RAJIV GANDHI UNIVERSITY OF HEALTH
SCIENCES, BENGALURU, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
NAME OF THE MRS. DIANA NORONHA
1 CANDIDATE AND SRI VENKATESHWARA INSTITUTE OF
ADDRESS NURSING SCIENCES
BOMMANAHALLI
HOSUR ROAD
BENGALURU- 560 068.
NAME OF THE SRI VENKATESHWARA INSTITUTE OF
2 INSTITUTION NURSING SCIENCES
BOMMANAHALLI
HOSUR ROAD
BENGALURU- 560 068.
COURSE OF MASTER OF SCIENCE IN NURSING
3. STUDY AND OBSTETRICS AND GYNAECOLOGY.
SUBJECT
DATE OF 14-06-20010
4. ADMISSION OF
THE COURSE
TITLE OF THE “A COMPARITIVE STUDY TO ASSESS
5. TOPIC THE KNOWLEDGE REGARDING
MINOR DISORDERS OF PREGNANCY
AMONG RURAL AND URBAN MEN IN
SELECTED AREAS OF BENGALURU”
6. BRIEF RESUME OF THE INTENDED WORK.
INTRODUCTION
“Health should mean a lot more than escape from death,
Or for that matter escape from diseases.”
“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 backbone of
the family”.1
Pregnancy, including birth, is perhaps the most emotional and dramatic
experience in a woman’s life. It involves all the family members because ‘conception is
the beginning not only of a growing foetus but also the family’s new form with an
additional member and with changed relationship’. Pregnancy is associated with
changes. This change not only involves physical and physiological changes but also
incorporates psychological, emotional and spiritual aspects of change, which can be
disturbing and distressing.2
During the eighties and early nineties, almost all the reproductive and child
health programmes in India focused exclusively on women. Men were left out of the
programmes. It was during the mid-nineties that researchers and policy makers started
realizing the important role that men can play as supportive partners in achieving good
health for women and children.3
Each member in a family has a role in pregnancy just as the woman does. The
partners’ main role in pregnancy is to nurture and respond to the pregnant woman’s
feelings of vulnerability. The partner must also deal with the reality of the pregnancy.
The partner’s support indicates his involvement in the pregnancy and preparation for
attachment to the child. Birth partners need to be kept informed, supported, and
included in all activities in which the mother desires their participation.
Lederman 1984 reported that couples grow closer during pregnancy and it also
has a maturing effect on the partner’s relationship as they assume new roles and
discover new aspects of one another. Partners who trust and support each other are able
to share mutual dependency needs.2
Pregnancy can challenge the current role of each family member. Little
attention is given to the development and emotional stages, to the behaviour and
characteristics of pregnancy as to how the couple is interpreting and coping with the
experience. The reason for this are numerous and include the health professionals own
adequacy and lack of perception in dealing with these issues as well as the pregnant
women’s desire to avoid giving the impression that she and the father of the baby are
having problems. The partner’s emotional support is an important factor in the
successful accomplishment of these developmental tasks. Maternity nurses as well as
other professionals need to expand the scope of their health care services by involving
husbands in antenatal care and child birth.2
6.1 NEED FOR THE 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 childbirth is one of the life’s major events that is joyous and
rewarding as the women passes through a transitional phase into a new life of
motherhood.4
According to WHO 5,85,000 women die each year from a pregnancy related
causes, 99% of whom are from the developing countries.4
Minor disorders are only minor as much as they are not life threatening. A
minor disorder may escalate and become serious complication of pregnancy, where
sickness develops into hyper emesis gravidarum, a condition which began, as a minor
disorder has become a life threatening abnormality.5
In India 10-30% of the pregnancies belongs to the high risk category and
accounts for 75-80% of the perinatal morbidity and the mortality.6
Minor disorders are related to hormonal changes occurring on metabolic,
personal change of the body during pregnancy. Every women experience this minor
disorders during pregnancy but in varying degree and produce unnecessary anxiety. The
discomforts are fairly specific to each trimester of pregnancy such as nausea, vomiting,
constipation, frequency of micturition, heartburn, vaginal discharge, fainting, varicose
veins, haemorrhoids, backache, cramps and fluid retention.
