A Study To Evaluate The Effectiveness of Structured Teaching Program On Knowledge and Practice Regarding Kangaroo Mother Care Among Post Natal Mothers Having Low Birth Weight Babies 1 PDF

AIJRPLS VOLUME 2, ISSUE 1 (2017, Jan/Feb/Mar) (ISSN-2456-3889) Online
ANVESHANA’S INTERNATIONAL JOURNAL OF RESEARCH IN PHARMACY AND LIFE SCIENCES
A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAM ON KNOWLEDGE AND PRACTICE REGARDING KANGAROO
MOTHER CARE AMONG POST NATAL MOTHERS HAVING LOW BIRTH
WEIGHT BABIES ADMITTED IN GOVERNMENT HOSPITAL AT JHUNJHUNU
[RAJASTHAN]
MAMTA CHAUDHAR Dr. NAVEEN PAREEK Dr. SANTOSH YADAV

Research scholar, Principal, D. P. Tiwari OSD, R.A.K. College of
Shri Jagdishprasad Medical and Nursing Nursing,
Jhabarmal Tibrewala Education Institute college New Delhi.
University, of Nursing, Muhana,
Jhunjhunu, India Sanganer, Jaipur
ABSTRACT: denoted by t-value of 48.36 in knowledge scores

Introduction: and 47.0 in practice scores at P<0.05.
Kangaroo Mother Care is a natural way of caring Keywords: Kangaroo mother care, Preterm and
of newborns especially premature and low birth low birth weight.
Weight baby. It is proved that the newborn thrives INTRODUCTION
best in its original “right place” on its be and for Kangaroo mother care is the innovative
prospective mother‟s and explains why Kangaroo method of taking care of low birth weight
mother care works.
infants. Birth weight is the single most
Methods:
A pre-experimental study was adopted for the important marker of adverse prenatal,
present study. A structured Knowledge neonatal and infantile outcomes. Over
questionnaire and practice checklist on „Kangaroo 80% of all neonatal deaths, in both the
Mother Care among postnatal mothers having low developed and developing countries, occur
birth babies‟ was developed to collect the data.
among the low birth weight babies.
Thestudy was conducted in government hospital at
Jhunjhunu, Rajasthan. One eighty postnatal In 2013, nearly 22 million newborns—an
mothers were selected by using purposive sampling estimated 16 per cent of all babies born
technique. Collected data was analyzed and globally that year—had low birth weight.
interpreted with help descriptive statistics and Accurate monitoring is challenging,
inferential analysis.
however, since nearly half of the world‘s
Result:
The mean difference between pretest and posttest infants are not weighed at birth.
knowledge was 30 and the „t‟ value was 48.36 and (UNICEF)
it was found to be highly significant at the level of Kangaroo mother care is defined as early,
p<0.05, whereas the mean difference between continuous and prolonged skin- to skin
pretest an posttest practice was 27 and the „t‟ value
contact between a mother and her low
was 47.0 and it was found to be highly significant
at the level of p<0.05. Significant relation was birth weight baby, both in hospital and
found between pretest knowledge and practice after discharge, until at least the 40th week
scores with r value of 0.09 at p<0.05. of postnatal gestational age. Kangaroo
Conclusion: mother care does not need a sophisticated
The present study was taken up in an effort to
equipment, can be applied almost
evaluate the effectiveness of structured teaching
programme on knowledge and practice of anywhere, could contribute to the
kangaroo mother care among postnatal mothers humanization of neonatal care contains no
having low birth babies. STP was effective as cost. Infant mortality rate is 60 per 1000

