RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1 NAME OF THE

CANDIDATE AND

ADDRESS (IN BLOCK

LETTERS)

MS. NIRMALA JOSHY,

I YEAR M.Sc. NURSING,

B.G.S. COLLEGE OF NURSING

KUVEMPUNAGAR

MYSORE-23

2 NAME OF THE

INSTITUTION

B.G.S.COLLEGE OF NURSING

SCIENCES, MYSORE.

3. COURSE OF STUDY AND

SUBJECT M.Sc. NURSING

CHILD HEALTH NURSING.4. DATE OF ADMISSION 15.06.2010

5. TITLE OF THE TOPIC:

A STUDY TO EVALUATE THE EFFECTIVENESS OF SELF

INSTRUCTIONAL MODULE RELATED TO KNOWLEDGE AND

ATTITUDE AMONG PRIMI MOTHERS ON MANAGEMENT OF

MINOR AILMENTS OF NEWBORN IN SELECTED HOSPITALS

AT MYSORE.”

INTRODUCTION:

“Whose eyes sparkle like the stars?

Whose smile outshines the sun?

Whose skin is soft as the moon glow?

Our precious little one!”

Kids brighten up our life

and home with their soulful laughter, childish talks and

unlimited energy. neonates or newborn are the most delicate

group among kids as they are not able to express their

feelings of happiness, sad, pain or discomfort and their

systems are immature ,just starting to adjust to the extra

uterine life. It is very difficult to see a newborn crying

when he or she is sick. They are the heart and the soul of

their parents, a precious gift to them after a long

expectation of nine months.

Mothers are angels in disguise,

always there for a family, silently supporting each family

members and building up the future generations of the

society and building up a good family. Being a mother for

the first time is a wonderful and exciting feeling for any

women in her life. Once she comes to know that she is going

to be a mother, she stars preparing for motherhood and waits

patiently and expectantly for her baby.

Most mothers observe their babies

carefully. A mother child bond is being developed soon after

the baby is brought to the mother1.

As she observes her baby, she

might often get worried by minor physical and physiological

peculiarities of the baby. This may include milia, Mongolian

spot, sneezing, hiccups, napkin rash, acne, cradle cap,

colic etc…2

These may be very alarming for

a mother especially for a first time mother. When parents

have the responsibility for a baby, it is only natural for

them to want to protect them as much as possible from

sickness and to deal with any signs of sickness quickly.

This is perhaps one of the most difficult parts of baby

care, as it can be difficult to find the balance between

allowing the sickness to take the natural course or rushing

to the doctor at every hint of a minor ailment.

She must be listened to

carefully and given reassurance and advice regarding minor

problems and difficulties of the newborn. Adequate

explanation and reassurance is necessary to allay her

anxiety which may lead to lactation failure.

BRIEF RESUME OF INTENDED WORK:

6.1 Need for the study:

There are various minor

health problems a newborn will suffer at some point of life,

especially in the neonatal period. Some of them requires no

management, it goes off by itself. some require simple

management which can even be done at home, while others

requires doctor’s consultation or medical or nursing

interventions. Mother’s have to be aware of this. Unless,

she is going to be aware of the minor ailments and their

management, she is going to get worried about her newborn

which is again going to affect her baby adversely. It is

worth bearing in mind that for minor ailments, there are

some home remedies that will help the baby to get rid of

that.

A study on knowledge,

attitude and practice of neonatal care among post natal

mothers in a tertiary care hospital in south India, during

April –July 2009, among 100 postnatal mothers concluded that

knowledge of mother’s was inadequate in areas of umbilical

cord care (35%) thermal care (76%) and vaccine preventable

diseases. 19% of them still practice oil instillation into

the nostrils of newborn and 61% of them administer gripe

water to their babies. The study concluded that awareness

and attitude of postnatal mothers towards neonatal care has

lots of lacunae especially in those who belong to the lower

socio-economic status and that there is a scope for

improvement by providing better care and health education

for antenatal mothers3.

