RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE



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PROFORMA FOR REGISTRATION

OF

SUBJECT FOR DISSERTATION

Submitted By:

Mrs. Febi Mary

1st Year M.Sc. Nursing,

Dept. Of Maternity Nursing

Sarvodaya College of Nursing

Bangalore-560 079.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE

BANGALORE,KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

|1. |NAME OF THE CANDIDATE |Mrs.Febi mary |

| |AND ADDRESS |I year M.Sc Nursing, |

| | |Sarvodaya College Of Nursing, |

| | |#11/2, Agrahara |

| | |Dasarahalli, |

| | |Magadi Main Road, |

| | |Bangalore-560079. |

|2. |NAME OF THE INSTITUTION |Sarvodaya College of Nursing |

| | |Vijayanagar, Bangalore-79. |

|3. |COURSE OF STUDY AND |1st Year M.Sc Nursing |

| |SUBJECT |( Obstetrics and Gynecologic Nursing ) |

|4. |DATE OF ADMISSION OF |01 JUNE 2007 |

| |COURSE | |

|5. |TITLE OF THE STUDY |“A Study To Assess The Knowledge Regarding Home Remedies Of |

| | |Minor Disorders Among Antenatal Women In Selected Hospitals, |

| | |Bangalore. With A View To Develop An Information Booklet” |

|6. |BRIEF RESUME OF THE | |

| |INTENDED WORK | |

| |6.1 INTRODUCTION |Enclosed |

| |6.2 NEED FOR THE STUDY |Enclosed |

| |6.3 STATEMENT OF THE PROBLEM |Enclosed |

| |6.4 OBJECTIVES OF THE STUDY |Enclosed |

| |6.5 OPERATIONAL DEFINITIONS |Enclosed |

| |6.6 INCLUSION CRITERIA |Enclosed |

| |6.7 EXCLUSION CRITERIA |Enclosed |

| |6.8 ASSUMPTION |Enclosed |

| |6.9 REVIEW OF RELATED |Enclosed |

| |LITERATURE |Enclosed |

|7. |MATERIALS & METHODS |

| |7.1 Source of data |

| |Data will be collected from antenatal women who are attending OPD. |

| |7.2 Method of data collection: |

| |Structured Interview schedule |

| |7.3 Does the study require any investigation or intervention to be conducted on the |

| |patient or these human beings or animals? |

| |NO |

| |7.4 Has ethical clearance has been obtained from your institution? |

| |YES |

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE

KARNATAKA, BANGALORE

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

|1. |NAME OF THE CANDIDATE |Mrs.Febi mary |

| |AND ADDRESS |I year M.Sc Nursing, |

| | |Sarvodaya College Of Nursing, |

| | |#11/2, Agrahara |

| | |Dasarahalli, |

| | |Magadi Main Road, |

| | |Bangalore-560079. |

|2. |NAME OF THE INSTITUTION |Sarvodaya College of Nursing |

| | |Vijayanagar, Bangalore-79. |

|3. |COURSE OF STUDY AND |1st Year M.Sc Nursing |

| |SUBJECT |( Obstetrics and Gynecologic Nursing ) |

|4. |DATE OF ADMISSION OF |01 JUNE 2007 |

| |COURSE | |

|5. |TITLE OF THE STUDY |“A Study To Assess The Knowledge Regarding Home Remedies Of |

| | |Minor Disorders Among Antenatal Women In Selected Hospitals, |

| | |Bangalore. With A View To Develop An Information Booklet” |

6. BRIEF RESUME OF THE INTENDED WORK

6.1 Introduction

“Health should mean a lot more then escape

From death or for that matters, escape from disease”

- K. Park

In all societies, the family is the Central nucleus for the people, for their lives, their dreams and their health. A women in her role as a mother forms the back bone of the fundamental right to survive while performing the physiological duty of pregnancy and child birth, however in most of the developing countries she is being denied of this right.1

Pregnancy is a creative and productive period in the life of a women. It is one of the vital events, which needs special care. Through out the pregnancy period every antenatal women need safe delivery and healthy baby.

