ORIGINAL ARTICLE. Associate Professor, PSG College of Nursing, Coimbatore 2

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1 Reviews of Progress ISSN: ORIGINAL ARTICLE Vol - 1, Issue - 8, June A STUDY TO ASSESS THE EFFECTIVENESS OF VIDEO TEACHING PROGRAMME ON PHYSICAL CARE OF NEWBORN AMONG PRIMIGRAVIDA MOTHERS ADMITTED IN URBAN HEALTH MATERNITY CENTRES, COIMBATORE, TAMILNADU M.D. SANTHI AND KOKILAVANI 1 Associate Professor, PSG College of Nursing, Coimbatore 2 Professor cum Principal, Adhiparasakthi College of Nursing, Melmaruvathur. ABSTRACT: To achieve Millennium Development Goals, it is expected to reduce the Neonatal mortality by two third of the present rate. Every newborn requires basic care which has to be provided by the mother at home it includes warmth, feeding, basic hygiene and identification of danger signs, and seeking help from health personnel whenever required. KEYWORDS: INTRODUCTION: Physical Care Of Newborn,health Maternity Centres. As per the Sample Registration System of Registrar General of India under the Ministry of Home Affairs, the infant mortality rate is estimated 53 and birth rate is 22.8 per thousand lives for the year In Tamil Nadu the Sample Registration System estimates the Infant Mortality rate is 31 and Birth rate is 15 per thousand lives for the year 2008 and in Coimbatore, the Infant Mortality rate is 16.8 and Birth rate is 15.9 in the year As per a report published by UNICEF, India is ranked 49 with 143 countries. These countries show a lower Infant Mortality Rate (IMR) in other countries compare to India. Another UNICEF report in 2010 said India ranked at 49th out of 193 countries in descending order of the Under Five Mortality Rate (U5MR) (Rao. M.V, 2010). OBJECTIVES 1.To assess the level of Knowledge on Physical Care of newborn among Primigravida mothers in experimental and control group before implementation of Video Teaching Programme. 2.To evaluate the Effectiveness of Video Teaching Programme on Physical Care of newborn among Primigravida mothers in both experimental and control group. 1

2 3.To associate the effectiveness of Video Teaching Programme with selected demographic variables of experimental and control group. 4.To correlate the post test knowledge and practice scores among experimental and control groups. HYPOTHESES a.there is a significant difference between pre and post test scores of the Primigravida mothers in experimental and control group regarding Physical Care of newborn. b.there is a significant difference between post test knowledge and practice scores of the primigravida mothers in experimental and control group regarding Physical Care of newborn. c.there is a significant association between post test scores and selected demographic variables of primigravida mothers in experimental and control group. THEORITICAL FRAMEWORK: Theoretical framework selected for this study was based on General System theory by Bertanlanffy (1968). In this theory main focus is on the discrete part and their inter relationship which make up and describe the whole. Input is pre assessment of knowledge on physical care (eye care, cord care and skin care). Throughput is showing the video teaching programme on physical care for experimental group mothers. The Output is Post assessment of knowledge and practice of physical care through structured interview schedule and checklist for Experimental and Control group mothers. REVIEW OF LITERATURE: Shams El Arifeen, et.al., (2012) conducted a research study on The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a communitybased, cluster-randomized trial shows that between June, 2007, and September, 2009, we enrolled 29,760 newborn babies (10,329, 9423, and 10,008 in the multiple-cleansing, single-cleansing, and dry cord care groups, respectively). Neonatal mortality was lower in the single-cleansing group (22 5 per 1000 live births) than it was in the dry cord care group (28 3 per 1000 live births; relative risk [RR] 0 80 [95% CI] ). Neonatal mortality in the multiple-cleansing group (26 6 per 1000 live births) was not statistically significantly lower than it was in the dry cord care group (RR 0 94 [ ]). Compared with the dry cord care group, we recorded a statistically significant reduction in the occurrence of severe cord infection (redness with pus) in the multiple-cleansing group (risk per 1000 live births=4 2 vs risk per 1000 live births=1 2; RR 0 35 [ ]) but not in the single-cleansing group (risk per 1000 live births=3 3; RR 0 77 [ ]). Neelima Thakur Arun Kumar (2012) conducted a study on knowledge and practices related to delivery and newborn care practices, immediate care after birth, breastfeeding practices in urban slums of Ganda community of Raipur city, Chhattisgarh. Crosssectional survey in a resettlement 6 Urban slum in Ganda Community Semi-structured, pre-tested schedule was used to interview 160 mothers of newborns in the study area. Majority (80.62%) of home deliveries, which were conducted by senior ladies/ neighbors, relatives % of the mothers were applied paste of mustered oil and turmeric power on stump. Bathing the baby immediately after birth was commonly practiced in (67.5%) of home deliveries % of mothers initiated the breastfeed within 2 hrs after birth. Majority (84.2%) newborns were not weighed at birth. 2

