Effectiveness of Structured Teaching Programme on Knowledge regarding Identification of High Risk Pregnancies among Auxiliary Nurse Midwives (ANMs^’) in Community Health Centre, Sarojini Nagar at Lucknow

 

Ms. Monica Nancy Lal¹*, Mrs. Misbah Izhar Siddiqui², Mrs. Sandhya³

¹Nursing Tutor, King George’s Medical University, Lucknow, U.P.

²Associate Professor, Department of Obstetrics and Gynecological Nursing,

Vivekananda College of Nursing, Lucknow, U.P.

³Assistant Professor, Department of Obstetrics and Gynecological Nursing,

Vivekananda College of Nursing, Lucknow, U.P.

 

ABSTRACT:

Introduction: A pregnancy is considered high-risk when maternal or fetal complications are present that could affect the health or safety of either the mother or baby. All pregnancies should be evaluated to know whether there are or will be risk factors. Risk factors present before pregnancy, problems in a previous pregnancy, disorders present before pregnancy and risk factors that develop during pregnancy can make a pregnancy high risk. Identifying a pregnancy as high risk helps ensure that it receives extra attention and proper care, thereby significantly decreasing maternal and neonatal morbidity and mortality rates. Objectives: The main objective was to assess the effectiveness of structured teaching programme on knowledge regarding Identification of High Risk Pregnancies among ANMs’ in Community Health Centre, Sarojini Nagar at Lucknow. The conceptual framework used by the investigator was General System Model given by Ludwig Von Bertalanffy Approach and design: In the study, quantitative research approach, Pre-experimental (one group Pre-Test and Post-Test) research design was used. Samples and sampling criteria: The knowledge was assessed among 40 ANMs’ by using purposive sampling technique. Initially the researcher got permission from concerned authority of Community Health Centre, Sarojini Nagar, Lucknow. The written consent was obtained from samples. The tool used were, performa of demographical variable, self-structured knowledge questionnaire. Assessment of pre-existing level of knowledge done by administering knowledge questionnaire after that on same day structured teaching programme on knowledge regarding Identification of High Risk Pregnancy was given. After 7 days post-test was conducted by the investigator. The data were collected and analyzed using descriptive and inferential statistics. Results: The findings of the study revealed that there was a significant difference between the mean Pre-test (20.40) and Post-Test (29.08) knowledge scores, it denotes that level of knowledge is increased after intervention. Conclusion: The study concluded that the Structured Teaching Programme was effective in enhancing knowledge of ANMs’ about Identification of High Risk Pregnancies and that was more effective and beneficial for them.

 

 

INTRODUCTION:

“Let every mother and child to be counted”:

Pregnancy and child birth are special events in women’s lives, and, indeed, in the lives of their families. This can be a time of great hope and joyful anticipation. Although pregnancy is not a disease but a normal physiological process it is associated with certain risks to health and survival both for the woman and for the newborn she delivers (WHO).¹

 

A High Risk pregnancy is the one in which the life or health of the mother or fetus is jeoparadised or endangered by a disorder coincidental with or unique to pregnancy.²

 

High-risk pregnancies affect a significant number of women each year. Approximately 22% of all pregnant women are classified as having high-risk pregnancies. Women going through high-risk pregnancies may require complex care involving lifestyle modifications, pharmacological and technical support and even hospitalization. As a result, these women may experience feelings of vulnerability because they have a high-risk pregnancy and thus be more exposed to stressful feelings.³

 

It is a tragic fact that in the very act of giving births of achieving motherhood nearly half a million women die every year world over. It is the women in the developing countries, who face the gravest risks. These women die of neglect, ignorance and in accessibility of required services. 25% of all the deaths occur in the child bearing age, women die in developing countries due to complication of pregnancy and child birth.⁴

 

In developed countries, the maternal deaths have been brought down to irreducible minimum and as such it may be prudent to consider or perinatal morbidity and mortality in identifying high risk cases. But in developing countries with a high maternal and perinatal mortality, the maternal factors also should be considered. The risk factors may be pre-existing prior to or at the time of first antenatal visit or may be developed subsequently in ongoing pregnancy, labour or puerperium. Over 50% of maternal complications and 60% of all primary caesarean section arise from the high risk group of cases. In 20-30% pregnancies the mother, foetus or neonate will be in a state of increased jeopardy. If we desire to improve obstetric results, this group must be identified and have to give extra care.⁵

