Mothers from urban setting have
more knowledge regarding prevention of infection
and maintenance of warmth.
Most of the mothers from rural (82.86%) and
urban 94.28% settings initiate breast-feeding soon
after birth. 92.86% of the mothers from rural
setting and97.14% of the mothers from urban
setting did not give any other feeding till breast-
feeding was initiated. Only 2.86% of the mothers
from both setting gave sugar water.
 CONT..
Three mothers 4.29% from rural setting gave
cow’s milk before initiation of breast feeds. There
where significant difference between two groups in
frequency of feeding.

Most of the mothers (80%) from rural setting

practice demand feed. Majority of mothers from
urban setting practice 2 hourly (38.57%) or more
frequent feeding (31.4%). Demand feeding is
practiced by only 30% of the mothers from urban
setting.
 CONT…
Twenty seven mothers (38.57%) from rural setting
and 23 (32.86%) mothers from
urban setting perceive that their milk will be
sufficient for their neonate, where as 60% of
mother from rural and 40% of mothers from urban
settings said they would give cow’s
milk if breast milk is not sufficient. All mothers
from urban setting and 98.57% mothers
from rural setting said they do not have any
practice before initiating breast feeds. One
mother from rural setting said that, mother and
baby should be taken bath before
initiating the feeds.
 CONT…
All mothers from both setting breast-feed their baby when
the baby cries excessively. Six mothers 8.57% and 19
(27.14%) from urban setting said they would also give other
fluids.
All mothers from rural setting (100%) and (28.57%) mother
from urban setting had practice of warding off the evil eye
when baby cries unusually or daily. Over all the test of
significance shows the two groups were similar in the
practice of breast feeding.
Sixty-eight (97.14%) mothers from rural setting & 66
(94.28%) mothers from urban setting said they would
continue breast-feeding their baby one year and beyond.
 CONT..
Majority of mothers from rural setting (67.14%)
apply baby powder on the baby’s umbilicus for
faster healing. They use the same water for bath
as well as cleaning the cord (68.57)%. Also they
dry the cord & apply baby powder.
But in urban setting 61.42% of the mother said
they do not apply anything on the cord. Those
who are applying, (38.57%) apply baby powder
(48.14%). The x2 value computed are not
significant. There fore the two groups are similar in
the practice of neonatal cord care
 Comparison between knowledge and practice of postnatal

mothers regarding neonatal care from rural and urban setting

RURAL URBAN T TEST

RANG MEA SD RANG MEA SD

E N E N

KT 5-20 11.53 3.21 3-25 14.93 4.2 t=5.38

P<0.001

PT 10-17 13.6 1.51 9-19 15.5 2.2 t=6.13

P<0.001
ASSOCIATION BETWEEN KNOWLEDGE AND
PRACTICE WITH SELECTED DEMOGRAPHIC
VARIABLES

correlation between mother’s age and

the knowledge about neonatal care is
significant (P<0.001) It shows older
mothers had better knowledge
regarding neonatal care. Whereas no
correlation between educational
status & economic status. (‘r’ values
with 183 df. ** p< 0.001)
 CONT..
The skilled working group’s mean
knowledge score is comparatively higher
than the semiskilled working groups. The
computed ‘t’ test value 3.81,is less than the
table value at0.001 level It means that the
difference between the two groups1are
significant.
There is no significant relationship
between mother’s knowledge and type of
family.
 CONT…
The mean knowledge score of multipara
mothers (14.8) are higher than the mean
knowledge score of primiparus mothers
(12.2). To know whether the difference is
significant, “F” test was computed.. & the
obtained value 8.25was significant at0.001
level. This shows the difference in the
knowledge between primi and multi
mothers are significant. (df: 2,137,F=8.25).
Implication of nursing service

Nurse as an organizer, leader,

educator, counsellor, motivator,
supervisor and team member in
various situation of work
Nursing service department can have
a group of adequately trained nurses
for Developing health education
manual for neonatal care.
 Implication Of Nursing
Education
Nurses must be encouraged to give
public education, life support training
should be looked into, as possible
means of improving the current
situation.
Introduce the preventive measures to
reduce the burden of mortality and
morbidity due to neonatal diseases.
 Implication Of Nursing
Administration

Nursing administrator plan the interventions

in neonatal care should include combined
efforts from the community, public and
private sector, governmental and non-
governmental organizations.
Facilitating free distribution of booklets,
handouts, charts regarding awareness of
neonatal care regularly to antenatal and
postnatal mothers.
IMPLICATION FOR NURSING
RESEARCH
The results of the study contribute to
the body of knowledge of nursing.
Future investigators can use the
methodology as reference material.
The suggestions and
recommendations can be utilized by
other researchers conducting further
studies in the same field.
 CONCLUSION
Overall knowledge level of the mothers
from rural setting was 38.43% and
mothers from the urban setting were
49.76%. There was significant difference
between the knowledge level of the two
groups, (t = 5.38, P < 0.001). Mothers
from urban setting had more overall
knowledge regarding neonatal care than
mothers from rural setting.
 CONT,..
This study revealed that there was a significant
relationship between knowledge and practice
among mothers from rural and urban setting.
Mothers from urban setting had better
knowledge level than mothers from rural
setting(.t=5.38,df=129.2,P<0.001) This suggest
that more knowledge may contribute to better
practice in caring the neonates. There was
also significant positive correlation between
knowledge and practice of each aspects of
neonatal care area expect knowledge and practice
in the area of cord care.
 LIMITATION OF THE STUDY
The limitation of the study were-
The study was conducted on post natal
mothers from roopena agrahara urban
areaand jigani rural area, this study results
to other population was limited.
The practices regarding neonatal care was
assessed through interview schedule ,and
therefore there can be variations in their
actual practice.
 RECOMMENDATIONS

The study can be replicated on larger

sample for generalization of findings.
A similar study with a planned teaching
program on thermo regulation and
umbilical cord care of neonates can be
conducted.
Knowledge and practice of mothers
regarding neonatal care can be studied.
A study can be conducted to find out the
actual incidence of hypothermia and cord
infection.