International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 6 Issue 7, November-December 2022 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

A Study to Assess the Effectiveness of Structured Teaching

Programme on Knowledge Regarding Dangerous Signs of New
Born Among the Postnatal Mothers at Selected Hospitals, Lucknow
Anubha Verma1, D Regina Rabello2
1
Lecturer, Bora Institute of Allied Health Sciences, Lucknow, Uttar Pradesh, India
2
Associate Professor, Hind College of Nursing Safedabad, Barabanki, Uttar Pradesh, India

ABSTRACT How to cite this paper: Anubha Verma |

Aim: This study aimed to determine the effectiveness of structured D Regina Rabello "A Study to Assess
teaching programme on knowledge regarding dangerous sign of new the Effectiveness of Structured Teaching
born among postnatal mothers at selected hospital Lucknow, Uttar Programme on Knowledge Regarding
Dangerous Signs of New Born Among
Pradesh India and to find out various factors associated with it.
the Postnatal Mothers at Selected
Materials and methods: An evaluative research approach with Pre- Hospitals, Lucknow" Published in
experimental one group pretest posttest design and convenient International
sampling technique were used to select 60 postnatal mothers at Journal of Trend in
selected hospitals Lucknow, Uttar Pradesh, India. A self-structured Scientific Research
knowledge questionnaire was used for assessing the knowledge and Development
(ijtsrd), ISSN:
among the subjects. SPSS version 25 was used for data analysis.
2456-6470,
Result: There was significant difference between Pre-test and Post- Volume-6 | Issue-7, IJTSRD52446
test intervention level of knowledge (t=40.533, p=0.0001) regarding December 2022,
dangerous sign of newborn among postnatal mothers. There was no pp.828-836, URL:
significant association between pretest knowledge score about www.ijtsrd.com/papers/ijtsrd52446.pdf
dangerous sign of newborn among postnatal mothers with their
demographic variables (p>0.05). Conclusion: Structure teaching Copyright © 2022 by author (s) and
programme was effective to enhance the knowledge of dangerous International Journal of Trend in
sign of newborn among postnatal mothers. Scientific Research and Development
Journal. This is an
KEYWORDS: Effectiveness, structured teaching programme, Open Access article
knowledge, dangerous sign of newborn, demographic variables distributed under the
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)

INTRODUCTION
Background:
Newborn baby is going through many changes in wrapping ; so skin to skin contact ;supporting breast
getting used to life in the outside world. This feeding infection prevention including hand washing,
adjustment almost always goes well but there are cord care, recognizing signs of illness in their
certain warning signs you should watch for with newborn baby and infant and basic life support.
newborns. These include :Not urinating (this may be Children who die within the first 28 days of birth
hard to tell, especially with disposable diapers ),No suffer from condition and disease associated with lack
bowel movement for 48 hours, Fever, Breathing fast,
of quality care at birth or skilled care and treatment
Pulling in of the ribs when talking a breath retraction, immediately after birth and in the first days of life.
Wheezing, grunting, or whistling sounds while
The majority of all neonatal deaths (75%) occurs
breathing etc.1 In poorly resourced areas key risk during the first week of life, and about one million
factors and associations are infection, hypothermia,
newborn die within the first 24 hours. pre term birth,
lack of breast feeding failure to recognize signs of
intrapartum related complications, infections and
illness in their baby and failure to provide adequate
birth defects cause most neonatal deaths in 2016.
basic resuscitation at birth. Education package
From the end of the neonatal period and through the
focused on improving neonatal mortality therefore first 5 year of life, the main causes of death are
include information on maintaining warmth; drying; pneumonia diarrhea birth defects and malaria.