Anemia is the leading cause of death among high risk pregnancies. It is a National nutritional problem with significant impact on the health and productivity of the population. The country registers 540 maternal deaths per 1,00,000 live births, higher than what it was a century ago in some of the today's advanced Nations. In rural India the figure is even higher at 619 according to facts and figures brought out by the United Nations Children's Fund. Iron deficiency Anemia, particularly in its severe form during pregnancy, is the major factor contributing to maternal morbidity and mortality as well as low birth weight. Studies show that about 70% of pregnant woman have Hb level lower than 9 gram /dl. Anemia is defined as reduction in circulating hemoglobin mass below the critical level one normal hemoglobin (Hb) concentration in the body is between 12-14 grams % therefore any hemoglobin level below 11gm in pregnancy should be considered as anemia. However in India and most of the other developing countries the lower limit is often accepted as 10 grams %.WHO has accepted up to 11garms % as the normal pregnancy level in pregnancy.⁶

 

According to Singh Samiksha et al (2019) conducted a cross sectional study to assess the knowledge, practice and attitude in management and referral for high-risk conditions and complications during the antenatal period on health providers in primary level public health care from poor and better performing districts from two states including Himachal Pradesh and Andhra Pradesh. The researcher selected 147 health care providers by purposive sampling. The result of the study revealed that only 31% mentioned screening for at least 10 of the 16 common high-risk conditions and early complications of pregnancy. Only 35% of the staff at Primary health centres, and 51% at Community health centres, mentioned that they managed these conditions and, the remaining staff referred most of such cases early in pregnancy. This concludes that staffs were unable to manage childbirth of women with high risk conditions along with their associated complications. Thus, due to lack of adequate resources and limited decision making staffs generally lack confidence in handling patient with high risk pregnancies and prefer referring it advanced centres for efficient care.⁷

 

According to P. Sathya et al (2017) conducted a descriptive study to assess the prevalence of anemia among women in a selected urban area in Coimbatore district. The researcher selected 245 women with the help of purposive sampling technique. The result of the study shows that out of 250 women, 89 (35.6%) had their normal hemoglobin level (>12.0g/dl), 6 (2.4%) had mild anemia (11-11.9g/dl), 145 (58%) had moderate anemia (8-10.9g/dl) and 10 (4%) had severe anemia. The study concluded that the incidence and prevalence of anemia is high in developing countries like India, where the present study mainly focused to identify the anemic women in the urban areas of Coimbatore.⁸

 

According to Devi Kumari Sinmayee et al (2015); “conducted a Quasi Experimental study to effectiveness of Self Instructional Module on Knowledge regarding Identification and Management of high risk pregnancy among the ANM student in selected nursing school, Bhubaneshwar, Odhsha.” 42 ANM students were selected by simple random sampling technique and Data was collected by using closed ended questionnaire within 7 days and collected data were analyzed by using descriptive and inferential statistics. Result findings revealed that highest percentage 50% of the ANM students were in the age group of 18-20 years. All were female and unmarried Majorities 98% of them are Hindus and 2% are Christians. The overall pre test mean score was (9.42±6.8) which is 31% of the total score reveals poor knowledge where as it was (16.85±9.7) which is 56% in posttest revealing 25% of enhancement knowledge score. Area wise highest post test mean score (4.9±5.2) which is 49% was obtained for the area of “risk factor” where as the lowest post test mean score (1.4±1.6) which is 46.6% was obtained for the area of “complication”. Highly significant (p<0.01) difference was found between pre and post test knowledge scores and no significant (p>0.05) association was found between post test knowledge scores in relation to demographic variables of ANM students. The study concluded from the finding of the present study it can be concluded that SIM regarding high risk pregnancy among ANM students was effective to improve the knowledge of ANM students.⁹

 

Every nurse must have the capability to develop comprehensive plans and interventions to tackle the high risk situations in pregnant women. Nurses should update their knowledge by getting and knowing the latest information on disease conditions and their management. There fore the investigator felt the strong need to conduct structured teaching programme on high risk pregnancy which will help to improve the knowledge of the ANM’s on identification of High risk pregnancies and thereby it can reduce the mortality and morbidity among mothers and their newborns.

