Quasi Experimental Study to assess the Knowledge regarding Breastfeeding among the Lactating Mothers

 

Kaur Harleen¹, Dr. Sohi Darshan², Mrs. Parveen Sultan³

¹Assistant Professor (Obstetrics and Gynaecology) Chief Khalsa Diwan International Nursing College, Amritsar.

²Professor and Principal Chief Khalsa Diwan International Nursing College, Amritsar.

³Assistant Professor, GHG College of Nursing, Rajkot

 

ABSTRACT:

INTRODUCTION: More than 1.4 million children in India die before their 1^st birthday and of them 1 million die within the 1^st month of their life. Instituting breastfeeding within the first 1 hour of birth alone can bring down this rate by 22%. Moreover if Exclusive Breastfeeding is done for first 6 months the disease specific mortality by pneumonia can be brought down by 2.5 times and that by diarrhoea by 4.6 times. Breastfeeding is an important cause of infant deaths by Neonatal Infections as Diarrhoea and Pneumonia.

AIM OF THE STUDY: To improve the knowledge of the lactating mothers regarding breastfeeding through structured teaching programme.

METHOD AND MATERIALS: Structured teaching programme on breastfeeding was delivered to the lactating mothers with the help of PPTs. Pretest and posttest knowledge was compared by applying statistical formulas.

RESULTS: The difference between pretest mean knowledge score of control and experimental group was statistically non-significant at p<0.05 level but the difference between post test knowledge score of both groups were statistically highly significant at p<0.001 level. This indicated that structured teaching programme was effective. In experimental group, family income had significant impact on the knowledge regarding breastfeeding among the lactating. In control group variables had no significant effect on knowledge.

CONCLUSION: it was concluded from the study that STP has impact in improving the knowledge regarding Breastfeeding.

 

 

INTRODUCTION :

There is evidence that long-term breastfeeding fosters a positive maternal–child bond, aids in postpartum weight loss, and provides the mother with an opportunity to reestablish healthy eating habits for her infant.¹

 

Babies who were exclusively breastfed had less acute respiratory infections, less ear infections, less thrush, fewer episodes of digestive infections, and fewer hospitalizations.² Mothers' breast milk contains vital antibodies, nutrients, vitamins and immunological factors that babies need to develop natural immunity to disease.³ the health workers and mothers should be educated regarding the importance of colostrum for feeding newborn. All mothers must be emotionally and physically prepared and motivated during pregnancy so that they do not encounter any difficulty to establish successful breastfeeding. The inverted and cracked nipples must be managed during pregnancy.⁴

 

NEED OF THE STUDY:

Adolescents who are breast fed at birth have stronger leg muscles than those who received artificial milk. Muscular leg strength was greater in those who had been breastfed for a longer period of time.⁵

 

During community and clinical posting investigator observed that few mothers were not properly breastfeeding their babies and breastfeeding was not started immediately after birth. Several misconceptions and rituals like janam ghuti, etc. were preferred above first breastmilk (colustrum), also benefits of breastfeeding were less known to local rural women. So with extensive review and personal experience the investigator felt need to give teaching on breastfeeding to enhance the knowledge of the lactating mothers regarding breastfeeding.

 

STATEMENT OF PROBLEM:

A Quasi Experimental Study to Assess the Knowledge Regarding Breastfeeding among the Lactating Mothers in Selected Rural Communities, Ludhiana.

 

OBJECTIVES:

1.        To assess the pretest knowledge score regarding breastfeeding among the lactating mothers in control and experimental group.

2.        To assess the posttest knowledge score regarding breastfeeding among the lactating mothers in control and experimental group.

3.        To compare pre and posttest knowledge score regarding breastfeeding among the lactating mothers in control and experimental group.

4.        To find out the relationship of pre and posttest knowledge score regarding breastfeeding  among the lactating mothers in control and experimental group with selected variables such as age, parity, education, family income, type of family, religion, occupation, mode of delivery  and source of information.

 

Research Hypothesis:

H₁: The post test mean knowledge score regarding breastfeeding among the lactating mothers in experimental group will be significantly higher than posttest mean knowledge score among the lactating mothers in control group as measured by self structured multiple choice questionnaire at p < 0.05 level.

