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Effectiveness of Education Program in Knowledge And Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X EFFECTIVENESS OF EDUCATION PROGRAM IN KNOWLEDGE AND PRACTICES FOR NURSE-MIDWIFE REGARDING PERSONAL HYGIENE, AND WOUND, SELF-CARE FOR PRIMIPARA WOMEN WITH CESAREAN SECTION AT MATERNITY HOSPITAL IN HOLY KARBALA Amel Khalaf Kadhim, MSc. N1, Rabea Mohsen Ali, PhD2 1Academic Nurse, Karbala Midwifery school 2Professor, Maternal and Neonate Nursing Department, College of Nursing, University of Baghdad. ABSTRACT Background: The ability to provide self- care is a fundamental requisite for childbearing women to maintain and improve health during the postpartum period. Promoting women’s self-care during postpartum is part of the nursing care process in the gravid-puerperal cycle. Objectives: To evaluate nurses-midwifes' knowledge and practices about personal hygiene ,and wound, self-care postpartum for primipara women with cesarean section; to determine the effectiveness of the educational program on knowledge and practices for nurses-midwifes'; and to identify the relationship between nurses-midwifes knowledge and practices about postnatal self-care and their demographic, variables ( age and education). Methodology: Quasi-experimental study design. Non-probability (purposive) sample consists of (60 nurse- midwife) their work at surgical ward in hospital. The sample was exposed to pretest, educational training program, posttest (1and 2). A pilot-study is conducted to determine the reliability of the questionnaire. Data were analyzed through the use of SPSS (24). Result: Nurse-midwives’ knowledge was poor in pretest; while in posttest was good after implementation the educational program. The intervention highly effective on nurse-midwives’ knowledge and practices evidenced by high significance at p-value=0.001. It is clear out of descriptive the noticeable increasing of mean score on nurses-midwives’ knowledge and practices in post-test 1 and 2 that indicate the effectiveness of educational program; and there is strong positive relationship between knowledge with nurse-midwives’ level of education at p-value= 0.001 Conclusion: The education program was effective in increasing nurse-midwives’ knowledge and practices regarding personal hygiene ,and wound, self-care for primipara women with cesarean section. Recommendations: Prenatal and postnatal childbirth education should be improved by giving priority to it, improving nurse/ midwife knowledge and practices regard self-care for primipara women with cesarean section and activation of their role as educator in routine prenatal and postnatal. Keywords: Knowledge, practices, Nurse-Midwife, Personal Hygiene, and Wound care, Self-Care I. INTRODUCTION: Postpartum period occurs when starting the restoration of the woman’s body after the situation of pregnancy phase, with a transition period in which mothers need to practice self-care for their own benefit, welfare, and health. The care of health professionals in this period should involve guidance to postpartum women, so they understand the importance of taking care of themselves and become able to perform self-care. Given this, nursing care must involve guidance to who has recently given birth, so that they understand the importance of taking care www.turkjphysiotherrehabil.org 8036 Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X of them and become able to perform self-care in this new phase. At this point, it is important that the nurse clarify doubts and guide women in self-care actions that can and must be exercised during the puerperium (1). Nurses- Midwives have a significant impact on the clinical outcome and the birthing experience of women, there has been a lack of research focusing specifically on clinical midwives’ learning and development of professional competence. Nurses- Midwives have an important and significant impact on the medical outcome and the birthing experience of women. The midwifery profession requires knowledge, competence, confidence and skills, and the competent and confident midwife can make the difference between life and death (2). Castillio, (2017) which indicates a need for women to be provided with comprehensive information on the normal discharge course, signs and symptoms of infection, activity restrictions, and instructions on when to seek medical attention. The Perceived Readiness for Discharge After Birth Scale is a validated tool that may help clinicians to identify patients who are at increased risk of problems after discharge (3) . II. METHODOLOGY: A quasi-experimental design was carried out throughout the present study with the application of a pre- post test1 and 2 for their knowledge