Ranjiv Gandhi University of Health Sciences

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

Mr. SHIVASHANKAR IST YEAR M.S c NURSING

PAEDIATRIC NURSING

2011-2012

ANURADHA COLLEGE OF NURSING SRIGANDAKAVAL HEGGANAHALLI CROSS SUNKADAKATTE VISHWANEEDAM POST BANGALORE-560091

1 RANJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION 1 NAME OF THE CANDIDATE AND MR. SHIVASHANKAR

ADDRESS ANURADHA COLLEGE OF NURSING SRIGANDAKAVAL HEGGANAHALLI CROSS SUNKADAKATTE VISHWANEEDAM POST BANGALORE-560091

2 NAME OF THE INSTITUTE ANURADHA COLLEGE OF NURSING SRIGANDAKAVAL HEGGANAHALLI CROSS SUNKADAKATTE VISHWANEEDAM POST BANGALORE-560091

3 COURSE OF THE STUDY AND M.Sc NURSING I YEAR PAEDIATRIC NURSING SUBJECT

4 DATE OF ADMISSION 1ST JUNE 2011

5 TITLE OF THE TOPIC

“A STUDY TO ASSESS THE KNOWLEDGE OF FATHER REGARDING NEWBORN

CARE AT SELECTED HOSPITAL, BANGALORE.”

6. BRIEF RESUME OF INTENDED WORK

2 INTRODUCTION “A baby is an inestimable blessing....” Mark Twain

The first week of life is the most crucial period in the life of an infant. In India 50-60% of all infant deaths occur within the first month of life. Of these, more than half may die during the first weed of birth. This is because the newborn has to adopt itself rapidly and successfully to an alien external environment. The risk of death is greatest during the first 24-48hrs1.

A review of ages at death during the first 28 days of reveals that 2/3 of deaths occurring the first week of life and 2/3 of these within the first 2days of life. Thus almost 45% neonatal deaths take place with in 48 hours of birth. The major causes of death during this period are birth asphyxia and trauma, problems related to low birth weight. Most of the problems occur due to inadequate care immediately after birth. Clearly the intervention package must focus not only on the newborn alone but treat the mothers and bay as one2.

Neonatology deals with the problems of babies during the first four weeks of life. Neonatal mortality accounts for more than the infant mortality (as per 1,000 live births) in India and in 3-4 times than that in the Western countries. Improved neonatal care can lead to better and intact infant survival, which will pave the way for better acceptance of small family norms3.

New born care is of immense importance for the proper development and healthy life of a baby. Although childhood and infant mortality in South Asia has reduced substantially during the last decade, the rate of neonatal mortality is still high. According to one source 60% of all neonatal deaths and 68% of world’s burden of prenatal deaths occur in Asia4.

The little that we do know indicates that fathers of infant in the face unique challenges. Fathers strive to strive balance between work and family life. Despite these completing demands, ensuring that each infant’s father is engaged actively with the infant in vital for developmental reasons. In addition, the involvement of fathers is crucial when major decisions have to be made regarding the clinical care of the infant5.

3 Most fathers are naturally protective, supportive and responsible and are able to provide a number of significant benefits for their children. Involved fathers offer developmentally specific provisions to their sons and daughters through out the life cycle and are impacted themselves by their doing so. Active father figures have a key role to play in reducing behavior problems in boys and psychological problems in young women. An increased amount of father child involvement has also proven to increase a child’s social stability, educational achievement and even their potential to have a solid marriage as an adult6.

Children who were raised without fathers perceive themselves to be less cognitively and physically competent than their peers from father present families. Mothers raising children without fathers reported more severe disputes with their child. Some raises without fathers showed more feminine but no less masculine characteristics of gender role behaviors. The father child relationship is the defining factor of the fatherhood role in life. A “dad” doe’s not always have to be a child’s biological father and some children will have a biological father and a step of nurturing father6.

Even from birth children who have an involved father are more likely to be emotionally secure, be confident to explore their surroundings and as they grow older, have better social connections with peers. These children also are less likely to get in trouble at home, school or in the neighborhood. Infants who receive high levels of affection from their fathers are more securely attached that if they can explore their environment comfortably when a parent is nearby and can readily accept comfort from their parent after a brief separation7.

NEED FOR THE STUDY The normal neonate continues to adapt to extra uterine life in the first weeks after birth, remaining vulnerable to airway abstractions, hypothermia, hypoglycemia and infection. The mother takes responsibility for this by continuing to develop and nurture the mother baby relationship. The father should also play his part and become involved in care of his baby8.

Children are one third of our population and all of our future, their health is our foundation. It has been noticed that almost one out of every eight live born infants dies before reaching the five years. Nearly half of all deaths before the age of one year occur during the neonatal period. This means that about 6 babies per sub center die before 28 days of life. Of these, 3 may die in the first

4 week itself. It may be due to prematurely or low birth weight, birth asphyxia, neonatal tetanus or sepsis9.

