Effectiveness of a Self-educational Module on Preterm Labor's Causes, Symptoms, and Prevention among Pregnant women in the OPD at particular hospitals in Kashmir
Aneesa Rehamani*, Saif Ullah Sheikh, Nasiya Wani, Seema Rasool
Desh Bhagat University, Punjab.
*Corresponding Author E-mail: aneesarehmani123@gmail.com
ABSTRACT:
Background: Preterm labour is defined as labour that starts before the baby has been pregnant for 37 weeks. Approximately 9% of all pregnancies have it. If a woman experiences uterine contractions that result in cervical effacement and dilatation, she is thought to be in premature labour. Any woman who exhibits a pattern of labour lasting more than an hour, with contractions lasting 30 seconds and happening as regularly as every 10 minutes apart, should be diagnosed as being in labour. Because a premature baby is born as a result of preterm labour, it is serious. Premature mothers may experience more painless contractions, backaches, and excessive vaginal discharge than other pregnant women. Preterm delivery is responsible for 75% of all perinatal fatalities and up to 50% of infant neurological impairments. Preterm birth rates vary among different demographics, with the socioeconomically privileged population experiencing the lowest rates and the medically underprivileged population seeing the highest rates. Finding the women who are at risk for preterm labour is the first step in managing this issue. Method: 40 volunteers total were chosen for this experimental investigation using a non-probability handy sampling strategy. Design experimentation was done. Data was gathered using a structured interviewing method. Information collected for the two portions, including socio-demographic data, a knowledge quiz, and a practice checklist. The split half technique formula was used to determine the tool's dependability. Knowledge yielded a reliability result of r=0.904. prenatal care instruction manual that you prepared yourself. Result: Pre-test knowledge for the expectant women was only average for 16(40%) and low for 24 (60%) of the mothers. When post test results were compared to pre test scores, it was clear that prenatal moms' knowledge had improved, as 12 of them (30%) had good knowledge and the remaining 28(70%) had average knowledge. The mean knowledge score increased from 16.2+2.85 to 22.45+2.13 in the post test from the pre test. Conclusion: The study demonstrated that the self-educational programme for primi para moms on the causes of preterm labor and how to prevent it was a rational, rational, and cost-effective technique.
KEYWORDS: Preterm Labor, Prevention, Antenatal mothers, Preterm Labor.
INTRODUCTION
A woman's pregnancy is a significant event in her life. A healthy baby who is delivered with a normal birth weight following the full gestation time makes the family happy.
The amount of time a baby has to grow and develop is reduced by a premature birth, and if the birth is too early, the baby may not be sufficiently developed to survive1. Even before birth, good health starts. An essential preventive measure that can help safeguard the health of both mother and child is timely prenatal care. As these kids become older and become adults, the nation's health as a whole can be gauged by looking at how well the current child population is doing2.
Preterm labour refers to births that occur before 37 weeks of pregnancy have passed. Approximately 9% of all pregnancies have it. If a woman experiences uterine contractions that result in cervical effacement and dilatation, she is thought to be in premature labour3. Any woman who exhibits a pattern of labour lasting longer than an hour, with contractions lasting 30 seconds and happening as regularly as every 10 minutes apart, should be regarded as in labor4. Because preterm labour causes the baby to be born prematurely, it is a problem. Premature mothers may experience more painless contractions, backaches, and more vaginal discharge than typical pregnant women5.
Preterm birth is responsible for 75% of all perinatal deaths and up to 50% of infant neurological impairments6. Preterm birth occurs in different populations at varying rates, with the socioeconomically privileged population experiencing the lowest rates and the medically underprivileged population experiencing the highest rates. Finding the women who are at risk for preterm labour is the first step in managing this issue7.
Preexisting preterm labor, infections, smoking, poor nutrition, uterine anomalies like cervical incompetence and uterine malformation, foetal complications like intrauterine death and placenta previa, iatrogenic and idiopathic causes, and maternal complications like pregnancy complications (preeclampsia, ante partum hemorrhage, premature rupture of membranes) are the main risk factors for preterm labor.8.