In India more than the one lakh women die annually for reasons related to
pregnancy. About 20-30% of pregnancy belongs to the high risk category and most of
which are preventable.7
“Every father is an involved father at conception.”
According to 2005-2006 NFHS report only 45.7% of urban men and 37.6% of
rural men knew about minor disorders of pregnancy.8
The women and partner need to accomplish certain developmental tasks of
pregnancy successfully to adapt to the pregnancy and future roles as parents. Like the
mother, the partner also has to take the reality of the pregnancy. In recent years leaders
in child birth education has recognized the vital role of the partner in pregnancy care.9
Only a few studies have examined the involvement of men in pregnancy and
delivery care of their wives. Most of these studies examined the positive health
benefits of men’s involvement for wives and children. A study conducted in
Mumbai found that involving husbands in antenatal care counseling significantly
increases the frequency of antenatal care visits, significantly lowers perinatal
mortality, and pays dividends even among uneducated and low socio-economic
groups. Further, in contrast to men who do not participate in antenatal care
counseling, men participating in antenatal care counseling tend to know more about
family planning, nutrition and health of their wives during pregnancy and the ways
and means of preventing complications during pregnancy, at delivery, or during an
abortion. An intervention during prenatal consultations to increase men’s
involvement in their partners’ maternal care provided evidence that educating
pregnant women and their male partners yields a greater net impact on maternal
health behaviours compared with education of women alone.3
From the above study we can conclude that husband’s involvement in
caring their wives during antenatal period results in positive outcome of pregnancy.
At this point male members of the family and community members should be
involved in decision making roles, but then men are not able to make proper
decisions regarding care seeking at the time of complications because they do not
understand the dangers involved during pregnancy and childbirth. Culturally there is
very little inter spousal communication.10
According to census of India 2001, the average household size at national
level has declined from 5.5 in 1991 to 5.3 in 2001. Today the no: of household is
growing faster than the population and this is indicative of growing nuclearization.
Karnataka itself has seen a raise in the nuclear families by 2.7% in 1991.8
Current trend is that most of the families belong to the one who shares all
the physical and psychological feelings of his spouse. Priority should be given to the
husband and he should be oriented to the problems faced by pregnant ladies during their
pregnancy time. Though the females are dominant, husband is the one who makes
decisions and he is left with the final decision- making. So researcher felt that there is a
need to educate the men to create awareness in the public by involving husbands to
reduce maternal, perinatal mortality and morbidity.
Hence the Researcher planned to find out the knowledge level of rural and
urban men regarding minor disorders in pregnancy in a view to develop a health
information booklet.
6.2 REVIEW OF LITREATURE:
A literature review is a body of text that aims to review the critical points of
current knowledge and methodological approaches on a particular topic.
Review of literature is organised under the following headings:
6.2.1 Studies related to minor disorders of pregnancy.
6.2.2 Studies related to knowledge of men regarding minor disorders of pregnancy.
6.2.3 Studies related to effectiveness of information booklet.
6.2.1 Studies related to minor disorders of pregnancy:
A prospective study was conducted in Spain to evaluate the prevalence of
constipation during pregnancy and its association with eating habits and life style. A
structured questionnaire was administered in the obstetric clinic in the first trimester of
pregnancy, telephonic interview in the second trimesters and in the puerperal period.
The prevalence of self-reported constipation was 45.4, 37.1, 39.4 and 41.8%
respectively. Thus the study revealed that there was an increase in the prevalence of
constipation during pregnancy and that no factor was associated with the prevalence.12
An exploratory study on fatigue in early pregnancy at the department of
maternal and child nursing, University of Chicago conducted among 30 women aged
between 20-35 years, who were less than 20 weeks of gestation, revealed that a large
population of the sample (90%) experienced fatigue and that this fatigue had a
significant impact on their ability to maintain personal and social activities.13
A longitudinal study was conducted in Portugal to assess the prevalence of
backache in pregnancy among 49 pregnant women aged between 20 and 39 years
evaluated at different weeks of gestation. The ANOVA for repeated measures was used
to compare the four periods of evaluation (12 weeks, 20 weeks, 32 weeks and 37 weeks)
in relation to back pain. A significant difference between the pain scores over the four
periods was observed. The study reported that at 12 weeks of gestation 71.4% of
women had back pain, while at 20 weeks only 16.3% confirmed pain. At 32 weeks
91.7% of women reported pain and at 37 weeks, 98% reported the same. Thus the study
revealed that back pain is prevalent during pregnancy and its intensity varies throughout
this period.14
A prospective study was conducted in Canada among 367 pregnant women
attending prenatal clinic to determine the impact of nausea and vomiting in pregnancy.
