AS TUDY TO ASSESS THE KNOWLEDGE, ATTITUDE AND PRACTICES OF by JcI076ti

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									A STUDY TO ASSESS THE KNOWLEDGE, ATTITUDE AND
  PRACTICES OF EMPLOYED MOTHERS REGARDING
          BREAST FEEDING IN SELECTED
               AREAS OF RAICHUR.




 PROFORMA FOR REGISTRATION OF SUBJECTS FOR
               DISSERTATION.




             GAYATRI DEVI.




      NAVODAYA COLLEGE OF NURSING,
               RAICHUR.


               NOVEMBER - 2007
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
          BANGALORE, KARNATAKA.


PROFORMA FOR REGISTRATION OF SUBJECTS FOR
           DISSERTATION.



1. Name of the candidate      :   GAYATRI DEVI
   and address                    M.Sc. Nursing Ist year,
                                  Navodaya college of Nursing
                                  P.B. No. 26, Mantralayam Road,
                                  Raichur-584103.



2. Name of the Institution    :   Navodaya College of Nursing.


3. Course of the study and    :   M.Sc. Nursing Ist Year,
   subject                        Obstetric and Gynacology.


4. Date of Admission to       :   25/05/07.
   the course



5. Title of the Topic         :

   A study to assess the Knowledge, Attitude and practice of
        Employed mothers regarding breastfeeding in
                   Selected areas of Raichur.
6. Brief Resume Of The Intended Work:

6.1 Need for the study:

        ‘Milk and Murder’, that deaths resulting from “……misguided
propaganda on Infant feeding should be regarded as murder.”1


        Children are our future and our most precious resources. For
most of the children breast feeding makes the different between life
and death and it is the infant “PASSPORT OF LIFE”. Breast milk not
only the best our must for the infants. Lack of breast feeding-
especially lack of exclusive breast feeding during first few months of
life are important risk factor for infant and childhood morbidity and
mortality. W.H.O. estimated that 1.5 million infant lives could be
saved each year through increased breast feeding. Customs,
Superstition, traditions and ignorance sometimes deprive the child
from getting this benefit, as the ideal food for the young infant is
human milk.2
        Mother and children constitute ¼ of the total National
population. They are the most vulnerable group to ill health. One of
the main cause for neonatal mortality and morbidity is inadequate
breast feeding, following faulty breast feeding techniques, ignorance
of mother regarding feeding practices, lack of health education given
by the nursing personals. Many cultural beliefs and practices are
prevalent in post partum period that some mothers may not feed the
baby immediately after birth. They neglect, “COLOSTRUM”, instead
of it they give sugar water, plain water, honey etc, all these practices
lead to suppression of lactation as prolactin gradually ceases and the
breast stops secreting milk.3


        Major problems exist among the post natal mother would be
ignorance of mother regarding breast care and breast feeding lead to
suppression of lactation. Due to inadequate breast feeding maternal
problems like breast engorgement, mastitis, breast abscess, cracked
and sore nipple and sub involution of uterus results with higher risk of
post partum hemorrhage. New born once not supplied with breast
milk were at risk of getting Gastrointestinal tract infection and
respiratory tract infection, iron deficiency anemia, allergy disorders
and it gradually increases Neonatal Mortality Rate.4


        Breast feeding problems, outcomes and satisfaction of
married, well-educated first time mothers who returned to work within
six months post partum were compared to those of mothers with the
same characteristic who stated at home. Mothers who planned to work
after having baby anticipated and experienced shorter duration of
breast feeding than did those who planned to remain at home. Breast
feeding experiences and satisfaction among working counterparts;
however, employment prior to two months post partum exerted some
negative effects on breast feeding outcomes.5


        A UNICEF (2007) report states that India has close to 2.5
million children born every year, out of these, 1.9 million are under-
five, who die in a year. Among the decreased children, 1.4 million
children die just within one year and roughly one million children die
with in a month. Most of these deaths are associated with infant and
young child malnutrition and other preventable disease caused mainly
due to poor care and inappropriate infant feeding practices. Only 23.4
% newborn across the country begins breast feeding within a hour of
birth. Early initiation of breast feeding practices provides quality
health care for children and reduces their specific health problems.
W.H.O. also recommends for optimal infant feeding practices to fight
against malnutrition and promote child survival.6