regarding personal hygiene and wound care through self-care for primipara women with cesarean section and checklist for their practices observation during self-care for primipara women with cesarean section. The education program consists of 2 major part, and it was implemented and introduced with respect to the essential information relative to knowledge and practices for nurse-midwife regarding self-care for primipara women with cesarean section, each session was designed and scheduled for approximately (15-20) for minutes. They were presented from the period 15 th April - 6 th November 2020 at maternity teaching hospital in Holy Karbala city. The education program sessions were managed by three methods, power point, education videos, education booklets, lectures discussion , direct intervention on the patient and follow up After the implementation of the education program. A questionnaire was used as a tool of data collection to fulfill the objectives of the study and consisted of demographic, knowledge and practices of nurse-midwife about self-care during the postpartum period include personal hygiene and wound care. III. RESULTS OF THE STUDY Figure (1): Distribution of Nurse-Midwives according to their Age Group (N=60) This figure shows that more than third of nurse-midwives are young with age group of (25-34) years (41.7%) and (36.7%) of them are with age group of (35-44) years www.turkjphysiotherrehabil.org 8037 Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X Figure (2): Distribution of Nurse-Midwives according to their Educational levels (N=60) This figure presents that the highest percentage regarding education level among nurse-midwives is referring to secondary nursing schools and nursing diploma (41.7%). Table (1a): Evaluation of Nurse-Midwives’ Knowledge about ―Personal Hygiene‖ during Postpartum period of Primipara Women with Cesarean Section Post-test 2 Pre-test (N=60) Post-test 1 (N=60) (N=60) List Item M. M.S R.S Eva. M.S R.S Eva. R.S Eva. S Washing hands with rubbing Goo 1 before and after entering the toilet .00 0 Poor .93 46.5 Good .93 46.5 d or changing the baby's diaper Not to shower during the first 2 .00 0 Poor .58 29 Fair .58 29 Fair week after the operation You do not need to brush your Goo 3 .00 0 Poor 1.00 50 Good .73 36.5 teeth during the postpartum period d Washing hands before eating or 4 .00 0 Poor .93 46.5 Good .62 31 Fair breastfeeding a newborn No body and pubic hair should be Personal hygiene Goo 5 removed during the postpartum .00 0 Poor 1.00 50 Good .80 40 d period Nails should be cleaned and Goo 6 trimmed during the postpartum .00 0 Poor .93 46.5 Good .93 46.5 d period M.S: Mean of score, R.S: relative sufficiency, Eva: Evaluation, Poor: M.S= 0 – 0.33, Fair: M.S= 0.34 – 0.67, Good: M.S= 0.68 – 1. This table depicts that nurse-midwives are showing poor level of knowledge among all items of ―personal hygiene‖ domain during the pre-test time, while they are showing good knowledge during the post-test 1 time among all item except item 2 that is showing fair level. During the post-test 2 they are still showing good level but only item 2 and 4 are declined to fair level. Table (1b): Evaluation of Practices’ Levels among Nurse-Midwives regarding ―Personal Hygiene‖ for Primipara Women with Cesarean Section Post-test 1 Post-test 2 Pre-test (N=60) The nurse teaches a mother to do the following (N=60) (N=60) List procedures: M. R. Eva M. R. M R. Eva Eva. S S . S S .S S . Washing hands with rubbing before and after entering Poo 2.0 66 Goo 1. 64 Go 1 .00 0 the toilet, or changing the baby's diaper r 0 .7 d 93 .3 od Shower during the first week after the operation and Poo 2.0 66 Goo 1. Go Hygiene 2 .03 1 54 Personal at any time, provided that the water does not reach the r 0 .7 d 62 od www.turkjphysiotherrehabil.org 8038 Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X place of the operation Brushing the teeth at least twice a day during the Poo 1.9 64 Goo 1. 64 Go 3 .00 0 postpartum period (morning and evening) r 3 .3 d 93 .3 od Washing hands before eating or breastfeeding a Poo 1.5 50 Goo 1. Go 4 .00 0 49 newborn r 3 .7 d 47 od Remove hair from the body and the pubic area during Poo 1.5 50 Goo 1. 50 Go 5 .00 0 the postpartum period r 2 .6 d 52 .6 od Nails should be cleaned and trimmed during the Poo 2.0 66 Goo 1. 45 Go 6 .00 0 postpartum period r 0 .7 d 37 .7 od M.S: Mean of score, R.S: relative sufficiency, Eva: Evaluation, Poor: M.S= 0 – 0.66, Fair: M.S= 0.67 – 1.33, Good: M.S= 1.34 – 2. This table reports that nurse-midwives are showing poor practices regarding ―personal hygiene‖ during the pre- test time, and they are showing good practices during the post-test 1 and 2 significantly.
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