Variables:
· Independent Variable: The self instructional module (SIM).
· Dependent Variable: Level of knowledge on antecedents of preterm labor and its prevention among antenatal mothers.
· Socio-demographic variables: Age, religion, family income, Place of residence, types of family, Gestational age
Population:
A population is a whole group of individuals or objects that share a trait of interest to the researcher9. Antepartum mothers in a few Kashmir OPD hospitals were the study's target demographic.
Sample:
A sample is a portion of the population that has been chosen to reflect the entire population10.
In the current study, 40 pregnant mothers from a few Kashmiri OPD hospitals make up the sample.
Sampling Technique:
Sampling is a process of selecting the portion of the population to represent the entire population 11.
Convenient sampling technique was used to select the sample for the present study
Sample Size:
40 Antenatal mothers in selected antenatal OPD hospitals at Kashmir wereconsidered as sample for the present study.
Setting of the Study:
The physical context and circumstances in which data gathering for a study takes place are referred to as the research setting. [11]. The present study was conducted in selected antenatal OPD hospitals atKashmir.
Method of Data Collection:
Data collection is gathering of information relevant to the research problem11.
The data for the present study was collected by using structured interview schedule on prevention of premature labor Interview schedule provides greater opportunity to probe and clarify the questions and thus collect complete and useful data with freedom to subject to respond on one’s own pace.
RESULTS:
SECTION 1: Analysis and interpretation of socio demographic characteristics of mothers.
Table 1: Frequency distribution of antenatal mothers according to their socio demographic characteristics.
|
No of respondents(f) |
% of respondents |
|
|
Age (in years) |
|
|
|
18-22 |
22 |
55.00 |
|
23-27 |
14 |
35.00 |
|
28 &above |
4 |
10.00 |
|
Educational status |
|
|
|
No formal education |
2 |
5.00 |
|
Primary |
12 |
30.00 |
|
Secondary |
6 |
15.00 |
|
PUC |
10 |
25.00 |
|
Diploma or/and graduation |
8 |
10.00 |
|
Post Graduation |
2 |
5.00 |
|
Occupation |
|
|
|
House wife |
10 |
25.00 |
|
Coolie |
16 |
40.00 |
|
Government employee |
6 |
15.00 |
|
Private employee |
8 |
20.00 |
|
Family Income(monthly) |
|
|
|
Rs. 1000/--Rs.2000/- |
2 |
5.00 |
|
Rs.2001/--Rs.4000/-. |
24 |
60.00 |
|
Rs.4001/--Rs.6000/-. |
6 |
15.00 |
|
Rs.6001/--and above |
8 |
20.00 |
|
Place of Residence |
|
|
|
Urban |
18 |
45.00 |
|
Rural |
22 |
55.00 |
|
Source of Information |
|
|
|
News paper |
4 |
10.00 |
|
Mass media |
10 |
25.00 |
|
Magazine |
6 |
15.00 |
|
Others |
20 |
50.00 |
|
Gestational age at the time of data collection |
|
|
|
Below 3 months |
1 |
2.5 |
|
3-5 months |
19 |
47.5 |
|
6-8 months |
13 |
32.5 |
|
8 months and above |
7 |
17.5 |
The percentage distribution of the study subjects is shown in Table.1. Out of 40 respondents, 22(55%) were between the ages of 18 and 22; 14(35%) were between the ages of 23 and 27; and 4(10%) were between the ages of 28 and above. Out of 40 subjects, 2(5%) had no formal education, 12(30%) had completed primary school, 6(15%) had finished high school, 10(25%) had completed PUC, 2(5%) had a diploma, 6(15%) had a degree, and the remaining 2(5%) had completed post-secondary education. Among the subjects, 10(25%) were housewives, 16(40%) were coolies, 6(15%) were government workers, and the remaining 8 (20%) were private workers. 2(5% of subjects) had incomes between Rs. 1000 and Rs. 2000, 24(60%) had incomes between Rs. 2001 and Rs. 4000, 6(15%) had incomes between Rs. 400 and Rs. 6000, and 8(20%) had incomes between Rs. 600 and Rs.