EMAILID:anveshanaindia@gmail.com,WEBSITE:www.anveshanaindia.com
93
live births and neonatal mortality rate is 40 ensures people from all economic
per 1000 live births in India and 44 per standards to give the needed care for their
1000 live births in Tamil Nadu and 40 per preterm babies. The preterm babies gain 6
1000 live births in Karnataka. Data temperature slowly and prevent
indicates an alarming situation. The Health hypothermia. Therefore, the preterm baby
for All by 2010 aims for 20 Infant becomes calm and relaxed. It also helps
Mortality Rate makes it imperative to the baby to conserve energy and bring the
develop and low cost effective modality organs to normal functioning.
while for caring preterm babies. Studies related to Kangaroo Mother
Need for the study: Care:-
Neo-natal mortality is defined as death Dr.Elwis Elias et al. (2014) conducted a
during the first 28 days of life. And India study with 80 LBW babies born and
reports the highest numbers in the world: admitted in NICU, Rajah Muthiah Medical
As many as 700,000 newborns die in India College Hospital, Tamilnadu during a
each year–29 per 1,000 births. This period of 1 year. LBW babies were
accounts for 26% of neo-natal deaths in randomized into two groups. 40 babies
the world, according to the United Nations were managed with kangaroo mother care,
Children‘s Fund (UNICEF). while rest of the 40 babies were managed
Successful kangaroo mother care is highly with Conventional Method Care (CMC).
dependent on the support parents receive, In both groups feeding, axillary
and the role of health professionals is temperature of the baby, weight gain,
crucial. Caring is a premature baby can be length, head circumference and
very stressful. Staff in the neonatal unit behavioural effect on mother (bonding and
can actively support parents by making confidence ) were studied. It was observed
them feel welcome, and establishing that the duration of hospital stay was less
appropriate procedures and setting which in kangaroo mother care group when
allow parents 24-hour access to their compared to CMC group.
babies. They can also help by performing Nirmala et al. (2006) conducted a
some components of the baby's care (for repeated measure design study to assess
example tube and cup feeding, especially perceptions of KMC among mothers and
during the night), so that parents can get healthcare workers. This study included a
sufficient rest. purposive sample of 50 neonates with birth
Health professionals can provide timely weight in the range 1070-2460 g.
information to parents (both orally and in Perceptions of KMC were assessed in a
writing) about the practicalities of sample of 45 mothers over a 6-week
kangaroo mother care, including the period (attrition rate = 8%) and 33
possibility of sharing the task with others healthcare workers. A guide was used for
members of their support network, to interviews with mothers that had been
provide parents with opportunities to rest. previously validated by nine experts, but
In India, most of the population below this is not provided in the paper and an
poverty line, thus restraining them' from overview of the questions was not given.
sophisticated care for their Low birth No information is provided on interviewer
weight infants. Thus, Kangaroo Care or their relationship with the study
94
participants.All mothers felt that KMC higher than pre test knowledge sore at the
improve bonding and made them feel level of P≤0.05.
good, satisfied and happy to be H3 - There is significant difference in
contributing to the care of their baby; pretest and posttest practice score of
86.7% found no problems providing KMC postnatal mothers regarding kangaroo
to their baby and 30% believed it had mother care after administration of
increased their milk production structured teaching programme at the
Nevertheless, 88% stated their intention to level of P≤0.05.
continue with KMC at home. Assumptions
Objectives of the Study:- In this study the investigator assumes
A. To assess knowledge of postnatal that:
mothers having low birth weight ❖ Postnatal mothers having LBW
babies before and after babies who are admitted at
implementation of structured teaching admitted in Government Hospital
programme on kangaroo mother care. at Jhunjhunu will have some
B. To observe practice of postnatal knowledge about kangaroo mother
mothers having low birth weight care.
babies before and after ❖ Information provided by the
implementation of structured teaching postnatal mothers represents their
programme on kangaroo mother care. true level of understanding.
C. To find out association between ❖ Sufficient knowledge of post natal
pretest knowledge scores regarding mothers regarding kangaroo
kangaroo mother care with selected mother care will promote
socio demographic variables adequate growth and wellbeing of
D. To evaluate the relationship between the LBW babies.
knowledge and practice pretest scores. ❖ Postnatal mothers will respond
E. To evaluate the effectiveness of truthfully and answer frankly to
structured teaching programme on questions.
knowledge regarding kangaroo Delimitations
mother care among postnatal mothers The study is delimited to-
having low birth weight babies.  Postnatal mothers having
F. To evaluate the effectiveness of babies of birth weight >1500
structured teaching programme on gms to <2500 gms.
practice regarding kangaroo mother  Postnatal mothers having
care among postnatal mothers having stable LBW babies.
low birth weight babies.  Postnatal mothers with their
Research Hypothesis LBW babies available in ward
H1 - There is significant association and nursery at the time of
between pretest knowledge scores and study.
selected demographic variables. Conceptual Framework:
H2 - The mean post test knowledge The conceptual framework developed by
score of postnatal mother is significantly the investigator is based on IMOGENE
KING‘S GOAL ATTAINMENT
95
THEORY. This theory focuses on the Research design