Another study was conducted on

Hispanic mothers' beliefs and practices regarding selected

children's health problems.

The purpose of this study was to identify and describe the

Hispanic mothers' initial sources of advice and help with

children's illnesses; beliefs about the etiology and

seriousness of certain children's illnesses, namely, fever,

cough, diarrhea, vomiting, conjunctivitis, skin rash, minor

wounds, and burns; practices for the management of these

children's health problems, including the use of home

remedies, if any. Interviews were conducted with 100 women

of Hispanic origin who had at least one child age 5 years or

less and who were attending a community clinic in a rural

area of central California. Mothers' beliefs about problem

etiologies varied widely and revealed several

misconceptions, folk beliefs, and lack of knowledge. The

findings also revealed that only 32% of the mothers used or

would use health professionals as the initial source of

advice or help with children's problems. The majority of the

subjects (81%) admitted to using home remedies to manage

children's problems; 17% sought the help of a folk healer

(mainly for the treatment of empacho). The various types of

home remedies used by mothers were described and included

the ingestion or application of certain foods, fluids,

herbal teas, or other materials as well as methods to

eliminate the perceived causes of the problems. It is

important to note that 11% of the mothers had used azarcon

or greta (substances containing lead) for treating empacho

and other stomach problems in children. The need for

culturally responsive and sensitive health care is

discussed4.

Another study on

Symptoms were assessed in 298 infants under 6 months old

seen at home by Thornton AJ, etal was done. In that their

mothers were asked if they were concerned about their babies

and then questioned about the presence, duration, and

severity of 28 predefined symptoms. Forty seven mothers

expressed concern about their babies (16%), whereas on

direct questioning 241 (81%) reported symptoms present

within the last 24 hours. One hundred and twenty three (41%)

reported three or more. Many of the symptoms occurred in

more than 15 babies (5%). The commonest were cold

peripheries (117, 39%), noisy breathing (88, 30%), and rash

(68, 23%)5.

A study on an overview of Diaper

dermatitis, by Prasad H.R.,Verma .K and Srivastava .P.

concluded that , it probably results due to an interaction

of multiple factors like increased wetness, elevated pH due

to urine, fecal enzymes and microorganisms under the nappy.

It manifests as an erythematous rash occurring on the convex

surfaces of skin under the nappy. Rashes resembling nappy

dermatitis can also be caused by some diseases which may

have serious systemic manifestations. Therefore it is

essential to differentiate and treat them. The principle of

treatment of diaper dermatitis is to keep the skin in the

nappy area as dry as possible with frequent nappy change.

The super absorbent disposable diapers are known to reduce

the incidence of diaper dermatitis. Barrier creams to

protect the infant's skin and mild topical corticosteroids

to reduce the inflammation are mainstays of therapy. The

incidence and severity can be reduced by keeping the skin

dry under the nappy and protected from irritants and

infections6.

A study by Atherton on maintaining

healthy skin in infancy using prevention of irritant diaper

dermatitis concluded that irritant napkin dermatitis is a

form of contact dermatitis that occurs in the nappy area as

a consequence of the disruption of skin barrier integrity by

prolonged contact with feces and urine. It is a condition

that still occurs regularly in young children, and is best

managed by prevention. In this update, we will consider the

reasons that irritant napkin dermatitis develops, and the

simple methods that parents can adopt to avert it. These

methods are equally appropriate for general skin care in

babies, with the aim of preventing atopic dermatitis,

another exceedingly common skin problem in this age group7.

Another study on

Neonatal dermatology at tertiary care teaching hospital by

Muhammad Javed found that All children under the age of 28

days, with dermatological problems visiting either Pediatric

or Dermatology ward/OPD/ Emergency of Hamdard University

Hospital were included in the study, these cases were seen

by pediatricians & confirmed by the dermatologist. The

history was followed by a general physical and systemic

examination and detailed skin examination. Relevant

investigations were done including blood cultures. 77 cases

below the age of 28 days (neonates) were seen during the

study period, there were 26 cases of neonatal skin

infections (33.76%), 13 cases of hereditary disorders

(16.88%), 12 cases of nappy rash (15.58%), 10 cases of

erythema toxicum neonatorum 9.8%), 8 cases of milia (10,38%)

and 4 cases of erythema following phototherapy(5.19%)8.

