RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES



|RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES |

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|PRELIMINARY SYNOPSIS ON THE M.Sc.(N) DISSERTATION |

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|EFECTIVENESS OF VIDEO ASSISTED TEACHING PROGRAMME ON KNOWLEDGE OF POSTNATAL EXERCISES AMONG POSTNATAL MOTHERS IN SELECTED |

|HOSPITALS IN MANGALORE |

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|Submitted By: |

|Ms. Salma Rani. S |

|1st year M.Sc.(N) |

|Srinivas Institute of Nursing Sciences, Farangipete Post, |

|Arkula, Valachil Padavu, |

|Mangalore – 574143. |

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|Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore. |

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|ANNEXURE – II |

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|PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION |

|1. |NAME OF THE CANDIDATE |Ms. SALMA RANI. S |

| |AND ADDRESS |1st YEAR M.Sc.(NURSING) |

| |(IN BLOCK LETTERS0 |OBSTETRICS AND GYNAECOLOGICAL NURSING |

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| | |SRINIVAS INSTITUTE OF NURSING SCIENCES |

| | |VALACHIL, MANGALORE - 574143 |

|2. |NAME OF THE INSTITUTION |SRINIVAS INSTITUTE OF NURSING SCIENCES |

| | |VALACHIL, PADAVU, ARKULA, |

| | |FARANGIPETE POST, |

| | |MANGALORE – 574143. |

|3. |COURSE OF STUDY, SUBJECT |M.Sc. NURSING |

| | |OBSTETRICS AND GYNAECOLOGICAL NURSING |

|4. |DATE OF ADMISSION |15/06/2009 |

|5. |TITLE OF THE TOPIC. |

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| |EFECTIVENESS OF VIDEO ASSISTED TEACHING PROGRAMME ON KNOWLEDGE OF POSTNATAL EXERCISES AMONG POSTNATAL MOTHERS IN SELECTED |

| |HOSPITALS IN MANGALORE |

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|6. |BRIEF RESUME OF INTENDED WORK |

| |Introduction |

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| |“ Those who think they have not time for bodily exercise will sooner or later have to find time for illness” |

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| |(Edward Stanely) |

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| |Bennett VR(1999)1 reported that puerperium or postnatal period is a period of approximately 6 weeks which commences |

| |following completion of the third stage of labour. During this time, the woman recovers from the stresses of pregnancy |

| |and delivery and the physiological adaptation which occurred during pregnancy subside, facilitating the restoration of |

| |non pregnant state. The postnatal period is defined as’ not less than ten and not more than 28 days |

| |after the end of the labour, during which the continued attendance of a midwife on the mother and baby is |

| |requisite’(UKCC 1993).T he management of postnatal care begins in the delivery suits and extends throughout the |

| |postnatal period. |

| |Fraser DM(2003)2 reported that following the birth of the baby and expulsion of the placenta, the mothers a period |

| |of physical and psychological recuperation. The overall expectation is that 6 weeks after the birth all the system in|

| |the women’s body will have recovered from the effects of the pregnancy and returned to their non pregnant |

| |state. The first 4 weeks after the birth is referred as the postnatal or postpartum period. When the extra ordinary |

| |changes in physiology that occur throughout pregnancy are considered. It should come as no surprise that the period of |

| |physiological adjustment and recovery following the end of the pregnancy is both complex and closely related to the |

| |overall health status of the individual. The intricate relationship between physiological, psychological and |

| |sociological factors are encompassed in the remit of postnatal care |

| |Bobak IM(1984)3 reported that the post partum period or puerperium is the period of recovery from childbirth .the |

| |postpartum period has changed from one modeled on the concept of sick care to one that is health oriented .Women |

| |are concerned about their comfort and recovery, decision of having contact with their infants ,motivated to learn |

| |about newborn care, and eager to share about their experiences with their families. Their health care is now |

| |collaborative effort on the part of all involved- mother, nurse, physician and family-to prevent complications, to |

| |provide comfort, rest, and nourishment, to engage in teaching learning activities related to self care of the newborn; |

| |and to foster parent – child relationship. |

| |Exercises may be started as soon as the mother’s condition permits, usually by the Obstetrician. They are helpful in |

| |trimming the figure and toning the musculature. If the woman is willing, Obstetrician should be outlined. If she is not|

| |receptive, the exercise benefits of household activities, that is, bending and stretching, should be emphasized. The |

| |woman is instructed to begin with a single exercises. Performed 5 times and repeated three or four times a day. |

| |Additional exercises are added sequentially. On the woman’s return home, a gradual increase in ambulation about the |

| |house is suggested, stairs offer few problems. Avoidance of fatigue should be the rule. Use Light house keeping can be |

| |resumed after the first week. Moderate work can be done during the third week, but full activity should be delayed |