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Malnutrition is the underlying contribution factor, Hyperthermia, Convulsion, Drowsy or
making children more vulnerable to severe diseases. unconsciousness, Body movements only when
A secondary aim was to explore the socio stimulated or no body movement if stimulated, Fast
demographic factors of mothers that influence breathing, Grunting and Sever chest in drawing,
knowledge of the WHO recognized dangerous signs Central cyanosis.
and the health seeking behavior of these mothers and The care seeking behavior among the postnatal
or caregiver.4 Before we asses a newborn for mothers underlines an urgent need to generate
dangerous signs, we should place the baby in warm awareness among them too able to recognize the
environment, take a weight and establish and IV line. danger sign in the newborn. Operational interventions
Then we should manage as follows: if the baby is not include promoting behavior changes among the
breathing or is gasping for air you should start community to avail newborn care services and
resuscitation immediately, if the child has respiratory building linkage with health facility in majority of
distress that is the breathing rate is greater than cases correct knowledge and care seeking behavior
60/min, chest retraction etc.. Unconscious could be during illness of newborn were lacking among
due to serious bacterial infection, birth asphyxia, students and this should be promoted through
neonatal tetanus or bilirubin toxicity. you should improve coverage with existing health services. Every
establish the cause by taking through history and treat year 3 million newborn die during their first seventh
by accordingly. control convulsion using day of life accounting for 75% of all neonatal death
Phenobarbital preferably iv 10-20 mg /kg give slowly mainly neonatal mortality rate NMR of 4 per 1000
while you watch the breathing. if Unable to live birth whereas the average NMR is33 per 1000
breastfeed The cause of this include serious bacterial live birth mainly the highest number of death occur in
infection, birth asphyxia or low birth weight, we south Asia.
should give dextrose 10mls/kg iv or nasogastric tube Adequate mothers and care giver knowledge of
to prevent hypoglycemia. this can be followed by neonate dangerous signs is important for reducing
giving breast milk as soon as possible according to infant mortality and morbidity. In this study we
the condition of the baby. assessed the mothers knowledge of the key dangerous
Maternal knowledge level about neonatal dangerous signs of newborn. slightly more than one third of
signs was very low. Therefore intervention modalities women appeared to have a satisfactory knowledge of
that focus on increasing level of postnatal mother the neonatal dangerous signs and the proportion of
education, access to postnatal mother services are women with knowledge of each frequently reported
needed. Postnatal mother can have a great role in dangerous signs was even less than fifty percent. the
caring new born baby and identifying neonatal danger majority reported that they have had an experience at
signs. And the need to increase educational efforts least one danger sign with their baby, which is
aimed for all postnatal women in the hospital as wells corroborated with the proportion postnatal mothers
in the community.9 mothers can have a great role in that appeared to know at least one danger signs.26
caring newborn baby and identified neonatal danger This study makes the postnatal mothers to come
signs. the finding of study revealed that there is poor forward for the awareness regarding dangerous sign
understanding of neonatal danger signs 174 (88.3%). of newborn illness which will ranked the
The existing knowledge gap in this key area of interventions in day to day life and will be make
neonatal danger signs affect the success of childcare effective to do the practice in home as well as
services; this need to increase educational efforts community.
aimed for all postnatal mothers in the hospitals as Objectives of the study:
well as in the community.10. There is urgent need to 1. To assess the pre-existing knowledge regarding
strengthen the teaching and training of expectant dangerous signs of newborn among the postnatal
postnatal mothers across all maternal socio mothers at selected hospitals, Lucknow.
demographic variables on these danger signs and the 2. To evaluate the structured teaching programme on
most appropriate measures to take when they occur. knowledge regarding dangerous signs of newborn
Need for study: among the postnatal mothers.
A new born is referred to who have completely 3. To identify the difference between pre-test and
covers the normal gestational age 38 weeks and its post-test knowledge regarding dangerous signs of
weight is 2.5-3.5 kilogram and normal from birth to 4 newborn among postnatal mothers.
weeks (28 days) age the baby is called neonate or 4. To find out the association between pre-test
newborn. Performing reflexes, spontaneous and Knowledge regarding dangerous signs of
normal color.” The dangerous signs include in new newborn among the postnatal mothers with their
born are: Not feeding well, Hypothermia, selected demographical variables.