The majority of the subjects—22—were living in rural areas (55%) while the remaining 18(45%) were in cities. The percentage distribution of the study sample by health-related information source is shown in the graphic below. 4(10%) of the subjects got their knowledge from the newspaper, 10(25%) from the mass media, 6(15%) from magazines, and 20(50%) from other sources like acquaintances, neighbors, and family members.
Section II: Analysis and interpretation of mothers' knowledge ratings of the causes of early labor:
This section discusses the percentage distribution, mean, and standard deviation of the sample's general knowledge levels, as well as its knowledge in certain areas linked to the causes of premature labor, both before and after the test. Using a systematic interview schedule with 28 knowledge-based and 32 practice-based questions, the knowledge of the sample of prenatal mothers was evaluated.
Table 2: Percentage distribution of knowledge levels of antenatal motherson prevention of premature labor in pre-test and post test
|
Levels of knowledge |
Pre test |
Post test |
||
|
Frequency |
Percentage |
Frequency |
Percentage |
|
|
High knowledge |
00 |
00 |
12 |
30 |
|
Average knowledge |
16 |
40 |
28 |
70 |
|
Lowknowledge |
24 |
60 |
__ |
__ |
Table 2 presents the overall knowledge levels of antenatal mothers on prevention on premature labor. Pre-test knowledge for the expectant women was only average for 16(40%) and low for 24(60%) of the mothers. When post test results were compared to pre test scores, it was clear that prenatal moms' knowledge had improved, as 12 of them (30%) had good knowledge and the remaining 28(70%) had average knowledge.
FIG:1 Percentage distribution of antenatal mothers by their knowledge on prevention on premature labour in pre test and post test
Table 3: Mean and standard deviation of pre test and post test knowledge scores of antenatal mothers regarding prevention of premature labour
|
|
Pre test |
Post test |
||
|
Mean |
Standard deviation |
Mean |
Standard deviation |
|
|
Knowledge regarding Infant care |
16.2 |
2.85 |
22.45 |
2.13 |
The mean and standard deviation of the pre- and post-test infant care knowledge scores for Primipara moms are shown in Table 3. It reveals unequivocally that the mean knowledge score increased from 16.2 + 2.85 to 22.45 + 2.13 after the post-test.
SECTION –IV: Testing hypothesis for evaluating effectiveness of self instructional module
Table 4: Comparison of knowledge scores of antenatal mothers regarding prevention of premature labour
|
Mean Difference |
Standard error of difference |
Paired ‘t’ test value |
||
|
Calculated value |
Table Value |
|||
|
07.3 |
2.23 |
19.07 |
2.26 |
|
(Table value of ‘t’ for 39 df at 0.05 level of significance is 2.26)
Table 4 shows that the paired 't' value for the overall mean difference was 19.07 and was at 7.3. The difference between the post-test and pre-test means was thus much greater, as was discovered. The table value for the paired "t" test with 39 degrees of freedom and a significance threshold of 0.05 is 2.26. The study hypothesis H2 was accepted because the calculated value was higher than the table value. In order to prevent premature labor, there was a substantial difference between the pre-test and post-test scores.
Table 5: Comparison of knowldge scores of antenatal mothers before and after intervention of self instruction module on premature labour.
|
Mean Difference |
Standard error of difference |
Paired ‘t’ test value |
|
|
Calculated value |
Table value |
||
|
08.66 |
2.4 |
17.49 1.96 |
|
(Table value of ‘t’ for 39 df at 0.05 level of significance is 2.26)
According to Table 5, the paired 't' value for the overall mean difference was 17.49, and it was 08.66. The difference between the post-test and pre-test means was thus much greater, as was discovered. The table value for the paired "t" test with 39 degrees of freedom and a significance threshold of 0.05 is 2.26. The study hypothesis H3 was accepted because the calculated value was higher than the table value. As a result, there was a substantial change in the practise test scores for preventing preterm labour between the pre-test and post-test.
