Effectiveness of Planned Health Teaching on Knowledge regarding Pregnancy Induced Hypertension among Antenatal Mothers in selected rural area

Shweta Shridhar Ghag¹, Vanita Gaikawad², Sara Tomy³, Kumari Nutan⁴, Pournima Naik⁵

¹M.Sc. Nursing. Department of Obstetrics and Gynaecological Nursing,

M.V.P.S’ Institute of Nursing Education, Adgaon, Nashik, Maharashtra, India.

²Assisstant Professor, Department of Obstetrics and Gynaecological Nursing

M.V.P.S’ Institute of Nursing Education, Adgaon, Nashik, Maharashtra, India.

³Assistant Professor, Department of Child Health Nursing,

M.V.P.S’ Institute of Nursing Education, Adgaon, Nashik, Maharashtra, India.

⁴Principal, M.V.P.S’ Institute of Nursing Education, Adgaon, Nashik, Maharashtra, India.

⁵Vice-Principal, M.V.P.S’ Institute of Nursing Education, Adgaon, Nashik, Maharashtra, India.

*Corresponding Author E-mail: shwetaghag08@gmail.com

ABSTRACT:

Hypertensive disorders of pregnancy are among the leading causes of maternal and perinatal deaths in developing countries. Hypertensive disorders of pregnancy rank high among the causes of maternal mortality and morbidity. Thus emphasizing the need to address this problem in order to ensure health and well-being of antenatal mothers. Methods: A pre experimental one group pre-test post-test study on effectiveness of planned health teaching on knowledge regarding pregnancy induced hypertension among antenatal mothers in selected rural area. Total 60 mothers were selected by method of Probability simple random sampling technique as per the inclusion criteria. Pre- test was conducted to assess the knowledge of antenatal mothers regarding pregnancy induced hypertension using structured knowledge questionnaire on day ‘1’. On the same day planned health teaching was also administered to antenatal mothers regarding pregnancy induced hypertension. On 7^th day Post-test was conducted to assess the gain in knowledge using the same planned health teaching on the same sample. Finding: The pre-test mean score was 5.25 and the post-test mean score was 13.65. Thus there was significant difference between pre-test and post-test knowledge. Paired ‘t’ test was applied and calculated t value is 15.56 at 59 degree of freedom which is higher than the tabulated value 7.45 at 5% level of significance. Hence it was statistically interpreted that planned health teaching on pregnancy induced hypertension was effective. There was significant association of post-test knowledge with selected demographic variables that is age, Education and occupation as chi-square value is 13.52 and 14.20 respectively higher than the table value at 5% of significance which was statistically accepted. Hence it can be concluded that the study concluded that the planned health teaching as effective in improving the knowledge of antenatal mothers regarding pregnancy induced hypertension.

KEYWORDS: Pregnancy induced hypertension, Planned Health Teaching, Antenatal mothers, Rural area, knowledge.

INTRODUCTION:

Pregnancy and childbirth are one of the vital and important life events for the mother. Pregnancy is a crucial period for both mother and fetus. Around 15% of pregnant women are expected to suffer from life-threatening complications either during pregnancy, at delivery or in post-partum period. Hypertensive disorders of pregnancy (HDOP) are the significant contributors to these complications.¹Blood pressure (BP) ≥140/90 mmHg, taken after a period of rest, on two occasions or ≥160/110 mmHg on one occasion in a previously normotensive woman is labelled as pregnancy-induced hypertension.²

Hypertensive disorders of pregnancy are one of the major causes of maternal morbidity and mortality leading to 10–15% of maternal deaths, especially in developing world.It may complicate about 3–10% of all pregnancies with variable incidence among different hospitals and countries.³

Antenatal care played an important role in diagnosing, curing, and preventing the hypertensive disorders of pregnancies. Frequent follow-up, assessment of blood pressure, and the search for proteinuria form the cornerstone of antenatal screening of all pregnant women for PIH and her fetus which can prevent maternal and fetal mortality and morbidity.⁶

According to, National High Blood Pressure Education Program 2000 and ACOG 2013 Basic classification of hypertensive disease in pregnancy include –

1. Gestational HTN – BP >140/90mm Hg after 20 weeks in previously normotensive women.

2. Preeclampsia syndrome – Gestational HTN withproteinuria.

3. Eclampsia syndrome – Women with preeclampsia, convulsion/ coma that cannot be attributed to another cause. Seizures are generalized and may appear before, during or afterlabor.

4. Preeclampsia superimposed on Chronic HTN – Chronic underlying HTN is diagnosed in women with documented BP > 140/90 mmHg before pregnancy or before 20 weeks gestation orboth.⁷

MATERIAL AND METHODS:

In view of the nature of the problem and to accomplish the objectives of the study, a one group pre-test post-test pre experimental research design was used to evaluate the effectiveness of planned health teaching regarding pregnancy induced hypertension among antenatal mothers in selected rural area.

