A Study to assess the effect of health teaching on knowledge regarding nipple abnormality among the primigravida mother in civil hospital, Mehsana

 

Mr. Chetan Prakash Bardwal

Joitiba College of Nursing, Bhandu, Dist: Mehsana

 

ABSTRACT:

Introduction: Breast feeding the newborn is a satisfying and sometimes anxiety provoking task. Besides providing essential nutrition, it is an important mechanism in the Formation of the trusting relationship between the infant and mother. It is most effective to prepare the mother for breast feeding examination of the areola and nipple is important to identify any anatomic. If any anatomical abnormalities exist, they should be cause difficulties to feed. The abnormalities of the nipple includes long nipple, short nipple, abnormally large nipple, inverted and flat nipple and cracked or damaged nipple long nipple can lead to poor feeding because the baby is able to latch on to the nipple without drawing breast tissue into his mouth. Design: A quantitative approach using pre experimental one group pre-test post-test design. Participants: 30 primigravida mothers were selected using Non Probability Purposive sampling technique in civil hospital Mehsana District. Interventions: Planned teaching programme was given to the primigravida mothers. Tool: Self Structured Questionnaire was used to assess the level of Knowledge of primigravida mothers regarding Nipple Abnormality. Results: In this study overall the highest percentage in the demographic data including the Age group 56.6% (20 –25), Religion 73.3% (Hindu), Occupation 50 % (Other), Education 53.3% (Primary), and Monthly income 60% (5001-10,000), Type of family 53.3% (Nuclear Family), Previous knowledge 76.6% (No), The post- test Knowledge mean score (15.36) higher than the mean pre-test knowledge score (4.83). The calculated ‘t’ value (31.06) was greater than the table value (1.98) at 0.05 level of significance. The planned teaching programme was effective in increasing the knowledge of primigraveda mother regarding Nipple abnormality. Conclusion: The findings of the study revealed that planned teaching programme helps in improving knowledge regarding Nipple Abnormality among the primigravida mothers.

 

INTRODUCTION:

“Breast feeding is a mother’s gift to herself, her baby and the earth” 

                                                                Pamela. K. Wiggins

Breast feeding the newborn is a satisfying and sometimes anxiety provoking task. Besides providing essential nutrition, it is an important mechanism in the formation of the trusting relationship between the infant and mother. It is also important in the emotional development of the infant. A mother who is breast feeding for the first time is in a vulnerable position and requires support assistance. She has to make the transition from being insecure, anxious and self-doubt to being self-assured and confident in herself and her abilities. The mother should be prepared for each breast feeding and helped with the supportive measures.¹

 

It is most effective to prepare the mother for breast feeding examination of the areola and nipple is important to identify any anatomic. If any anatomical abnormalities exist, they should be cause difficulties to feed. The abnormalities of the nipple includes long nipple, short nipple, abnormally large nipple, inverted and flat nipple and cracked or damaged nipple long nipple can lead to poor feeding because the baby is able to latch on to the nipple without drawing breast tissue into his mouth.²

 

As the baby from a teat from both the breast and nipple, short nipple should not cause problems. If the mother is having abnormally large nipple and the baby is small, his mouth may not be able to get beyond the nipple and on to the breast. If the nipple is deeply inverted it may be necessary to initiate lactation by expressing and delay of tempting to attach the baby to breast until lactation is established The cracked nipple can occur because of trauma from baby's mouth and tongue which results from incorrect attachment of baby to the breast.³

 

It is most effective to prepare the breast during antenatal period for establishment of lactation. Examination of the areola and nipple is important to identify any anatomical problems. If any anatomical abnormalities exist, they should be discussed. Such abnormalities may cause difficulties to feed. The abnormalities of the nipple includes long nipple, short nipple, abnormally large nipple, inverted and flat nipple, and cracked or damaged nipple⁴.

 

NEED OF THE STUDY:

During the initial stage mother are likely to develop engorgement of breast and soreness of nipple due to poor positioning of the breast feeding infant and such problems may discourage them not to breast feed the infant. Thus the health counselors visit post natal mother during the first 2-3week should clarify the doubts of mother related to production of breast milk and related problems nipple abnormalities are commonly encountered in clinical practice especially in related to lactation problems postnatal. These abnormalities include flat or inverted nipple, fissured nipples. This are common with an incidence of 16.3% among nulliparous women attending ANCs large majority (90.2%) of them exclusively breast fed with satisfactory weight gain with adequate support incidence of flat/ non protractile inverted nipple is 9.6% large majority of plat / non protractile can be corrected atenatal (75%) with Hoffman exercise and they could successfully breast feed of offspring .Many mother experience painful sore nipple they stop breastfeeding before they inverted.⁵

 

Assessment of breast feeding should be comprehensive and should begin before the infant is at the breast early stage of the infants breast seeking behaviours should be observed as well as actual feeding It was identified by investigator during clinical experience at civil hospital mehasana that many primigravida mothers have nipple abnormalitie This is being a major problem among primigravida mother against Brest feeding.⁶

 

STATEMENT OF THE PROBLEM:

“A study to assess the effect of health teaching on knowledge regarding nipple abnormality among the primigravida mother in civil hospital, mehsana”.

 

OBJECTIVES OF THE STUDY:

·       To assess the knowledge regarding nipple abnormalities among primigravida mothers.