Pregnancy is a period of great anabolic activity when the most rapid rate of growth takes place. It is a condition in which the fetal growth is accompanied by extensive changes in maternal body composition and metabolism. A number of factors have an influence on pregnancy outcome, such as economic and educational status of the mother, age of the mother, parity, weight gain during pregnancy, duration of gestation, maternal hemoglobin level of pregnant women. During pregnancy women may experience one or more wide variety of discomforts. 2

Minor disorders are only minor, they are not life-threatening. Minor disorders during pregnancy are nausea, vomiting, heartburn, pica, excessive Salvation, constipation, backache, muscle cramps, frequency of micturation, leucorrhoea, fainting - supine hypotension, varicosities, carpal tunnel syndrome, headache and insomnia. These are due to accommodation, metabolic and postural changes.

Pregnancy and childbirth are special event in women’s lives and indeed in lives of their families. Pregnancy is a normal physiological process however, it is associated with certain risk to health and survival of both for the woman and for the baby she bears. Hence information and adequate knowledge may help the mothers to adopt and maintain healthy practices and life styles, which will help the mother to bring forth a healthy baby.

6.2 Need For Study :-

“Pregnancy itself is a healthy, normal occurrence, humans unfortunately are the only species with the ability to worry about it”

- Fritzi Kallop

Pregnancy and child birth is one of the life’s major events that is joyous and rewarding as the women phase through a transitional phase into a new life of motherhood.

During pregnancy a variety of physiological events occurs which serve to accommodate the growing fetus and prepare women for labour. These changes can make pregnancy an unpleasant and painful experience for some but are not indicative of any serious problem.

Most pregnant women experience one or the other minor disorders during pregnancy although their minor disorder do not threaten life, but they must not be ignored or taken lightly become by interfering with nutrition, sleep and creating anxiety may adversely affect the women’s health.

According to WHO 5,85,000 women die each year from a pregnancy related causes, 99% of whom are from the developing countries. In India 10-30% of pregnancies belongs to the high risk category and accounts for 75-80% of the perinatal morbidity and mortiality.

Nakamura MU, Cordeiro JA, Kulay L Jr.(2004): conducted a retrospective study on “Acupuncture for low back pain in pregnancy”. A total of 61 conventionally treated pregnant women were allocated randomly into two groups to be treated or not by acupuncture. 27 patients formed the study group and 34 control groups. Average pain scores decreased by at least 50% overtime in 21 (78%) patients in the control group and in five (15%) patients in the control group. Maximum pain and pain at the moment of interview were also less in acupuncture group compared with the control group. These results indicates the acupuncture seems to alleviate low back pain during pregnancy. 6

Keating A, Chez RA(2003): conducted a study on “Ginger Syrup as an antiemetic in early pregnancy”. Selected 26 patients as subjects in the first trimester of pregnancy. Subjects ingested one table spoon of commercially prepared study group (or placebo) in 4 to 8 ounces of hot or cold water 4 times daily. After 9 days, 13 (77%) subjects were receiving ginger had at least a 4- point improvement on the nausea scale. Only 2 of the 10 (20%) reaming subjects in the placebo group had the same improvement. Conversely, no women in the ginger group but 7 (70%) of the women in the placebo group had a 2- point or less improvement on the nausea scale. Eight of the 12 (67%) women in the ginger syrup who were vomiting daily at the beginning of the treatment stopped vomiting by day 6. Only 2 of the 10 (20%) women in the placebo group who were vomiting stopped by day 6. study concluded that ginger therapy for treating nausea and vomiting during pregnancy is more effective.7

Valbo, Bohmes (1999): Conducted a study to assess who suffering from leg cramp during pregnancy. To 120 pregnant women a questionnaire was sent. The result revealed that 45% had suffered leg cramps during pregnancy, 54% of women get relief from cramps after pregnancy. This study clearly reveals that most of the women suffering from leg cramps during pregnancy and get relief after pregnancy. 8

The investigator during her postings in antenatal clinics and community visits observed that many of the antenatal women suffer from one or other minor ailments during pregnancy and most women do not know to take care her self in their home. Hence the investigator felt the need to prepare an information booklet on home remedies of minor disorders of pregnancy, which will help to improve knowledge of the mothers on care of minor disorders of pregnancy and therapy can reduce the minor discomforts.