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OPERATIONAL DEFINITIONS: 5. Knowledge level of postnatal mothers may vary
1. ASSESS with their selected demographic variables.
It refers to the statistical measurements of the
HYPOTHESIS:
knowledge of postnatal mothers regarding Dangerous H1. -There will be significant difference between pre-
signs of Newborn by using structured questionnaire. test and post- test knowledge score regarding
2. EFFECTIVENESS Dangerous signs of Newborn among the postnatal
In this study effectiveness refers to the extent of mothers.
structure teaching programme to achieve that desire H2. -There will be significant association between the
improvement in knowledge of postnatal mothers in level of knowledge regarding Dangerous signs of
dangerous signs of newborn baby. Newborn among the postnatal mothers with their
3. KNOWLEDGE selected demographic variables.
In this study knowledge refers to correct response
DELIMITATION:
from postnatal mothers regarding Dangerous sign of The study is limited to:
Newborn as selected through self-administered 1. Postnatal Mothers from selected hospitals
questionnaire before and after the Structured Lucknow.
Teaching Program. 2. Postnatal Mothers who are willing to participate
4. STRUCTURED TEACHING PROGRAMME in the study.
It refers to systematically organized teaching 3. Postnatal Mothers who are available during the
programme including cause of Neonatal Dangerous period of study.
signs and Neonatal illness related death, prematurity
METHODOLOGY:
and congenital abnormality as it affects the neonatal
RESEARCH APPROACH:
live birth rate per year etc. prepared by the An evaluative research approach was adopted in this
investigator to educate the postnatal mothers on study.
dangerous signs of newborn baby.
RESEARCH DESIGN:
5. DANGEROUS SIGNS Pre experimental one group pretest posttest design.
In this study a Newborn Dangerous signs refers to
presence of clinical sign that would indicate high risk Research Setting:
of neonatal morbidity and mortality and the need for Selected hospitals in Lucknow.
early therapeutic interventions which includes poor Population:
sucking, lethargy, or drowsiness rapid or difficulty in The population in the study was postnatal mothers.
breathing, hyperthermia and hypothermia yellow
colors of palms and soles, abdominal distention, SAMPLES:
bleeding from cord, diarrhea loose or bloody stool, The postnatal mothers at selected hospitals in
convulsions and vomiting. Lucknow.
6. MOTHERS SAMPLE SIZE:
In this study refers to those who are postnatal mothers 60 postnatal mothers in selected hospitals Lucknow.
1. Structured Teaching Programme improves the SAMPLING TECHNIQUES:
knowledge of postnatal mothers regarding Purposive sampling technique was used in this study.
dangerous signs of new born.
2. This study will help the mothers to assess and Variables:
care of Dangerous signs of Newborn baby. Dependent Variables: Knowledge of postnatal
3. This study will help the mothers to educating mothers regarding dangerous signs.
regarding Dangerous signs of Newborn. Independent Variables: Structure teaching programme
on dangerous signs of newborn.
ASSUMPTION:
1. Postnatal mothers may have knowledge about CRITERIA FOR SAMPLE SELECTION:
dangerous signs of new born baby. Inclusion criteria: The study includes:
2. Negligence leads o complications. High risk postnatal mothers who are planned to stay
3. Postnatal Mothers will have some interest to for 2 weeks
know more about danger sign of new born baby. Lowest caesarean section postnatal mothers
4. Structured teaching programme may effective for Postnatal mothers who are willing to participate in the
postnatal mothers regarding dangerous signs of study
new born baby.

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Postnatal mothers who can understand, read and the tool is reliable, applicable, feasible and
speak Hindi and English language practicable in all aspects to conduct the main study.
Exclusion criteria: The study excludes: DATA COLLECTION PROCEDURE:
Postnatal mothers who are not willing to participate in The data collection was done for 5weeks at
the study Veerangana Avanti Bai Mahila Chikitsalay, K.K
Postnatal mothers who are discharged within a short Hospital, Lucknow. Before conducting the study, I
time. obtained formal permission from the head of the
institution. Total 60 postnatal mothers were included
DESCRIPTION OF THE TOOLS: in the study. After explaining the importance and
It consists of two parts i.e. Section I, Section II purpose of study the tool was administered for data
Section I: - It consisted of demographic variables collection. 30-40 minutes were taken for conducting
information such as age, sex, education, income, no. interview. After the pre-test the administered the
of living children, etc. structured teaching programme on knowledge
Section II: - The structured questionnaires on regarding “dangerous signs of new born. All the
knowledge of dangerous signs of new born and its queries were cleared. The post test was conducted
management were prepared. after 1- 2 weeks using structured interview schedule
There is 30 structured questionnaire used in this with knowledge questionnaire the same procedure
study. Every item was of multiple choice type with was applied for all the samples.
one correct answer carrying one mark with remaining PLAN FOR DATA ANALYSIS:
options zero mark. The maximum score was 30 and The data obtained were analyzed in terms of
minimum score 0. The score graded as 21 to 30 were objectives of the using descriptive and inferential
considered good knowledge, 11 to 20 were statistics. SPSS version 25 was used for data analysis
considered as average knowledge, 0 to 10 were and 0.05 was the level of significance.
considered as poor knowledge.
RESULT:
CONTENT VALIDITY OF THE TOOL: Table 1 Frequency and Percentage distribution
Tool was validated by experts from Obstetrics and of Age and Religion, subjects (n=80)
gynecologist and obstetrics and gynecological nursing S. Demographic Frequency Percentage
departments, suggestions given by experts were No. variable (f) (%)
incorporated and tools are finalized. Age
RELIABILITY: a.16-20 years 9 15.0%
The tool after validation was tested for reliability. The 1. b. 21-25 years 28 46.7%
tool was tested by administering for 10 postnatal c. 26-30 years 18 30.3%
mothers who are admitted in the department of d.30 years 5 8.3%
obstetrics and gynecology Veerangana Avanti Bai Religion
Mahila Chikitsalay, K.K Hospital; Lucknow. In order a. Hindu 51 85.0%
to establish reliability of the tool, the split half 2. b. Muslim 3 5.0%
method was used. Correlation of the half test was c. Christian 5 8.3%
found by using Karl Pearson correlation coefficient d. Others 1 1.7%
formula and reliability co-efficient of the whole test
Table1 shows that, the Frequency and Percentage
was established by Spearman Brown’s Prophecy
distribution of demographic variables like age and
formula that is r=2r/1+r.The calculated “r” value was
0.82 and the tool was found to be reliable. religion of postnatal mothers.
In the Age group, the majority of 9 (15%) of postnatal
PILOT STUDY:
Pilot study was conducted on 10 postnatal mothers at mothers are in between the age group 18-20 years,28
selected hospitals to find out the validity and (46.7%) postnatal mothers are in the age group of 21-
reliability of the tool. Pilot study was conducted in 25 years, 18 (30.3%) students are in between 26-
postnatal mothers at Veerangana Avanti Bai Mahila 30years of age group, 5 (8.3%) postnatal mothers are
Chikitsalay, K.K Hospital, Lucknow UP, 10 postnatal in the age group of 30years.
mothers who met in inclusion criteria was selected by Regarding religion of postnatal mothers, 51 (85%)
using purposive sampling technique, structured postnatal mothers are Hindu, 3 (5%) postnatal
questionnaire was administered to the 10 sample. The mothers are Muslim, 5 (8.3%) Postnatal mothers are
reliability of the tool was done by using split half Christian and 1 (1.7%) postnatal mothers are belongs
method and reliability found as r=0.82, which denotes to others religion.

