`

SUBMITTED BY:

Ms. G.Jyothi

1st year M.Sc. Nursing,

Obstetrics and Gynecological Nursing,

2011-2013 batch.

Oriental College of Nursing,

Bangalore – 560079.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

0

PROFORMA FOR REGISTRATION

OF SUBJECT FOR DISSERTATION

KARNATAKA, BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION1 NAME OF THE CANDIDATE

AND ADDRESS Ms. G.JYOTHI1st YEAR M .SC. NURSING,Oriental college of nursing,No43/52,2ndMain industrial town, west of chord roadBangalore-560079

2 NAME OF THE INSTITUTION Oriental college of nursing,Bangalore-79

3 COURSE OF STUDY AND SUBJECT

1st Year M.sc nursing,Obstetrics and Gynecological Nursing

4 DATE OF ADMISSION OF THE COURSE

11.10.2011

5 TITLE OF THE STUDY “A study to assess the effectiveness of video assisted teaching programme on knowledge and skill regarding prenatal yoga among primigravida mothers in selected maternity units Bangalore.”

6 BRIEF RESUME OF THE WORK6.0 Introduction6.1 Need for the study6.2 Review of literature6.2.1 Statement of the problem6.3 Objectives of the study6.3.1 Operational definitions6.3.2 Assumptions6.3.3 Hypothesis6.3.4 Sampling criteria(Inclusion and exclusion criteria)

Enclosed EnclosedEnclosedEnclosedEnclosed EnclosedEnclosed EnclosedEnclosed

7 MATERIALS AND METHODS7.1 Sources of data: Data will be collected from selected maternity units, Bangalore7.2 Method of data collection: Interview and observation method.7.3 Does the study require any investigations or interventions to be conducted on the patients or the other humans or animals? : Yes7.4 Has ethical clearance been obtained from your institution? -Yes, ethical committee’s report is here with enclosed.

8 LIST OF REFERENCES Enclosed

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

1

KARNATAKA, BANGALORE.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATE AND ADDRESS Ms. G.JYOTHI

1st year M.Sc. Nursing,

2011-2013 batch.

Oriental College of Nursing, No.43/52,

2nd main industrial town, west of chord road,Bangalore-560079

2. NAME OF THE INSTITUTION Oriental College of Nursing,

Bangalore-560079.

3. COURSE OF STUDY AND SUBJECT 1st Year M.Sc. nursing,

Obstetrics and Gynecological Nursing.

4. DATE OF ADMISSION OF THE COURSE 11.10.2011

5. TITLE OF THE STUDY “A study to assess the effectiveness of video assisted teaching programme on knowledge and skill regarding prenatal yoga among primigravida mothers in selected maternity units, Bangalore.”

6. BRIEF RESUME OF INTENDED WORK

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6.0) INTRODUCTION

Birth is a miracle and each baby is life`s perfect creation. Pregnancy is often a

time of hope for the future. Process of pregnancy and child birth are very much a

personal journey. Each woman experiences the beauty of creating and giving birth to a

child. The journey motherhood is a beautiful life of passage.1

Yoga is a science of right living and it works when integrated in our daily life. It

works on all aspects of the person: The word yoga means ‘unity’ or ‘oneness’ and is

derived from the Sanskrit word ‘yuj’ which means ‘to join’2.

Yoga has a diverse range of things that it can offer. It could be said that a primary

goal of yoga is to gain balance and control in one’s life. To free one from confusion and

distress. To provide a sense of calm that comes from the practice of yogic exercises and

the practice of breath control.2

The practice of yoga exercises aims at overcoming the limitations of the body.

Other forms of exercises are good but good is not enough; they strain the muscles, joints,

the entire skeletal system and cause free radical damage at a cellular level.2

To bear a child is undeniably the ultimate dream of the majority of women. It is

an almost divine fulfillment that the women hope to attain through this of procreation.

Fear and apprehensions often could the mind, the moment pregnancy is confirmed.3

Child birth is surely the greatest act performed by women. It can be a great

emotional experience. The physical and psychological aspects can’t be separated. For a

number of women labor is a time of apprehension of fear and agony. But with a proper

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antenatal preparation the majority women can have and labor that is easy and painless

and women can actually enjoy the labor and experience a sense of fulfillment.3

Yoga poses help to breathe and relax, which can help to adjust the physical

demands of labor, birth and motherhood. The practice of medication is extremely

beneficial for pregnant women and babysit has been proven to slow down the heart rate,

relax and focus the mind.3

Yoga during pregnancy is a great form of exercise, both for mind and body and

regarding for the birth of the baby. Yoga practice during the pregnancy requires

modifications from typical yoga practice. The first trimester is the most similar to “non

pregnant” yoga with few changes.4

Prenatal yoga is a great way to cultivate strength, flexibility and stamina all of will

help the women feel to great throughout the pregnancy as well as prepare the mind and

body for labor and motherhood along with breathing exercises and relaxation techniques.