 

OBJECTIVES:

1.     To assess the existing knowledge of ANMs’ on identification of high risk pregnancies before the administration of Structured Teaching Programme.

2.     To assess the knowledge of ANMs’ on identification of high risk pregnancies after the administration of Structured Teaching Programme.

3.     To find out the association between pre-test knowledge scores with their selected demographic variables.

RESEARCH HYPOTHESES:

The hypotheses will be tested at the 0.05 level of significance.

H₁: The mean post test knowledge scores will be significantly higher than the mean pre test knowledge scores.

H₂: There will be significant association between pre-test knowledge scores with their selected demographic variables.

 

MATERIAL AND METHODS:

Research Design:

The pre- experimental (one group pre test post test) research design without randomization.

 

Settings:

The study was conducted in Community Health Centre, Sarojini Nagar at Lucknow

 

Population:

Accessible population for this study includes ANMs’ working in Community Health Centre, Sarojini Nagar, at Lucknow.

 

Sample:

40 ANMs’ was taken as a sample.

 

Sampling Technique:

The samples were selected for this study by non-probability purposive sampling technique.

 

Data analysis:

The demographic variables were organized by using descriptive measures (frequency and percentage). The data from the structured knowledge questionnaire before and after administration of structured teaching programme will be analyzed using mean, standard deviation (SD) and paired “t” test. The association between the level of knowledge and the selected demographic variables were assessed by Chi-square test.

 

RESULT:

SECTION I:

This section describes sample subject distribution according to their demographic variables. Demographic variables were age in years, monthly income, residential area, area of working, source of information regarding High Risk Pregnancies, total working experience in years.

 

 

Table No. 1: Frequency and Percentage distribution of ANMs’ according to their demographic variables.

S. No.	Demographic Variables		Frequency	Percentage
			F	%
1.	Age (Years)	a.    20-25 years	11	27.5
		b.    26-30 years	7	17.5
		c.    31-35 years	11	27.5
		d.    36 years and above	11	27.5
2.	Monthly Income	a.    Rs. 5,000-10,000	2	5.0
		b.    Rs. 11,000-20,000	3	7.5
		c.    Rs. 21,000-30,000	20	50.0
		d.    Rs. 30,000 and above	15	37.5
3.	Residential Area	a.    Rural	13	32.5
		b.    Suburban	7	17.5
		c.    Urban	20	50.0
4.	Area of Working	a.    PHCs	3	7.5
		b.    Sub-centres	35	87.5
		c.    District Hospitals	2	5.00
		d.    Private hospitals/dispensaries	00	00.00
5.	Source of information regarding High Risk Pregnancies	a.    Colleagues	3	7.5
		b.    Obstetrician and Gynaecologist	10	25.0
		c.    Book and Articles	1	2.5
		d.    Newspaper/Magazines	1	2.5
		e.    Conferences and Workshops	00	0.0
		f.     Mass Media	00	0.0
		g.    Past Experience	25	62.5
6.	Total working experience in years	a.    Less than or equal to 1 year	7	17.5
		b.    2-3 years	11	27.5
		c.    3-4 years	6	15.0
		d.    More than or equal to 5years	16	40.0

 

SECTION II:

This section describes the frequency percentage distribution of sample subjects according to the pre-test and post-test level of knowledge regarding Identification of High Risk Pregnancies.

 

Table No. 2: Pre-test Frequency and Percentage distribution of Sample Subjects

S. No.	Pre-test Knowledge	Frequency	Percentage
1	Inadequate (≤50%)	25	62.5
2	Moderate (51-75%)	15	37.5
3	Adequate (≥76%)	00	0.0

 

Table No. 3: Post-test Frequency and Percentage distribution of Sample Subjects

S. No.	Post-test Knowledge	Frequency	Percentage
1	Inadequate (≤0%)	2	5.0
2	Moderate (51-75%)	21	52.5
3	Adequate (≥76%)	17	42.5

 

 

 

COMPARISON OF PRE-TEST AND POST-TEST KNOWLEDGE SCORES:

 

Figure 3: Cone graph showing percentage distribution of sample subjects according to their level of Pre-test and Post-test knowledge scores.

 

SECTION III:

This section depicts effectiveness of structured teaching programme on knowledge regarding identification of high risk pregnancies.