·       To evaluate the effect of health teaching regarding nipple abnormalities among primigravida mothers.

·       To find out the association between knowledge score and selected demographic variable.

 

HYPOTHESIS:

H0:   There will be significant deference in the pre test and post test knowledge of primigravida mothers regarding the nipple abnormalities.

H1:  There will be significant association between knowledge score with selected demographic variables.

 

MATERIAL AND METHODS:

Quasi experimental one group Pretest/Post test research design and Quantitative Approach. Effectiveness of Planned teaching program knowledge regarding Nipple Abnormality among the Primigravida Mother in Civil Hospital, Mehsana”. The data were collected from 30 Primigraveda Mothers. “Non Probability Purposive Sampling” sampling technique was used. A structured questionnaire was selected to assess the knowledge regarding Nipple Abnormality.

 

RESULTS:

Demographic data was analyzed using frequency and percentage. Frequencies, percentage, mean, mean percentage and standard deviation was used to determine the knowledge score. The ‘t’ value was computed to show the effectiveness of teaching programme and chi-square test was done to determine the association between the pretest knowledge of Primigravida Mother with selected demographic variables.

 

 

 

Finding related to demographic data:

In this study overall the highest percentage in the demographic data including the : In this study overall the highest percentage in the demographic data including the Age group 56.6% (20 25), Religion 73.3% (Hindu), Occupation 50 % (Other), Education 53.3% (Primary), and Monthly income 60% (5001-10,000), Type of family 53.3% (Nuclear Family), Previous knowledge 76.6% (No),

 

Finding related to pre and post knowledge score:

Level of Knowledge	Pre-test		Post-test
	Frequency	Percent (%)	Frequency	Percent (%)
Poor (Score 0-3)	8	26.6%	0	0%
Average (Score 4-7)	21	70.0%	0	0%
Good (8 – 12)	1	3.3%	1	3.3%
Excellent (Score 13-20)	0	0.0%	29	96.6%

 

Pre-test, only 8 (26.6%) of Primigraveda Mother had Poor level (0 -3 score) of knowledge on Nipple Abnormality, 21 (70%) of Primigraveda Mother had average (4 - 7 score) level of knowledge. 1 (3.3%) of Primigraveda Mother had a Good (8 - 12 score) level of knowledge on Nipple abnormality, and no one had excellent knowledge (23 – 33 score) on Nipple Abnormality

 

During Post-test, No one of Primigraveda Mother had Poor level (0 - 3 score) of knowledge on Nipple Abnormality, No one of Primigraveda Mother had Average level (4 - 7 score) of knowledge on Nipple Abnormality, 1(3.3%) of Primigraveda Mother had Good (8 - 12 score) level of knowledge on Nipple Abnormality and 29(96.6%) had excellent knowledge (13 – 20 score) on Nipple Abnormality.

 

It was inferred from the above table that the planned teaching programme was effective in improving knowledge regarding Nipple abnormality among primigraveda mothers.

 

Finding related to effectiveness of Planned teaching programme:

Distribution of subject on paired ‘t’ test between pretest and posttest knowledge score regarding Nipple abnormality among primigraveda mothers.

 

Parameter	Mean	Standard Deviation	‘t’ value
Pre-test	4.83	1.076	T = 31.90* DF =29
Post-test	15.36	1.45

 

 

 

Finding related to association between pretest knowledge score of Primigraveda Mother with selected demographic variables:

Table show that the association between the Pre test level of Knowledge and socio demographic Variable. The association between knowledge and demographic variables was assessed using chi-square test. Since p-values corresponding to all demographic variables are large (greater than 0.05). Thus, none of the demographic variable was found to have significant association with knowledge regarding nipple abnormalities among primigravida mothers.

 

CONCLUSION:

The present study aims to assess the effect of health teaching on knowledge regarding nipple abnormality. The study was conducted by using Pre experimental one group pre-test post-test research design. Mehsana district was selected for conducting the study. The sample size was 30 primigravida mother using Non probability Purposive Sampling method.

 

REFERNCES:

1.          Singh Amarjeet, breast and abnormalitiesin India, Indian Journal Community Medicine, Vol.9(33),2008 July; p. (196–97).

2.          Helen G, “role of single antenatal breast examination and advice by an obstetric resident on lactation performance in mothers”, Reproductive Health Matters, Vol.19(37),2012 May; p. (42-51).

3.          Mohammadzadeh A, breast feeding practices, vol.21(32),2011 Apr; 27(4):570, p;(28-30)

4.          Health & Gender-Based Medicine, 2009 July; Vol. 9; p. (15-25).

5.          Australian breastfeeding association. Breastfeeding with nipple problems. State of Victoria,

6.          Australia: 2010; 16(3):1-3.

7.          Kumar H. Sawkar Abhinandan, breast engorgement, Department of obstetrics and gynaecology, B.G. Nagara Karnataka, India, 2009 April; p. (2-36).

8.          Australian breastfeeding association, Factors contributing to unsuccessful breastfeeding among primigravida mothers, State of Victoria, Australia: 2010 May; Vol.16 (3); p. (1-3).

 

 

 

Received on 28.11.2019          Modified on 26.12.2019

Accepted on 09.01.2020   © A&V Publications all right reserved