INTRODUCTION:

Neonates or new-born are the most delicate group among kids as they are not able to express their feelings of happiness, sad, pain or discomfort and their systems are immature, just starting to adjust to the extra uterine life. It is very difficult to see a new-borns crying when he or she is sick. They are the heart and the soul of their parents, a precious gift to them after a long expectation of nine months. Being a mother for the first time is a wonderful and exciting feeling for any women in her life. Once she comes to know that she is going to be a mother, she starts preparing for motherhood and waits patiently and expectantly for her baby.¹

Mother plays an important role in identifying minor developmental deviations and early evidence of the disease process because she is constantly and closely watching her baby. The most common minor problems occur in new-borns are vomiting, constipation, diarrhea breath holding spells, cradle crap, physiological jaundice, hiccups, napkin rash, abdominal colic, oral thrush, erythematoxicum (new-born rash), milia, Epstein pearl, neonatal acne, neonatal conjunctivitis etc.²World health organization (WHO) estimates that more than nine million infants die before birth or in the first few weeks of life each year and that nearly all of these deaths occur in developing countries. Irrespective of various developments, the situation relating to neonatal health remains a major concern and a daunting challenge. Neonatal infections and the minor problems is one of the major leading causes of death during the neonatal period. It can contribute up to 13-15% of all deaths during the neonatal period with the mortality rate reaching as high as 50% for infants who are not treated timely. One of the aims of the Infant and Neonatal Health (INH) team within the WHO Department of Child and Adolescent Health and Development (CAH) is to reduce infant mortality and to ensure that new-born have the opportunity for a healthy start in life³. For infants touching occurs during the physical care given by the parents or mother .this touch will heal ailments from a skinned knee to bruises by holding and loving them³. Maternal knowledge on care and practice to prevent the problems place a vital role⁴.

NEED FOR THE STUDY:

Three major causes that contribute to about 60 percent of all deaths in the new-born period is pre-maturity and low birth weight, birth asphyxia and infections, Inappropriate practices such as delayed initiation of breastfeeding, delayed clothing and early bathing, not seeking care when new-borns are sick and applying harmful material on cord-stump increase the risk of new-born deaths. Diarrhoea is a fifth deadly disease in India among the new-borns, despite the availability of easily implementable interventions and existence of National Guidelines for management at the community level. As per the NRHM scheme IMR has reduced from 58/1000 live births in year 2005 to 47/1000live births in year 2010.With current rate of decline, by 2012 IMR would be 44/1000 live births instead of the expected target of 30/1000live births. Each year over 26 million babies are born in India accounting for 50 births per minute, in that 1.2 million neonate die per year representing almost three deaths per minute .Neonatal deaths now account for up to two thirds of all infant deaths in developing countries. High neonatal mortality rate one of the most sensitive indicators of the health status of the population.⁵

The minor disorders are most common in newborn, neglecting the minor health problem is the one of the factor contributing to the high neonatal mortality rate. A major reason for the high mortality rate is lack of care at birth. In India most the mothers are not aware of minor disorders of newborns. There is a famous proverb “Prevention is better than cure” so researcher felt it is better to educate the postnatal mothers by using PTP ,before they face the minor ailments in their newborns .Hence it will reduce the morbidity and mortality rate, and promote good health in the newborns⁶.

STATEMENT OF THE PROBLEM:

A study to assess to the effectiveness of planned teaching program on knowledge regarding common minor neonatal problems and its management among postnatal mothers in SS Hospital, Davangere, Karnataka

OBJECTIVES OF THE STUDY:

1) To assess the pretest knowledge score regarding common minor neonatal problems and its management among the post natal mothers.

2) To evaluate the effectiveness of planned teaching programme regarding common minor neonatal problems and its management among postnatal mothers in terms of posttest knowledge score.

3) To find out the association between posttest knowledge score regarding common minor neonatal problems among post natal mothers with their selected socio demographic Variables.