interpersonal relationship between the The research design is the plan, structure
Investigator and the Post natal mothers and strategy of investigation. Research
having low birth weight babies. The design is design as ‗A researchers overall
interaction is influenced by the perception for obtaining answers to the research
and leads to mutual goal setting which are question or for testing the hypothesis. The
to be achieved by the Nurse and the Client. design adapted for this study by the
In the present study, interaction takes place investigator is pre experimental research.
between the investigator and the Post natal Variables
mothers having low birth weight babies A variable is an attribute to a person or
object that varies that it takes on different
values.
Independent variables:
In the study the independent variable
refers to structured teaching programme
knowledge and practices regarding
kangaroo care among post natal mothers
having LBW babies.
Dependent variable:
In the present study it refers to the
knowledge and practices regarding
kangaroo care among post natal mothers
having LBW babies.
Extraneous variable:
Materials and Methods:
Extraneous variables in the study are
Pre-experimental research design was used
background variables such as age ,
to conduct the study. The study was
education qualification, religion, number
conducted at govt hospital, at Jhunjhunu
of children, duration of pregnancy,
[Rajasthan].
previous knowledge about kangaroo
Setting
mother care and source of information.
Based on the setting and availability of the
Population
sample, the present study was conducted at
Population is the entire aggregation of
Government Hospital at Jhunjhunu
cases that meet a designed set of criteria
[Rajasthan]
Polit and Hungler (1999). The population
Research approach
again divided into two types. Those are
Research approach is an overall plan to
target and accessible population.
carry out research study. In the present
Target population:
study an evaluative approach was used to
It refers to the elements, people, objects to
assess the effectiveness of a structured
which the investigator wants to generalize
teaching programme on knowledge and
the research finding. In the present study
practices regarding kangaroo care among
the target population were postnatal
postnatal mothers having low birth weight
mothers having LBW babies.
babies.

96
Accessible population 2001).Purposive sampling technique was

Accessible population refers to the adopted for the present study.
aggregate of cases which confirm to the Criteria for selecting the sample
designed criteria and which is accessible to In sampling criteria, the researcher
the researcher as a pool of subjects or specifies the characteristic of the
objects. In the present study the accessible population under the study by detailing the
population was In the present study inclusion and exclusion criteria. Inclusion
population is all postnatal mothers having criteria are the characteristic that each
low birth weight babies admitted in sample elements must possess to be
postnatal wards, and neonatal nursery of included in the sample. Exclusion criteria
Government Hospital, Jhunjhunu. are characteristic that could confound or
Sample and sample size contaminate the results of the study
Sample: therefore such participants are excluded
Sample may be defined as representative from the study.
unit of a target population, which is to be Inclusion criteria:
worked upon by researchers during their Postnatal mothers who are,
study. For the present study postnatal 1. Having low birth weight babies
mothers having low birth weight babies 2. Available during the period of data
admitted in postnatal wards, and neonatal collection
nursery of Government Hospital, 3. Willing to participate in the study
Jhunjhunu were selected. Exclusion criteria:
Sample size: Postnatal mothers who are,
According to Polit and Hungler (1999), a 1. Sick at the time of data collection
sample is a sub set of a population selected Development of the tool
to participate in research study. The A structured knowledge questionnaire was
sample consisted of cancer clients prepared by the investigator to assess the
receiving radiation therapy from selected knowledge of postnatal mothers regarding
hospitals of Hyderabad were selected . kangaroo mother care, which included of
Factors like nature of the study, two parts Part-A: consists of selected
availability of sample, time, money and background variables .Part-B: consists of
material were considered while deciding 25 knowledge items related to Kangaroo
the sample size. mother care. The questionnaire is prepared
The sample size of the present study to assess knowledge of postnatal mothers
consists of 180 postnatal mothers having having low birth weight babies in selected
LBW babies admitted in postnatal wards, Hospitals. To assess the practice regarding
neonatal nurseries of Government kangaroo mother care apractice check list
Hospital, Jhunjhunu, fulfilling the was prepared , the tool consists of 15 items
sampling criteria. the deals with statements related to
Sampling technique: practices regarding rehabilitation.
Sampling technique refers to the process Scoring key:
of selecting a portion of the population to Structure knowledge questionnaire:
represent the entire population (Polit consists of 25 items each question has four
options (a, b, c, d). Correct option was
97
given a score of one, wrong given a score Christian 10 6%

