A Pre-experimental study to assess the Effectiveness of the Self-instructional Module (SIM) on Knowledge regarding Prevention and Management of selected Breast Disorders during Postnatal Period among Antenatal Mothers in Third Trimester visiting a selected Antenatal Clinic at Mangalore

 

Ms.Teena Jacob ¹, Mrs. Sandhya D’Almeida²

¹M.Sc Nursing II Year, Dept of OBG (N). Laxmi Memorial College of Nursing, Mangalore, Karnataka

²Asst. Professor, Dept of OBG (N), Laxmi Memorial College of Nursing, Mangalore, Karnataka

 

ABSTRACT:

Breastfeeding is not as natural as it is thought to be. It has to be practised, learned and it needs a lot of determination, patience and effort on the part of the mother. A pre experimental, one group pre-test post-test design was used for the study. Using the purposive sampling technique, 50 antenatal mothers were selected and the data was collected by administering the Structured Knowledge Questionnaire on breast disorders during postnatal period. After collecting data, the Self-instructional Module (SIM) was administered to the subjects on the same day and on 8th day; a post-test was conducted using the same Structured Knowledge Questionnaire. The collected data was analyzed using the descriptive and inferential statistics. The analysis of the pre test knowledge revealed that in the pre-test scores, majority (84%) of the sample had average knowledge, 12% had good knowledge and 4% of them had poor knowledge on breast disorders where as in the post test scores, majority (66%) of the sample had average knowledge and 34% of the sample had good knowledge and none of them had poor knowledge on breast disorders. There was no significant association between the variables like age, type of family, place of residence, religion, and occupation and there was significant association between the variables like educational status, parity and previous knowledge and the post-test knowledge scores. The findings of the study concluded that the Self-instructional Module on breast disorders was effective in improving the knowledge of the antenatal mothers regarding prevention and management of breast disorders during postnatal period.

 

BACHGROUND OF THE STUDY:

Every year, the Women’s International Day is celebrated inspiring the women of today to stride ahead in life. While women have made progress in most of the field, still she tends to inexplicably neglect her own health. The technological advancements, modernization, urbanization, economic liberalization, and changing values of the society have been influencing the healthcare tremendously.

 

Breastfeeding has been accepted as the most vital intervention ensuring optimal growth and development of the baby and for reducing infant mortality. In India, though breastfeeding is universal but traditionally, initiation of breastfeeding is considerably delayed in our country. Also, in most cases valuable colostrum is discarded before putting the child to the breast. Based on most recent scientific evidence, WHO recommends that breastfeeding should be commenced at the earliest after child birth. Neonate should receive benefits of colostrum feeding and newborn must receive exclusive breastfeeding for first 4-6 months. Thereafter, there should be addition of semisolid and solid foods as a complement to breast milk till the child is able to take normal food. It has been conclusively deduced that beneficial effects of breastfeeding depend directly on the time period of breastfeeding initiation as also on the total duration of breastfeeding. Although breastfeeding is universal in India, but exclusive breastfeeding and appropriate weaning practices still remain far from satisfactory. Various socio cultural factors influence this aspect and these factors vary from region to region.

 

Objectives of the Study

·        To determine the knowledge regarding prevention and management of selected breast disorders among antenatal mothers.

·        To evaluate the effectiveness of Self-instructional Module regarding prevention and management of selected breast disorders among antenatal mothers.

·        To find out the association of the post test knowledge scores with the demographic variables.

 

Hypotheses

The hypotheses will be tested at 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 is a significant association of the post test knowledge scores with the demographic variables

 

MATERIAL AND METHODS:

Research approach

An evaluative approach was used for the present study.

Research design

Pre-experimental one group pre-test post-test design was adopted

Setting

The study was conducted in the Antenatal clinic of Lady Goschen Hospital, Mangalore.

Sample and sampling technique

Sample for the present study consisted of 50 antenatal mothers in third trimester who fulfilled the criteria. Purposive sampling technique was used to select the sample from the population.

Selection and development of the tool

A baseline proforma and the Structured Knowledge Questionnaire on prevention and management of breast disorders during postnatal period were prepared. The tool for data collection had two sections – Section A and B.

Section A: Demographic proforma consisted of antenatal mother’s age, type of family, place of residence, religion, educational status, occupation, parity and previous knowledge on prevention and management of breast disorders during postnatal period.

Section B: Structured Knowledge Questionnaire on prevention and management of breast disorders during postnatal period had 30 items. The scoring was done by just counting the correct responses and according to the total score obtained. The highest possible score was 45. It was arbitrarily classified into three levels: [0-15 (Poor)], [16-30 (Average)] and [31-45, (Good)].

Development of the Self-instructional Module (SIM)

The Self-instructional Module on prevention and management of breast disorders during postnatal period was developed according to the planned objectives. The SIM consisted of two chapters: Chapter 1 had two modules that included the structure and function of breast and physiology of lactation and Chapter 2 had five modules that included prevention and management of selected breast disorders during postnatal period.

