A Study
to Assess the Knowledge of Antenatal Mothers on Prevention of Nutritional
Anaemia in Selected Hospital, Thrissur with a View to Develop a Self
Instructional Module
Dr. V. Indra
Principal
cum Professor, Aswini College of Nursing, Thrissur, Kerala
Corresponding
Author Email: indra.selvam1@gmail.com
ABSTRACT:
Nutritional
problems have serious public health significance impacting psychological,
physical, developmental, behavioural and work performance of pregnant women.
Anaemia is a widespread public health problem associated with an increased risk
of morbidity and mortality, especially in pregnant women and young children.
Poor nutritional status and anaemia in pregnancy have consequences that extend
over generations. Hence a study was undertaken to assess the knowledge of
antenatal mothers on prevention of nutritional anaemia in selected hospital at
Thrissur with a view to develop a self instructional module. It is a quantitative
descriptive research approach and the study was based on Health belief model.
After getting informed consent, 100 antenatal mothers were selected for the
study by using non probability purposive sampling. Structured knowledge
questionnaire were administered to get a base line data about the mother, and
also to assess the knowledge on prevention of nutritional anaemia. Followed by
the researcher has provided the self instructional module on prevention of
nutritional anemia to each samples. The statistical analysis of the study shows
that, among 100 samples, 21 (21%) were having inadequate knowledge, 71 (71%)
were having moderate knowledge and only 8 (8%) were having adequate knowledge
regarding prevention of nutritional anemia the study also reveals that there is
a significant association between the knowledge levels of antenatal mothers
with selected demographic variables like age in years and source of
information. However, the distribution of self instructional module will help
the antenatal mothers to prevent nutritional anemia and further complications.
Background and Purpose: The purpose of the study was to assess
the knowledge of antenatal mothers on prevention of nutritional anemia in
selected hospital at Thrissur with a view to develop a self instructional
module. The study was conducted in Aswini Hospital, Thrissur. The data
collection was carried out in the month of January for a period of 4 weeks. The
data was collected from 100 antenatal mothers though a structured questionnaire
and collected the baseline data and also find out the knowledge of antenatal
mothers regarding prevention of nutritional anemia. The samples were selected
by non probability purposive sampling technique. After the data collection, the
prepared self instructional module was distributed individually to the sample.
The findings were tabulated, analyzed and interpreted.
Objective: To assess the existing level of knowledge
of antenatal mothers regarding prevention of nutritional anaemia.
·
To
associate the level of knowledge of antenatal mothers regarding prevention of
nutritional anaemia with selected demographic variables.
·
To
develop a self instructional module on prevention of nutritional anaemia.
Design: A descriptive survey design was used
Settings: The setting is the physical location and
conditions in which data collection takes place in a study.
The present
study was conducted in the antenatal OPD’s of Aswini Hospital (P) Ltd,
Thrissur.
In this study sample
consisted of 50 mothers of preterm infants admitted at Maternity Hospital,
Thrissur, Kerala.
Samples: Antenatal mothers, who meet the inclusion
criteria were taken as samples. The sample size was 100.
Result: It reveals that there is a significant association between
the knowledge levels of antenatal mothers regarding prevention of nutritional
anemia and selected demographic variables like age in years and source of
information. It also reveals that, there no association between knowledge of
antenatal mothers and their demographic variables like religion, education of the
mother, occupation of the mother, education of the husband, occupation of the
husband, family monthly income, type of family, no of family members, gravida,
no of children and dietary pattern.
Conclusion: Antenatal mothers are having inadequate
knowledge regarding prevention of nutritional anemia. Moreover, the researcher
found that there is no significant association between knowledge of antenatal
mothers with selected demographic variables like religion, education of the
mother, occupation of the mother, education of the husband, occupation of the
husband, family monthly income, type of family, no of family members, gravida,
no of children and dietary pattern.
KEY WORDS: nutritional anemia, knowledge level,
antenatal mothers, demographic variables, self instructional module.
INTRODUCTION:
There is a
saying “be good to your baby before it
is born”. Pregnancy is truly an amazing and glorious time in a
women’s life. There is nothing more amazing than creating a brand new
life[1]. Pregnancy is a prominent event in a woman’s life, able to
transform her life forever. Pregnancy is a physiological state, which
produces several normal and expected changes, in all the maternal organ
systems. The nutrient demands of the embryo or the foetus developing in
the uterus must be met in addition to those for maintenance of the adult
women; this calls for quality nutrition both before and during pregnancy.