 

ITEM WISE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME:

Table No 4: The date revealed that highest percentage 47.5% of effectiveness was observed in item no. 4  n=40

ITEM NO.	PRE TEST (X)		POST TEST (Y)		(Y-X)
	No.	%	No.	%	No.	%
1	30	75.00	37	92.50	7	17.5
2	24	60.00	35	87.50	11	27.5
3	29	72.50	38	95.00	9	22.5
4	16	40.00	35	87.50	19	47.5
5	16	40.00	20	50.00	4	10
6	38	95.00	40	100.00	2	5
7	25	62.50	35	87.50	10	25
8	14	35.00	30	75.00	16	40
9	22	55.00	36	90.00	14	35
10	11	27.50	13	32.50	2	5
11	9	22.50	15	37.50	6	15
12	16	40.00	33	82.50	17	42.5
13	10	25.00	30	75.00	20	50
14	37	92.50	35	87.50	-2	-5
15	16	40.00	28	70.00	12	30
16	16	40.00	14	35.00	-2	-5
17	32	80.00	31	77.50	-1	-2.5
18	17	42.50	30	75.00	13	32.5
19	18	45.00	25	62.50	7	17.5
20	3	7.50	25	62.50	22	55
21	17	42.50	30	75.00	13	32.5
22	7	17.50	18	45.00	11	27.5
23	16	40.00	30	75.00	14	35
24	23	57.50	28	70.00	5	12.5
25	8	20.00	17	42.50	9	22.5
26	24	60.00	30	75.00	6	15
27	20	50.00	17	42.50	-3	-7.5
28	14	35.00	20	50.00	6	15
29	27	67.50	34	85.00	7	17.5
30	33	82.50	37	92.50	4	10
31	19	47.50	26	65.00	7	17.5
32	14	35.00	26	65.00	12	30
33	20	50.00	28	70.00	8	20
34	24	60.00	32	80.00	8	20
35	32	80.00	38	95.00	6	15
36	24	60.00	36	90.00	12	30
37	16	40.00	24	60.00	8	20
38	26	65.00	39	97.50	13	32.5
39	22	55.00	30	75.00	8	20
40	31	77.50	38	95.00	7	17.5

 

TESTING OF HYPOTHESIS:

Table No. 5: The data presented in the mentioned table shows that the mean post-test knowledge scores of sample subjects was 29.08 and mean pre-test knowledge score was 20.40. The ‘t’ value was computed and found to be 11.112 which is more than the table value i.e., 2.023. This shows that the difference between pre-test and post-test of sample subjects was a true difference and not by chance. Hence, research hypothesis H₁ was accepted.

                                                                                                                                                                                                  

 

 

 

Table No. 5: (n=40)

Knowledge Scores	Mean and Standard Deviation	Std. Error Mean	‘t’- Value	df	p- Value
Pre - test	20.40 ± 5.037	0.781	11.112	39	<0.001
Post - test	29.08 ± 3.944

t (39) = 2.023 and p<0.05

 

SECTION IV:

This section describes the association between the level of Pre-test knowledge scores with their selected demographic variables.

 

Table No. 6: It shows the association between pre-test level of knowledge scores regarding Identification of High Risk Pregnancies with their selected demographic variables among ANMs’                                                                                                                     (n=40)