 

RESULTS:

Table 1: Frequency and percentage distribution of antenatal mothers according to the demographic variables

N=50

 

Table 1. shows that the highest (52%) of the sample were in the age group of 18-21 years and the least percentage (12%) belonged to 30 years and above, the highest percentage (48%) of the sample belonged to joint family and the least percentage (26%) belonged to extended family, the highest percentage (58%) of the antenatal mothers resided in the rural area and 42% were from urban area, most (38%) of the antenatal mothers were Hindus, 30% of the mothers were Christians and 32% among them are Muslims, majority (46%) of the antenatal mothers had primary education, 28% of them had high school education and 26% had PUC and above education, majority (30%) of the antenatal mothers were agriculturalists, 28% of them were professionals, 22% of them were doing business and 20% were coolie/unskilled workers, majority (58%) of the antenatal mothers were multipara and 42% of them were primipara, most (66%) of the antenatal mothers had previous knowledge regarding breast disorders and the least (34%) had no knowledge regarding breast disorders and the highest percentage (51.51%) of the antenatal mothers was aware of breast disorders from the family members and least percentage (12.12%) were through the contact with health personnel.

 

Table 2: Frequency and percentage distribution of knowledge scores of antenatal mothers on breast disorders during postnatal period

N=50

Grade of Knowledge	Range of Score	Pre-test		Post-test
		Frequency	%	Frequency	%
Poor	0-15	2	4	-	-
Average	16-30	42	84	33	66
Good	31-45	6	12	17	34

 

Table 2 shows that in the pre-test majority (84%) of the antenatal mothers had average knowledge and only 12% of the antenatal mothers had good knowledge and 4% of them had poor knowledge, whereas in the post-test (66%) of the antenatal mothers had average knowledge and 34% of the mothers had good knowledge and none of them had poor knowledge regarding breast disorders during postnatal period.

 

 

Table 3: Area-wise mean, standard deviation and mean percentage of the pre-test and the post-test knowledge scores of antenatal mothers on breast disorders during postnatal period                                                                                                                 N=50

 

 

Table 3 shows that in all the areas, the mean post-test knowledge scores were higher than the mean pre-test knowledge scores. The mean percentage of the pre-test score was highest (71%) in the area of definition and lowest (36.66%) in the area of structure and function of the breast. Mean percentage of the post- test score was maximum (95%) in the area of definition and lowest (40.5%) in the area of prevention of breast disorders.

 

 

Table 4: Chi-Square test showing association of the post-test knowledge score with the demographic variables                     N=50

p < 0.05, * Significant

 

Table 4 shows that significant association was found between educational status, parity, previous knowledge and the post test knowledge scores. Hence the null hypothesis was rejected and research hypothesis was accepted at 0.05 level of significance. Whereas no significant association between age, type of family, place of residence, religion and occupation. Hence the null hypothesis was accepted at 0.05 level of significance.

 

 

CONCLUSION:

The findings of the study concluded that the Self-instructional Module on breast disorders was effective in improving the knowledge of the antenatal mothers regarding prevention and management of breast disorders during postnatal period. Educating the antenatal mothers, will help them to become more aware about their own breast health and also helps for early detection and treatment.

 

RECOMMENDATIONS:

Based on the study findings, the following recommendations are stated:

·        A similar study can be done on a larger sample to validate and generalise the findings.

·        A similar study can be conducted by using the experimental and randomised control trial group method.

·        A similar study can be conducted by the descriptive method on knowledge and attitude on antenatal mothers on breast disorders

·        A comparative study can be conducted on both the rural and urban women regarding knowledge on prevention and management of breast disorders during postnatal period.

·        Replication of the study can be conducted among other antenatal mothers in the antenatal clinics.

·        A comparative study can be conducted to find out the effectiveness between various teaching methodologies.

 

REFERENCES:

·        Bailey T. Nurse’s role in promoting breast awareness. Nursing Standards 2000;14(30):34-6.

·        Dutta DC. Textbook of obstetrics including perinatology and contraception. 7^th ed. London: New Central Book Agency; 2011; P. 15, 49.

·        Parveen S, Sareen IB, Dahiya BR. Breastfeeding practices in post IMNCI era in rural community of Haryana. Indian Journal of Public Health Research and Development 2012;4(3):205-9.

·        Mala LC. Effectiveness of educational programme on infant feeding practices among mothers of infants. Prisms Nursing Practice 2012;1(7).

·        Jain A. Code Watch: 25 years of protecting breastfeeding. Nightingale Nursing Times 2009;5(9):48-51.

 

 

Received on 19.05.2014           Modified on 05.06.2014

Accepted on 10.06.2014           © A&V Publication all right reserved