Out of the 367 pregnant women included in the study, 78.5% of women reported nausea
and vomiting of pregnancy in the first trimester of pregnancy which was significantly
affecting their day to day activities. These findings shows that the presence and severity
of nausea and vomiting of pregnancy have a negative impact on health related quality of
life, which emphasise the importance of an optimal management.15
A prospectively collected cohort of women who were experiencing nausea and
vomiting of pregnancy and heartburn or both was conducted in Canada among 194
women to assess the relationship between heartburn and intensity of nausea and
vomiting. This cohort group was compared with a control group of 188 women having
nausea and vomiting of pregnancy but no heart burn. Pregnancy- Unique Quantification
of Emesis and Nausea (PUQE) scale and its well being scale was used to compare the
severity of the study cohort symptoms. The results showed that women with heartburn
reported higher PUQE scores compared with controls. Similarly, well being scores for
women experiencing heartburn were lower compared with controls. The study
demonstrated that increased PUQE scores and decreased well being scores were due to
the presence of heartburn. This cohort study revealed that heartburn is associated with
increased severity of nausea and vomiting in pregnancy. Managing heartburn may
improve the severity of nausea and vomiting.16
A study was conducted in London among 607 consecutive women at various
stages of pregnancy using self administered questionnaire, to understand the
relationship between prevalence and severity of heartburn with that of gestational age
and parity. Among the sample about 22% of them reported heartburn in the first
trimester, 39% in the second trimester and 72% in the third trimester. Thus the study
concluded that the prevalence of heartburn increased with gestational age as did severity
of heartburn. So proper management at proper time can reduce the discomfort.17
A prospective study was done on 127 pregnant women at different gestational
weeks (8-12 weeks, 18-22 weeks, 25-28 weeks, and 35-38 weeks) to study the sleep
pattern and prevalence of sleep disturbances during pregnancy. Findings revealed that a
large percentage of women experienced sleep disturbances during pregnancy. Thus
there is prevalence of sleep disturbances among pregnant women especially at the last
trimester.18
6.2.2 Studies related to knowledge of men regarding minor disorders of pregnancy:
“Knowledge is one of the benefactors of the investment in information”
A study was done to assess the knowledge of husbands regarding antenatal care.
It was a non experimental descriptive study conducted on husbands of antenatal mothers
attending OPD at Bowring and Lady Curzon Hospital, Bengaluru. Non-purposive
sampling was used for this study. Results showed that only 27.76% of husbands of
primigravidae had knowledge regarding antenatal care. The study concluded that
husbands had inadequate exposure to reproductive matters and little or no involvement
in meeting the wives needs during pregnancy. So there is a great need to impart
knowledge to men regarding women’s reproductive process and wellbeing.19
A study was done in Chandigarh among 100 couples from 4 prospective
villages to know the amount of knowledge and care given by partners to pregnant
women and also to assess the role of husbands during pregnancy, Puerperium and
during their wives illness. Results showed that only 30% - 40% of husbands escorted
their wives to hospitals, and only 10% of husbands took time off their work during
wives sickness and helped in household works. This proves that only minimum numbers
of husbands are aware of the importance of their role during their wives antenatal
period. Taking this into account there is a great need for educating the men population
regarding women’s health.20
6.2.3 Studies related to effectiveness of information booklet:
Studies have shown that provision of information booklet has been effective in
improving the knowledge. This is supported by a study conducted among two groups of
pregnant women in New Zealand, One group consisting of 281 women were provided
with a booklet containing the information regarding ‘Your Pregnancy’. The second
group consisting of 267 pregnant women were kept as control group. Effectiveness of
the booklet was gauged by comparing the two groups of women on the extent to which
their needs for information had been met, the ease with which they could question
others about their pregnancy, locus of control, self-care and self-knowledge. The result
showed about 73% of women found it really effective, that they passed the booklet to
others. This supports the effectiveness of information booklet.21
A study was done in Lebanon to evaluate the impact of providing women with
written educational material on their satisfaction with care and use of health services
postpartum. All women having a live birth at 4 private hospitals in Lebanon were
eligible. The sample consisted of 187 women in interventional group and 191 in the
control group. A written material was handed over to the women just before discharge
from hospital; Satisfaction was about 57.2% in the intervention and 38.9% in the control
group. Around 85% of women in the interventional group had a post partum visit
compared to 55% in the control, it is supporting the need for educational information.22
STATEMENT OF THE PROBLEM
“A COMPARITIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING
MINOR DISORDERS OF PREGNANCY AMONG RURAL AND URBAN MEN
IN SELECTED AREAS OF BENGALURU.”
