A STUDY TO ASSESS THE KNOWLEDGE ,ATTITUDE AND …



A STUDY TO EVALUATE THE EFFECTIVENES OF HEALTH TEACHING ON KNOWLEDE AND ATTITUDE OF POSTNATAL MOTHERS

TOWARDS KANGAROO MOTEHR CARE IN SELECTED

HOSPITAL AT BANGALORE

M.Sc. Nursing Dissertation protocol submitted to

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Rajiv Gandhi University of health Sciences, Karnataka, Bangalore.

By

Ms. S. SANDEEPTHI

M.Sc. NURSING FIRST YEAR

YEAR 2009-2011

Under the guidance of

Mrs. LOKESHWARI

K.T.G. college of nursing,

HOD THE DEPARTMENTOF OBG

Sreegandhadakavalu, Hegganahalli cross

Sunkadakatte road, Bangalore-560091.

RAJIV GANDHI UNIVERSITY OF HEALTH SCINCES,

BANGALORE , KARNATAKA.

SYNOPSIS PERMORMA FOR REGISRATION OF SUBJECT

FOR DISSERTATION

|1. |NAME OF THE |MS. S.SANDEEPTHI |

| |CANDIDATE |FIRST YEAR M.Sc. NURSING |

| |AND ADDRESS |K.T.G. COLLEGE OF NURSING. |

| | |SREERGANDHADAKALALU, |

| | |HEGGANAHALLI CROSS. |

| | |SUNKADAKATTE ROAD, |

| | |BANGALORE- 560091 |

|2. |NAME OF THE |K.T.G. COLLEGE OF NURSING. |

| |INSTITUTION |SREERGANDHADAKALALU, |

| | |HEGGANAHALLI CROSS. |

| | |SUNKADAKATTE ROAD, BANGALORE- |

| | |M.Sc. NURSING FIRST YEAR |

|3. |COURSE OF THE STUDY AND SUBJECT |OBSTERTICAL & GYNAECOLOGICAL |

| | |NURSING |

| | | |

| | | |

|4. |DATE OF ADMISSION |15- MAY- 2009 |

| |TO THE COURSE | |

| | | |

| | | |

|5 |TITLE OF THE TOPIC |A STUDY TO EVALUATE THE EFFECTIVENESS OF |

| | |HEALTH TEACHING ON KNOWLEDGE AND |

| | |ATTITUDE OF POSTNATAL MOTHERS TOWARDS KANGAROO MOTHER CARE IN SELECTED |

| | |HOSPITAL AT BANGLORE |

| | |

| |BRIEF RESUME OF THE INTENDED WORK: |

| |INTRODUCTION |

| | |

| |Human babies are the most dependent young ones and for a much longer time than the young ones of other species. In the case of other mammals the |

| |young ones immediately after birth or very soon become independent. They learn to be independent fast and they are left unaided very soon. For |

| |example in the case of cattle as soon as the calf in born, it learns to stand up by itself, and suck the milk from the mother and begins to run |

| |around soon. If the new born babies are left unaided or not taken care they cannot survive. So much care is needed to a new born infant, especially|

| |from the mother and this care includes love, affection, warmth, protection, nutrition fro good health. |

| | |

| |Kangaroo Mother Care is the method of holding an infant with skin to skin contact, prone and upright on the chest of the parents. This method was |