Section V: Finding the association between knowledge scores through data analysis and interpretation is covered
The association between prenatal moms' knowledge of early care prevention and that knowledge was calculated using Karl Pearson's coefficient correlation. The connection between the knowledge and practice ratings of expectant women was found to be positive with a "r" value of 0.052. As a result, the study premise H1 is accepted.
Section VI: Pretest knowledge scores and specific socio-demographic factors are correlated.
Table 6: Association between knowledge scores and selected socio demographic variables
|
S. No |
Socio demographic variables |
Df |
Chi-square value |
Table value |
Level of significance |
|
1. |
Age |
1 |
3.523 |
3.84 |
0.05 |
|
2. |
Educational status |
1 |
12.2 |
3.84 |
0.05 |
|
3. |
Occupation |
1 |
7.29 |
3.84 |
0.05 |
|
4. |
Place of residence |
1 |
6.532 |
3.84 |
0.05 |
|
5. |
Source of information regarding health |
1 |
2.434 |
3.84 |
0.05 |
The correlation between the sample's socio-demographic characteristics and knowledge scores is shown in Table No. 8. The calculated value of 2 for age was 3.523, and the table value of 2 at 5% level of significance with degree of freedom 1 is 3.84. The research hypothesis related to sample age and pre-test knowledge score was accepted because the calculated value was lower than the table value. As a result, there was no correlation between prenatal moms' ages and their ability to prevent premature labor.
12.2 was the estimated 2value, and 3.84 is the table value of 2 at the 5% level of significance with degree of freedom 1. The research hypothesis connected to the educational status of the sample and pre-test knowledge score was rejected since the calculated value was higher than the table value. Therefore, a strong correlation between the expectant mothers' educational status and their pre-test knowledge score on specific premature labour and their prevention was found.
The estimated 2 value for schooling was 7.29, and the table value of 2 at 5% level of significance with degree of freedom 1 is 3.84. The research hypothesis connected to occupation of the sample and pre-test knowledge score was rejected since the calculated value was higher than the table value. Therefore, a significant correlation between the antenatal mothers' occupation and their knowledge score regarding the prevention of premature labour was found. 6.532 was the estimated 2 value for the family monthly, and 3.84 is the table value of 2 at 5% level of significance with degree of freedom 1. The research hypothesis connected to family income of the sample and pre-test knowledge score was rejected since the estimated value was higher than the table value. Therefore, a strong correlation between the prenatal mothers' family income and their pre-knowledge score on specific prevention of premature labour and their prevention was found.
The estimated two-value (2) was 2.434, while the table value of 2 at 5% level of significance with degree one is 3.84 The research hypothesis connected to the sample's informational source and pre-test knowledge score was approved because the calculated value was lower than the table value. Therefore, no correlation between the expectant moms' informational sources and their pre-test knowledge score on specific premature labour and their prevention was found.
The relationship between practises scores and socio demographic factors is shown in Table No. 7. The calculated 2value for age of the sample was 2.732, while the table value of 2 at 5% level of significance with degree of freedom 1 is 3.84. The research hypothesis related to sample age and practise score was rejected since the estimated value was lower than the table value. As a result, there was no connection between the age of the pregnant women and any meaningful outcome.
Table 7 Association between practice scores and selected socio demographic variables
|
S. No |
Socio demographic variables |
df |
Chi-square value |
Table value |
Level of significance |
|
1. |
Age |
1 |
2.732 |
3.84 |
0.05 |
|
2. |
Educational status |
1 |
4.905 |
3.84 |
0.05 |
|
3. |
Place of residence |
1 |
5.633 |
3.84 |
0.05 |
|
4. |
Occupation |
1 |
3.346 |
3.84 |
0.05 |
|
5. |
Source of information regarding health |
1 |
1.346 |
3.84 |
0.05 |
The estimated 2 value for the sample's level of education was 4.905, while the table value of 2 at 5% level of significance with degree of freedom 1 is 3.84 The hypothesis relating to the educational status of the sample and practice score was accepted because the calculated value was greater than the table value. As a result, a substantial correlation between the pregnant moms' educational level and their ability to avoid premature labor was found.