6.3 OBJECTIVES:
1. To assess the knowledge about minor disorders of pregnancy among rural and
urban men.
2. To compare the knowledge regarding minor disorders of pregnancy between
rural and urban men.
3. To determine the association between knowledge level of rural and urban men
with selected demographic variables.
4. To develop a booklet on minor disorders of pregnancy.
6.4 HYPOTHESES OF THE STUDY
6.4.1 RESEARCH HYPOTHESES
H1: There will be significant differences in the knowledge level of rural and urban
men regarding management of minor disorders in pregnancy.
H2: There will be a significant association between the selected demographic
variables and the knowledge scores of rural and urban men.
VARIABLES UNDER STUDY
1. Knowledge of rural and urban men regarding minor disorders of pregnancy.
2. Selected demographic variables such as age, education, religion, income,
occupation, type of family, duration of marital life, source of information.
6.5 OPERATIONAL DEFINITIONS
6.5.1 Knowledge:
In this study it refers to the correct responses received from the rural and urban
men regarding minor disorders of pregnancy.
6.5.2 Rural men:
It refers to men who are married, residing in Chandapura (rural area) of
bengaluru, south Karnataka, between the age group of 21-35 years. Chandapura
is a rural area located 12km away from the college with a population of 38,339
having a primary health centre.
6.5.3 Urban men:
It refers to men who are married, residing in Begur (urban area) of bengaluru,
south Karnataka, between the age group of 21-35 years. Begur is an urban area
located 2km, away from the college with a population of 51,171 having a
primary health centre.
6.5.4 Minor disorders of pregnancy:
In this study it refers to the discomforts that occur during pregnancy. It includes
nausea, vomiting, heartburn, constipation, backache, cramps, fainting,
varicosities, frequency of micturition, insomnia.
6.5.5 Selected demographic variables:
In this study it refers to age, education, religion, income and occupation, type of
family, duration of marital life, and source of information.
6.5.6 Information booklet:
In this study it refers to the self learning material about minor disorders in
pregnancy prepared in simple and attractive manner.
6.6 ASSUMPTIONS
1. The rural and urban men may not have adequate knowledge regarding minor
disorders in pregnancy.
2. Men’s knowledge regarding minor disorders in pregnancy will have a
positive impact on pregnancy outcome.
6.7 DELIMITATION
The study is limited to rural and urban men who are married and in the age
group of 21-35 years residing at Chandapura (rural area) and Begur (urban area)
of Bengaluru, South Karnataka.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
Data will be collected from men in Chandapura (rural area) and Begur (urban
area) of Bengaluru, South Karnataka.
7.2 METHOD OF DATA COLLECTION
7.2.1 RESEARCH APPROACH
Survey approach.
7.2.2 RESEARCH DESIGN
Descriptive and Comparative design.
7.2.3 SETTING
The study will be conducted in Begur (urban area) and Chandapura (rural area)
of Bengaluru, South Karnataka.
