RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA

BANGALORE

SYNOPSIS

FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 Mrs. SAVITA R H
Name of the Candidate .

2 Diana College of Nursing, No. 68,

Chokkanahalli, Jakkur Post,
Name of the Institution
Bangalore - 64

3 Master of Science in Nursing

Obstetrics and Gynaecological Nursing
Course of Study and Subject
Speciality

4 Date of Admission 28-06-2008

Effectiveness of Structured Teaching

Programme on Minor Ailments of Pregnancy
Among Primi Gravida Mothers attending
5 Title of the Topic Antenatal Clinic at K.C.General Hospital,
Bangalore.

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6. Brief resume of intended work

6.1 Need for Study

Women are the first and foremost key person and when she bears a child, a mother. Many
societies define her through her fertility and her body is adopted for this day its shape and
function childbirth or pregnancy is one of the major event in women’s life. Its memory
and effect will remain her throughout her life, coloring her life and of those with her and
around (Bennet RV Brown, 1996).1

Pregnancy is a creative and productive period in the life of women. It is one of the
physiologic vital events, which needs special care from the conception to postnatal
period, every mother wants to enjoy the nine months period with the baby inside her
womb. The mothers joyful experience of the pregnancy is not going to be always but
sometimes it is associated with problems of some minor ailments that may present among
mothers which cause discomfort to the mothers during pregnancy.2

WHO (2005) reported that maternal mortality is currently estimated to be 5, 29,000 death
per year, a global ratio of 400 maternal death per 1, 00,000 live births. Between 11 to 17
% of maternal death happen during child birth. The current estimate of south East Asia
region account for 1, 70,000 maternal deaths annually. In India 450 maternal deaths per 1,
00,000 live birth.3

Minor ailments may occur due to hormonal changes, accommodation changes, metabolic
changes and postural changes every system of the body is affected by pregnancy, she also
needs knowledge when she facing with discomfort or worrying symptoms, Bennet RV
Brown (1996).1

Treatment for the minor ailments such as nausea and vomiting, Heart Burn, Frequency in
Urination, Back Ache can be taken care in following manners;

For nausea and vomiting eat a piece of bread or a few dry fruits, dry biscuits, orange
sweets, pickles. Before getting up in the morning, Take small meals every two to three
hours and Take carbohydrate rich food like soft mashed potatoes, bread rice and noodles.
For heart burn Eat small, low fat meals frequently, Chew the food well and eat slowly and
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Avoid spicy food. For frequency in urination never restrict fluid in take because this will
only increase the chance of urinary tract infection. If symptoms of urinary tract infection
consult doctor and take prescribed anti biotic. For back ache avoid high heel shoes, to
maintain correct posture while sitting and standing, and Practice antenatal exercise to
relax muscle and spine.4

Pregnancy is considered as a normal physiological process during the reproductive age,

but stands for mortality of the mother and child if not cared properly during pregnancy
period. Most women experience Minor Ailments or side effects during their pregnancies
usually nausea and vomiting heart burn, frequency of urination, hemorrhoids, Back Ache,
constipation , cough, hiccough varicose vain anxiety during pregnancy, acidity and heart
burn abnormal carving, leg crams and oedema.5

Ngoozi po. (2008) conducted a study on pica practices of pregnant women in Narrobi to
determine the characteristics of women who reported practicing pica descriptive study
involving use of questionnaire administered in interview format. The finding says that
pica prevalence was significant high among the subjects; hence there is need to routinely
screen pregnant women for pica during antenatal visit.6

Markl GE, Hasford J (2008) a study conducted identifies predictors for nausea and
vomiting during pregnancy. As a result the risk of developing nausea and vomiting during
pregnancy was two times higher for non smokers than for the smokers. Physicians should
be aware of this fact when seeing women asking for treatment.7

Hanif S. (2006) a study conducted on frequency and pattern of urinary complaints among
pregnant women. As a result out of 1000 pregnant women 426 (42.6%) complained of
urinary system. Problems like Diurnal & Nocturnal frequency was the most commonly
encountered symptom (87.32%) followed by irritative symptoms and voiding difficulties.
The findings say that lower urinary tract symptoms are frequently present in pregnant
women.8

Every pregnancy is a unique experience for that women and each pregnancy that the
women experiences will be new and uniquely different. This is why it is so important that
the midwife should have knowledge and understanding of the common ailments of

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pregnancy in order to advise, treat and help further the women on strategies that will help
her to cope up with the condition and minimize the effects she experiences.

