INTRODUCTION:

A neonate is a god's divine precious gift given to a mother. Hence the birth of a neonate is one of the most awe inspiring and marvellous joyful events that occur in every woman's life time. The cry of neonate is the only means of communication and brings a message that “I need care”. This also aims at keeping the newborn safe from the environmental and practical harm such as maintaining the normal body temperature.¹

Newborns are more prone to get hypothermia because of their limited ability to generate and conserve heat. Hypothermia is an essential aspect of neonatal care especially in the immediate neonatal period. So great care is necessary by cloth the baby properly and to maintain the surrounding temperature and humidity, which suits the individual infant.²

Neonatal Hypothermia has been defined by WHO as body temperature below the normal range (36.5°C – 37.5°C) and has been sub-classified into three grades: mild (36.0°C – 36 .5°C), moderate (32.0°C – 35.9°C), and severe (<32.0°C) hypothermia.³

Each year an estimated 3.6 million neonatal deaths occur, primarily due to infection, complications of preterm birth, and intra-partum related hypoxic events Infections are estimated to account for approximately one-third of the global burden of neonatal death, with estimates rising to more than half in high mortality settings⁴

Neonatal hypothermia is a major contributor to neonatal illnesses and deaths both in the developed and developing parts of the world of 150 babies aged 0 to 648 hours, 93 had hypothermia with an incidence of 62%. Mild and moderate hypothermia accounted for 47.3% and 52.7% respectively. The incidence of hypothermia was highest (72.4%) among babies aged less than 24 hours. It was also higher among out-born babies compared to in-born babies (64.4%). Preterm babies had significantly higher incidence of hypothermia (82.5%) compared with 54.5% of term babies.⁵

Caring for a newborn is one of life's biggest challenges to care for a newborn child and can be somewhat more difficult than caring for an older infant. a newborn baby's basic need is pretty clear; to be comfortable and to be fed. Hypothermia in neonate is a common problem and is associated with increased morbidity and mortality. Prevention of Hypothermia is therefore an essential aspect of neonatal care especially in the immediate neonatal period.⁶

OBJECTIVE:

· To assess the knowledge of postnatal mothers regarding prevention of neonatal hypothermia.

· To prepare and conduct planned teaching program for postnatal mothers regarding prevention of neonatal hypothermia.

· To evaluate the effectiveness of planned teaching program for postnatal mothers regarding prevention of neonatal hypothermia.

· To find out the association of pretest knowledge score and selected demographic variables.

HYPOTHESIS:

· Null Hypothesis (H0): There will be no statistically significant association between pre-test knowledge scores and selected demographic variables

· ResearchHypothesis (H1): There will be statistically significant association between pre-test knowledge scores and selected demographic variables

MATERIAL AND METHODS:

The research design selected for present study was pre-experimental one group pre-test and post-test designto assessknowledge of postnatal mothers regarding prevention of neonatal hypothermia. The present study was conducted at selected OBG Ward, SGT hospital, Gurugram. the population comprised of mothers admitted in OBG ward in SGT hospital, Gurugram.The samples in this study were 30 postnatal mothers. Non probability - convenientsampling technique is used for selecting the samples.

Sampling Criteria:

Non probability - convenientsampling technique is used for selecting the samples. Primi and multi gravida mothers admitted in postnatal ward. Who are willing to participate and present during data collection were included. While Mothers who are illiterate. Mothers of neonate those who are severely ill at the time of data collection.

DESCRIPTION OF THE TOOL:

Data collection tools and technique tools are given as under.

Section I: Items on selected baseline data include age, marital status, educational status of mother, religion, area of living, source of information, type of family.

Section II: Items assessing the knowledge of mothers:

Part-I: General questions related to neonatal hypothermia.

Part-II: Questions related to causes and sign and symptoms of neonatal hypothermia.

Part-III: Questions related to prevention and management of neonatal hypothermia.

For the 20 items on knowledge of prevention and management of neonatal hypothermia, a score of ‘1’ was awarded to correct response, which a score of ‘(o)’ wasawarded to an incorrect response.