Lee HJ et al conducted a study of parental knowledge and confidence in newborn care among 113 newborns parents. The result of this study was father’s means was 13.59 (SD= 5.32) and mother’s mean was 17.55(SD=3.72) there was meaning full difference in knowledge about newborn care between father and mother. There were meaningful differences in knowledge about newborn care between father and mother. The mother knowledge was significant higher then the father knowledge .there need to educate the fathers to enhance their knowledge about newborn care more research is needed to study the relationship between parental knowledge and accuracy of behavior regarding newborn care10.

Studies on attachment have shown there are no differences between fathers and mothers potential abilities to develop an attachment to their children. It has been shown that fathers and mothers in a representative population are equally able to form a secure base for their children. A Danish study of fathers attachment to their infants shows that men’s working models of care giving for their emerge from their relations with their own mothers. Fathers and mothers have almost identical practices and interactions with infants with small deviations11.

Studies on the ability of father to take care of newborns and infants have shown that the fathers in these studies were fully capable of doing so and that the care they provided for their infants was similar to mothers. Primary- caregivers fathers are as affectionate with their children and are just as much in tune with them as per primary- caregiver mothers11.

Involved fathers bring positive benefits to their children that no other person is as likely to bring. Fathers have a direct impact on the well being of their children. It is important for professionals working with fathers- especially in the difficult, emotionally, charged arena in which child protective services case workers operate to have a working understanding of the literature that addresses this impact. Such knowledge will help make the case for why the most effective CPS case plans will not involve fathers11.

The way fathers play with their children also has an important impact on a child’s emotional

5 and social development. Fathers spend a much higher percentage of their one- on – one interaction with infants and preschoolers in stimulating, playful activity than do mothers. From these interactions children learn how to regulate their feelings and behavior11.

The mother as a father, you have an important role to play in taking care of your baby. Your baby needs you. And father needs do share many of the responsibilities of taking care of new baby11.

REVIEW OF LITERATURE

The literature was reviewed and is presented under the following headings.

1. Study related to knowledge of newborn care. 2. Study related to knowledge of newborn care among fathers.

STUDIES RELATED TO KNOWLEDGE OF NEWBORN CARE Syed. U. et al conducted a study on using formative research to design programmed interventions to save newborn lives in poor and rural districts of Bangladesh. In depth interviews and focus group discussions regarding newborn care practices were conducted with mothers in law, delivery attendants, health care providers, husbands/fathers. Finding from the study, reports were used to design behavior change communication strategies that addressed the underlying reasons of newborn care practices were sub-optimal12.

Waldemar a et al conducted a study on knowledge regarding newborn care among parents. The essential newborn care interventions was assessed among 500 parents with the use of a before and after design. The result of this study was the post test knowledge score was higher then the pre test knowledge score13.

Svend et al conducted a study on men too are competent care givers. The historical and mythological image of the father as distant and absent and of men as unwilling or unable to care for their children is false. This study has shown men to be just as capable as women at building close affectionate bonds with their infants and providing the care needed fore healthy psychological and social development in child. Men’s potential as care givers is strong and studies have shown that

6 infants attachment to a primary care giver is gender neutral. However, the barriers against developing this potential are multiple and are economic, cultural and psychological in nature of even greater urgency is to create better opportunities for men to take time out for parental leave and to work part time during the child’s early years14.

STUDIES RELATED TO KNOWLEDGE OF FATHERS REGARDING NEWBORN CARE:

Halle. C et al conducted a study on knowledge about the experience of fatherhood among newborn care. 267fathers were selected to this study. It focuses on the exploration of 22 men’s feeling and beliefs about fatherhood: and their expectation and views about parenting. The quantitative and qualitative data of the 22 fathers who responded to newborn care questionnaires. They are having inadequate knowledge regarding care of newborn babies15.

Korean j et al conducted a study on the effects of fathers class upon father’s level of know and confidence about newborn care at pediatric hospitals. Korea. Research design was quasi experimental study using non equivalent experiment and control group the reliability15.

Vicent Arockiaswamy et all conducted a study on father’s experiences in the neonatal intensive care unit. 60 fathers of very ill and /or very preterm infants who had been ii NICU for 30 days were interviewed by a male physician. The result of this study was reported that relationships with friends/family/health care team, receiving information consistently and receiving short written materials on common conditions were ways of giving them support. Fathers experiences a sense of lack of control when they have an extremely ill infant in the NICU. Specific activities help fathers regain a sense of control and help them fufill varies roles of protectors, fathers. Parents and bread winner16.