S. No.	Variables	Level of Knowledge				Statistical Significance
		Inadequate (n=25)		Moderate (n=15)		Chi - Square	df	p – Value
		No.	%	No.	%
1.	Age (Years)
	20-25years	4	16.0	7	46.7	4.426	3	0.219
	26-30 years	5	20.0	2	13.3
	31-35 years	8	32.0	3	20.0
	36 and above	8	32.0	3	20.0
2.	Monthly Income
	Rs.5,000- 10,000	2	8.0	0	0.0	1.813	3	0.612
	Rs.11,000- 20,000	2	8.0	1	6.7
	Rs.21,000- 30, 000	11	44.0	9	60.0
	Rs.30,000 and above	10	40.0	5	33.3
3.	Residential Area
	Rural	7	28.0	6	40.0	6.467	2	0.039
	Suburban	2	33.3	5	33.3
	Urban	16	26.7	4	26.7
4.	Area of Working
	PHC’s	3	12.0	0	0.0	3.429	2	0.180
	Sub-centers	20	80.0	15	100.0
	District Hospitals	2	8.0	0	0.0
	Private hospitals/dispensaries	0	0.0	0	0.0
5.	Sources of information regarding High Risk Pregnancies
	Colleges	3	12.0	0	0.0	5.184	4	0.269
	Obstetrician and Gynecologist	4	16.0	6	40.0
	Book and Articles	1	4.0	0	0.0
	Newspaper/Magazines	1	4.0	0	0.0
	Conferences and Workshops	0	0.0	0	0.0
	Mass Media	0	0.0	0	0.0
	Past Experience	16	64.0	9	60.0
6.	Total experience in years
	Less than or equal to 1 Year	6	24.0	1	6.7	5.127	3	0.163
	2-3 years	4	16.0	7	46.7
	3-4 Years	4	16.0	2	13.3
	More than or equal to 5 years	11	440	5	33.3

 

The findings of the research study also shows that there is a significant association between knowledge level and Residential Area (p=0.039). There is a significant association at p=0.05 level of significance.

 

Thus it can be concluded that the research hypothesis accepted, which means there is an association between two variables.

The pre test knowledge scores shows that the majority of the samples (62.5%) had inadequate level of knowledge (37.5%) has moderate level of knowledge and none of the samples had adequate level of knowledge but after using structured teaching programme as an intervention, in post-test majority of the samples (52.5%) had moderate level of knowledge, (42.5%) had adequate level of knowledge and only (5%) had inadequate level of knowledge. The calculated ‘t’ value was found to be 11.112 which is more than the tabulated value i.e., 2.023 at 0.05% level of significance. There was a significant association between the pre-test knowledge scores and other demographic variable like residential area of ANMs’ (ꭓ² = 6.467).

 

DISCUSSION:

The discussion of the study is based on the objectives of the study.

 

The first objective of the study was to assess the existing knowledge of ANMs’ on identification of high risk pregnancies before the administration of Structured Teaching Programme:

The present study shows that majority (62.5%) of the sample subjects had inadequate level of knowledge, (37.5%) of sample subjects were having moderate level of knowledge whereas none of the sample subjects were having adequate knowledge.

 

While comparing the study findings of the other published researches, findings of this study were also consistent with study conducted by Dhanalakshmi, J (2017) they found majority of the sample subjects 76.7% (46) had inadequate knowledge, 23.3% (14) of them had moderate knowledge, and none of them are having adequate level of knowledge.¹⁰

 

The second objective of the study was to assess the knowledge of ANMs’ on identification of high risk pregnancies after the administration of Structured Teaching Programme.

The present study revealed that after administration of Structured Teaching Programme mean post-test value is (29.08) which was higher than the mean pre-test value i.e., (20.40) at 0.05 level of significance. The calculated t- value (11.112) was more than the tabulated value (2.023). Hence there was statistically significant difference between pre-test and post-test knowledge scores.

 

The above findings of the study were supported by Minalkar S. Surekha (2007) which showed that after the administration of structured teaching programme mean post-test value (35.08) was higher than the mean pre-test value (20.60) at 0.05 level of significance. This shows there is significant mean difference (14.48) between pre-test and post-test knowledge scores. Overall the findings revealed that there is a effectiveness of structured teaching programme.¹¹

 

The third objective was to find out the association between pre-test knowledge scores with their selected demographic variables:

The findings of demographic variables Shows that the majority of the sample subjects belong to the age group 31-35 years with more than 5 years of working experience i.e., (44%).

 

In the present study association of pre-test knowledge scores was found only with Residential Area of ANMs’ i.e., more than the table value (ᵡ²  = 6.467).

 

This result is contradicted by similar findings of Shukla Dipti (2016) in this among staff Nurses majority of them belong to the age group (31-35 years). Most of the staff nurses were having (8.1-17 years) of working experience. There was no association with the pre-test knowledge scores with their selected demographic variables.¹²

IMPLICATIONS OF THE STUDY:

The result of the study proved that Structured Teaching Programme among ANMs’ had significant effect in improving their knowledge. Hence the responsibility of the health personnel is to create awareness regarding identifying the high risk conditions in pregnancy its causes, clinical manifestations, prevention, treatment and its complications. The findings of the study have implications in various areas of nursing namely: Nursing Practice, Nursing Education, Nursing Research, Implication in Community and Public Education.