The prenatal yoga focus on poses that help ease the discomforts associated with

pregnancy and prepare the body for child birth. Yoga is often recommended by doctors to

pregnant patients and it is often possible to be specialist yoga units.5

6.1) NEED FOR STUDY

Prenatal yoga may help to prepare for labor and promote the baby’s health.

Prenatal yoga is a multifaceted approach to exercise that encourages stretching, mental

centering and focused breathing. It will improve the sleep and reduces stress and anxiety.6

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The prenatal yoga will increase the strength, flexibility and endurance of muscles

needed for child birth. It will decreases lower back pain,nausea,carpal tunnel syndrome,

headaches and shortness of breath and also it decreases the risk of preterm

labour,pregnancy induced hypertension and intrauterine growth restriction.6

A study conducted in French university hospital about prenatal depression,

prenatal anxiety and spontaneous preterm birth among women with early and regular

care. Spontaneous preterm birth occurred in 31 women (4.8%). The rate of

spontaneous preterm birth was significantly higher among women with high depression

scores (9.7%) as opposed to other women (4.0%) even after adjustment for potential

confounding factors.7

A study conducted in university of California, United States of

America.A pilot study on the effects of mindfulness based yoga intervention on sleep in

pregnant women.Fiffteen healthy, nulliparous women in their second trimester or third

trimesters with single tone pregnancies attended weekly mindfulness meditation and

prenatal hatha yoga classes in the community for 7 weeks. Sleep variables, as estimated

by 72 hours of the continuous wrist actigraphy and the general sleep disturbance scale

(GSDS) were recorded at baseline (time 1) and post intervention(time2).Women who

began the intervention in the second trimester had significantly fewer awakenings, less

wake time during the night. Mindful yoga shows promise for women in their second

trimester of pregnancy to diminish to total number of awakenings at night and improve

sleep efficiency .8

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An article shows that women practicing mindfulness yoga in their second

trimester reported significant reductions in physical pain from baseline to post

intervention compared with women in the third trimester whose pain increased. Women

in their third trimester showed greater reductions in perceived stress and trait anxiety.

Preliminary evidence supports yoga’s potential efficacy in these areas, particularly if

started early in the pregnancy.9

A study conducted in gunasheela surgical and maternity hospital (GSMH)

in Bangalore, India, was enrolled between 18-20 weeks of pregnancy in prospective,

matched, observational study.68 women in the control group. Women were matched for

age, gravida and Doppler velocimetry scores of umbilical and uterine arteries. Yoga

practices including physical postures, breathing and meditation were practiced by the

yoga group. One hour daily, from the date of entry into the study until delivery. The

control group walked half an hour twice a day during the study period. Compliance in the

groups was ensured. In babies the birth weight is significantly higher (P<0.018) in the

yoga group (2.78+/-0.52kg) compared to the control group (2.55+/-0.52kg) occurrence of

complications of pregnancy (pregnancy induced hypertension, intra uterine growth

retardation, pre term deliver) shows lower trends in yoga group.10

The above studies shows that yoga during pregnancy reduces the pregnancy

related minor complications as a student researcher from my clinical experience i have come

across many instances in which mothers suffer due the minor disorder such as nausea ,vomiting

sleep disturbances ,musculoskeletal problems etc which made me to take up a study based on the

topic

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6.2 REVIEW OF LITERATURE

Review of literature is a critical summary of research on a topic of interest often

prepared to put a research in a context or as the basis for an implementation project.

REVIEW OF LITERATURE WAS CONDUCTED ON THE FOLLOWING ASPECTS:

1) Reviews related to complications occurring in pregnancy.