| |until after the post delivery visit and examination. Most women can resume all but the physical tiring employment 4 or |

| |5 weeks after childbirth. An increase in the amount of Lochia Rubra or its reappears may indicate too much actively. |

| |Carolyn Jenkins (2005)4 reported that Regular physical activity and more specifically regular |

| |exercise, provides most people with both physical and mental health benefits. For some, a regular pattern of |

| |exercise becomes an ingrained habit, however interruption such as life style transitions can distract |

| |the most well–intentioned and most avid exercises. Physical activity surveys suggest that women aged between 25 -34 |

| |years have the lowest activity levels of all New Zealand adults. Family responsibility |

| |have been postulated to account for decreased physical activity levels in this age bracket, with |

| |mothers shown children. As a period of biological, psychological, behavioral and social |

| |change, the transitions into motherhood is dramatic and undoubtedly impacts on a woman’s desire, commitment, and |

| |ability to resume or maintain exercise regimen. The exercises should be started as soon after birth as |

| |possible in order to improve circulation, strengthen pelvic floor and abdominal muscles and prevent transient and long |

| |term problems. |

| |There has been a gradual acceptance that exercise is beneficial for women during part of the reproductive process. |

| |Benefits are particularly apparent for those women exercising post partum, where exercise has been found to improve |

| |cardio – vascular fitness, contribute is weight loss, and prevent long term weight retention Koltgn and Schultness |

| |demonstrated that a single bout of exercise reduced depression, state anxiety, total mood disturbance and increased |

| |vigour in post partum mothers. Stress relieving exercise may facilitate post partum adaptations and help prevent or |

| |manage postnatal depression, a disorder that afflicts 10-15% of all mothers. |

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| |6.1 Need for the Study |

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| |Fraser DM (2003) 2 reported that within the current national policy for health promotion there is an emphasis on |

| |increasing the understanding the general population about the value of different forms of exercises and health. |

| |It is difficult to imagine that a women with a new baby will not undertake quite a substantial amount of |

| |exercise once she has recovered from the birth event, but women vary considerably in their perception of exercise. One |

| |woman will be wanting to get back to her weight lifting whilst another may be having a struggle just giving |

| |up and downstairs more often than previously. Exploring each person’s level of activity will encourage advice in |

| |relation to appropriate exercise and by association, nutritional intake and rest or relaxation and sleep. Undertaking |

| |regular pelvic exercise is of benefit to women’s long term health Foot and leg exercises as described in the antenatal |

| |section must be performed very frequently in the immediate postnatal period to improve circulation and reduce Edema. |

| |Early ambulation will help prevent deep vein thrombosis (DVT). If Edema is present the woman’s legs may be slightly |

| |elevated. |

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| |The American college of sports medicine endorses the health benefit for post-natal women and their baby. The published |

| |report is based on findings from a national panel of Scientific and clinical experts who evaluated numerous published |

| |studies. The report is based on most current research; with clearly suggest long – term benefits from physical activity|

| |for both the mother and her baby. |

| |It is the consensus of the expert panel that exercises during the pregnancy and the post partum period. The health |

| |benefits of the postnatal exercises are, helps to reduce postnatal depression known as the “baby blues”, Quicker |

| |recovery back to pre – pregnancy body, Increased much needed energy, Stress release (time to focus on yourself). |

| |Dutta DC(2004)5 reported that the objectives of postpartum exercises are to improve the muscle tone which are stretched|

| |during pregnancy and labour specially the abdominal and perennial muscles ,to educate about correct posture to be |

| |attained when the patient is getting up from her bed. This also includes the correct principle of lifting and working |

| |positions during day –to-day activities. Other advantages of postnatal exercises are, to prevent back ache, to prevent |

| |genital prolapse and stress in continence of urine, to minimize the risk of puerperal venous thrombosis by promoting, |

| |arterial circulation and preventing venous stasis. |

| |Krummel D.A. et. al (2004)6 conducted a study related to stages of change for weight management in post partum women. |

| |Subjects were a sample of WIC recipients (N = 151) older than 18 years of age with a child younger than 2 years. |

| |Statistical analysis, the dependent variables were the stages of change for weight management behaviors (losing weight,|

| |avoiding high fat foods, eating a high fiber diet and exercising). Demographic health and psychosocial variables were |

| |examined as independent variables. One way analysis of variance was used to compare means and chi (2) was used for |

| |proportions. Where as55% of women were in the action stage for weight loss, fewer women were in the action stage for |

| |the following weight management behaviours- avoiding high fat foods (24%) increasing fiber (19%) and exercising three |

| |times per week (29%). Identifying pros for weight management was related to stages for losing weight, high fat food |

| |avoidance and exercise (f=13.4,P ................
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