of zero. The total score was thirty. The Muslim 47 26%
score has been categorized into below Others 12 7%
average, average and above average based Education
on their responses. Illiterate 103 57%
Below 50% below average 10thclass 29 16%
51-75% Average Intermediate 48 27%
Above 75% above average Occupation
Practice checklist: For the present study
House Wife 108 150%
the practice checklist had ‗Yes‘ or ‗No‘
Pvt Employee 18 25%
responses. The scoring for the Yes
Business 13 18%
response is ―1‖ whereas the scoring for No
Others 41 57%
response is ―0‖. The scores were
Monthly income
categorized into below average, average
Below Rs. 80 44%
and above average based on their
5000/-
responses.
Rs. 5000 to 71 39%
Below average <50%
10000
Average 51-75%
Rs. 11001Rs- 29 16%
Above average >75%
15000
The tool was given for content validity to
experts in the field of nursing and Above 15000 0 0%
medicine. The reliability of the tool was No of children
checked by Karl Pearson and Spearman One 29 16%
Brown Prophecy formula. The results Two 48 27%
indicated that that the tool was valid and Three 63 35%
reliable. More than 40 22%
Data Analysis and Interpretation Three
Inferential Statistics & Descriptive Previous knowledge about kangaroo
Analysis was adopted for the study. mother care
Table No.1 Distribution of postnatal Yes 162 90%
mothers according to their demographic
No 18 10%
variables (n=180)
Source of Information
Socio Number Percentage
Demographic News paper 60 33%
Variables Television 22 12%
Age Health 43 24%
20-30Years 23 13% education in
31-40 years 137 76% hospital
Less than 16 9% Others 55 31%
20years Table.2 Relationship between Pretest
More than 40 4 2% Knowledge and Practice Scores Regarding
Religion KMC among Postnatal Clients Having
Hindu 111 62% Low Birth Babies
98
Variables Mean SD r Value  Nursing Education should prepare

Knowledge 48 8.6 0.09 nurses with the potential for
managing the low birth weight
Practice 47 8.3
babies.
Table 3: Comparison of pre test and

Nursing Administration
post test knowledge and practice scores 
Nursing administrator should
among postnatal mothers. provide necessary facilities and
(n=180)
opportunities for mothers to equip
Prete Postte Mean t- themselves with knowledge and
st st Differen valu skill to prevention of Neonatal
Mea Mean ce e Hypothermia.
n  Administration of Health services
Knowled 48 78 30 48.3 should organize inservice
ge 6 education programme, provide
Scores supervision and guidance to the
Practice 47 74 37 47.0 Staff Nurses on kangaroo mother
Scores care.
 Administration of private and
Implications government health agency can
Nursing Practice: organize health education

Nurses play a very important role programmes, camps and puppet
in providing care kangaroo care. So show in the community and in the
She should adhere to the standards hospital setup to create awareness
of practice and strictly follow to the public on newborn care.
them. Nursing Research

Nurses should be involved in  This study will be a valuable
monitoring the practices of reference for further references.
kangaroo mother care and improve  This study will help the nurse
the quality care with better nursing researches to develop indepth into
practices. the development of teaching

The nursing professionals can module and set information on
conduct health education newborn care among mothers of
programmes in the Newborn.
wards,outpatient departments and Limitations
in the community regarding care of The study has the following limitations:
the newborn .  The study was limited to postnatal
Nursing Education having low birth weight babies at
 Nursing educators should selected hospitals.
emphasize and motivate the  Sample size was limited to 180
nursing students to give planned only.
health teaching debates regarding
kangaroo mother care.

99
Recommendations 11. Polit, F., Denise, and Beck Cherly Toronto

● The same study can be replicated (2008),”Nursing research generating and
assessing evidence for nursing
on larger sample for better
practice”.(8th edition), New Delhi.
generalization. 12. Kumar , V. (2006) . Introduction of
● A descriptive study on knowledge, community based skin-to skincare in rural
attitude and practices of postnatal uttarpradesh, India , journal of
mothers regarding kangaroo perinatology. 26(10) P.no:- 597-604.
13. Gardene, S., and Goldson (2002) the
mother care can be conducted.
mother as incubator after delivery. Journal
CONCLUSION of obstetrics, Gynaecologic and
This study will provide Postnatal neonatology nursing P. No:174-176.
mothersthe creditability to influence 14. Daga S.G. (1989). Reduction in
decision making and policies to meet the neonatology mortality with simple
interventions. Journal of tropical pediatrics
needs of the low birth weight babies.
35 P. No: 191-194.
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AIJRPLS VOLUME 2, ISSUE 1 (2017, Jan/Feb/Mar) (ISSN-2456-3889) Online

ANVESHANA’S INTERNATIONAL JOURNAL OF RESEARCH IN PHARMACY AND LIFE SCIENCES