2) Reviews related to effectiveness of prenatal yoga

3) Reviews related to outcome of prenatal yoga

1. Reviews related to complications occurring in pregnancy

American sociological association (1983) conducted a study on life stress,

social support and emotional disequilibrium in pregnancy. This study used a multivariate

approach to determine the effects of selected psychosocial variables on pregnancy

complications in a naturally occurring population of medically normal women from

various, marital and socio economic groups. Pregnant women between 12to28 weeks of

gestation (N=17) were tested with standardized instruments that measured life stress

social support and the emotion state variables of anxiety, depression and self esteem. Life

stress during pregnancy was measured in the last prenatal month. Significant main effects

were found for life stress during on overall and gestation complications and for emotional

disequilibrium on infant condition. Significant interaction of life stress (during

pregnancy) and social support (tangible) was found for all three types of complications

but not for overall pregnancy complications.11

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A study was conducted in Kwantung university by department of nursing

(2011) A study contains relationship of prenatal stress and depression to maternal and

fetal attachment and fetal growth. The purpose of this study was to examine pregnant

women’s stress and depression and their impact on maternal and fetal attachment and

fetal growth. Prenatal depression had significant correlations with length of pregnancy

and level of stress. Even through correlations between maternal stress and fetal

weight(r=15, p=.099) and correlations between maternal depression and maternal fetal

attachments(r=-13, p=.095) were not statistically significant. Maternal fetal attachments

and fetal growth can be affected by maternal emotional state, including stress or

depression.12

A study conducted in French university hospital of caen.A prospective cohort study

on prenatal depression, prenatal anxiety and spontaneous preterm birth among 681

women with single tone pregnancies consecutively recrited between 20 to 28 weeks of

gestation in the obstetrics department. Most of European ethic origin and received early

regular antenatal care. The assessment of gestational age was based on ultrasound

examination. Depression and anxiety were assessed self-administer questionnaires.

Spontaneous preterm birth occurred in 31 women (4.8%).The rate of spontaneous

preterm birth was significantly higher among women with high depression scores(9.7%)

as opposed to other women(4.0%)even after adjustment for potential confounding

factors.13

A study conducted in England on mood and anxiety disorders in women

frequently begin during the child bearing years. In a recent prospective longitudinal study

of 417 pregnant women in which depression was by the Edinburgh postnatal depression

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scale, 41 women (9.8%) were depressed during the pregnancy and 31 women (7.4%)

were depressed at 3 months postpartum. Because women are vulnerable to mood and

anxiety disorders.Phyicians in all patient care specialties need to be familiar with the

prevalence and course of these disorders, particularly during pregnancy and the post

partum period. 14

2. REVIEW RELATED TO EFFECTIVENESS OF PRENATAL YOGA

A study was conducted in Taiwan .This non randomized study aimed to provide yoga to

Primigravidas in the third trimester of pregnancy to decrease discomforts associated

With pregnancy and increase childbirth self efficacy low risk, sedentary primigravidas

Were targeted .The programmed was 12-13 weeks, with at least three sessions per week

.Each work out lasted for thirty minutes .Program participants reported significantly

Fewer pregnancy discomforts than the control group (38.28 vs. 43.26, z=-2.58, p=0.01) at

38-40 weeks of gestation and exhibited higher outcome and self efficacy expectancies

during the active stage of labor (104.13 vs. 83.53, t=3.24, p=0.002; 99.2vs.77.70, t=3.99,

p<=0.001) and these second stage of labor (113.33vs.88.42, t=3.33, p=0.02;

102.19vs.79.40, t=3.71, p<=0.001) compared with control Group .Interestingly, the

researchers concluded that the provision of booklets and videos of yoga during pregnancy

may contribute to a reduction in pregnancy discomforts and improved child birth self

efficacy.15

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3. REVIEW RELATED TO OUT COME OF PRENATAL YOGA

This study was conducted on prince of songkla university, hat yai, Thailand

examined the effects of a yoga program on maternal comfort, labor pain and birth

outcomes.74-primigravida Thai women randomized. The women were randomized. The

yoga program involved six, 1-h sessions at prescribed weeks of gestation. Variety of

instruments was used to assess maternal comfort, labor pain and birth outcomes. The

experimental group was found to have a shorter duration of the first stage of labour.No

differences were found between the groups, regarding pethidine usage,labour

augmentation or newborn Apgar scores at 1and 5 mintues.We also found a small, non-

randomized study that indicated chronic practice of yoga produce similar affects.16

A study was conducted in Bangalore about efficacy of yoga on pregnancy outcome. In this study Three hundred thirty five (335)women attending

the antenatal clinic at Gunasheela Surgical and Maternity Hospital in banglore.India, were enrolled between 18 and 20 weeks of pregnancy in a

prospective ,matched, observational study;169 women in the control group. They matched for age, parity, body weight, and Doppler velocimetry scores of

umbilical and uterine arteries. Yoga practices including physical postures, breathing, and meditation were practiced by the yoga group one hour daily,

from the date of entry into the study until delivery. The control group walked 30 minutes twice a day (standard obstetric advice) during the study period.