6.3 Statement of the Problem

“ A Study To Assess The Knowledge Regarding Home Remedies Of Minor Disorders Among Antenatal Women In Selected Hospitals, Bangalore. With A View To Develop An Information Booklet”.

6.4 Objectives of the Study

1. To assess the knowledge of antenatal women regarding home

remedies of minor disorders.

2. To find out the association between knowledge on home

remedies of minor disorders with selected variables.

3. To provide an information booklet on home remedies of minor

disorders.

6.5 Operational Definitions

1. Knowledge: Refers to the awareness of women regarding home

remedies of minor disorders during pregnancy as assessed by

the proper response to items of the knowledge questionnaire.

2. Antenatal women: Refers to primi women who are in first & second

trimester.

3.Minor disorders: Nausea, vomiting, heart burn, pica, excessive salivation, constipation, backache, muscle cramps, frequency of micturation, leucorrhoea, fainting- supine hypotension, varicosities, carpal tunnel syndrome, headache, insomnia experienced by the women during pregnancy

4. Home remedies : Refers to measures taken to relieve physical ailments during

pregnancy at home.

6.6 Inclusion Criteria

1. Who are willing to participate

2. Who are available at the time of study.

6.7 Exclusion Criteria

1. Antenatal mother with associated disorders.

6.8 Assumption

1. It is assumed that women will have inadequate knowledge regarding

home remedies of minor disorders during pregnancy.

6.9 Review of Related Literature

Review of related literature is a key step in research process. It refers to an extensive, exhaustive and systematic examination of publications relevant to research process.

Melhado EM, Maciel JA Jr, Guerreiro CA (2007): Conducted a study on “Headache during gestation”. Prospectively evaluated 1101 pregnant women (12-45 years old) with a history of headache, at two Parental clinics were interviewed using a semi structured questionnaire during first, second and third gestation trimester. In 1029 women there was a history of headache prior to the current pregnancy, 36 (3.4%) women first experienced headache during this pregnancy and 40 patients experienced new types of headache (40.8%) and 5 had headache not classified elsewhere. (6.6%) According to IHSC -2004 (criteria, we found migraine in 848/1029 women (82.4%) with pregestational headache. Study concluded that most of the pregnant women presented with headache, mainly on migraine, prior to pregnancy and most of the headached improved or disappeared during the second and third gestation trimester. 9

Young G, Jewell D (2007): conducted a randomized trial study on “interventions for pregnancy and treating pelvic back pain in pregnancy.” Three trials are included in this review involving 378 women. One randomized trial compared water gymnastics from 20 weeks with no treatment. The group report less pain in the treatment group (Odds ratio 0.38,95% confidence intervals 0.16-0.88). In another trial acupuncture was related as giving ‘good’ or ‘excellent’ help more frequently than physiotherapy (odds ratio 6.58, 95% confidence intervals 1.0-43.16). One trial of 109 women compared the use of a special shaped pillow to fit under the women’s abdomen (ozzlo pillow) with a standard pillow. Fewer women rated the ozzlo pillow of ‘little help’ compared with the standard pillow (odds ratio 0.32, 95% confidence interval 0.18 to 0.58) study concluded that water gymnastics specially shaped pillows, physiotherapy and acupuncture may reduce back pain.10

Hanif S (2006): conducted a study on “Frequency pattern of urinary complaints among pregnant women”. 1000 pregnant women, attended antenatal clinics were selected Out of 1000 pregnant women, 426 (42.6%) complained of one or more urinary symptoms. Diurnal and nocturnal frequency was the most commonly encountered symptom (87.32%)Complete urine examination of symptomatic patients reveled 5 pus cells in 322 cases and 6-20 pus cells in the remaining 104 cases. Study concluded that lower urinary tract symptoms are frequently present in pregnant women, which can be due to both pregnancy – included changes on urinary system as well as urinary infection.11