An article by

Chandramita Bora on neonatal acne says “It has been observed

that almost 20% of the newborn babies can get acne, which is

also known as neonatal acne and acne infantum within a few

weeks after their birth. The incidence of neonatal or baby

acne has been found to be more in baby boys than baby

girls.” 9

Another study

conducted by N.Singh and Purtthi P.K, Sachdev A. etal on

disposable diapers: safe and effective method, in 2003,

concluded that nappy rash is a common problem in infants due

to their thinner skin, wetness, heat and friction under

cloth nappy, fecal enzymes and alkaline urine. The

disposable diapers containing super absorbent material

reduce the incidence of nappy rash. 10

In 2009, a University of

Texas study observed that colicky babies had a higher

incidence of mild intestinal inflammation and a specific

intestinal bacterium, Klebsiella. But, a commentary in the

same journal, noted that the inflammation and bacteria were

most likely just an exaggerated variation of normal.10

In order to bridge the gap

in knowledge and the mothers be free of unnecessary anxiety

over the minor ailments of newborn they need to be

adequately informed and given support and counseling

6.2 Review of Literature:

Literature review is

an essential step in the whole process of research. The term

review of literature refers to the activities involving in

identifying and searching for information on a topic and

developing an understanding of the state of knowledge on

that topic. It is also used to designate a written summary

of the state of the art on a research problem.

The review of

literature has been divided into following headings

Review of literature on nappy rash

Review of literature on colic in newborn

Review of literature on neonatal acne

1. Review of literature on nappy rash

A study was conducted in USA on Skin

care in the NICU patient: effects of wipes versus cloth and

water on stratum corneum integrity. New Zealand to test that

baby diaper wipes with emollient cleansers and a soft cloth

would minimize skin compromise relative to cloth and water.

130 NICU infants (gestational age 23-41 weeks, at enrollment

30-51 weeks), measurements of skin condition, i.e., skin

erythema, skin rash, transepidermal water loss (TEWL) and

surface acidity (pH), within the diaper and at diaper and

chest control sites were determined daily for 5-14 days

using standardized methods. Experimental design was used and

Treatments were randomly assigned based on gestational age

and starting skin irritation score A, wipe B, and the

current cloth and water NICU. Data were collected by using

experimental method and were analyzed using descriptive

statistics. Findings of the study showed that Perineal

erythema and TEWL were significantly lower for wipes A and B

than cloth and water beginning at day 5 for erythema and day

7 for TEWL. Wipe B produced a significantly lower skin pH

than wipe A and cloth and water. The study concluded that

the Both wipes are appropriate for use on medically stable

NICU patients, including both full and preterm infants, and

provide more normalized skin condition and barrier function

versus the cloth and water standard. Wipe B may facilitate

acid mantle development and assist in colonization,

infection control and barrier repair11.