Compliance in both groups was censured by frequent telephone calls and strict maintenance of an activity daily. The result shows the number of babies

with birth weight>or =2500 grams was signicantly higher (p<0.01) in the yoga group. Preterm labor was significantly lower (p, 0.0006) in the yoga group.

Complications such as isolated intrauterine growth retardation (IUGR) (p=0.003) and pregnancy induced hypertension (PIH) with associated IUGR)

(P<0.025)were also significantly lower in the yoga group. There were no significant adverse effects noted in the yoga group.17

The study was conducted in college of nursing science, kyung hee university,

korea to examine the effect of the yoga during pregnancy on the maternal weight,

delivery experience and infant birth weight. The nonequivalent control group pre test-

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post test design was used. The participants were the healthy pregnant women, whose

pre-pregnancy BMI was normal, gestational period was more than 20 weeks. The final

sample consisted of 21 mother-infant dyads for experimental group and 20 dyads for

control group and who agreed to participate in this study. Data were collected from

February 1st to December 15th, 2006. The Qi exercise prenatal program was carried

out for 90 minutes a day, 2 times a week for 12 weeks. The data were analyzed using

SPSS 16.0 Program. The degree of maternal weight gain (p<.001), labor pain (p<.001),

discomfort after delivery (p<.001) and infant's birth weight (p<.001) were significantly

different between two groups. The yoga during pregnancy managed weight gain of

mothers. Therefore, this study suggests that yoga during pregnancy to promote

stabilization can be beneficial for maintaining healthy weight, decreasing labor pain

and discomfort after delivery for pregnant women and increasing infant's birth

weight.18

6.2.1 STATEMENT OF THE PROBLEM

“A study to assess the effectiveness of video assisted teaching programme on

knowledge and skill regarding prenatal yoga among primigravida mothers in

selected maternity units Bangalore.”

6.3. OBJECTIVES OF THE STUDY:

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1. To assess the level of knowledge and skill regarding prenatal yoga among

primigravida mothers before and after video assisted teaching programme.

2. To assess the effectiveness of video assisted teaching programme on knowledge and

skill regarding prenatal yoga among primigravida mothers.

3. To assess the relationship between knowledge and skill of primigravida mothers

regarding prenatal yoga

4. To determine the association between the level of knowledge and skill regarding

prenatal yoga among primigravida mothers and selected demographic variables.

6.3.1 OPERATIONAL DEFINITIONS:

1) EFFECTIVENESS:

In this study effectiveness refers to the extent to which video assisted teaching

programme helps to improve the knowledge and skill of primigravida mothers regarding

prenatal yoga as measured by post test scores.

2) PRENATAL YOGA:

It refers to the selected yoga done during pregnancy such as Pranayam, Sukhasana,

Shavasana Chakra asana, Baddhakonasana and Ardhachandrasana

3) PRIMIGRAVIDA MOTHERS

Refers to women who are pregnant for the first time and in the first trimester.

4) KNOWLEDGE

Refers to awareness of primigravida mothers regarding prenatal yoga as measured by

their response to the items in structured knowledge questionnaire

5) SKILL

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Refers to ability of primigravida mother to perform prenatal yoga as measured by using

check list

6.3.2. ASSUMPTIONS:

1. It is assumed that the primigravida mothers may have some knowledge and

skill regarding prenatal yoga.

2. It is assumed that the Video assisted teaching programme helps to improve the

knowledge and skill of primigravida mothers on prenatal yoga.

6.3.3. HYPOTHESES:

H1: There will be significant improvement in knowledge and skill of primigravida

mothers regarding prenatal yoga after the video assisted teaching programme.

H2: There will be significant association between level of knowledge and skill of

primigravida mothers and selected demographic variables.

6.3.4. SAMPLING CRITERIA:

1) Inclusion Criteria. primigravida mothers,

- Who are willing to participate.

- Those available at the time of data collection.

- Who can understand English and Kannada

2) Exclusion Criteria.

-Primi gravida mothers who are mentally unstable (anxiety, postnatal depression)

- who have undergone training and practicing prenatal yoga.

6.3.5 DELIMITATIONS

1. Study is delimited for 4 weeks.

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7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

Primigravida mothers who are in first trimester of pregnancy, attending OPD

and who are admitted in selected maternity units Bangalore.