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Figure 1:- Bar diagrams reveals the frequency and percentage distribution of Postnatal mother’s age

Figure 2:-Cone diagrams reveal the frequency and percentage distribution of postnatal mother’s
religion.
Table 2 Comparison of pre and post-test knowledge level regarding dangerous signs among post natal
mothers of newborn baby
Mean (f) Std. Error Mean “t” value Df Significant
Pre-test 10.45 60 0.329 59 0.0001
40.533
Post-test 24.28 60 0.373 59 0.0001
**Significant at p<0.0001 level

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Table 2 shows that Paired t test value is 40.533 which are significant at 0.0001 level.
H1-There is a significant difference between pre-test knowledge and post-test knowledge scores among postnatal
mothers on dangerous signs of new born baby.
The table represents the mean of pre and post-test knowledge of dangerous signs among postnatal mothers of
newborn baby. The paired “t” test was carried out and it is found to be invariably significant at p<0.0001 level.
Hence research hypothesis (H1) is accepted. It provide for evidence that the structured teaching program was
significantly effective in improving the postnatal mothers knowledge on dangerous signs.
ASSOCIATION BETWEEN POST-TEST LEVEL OF KNOWLEDGE REGARDING DANGEROUS
SIGNS WITH THEIR SELECTED DEMOGRAPHIC VARIABLES.
Table 3 Chi-square test showing association between post-test levels of knowledge regarding
dangerous signs with their selected demographic variables.
Knowledge of Level P
Sl. (median=10) Calculated
Demographic variables Df value
No value (x2 )
≤ 10 >10
Age
a. 16-20 5 4
0.89
1 b. 21-25 13 15 0.61 3
(NS)
c. 26-30 10 8
d. >30 3 2
Religion
a. Hindu 28 23
0.25
2. b. Muslim 1 2 4.08 3
(NS)
c. Christians 1 4
d. Others 1 0
Occupation
a. Govt sector 1 4
0.01*
3. b. Private sector 6 3 11.29 3
(S)
c. Non-governmental organization 1 8
d. Home maker 23 14
Additional qualification
a. Illiterate 5 2
0.001*
4 b. Primary sector education 11 0 20.33 3
(S)
c. Intermediate education 11 10
d. Graduation education 4 17
Family income per month
a. <Rs 5000 14 7
0.21
5 b. Rs 5000-Rs 10000 12 17 3.13 2
(NS)
c. Rs 10000-Rs15000 5 5
d. Above Rs 15000 0 0
No. of living children
a. Only one children 13 13
0.81
6 b. Two children 13 10 0.42 2
(NS)
c. Three children 5 6
d. Four and above 0 0
Types of family
a. Nuclear family 14 15
0.44
7 b. Joint family 11 12 2.72 3
(NS)
c. Single parent family 5 2
d. Step family 1 0