Although ailments are often termed minor disorders they are far from minor for the
women who is experiencing them and the midwife must remember this, it is also
important that the midwife recognize when a common disorders (ailments) of pregnancy
becomes a medical disorder of pregnancy for which the woman must be referred to the
appropriate medical practitioner. Hence, the researcher chosen this study to teach the
young Primi Gravida mothers to avoid the problem to make her happy during her
antenatal period.

6.2 Review of Literature

The term review of literature refers to the activities involved in identifying and searching
for information on a topic and developing a comprehensive picture of the state of
knowledge on that topic.9

Review of Literature related to minor ailments among pregnancy

SECTION A : Study related to nausea and vomiting.

SECTION B : Study related to abnormal craving (Pica).
SECTION C : Study related to Backache.
SECTION D : Study related to heart burn and Acidity.
SECTION E : Study related to frequency of maturation.

Koken G. (2008) Study conducted on Nausea and vomiting in early pregnancy

relationship with anxiety and depression. 230 women were investigated, by using the
Rhode's system. These scores and demographic data were compared and P < 0.05 was
considered significant. As a result a significant correlation between Rhode's score and
both anxiety (r=0.388, P < 0.001) and depression score, (r=0.351, P < 0.001) was found.
Gestational age showed and inverse correlation with anxiety scores (P=0.019). There was
no significant correlation between demographic data and anxiety/depression scores, or
Rhode's scores. The findings suggest that there is an association between anxiety and
depression early in pregnancy and severity of Nausea and vomiting of pregnancy.

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Lacasse A, Berard (2008) Study conducted on the Nausea and the Vomiting of
Pregnancy specific health related quality of life (QOL) questionnaires. As a result 367
women included in the study, 288 (78.5%) reported Nausea and the Vomiting of
Pregnancy in the first trimester of pregnancy. Among these women, the Cronbach's alpha
coefficients were high for the complete Nausea and the Vomiting of Pregnancy quality of
life questionnaire (alpha = 0.98), and for the four distinct domains [physical symptoms
and aggravating factors (alpha = 0.90); fatigue (alpha = 0.94); emotions (alpha = 0.86);
limitations (alpha = 0.97)]. The findings suggest that the Nausea and the Vomiting quality
of life is a reliable and valid index to measure NVP-specific QOL in the first trimester of
pregnancy.11

Anderson AM (2006) Study conducted on Pica in pregnancy in a privileged population:

myth or reality. Most studies have focused on less privileged populations, but is pica
prevalent among privileged pregnant women? 100,000 pregnant women in the Danish
National Birth Cohort were asked about pica in a food frequency questionnaire mailed in
gestation week 25. As a result 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, i.e. 0.02% had pica in this cohort of well nourished Danish
women. The findings suggest that it seems that, in privileged populations, pica is more a
myth than a reality.12

Madugu HN (2001) Study conducted to determine the prevalence of pica, and factors
associated with pica in pregnant women in Zaria. Using a structured questionnaire
administered by medical staff and mothers. Statistical analyses included 95% confidence
intervals, chi-squared and Fisher's exact tests. The prevalence of pica among the subjects
was 50%. The prevalence of non-food pica was significantly higher than that for food
pica (difference = 17.8%, 95% confidence interval = 8.3 to 27.3%). There was a
significant association between pica in family, friends or other members of the
community and pica in the index pregnancy (chi 2 = 10.78, p = 0.007). Pica is common in
pregnant women in Zaria, and their care should, therefore, include adequate dietary