7.2.4 POPULATION
The population of the study comprises of married men between the age group of
21-35 years residing in Begur (urban area) and Chandapura (rural area) of
Bengaluru, South Karnataka.
7.2.5 SAMPLING TECHNIQUE
Purposive sampling technique
7.2.6 SAMPLE SIZE
The total sample of the study consists of 50 men from Begur (urban area) and 50
men from Chandapura (rural area) of Bengaluru, South Karnataka.
7.2.7 SAMPLING CRITERIA
Inclusion criteria
1. Men residing at Chandapura (rural area) Bengaluru, between the age group of
21-35 years and who are married.
2. Men residing at Begur (urban area) Bengaluru, between the age group of 21-35
years and who are married.
Exclusion criteria
1. Men who are not willing to participate in the study.
2. Men who are not having sound physical and mental health.
7.2.8 DATA COLLECTION TOOL
Structured interview schedule will be used to collect data, it consists of 2
sections, part I and part II.
Part I:
Selected demographic variables such as age, religion, education, occupation,
income, type of family, duration of marital life, source of information.
Part II:
Structured Interview schedule regarding minor disorders of pregnancy.
7.2.9 DATA ANALYSIS METHOD
The data analysis will be done through descriptive and inferential statistics.
Descriptive statistics
Frequency, mean, median, percentage and standard deviation are used to
describe demographic variables.
Inferential statistics
1) Parametric student’t’ test to find out the significance of difference between
the mean knowledge scores of rural and urban men.
2) Non parametric Chi square test to determine the association between
selected variables and the knowledge level of rural and urban men regarding
minor disorders of pregnancy.
7.3. DOES THE STUDY REQUIRE ANY INTERVENTION TO BE
CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS?
Yes, the study requires data collection by structured interview schedule from
the rural and urban men between the age group of 21-35 years.
7.4. HAS THE ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
INSTITUTION?
Ethical clearance will be obtained from:
Ethical committee certificate of Sri Venkateshwara Institute of Nursing
Sciences, Bengaluru.
Permission will be granted by authorities of selected Primary Health Centres.
Informed consent will be taken from the candidates, willing to participate in the
study.
8. LIST OF REFERENCE.
1. Park k. Parks textbook of preventive and social medicine. 17th ed. India. Banarsidas
Bhanot. 1997.
2. Lowdermilk D, Perry PF, Bobak TM. Maternity and women’s health care. 6th ed. St
Luis. Mosby publishers. 1997. p.187-196.
3 Singh A. Men’s involvement during pregnancy and childbirth. Project MUSE journal
Population review. 2009. (vol 48).
4. Boora, Kaur P, Kapoor YP, Chawla S Food. Consumption pattern of pregnant and
Lactating mothers in rural Haryana: The journal of nutrition and dietetics. 1997. p 34;
40-48.
5. Jenson B. Maternity and Gynaecological care. Philadelphia. India. Orient Longman.
1999. p.48-56; 214-227.
6. Pathnam SS. Obstetrics and gynaecology for post graduates. India. Orient Longman.
1999. p.48-56; 214-227.
7. Dutta DC. Textbook of obstetrics. 3rd ed. Calcutta. India. 1993. p.108.
8. Census of India. 2001. Government of India. TMHFW.p.1-2. Available from URL.
9. Neff.MC. Spray M. Introduction to maternal and child health nursing. Philadelphia.
Lippincott. 1996. p.100-101.
10. Nagrath A, Malhothra N, Singh M. Progress in obstetrics and gynaecology. 1st ed.
New Delhi. Jaypee brothers medical publishers. 2003. p.23-24.
11. Review of literature (online). ( cited 2010 April 5);
Http://en.wikipedia.org/wiki/literature-review.
12. Ponce J, Martinez B, Fernandez A, Ponce M, Bastida G, Pla E. et al. Constipation
during pregnancy: a longitudinal survey. ( serial online). 2008 Jan; 20(1): p.56-61.
Available from URL
13. Rerves N, Potempa K, Gallo A. Fatigue in early pregnancy. Journal of nurse
Midwifery. 1991. Sep- Oct; 36(5) ;p 56-61.