3 Agarwal PK, et.al., (2012) conducted a study on Clean cord care practices and neonatal mortality: evidence from rural Uttar Pradesh. The study used data from a household survey conducted to evaluate a community-based intervention program in two districts of Uttar Pradesh, India. Analysis included data from 5741 singleton live births delivered at home during The association between clean cord care (clean instrument used to cut cord, clean thread used to tie cord and antiseptics or nothing applied to the cord) and neonatal mortality was estimated using multivariate logistic regression models. Thirty per cent of the study mothers practiced clean cord care. Neonatal mortality rate was significantly lower among newborns exposed to clean cord care (36.5/1000 live births, 95% CI 28.0 to 46.8) than those who did not practice (53.0/1000 live births, 95% CI 46.1 to 60.6). Clean cord care was associated with 37% lower neonatal mortality (OR=0.63; 95% CI 0.46 to 0.87) after adjusting for mother's age, education, caste/tribe, religion, household wealth, newborn thermal care practice and care-seeking during the first week after birth and study arms. Concluded that promoting clean cord care practice among neonates in community-based maternal and newborn care programs has the potential to improve neonatal survival in rural India and similar other settings. MATERIAL AND METHODS: The research design used in the study was Quasi Experimental Design- Pre test and Post test design with Control group. Experimental Group Pre test Video teaching on Physical care of Newborn Post test Control Group Pre test Routine care Post test The population of the present study comprised of 30 Primigravida mothers with 37 weeks of gestational age attending 6 Main Urban Health Maternity centers, Coimbatore for antenatal care and delivery. Data was collected after obtained the Institutional Human Ethical Committee clearance from PSG College of Nursing, Coimbatore and the formal permission from Health Commissioner and City Health Officer of Coimbatore Corporation. Data Collection Procedure Informed consent was obtained from the Primigravida Mothers in both groups. Structured Interview Schedule and Observational Checklist in Tamil were used to assess the physical care (eye care, cord care and skin care) of newborn among Primigravida mothers in both groups. Pre-test was conducted to the Primigravida mothers in both groups through structured interview schedule in her 37th week of gestation. Implemented Video Teaching Programme on Physical Care of newborn for minutes after pre test for experimental group mothers. Post test was conducted with same pretest knowledge tool after delivery of both experimental and control groups. Immediately after delivery of the baby, observation was made on physical care of neonates among Primipara mothers in both groups by using observational checklist for 2-3 days. 3

4 Plan for Data Analysis The collected data was organized, tabulated and analyzed by using descriptive statistics that is percentage, mean and standard deviation. The inferential statistics like Chi-square was used to find the association between demographic variables with Physical care of newborn knowledge and practice. Correlation and co-efficient was used to find the relation between Physical care of newborn knowledge and practice. The paired't' test was used to find out the difference in pre and post test score of Physical care. The Independent't' test was used to find out the difference among the experimental and control group mothers. FINDINGS Among 30 mothers, maximum (7) were in the age group of years, 8 mothers had secondary education and 6 mothers were housewives. Most of the mothers were getting monthly income between Rs. 3,000 to 5,000 and 9 mothers were belonged to nuclear family. Maximum (7) were Hindus and 12 mothers were resided in rural areas. Figure 1: Distribution of experimental group mothers according the their level of pre and post test knowledge scores Distribution of experimental group according to their level of pre and post test knowledge regarding physical care shows in post test all of them had excellent knowledge. Whereas in pre test it shows 40% of mothers had very poor knowledge and remaining 60% had poor knowledge on physical care aspects. It shows that most of the mothers had poor knowledge on physical care aspects before implementing the video teaching programme. 4

5 Figure 2: Distribution of control group mothers according to their level of pre and post test knowledge scores Distribution of control group according to their level of pre and post test knowledge regarding physical care shows in post test 67% of mothers had very poor knowledge on physical care aspects and remaining 33% were had poor knowledge. Whereas in pretest it shows 60% of mothers had very poor knowledge on physical care aspects and remaining 40% had poor knowledge. It concludes that most of the mothers had very poor knowledge on physical care aspects in pre and post test scores among control group mothers. Figure 3: Comparison of Mean, SD and Mean % of pre and post test knowledge scores of Experimental and Control group Comparison of mean, SD and mean % of pre and post test knowledge scores of physical care among experimental & control group shows that, in pre test the mean score was (3.33±1.491) and mean % And the post tests mean score was (18.8±0.4) and mean % 99. It reveals that the mothers had poor knowledge on physical care aspects prior to implementation of video teaching programme. However, the post-test mean score shows excellent knowledge in all areas of breast feeding. Whereas in control group the mean score was same in pre and post test scores and mean % were It shows that mothers had very poor knowledge on physical care aspects. 5

