A Study to Assess the Effectiveness of Planned Teaching Programme on the Knowledge Regarding Management of Pre-Eclampsia among Antenatal Mothers

Background of the Study: Pre-eclampsia is a multisystem disorder with an unknown aetiology that appears as hypertension of 140/90 mm hg or higher with proteinuria after the 20th week in a previously normotensive and non-proteinuric woman. Pre-eclampsia is unique among hypertension illnesses in terms of the effects it has on maternal and newborn health. It is a leading cause of maternal and neonatal mortality and morbidity around the world. Objectives of the Study: 1. To assess the existing knowledge regarding pre-eclampsia among antenatal mothers. 2. To evaluate the effectiveness of planned teaching on knowledge regarding pre-eclampsia among antenatal mothers. 3. To find out the association between knowledge score with selected Demographic variables. Materials and Methods: 100 samples were taken from selected Hospital Wardha by Non probability sampling technique. Research design descriptive survey was used. Statistical compare ANOVA and t-test formula used. Results: In pre test Antenatal mothers have 65% fair knowledge regarding pre-eclampsia , and Original Research Article Chaudhari et al.; JPRI, 33(58A): 595-603, 2021; Article no.JPRI.78173 596 mean knowledge score was 2.02%. In post-test of Antenatal mothers have 52% Excellent knowledge and mean knowledge score was 0.97 % regarding management of pre-eclampsia. Conclusion: It is concluded that In Pre – test level of knowledge score fair was 65 % and mean knowledge score was 2.02 % And In Post test level of knowledge score excellent was 52 % andmean knowledge score was 0.97 %. Study conclude that their is lack of knowledge of Preeclampsia among antenatal mothers. After the completion of the study it is revealed that the planned teaching program was effective in gaining the knowledge regarding management of preeclampsia among antenatal mothers. It can improve their health status and prevent from sideeffect.


INTRODUCTION
Pre-eclampsiais the most common medical complication in the pregnancy , is defined as preeclampsia is a multiple system disorder of unknown etiology characterized by development of hypertension to the extent of 140/90 mm hg or more with proteinuria after 20th week in a previously normotensive and non-proteinuric woman. Pre-eclampsia stands out among the hypertensive disorders for its impact on maternal and neonatal health. It is one of the leading causes of maternal and perinatal mortality and morbidity worldwide. However, the pathogenesis of pre-eclampsia is only partially understood and it is related to disturbances in placentation at the beginning of pregnancy, followed by generalized inflammation and progressive endothelial damage. Obesity,chronic hypertension and diabetes are among the risk factors for preeclampsia, which also include Nulliparity, adolescent pregnancy and conditions leading to hyperplacentation and large placentas (e.g.twin pregnancy). Pre-eclampsia is usually classified as mild or severe. In most settings, preeclampsia is classified as severe when any of the following conditions is present conditions is present : severe hypertension , heavy proteinuria or substantial maternal organ dysfunction [1].

Aim of the Study
A study to assess the effectiveness of planned teaching programmed on knowledge regarding management of pre-eclampsia among antenatal mothers on selected care of pre-eclampsia patient in selected hospitals [2].

METHODS
Non -probability descriptive research approach was selected for this study. The study was conducted in hospital of the Sawangi (Meghe) Wardha city [3]. The population of the study was antenatal mothers of Hospital. Sample size was 100. The formula use for sample size calculation is compare ANOVA And tt-test. Sample size 100 is sufficient and purposeful for data analysis and interpretation. Antenatal mothers were selected by using a non-probability convenient sampling technique. This study included those who are antenatal mothers are present at the time of the study. The demographic performs structured questionnaires on knowledge regarding preeclampsia and also management of Preeclampsia among antenatal mothers with a formal teaching program in this research [4].
The investigator obtained permission from the concerned authorities of Smt. Radhikabai Memorial College of Nursing and the hospital respectively. Informed consent is taken from the participants. The subject is requested to complete the tool after assuring confidentiality of the information. Consent is obtained from the subject. Explained what is the need and purpose behind conducting the research. The participant's actively participated data got collected and finally the investigator thanked all of the research samples as well as the authorities for their assistance after the data collection process was completed [5].