A study was conducted in USA

on Clinical demonstration of skin mildness and suitability

for sensitive infant skin of a new baby wipe. To evaluate

the skin effects of a novel baby wipe formulation with

increased pH buffering. Experimental design was used A

series of clinical studies was designed and conducted to

evaluate the skin effects of the new baby wipe, a 4-week

study in babies with medically confirmed atopic dermatitis

(n = 32), a 2-week study comparing skin pH of babies (n =

15) following use of wipes compared with water and wash

cloth, a series of clinical skin pH measurements following

fecal exposure and subsequent cleaning with different

products (n = 50) and a study evaluating comfort of product

application on irritated skin (n = 31) and the samples were

selected by random sampling technique. The findings showed

that The wipes formulation was well-tolerated, even in

babies with atopic dermatitis, and was more comfortable

versus water and washcloth. Increased buffering capacity of

a wet wipes lotion helps to maintain a physiologically

balanced skin pH value in the diaper region.12

A Comparative study was

conducted in Europe to determine the clinical benefits of a

novel disposable diaper designed to deliver a zinc oxide and

petrolatum-based formulation continuously to the skin during

use. All studies were independent, blinded, randomized

clinical trials. Study A was conducted to confirm transfer

of the zinc oxide/petrolatum (ZnO/Pet) formulation from the

diaper to the child's skin during use. Study C evaluated

skin erythema and diaper rash in 268 infants over a 4-week

usage period. One half of the infants used the ZnO/Pet

diaper, while the other half used a control diaper that was

identical except for the absence of the ZnO/Pet formulation.

The results showed the ointment formulation and ZnO

transferred effectively from the diaper to the child's skin

during product use. Transfer of ZnO increased from 4.2

microg/cm2 at 3 h to > 8 microg/cm2 at 24 h. Greatest

reductions were seen for the ZnO containing formulations.

Wearing of the formulation treated diaper was also

associated with a significant reduction in skin erythema and

diaper rash compared to the control product.. The results

demonstrated the clinical benefits associated with

continuous topical administration of a zinc

oxide/petrolatum-based formulation by this novel diaper13.

A study was conducted in Europe, to

determine the clinical benefits of a novel disposable diaper

designed to deliver a petrolatum-based formulation

continuously to the skin during use. Two independent,

blinded, randomized clinical trials were conducted,

involving an aggregate total of 391 children, 8-24 months of

age. All comparisons were done versus a control diaper,

identical to the test product except for the absence of the

petrolatum formulation. The studies determined the effects

of the novel diaper on skin erythema and diaper rash using a

convenience sample. The results were use of the formulation-

treated diaper was associated with significant reductions in

severity of erythema and diaper rash compared to the control

product. The study concluded that clinical benefits

associated with continuous topical administration of a

petrolatum-based formulation by this novel diaper.14

Another study on frequency

and contributory factors in hospital attending children was

done in UK to better understand the frequency of diaper

dermatitis, treatment practices and the current importance

of previously identified etiologic factors was done.

Research design was descriptive. A questionnaire survey

method of parents who had children wearing diapers (n==532)