PROCEDURE FOR DATA COLLECTION:

The research investigator obtained ethical clearance and formal permission from the Medical Superintendent, SGT hospital, Gurugram to collect data for the main Study. The main study was conducted at Post natal ward of OBG Ward SGT hospital, Gurugram from 25 April to 9 May 2017.

The steps used for data collection were mentioned below:

1. Written permission was obtained from Dean, Faculty of Nursing SGT University

2. Formal permission was obtained from the Medical Superintendent, SGT hospital, Gurugram.

3. Selected the subjects as per inclusion criteria.

4. On the day of pre-test, at the very beginning, self introduction of investigator to mothers and were explained the purpose of the study.

5. Informed written consent was obtained from each Subjects for willingness to participate in the study.

6. The pre-test was conducted on 20 April 2017 Which included items to assess the knowledge of mothers regarding neonatal hypothermia.

7. Planned teaching programme was administered at the end of pretest.

8. The post-test was taken after 30 Minute after administration of PTP using the same structured knowledge questionnaire used for the pre-test.

9. Data collected was tabulated and analyzed.

CONTENT VALIDITY:

The tool and lesson plan blue print and the lesson plan for planned teaching programme were evaluated by5 experts in the areas of Child Health Nursing.

RELIABILITY:

Reliability of an instrument is the consistency with which it measures the target attribute. An instrument is reliable to the extent that its measures reflect true reliability of the tool was assessed by administering the tool to 10 postnatal mothers who are admitted in OBG ward in SGT hospital, Gurugram. Reliability of the section of the tool consisting of knowledge questions was tested by Split Half method using Karl Pearson’s co-efficient of correlation formula and the reliability computed was r = 0.78. The content validity index [CVI] across the expert’s ratings of each item relevance was calculated. A CVI of 0.75 was found for the structured knowledge questionnaire. A CVI of 0.87 was found for planned teaching programme.

PLAN FOR DATA ANALYSIS:

The data obtained was analyzed in terms of the objectives of the study using descriptive and inferential statistics. Experts in the field of nursing and statistics directed the development of data analysis plan, which was as follows:

· Organizing data on a master sheet

· Computation of frequency percentage to describe background data and computation of mean, standard deviation and range to describe the data on knowledge scores.

· Classifying knowledge scores using mean, and standard deviation as follows:

X + SD = Good score

X – SD to X+ SD = Average score

X – SD = Poor score

A score of ‘1’ was awarded to a correct response while a score of ‘O’ was awarded to an incorrect response for the 20 knowledge items.

RESULT:

The data reveals that 10% of the respondents were less than the age group of 20 years, 86.67% of them were between the age group of 20-30 years and only 3.33% were more than the age group of 30 year.100% of the respondents were married. None of them were single, divorced, widow. 83.33% of the respondents were undergraduate, 16.67% were graduate, whereas no one was illiterate 100% of the respondents were Hindu. None of them were Muslim, Sikh, and Christian.76.67% of the respondents were living in rural area, 23.33% were living in urban area, whereasno one was living in slum area. The sources of information regarding prevention of neonatal hypothermia among the respondents from family and friends were 50%, mass media 26.67%, health personals 13.33% and from any other was10%. respectively.

The majority of respondent (66.67%) were living in joint family, 33.33% were living in nuclear family. None of them were living in the extended family.

Table 1: Frequency and percentage distribution according to socio demographic variables.

Socio-demographic variables		Frequency	Percentage
Age	Less than 20 year	3	10%
	Between 20-30 year	26	86.67%
	More than 30 year	1	3.33%
Marital status	Single	0	0%
	Married	30	100%
	Divorced	0	0%
	Widow	0	0%
Educational status	Illiterate	0	0%
	Under graduate	25	83.33%
	Graduate	5	16.67%
Religion	Hindu	30	100%
	Muslim	0	0%
	Sikh	0	0%
	Christian	0	0%
Area of living	Rural	23	76.67%
	Urban	7	23.33%
	Slum	0	0%
Source of information	Family and friends	15	50%
	Mass media	8	26.67%
	Health personals	4	13.33%
	Any other	3	10%
Type of family	Nuclear family	10	33.33%
	Joint family	20	66.67%
	Extended family	0	0%

The data presented in table-5 presents that the mean value of knowledge scores between pre and post test was 6.000, S.D was 2.803, Standard error was 0.511. The calculated “t” valuewas 11.720 (in 29 degrees of freedom) and p =0.000 which is significant at the level of 0.05. So there is the significant difference between the knowledge of post natal mothers before and after the implementation of planned teaching program

Table 4: Data on association between selected demographic variables of the postnatal mothers and their knowledge (Chi-square test) regarding prevention of neonatal hypothermia.