Inclusion Criteria
The study include:  ANC mothers admitted to obstetrics and gynaecology wards and OPD.
 Those mothers are willing to participate in these study.

Exclusion Criteria
The study excludes:  Those mothers having chronic illness not participates in this study.

Pre-Test
The Table 1 shows that in pretest the level of knowledge score fair was 65%, good was 35%, minimum score was 6%, maximum score was 15% and mean knowledge score was 2.02%.

Post-Test
In Post test the knowledge of antenatal mothers regarding the management of preeclampsia. The above table shows that in post-test the level of knowledge score good was 48 %, excellent was 52 %, minimum score was 13 %, maximum score was 17 %, and mean knowledgescore was 0.97% [9].

Comparison of Pre-test and Post-test Score
The

DISCUSSION
The current research was carried out as part of a larger project. "To assess the effectiveness of planned teaching programmed on knowledge regarding management of pre-eclampsia among antenatal mothers on selected care of preeclampsia patient in selected hospitals". In the planned teaching program we have to discussed about the definition of preeclampsia, type, risk factors, causes, pathophysiology, sign and symptoms. And explain in detail about medical and surgical management. And also explain in detail about the nursing management, health education and role of nurse in management of Pre-eclampsia [11].
The study was to assess the knowledge about preeclampsia among antenatal women in a tertiary teaching hospital in Kelantan. The design selected for the study is cross-sectional design conducted on 76 antenatal mothers above 20 weeks of gestational age and attending antenatal clinical in Hospital University Sains Malaysia, Kelantan. Non-probability purposives sampling technique was used. The tool included sociodemographic proforma and knowledge questionnaire on preeclampsia. The data was analysed in terms of both descriptive and inferential analysis [12]. Data analysis regarding level of knowledge revealed that minority of mothers (18.4%) had adequate knowledge with a mean score of 53.46(±26.42). Maternal age and receipt of information towards preeclampsia how association with knowledge scores at 0.05 level of significance. The study showed a need for awareness program and public education about preeclampsia among antenatal mmothers Methods:-A cross -sectional design was conducted from December 2014 to February 2015 in Hospital Universiti Sains Malaysia (USM). The sample consists of 76 antenatal mothers obtained through convenience sampling. In this study, the inclusion criteria were antenatal mothers who are above 20 weeks of gestational age and mentally and emotionally stable, be conversant with either English or Bahasa Malaysia, and willing to participate in this study. Material :-The questionnaire was developed by the researchers based on the literature reviewer. Questionnaire consists of three sections: sociodemographic (age, ethnicity, education, occupation, monthly income and parity), information about preeclampsia and knowledge on preeclampsia. The question on knowledge regarding pre-eclampsia had 15 closed ended dichomous questions with a 'True' and 'False' criteria [13].
To determine the incidence and associated factors of superimposed preeclampsia among pregnant women with chronic hypertension. Methods: A total of 300 pregnant women diagnosed with chronic hypertension were reviewed. Data were retrieved from medical record's, including obstetric data, characteristics of hypertension, and pregnancy outcomes. Incidence of superimposed preeclampsia was estimated .Various characteristics were compared to determine associated risk factors. Results: Mean age of the cohort was 34.3 years, 47% were nulliparous, 50% had hypertension before pregnancy, and the others presented with hypertension before 20 weeks [14]. Incidence of superimposed preeclampsia was 43.3% (95%confidence interval (CI)37.8-48.9). Women with superimposed preeclampsia were significantly more likely to have mean arterial pressure (MAP) ≥ 105 mmHg at 18-20 and 24-28 weeks. Adverse neonatal outcomes were significantly more common among women with superimposed preeclampsia, including small for gestational age, low birth weight, asphyxia, and neonatal intensive care unit admission. Logistic regression analysis demonstrated that only MAP ≥ 105mmHg at 24-28 weeks was independently associated with the increased risk of superimposed preeclampsia by 1.8-fold (adjusted OR1.8,95%CI 1.1-3.1, p =0.031). Conclusion: Incidence of superimposed preeclampsia was 43.3% among pregnant women with chronic hypertension, with increased adverse neonatal outcomes. High MAP ≥105 mmHg during late second trimester might be an important predictor of the condition [15].
The above up ported study help in the present study and the result of present study was that In Pre-test level of knowledge score fair was 65% and mean knowledge score was 2.02 % And In Post-test level of knowledge score excellent was 52 % and mean knowledge score was 0.97 %. Result of this study is good than previous study. Study conclude that their is lack of knowledge of pre-eclampsia among antenatal mothers. After the completion of the study it is revealed that the planned teaching program was effective in gaining the knowledge regarding management of pre-eclampsia among antenatal mothers [16]. It can improve their health status and prevent from side-effect [17].