attending a UK general hospital was undertaken. Results were

that at the time of survey, only 16% of the study population

had diaper dermatitis. 48% of the study population had never

had an episode of diaper dermatitis. In a multivariate

analysis current diaper dermatitis was independently

associated with 4 factors: presence of oral thrush, number

of previous episodes, frequency of diaper changes and

diarrhea. Recurrent episodes of diaper dermatitis were

associated with increasing age, lack of barrier cream use,

current diaper rash and frequency of diaper changes. The

study concluded that diaper dermatitis usually presents and

is treated successfully outside the hospital setting and is

not a common clinical problem in secondary care.15

2. Review of literature on colic in newborn

A study was conducted in USA on

new strategies for the treatment of colic: modifying the

parent/infant interaction to validate the effectiveness of

behavior modification in treating colicky infants. A quasi-

experimental design with an untreated control group and a

pretest and posttest was used for the study. Twenty-three

infants were randomly assigned to intervention,

nonintervention, and control groups. Crying diaries kept by

the parents were used to obtain quantitative measurements of

crying before and after intervention. The Nursing Child

Assessment Feeding Scale (NCAFS) was used to measure

parent/infant interaction. The results were crying was

significantly reduced from 3.79 hours per day to 1.12 hours

per day among infants whose parents received interventions

of individualized counseling and education. Caregivers of

colicky infants in the intervention group scored lower on

the NCAFS. The study concluded that crying can be reduced by

modifying parental responses to the infant.16

Another study was conducted

in USA on excessively crying infant in the family: mother-

infant, father-infant and mother-father interaction to find

out the relationship between family interaction and colic in

infants. Mother-infant, father-infant and mother-father

interaction in 32 families with an excessively crying infant

and in 30 control families were studied. The group with

excessive criers was divided further into subgroups of

severe colic (n=13) and moderate colic (n=19). The three

dyads of the family were video-recorded when the infants

were an average of 5 weeks old. The assessment was carried

out during the infant's feeding, nappy change and discussion

between the parents. During the assessment, only four

infants were crying. The Parent Child Early Relational

Assessment Scale and the Beavers Scale were used. The

results were that both parents of colicky infants had less

optimal parent-child interaction compared with the control

parents. The father-infant interaction was less optimal in

13 items of 65 (20%) in the severe colic group, in one item

of 65 (2%) in the moderate colic group and in none of the

items in the control group. The mother-infant interaction

was less optimal in six items out of 65 (9%) in the severe

colic group, in three items out of 65 (5%) in the moderate

colic, and in none of the items in the control group.

Severely colicky infants were also less competent in

interacting with their parents. In addition, interaction

between the parents was more often dysfunctional in the

severe colic group. The study concluded that the problems in

early family interaction may threaten the well-being of

families with excessively crying infants and they therefore

deserve special attention from the health care

professionals.17

A study conducted was in

America, on excessive infant crying: the impact of varying

definitions to assess the impact of varying definitions of

excessive crying and infantile colic on prevalence estimates

and to assess to what extent these definitions comprise the

same children. Parents of 3345 infants aged 1, 3, and 6

months were interviewed on the crying behavior of their

infant in a Dutch cross-sectional national population-based

study. The results were Overall prevalence rates of

excessive crying varied strongly between definitions, from

1.5% to 11.9%. They were always highest in 1-month-old

infants. The study concluded that: Different definitions of

excessive crying lead to the inclusion of very dissimilar

groups of infants. We recommend presenting study results

using clearly described definitions, preferably concerning

both duration of crying and parental distress. This may

improve the comparability of studies on the cause and

treatment of excessive infant crying. The impact of the

method of data collection on this comparability needs

additional study colic, preventive child health care,

prevention, infancy.18

Another study was conducted in

Netherlands, on prevalence of parental behavior to diminish

the crying of infants that may lead to abuse to estimate the

prevalence of parental actions to stop infant crying that

may threaten infant health, and to determine specific risk

groups regarding these actions. Before their visit to a

well-baby clinic in the Netherlands, parents of 3345 infants

aged 1-6 months (96.5% response) filled out an anonymous

questionnaire on actions that they undertook to stop their

child crying. The results of the study was at 6 months, 5.6%

of all the parents reported having smothered, slapped, or

shaken their infant at least once because of its crying. The

highest risks for detrimental parental actions were run by

infants of parents from non-industrialized countries, of

parents with no or only a part-time job, and of parents who

had judged their infant's crying as excessive. The study

concluded that Clinicians should be aware of the observed

risk factors for abuse of young children known to cry a lot,

in order to help parents to cope with this crying.19

A study was conducted in

Britain on systematic review of effectiveness of treatments

for infantile colic to evaluate the effectiveness of diets,

drug treatment, and behavioral interventions on infantile

colic in trials with crying or the presence of colic as the

primary outcome measure. Research design was experimental.

Controlled clinical trials identified by a highly sensitive

search strategy in Medline (1966-96), Embase (1986-95), and

the Cochrane Controlled Trials Register, in combination with

reference checking for further relevant publications. Two

independent assessors selected controlled trials with

interventions lasting at least 3 days that included infants

younger than 6 months who cried excessively. The results

were27 controlled trials were identified. Elimination of

cows' milk protein was effective when substituted by

hypoallergenic formula milks. The effectiveness of

substitution by soy formula milks was unclear when only

trials of good methodological quality were considered. The

benefit of eliminating cows' milk protein was not restricted

to highly selected populations. Dicyclomine was effective

but serious side effects have been reported. The advice to

reduce stimulation was beneficial, whereas the advice to

increase carrying and holding seemed not to reduce crying.