Demographic variables	Pre test x²value	Df	P value
Age	5.275	4	0.260
Education status	8.585	2	0.014
Area of living	0.842	2	0.657
Source of information	9.231	6	0.161
Type of family	0.074	2	0.964

Above table reveals that the chi-square values showing the association between the selected demographic variables (age, education status, area of living, source of information, type of family) and the pre knowledge levels of the postnatal mothers regarding prevention of neonatal hypothermia.

It is seen in table that the chi-square values computed between pre knowledge scores and age (x²= 5.275 in the pretest and df=4 and p=0.260), area of living (x²= 0.842 in the pretest and df =2 and p=0.657), source of information (x² = 9.231in the pre testand df=6 and p=0.161) and type of family (x²= 0.074 in the pretest and df=2 and p=0.964) were not found to be statistically significant at 0.05 level of significance. So, there is no association of pretest knowledge score of post natal mothers with selected demographic variables.

Where as education status (x²= 8.585 in the pretest and df=2 and p=0.014) were found to be statistically significant at 0.05 level of significance. So there is association of pretest knowledge score of post natal mothers with education.

CONCLUSION:

1. The findings of the study revealed that majority (90%) hadlow knowledge, 10%had average knowledge regarding prevention of neonatal hypothermia in pre test. Similarly, the post test scores depicted that majority (80%) had good knowledge, 20% had average knowledge and none of them had low knowledge regarding prevention of neonatal hypothermia.

2. Most of demographic variables were not significantly associated with level of pre knowledge of postnatal mothers regarding prevention of neonatal hypothermia. Only mother's education status (x²= 8.585 in the pretest and df=2 and p=0.014) were found to be statisticallysignificant at 0.05 level of significance.

3. There was significant difference between the knowledge of postnatal mothers before and after the implementation of planned teaching program (t = 11.720, P = 0.000 level).

This study showed that, the postnatal mother's knowledge regarding prevention of neonatal hypothermia was low and planned teaching program is effective to improve their knowledge.

REFERENCES:

1. WHO. Thermal control of newborn. Maternal and safe motherhood programme. 2013.

2. Datta Paurl. Pediatric Nursing. 2 nd edition. Jaypee brothers medical publishers (P) Ltd. 2009. page no.124-140.

3. WHO. Neonatal care: report of WHO scientific group. Technical report. Series no.424.

4. Haliday HL, Jenkins JS. Interventions to prevent hypothermia at birth in preterm and/ or low birth weight infants. 2010.

5. NNF Teaching AIDS: Newborn care; hypothermia in newborn.[on line]. [cited 17.7.2010]. Available from: URL:http:// www.newborn_whocc.org/pdf/teaching-aids/hypothermia.pdf (accessed on 9.9.2010).

6. Lalita Behl, Neelam Grover, Shyam L. Kaushik. Perinatal and Neonatal Mortality- A Hospital Based Study. Indian Pediatr 1998; (35):683-684. Available at URL: http://indianpediatrics.net/ july1998/july-683-684.htm.

Received on 29.05.2020 Modified on 24.07.2020

Int. J. Nur. Edu. and Research. 2020; 8(4):474-477.

DOI: 10.5958/2454-2660.2020.00104.0

Level of knowledge	Range of scores	Pre test		Post test
Level of knowledge	Range of scores	No. of respondent	Percentage of score	No. of respondent	Percentage of score
Good	15-20	0	0%	24	80%
Average	10-14	3	10%	6	20%
Low	0-9	27	90%	0	0%

	Mean	S. D.	Standard error	Calculated t value	df	p value
Pre test-post test knowledge	6.000	2.803	0.511	11.720	29	0.000