CONCLUSION
This thesis leads to the following the conclusion, after the detailed analysis this section looks at determining, the researcher performed descriptive study on a topic, "A study to assess the effectiveness of planned teaching programme on knowledge regarding and management of Pre-eclampsia among antenatal mothers" [18].
Pre-eclampsia is a multisystem disorder with an unknown aetiology that appears as hypertension of 140/90 mm hg or higher with proteinuria after the 20th week in a previously normotensive and non-proteinuric woman. Pre-eclampsia is unique among hypertension illnesses in terms of the effects it has on maternal and newborn health. It is a leading cause of maternal and neonatal mortality and morbidity around the world [19].
The research objectives that have been formulated are:  To assess the existing knowledge regarding pre-eclampsia among antenatal mothers.  To evaluate the effectiveness of planned teaching on knowledge regarding preeclampsia among antenatal mothers.  To find out the association between knowledge score with selected demographic variables [20].
All the objectives are fulfilled in this study.
It is concluded that In Pretest level of knowledge score fair was 65 % and mean knowledge score was 2.02% And In Post-test level of knowledge score excellent was 55% and mean knowledge score was 0.97 %. Study conclude that their is lack of knowledge of preeclampsia among antenatal mothers. After the completion of the study it is revealed that the planned teaching program was effective in gaining the knowledge regarding management of pre-eclampsia among antenatal mothers. It can improve their health status and prevent from side-effect [21].

Nursing Implications
Nursing is a client centered profession -Some of the implications derived from the present study in various areas of nursing areas follows:

Nursing Education
The present nursing curriculum should include in detail about care of pre-eclampsia patients and all nursing students should have knowledge in depth regarding its care .Nursing teachers might utilize the study's findings as an educational illustration for nursing students. More emphasis may be placed on the necessity of pre-eclampsia patient care for student nurses, and this study will aid nurses in preventing problems caused by a lack of care [22].

Nursing Administration
The study's findings point to the necessity for nurses working in wards to have continuing inservice education. Both theoretical and practical input should be included in the in-service education programme. This may help raise awareness among nurse administrators about the importance of providing pre-eclampsia patient care training to in coming staff nurses. Nurse administrators can create a new protocol for preeclampsia patients treatment. With the assistance of specialists, the hospital management should give in-service education and orientation to the antenatal mother on special care [23].

Nursing Services
The most important role of the nurse is to provide adequate care to the patient so it will improve the patients' health she/he is fully responsible for care of the patient and while given the nursing care to pre-eclampsia patient. The nurses of obstetric department must have special skill in care of preeclampsia patient. This study will help the nurses for prevention of complication due to lack of knowledge regarding nursing Care. Continuing nursing education programmed should be conducted in different settings. It will also help the nurses to keep update knowledge regarding the care of the pre-eclampsia patients [24].

Nursing Research
The research serves as a foundation for future research in the subject. It is necessary to conduct research to determine the effectiveness of instructional methods and conduct in special care programmed. It is necessary to do research in order to develop novel iin-service education approaches. Nurses should be given adequate funding, manpower, and time to undertake research.

RECOMMENDATIONS
On the basis of the findings of the study, it is recommended that the following studies can be conducted.

LIMITATION
Study is limited to antenatal mothers in Hospital, Sawangi (Meghe) Wardha.

CONSENT
As per University Standard, Participant's written consent has been collected and preserved by the author(s).

ETHICAL APPROVAL
It is not applicable.