No benefit was shown for simethicone. Uncertainty remained

about the effectiveness of low lactose formula milks. The

study concluded that infantile colic should preferably be

treated by advising carers to reduce stimulation and with a

one week trial of a hypoallergenic formula milk20

3. Review of literature related to newborn acne

A retrospective study was conducted

on 16 cases on infantile acne in France on infantile acne

was done to improve knowledge about the epidemiology and

clinical course of infantile acne and evaluate approaches to

treatment. The research design was survey method and covered

the period between 1985-2007. The data were drawn from

clinical and photographic records, followed by

administration of a telephone questionnaire to parents. It

was proposed that each case be reviewed on the basis of the

child's appearance and score on an acne scar clinical

grading scale. Sixteen children were included. The results

were that nine had a family history of severe adolescent

acne. The average duration of disease was 22 months. Two

patients had been effectively treated with oral

isotretinoin. More than half of the patients exhibited

scars. The study concluded that On the basis of the

frequency of scarring, and the severity and average duration

of lesions, the use of oral retinoid in severe infantile

acne warrants evaluation.21

A study was conducted in eastern Saudi

Arabia on acne neonatorum to elucidate the clinical profile

of acne neonatorum in eastern Saudi Arabia. Research design

was survey method sampling technique was purposive sampling.

The results were acne neonatorum was diagnosed in 26

patients (male/female ratio 1:1). The lesions included

mainly facial comedones (30.8%); papules and pustules (15.3%

each); and combination of papules, pustules, and cysts

(53.4%). The study concluded that all patients recovered

spontaneously. In 50% of the cases, one of the parents

reported having had acne vulgaris during adolescence.

Hereditary factors seem to play a significant role in our

series.22

Another study was conducted in USA on

Colonization of neonate skin by Malassezia species:

relationship with neonatal cephalic pustulosis. To determine

the skin colonization by Malassezia in healthy newborns, and

to investigate its association with neonatal cephalic

pustulosis. Research design was descriptive design and

method of sampling was randomized sampling. Samples for

Malassezia colonization were taken from cheeks and scalps of

104 neonates between 24 and 72 hours after birth, and again

2 or 4 weeks later. Pustules were sampled with concomitant

nonlesional skin cultures if neonatal cephalic pustulosis

was diagnosed. The results were Malassezia colonization

increased significantly with age of the neonate (5% at the

first week, 30% at 2-4 weeks). In all, 26 patients were

given the diagnosis of neonatal cephalic pustulosis during

follow-up. No correlation was found between the severity of

the disease and Malassezia isolation. Skin colonization of

patients with neonatal cephalic pustulosis (20.8%) was not

higher than colonization of healthy newborns (37%). The

study concluded that Malassezia colonization increases after

the first week of life. No correlation was found between

neonatal cephalic pustulosis and Malassezia.23

6.3 Problem Statement:

A study to evaluate the effectiveness of self instructional

module related to knowledge and attitude among primi mothers

on the management of selected minor ailments of newborn in

selected hospitals at Mysore.

6.4 Objectives of the Study:

1. To develop a self instructional module on management

of selected minor ailments of newborn for primi

mothers.

2. To assess the knowledge and attitude of primi mothers

on management of selected minor ailments of newborn.

3. To assess the effectiveness of self instructional

module on management of minor ailments of newborn

4. To correlate the knowledge and attitude regarding

management of minor ailments of newborn.

5. To find out the association between knowledge and

attitude of management of minor ailments of newborn

with selected background factors.

6.5 Operational Definitions:

1. Effectiveness: In this study effectiveness refers to gain in

knowledge and altered attitude toward the management among

primi mothers.

2. Knowledge:

In this study, refers to the amount of

information or understanding about management of minor

ailments of newborn; as measured by structured

questionnaire.

3. Attitude:

In this study it refers to way of

thinking towards management of minor ailments of newborn.

In this study it refers to nappy rash,

newborn acne and colic in newborn.

4. Minor ailments :

5. Newborn:

In this study, it refers to babies

between one to twenty eight days.

6.6Assumptions:

The researcher assumes that primi mothers will

Have some knowledge on minor ailments of newborn.