        Colostrum is pale yellowish milk which is secreted for the
first 3 days of delivery. It can be considered as the first vaccine which
needs a “warm chain” made by mother-infant contact. It is secreted in
very less amounts (30-100 ml/day). So the mothers need to be
explained that this small amount of Colostrum is for adequate and
must not be denied to the baby. It has abundant anti infective
properties.7




        As breast feeding has so many advantages for mothers as well
as children but in spite of having knowledge employed mothers
neglect it because of lack of time and superstitious beliefs. Hence, the
researcher felt the need to assess the knowledge, attitudes and
practices of breast feeding among employed mothers.
6.2 Review of Literature:.
        Review of literature is a critical summary of research on a
topic of interest generally prepared to put research problems in
context on to identify gaps and weakness in prior studies so as to
justify a new investigations. In this chapter the investigator reviewed
the available research studies and relevant literature from which the
strength of study was drawn.


        An observational study was conducted to assess the
breastfeeding practices of post natal mothers in selected hospitals of
Hydrabad. A sample of 60 mothers was selected by random sampling.
Data were collected by observational checklist and structured
interview schedule. The results of the study showed that 50% mothers
had adequate knowledge but majority were ignorant about hygienic
practices. The study recommended that health education specially
about importance of Colostrum, breast feeding techniques and
hygienic practices are needed.8


        A descriptive survey was conducted on “knowledge, attitude
and practices of employed mothers about breast feeding in selected
areas of Mangalore city.” Purposive sampling technique was used to
select 60 mothers, working in selected colleges having a child with
two years of age. A structured interview schedule was prepared to
determine the knowledge and attitude and semi-structured interview
schedule was prepared to determine the practice of breast feeding. The
results of the study showed that 73% of mothers have knowledge
regarding the benefits of breast feeding but only 24% of them had
knowledge regarding ‘expression and storage of breast milk.’ The
finding also reveals that all 100% mothers had positive attitude
towards breast feeding.2


        A descriptive survey was conducted to find out the “Existing
breast feeding practices among the urban mothers in selected areas of
Manipur.” Fifty mothers with the age group of 16 to 35 years were
chosen for the study. Semi structured questionnaire was used to
collect the data. The finding revealed that most of the mothers started
breastfeeding within 24 to 48 hours of delivery. The study reveals that
there   is   significant   (p>0.001)   relationship   between   mothers
educational level, duration of breast feeding, social-economic status of
family, mothers with higher education. Socio-economic status tend to
stop breast feeding earlier than the mothers from lower educational
and socio-economic status.9


        A descriptive study was conducted on “Breastfeeding and
weaning practices among postnatal mothers in selected government
hospitals of Delhi.” The sample of 350 post natal mothers was taken
for the study. Data collection was done with structured questionnaire.
The study finding reveled that 58.8% of mothers answered that they
follow breast feeding, since the other women do, 12% of mother
undertook it on the advice of elder women, 12% undertook on medical
advice and remaining considered breast milk to be pure food for
babies. 10
        A retrospective study was conducted on “Duration of breast
milk expression among working mothers enrolled in an employer
sponsored lactation program in the selected areas of Burbanr” Canada.
A sample of 462 mothers employed by 5 corporations is taken. Data
was collected by interview schedule. The results showed the breast
feeding was initiated by 97.5 per cent of the participants, with 57.8
per cent continuing for at least 6 months, of the 435(94.2 per cent)
attempted pumping milk at work, and 336(98 percent) were
successful. They expressed milk in the workplace for a mean of 6.3
months (S.D. = 3.9, range 2 weeks to 21 months). Most of the women
who pumped their milk at work were working full time (84.2 per
cent).11


6.3 Statement Of The Problem.
 A study to assess the knowledge, attitude and practices of employed
                mothers regarding breast feeding in selected
                             areas of Raichur


6.4 Objectives Of The Study.
1. To determine knowledge, attitude and practice of employed
   mothers regarding breastfeeding.
2. To find association of knowledge, attitude and practice of
   employed mothers regarding breastfeeding with demographic
   variables.