OPERATIONAL DEFINITIONS:

Assess: -

It is organized, systemic and continues process of collecting data from postnatal mothers on management of common minor neonatal problems among postnatal mothers.

Effectiveness:

In this study, effectiveness refers to the extent to which the planned teaching programme has achieved its desired effect that represents the gain in post-test knowledge scoresof postnatal mothers regarding common minor neonatal problems in new-borns.

Planned teaching programme:

It is a consistent, well planned, and informative teaching program on meaning, causes, clinical features, management and prevention of common minor neonatal problems.

Management:

It refers to measure taken to cure and treat common minor neonatal problems.

Common minor neonatal problems:

It refers to the minor problems that occur in the first 28 days of life such as vomiting, constipation, diarrhoea ,breath holding spells, cradle crap, physiological jaundice, hiccups ,napkin rash ,abdominal colic, oral thrush, erythema toxicum (new-born rash), milia, Epstein pearl, neonatal acne, neonatal conjunctivitis.

Newborns:

The live babies who are within 28 days of life and whose mothers are admitted in S.S Hospital, Davangere.

Postnatal mothers:

It refers to women who had given birth to live baby irrespective of parity, mode of delivery and who are admitted at S.S Hospital Davangere.

Assumptions:

It is assumed that:

1. The level of knowledge among postnatal mothers differs from individual to individual

2. The postnatal mothers may have less knowledge regarding common minor neonatal problems and its management.

3. Planned teaching programme will help to improve the knowledge of postnatal mothers regarding common minor neonatal problems and its management.

Delimitation:

The study is delimited to the postnatal mothers admitted in SS hospital, Davangere, Karnataka

RESEARCH METHODOLOGY:

Research Approach:

An Experimental approach was adopted in this study.

Research Design:

A pre – experimental one group pre-test post test research design was adopted to carry out the present study.

Research Setting:

The setting selected for the present study was postnatal mothers admitted in S.S hospital, Davangere, Karnataka

Research Variable:

Knowledge regarding common minor neonatal problems

Population:

In the present study population comprises of postnatal mothers admitted in S.S hospital, Davangere, Karnataka

Sample and Sample Size:

The sample chosen for the present study were postnatal mothers and the sample size considered for the study was 30 postnatal mothers

Sampling Technique:

The sampling technique used for the study was purposive sampling which is a type of non-probability sampling.

Description of Tool:

A structured knowledge questionnaire on common minor neonatal problems for postnatal mothers admitted in S.S hospital, Davangere, Karnataka

Description of the Tool

The tool consist of that questionnaire that consist of parts

Part -1 It consist of socio –demographic data of the subjects.

Part – 2

Section (a) it consists of 23 multiple choice questions in question about knowledge regarding of postnatal mothers regarding management on common minor neonatal problems and its management

Section (b) consists of Yes or No questions to assess the knowledge of postnatal mothers regarding common minor neonatal problems and its management.

Method used for data collection:

Step I: The group obtained permission from respective authority and institute to conduct the study.

Step II: Formal permission obtained by S.S Hospital Davangere.

Step III: The group introduced them self to the subjects.

Step IV: The group selected the subjects for the study.

Step V: The group distributed the research material (Pre test Questionnaires).

Step VI: Planned teaching programme was administered to the group through power point presentation

Step VII: Post test questionnaire was administered to the same samples

Step VIII: Data was tabulated and analyzed by using descriptive and inferential statistics.

a. Organizing of data on a master sheet.

b. Tabulation of data in terms of frequencies, percentage, mean, median, mode, standard deviation and range.

c. Classify the knowledge scores as follows:

· Good score: 20-30

· Average score: 10-19

· Poor score: 0-9

RESULTS:

The major findings of the study were as follows:

1. Findings related to social demographic variables of postnatal mothers.

· Most of the mothers i.e. 12 (40 %) were in the age group of 18-23 years.