The future health of the developing child depends to a larger extent on the nutritional
foundation established in prenatal life. The selection of a diet to meet the
needs of pregnancy requires careful choices of food and is not particularly
complicated[2].
The pregnant
women constitute the most vulnerable segment of a population from the
nutritional standpoint; in particular the condition of pregnant women belonging
to low income group is a matter of serious concern. These groups are the most
deprived, down trodden, illiterate, neglected and weakest group of the
population. All these factors influence the dietary intake of the pregnant
women belonging to the low income group, which in turn affects their
nutritional status.
Anemia is one
of the world’s most widespread health problems. It affects more than 2 billion
people worldwide – one third of the world’s population [3][16]. It is a
significant public health problem and responsible for 20% of maternal death
throughout the developing world[4]. In almost all developing countries, between
one third and one-half of the female and child populations are anemic[16].
Prevalence among pregnant women and children under 2 years of age (the groups at
highest risk) is typically more than 50 percent. In a 2002 report, the World
Health Organization lists iron deficiency, a major cause of anemia, as one of
the top 10 risk factors in developing countries for “lost years of healthy
life”[3][15]. Anaemia is one of the most widespread nutritional deficiency
diseases. It affects all age groups and both sexes in most states of India.
Profoundly affected groups are adolescent girls (74% to 98%), pregnant women
(82% to 98%) and women in childbearing age (74% to 99%)[5].
Anemia is the
decreased ability of the red blood cells to provide adequate oxygen to the body
tissues. According to WHO, hemoglobin level below 11gm/dl in pregnant women
constitute anemia and hemoglobin below 7gm/dl is severe anemia.[6] Worldwide,
approximately 50% of pregnant women are anemic. More than 350 million women
around the world suffer from nutritional anemia. Among these, the highest
prevalence of anemia is found in South Asia[6]. Nutrition is a basic human need
and a prerequisite to a healthy life. A proper diet is essential from the very
early stages of life for proper growth, development and to remain active[7].
Nutritional anemia describes a condition in which the hemoglobin or red blood
cell content of the blood is lower than normal because of too little iron. It
is the most common anemia in South Asia. The causes of iron deficiency
includes, too little iron in the diet, poor absorption of iron by the body and
loss of blood (including heavy menstrual bleeding and gastro intestinal tract
ulcers) and parasite infestations[6]. The strategies to prevent nutritional
anemia aim at improving diet, increasing biodiversity of dietary iron,
prevention and treatment of infections like hookworm and malaria and iron folic
acid supplementation. Food fortification and genetic modification of food are
some of the other strategies being evaluated[8]. The United Nations’ goal of
reducing by one third the prevalence of anemia by 2010 is unlikely to be met.
Nutritional anemia remains common in many countries of the world and its
eradication through effective interventions must be a priority for attention
and action[9].
NEED FOR THE STUDY:
Malnutrition is
intergenerational. That is, the nutritional status of a mother has an effect on
that of her children and even grand children. In order to improve the
nutrition, people at all stages of life must be able to have better access to
food, health and care. Women and girls are more affected by malnutrition during
the life cycle and from one generation to the next, because of reproduction
babies. There for a good start in life for a anew baby is depend upon the
health and nutrition of his or her mother[6].
Anaemia is the
world’s second leading cause of disability and thus one of the most serious
global public health problems. In India, it affects over half of pre-school
children and pregnant women10. The nutritional status of Kerala is also not
different. Very recently Deshabhimani daily reported that, 99% of nursing
mothers and antenatal mothers in Attappady were anemic[11]. The Hindu daily
reported that, the health indicators of Attappady remain lower than those of
the State and the nation. The maternal mortality rate is seven per 1,000,
compared with the State figure of 1.3[12][20]. Most anemia during pregnancy results
from an increased need for iron. It is estimated that women will need
approximately 50% more iron during pregnancy; increasing from 18 to 27
milligrams (mg) per day. A mother and baby need more iron for a few different
reasons. As the mother’s body grows, the amount of blood in her body also
grows, especially in the last three months of pregnancy. During this time she
will have as much as 50% more blood in her body. To produce more red blood
cells, the mother’s body will need additional iron to make hemoglobin, the part
of the red blood cell that carries oxygen[13]. Also, the growing baby takes all
the iron it needs from mom, regardless of how much she has available in her
system. Towards the end of pregnancy the baby will be storing iron for his or her
first six months of life. Because of these changes and other changes like
these, some women may develop anemia during their pregnancy[13]. The
consequences of anemia during pregnancy extend beyond simply feeling tired and
weak. Pregnant women who are anemic have an increased risk for problems when
their baby is born, particularly if they are anemic in the first
trimester[11][13]. Deshabhimani daily reported that, the root cause for the
death of tribal children in Attappady of Palakkad district is due to the
maternal malnutrition during their antenatal period12. Additionally, current
research shows that babies born to mothers suffering from anemia may not be
able to store enough iron before birth, are more likely to be born prematurely,
and have lower birth weights. This lack of stored iron may continue well into
the baby’s first year of life[13].