 

Nursing Practice:

·       The extended role of the professional nurse emphasizes those activities which promote health promotion and preventive behaviour among people.

·       The nursing service department can have Identification of High Risk Pregnancies with a band of adequately prepared nurses for developing educational materials for teaching clients, families and communities. This will help the nursing profession more advanced towards the goal of providing holistic client care.

·       Ongoing assessments must be in place to ensure services meet the need of ANMs’

·       Nurses integrate the science and art of nursing into their practice, the quality of care provided to clients is at a level of excellence that benefits clients in numerous ways. They are the key persons of the health team, who plays a vital role in the promotion and maintenance of health.

·       Regular health education programme can be conducted by the nursing personnel in colleges and community areas. Measures should be taken to Identify High Risk Pregnancies and for early referral.

 

Nursing Education:

·       Nursing curriculum at all level should have more content on Identification of High Risk Pregnancies.

·       The curriculum should such that it generates sensitivity among the student nurses on Identification of High Risk Pregnancies.

·       Student nurses should appraise and guide the pregnant women especially the vulnerable groups for example High Risk Pregnant women for knowing their associated risk factors related to high risk pregnancy.

·       The knowledge deficit of nursing student on Identification of High Risk Pregnancies indicates the need for organizing Identification of High Risk Pregnancies education programs for them, a part of their college curriculum, as well as in community settings.

·       The teacher program can be further developed in the form of SIM, Pamphlets and audio –visual tapes.

Nursing Administration:

·       Nurse administrators are the key persons to plan, organize and conduct In-service Education Programmes. Nurse administrators’ support should be necessary to conduct and evaluate health education programmes.

·       Nurse administrator can improve the knowledge of staff nurses working in Obstetrics and Gynaecological departments by providing various teaching programmes with the help of various Audio-Visual Aids.

·       Cost-effective production of identification of high risk pregnancies educational material should be encouraged. This will help to develop effective client teaching material and improve their knowledge on Identification of High Risk Pregnancies.

·       They are in a key position to organize, implement and evaluate educative programmes which will in turn helps to improve the knowledge as well as to meet the future needs and accelerates the standards of nursing services.

·       In community area community health nurse can plan, organized and conduct the health awareness on Identification of High Risk Pregnancies. Nurse should see that the Structured Teaching Programme is effectively implemented, using adequate resources and beneficial to the population.

 

Nursing Research:

·       The main goal of nursing research is to improve the knowledge of nursing student and staff through the implementation of evidence based practice. The study provides a baseline data for conducting other research studies.

·       The study will be a motivation for the budding researchers to conduct similar studies at large scale. The study will be a reference for the research scholars.

·       There is a need to conduct further research in India in the field of Identification of High Risk Pregnancies. Nurses, who form an important cadre of health professionals, should take initiative to conduct this type of research in the field of nursing in changing Indian society, therefore, needs to be assessed. To develop the body of knowledge to test the strategy to bring new findings, current education in the field of treatment and quality care, nursing research is essential.

·       Based on the review of literature, not enough studies are done to assess the knowledge of different categories of people that showed the need for providing educational program, need to increase awareness of people especially of high risk pregnant women.

 

Implication in Community:

·       Community area should include activities like preparation of self instructional module, pamphlets, and booklets. It should emphasize on the provision of health information to community peoples especially the health workers of community for Identifying High Risk cases during pregnancy.

·       Since among most vulnerable group, pregnant women’s also do come hence provision of health education for them too is necessary.

 

Public Education:

·       Carefully prepared identification of High Risk Pregnancies program, as a part of mass education, will be useful in creating awareness among general public in the maintenance of health of a pregnant women.

·       Nurses are vital source in educating the public through such programmes.

 

RECOMMENDATIONS:

Based on the findings of the study the following recommendations are made.

·       A similar study may be conducted on a larger sample for wider generalization.

·       A similar study may be replicated with control group.

·       A similar study can be conducted among GNM, B.Sc, P.B.B.Sc and staff nurses.

·       The comparative study can be conducted in urban and rural area.

·       Longitudinal studies to determine the constant effectiveness of structured Teaching Programme over a period of time may be conducted.