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history and counselling. There is also a need to raise public awareness of the adverse
effects of this practice.13

Palma PC (2006) Descriptive study was conducted to determine the frequency pattern of
presentation and causative agents of lower urinary tract symptoms in pregnant females.
One thousand consecutive pregnant women, attending the antenatal clinic were included
in the study. All women underwent complete examination of urine. Out of one thousand
pregnant women, 426 (42.6%) complained of one or more urinary symptoms. Diurnal
and nocturnal frequency was the most commonly encountered symptom (87.32%),
followed by irritative symptoms and voiding difficulties. Complete urine examination of
symptomatic patients revealed<5 pus cells /HPF (high power field) in 322 cases and 6-20
pus cell/HPF in the remaining 104 cases. The urine culture of the symptomatic patients
(426 cases) showed growth in only 37 cases (8.69%).Escherichia (E.) coli was the
commonest organism (89.1%) followed by Staphylococcus (S.) aureus (8.1%) and
candidiasis (2.7%). The finding suggest that Lower urinary tract symptoms are frequently
present in pregnant women, which can be due to both pregnancy-induced changes on
urinary system as well as urinary infection.14

Morair S Herrmann Y. (2006) Study conducted on the prevalence of irritative bladder

symptoms of women in the third trimester of pregnancy and the correlation to parity and
route of delivery. As a result 80.6% presented nocturia, 70.3% presented urinary
frequency and 44.4% presented urgency. No statistic correlation was observed between
irritative bladder symptoms and route of delivery however, when considering parity,
nocturia and urinary frequency were significantly more frequent in multiparous women.
The finding suggests that in the population under study pregnancy percentage was
associated to a high prevalence of irritative bladder symptoms.15

Hart Din (1978) Study conducted on heartburn with associated oesophagitis is

experienced by 45% to 70% of pregnant women. Posture is the most constant associated
factor; bile regurgitation through the pylorus is likely to be important in its etiology but
gastric acidity is not. Treatment with alkalis or dilute hydrochloric acid affords some

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relief in 95% of cases and patient acceptability is the most important factor in choice of
preparation. Hiatus hernia is likely to be present in severe cases and rupture of the
oseophagus has been reported. Early delivery may be advisable in the interest of the
mother.16

Robertson EJ Moshal MG (1979) Study conducted on heartburn, thought to indicate

reflux of gastric contents into the oesophagus, occurs frequently in pregnant women
during the last trimester, its etiology is not clear. Prolactin blood concentrations rise
progressively during pregnancy and heartburn is known to disappear spontaneously
during the last weeks of pregnancy. Results show that patients with prolactin levels over
3,000 micro units/ml had significantly higher mean barrier pressures (sphincter pressure-
gastric pressure)than the patients with hormone levels of less than 3,000 micro units/ml
(P less than 0,02). No direct correlation could, however, be demonstrated between barrier
pressures and prolactin levels (r = 0, 3494). It is concluded that further studies would
seem to be indicated on any model to establish the importance of prolactin in the
regulation of the lower oesophageal sphincter tone.17

Review of literature related to structured teaching programme on minor

ailments

Harris VG (1980) conducted a quasi experimental study to find out the effectiveness of
minor ailments in pregnancy in the preparation for motherhood. The structure and process
of antenatal classes on the topic of motherhood were observed using an observation
guide. The major findings of the study were that mothers had poor knowledge. The mean
post test scores (30.58%) were significantly highly (P<0.001) than the mean pre test score
(10.82%).18

Chandra (2003) a study conducted on effectiveness of structured teaching programme on

management and its prevention about minor disorder during pregnancy. The study
revealed that the improvement mean score was 49.7 with ‘t’ value 21.3, which shows that
structured teaching programme is effective in improving the knowledge.19

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Statement of the problem
Effectiveness of Structure Teaching Programme on Minor Ailments of Pregnancy
among Primi Gravida Mothers Attending Antenatal Clinic at K.C.General
Hospital, Bangalore.