Unfortunately,
many women start pregnancy without sufficient stored iron to meet their body's
increased demands[14]. Women who start their pregnancy with low stored iron are
more likely to become anemic during the course of the pregnancy. All women of
childbearing age regularly lose blood during menstruation. If their diet does
not contain enough iron to replace what is lost every month, their stored iron
becomes depleted. As pregnancy exhausts the already depleted iron, the mother
no longer has enough iron to make the hemoglobin she needs, and she becomes
anemic. Because so many women do have low stored iron, it is has become
standard practice to be evaluated for anemia at your first prenatal
appointment[13].
During
pregnancy, it is extremely important to eat a well-balanced meal. Even then it
is difficult to get the recommend 27mg of iron a day since even nutritious
diets only provide about 12-14mg of iron. In order to avoid iron deficiency, it
is often necessary for pregnant women to take iron supplements. The Centers for
Disease Control and Prevention (CDC) recommends that all pregnant women take a
daily supplement of 30mg of elemental iron as a preventive dose[13][14]. The
investigator during her clinical experience in the antenatal mothers with
complaints of tiredness, giddiness, fatigue general malaise, inability to work
efficiently, most of them were diagnosed to be Anaemia[13]. The investigator
discussed these problems with the nurses in charge of the clinic and the area,
they expressed that though they were distributing iron and folic acid tablets
to mothers they were not taking the supplement to the whole course and
discontinuing and also not taking the diet which is rich in iron and folic
acid. The pregnant mother and the family are opened to teaching and interested
in improving their life style behaviour too maximizes the health of women and
the foetus. As per the significance, anaemia is the most frequent maternal
complications during pregnancy. Adequate teaching on anemia can be provided
when the patient visits antenatal OPD and / or is admitted in the maternity
ward by nursing staff specialized in obstetrics nursing or midwife with the
help of health education and counseling seminar by using videos, CDs
questionnaire, informative booklets etc. So the researcher felt that antenatal
care should be concerned with early detection and management of nutritional
anaemia.
OBJECTIVES:
·
To
assess the existing level of knowledge of antenatal mothers regarding
prevention of nutritional anaemia.
·
To
associate the level of knowledge of antenatal mothers regarding prevention of
nutritional anaemia with selected demographic variables.
·
To develop a self instructional module on prevention of
nutritional anaemia.
RESEARCH HYPOTHESES:
The study
assumes that:
·
Antenatal
mothers may have less knowledge regarding prevention of nutritional anaemia.
·
There
may be significant association between the knowledge of antenatal mothers regarding
prevention of nutritional anaemia with their selected demographic variables.
A conceptual
frame work is a set of highly abstract, related constructs that broadly
explains phenomena of interest, expresses assumptions, and reflects a
philosophical stance14.The conceptual frame work for the present study was
developed by using the concepts from Modified Rosenstoch’s (1947) and Becker
and Maiman’s (1975) Health Belief Model. In the current study the investigator
has aimed to assess the knowledge of antenatal mothers on prevention of
nutritional anemia. Health belief model provides a way of understanding and
predicting how clients will behave in relation to their health and how they
will comply with health care therapies[17]. The model proposes that clients are
more likely to engage in health behaviours if they have high perceived threats,
high benefits from engaging in the related preventive action, and low cost[18].
The model comprises of three primary components, including individual
perceptions, modifying factors, factors affecting the likelihood of initiating
or engaging in action.