Be willing to participate in the study.

Give free and frank responses during pre-test and post-

test.

Delimitations:

The study is delimited to primi mothers

Ready to participate in the study

Available at the time of the study.

6.8 Projected Outcome (Hypothesis):

At 0.05 level of significance.

H1: The mean post-test knowledge scores of the primi mothers

getting the self instructional module will be significantly

higher than the mean pre-test knowledge scores on management

of minor ailments of newborn.

H2 : The mean post-test attitude scores of the primi mothers

getting the self instructional module will be significantly

higher than the mean pre-test attitude scores on minor

ailments of newborn.

MATERIALS AND METHODS:

7.1 SOURCE OF DATA:

The data will be collected from primi mothers

who had delivered the baby or underwent caesarian section

and admitted in selected hospitals at Mysore.

7.1.1 Research Design:

The study design selected for this study is one group pre-

test and post-test (pre-experimental) design.

Pre-test

Treatment

Post-test

01

X

02

7.1.2. Variables:

Independent variable: self instructional module

Dependent variable: knowledge and attitude on

management of minor ailments of newborn.

Extraneous variables: age, education, socioeconomic

status.

7.1.2 Settings:

The study will be conducted in selected hospitals atMysore.

7.1.3 Population:

Primi mothers who had delivered the baby or underwent

caesarian section admitted in selected hospitals at

Mysore.

7.2. METHOD OF DATA COLLECTION

The data will be collected from primi mothers who had

delivered the baby or underwent caesarian section regarding

the knowledge and attitude on management of selected minor

ailments of newborn using structured questionnaire method

and rating scale.

7.2.1 Sampling Procedure:

This research study will adopt convenient sampling for

selecting samples. Out of the total population defined those

who will meet the inclusion criteria will be selected for

the study.

7.2.2 Sampling Size:

Fifty primi mothers will be selected for the sample by

convenient sampling.

7.2.3 Inclusion Criteria for Sampling:

The study will include

Primi mothers who had undergone normal delivery.

Primi mothers who had undergone caesarian section.

Those who are present at the time of the study.

7.2.4 Exclusion Criteria for Sampling:

The study will exclude

Those who do not give consent to participate in the

study.

Those who are absent during the data collection.

Those who are multiparous.

7.2.5 Instrument Used

The following tool will be developed by the researcher using

review of literature and consultation with subject experts:

A structured questionnaire to assess the knowledge and a

rating scale to measure the attitude.

7.2.6 Data Collection Method:

The data collection technique adopted in the study is

structured questionnaire on knowledge and rating scale for

attitude.

7.2.7 Data Analysis Plan:

The data obtained would be analyzed using both descriptive

and inferential statistics. The analysis will be done on the

basis of objectives and hypothesis stated. The significance

of pre-test and post-test scores would be tested using ‘t’

test.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION ON

INTERVENTION TO BE CONDUCTED ON PATIENTS OR

OTHER HUMANS OR ANIMALS? IF SO PLEASE DESCRIBE

BRIEFLY:

Yes, the study requires providing a self instructional

module among primi mothers who had undergone normal delivery

or caesarian section.

7.4HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION IN CASE OF 7.3:Yes, Ethical clearance has been obtained from our

institution

LIST OF REFERENCES

1. Singh Meharban “.Care of the newborn”.6th ed,

New Delhi, Sagar

publications: 2004: p: 135

2. Parthasarathy A, Nair MKC, Menon PSN.” IAP

Textbook of pediatrics”.

3rd ed. New Delhi, Jaypee publication; 2004:

p: 56

3. Mohamed Asif Padiyath, etal. “Knowledge attitude

and practice of

neonatal care among postnatal mothers “. Current

Pediatr Research

2010; 14 (2): p: 147-152

4. Mikhail BI. “Hispanic mothers' beliefs and

practices regarding selected

children's health problems”. West J Nurs Res;

1994 Dec; 16(6): p: 623-38

5. Thornton AJ, etal. “Symptoms in 298 infant

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