6.3 Objectives of the study

1. To assess the knowledge on minor ailments of pregnancy among Primi Gravid

mothers attending antenatal clinic before intervention.
2. To compare the pre test and post test knowledge scores on minor ailments among
Primi Gravid mothers attending antenatal clinic.
3. To associate the post test knowledge scores on minor ailments of pregnancy
among Primi Gravida mothers with their selected demographic variables.

Operational definitions

1. Effectiveness: It refers to significant gain in knowledge as determined by

statistical difference in the pre test and post test knowledge scores on minor
ailments of pregnancy among Primi Gravida Mothers.
2. Structured Teaching Programme: It refers systematically organized series of
content on minor ailments of pregnancy for Primi Gravida mother. It includes
nausea and vomiting, heartburn, frequency of urination, pica, and backache,
influencing signs and symptoms & management of minor ailments.
3. Minor Ailments of pregnancy: It refers physical and psychological problem
during pregnancy of Primi Gravida mothers includes Nausea & Vomiting, pica,
Heartburn frequency of urination & backache.
4. Primi Gravida Mothers: It refers to a woman pregnant for the first time between
18-35 years of age attending antenatal clinic at KC General Hospital, Bangalore.

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 Assumptions

1. The Primi Gravida Mothers will have some knowledge on minor ailments of
pregnancy.
2. Structure teaching program may enhance the knowledge of Primi Gravida
mothers regarding minor ailments of pregnancy.

Hypothesis

H1: There will be significant difference between the pre test and post test

knowledge scores on minor ailments of pregnancy.

H2: There will be significant association between post test knowledge scores of

Primi Gravid mothers with selected demographic variables.

7. Materials and methods

7.1 Sources of data : Primi Gravida Mothers attending antenatal clinic at KC

General Hospital, Bangalore.

7.2 Method of data collection

Research Design Quasi experimental approach with one group pre test and post test

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 design to assess the effectiveness of Structured Teaching Programme on
minor ailments in pregnancy.

Setting Antenatal Clinic at K.C.General Hospital

Population Primi Gravida Mothers

Sample Primi Gravida Mothers between 18-35 years of age attending antenatal
Clinic at K.C.General Hospital

Sample Size 60 Primi Gravida Mothers

Sampling Purposive Sampling technique will be used to select the Primi Gravida
Technique Mothers.

Tools Structured interview schedule

Data collection Prior to the study written permission will be obtained from the
concerned authorities. The purpose of the study will be explained to the
Primi Gravida mothers and then consent will be obtained to participate
in the study

Inclusion and Inclusive Criteria

Exclusion
1. Primi Gravida Mothers between 18-35 years of age.
Criteria
2. Primi Gravida Mothers willing to participate in the study.
3. Primi Gravida Mothers who will understand Kannada
4. Primi Gravida Mothers available at the time of data collection
Exclusive Criteria
1. Primi Gravida Mothers with complications.
2. Primi Gravida Mothers not available at the time of data
collection.

Analysis and Data will be analyzed using both descriptive and inferential statistics,
interpretation of percentage, mean, media, mode, standard deviation and chi square will
data be used for analysis of knowledge of Primi Gravid Mothers regarding
Minor Ailments of pregnancy.

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7.3 Does the study require any investigation or intervention to be conducted
on patients or others humans or animals if so please describe briefly.
YES,
The intervention will be conducted on Primi Gravida Mothers between 18-35 years of
age attending antenatal Clinic at K.C.General Hospital.

7.4 Has ethical clearance been obtained from your Institution in case of 7.3?
YES,
Informed consent will be obtained from the Institution, authorities and subjects. Privacy,
Confidentiality and anonymity will be guarded. Scientific objectivity of the study will be
maintained with honesty and impartiality.

Ethical Committee

Effectiveness of Structure Teaching

Title of the topic Programme on Minor Ailments of
Pregnancy Among Primi Gravida Mothers
Attending Antenatal Clinic at K.C.General
Hospital, Bangalore.

Mrs. Savita R.H.