· Most of the mothers i.e. 24 (80%) belongs to Hindu religion

· Many of them i.e.21 (70%) have completed their education up to pre university

· Highest percentage of them, 17 (56.7%) were home maker.

· Many of them i.e.14 (46.7%) having monthly income less than 5000.

· Most of the mothers having 1or 2 children i.e. 46.7%

1. Findings related to the pre test knowledge level of postnatal mothers :

The majority of the postnatal mothers had average pretest knowledge scores that is 29 (99%) and average knowledge and 1(1%) had poor knowledge regarding common minor neonatal problems and its management.

2. Findings related effectiveness of PTP regarding common minor neonatal problems and its management among postnatal mothers

The mean knowledge scores in pre-test were 1.32 and SD was 0.469 and in post-test mean was 1.52 and SD was 0.499. So, it is evident that mean post-test knowledge score of primi mothers were significantly greater than their mean pre-test knowledge score. t’ _{1199}= 10.572 at P < .005 level of significance. This shows that STP on common minor neonatal problem and its management has enhanced knowledge on common minor neonatal problems Hence Hypothesis H₁ is proved.

3. Findings related to association of post test knowledge score regarding common minor neonatal problems with selected socio demographic variables.

· Calculated ‘p’ value is 0.105 which is greater than 0.05 hence there is no association between level of knowledge and age of mother.

· Calculated ‘p’ value is 0.406 which is greater than 0.05 hence there is no association between level of knowledge and religion

· Calculated ‘p’ value is 0.0008 which is less than 0.05 hence there is association between level of knowledge and educational status of mother. Hence H2 was accepted in this condition

· Calculated ‘p’ value is 0.123 which is greater than 0.05 hence there is no association between level of knowledge and educational status of husband

· Calculated ‘p’ value is 0.103 which is greater than 0.05 hence there is no association between level of knowledge and occupation of mother

· Calculated ‘p’ value is 0.046 which is less than 0.05 hence there is association between level of knowledge and occupation of husband. H2 was accepted in this condition

· Calculated ‘p’ value is 0.160 which is greater than 0.05 hence there is no association between level of knowledge and family income.

· Calculated ‘p’ value is 0.569 which is greater than 0.05 hence there is no association between level of knowledge and Number of children.

· Calculated ‘p’ value is 1.22 which is greater than 0.05 hence there is no association between level of knowledge and type of family

· Calculated ‘p’ value is 0.185 which is greater than 0.05 hence there is no association between level of knowledge and source of income

Graph 1: The bar graph diagram represents frequency and percentage distribution of subjects according to age in years

Graph 2: The cone diagram represents frequency and percentage distribution of subjects according to religion

Graph 3: The Bar diagram diagram represents frequency and percentage distribution of subjects according to mothers education

GRAPH 4: Pie diagram showing frequency and percentage distribution of knowledge of the subjects regarding Husband education.

GRAPH 5: Bar diagram showing frequency and percentage distribution of knowledge of the subjects regarding Source of Information

Graph 6: Pie diagram showing distribution of samples based on their pretest knowledge scores on common minor neonatal problems and its management.

INTERPRETATION AND CONCLUSION:

Based on the findings of the study, the following conclusions have drawn.

1. Over all the knowledge of postnatal mothers regarding common minor neonatal problems was average.

2. The significant improvement in the postnatal mothers level of knowledge regarding common minor neonatal problems after PTP. Thus the study concluded that PTP was an effective method of teaching the postnatal mothers to improve the knowledge regarding common minor neonatal problems and its management.

3. There was a significant association found between post test knowledge with the selected socio demographic variables like educational status of mother, occupational status of husband.

4. There was no significant association found between post test knowledge with the selected socio demographic variables like age of mother, religion, educational status of husband, occupation of mother, family income, number of children, type of family, source of information.

IMPLICATION:

The findings of the study have implications in the field of nursing education, nursing practice, nursing administration, and nursing research.