Individual Perceptions Include:
·
Perceived Susceptibility:
it is the
knowledge which the individual possess due to some life experience or exposure
to various life events. In the present study it is the antenatal mother’s
estimated probability of encountering a specific health problem during
pregnancy.
·
Perceived Seriousness:
The existing
knowledge regarding the complications of disease conditions. In the present
study it is the degree of concern on experiences created by the thought of
complications occurs during pregnancy.
·
Perceived Threat:
it is the
combined impact of perceived susceptibility and perceived seriousness. In the
present study the perceived threat of antenatal mothers regarding nutritional
anemia was assessed by using structured questionnaire on nutritional anemia
during pregnancy[19].
Modifying Factors Includes:
·
It
includes a variety of selected demographic variables, socio- psychological and
structural factors that predispose to the above factors, i.e. age of the
mother, religion, education of mother, occupation of mother[19].
Cues to Action:
·
It is
the factor that purports to trigger health action. In this study, cues to the
action are the source information related to prevention of nutritional anemia
during pregnancy. It is the self instructional module on prevention of
nutritional anemia during pregnancy given to the subjects by the researcher.
Likelihood of Action:
·
It is
the positive difference between perceived benefits and perceived barriers.
Perceived Benefits:
·
In
this study the researcher belief that the antenatal mothers get adequate
knowledge regarding prevention of nutritional anemia during pregnancy with the
help of self instructional module.
Perceived Barriers:
·
It is
the hindrance in engaging in actions which includes poor knowledge regarding
prevention of nutritional anemia during pregnancy.
Likelihood of Taking Recommended Action:
·
In
the present study the researcher belief that the subjects are ready to take the
likelihood of recommended action by notifying the mother’s significant interest
in clarifying doubts after receiving the self instructional module on
prevention of nutritional anemia during pregnancy.
·
In
the present study it is conceptualized that antenatal mothers who consulted in
Aswini Hospital, Thrissur have less knowledge on prevention of nutritional
anemia during pregnancy. To assess the knowledge of antenatal mothers on
prevention of nutritional anemia during pregnancy, a conceptual frame work was
formulated based on Health Belief Model[19].
SAMPLE:
In this study,
non-probability purposive sampling technique was used. Purposive sampling is
more commonly known as judgemental or authoritative sampling, in which the
subjects are chosen to be part of sample with specific purpose in mind. In this
sampling technique, samples were chosen by choice not by chance, through a
judgement made the researcher based on her knowledge about the population.
Sampling Criteria:
Inclusion criteria for sampling:
·
Antenatal
mothers who are available at the time of study
·
Antenatal
mothers who are willing to participate in the study
·
Antenatal mothers who are able to read and understand Malayalam
Exclusion criteria for Sampling:
·
Clients
who are not willing to participate in the study
·
Antenatal mothers who are not able to read and understand
Malayalam
TOOL DESCRIPTION:
The following
steps were taken for the selection of items and development of tool.
Preparation
of Draft:
The first draft
was developed after an extensive review of literature and in consultation with
medical and nursing experts in the field of obstetrics and gynaecology. It
consists of four sections, section A, section B and section C.
Section A:
Description of
demographic profile of the antenatal mothers
Section B:
Description of
structured knowledge questionnaire on prevention of nutritional anemia.
Section C:
Description of
self instructional module on prevention of nutritional anemia.
Section A:
Description of Demographic Profile of the Antenatal Mothers:
Section A
consist of structured questionnaire to assess the base line data of the
antenatal mother and the profile includes, age in years, religion, education of
the mother, occupation of the mother, education of the husband, occupation of
the husband, family monthly income, type of family, no of family members,
gravida, no of children, dietary pattern, source of information and family
support system.
Section B:
Structured Knowledge Questionnaire on Prevention of Nutritional Anemia:
Section B
consists of 30 questions to assess the knowledge of antenatal mothers on
prevention of nutritional anemia. The questions are related to diet during
pregnancy, anemia, causes of anemia, diagnosis of anemia, prevention of
nutritional anemia during pregnancy, treatment of anemia and complications of
nutritional anemia. There were 30 multiple choice questions for that only one
correct answer. Every correct answer was accorded a score of 1 point and every
incorrect/ unanswered one was accorded zero. The maximum score of knowledge
questionnaire was 30 and minimum score was zero.