6 Figure 4: Distribution among experimental and control group mothers according to their level of post test practice scores Distribution of experimental and control group mothers according the their level of post test practice scores on physical care aspects reveals that, in experimental group all the mothers had (100%) completely adoptive practice. It shows all the mothers had fully adoptive practice of physical care after implementing the video teaching programme. Whereas in control group it shows that all the mothers had (100%) only partially adoptive practice on physical care aspects. It concludes that video teaching programme was effective in experimental group mothers. Table 1: Comparison of Mean, SD and Mean % of post test practice scores among Experimental and Control group N=30 S. Areas No 1. Physical Care (Eye care, Cord care and skin care) Max. Post test Practice score t Marks Experimental Group Control Group value Mean SD Mean % Mean SD Mean % Comparison of mean, SD and mean % of post test practice scores show that mean % (94.9) was obtained for physical care aspects (19.93±6.202) in experimental group. Whereas in control group the mean % was It seems that video teaching programme was highly effective on physical care aspects. The independent 't' test to analyze the differences among experimental and control group post test practice scores shows there was highly significant at P<0.05 level at 28 degrees of freedom, so the research hypothesis is accepted. 6

7 Table 2: Paired't' test to analyze the differences in pre and post test knowledge scores among experimental and control group N=30 S. No Areas Experimental Group Control Group t Value Level of Significance t Value Level of Significance 1. Physical Care (Eye care, P< 0.05 Significant 3.77 P< 0.05 Significant Cord care and skin care) df 14 (n-1) Table Value = (P < 0.05 Significant) Paired 't' test calculated to analyze the differences in pre and post test knowledge scores on physical care aspects among experimental group shows that observed 't' value is 37.26, while the 't' table value is (P<0.05) level of significance at 14 degree of freedom, so the research hypothesis is accepted. The table concludes that there is highly significance in experimental group mothers. However in control group mothers shows that the observed't' value is So the research hypothesis is accepted. Table 3: The Independent 't' test to analyze the differences in post test knowledge scores among experimental and control group N=30 S. No Areas Experimental and control group Level of Significance 1. Physical Care (Eye care, Post test knowledge scores t value P< 0.05 Significant Cord care and skin care) df 28 (n-2) Table Value = (P < 0.05 Significant) The independent 't' test to analyze the differences between experimental and control group post test knowledge scores shows that there was highly significant in physical care aspects. The overall observed 't' value is 58.85, while the 't' table value is at P<0.05 level of significance at 28 degree of freedom, so the research hypothesis is accepted. The table concludes that there was highly significant difference in post test knowledge score on physical care aspects among experimental and control group. There was no significant association between knowledge and practice scores of post test among experimental and control group mothers when compared to age, education, occupation, family monthly income, type of family, religion and residence at P>0.05 level of significant. Hence, it can be interpreted that the research hypothesis was rejected. 7

8 Table 4: Correlation between post test knowledge and practice scores among experimental and control group N=30 Group r value Level of Significant Post test Knowledge & Practice value Experimental Group r = 0.76 P< 0.05 Significant Control Group r = 0.18 P< 0.05 Significant Correlation coefficient (r) was calculated to find the correlation between physical care aspects knowledge and practice among experimental and control group mothers shows, in experimental group mothers had highly significant relationship which reveals that when knowledge level increases, the practice also increases. Hence, there was positive relationship between these variables. However the research hypothesis is accepted. Whereas in control group mothers had significant relationship, so the research hypothesis is accepted. CONCLUSION From the findings it can be concluded that after implementation of video teaching programme the experimental group mothers gained excellent knowledge and completely adoptive practice on physical care aspects whereas control group had very poor knowledge and not adoptive practice in pre and post test scores. There was highly significant difference was found between pre and post test knowledge scores in experimental group when compared to control group it was only significant. There was highly significant difference between post test knowledge and practice scores of experimental and control group mothers. No significant association was found between post test knowledge and practice scores with demographic variables of experimental and control groups. Positive correlation was found between breast feeding knowledge and practice of both experimental and control group mothers. NURSING PRACTICE: Video teaching programme can be used in various post-natal wards and paediatric setting to give health education to the mothers and care takers of the newborn. IMPLICATIONS Findings of the study imply that since mothers are not having adequate knowledge and practice on physical care aspects of newborn. The nurse educator should educate the peripheral level health-workers and also postnatal mothers to improve the knowledge and motivate their practice of physical care of newborn as recommended. RECOMMENDATIONS: Similar study can be under taken with a large sample and longer duration to generalize the findings. A comparative study can be conducted for mothers in hospital settings and maternity 8

9 centers. BIBLIOGRAPHY: 1.Peeyush Grover and Pragti Chhabra, Neonatal care practices in urban villages, Indian Medical Gazette, Rekha Dutt, Kangaroo Mother Care An Appropriate Technology to Reduce Neonatal Mortality Rate in Developing Countries, National Journal Research Community Medicine, 2012 July; 1(3): Agrawal PK, et.al., Clean cord care practices and neonatal mortality: evidence from rural Uttar Pradesh, India. J Epidemiol Community Health Aug; 66(8): Shams El Arifeen, et.al, The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial, Lancet 2012; 379: Neelima Thakur and Arun Kumar, A Study on Delivery and Newborn Care Practices in Urban Slums of Ganda Community, Antrocom Online Journal of Anthropology 2012; 8(1). 9