Name of the candidate

Master of Science in Nursing

Course and the subject Obstetrics and Gynaecological Nursing
Specialty

Name of the guide Prof. Kalaivani

Head of the Department
Department Obstetrics and Gynaecological
Nursing
Diana College of Nursing, Bangalore
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Ethical committee Approved

Members of ethical committee

1. Prof. Veda Vivek
Principal and HOD
Department of Community Health Nursing
Diana College of Nursing, Bangalore – 64
2. Prof. Elizabeth Dora
Head of Department
Department of the Child Health Nursing
Diana College of Nursing, Bangalore - 64
3. Prof. Kalaivani
Head of the Department
Department of Obstetrics and gynecological Nursing
Diana College of Nursing, Bangalore – 64
4. Prof. Vasantha Chitra
Head of the Department

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 Department of Medical Surgical Nursing
Diana College of Nursing, Bangalore – 64
5. Prof. Surendra
Biostatistician, GKVK, Jakkur, Bangalore.

List of references
Books
1. Bennet RV Brown KL Myles textbook for midwives. New York Churchill
Livingstone, 1996. Page no. 13.
2. Nightingale Nursing Times, Vol2, issue10, Jan2007. Page24-27.

3. World health organization, regional health forum vol.9(1) 2005

4. Annamma Jacob, A comprehensive text book of midwifery, first edition 2005.

Page no.98 – 101.

5. Sabaratnam Arul kumaran Essentials of Obstetrics 1 st edition 2004 page no. 115-
117.
6. Ngozi po pica practices of pregnant women in Narrobi, Kenya 2008, feb: 85 (2)
72-9.
7. Markl GE Hasford J The association of psychosocial factors with nausea and
vomiting during pregnancy j psychosom obstat Gynaecol 2008 Mar; 29(1) 17-22
8. Hanif S. frequency & pattern of urinary complaints among pregnant women 2006
Aug; 16(8):514-7.
9. Polit DF & Hungler BP Nursing Research-Principles & methods. Philidelphia.
Lippincott Co. 2000.
10. Koken G. Yilmazer M.Sahin F.K. “Nausea and Vomiting in early pregnancy
relationship with anxiety and depression J psychosom obstet Gynaecol 2008
Jun;29(2)91-5
11. Lacasse A, Berard A Validation of the nausea & vomiting of pregnancy specific
health related quality of life questionnaire 2008 May 96:32.
12. Anderson AM olsen SF pica in Pregnancy in a privileged population myth or
reality Acter obstet gynaecol Scand 2006; 85 (10):1265 – 6.
13. Madugu HN sule S. pica in pregnant women in Zaria, Nigeria J med. 2001 Jan –
Mar; 10 (1): 25 – 7.
14. Palma PC. Frequency and pattern of urinary complaints among pregnant women.
2006 Aug; 16 (8): 514-7.

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 15. Morair S herrmann Y. Prevalence of Urinary systems in the third trimester of
pregnancy. 2006 May-Jun: 52(3): 153-6.
16. Hart Din Heartburn in pregnancy 1978;6 Suppl 1:1-5.
17. Robertson EJ Moshal MG A possible role of prolactin in preventing heartburn
during pregnancy. 1979 jan 27:55(4):127-8.
18. Harris VG effectiveness of minor ailments in pregnancy in the preparation for
motherhood, 1980. Oct;87(10):897-900
19. Chandra, klein Mc. The management of and its prevention on minor disorder,
2003. Jan; 25(1):13.

9. Signature of the candidate

(Mrs. SAVITA R.H.)

The research topic selected for this candidate is

10. Remarks of the guide relevant. The study related to Health and
illness of Pregnant women. There is a need to
assess the knowledge of primi gravida Mothers
regarding minor ailments during pregnancy.

Mrs. KALAIVANI
11. Name and designation of guide Head of the Department
Department of obstetrics and gynaecological
nursing
Diana college of nursing, Bangalore - 64

Signature
12. Remarks of the Chairman and The selected study is feasible and
Principal researchable and forwarded for needful
action.

Signature

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