| |described as human incubator low birth weight babies. |

| |K M C satisfies all five senses of the baby. |

| | |

| |Touch -skin to skin contact |

| |Hearing - listens to mother’s voice and heart beat. |

| |Taste -sucks on breast |

| |Vision -eye contact with mother |

| |Olfactory - smells mother’s odour. |

| | |

| | |

| |Nils Bergman (1979) defines KMC from child’s point of view as |

| |“Hold me, Feed me, Love me” |

| | |

| |Milestones in the development of KMC |

| |1979 → Dr Rey and Martinez started programme in Bogota, Columbia |

| |In response to shortage of incubator’s and severe hospital |

| | |

| |Infections. |

| |1983 → UNICEF brought attention to programme, Spanish |

| |1985 → Number of visits from U.S.A, U.K. and Scandinavia, first |

| |English report published in the lancet by Whitelaw and sleath, |

| |May 1985 |

| |1986 → Research in Europe and USA. Implementation widespread in |

| |Scandinavia and Germany. Early implementation in Mozambique |

| |And other African countries. |

| |1991 → First review of research published by Gene Cranston Anderson. |

| |1996 → First international workshop, Trieste Italy hosted by Adreano |

| |Catlaneo and team. Noted over thirty different terms used, agreed |

| |to use KMC , defining the programme of skin to skin contact, |

| |Breast feeding and early discharge. The term ‘KC’ refers to |

| |Intervention intra hospital maternal – infant skin to skin contact”. |

| |1998 → First international conference on kangaroo care, Baltimore, |

| |Maryland USA, arranged by Susan Ludington Hoe. |

| |2000 → Third International workshop, Yogyakarta Indonesia |

| | |

| | |

| |Milestones in the development of KMC |

| |1979 → Dr Rey and Martinez started programme in Bogota, Columbia |

| |In response to shortage of incubator’s and severe hospital |

| | |

| |Infections. |

| |1983 → UNICEF brought attention to programme, Spanish |

| |1985 → Number of visits from U.S.A, U.K. and Scandinavia, first |

| |English report published in the lancet by Whitelaw and sleath, |

| |May 1985 |

| |1986 → Research in Europe and USA. Implementation widespread in |

| |Scandinavia and Germany. Early implementation in Mozambique |

| |And other African countries. |

| |1991 → First review of research published by Gene Cranston Anderson. |

| |1996 → First international workshop, Trieste Italy hosted by Adreano |

| |Catlaneo and team. Noted over thirty different terms used, agreed |

| |to use KMC , defining the programme of skin to skin contact, |

| |Breast feeding and early discharge. The term ‘KC’ refers to |

| |Intervention intra hospital maternal – infant skin to skin contact”. |

| |1998 → First international conference on kangaroo care, Baltimore, |

| |Maryland USA, arranged by Susan Ludington Hoe. |

| |2000 → Third International workshop, Yogyakarta Indonesia |

| | |

| | |

| | |

| |Need for the Study |

| | |

| |Some 20 million low birth weight babies are born each year, because of either preterm birth or impaired prenatal growth, mostly in less developed |

| |countries. LBW and preterm birth are thus associated with high neonatal and infant morbidity. This represents more than a fifth. In India, 32.8% of|

| |newborn babies are LBW .Larger number of deliveries are unattended experts especially in rural areas and urban slums. Therefore, the care of such |

| |infants becomes a burden for health and social systems everywhere. |

| | |

| |Modern technology is either not available or cannot be used properly, often due to the shortage of skilled staffs incubator instance where |

| |available are often insufficient to meet local needs or are not adequately cleaned purchase of equipments, maintenance is difficult Advanced |

| |Technology has resulted in separation of infants from mothers. Under such circumstances good care of preterm and LBW babies is a big problem and it|

| |leads to poor out comes. |

| | |

| |Under the National Rural Health Mission [NRHM] programme, the government of India is committed to improve the newborn care and bring down the |

| |neonatal and infant mortality to meet the millennium development Goals. It is therefore important to operationalise primary health for round the |

| |clock deliveries and upgrade the health facilities at the district hospital and referrals centers. It is also important to build up public private |

| |partnership at each level. |

| |According to 2000 statistics, IMR of Andhra Pradesh, was 65/1000 live births. Krishna District has high rates of LBW and preterm births in urban |

| |and semi urban slums. The main causes are |

| | |

| | |

| |Poor socio economic status |

| |Illiteracy |

| |Cultural and social factors. |

| | |

| |Depriving the baby of first milk or colors Poor nutritional intake by mothers. |

| |Food taboos, myths and customs. |

| | |

| |These factors also make the mother vulnerable to various diseases and related problems. |

| |KMC is humanization of high technology and is an alternative for minima neonatal care unit. In communities where majority of deliveries are at home|

