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