The estimated 2 value for place of residence was 5.633, while the table 2 value at 5% level of significance with degree of freedom 1 is 3.84. The research hypothesis connected to the sample's place of residence and practise score was approved because the calculated value was lower than the table value. As a result, a substantial correlation between pregnant mothers' location of residence and their ability to avoid premature labour was found.
The estimated 2value for the sample's employment status was 3.346, while the table value of 2 at the 5% level of significance with degree of freedom 1 is 3.84. The study hypothesis connected to the occupation of the sample and practise score was rejected since the calculated value was smaller than the table value. Therefore, there was no connection between the prenatal moms' occupation and their ability to avoid premature labour.
The estimated 2 value for the sample's information source was 1.346, and the table value for 2 at the 5% level of significance with degree of freedom 1 is 3.84. The study hypothesis relating to the source of information for the sample and practise score was rejected since the calculated value was lower than the table value. As a result, there was no connection between the expectant moms' informational sources and their ability to avoid premature labour.
DISCUSSION:
The goal of the current study was to assess how well a structured education programme affected knowledge and practises related to newborn care. A quasi-experimental one group pretest posttest design with an evaluation approach was used to meet the goals of the current study. By using a convenient random sampling procedure, the sample was chosen. Data were gathered from the sample of 40 pregnant moms both before and after the self-instruction module was administered.
We would like to thank all study participants and data collectors for their contribution in the success of our work.
This manuscript maintains no competing financial interest declaration from any person or organization, or non-financial competing interests such as political, personal, religious, ideological, academic, intellectual, commercial or any other.
Conceived and designed the study, analyzed thedata and wrote the manuscript. Involved in data analysis, drafting of the manuscript and advising the whole research paper and also were involved in the interpretation of the data and contributed to manuscript preparation. Similarly, all authors have read and approved the final version of the manuscript.
REFERENCES:
1. International Pregnancy and Infant Loss Remembrance Day [Internet]. Newborn Baby. 2020 [cited 19 November 2020]. Available from: https://newbornbaby.com.au/2020/10/international-pregnancy-and-infant-loss-remembrance-day.
2. Preterm birth [Internet]. Who.int. 2020 [cited 19 November 2020]. Available from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
3. Pillitteri A. Maternal and child health nursing. 2nded. Philadelphia: JB Lippincott Company; 1995. p. 462.
4. Altarum.org. 2020 [cited 19 November 2020]. Available from: https://altarum.org/sites/default/files/uploaded-publication-files/c06.pdf
5. Varney H, Kriebs JM, Gegon CL. Text book of Midwifery. 4thed. New Delhi: All India publishers and distributors; 2005. p. 856.
6. Dutta DC. Text book of obstetrics. 6th ed. Calculta: New central book Agency; 2004.p. 314.
7. Ministry Of Health clinical practice guidance. Management of preterm Labor. Ministry of health, Singapore: 2001May; 3:1-2.
8. Wood G, Haber J. Nursing research methods- critical appraisal and utilization. 3rded.London. Mosby; 1994.
9. Basvanthappa BT. Nursing research. New Delhi : Jaypee Brothers; 1998.
10. Kerlinger FN. Foundation of Behavioral Research. New York : Hold International Edition; 1973.
11. Basvanthappa BT. Nursing Research. New Delhi: Jaypee Brothers Medical publishers (9) ltd; 2003
Received on 20.10.2022 Modified on 13.11.2022
Accepted on 29.11.2022 © A&V Publications all right reserved
Int. J. Nur. Edu. and Research. 2023; 11(1):30-34.
DOI: 10.52711/2454-2660.2023.00006