 

CONCLUSIONS:

The study concludes that there was a significant improvement in the level of knowledge regarding Identification of High Risk Pregnancies in Post-Test after administration of Structured Teaching Programme. Thus, Structured Teaching Programme was found to be effective in improving the knowledge regarding Identification of High Risk Pregnancies.

 

REFERENCES:

1.      Phillip Bindu (2007); “A study to evaluate the effectiveness of structured teaching programme regarding Gestational Diabetes Mellitus among Antenatal women in selected hospitals, Bangalore”; dissertation of Rajiv Gandhi Universities and Health Sciences; available on www.rghus.ac.in

2.      M. Saradhambal (2016); “A descriptive study on Prevalence of High Risk Pregnancies; published in International Journal of Advanced Research (IJAR); Volume 4(9); ISSN: 2320-5407; Page No- 1220-1224; available on http://www.scribed.com

3.      Rodrigues Borba Paula et al (2016); “Special features of High Risk Pregnancies as factors in development of mental distress”; published in Trends in Psychiatric and Psychotherapy; Volume 38 (3); Page No-136-140; available on http://www.scielo.br

4.      Kaur Sharanjeet; “ A study to assess the effectiveness of structured teaching programme on knowledge regarding pre-eclampsia among the staff nurses working in Government District Hospital, Tumkur; Dissertation of Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka; available on www.rguhs.ac.in

5.      Thomas Mary Anu (2017); “ A study to evaluate the effectiveness of video assisted teaching module on knowledge regarding care during high risk pregnancy among the high risk antenatal women in selected maternity hospitals, Mangalore; dissertation of Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka; available on www.rguhs.ac.in

6.      Masih A Priyanka(2020); “Assessment of knowledge among pregnant women regarding anemia in Gynecological and obstetrical OPD of Guru Nanak Mission hospital, Punjab.” published in Asian Journal of Nursing education and research; ISSN 2349-2996; Volume 10; Issue-2; Year 2020; Page No-163-170; available on www.anvpublication.org

7.      Singh Samiksha et al (2019);A cross sectional study to assess the knowledge, practice and attitude in management and referral for high-risk conditions and complications during the antenatal period on health providers in primary level public health care from poor and better performing districts from two states including Himachal Pradesh and Andhra Pradesh. Published in National Centre for Biotechnology Information; PMC6617826; July 2019; available on http://www.ncbi.nlm.nih.gov

8.      P. Sathya et al (2017); “A descriptive study to assess the prevalence of anaemia among women in a selected urban area in Coimbatore district”; published in Journal of Scientific and Innovative Research; Volume6(1); ISSN 2320-4818; Page No-11-15 available on http://www.jsirjournal.com

9.      Devi Kumari Sinmayee et al (2015); “A Quasi Experimental study to effectiveness of Self Instructional Module on Knowledge regarding Identification and Management of high risk pregnancy among the ANM student in selected nursing school, Bhubaneshwar, Odhsha”; published in Asian Journal of Nursing Education and Research; Vol 5(1); ISSN 2349-2996;2015;Page no-146-150; available on www.anvpublication.org

10.   Dhanalakshmi. J(2017); “A pre-experimental study to evaluate the effectiveness of structured teaching programme on knowledge regarding Early Identification of High Risk Pregnancy among Antenatal mothers attending at Institute of Obstetrics and Gynaecology; Dissertation of Dr. Medical University; Page No-1-215; available on www.repositorytnmgrmu.ac.in

11.   Minalkar S. Surekha (2007); “ A Quasi-experimental study to evaluate the effectiveness of structured teaching programme on knowledge regarding Identification of High Risk Pregnancies among ANM’s of PHC in Bangalore”; dissertation of Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka; Page No-1-191; available on www.rguhs.ac.in

12.   Shukla Dipti (2016); “A study to assess the effectiveness of self instructional module on knowledge regarding the selected care of pre-eclampsia patient among nurses in selected hospitals of Vidarbha Region”; published in IOSR Journal of Nursing and Health Sciences; Volume no-5(5); ISSN:2320-1959;Page No-01-05; available on www.iosrjournals.org

 

 

Received on 19.05.2020          Modified on 13.06.2020

Accepted on 03.07.2020    © AandV Publications all right reserved