6.5 Hypothesis:
            There will be a significant relationship between the
                 knowledge of employed mothers regarding breast
                 feeding with the selected socio demographic variation.
            There will be a significant relationship between the
                attitudes of employed mothers regarding breast feeding
                with the selected socio demographic variables.
            There will be significant relationship between the
                practices of employed mothers regarding breastfeeding
                with the selected socio demographic variables.


6.6 Operational Definitions
1. Knowledge:
        Refers to the level of understanding of employed mothers
with regard to breastfeeding as measured by the correct responses of
the women to the knowledge items of questionnaire.
2. Attitude:
        Refers to the opinion, ideas, beliefs and feeling of employed
mother with regard to breastfeeding as responded to the attitude scale.
3. Practices:
        It refers to the activities followed or undertaken by the
mothers with regard to breastfeeding among employed mothers.
4. Employed mothers:
       Refers to women who do services in return for payment.
5. Breastfeeding :
        Refers to the right act of giving breast milk by the mother to
the new born baby till one year and so on which includes the position,
time and hygiene in the postnatal period.
7. Materials and Methods.


7.1 Source of Data.
Design:
       A descriptive survey design will be adapted for conducting
the present study.


Setting of the Study:
        Raichur is one of the backward district situated in Northern
Karnataka. It has an area of 60 Sq. and consists of 5 towns and 300
villages. The total urban population of Raichur is 2, 07,421 with a
total number of 38,080 homes. Raichur town consists of 35 election
wards and 15 revenue wards. Among above mentioned areas Vidya
Nagar has been selected for the study.


Population:
       The population of the study comprised of all the employed
mothers in urban areas of Raichur.

Sample:
      A sample consists of subjects of units that comprise the
population for present study. The sample size is 60 employed mothers.


Sample Technique:
        Cluster sampling will be used to select the area and purposive
sampling technique will be used for selecting the sample.
Inclusion criteria:
       The study includes the mothers, who are:
           employed and having children.
           residing in Vidya Nagar.
           able to read and write Kannada or English.
           available at the time of data collection.
           willing to participate in the study.


Exclusion criteria:
       The study excludes the mothers, who are not:
          employed.
          residing in Vidya Nagar.
          able to read and write Kannada or English.
          available at the time of data collection.
          willing to participate in the study.


SELECTED VARIABLES:
       Variables included in the present study are:


Dependent variables:
       Knowledge, attitude and practices of breast feeding among
employed mothers.
Extraneous variables
   1. Age:
           Age of the subjects in present study is categorized as:
         (a). 19-24 years
         (b). 25-30 years
         (c) 31-36 years
         (d). Above 37 years
   2. Religion:
           Refers to the system of faith or worship the females follows:
         (a) Hindu
         (b) Muslim
         (c) Christian
         (d) Others
   3. Education of mothers:
           It refers to previous education of subjects. It is categorized as:
           (a) Primary school
           (b) Secondary school
           (c) High school
           (d) PUC
           (e) Graduation
           (f) Post-Graduation and above
   4. Type of family:
           It refer to the family type. For the present study it is
   categorized as:
           (a) Nuclear
           (b) Joint
5. Number of children in family:
        Refers to the children between 0 to 2 years of age.
        (a) One
        (b) Two
6. Type of Employment:
        Refers to their occupation and work.
        (a) Health workers
        (b) Teachers
        (c) Others
7. Monthly income of family:
        It refers to the monitoring earning of the parents.
        (a) Less than Rs. 1,000/-
        (b) Rs. 1,001 – Rs 3,000/-
        (c) Rs 3,001 – Rs 5,000/-
        (d) Rs 5,001 – Rs 7,000/-
        (e) Rs 7,001 and above
8. Source of information:
        It refer to the media through which the information was
gathered. For the present study it is categorized as
        (a) News papers
        (b) Television
        (c) Radio
        (d) Family members
        (e) Friends
        (f) Partner
7.2 Method of Data Collection.
Data collection instrument:
        The investigator planned to assess the knowledge and
attitudes of employed mothers regarding breast feeding through
structured interview schedule and breast feeding practices of
employed mothers by check list.
        Section 1 –    deals with the socio demographic data.
        Section 2 -   deals with the assessment of knowledge and
        attitude related to employed mothers regarding breast feeding.
        Section 3 – deals with the items related to breast feeding
        practices among employed mothers.