7.2 METHOD OF DATA COLLECTION:

a) Research Approach : Evaluative approach

b) Research design : Quasi experimental design

c) Settings :Selected maternity

units ,Bangalore

d) Population : primigravida mothers who are in first trimester

attending selected maternity clinics ,Bangalore

e) Sample : primigravida mothers who are in first trimester and

meets inclusion criteria

f) Sample technique: : Simple random sampling

g) Sample size : 60

h) Method of data collection: Self administrative questionnaires

i) Tool for data collection: Structured knowledge questionnaires to assess the

knowledge on prenatal yoga,

Check list to assess the skill to perform prenatal yoga.

Method of data analysis and interpretation:

The researcher will use appropriate statistical techniques for data analysis and

present in the form of tables and diagrams.

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1. Demographic variables will be analyzed by frequency and percentage

distribution.

2. Level of knowledge and skill will be analyzed by mean, mean percentage, and

standard deviation.

3. Effectiveness of video assisted teaching programme will be analyzed by

paired ‘t’test.

4. Relationship between knowledge and skill will be analyzed through

correlation coefficient

5. Association between level of knowledge and skill and selected demographic

variables will be analyzed by chi square test.

Duration of study: 4 weeks.

VARIABLES:

Independent variable: Video assisted teaching programme on prenatal yoga.

Dependent variable: knowledge and skill of primigravida mothers regarding prenatal

yoga.

DEMOGRAPHICAL VARIABLES:

Age

Education

Occupation

Dietary pattern

Weeks of gestation

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Income

Socio economic status

Area of residence.

Previous source of information

PROJECTED OUTCOME:

The study will be successful in improve the knowledge and skills of primigravida

mothers on prenatal yoga and it will help in reducing the intensity of minor disorders of

pregnancy.

7.3 Does the study require any investigations or interventions to be conducted on

patient or other human being or animals?

Yes, investigations or interventions will be done on human beings.

7.4 Has ethical clearance been obtained from your institution?

Yes, Ethical committees report is here with enclosed.

8. LIST OF REFERENCES.

1. Jena walker. My unforgettable experience. Search warp.2006 July

http://search warp.com/saw 76469.htm

2. Introduction to yoga, yoga alliance, 2003

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http://www.introduction to yoga.com/

3. Prenatal yoga, asana, pranayana, medication during pregnancy

http://www.yoga point.com/info/yoga in pregnant.

4. Prenatal yoga, Aug 9, 2010

http://yoga life journey.com/pregnancy yoga

5. Prenatal yoga Apr 28, 2009

http://www.baby belly yoga.com/prenatal yoga.

6. Prenatal yoga understand the basics and benefits of prenatal yoga

http://www.mayoclinic.com/health/prenatal yoga

7. Prenatal depression, prenatal anxiety, and spontaneous preterm birth 1st Nov 2006

http://www.ncbi.n/m.nih.gov/pubmed/1707970

8. Effects of mindful yoga on sleep in pregnant women. April 2012

http:brn.sage pub.com/content/11/4/363 abstract

9. Article related to the women participating in mindful yoga

http://www.ncbi.n/m nih.gov/pubmed/19538619

10. Efficacy of yoga in pregnant women with abnormal Doppler study of umbilical and

uterine arteries Jan 2005

http://www.ncbi.n/m.nih.gov/pubmed/1600832

11. Life stress, social support and emotional disequilibrium in complications of

pregnancy

http://www.jstor.org/discover/10.2307/2136301

12. Relationship of prenatal stress and depression to maternal fetal attachment and fetal growth

17

.Mar 24, 2010

http://www.ncbi.n/m.nih.gov/pubmed/21551999

13. Prenatal depression, prenatal anxiety, and spontaneous preterm birth.Nov 1st, 2006

http://www.ncbi.nlm.nih.gov/pubmed/1707970

14. An update on mood and anxiety disorders during pregnancy and postpartum period.

Primary care companion J clin psychiatry Dec.2000.

http;//www.ncbi.nlm.nih.gov/pubmed/1707970

15. Effects of prenatal yoga programme on the discomforts of pregnancy and maternal

child birth self efficacy Feb 2009

http://www.science direct.com/science/article/p

16. Effects on maternal comfort, labour pain and birth out comes May 2008

http://www.science direct.com/science/article/p

17. Efficacy of yoga on pregnancy outcome Apr, 2005

http://online.liebrt pub.com/doi/abs/10.1089/p

18. E effects of yoga during pregnancy on weight gain, delivery experience and infants

birth weight.Jun, 2009http:journal.women-health-nursing.or.kr/kjwl

9. Signature of the candidate :

10. Remarks of the guide :

11. Name and designation (in block letters) :

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11.1 Guide :

11.2 Signature :

11.3 Head of the department :

11.4 Signature :

12.

12.1 Remarks of chairman & principal :

12.2 Signature :

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