Mikkelsen TB, Andersen AM, Olsen SF(2006): Conducted a study on “ Pica in Pregnancy in a privileged population: myth or reality”.100,000 pregnant women in Danish National Birth Cohort were asked about Pica in a food frequency questionnaire mailed in gestation week 12. The response rate of the questionnaire was 70% of Danish National Birth Cohort participants. Only 14 women reported to have eaten substances that were clearly not foods. That is, 0.02 had Pica in this Cohort of well nourished Danish women. It seems that in privileged populations, pica is more a myth than a reality.12

Da Silva JB (2005): conducted a prospective, quasi-randomized study on “Acupuncture for insomnia in pregnancy”. A total of 30 conventionally treated pregnant women were allocated at random into groups with or without acupuncture. Seventeen patients formed the study group and 13 in the control group. Eight women dropped out, five in the study group and three in the control group. Average insomnia scores decreased by at least 50% over time in 9 (75%) patients in the study group and in 3 (30%) of the control group. The results of this study suggest that acupuncture alleviates insomnia during pregnancy.13

Stadnicka G, Iwanowicz’ Palus GJ (2004): conducted a study on “urinary incontinence in pregnancy”. The study was carried out among 146 women at maternity wards of the clinical Hospital and District Hospital in Lublin. It was stated that incontinence problems in pregnancy were reported by 79.5% of the surveyed women. The symptoms of urinary

incontinence in pregnancy were reported by 37.7% of women, and 38.2% of women declared to be unable to stop the stream of urine. The first symptom of urinary stress incontinence occurred in 3.6% women before first pregnancy, in 12.7% women they occurred in the formal pregnancy and in 5.5% after previous delivery. This study revealed, the correlation between the occurrence of urine incontinence and pregnancy.14

Chou FH, Lin LL, Cooney AT, Walker LO, Riggs M (2003): Conducted a study on “psychosocial factors related to nausea, vomiting and fatigue in early pregnancy”. Findings of 113 participants, 30(35.4%) reported no, 43 (38.11%) occasional and 40(35.4%) frequent nausea and vomiting. Depressive symptom had the highest correlation with nausea and vomiting. Four (3.5%) women reported no fatigue, 49 (43.4%) reported occasional fatigue, and 60(53.1%) reported frequent fatigue in the past month. Study concluded that, only a limited number of psychosocial factors were associated with nausea, vomiting and fatigue in early pregnancy. 15

Rabhi V, Charras: Arthapignet C,Gris JC, Ayoub J, Brun JF, Lopez FM, Janbon C, Mares P, Dauzat M (2000): Conducted a study on ‘Pregnancy-induced changes in lower limb venous function. Study conducted on 190 consecutive women during and after uncomplicated pregnancies. Spontaneous blood flow echogenicity in the common femoral veins was clearly visible in 6% of cases during the first trimester of pregnancy, 63% during the second trimester, and 96 % during the third trimester, versus 6% after delivery. Study concluded that the percentage of women with clinical symptoms and signs of venous insufficiency increased significantly during pregnancy.16

7. MATERIALS & METHODS

7.1 Source of the data:

Data will be collected from antenatal women who are attending Out Patient

Department (OPD) in a selected hospital.

7.2 Method of data collection:

i) Research design : Descriptive design

ii) Setting : Selected hospitals in Bangalore

iii) Sampling technique : Purposive sampling

iv) Sample size : 60 women

v) Method of data collection : Structured interview schedule

vi) Tool for data collection : Structured Interview questionnaire

vii) Method of data analysis and interpretation : The researcher will use appropriate statistical data analysis and present in the form of tables and diagram. The data will be analyzed by using descriptive and inferential statistics

1. Knowledge : Frequency & percentage

2. Chi-Square will be used to determine association between

Knowledge on home remedies of minor disorders during pregnancy

and selected variables.

viii) Duration of the study : 6 Weeks

ix) Variables

Research Variable : Knowledge

Demographic Variable : Age

Education

Parity

Occupation

Previous history

x) Projected outcome:

The study will increase the awareness regarding home remedies of

minor disorders among antenatal women.