14. Quaresna C, Silva, Secca MF, O Neill JG, Branco. Back pain during pregnancy: a
Longitudinal study. 2010. Jul-Sep; 35(3). p. 346-351.
15. Laccasse A, Rey E, Ferreira E, Morin C, Berard A. Nausea and vomiting of
Pregnancy: what about quality of life. 2008. Nov; 115(2). p.1484-1493.
16. Gill SK, Maltepe C, Koren G. The effect of heartburn on the severity of nausea and
Vomiting. 2009. Apr; 23(4). p. 270-272.
17. Marrero JM, Goggin PM, Caesteckor JS, Pearce JM, Maxwell JD. Determinants of
Pregnancy heartburn. 1992. sep; 99(9). p. 731-734.
18. Jodi AM, Barry JJ. Sleep disturbances during pregnancy. Journal of obstetric,
gynaecologic & neonatal nursing. 2000.Nov; 6(29). p.590-597.
19.Redamma.GG. Knowledge of husbands of primigravidae regarding antenatal care:
The nursing journal of India. 2010.Nov(11).
20. Singh A, Kaur AA. How much do rural Indian husbands care for the health of their
wives. 2007. Apr. Available from URL.
21. Durhans G. Evaluation of your pregnancy; A NewZealand health information
booklet for pregnant women. 1989. sep: 3(13). p.281-285.
22. Kabakian TK, Oona MR, Impact of written information on women’s use of
Postpartum services: a randomised controlled study.2007; 7(86). p.793-796.
9. SIGNATURE OF STUDENT:
10. REMARKS OF THE GUIDE: It
is relevant to assess and promote the
knowledge of rural and urban men
regarding minor disorders of pregnancy.
11 NAME & DESIGNATION OF
GUIDE: Asso. Prof. Mrs. Saraswathi. P
Head of the Department
Sri Venkateshwara Institute of
Nursing Sciences.
Bommanahalli, Bengaluru.
11.1. SIGNATURE OF THE GUIDE:
11.2. HEAD OF THE DEPARTMENT: Asso. Prof. Mrs. Saraswathi.P
Head of the Department
Department of OBG Nursing
Sri Venkateshwara Institute of
Nursing Sciences.
Bommanahalli,
Bengaluru-560068.
11.3. SIGNATURE OF H.O.D:
12. REMARKS OF THE PRINCIPAL: The selected topic is relevant as the
study explores the knowledge of
rural and urban men regarding
minor disorders of pregnancy
which is the need of the hour with
a view to improve their knowledge
12.1 SIGNATURE OF THE PRINCIPAL:
: Asso Prof. Mrs. Saraswathi.P
Head of the Department
Department of OBG Nursing
Sri Venkateshwara Institute of
Nursing Sciences.
Bengaluru-560068
SRI VENKATESHWARA INSTITUTE OF
NURSING SCIENCES
BOMMANAHALLI, HOSUR ROAD, BENGALURU-560068
ETHICAL COMMITTEE
NAME OF THE CANDIDATE: MRS. DIANA NORONHA
YEAR : 1ST YR MSC NURSING (2010-2011)
SUBJECT : OBSTETRICS AND GYNAECOLOGICAL
NURSING
TITLE OF THE TOPIC : A COMPARITIVE STUDY TO ASSES THE
KNOWLEDGE REGARDING MINOR DISORDERS OF PREGNANCY
AMONG RURAL AND URBAN MEN IN SELECTED AREAS OF
BENGALURU.
ETHICAL COMMITTEE MEMBERS APPROVAL
DESIGNATION NAME SIGNATURE
1. CHAIRMAN : ASSO. PROF. P. SARASWATHI
2. LEGAL ADVISOR : MAJOR. MUDDEGOWDA
3. SOCIOLOGIST : PROF. LEELAVATHY
4. PSYCHOLOGIST : MRS.MAMTHA
5. STATISTICIAN : DR. RANGAPPA
6. FACULTY ADVISOR : ASSO. PROF. S. BHARATHI
SIGNATURE OF THE PRINCIPAL