Scoring key
|
Scores
|
Category
|
|
0 - 10
|
Inadequate knowledge
|
|
11 - 20
|
Moderate knowledge
|
|
21 -30
|
Adequate knowledge
|
Section C: Self Instructional
Module on Prevention of Nutritional Anemia:
The self
instructional module was prepared based on extensive review of literature, in
consultation with experts and seeking suggestions from the guide. The SIM
consist of information regarding importance of diet during pregnancy, causes,
classification, symptoms and diagnosis of anemia, prevention of nutritional
anemia (sources and functions of essential nutrients, iron rich food stuffs,
proper cooking practices and other preventive measures), treatment of anemia
and consequences of nutritional anemia.
Data Collection
Process:
A systemic
collection and analysis of data are most vital to the research17. To conduct
the research study in Aswini Hospital, Thrissur, a formal written permission
was obtained from the hospital authority prior to the data collection. The
investigator conducted the main study in the month of January for a period of 4
weeks. The sample of 100 antenatal mothers who met with the inclusion criteria
was selected by using purposive sampling method. After the self introduction,
the researcher explained the purpose of the study and developed a rapport with
the samples. The investigator reassured the samples that the collected data
would be kept confidential and obtained a written informed consent from the
subjects prior to the study. The researcher administered the structured
questionnaires to the samples and they were taken 20-30 minutes for completion.
Followed by, the investigator provided the self instructional module to each
subjects. The subjects were comfortable and cooperated well during the course
of study. The researcher expressed her gratitude to the mothers for their
co-operation.
|
TARGET
GROUP
|
Personal
variables
|
Preparation
of tool
|
IMPLEMENTATION
OF TOOL
|
Evaluation
|
|
|
|
|
|
|
|
|
|
·
Assessed
the knowledge of antenatal mothers
·
Administered
self instructional module
|
ANALYSIS AND INTERPRETATION OF DATA
|
|
|
POPULATION
antenatal mothers
|
Demographic variables
·
Age
·
Religion
·
Education
·
Occupation
·
Education
of husband
·
Occupation
of husband
·
Monthly
income of family
·
Family
type
·
No.
of family members
·
Gravid
·
No.
of children
·
Dietry
preference
·
Source
of information
·
Family
support
|
·
Knowledge
questionnaire
·
Self
instructional module on prevention of nutritional anaemia
|
|
|
|
|
|
|
|
|
SAMPLES
100 mothers
|
ANALYSIS OF KNOWLEDGE
|
|
|
|
|
|
|
|
|
RESULT
·
Association
between knowledge of antenatal mothers with selected demographic variables
such as age in years and source of information
|
|
|
SETTING
Aswini Hospital
|
|
|
|
|
|
|
SAMPLING TECHNIQUE
Non probability purposive sampling
|
|
|
·
Draft
preparation
·
Content
validity
·
Translation
·
Administrative
permission
·
Pretesting
·
Reliability
·
Pilot
study
|
|
Fig. 1 Schematic representation of
research design
RESULTS:
The collected
information was organized and presented under 3 sections:-
PART I:
Distribution of
demographic variables of antenatal mothers.
PART II:
Knowledge of
antenatal mothers regarding prevention of nutritional anemia.
Section A:
Assessment of
the level of knowledge of antenatal mothers
Section B:
Area wise mean,
SD and percentage of knowledge scores.
PART III:
Association of
knowledge of antenatal mothers with selected demographic variables.
PART I:
Distribution of demographic variables of antenatal mothers.
Fig 2 showing percentage distributions of mothers by age in years
Fig 3: Shows percentage distribution of mothers by number of
children
Fig 4. Show percentage distribution of mothers by dietary
preference
PART II:
Knowledge of antenatal mothers regarding prevention of nutritional anemia.
Section A:
Assessment of the level of knowledge of antenatal mothers regarding prevention
of nutritional anemia.
Table 1 Distribution of knowledge scores of antenatal mothers on
prevention of nutritional anemia n=100
|
Variables
|
Frequency (N)
|
Percent %
|
|
Inadequate (0-10)
|
21
|
21.0
|
|
Moderate (11-20)
|
71
|
71.0
|
|
Adequate (21-30)
|
8
|
8.0
|
Table 1
displays the level of knowledge of antenatal mothers regarding prevention of
nutritional anemia. Among 100 samples, 21(21%) were having inadequate
knowledge, 71(71%) were having moderate knowledge and 8(8%) were having
adequate knowledge.