7.3 Does the study require any investigations or intervention to be

conducted on patients or other human beings or animals?

NO

7.4 Has ethical clearance been obtained from your institution?

YES, ethical committees report is herewith enclosed.

BIBLOGRAPHY

1. Park K. Parks text book of preventive and social medicine. 17th ed. India: Banarsiclas bhanat; 1997

2. Boora, Kaur P, Kapoor YP, Chawala S. Food consumption pattern of pregnant and locating mothers in rural Haryana. The journal of nutrition and dietics. 1997, P:34, 40-48

3. Ruth BV, Linda KB. Myles text book for midwives. 12th ed. Toronta. Churchill Livingstone; 1993, P: 119

4. Susan Peri, Nausea during pregnancy. Internet journal of mid wifery today. News. 2003.P;10

5. Dutta DC. Text book of obstetrics. 3rd ed. Calcutta, India :1993.P:108

6. Nakamura MU, Cordeiro JA, Kulay LJ Jr. ‘Acupuncture for low

back pain in pregnancy’. Acupunct Med. (serial online) 2004 Jun

(cited on 2007 11); 22(2) : (60-7) Available

from:URL:http//ncbi.nlm.sites/entrez

7. Keating A, Chez RA. Ginger syrup as an antiemetic in early

pregnancy. Altern Ther Health Med.(serial online) 2003 Jan-Feb.

(cited 2007 oct.10): 9(1) : (19-21). Available

from:URL:http//ncbi.nlm.sites/entrez

8. Valbo, Bohmer. Leg Cramps during pregnancy. Journal of Obstetrics end Gynecologic Nsg 1999;103 (2) P: 218-9

9. Melhado EM, Maciel JA Jr, Guerrreiw CA. Headache during

gestation. Can J Neurol Sci (serial online) 2007 May (cited 2007

oct.11.): 34 (2) : (187-92). Available

from:URL:http//ncbi.nlm.sites/entrez

10. Young GL, Jewell D. Interventions for preventing and treating

pelvic back pain in pregnancy. Cochrane Database Syst

Rev.(serial online) 2007 (cited 2007 Oct.02) (2):CD001139.

Available from:URL:http//ncbi.nlm.sites/entrez

11. Hanif S: ‘Frequency and pattern of urinary complaints among pregnant

women, J coll physician’s Surg Pek.(serial online) 2006 Aug (cited 2007 11);

16(8) : (514-7). Available from:URL:http//ncbi.nlm.sites/entrez

12. Mikkelsen TB, Andersen AM, Olsen SF: ‘Pica in pregnancy in a privileged

population : muyth or reality, Acta Obstet Gynecol Scand. (Serial Online )

2006 (cited 2007 oct. 08); 85 (10) : 1265-6. Available from:

URL:http//ncbi.nlm.sites/entrez

13. da Silva JB, Nakamura MU, Cordeiro JA, Kulay LJ. Acupuncture

for insomnia in pregency. Acupunct Med. (serial online) 2005 Jun

(cited 2007 Oct.11); 23 (2): (47- 57). Available

from:URL:http//ncbi.nlm.sites/entrez

14. Stadnicka G, Iwanowicz’ Palus GJ. Urinary incontinue in

pregnancy. Wiad lek. (serial online) 2004 (cited on 2007 07); 57

suppl 1: (314-8). Available from:URL:http//ncbi.nlm.sites/entrez

15. Chou FH, m Lin LL, Cooney AT, Walker LO, Riggs MW,

Psychosocial factors related to nausea , comiting and fatifue in early

pregnancy. J Nurs Scholarsh (serial online) 2003 (cited on 2007

oct.10); 35 (2) : (119-25). Available

from:URL:http//ncbi.nlm.sites/entrez

16. Rabhi y, Charras: Arthapignet c,gris JC, Ayoub JC Brum JF, Lopez FM, Janbon c, Mases P, Dauzat M. Pregnancy included changes in lower limb venous function. J elin ultrasound (serial online) 2000 Oct (cited 2007 oct.11); 28 (8): (407-13). Available from:URL:http//ncbi.nlm.sites/entrez

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