 

Conceptual framework:

Conceptual framework of the present study is based on General System Theory by Ludwig Von Bertalanffy (1968). Investigator considered the lactating mothers as an open system which is affected by certain environmental factors (variables). The input mode consisted manipulation by STP and out involved improvement in knowledge regarding breastfeeding among the lactating mothers.⁶

 

METHOD AND MATERIALS:

Research Approach and Research Design:

This study was quasi experimental (non-equivalent control group pretest-posttest design) which involves manipulation and control group but lacks randomization.  The present study lacks randomization.  Attempt has been made to assess the effectiveness of structured teaching programme on breastfeeding among the lactating mothers.

 

Independent variables included in the study are age, parity, education, family income, type of family, religion, occupation, mode of delivery, source of information and structured teaching programme on breastfeeding.

 

Dependent variable is knowledge of the lactating mothers regarding breastfeeding.

 

Research Setting:

The present study was conducted on the lactating mothers in rural communities Lohatbaddi and Kalsian of district Ludhiana.

 

Population:

The population of this study consisted of lactating mothers of villages Lohatbaddi and Kalsian, tehsil Raikot, district Ludhiana.

 

Sample and Sampling Technique:

Investigator selected a sample of 60 lactating mothers, 30 for experimental group and 30 for control group by using purposive sampling technique.

 

Research Tool:

A self structured multiple choice questionnaire on breastfeeding was prepared to assess the knowledge regarding breastfeeding among the lactating mothers. The tool consisted of following three parts:

 

Part I: Demographic data:

This part consisted of 9 items for obtaining personal information about subjects.

 

Part II:

This part consisted of self structured multiple choice questionnaire. Questionnaire was divided into eight areas having 40 items regarding breastfeeding.

 

Part III:

This part consisted of structured teaching programme on breastfeeding.

 

Criterion Measure:

Each item was given 1 mark for correct answer. Maximum scores were 40 and Minimum score was 0. Criterion measurement for assessment of knowledge is as excellent (>75%), good (51-75%), average (26-50%), below average (< 25%).

 

Data Collection Procedure:

After getting formal permission from the Sarpanch of village Lohatbaddi and Kalsian of Ludhiana district. A verbal consent was taken from the lactating mothers for their participation in the study. Before starting data collection procedure, the investigator distributed the lactating mothers in two groups-Control and Experimental group. Matching of samples was done by matching all the independent variables taken for the study. Pretest was taken from control and experimental group and thereafter structured teaching was given to experimental group with the help of lesson plan and audio visual aids. The investigator spent 45 minutes to complete the teaching. On the 3rd day of teaching posttest was taken from both the groups i.e. Control and Experimental.

 

RESULTS:

Table 1. Frequency and Percentage Distribution of Pre and Post Test Mean Knowledge Score Regarding Breastfeeding Among the Lactating Mothers in Control and Experimental Group.                                                                                              N=60

Maximum Score = 40

Minimum Score = 0

 

Table 1 reveals that in control group pre and posttest mean knowledge score of 25 (83.3%) was average followed by 4 (13.3%) good, 1 (3.3%) below average and no one had excellent knowledge score. In experimental group pretest knowledge score of 27 (90%) lactating mothers was average, 2 (6.7%) below average, 1 (3.3%) had good knowledge score and none of them had excellent knowledge score. In posttest mean knowledge score of 20 (66.7%) lactating mothers was good followed by (30%) excellent, 1 (3.3%) average and none of them was below average.

 

Thus it showed that structured teaching programme had definite impact on raising the lactating mother’s knowledge regarding breastfeeding.

 

Table 2. Comparison of Pre and Post test Mean Knowledge Score regarding Breastfeeding Among the Lactating Mothers in Control and Experimental Group.                                                                                                            N=60

Maximum Score=40                                   NS =Non Significant at p<0.05 level               

Minimum Score=0                                          *** = Significant at p<0.001level

 

Table 2 depicts that there was no significant difference between pretest mean knowledge score between control and experimental group (16.80, 17.0) but the difference between posttest mean knowledge score between control and experimental group (16.60, 28.0) was highly significant at p<0.001 level.

 

Hence, research hypothesis (H₁) was accepted. Thus it was concluded that structured teaching programme had definite impact on raising the knowledge of lactating mothers regarding breastfeeding.