| |and very limited resources for neonatal care are available, KMC is an alternative for all low birth weight and sick newborn babies. |

| | |

| |Since large number of deliveries occur in hospital now –a-days we require that sufficient knowledge should be created enough to mothers regarding |

| |“quality mothering “ through natural and universally approved easily applicable way of Kangaroo Mother Care among staff nurses. |

| | |

| | |

| |REVIEW OF LITERATURE |

| | |

| |SUSAN M LUDINGTON 2008 Conducted a study on Randomized controlled trail of Kangaroo care cardio respiratory and thermal effects on healthy term |

| |infants. |

| | |

| |To determine the safety and effects on healthy preterm infants of 3 continuous hours of kangaroo care compared to standard NICU care by measuring |

| |cardio respiratory and thermal responses. |

| | |

| |Results include cardio respiratory and temperature outcomes remained within clinically acceptable ranges during kangaroo care. |

| | |

| |Regular breathing increased for infants receiving KC compared to infants receiving standard NICU care. |

| | |

| |KADAM S BINOY 2008 conducted study on feasibility of kangaroo mother in Mumbai. |

| |A randomized controlled trail was performed over one year period in which 89 neonates were randomized into 2 groups Kangaroo Mother Care (KMC) and |

| |Conventional Mother Care (CMC). |

| | |

| |The study reveals that 44 babies were randomized into KMC group and 45 to CMC .There was significant reduction in KMC vs CMC group of hypothermia, |

| |higher oxygen saturation and decrease in respiratory rates. |

| | |

| |GENE CRANSTON ANDERSON conducted study on mother – newborn contact in a randomized trail of kangaroo skin to skin care. |

| | |

| |The research describes the type and percent time of contact 0-48 hrs post birth for mother- preterm newborn given kangaroo care. Results were a |

| |group of mother – baby nurses formed an evidenced based practice project team to review published. It lead to some benefits of kangaroo care |

| |include increase breast feeding, reduction in crying, low body temperature. |

| | |

| |DE ALENCAR AE conducted a study on effect of kangaroo mother care on postpartum depression in Brazil. |

| | |

| |The popular study included 177 low income mothers with their preterm infants. The mother’s were evaluated twice at neonatal ICU admission & |

| |Kangaroo Mother Care Discharge. We found 66 mothers with depression and it decreased to 30 KMC Intervention. They concluded that KMC may lessen |

| |maternal depression further studies may be required to clarify this preliminary findings. |

| | |

| |SUSAN M LUDINGTON _HOE conducted study to determine he safety and effects on healthy preterm infants of three continuous hours of kangaroo care |

| |compared to standard NICU care by measuring cardio respiratory and thermal responses. |

| | |

| |The result was cardio respiratory and the temperature outcomes remained with clinically acceptable ranges during kangaroo care. |

| | |

| |POLIT AND HUNGLER (1999) state that review of literature refers to activities involved in identifying and searching for information in atopic and |

| |developing an understanding of the state of knowledge on that topic as well as to the actual written summary of the state of the art on a research|

| |problem . Both the search and the write up are important. |

| | |

| |LITERATURE RELATED TO GENERAL ATTITUDE TOWARDS KANGAROO MOTHRE CARE: |

| |WHITE LAW, (1986) reported that mother’s have commented that their lactation is better following a period of skin to skin contact. |

| |SLEATH AND WHITE LAW, (1987) stated that after kangaroo care and breast feeding “mother’s” gained more confidence and made comments such as “NOW I |

| |FEEL LIKE MUMMY” and Now I feel he ‘’s getting to know me “. |

| |AFFONSO et al (1989) said that Kangaroo care mother’s felt confidence in breast feeding comfortable in nursery, and eager for discharge verses |

| |frequently abandoned breast feeding, anxious in nursery and about discharge. |

| |THOMAS, Hartsock and Larson (1979) reported that all KC mother’s attempted breast feeding in the delivery room 9/15 controls and 13/15 KC’ers had |

| |happy maternal reaction to infant. |

| | |

| |COLONNA et al (1990) conducted a descriptive study on 100 KC preyerm infants ................
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