Data collection method:
        Prior permission will be obtained by the significant authorities
and the subjects. Then face to face interviews with subjects will be
conducted by the investigator personally by using the structured
interview schedule to assess the knowledge and attitudes regarding
breast feeding where as checklist will be used to assess the breast
feeding practices.


7.3 Projected Outcomes:
        The present study will help the employed mothers to gain
knowledge, develop positive attitudes and follow safe and good
practices of breast feeding and hence preventing infant mortality and
morbidity rates.
7.4 Does the study require any investigation or intervention to be
conducted on patients or other human or animals? If so, please
describe briefly?
        Since, It’s a descriptive survey the study does not require any
intervention or investigation.


7.5 Has ethical clearance been obtained from institution in of 7.4?
        Ethical clearance is obtained from the institutional ethical
committee and consent will be obtained from all the subjects.
8. LIST OF REFERENCES:

1. Dr .M. Gandhimathi. NIGHTINGALE NURSING TIMES. 2007
  August: 6-13.
2. Rinda John. KNOWLEDGE, ATTITUDE AND PRACTICES OF
  EMPLOYED MOTHERS ABOUT BREAST FEEDING. 2005
  April; Vol XCVI. No. 4.
3. Mallika, Katiyar. CULTURAL BELIEFS AND PRACTICES OF
  BREAST FEEDING. 1999 June.
4. UNICEF. PROTECTING, PROMOTING AND SUPPORTING
  BREAST FEEDING. THE NURSING JOURNAL OF INDIA.
  2003 June; Vol-5 No. 11, 3-7.
5. J Obstet Gynecol. NEONATAL NURSES BREAST FEEDING
  AND EMPLOYMENT. 1991 Nov- Dec; 20(6): 471-80.
6. UNICEF. NURSING TIMES. 2007 Aug.
7. Dr. S. Kalavathi. NIGHTINGALE      NURSING TIME. 2007.
  August: 12.
8. Katiyar. BREAST FEEDING PRACTICES OF POST NATAL
  MOTHERS. THE NURSING JOURNAL OF INDIA. Vol. 8
  No.36: 22-25.
9. Pinto. A. BREAST FEEDING AND PRACTICES OF POST
  NATAL        MOTHERS.     THE   AMERICAN   JOURNAL   OF
  MATERNAL AND CHILD NURSING. 2001 June; Vol. 55 No.
  56: 27-28.
10.Bhatia. BREAST FEEDING AND WEANING PRACTICES.
  WHO. REGIONAL PUBLISHERS. 2001 Aug.
11.Ortiz J, M. C. Gilligan. K. DURATION OF BREAST MILK
  EXPRESSION AMONG WORKING MOTHERS ENROLLED
  IN AN EMPLOYER SPONSERED LACTATION PROGRAM.
  2004 Mar-Apr; 30(2): 1119-1122.
9. Signature of the Candidate :


10. Remarks of the Guide      :


11 Name & the Designation of :


  11.1 Guide                  : Mrs. Sreelekha. C
                                  Asst Professor, .
                                  DEPT.OF OBSTETRICS AND GYNAECOLOGY
                                  NURSING.

  11.2 Signature              :


  11.3 Co-guide (if any)      :


  11.4 Signature              :


  11.5 Head of the Department :Mrs. Sreelekha .C
                                  Asst Professor,
                                  DEPT. OF OBSTETRICS AND GYNECOLOGY
                                  NURSING

  11.6 Signature              :


12.1 Remark of the Chairman
     & Principal              :


12.2 Signature                :

								
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