Imtiaz Jehan et al conducted a study in evolution and Human Behaviour in2007. they found that newborn actually look more like mothers than their fathers in the first three days of their lives as judged in the unrelated assessors. But the babies mothers tent to say just the opposite, emphasizing the child’s resemblance does not reflect actual resemblance and may be an evolved or conditioned response to assure domestic fathers of their protection16.

7 STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE KNOWLEDGE OF FATHER REGARDING NEWBORN CARE AT SELECTED HOSPITAL, BANGALORE”

6.3 OBJECTIVES OF THE STUDY

6.3.1 To assess the knowledge of father regarding newborn care

6.3.2 To assess the knowledge of father regarding newborn care with selected demographic Variables

6.3.3 To prepare information guide sheet regarding newborn care

6.4 HYPOTHESIS

H1 –There is a significant association between the levels of knowledge of father with selected demographic variables

6.5 OPERATIONAL DEFINITION ASSESS It refers to the process used to identify the level of knowledge of father regarding newborn care

KNOWLEDGE It refers to the respondent’s verbal responses regarding newborn care

FATHER It refers that a male parent of any type of offspring.

NEWBORN The infant from birth to four weeks (28 days) is called newborn

8 6.6 ASSUMPTION The study assumes that, - Father may have inadequate knowledge on newborn care - Father will have interest to know more about newborn care

6.7 DELIMINATION - This study is limited to Fathers to have newborns - Fathers who will be available during the data collection

7.0 MATERIALS AND METHODS 7.1 SOURCES OF DATA Data will be collected from the father of newborn in selected hospital in Bangalore

7.2 METHODS OF DATA COLLECTON Method of data collection is through structured questionnaire by interview schedule

7.2.1 RESEARCH DESIGN Non – experimental design

7.2.2RESEAECH APPROACH Descriptive survey approach

7.2.3 SETTING OF THE STUDY This study will be conducted in fathers of newborn at selected hospital in Bangalore

7.2.4 POPULATION The population of present study comprises of father of newborn.

7.2.5 SAMPLING SIZE The sample of study consist of 100 fathers of newborns

9 7.2.6 SAMPLING TECHNIQE Purposive sampling

7.2.7SAMPLING CRITERIA Inclusive Criteria Fathers - Who have newborn - Who can speak, understand Kannada and English - Who are willing to participate

Exclusive Criteria Fathers - Who do not speak and understand Kannada and English - Who are not willing to participate - Who are not present during data collection

7.2.8 DATA COLLECTION TOOL The tool for data collection consist of 2 pairs; part- & part-2 PART – 1 Selected demographic data such age, education, occupation, income, number of children, source of information etc.

PART – 2 Structured questionnaire on knowledge regarding newborn care

7.2.9 DATA ANALYSIS METHOD The collected data analysis through descriptive and inferential statistics

10 Descriptive statistics Frequency, mean, mean percentage and standard deviation of described demographic variables

Inferential statistics Chi- square test will be used to fine out the association between selected demographic variables and knowledge score

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVIEWS TO BE CONDUCTED ON PATIENT OR OTHER HUMANS OR ANIMALS? Yes

7.4 HAS THE ETHICAL CLEARANCE BEN OBTAINED FROM YOUR INSTITUTION? Permission will be obtained from; - The research committee of Anuradha College of Nursing - Ethical committee of selected college

8. LIST OF REFFERENCE

1. K.Park, “Preventive and social medicine”(2005), 18th Edition, m/s. Banarsidas Bhanot, Jabalpur, Page no.391.

2. Htt://www.Newborncare.com.

11 3. J.Viswanathan, “Achar’s Text book of Pediatrics”, 2007, 3rd Edition, Orient Longman private Limited, Hyderabad.

4. Htt://www.google.com

6. Htt://www. Pubmet.com

7. Htt://www.google.com.

8. Diane.M.Fraser, “Myles Text Book for Midwives,2009, 15th Edition, Elsevier Churchill Livingstone, London, Page no. 764

9. B.T. Basavanthappa, “Essential Of Community Health Nursing.” 2011, 1st Edition, Jaypee Brothers med. Publisher (P)ltd, New Delhi.

10. Korean J. Journal of Korean Academy of Child health nursing, 2004 Jul10(3):262-271

12. Htt://www.Pubmed.com-Indexed for Medline

13. Htt://www.Wikipedia.com

14. Htt://www.Google.com

15. Htt://www.Wikipedia.com

9. SIGNATURE OF THE CANDIDATE

10. REMARKS OF THE GUIDE

12 11. NAME AND DESIGNATION OF

11.1 GUIDE

11.2 SIGNATURE

11.3 CO-GUIDE

11.4 SIGNATURE

11.5 HEAD OF DEPARTMENT

11.6 SIGNATURE

12 12.1 REMARKS OF THE PRINCIPAL

12.2 SIGNATURE