The study design shows that on first day (day 1), pre-test was given to assess the existing knowledge regarding pregnancy induced hypertension among antenatal mothers in selected rural area. The planned health teaching was also administered on the same day, On seventh day (day 7), post-test was conducted to assess the gain in knowledge using the same structured knowledge questionnaire. The study design systematically represented as follows:

Table No. (1) A Pre experimental one group pre-test post-test research design

Sample

Pre- Test

Intervention

Post –Test

Antenatal Mothers

Administration of structured knowledge questionnaire on day 1

Administration of planned health teaching on day

Administration of structured knowledge questionnaire on day 7

O₁

O₂

Key:

O₁Administration of structured knowledge questionnaire to assess pre-test knowledge regarding pregnancy induced hypertension among antenatal mothers on day 1.

X Intervention includes providing planned health teaching to antenatal mothers on day 1.

O₂Administration of structured knowledge questionnaire to assess post-test knowledge regarding pregnancy induced hypertension among antenatal mothers on day 7.

In the present study comprised of antenatal mothers of selected rural area, who fulfilled the inclusion criteria and present on the day of data collection.

In the present study, researcher was used Probability simple random sampling technique was used. The sample size selected for this study was 60 samples who fulfilled the sampling criteria and who were willing to participate in the study.

For this study, tool used to collect the data from the subjects included Structured knowledge questionnaire to assess the knowledge regarding pregnancy induced hypertension among antenatal mothers.

Figure No. (1) Bar diagram showing mean score of Pre-test and Post-test knowledge of antenatal mothers regarding pregnancy induced hypertension.

· The figure reveals the effectiveness of planned health teaching on knowledge regarding pregnancy induced hypertension among antenatal mothers.

· The pre-test mean score was 5.25 and the post-test mean score was 13.65.

· Thus there was significant difference between pretest and post-test knowledge.

· The calculated 't' value is 15.56 at 59 degree of freedom which is higher than the tabulated value that is 7.45 at 5% level of significance. Hence it was statistically interpreted that null hypothesis was rejected and H₁ accepted which states that the planned health teaching was effective to improve the knowledge of antenatal mothers regarding pregnancy induced hypertension.

· Hence the researcher accepted H₁ hypothesis and rejected the null hypothesis.

· H₁: Hence, there was significant difference between the pre-test and post-test knowledge of antenatal mothers regarding pregnancy induced hypertension. So it was concluded that planned health teaching was effective to improve the knowledge of antenatal mothers regarding pregnancy induced hypertension.

DISCUSSION:

The pre-test mean score was 5.25 and the post-test mean score was 13.65. Thus there was significant difference between pretest and post-test knowledge. Paired ‘t’ test was applied and calculated t value is 15.56 at 59 degree of freedom which is higher than the tabulated value 7.45 at 5% level of significance. Hence it was statistically interpreted that planned health teaching on pregnancy induced hypertension was effective to improve the knowledge of antenatal mothers regarding pregnancy induced hypertension. There was significant association of pre-test knowledge with selected demographic variables that is Education as chi-square value is 12.19 higher than the table value at 5% of significance which was statistically accepted. As well as there was significant association of post-test knowledge with selected demographic variables that is Education and occupation as chi-square value is 13.52 and 14.20 respectively higher than the table value at 5% of significance which was statistically accepted.

CONCLUSION:

From the study findings it is concluded that the planned health teaching was effective in improving the knowledge of antenatal mothers regarding pregnancy induced hypertension.

REFERENCES:

1. Berhe AK, Kassa GM, Fekadu GA. Muche AA. Prevalence of hypertensive disorders of pregnancy in Ethiopia: A systemic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18:34

2. World Health Organization. Managing complications in pregnancy and childbirth: A guide for midwives and doctors. World Health Organization; 2017.

3. Barron WM, Murphy MB, Lindheimer MD. In: Management of hypertension during pregnancy. 3rd ed. Raven. Laragh GH, Brenner BM, editors. Vol. 2. New York: Hypertension Pathophysiology, Diagnosis and Management. 1990. pp. 1809–27

4. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122: 1122–1131.

5. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Sibai BM Obstet Gynecol. 2003;102:181-92

6. Kintiraki E, Papakatsika S, Kotronis G, Goulis DG, Kotsis V. Pregnancy-Induced hypertension. Hormones. 2015;14(2):211-23.

7. Bhattacharya S, Campbell DM. The incidence of severe complications of preeclampsia. Hypertens Pregnancy. 2005; 24(2): 181-90.

8. Kavitha V. Assessment of Knowledge and Attitude of Antenatal Mothers Towards Caesarean Section and Normal Vaginal Delivery at Selected Hospital, Coimbatore. Asian J. Nur. Edu. and Research. 2013; 3(3): 190-191.

9. Marie Rosy. A Study to Assess the Knowledge and Practice Regarding Minor Disorders of Pregnancy and the Incidence among the Antenatal Mothers who Attending OPD at Selected Hospital, Kolar. Asian J. Nur. Edu. & Research. 2014; 4(3): 284-287.