DISCUSSION:

The majority of lactating mothers in both control and experimental group (83.3% and 90%) had average pretest knowledge regarding breastfeeding. Kuriakose JR (2010)⁷and Malak AT, Dicle A (2007)⁸ reported similar findings that the knowledge of subjects was average in pretest. 

 

The posttest mean knowledge scores of control and experimental group were 16.60 and 28 respectively. In control group majority of lactating mothers (83.3%) had average posttest knowledge and in experimental group maximum (66.7%) lactating mothers had good and (30%) excellent posttest knowledge regarding breastfeeding which was similar to the findings of Dadhich A (2007)⁹ who found that in control group participants had average (55%) knowledge and in experimental group good (50%) and excellent (45%) knowledge in posttest. Singh G (2008)¹⁰ reported similar findings in his study for experimental group (30%) mothers had excellent, good and average posttest knowledge respectively but in control group mothers posttest knowledge was average (50%).

 

Analysis reveals that there was no significant difference in pretest mean knowledge score between control and experimental group (16.80, 17). Similar findings were shown by Sharma S, Nagar S (2006)¹¹ i.e. during pretesting mothers in both group had similar levels of knowledge on all the aspects of nutrition.

 

The findings of present study showed that posttest mean knowledge score of lactating mothers in experimental group (28.0) was higher than posttest mean knowledge score of lactating mothers in control group (16.60) hence, research hypothesis (H₁) was accepted and concluded that structured teaching programme had definite impact on raising the knowledge of lactating mothers regarding breastfeeding. Similar findings were shown by Kang JS (2008)¹² who found that the breastfeeding empowerment scores were higher in the experimental group than in the control group due to breastfeeding empowerment programme.

 

CONCLUSION:

The difference between pretest mean knowledge score of control and experimental group was statistically non-significant at p<0.05 level but the difference between post test knowledge score of both groups were statistically highly significant at p<0.001 level. This indicated that structured teaching programme was effective. In experimental group, family income had significant impact on the knowledge regarding breastfeeding among the lactating. In control group variables had no significant effect on knowledge.

 

REFERENCES:

1.        Carwell, Micaela L, Spatz, Diane L. Eating Disorders and Breastfeeding. American Journal of maternal Child Nursing 2011; 36(2):112-7.

2.        Neustaedter R. Exclusive breastfeeding protects against infections. 2011, January 29. Available from http://www.naturalnews.com/031142_breastfeeding_infections.html.

3.        Huff E A. Breastfeeding better than vaccines at preventing infection 2010, September 30. www.naturalnews.com/029899_breastfeeding_infections.html. 

4.        Singh M. Care of the newborn. 7^th ed. Sagar Publications 2010: 168.

5.        Christensen J, Kenny Janet. Nursing Process-Application of Conceptual Models. 3^rd ed. Missouri: Mosby Company1990.

6.        Kuriakose JR. Nutritional Status and Feeding Practices of Infants. The Nursing Journal of India 2010; 101(8):184-6.

7.        Malak AT, Dicle A. Assessing the efficacy of a peer education model in teaching breast self examination to university students. Asian Pacific Journal of Cancer prevention, 2007; 8(4):481-4.

8.        Dadhich A. A Quasi Experimental Study to Assess the Effectiveness of Structured Teaching Programme on Pain Measurement In Children (0-15 Years) Among Staff Nurses Working In MCH Area of Selected Hospital, Ludhiana, Punjab. Unpublished Master of Nursing Thesis, Baba Farid University of Health Sciences, 2007. 

9.        Singh G. A Quasi Experimental Study to Assess the Effectiveness of Structured Teaching Programme on Prevention and Control of Tuberculosis in Children among Mothers of Children (0-5 Years) in Selected Hospital Ludhiana, Punjab. Unpublished Master of Nursing Thesis, Baba Farid University of Health Sciences, 2008.

10.     Sharma S, Nagar S. Impact of Educational Intervention on Knowledge of Mother Regarding Childcare and Nutrition in Himachal Pradesh. Journal of social sciences 2006; 12(2):139-142.

11.     Kang JS, Choib SY,  Ryuc EJ. Effects of a breastfeeding empowerment programme on Korean breastfeeding mothers: A quasi-experimental study. International Journal of Nursing Studies 2008; 45(1):14-23.

 

 

 

 

 

Received on 14.02.2017      Modified on 29.03.2017

Accepted on 20.06.2017     © A&V Publications all right reserved