Nursing Education:

Education is the key component in improving the knowledge of nurses and to keep pace with the advancing medical field. Before clients undergo any diagnostic or therapeutic procedure providing health teaching in any form must be emphasized in the nursing curriculum, so that nursing students will be aware of the importance of pre procedural teaching in clinical settings so as to contribute for effective patient care in hospital settings. In-service education can also be conducted to improve knowledge of health professionals regarding various aspects of neonatal problems and its management. Several studies have been conducted to the patients formally address the role of planned teaching program in disseminating information to patients. Planned teaching based information provided to the patents has shown effectiveness in improving patients' knowledge about common minor neonatal problems and its management. This was found to be effective in improving the patient’s knowledge. The planned teaching program was conducted in clinical settings including postnatal ward, and outpatient clinics. So there is good scope for introducing planned teaching program methods in the nursing curriculum so that nurses can effectively and efficiently use their skills in transmitting health information to patients based on their health information needs.

Nursing Practice:

Planned teaching program is low cost intervention that demonstrates clear short term benefits. Health care workers in developing countries can help educate individuals presenting to hospitals by giving intervention that is planed teaching program (PTP) are very effective in hospital settings to improving the knowledge of mothers. The function of nurse is to provide proper education given to the mothers regarding the common minor neonatal problems and its management.

Nursing Administration:

Patient education goes hand-in-hand with improved patient outcomes and quality of life. Educating the patient is an integral part of the nurse's role in patient care. In order to ensure the success of the patient teaching plan, the processes involved in developing a patient teaching plan should be centered around the patient and inclusive of the family. An efficient nursing administrator makes sure that patients are treated quickly and effectively without sacrificing quality of care. Anurse administrator can identify how the teaching plan will be carried out and can implement the plan according the patient's learning style and based on health status of the patient. Nurses are challenged to play the role of efficient administrators as well as practitioner. In-service education can be conducted by nursing administrators to improve knowledge of health professionals regarding common minor neonatal problems and importance of teaching programs using various methods prior to diagnostic and therapeutic procedures which can improve the patient’s knowledge regarding common minor neonatal problems.

Nursing Research:

The findings of the present study is helpful for the nursing professional to conduct further research studies and to find out various methods of care of neonates which help in improving knowledge of mothers. This helps in good growth and development of children.

RECOMMENDATION:

1. A similar study on large and wider sample for a longer period of time would be more pertinent in making broad generalization.

2. A similar study can be conducted to find out the effectiveness of PTP on common minor neonatal problems among postnatal mothers in other hospitals.

3. Similar PTP based teaching can be given to antenatal mothers before any diagnostic or therapeutic interventions.

4. A similar study can be conducted in community settings.

5. A comparative study can be conducted on use of information leaflet and video based information on common minor neonatal problems and its management.

6. A self Instructional module can be developed regarding common minor neonatal problems and administered to all mothers of antenatal, postnatal mothers and mothers attending OPD’s

REFERENCE:

1. Achar’s Text Book of Pediatric ; (2004); Third Edition; Orient Longman Publication

2. Singh Meharban “.Care of the Newborn”.6^th ed, New Delhi, Sagar Publications: 2004

3. Marlow And Redding; Text Book of Pediatric Nursing; Sixth edition, Elsevier Publication;2006

4. Santhi M D. Effectiveness of compact disc on knowledge and practice of neonatal care among primi para mothers. Nightingale Nursing Times. Jan 2009; 48-51.

5. Health for the millions “state of art of National Rural Health Mission (NRHM) July-Sept 2012 vol 38 no.3

6. O.P Ghai, Essential Pediatrics, Sixth edition; C.B.S Publication; 2005

Received on 02.12.2015 Modified on 08.12.2015

Int. J. Nur. Edu. and Research.2016; 4(2):129-135.

DOI: 10.5958/2454-2660.2016.00030.2