10. Preethi Jazna.B, ReetaJebakumari, Nalini JeyavanthaSantha. A Study to Assess the Effectiveness of Benson Relaxation Therapy on Blood Pressure and Stress among Women with Pregnancy Induced Hypertension in Selected Hospitals, Madurai. Asian J. Nur. Edu. and Research. 2016; 6(2): 167-170.

11. Gehan. H.Soliman, Seham Mohamed Abd Elalem, Samah Mohamed Elhomosy. The Effect of Relaxation Techniques on Blood Pressure and Stress among Pregnant Women with Mild Pregnancy Induced Hypertension. Asian J. Nur. Edu. and Research. 2017; 7(3): 321-329.

12. G. Kalaiselvi, K. Savithri. Effectiveness of Yoga Therapy on Mild Pregnancy Induced Hypertension. Asian J. Nursing Education and Research. 2021; 11(1):11-14.

13. Devangamath BG, Raddi SA. A Randomized Control Trial to Assess the Efficacy of Dry Ginger Powder on Management of Nausea and Vomiting Among Antenatal Mothers Attending Selected Urban Health Centres of Belgaum, Karnataka – One Group Pretest Post Test Pre ExperimentalStudy.Asian J. Nur. Edu. and Research. 2016; 6(1): 17-26.

14. Shashikala Somane. A descriptive study to Assess the Knowledge and Attitude of Third Trimester Antenatal Mothers regarding Colostrum Feeding. Asian J. Nur. Edu. and Research. 2016; 6(3): 292-300.

15. Arun Kumar Jindal, Rimpy, Kiranjeet Kaur, Harpreet Kaur, Rahul. Knowledge regarding Danger Signs of Pregnancy among Antenatal Mothers. Asian J. Nur. Edu. and Research.2017; 7(2): 225-227.

16. Ann Maria Thomas. Effect of Planned Teaching Programme on Knowledge and Practices in Relation to Prevention of Complications among selected High Risk Antenatal Mothers in a Selected Hospital. Asian J. Nur. Edu. and Research. 2017; 7(3): 308-320.

17. Bincy Mathew. A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge and Attitude Regarding Diet in Pregnancy among Antenatal Mothers. Asian J. Nur. Edu. and Research. 2017; 7(3): 345-347.

18. Dhanalakshmi N, Bhavya SV, Sheela Williams. Knowledge and Attitude of Antenatal Mothers Regarding Early Initiation of Breast Feeding. Asian J. Nur. Edu. and Research. 2017; 7(3): 278-280.

19. A. Jessie Angel Dayna, Shraddha Patel. A Study to Evaluate the effectiveness of Structured Teaching Programme on knowledge regarding “Torch” infections during pregnancy among Antenatal mothers in a selected villages of Mehsana district. Asian J. Nursing Education and Research. 2019; 9(4):512-514.

20. Seema Chapadiya, Ponmani. P. ,Jeenath Justin Doss. K.. A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Umbilical Cord Stem Cell Banking among Antenatal Mothers in selected Hospital, at Rajkot. Asian J. Nursing Education and Research. 2020; 10(1):60-62.

21. Lakshmi. K. Effectiveness of Nursing care of antenatal mothers with Gestational diabetes mellitus. Asian J. Nursing Education and Research. 2020; 10(3): 286-290.

22. Payal T Vaghela. A study to assess the effectiveness of structured teaching programme regarding Kangaroo Mother Care (KMC) among antenatal mothers of selected hospital in Mehsana city. Asian J. Nursing Education and Research. 2020; 10(3): 305-307.

23. Honey Varghese, Jereena Jerome, Jincy Jose, Jitty Jose, Varsha Julius, Nisha John. Study to assess the Knowledge regarding Complementary Therapies among Antenatal mothers attending Antenatal clinic in selected hospital at Kollam. Asian Journal of Nursing Education and Research. 2021; 11(3):415-8.

24. Pallavi Devkate, Bincy Mathew, Krina Patel, Shital Halpati, Dimple Dhodi, VishvanginiHalpati, Celine Fernandes, Rima Joshi, Ashwini Ghutiya, PaulomiKapadi, Radhika Halpati, Kavitha Sebastian. A study to assess the knowledge regarding self-management of minor ailments in pregnancy among antenatal mothers. Asian Journal of Nursing Education and Research. 2022; 12(1):21-4.

25. Anuradha Panda, Ashabari Pradhan, Suchismita Pradhan, Bidisha Nath. A Descriptive Study to Identify the Cultural Beliefs related to Pregnancy among Antenatal Mothers in Rural Areas, Chakeisiani, BBSR, Odisha. Asian J. Nursing Education and Research. 2022; 12(3):342-4.

Knowledge	Maximum score	Mean score	SD	‘t’ value	Degree of freedom	significance
Pre- test	20	5.25	2.66	15.56	59	Highly significant(p<0.05)
Post-test	20	13.65	3.24	15.56	59	Highly significant(p<0.05)