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Previous knowledge regarding dangerous signs of newborn
a. Awareness campaign 9 11
0.56
8 b. Hospital instruction 8 4 2.05 3
(NS)
c. Family and friend education 9 7
d. Mass media communication 5 7
Previous experience in handling dangerous signs of newborn
0.63
9 a. Yes 12 13 0.05 1
(NS)
b. No 19 16
No. of hospital visit of mothers for their neonatal dangerous signs
a. Less than 2 times 14 13
0.83
10 b. 2-4 times 7 6 0.88 3
(NS)
c. 4-6 times 5 7
d. >6 times 5 3
Note: N.S-Not significant, S- Significant at P<0.05 level
H2- There is a significant association between the level of knowledge regarding Dangerous signs of Newborn
among the postnatal mothers with their selected demographic variables.
The result of the chi-square presented in table 4.4 indicates that there is significant association between post-test
knowledge score with demographic variables such as age, religion, occupation, additional qualification, family
income per month, no. of living children, types of family, previous knowledge regarding dangerous signs of
newborn, previous experience in handling dangerous signs of new born baby, No. of hospital visit of mothers for
their neonatal dangerous signs that there is statistically association at p<0.05 level. Hence the research
hypothesis (H2) is accepted.
DISCUSSION SIGNIFICANT FINDINGS OF THE STUDY:
A study was undertaken to assess the effectiveness of Distribution of samples according to the socio-
structure teaching programme on knowledge demographic variables.
regarding dangerous signs among postnatal mothers Age: Majority (46.7%) of postnatal mothers were
in selected hospitals at Lucknow. In order to achieve aged between above21-25years.
the objectives of the study, purposive sampling
Religion: Majority (85%) of postnatal mothers
technique was used to select the samples. The data
were Hindu.
was collected from 60 postnatal mothers at Obstetrics
and gynaecology department, by structured Occupation: Majority (61.7%) of postnatal
questionnaire. The findings have been discussed with mothers are home maker.
reference to the objectives. The data was organized, Additional qualification: Majority (35%) of
analysed and presented in five sections: postnatal mothers have intermediate and graduate
1. To describe the socio-demographic variables of education.
postnatal mothers. Family income: Majority (48.3%) of the postnatal
2. To assess the pre-existing knowledge level mother earnsRs5000-Rs 10000
regarding dangerous signs among postnatal Number of living children: Majority (43.3%) of
mothers of new born baby. the postnatal mothers were having one children.
3. To evaluate the effectiveness of structured Type of the family: Majority (48.3%) of the
teaching programme on knowledge regarding postnatal mothers belongs to nuclear family.
dangerous signs of new born baby among
postnatal mothers. Previous knowledge regarding dangerous signs of
newborn : Majority (33.3%) of the postnatal
4. To identify the difference between pre-test and mothers having knowledge through Awareness
post-test knowledge regarding dangerous signs of campaign
new born among the postnatal mothers.
Previous experience in handling dangerous signs
5. To identify the association of knowledge of new born baby: Majority (58.3%) of postnatal
regarding dangerous signs of new-born among the mothers were having no idea about handling
postnatal mothers with their selected socio- dangerous signs of newborn baby.
demographic variables.

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No. of hospital visit of postnatal mothers for their Structured teaching programme is effective in
neonatal dangerous signs: Majority (45%) of the improving the knowledge of postnatal mothers of
postnatal mothers were visit the hospital less than new born baby regarding dangerous signs.
2 times.
The findings of the study revealed that there was
Research hypothesis (H1) is accepted. a significant association of knowledge with
selected demographic variables such as,
NURSING IMPLICATIONS:
occupation, Additional qualification.
The investigator has drawn the following
implications from the studies which are the vital There was no association between age, religion,
concern for nursing education, nursing practice, family income, No. of living children, types of
nursing administration and nursing research. family, Previous knowledge regarding dangerous
signs of newborn, Previous experience in
RECOMMENDATIONS:
handling dangerous signs of new born, No. of
Similar studies can be replicated on larger
hospital visit of mother for their neonatal
samples for wider generalization mainly in the
dangerous signs.
community.
Financial support and sponshership: - Nil
With true quasi experimental and descriptive
design. Conflicts of interest:-There are no conflicts of
interest
To assess the comparative knowledge level
between primigravida and multipara postnatal BIBLIOGRAPHY
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