Fig 5. Show percentage distribution of level of knowledge of
mothers
Section B: Area wise mean, SD and percentage of
knowledge scores of antenatal mothers
Table 2 Area wise mean, SD and percentage of knowledge scores of
antenatal mothers
|
Dimensions
|
No. of
statements
|
Mean
|
SD
|
Percentage
Score (%)
|
|
Diet during pregnancy
|
4
|
1.94
|
0.952
|
48.5
|
|
Anemia
|
2
|
0.91
|
0.653
|
45.5
|
|
Causes of anemia
|
6
|
2.34
|
1.165
|
39.0
|
|
Diagnosis of anemia
|
3
|
1.62
|
0.862
|
54.0
|
|
Prevention of nutritional anemia
|
10
|
5.58
|
1.913
|
55.8
|
|
Treatment of anemia
|
4
|
2.02
|
0.985
|
50.5
|
|
Complication of anemia
|
1
|
0.61
|
0.49
|
61.0
|
|
Overall knowledge
|
30
|
15.02
|
3.646
|
50.1
|
Table 2 displays the area wise mean, SD and
percentage of knowledge scores. In the area of diet during pregnancy, it
reveals that mean percentage score was 48.5% with total mean and SD 1.94 +
0.952. In the area of anemia, it shows that mean percentage score was 45.5 with
total mean and SD 0.91+ 0.653. In the area of causes of anemia, the mean
percentage score was 39.0 with total mean and SD 2.34 + 1.165. In the area of
diagnosis of anemia, it reveals that the mean percentage score was 54.0 with
total mean and SD 1.62+ .862. In the area of prevention of nutritional anemia,
the mean percentage score was 55.8 with total mean and SD5.58+ 1.913. In the
area of treatment of anemia, the mean percentage score was 50.5 with total mean
and SD 2.02+ 0.985. In the area of complication of anemia, the mean percentage
score was 61.0 with total mean and SD 0.61+ 0.41. In total the table reveals
that, the mean percentage score was 50.1with total mean and SD 15.02+ 3.646.
Fig 6. Show percentage
score of each dimensions of the knowledge
PART III:
Association of knowledge of antenatal mothers with selected demographic variables
Table 3 Association of knowledge of antenatal mothers with
selected demographic variables
|
Demographic variables
|
χ
|
df
|
Table value
|
|
Age in years
|
14.676*
|
6
|
12.6
|
|
Religion
|
5.541ns
|
3
|
7.81
|
|
Education of Mother
|
7.277 ns
|
6
|
12.6
|
|
Occupation of Mother
|
7.789 ns
|
6
|
12.6
|
|
Education of Husband
|
5.346 ns
|
6
|
12.6
|
|
Occupation of Husband
|
1.778 ns
|
4
|
12.6
|
|
Family income
|
4.870 ns
|
4
|
12.6
|
|
Family type
|
0.778 ns
|
2
|
5.99
|
|
Number of family members
|
3.591 ns
|
6
|
12.6
|
|
Gravida
|
0.441 ns
|
2
|
5.99
|
|
No. of children
|
0.441 ns
|
2
|
5.99
|
|
Dietary pattern
|
0.542 ns
|
2
|
5.99
|
|
Source of information
|
13.219*
|
6
|
12.6
|
Table 3
discloses the association of knowledge of antenatal mothers with selected
demographic variables like age in years, religion, education of the mother,
occupation of the mother, education of the husband, occupation of the husband,
family monthly income, type of family, no of family members, gravida, no of
children, dietary pattern and source of information. The association is statistically tested by chi
square. It indicated that chi square value computed between the knowledge
scores and religion (c2=5.541), education of the mother (c(chi) 2=7.277),
occupation of the mother (c2=7.789), education of the husband (c2=5.346),
occupation of the husband (c2=1.778), family monthly income (c2=4.870), type of
family (c2=0.778), no of family members (c2=3.591), gravida (c2=0.441), no of
children (c2=0.441) and dietary pattern (c2=0.542) were found to be
statistically highly significant at 0.05 level of significance and age in years
(c2=14.676) and source of information (c2=13.219) was found statistically no
significant at 0.05 level of significance.
CONCLUSION:
In the present
study, the researcher investigated the knowledge of antenatal mothers on
prevention of nutritional anemia and the association of knowledge with selected
demographic variables. The researcher found that, the antenatal mothers have
inadequate knowledge on prevention of nutritional anemia and there is a
significant association between the knowledge levels of antenatal mothers with
selected demographic variables like age in years and source of information.
However, the distribution of self instructional module will help the antenatal
mothers to prevent nutritional anemia and further complications. Keeping in
view the findings of the present study, the following recommendations were
made.
1. The similar
study can be conducted on a large scale.
2. A study can
be conducted to find out the effectiveness of SIM on knowledge.
3. The similar
study can be done by including domains like practice.
4. A similar
study can be conducted using other strategies like planned teaching programme,
video assisted teaching etc.
REFERENCES:
1.
Tietje K. 10 Reasons Why Pregnancy is Beautiful (internet).
(Cited on 2011June 8th). Available from: http://www.babble.com/pregnancy/10-reasonswhy-
pregnancy-is-beautiful/.
2.
Vijayalaxmi A.H.M, Kadapatti M. A comparative study on
nutritional status of selected pregnant women. Indian streams research journal
vol - I , issue – VII. 2011 August. Available from: http://www.google.co.in/#sclient=psyabandq=Indian+streems+research+journal+Vol++I+%2C+issue+VII+andoq=7oandpbx=1andbav=on.2,or.r_qf.andfp=52494d996f4f7df8andbiw=1366andbih=678
3.
United Nations system standing committee on nutrition.
Anemia Prevention and Control: What Works Part 1 (internet). June 2003 (cited
on 2003).Available from:
worldbank.org/NUTRITION/Resources/281846-1090335399908/Anemia_Part1.pdf.
4.
Dutta D C. Text book of obstetrics including perinatology
and contraception.7th ed. Kolkata: new central book agency (P) Ltd; 2011
5.
Kaur M, K. Effect of health education on Knowledge,
attitude and practice about anemia among rural women in Chandigarh. Ind Medica
(internet).vol. 26,no. 3. 2001=07 – 2001-09. Available from:
http://www.indmedica.com/journals.php?journalid=7andissueid=45andarticleid=554andaction=article.
6.
UNICEF. Prevention and control of nutritional anemia: a
south asian priority (internet). 2002. Available from:
http://www.unicef.org/rosa/Anaemin.pdf.
7.
National institute of nutrition. Hydrabad. Dietary guidelines
for Indians (internet). 2011. Available
from:http://www.ninindia.org/DietaryguidelinesforIndians-Finaldraft.pdf.
8.
Trivedi SS, Puri M. Anemia in pregnancy. 1st ed. New Delhi:
Jaypee Brothers Medical Publishers (P) Ltd; 2008.
9.
Badham J. The Guidebook Nutritional Anemia (internet).
Johannesburg, South Africa: Sight and life press; 2007. Available
from:http://www.sightandlife.org/fileadmin/data/Books/nutritional_anemia_guidebook_e.pdf.
10. WHO. Anemia
prevention and control (internet). (Cited on 2013). Available from:
http://www.who.int/medical_devices/initiatives/anaemia_control/en/.
11. Attappadiyilethu Vamshahathya:
Medical Sangham. The Deshabhimani Daily 2013 May 22.
12. Prabhakaran G.
Malnutrition deaths dent Kerala’s HDI claims. The Hindu Daily. Palakkad ed.
2013 April 18
13. Anemia.org. Women
and Anemia: Increased Need for Iron during Pregnancy (internet). (Cited on 2008
September 19). Available
from:http://www.anemia.org/patients/feature-articles/content.php?contentid=000245.
14. http://www.babycenter.com/0_iron-deficiency-anemia-in-pregnancy_3073.bc
15. http://documents.worldbank.org/curated/en/2003/06/12665152/anemia-prevention-control-works-vol-1-2-part-one-program-guidance
16. http://www.slideshare.net/sagunpaudel/introduction-16582207
17. http://quizlet.com/2678203/nursing-110-test-2-flash-cards/
18. Kozier B,Erb G,
Berman A, Synder S. Fundamentals of nursing: concept, process and practice. 7th
ed. New Delhi: Pearson; 2004.
19. Burke E. Health
belief model [Internet]. Available from:
www.personal.psu.edu/eab5160/blogs/the-professional_e-portfolio-of-evenburkel/the%20Health%20Belief%20Model.pdf.
20. http://www.thehindu.com/todays-paper/tp-national/malnutrition-deaths-dent-keralas-hdi-claims/article4628487.ece