A Study to Assess the Effectiveness of Self-Instructional Module on Post Abortion Care (PAC) Among Staff Nurses Working in Maternity Wards of Selected Hospitals, Bangalore, Karnataka

 

Komal. S.C¹, Chaitra. S², Lingaraj. L³, Ramya. R⁴

¹Lecturer, Dept. of OBG Nursing of Kumuda Institute of Nursing Sciences,

Davangere, Karnataka, India.

²Assistant Professor, Dept. of Child Health Nursing,

Kumuda Institute of Nursing Sciences, Davangere, Karnataka, India.

³Assistant Professor, Dept. of Child Health Nursing,

Kumuda Institute of Nursing Sciences, Davangere, Karnataka, India.

⁴Assistant Professor, Dept. of OBG Nursing,

Harsha College of Nursing Nelamangala, Bangalore, India.

 

ABSTRACT:

This study was under taken to assess the effectiveness of self-instructional module on Post Abortion Care (PAC) among staff nurses working in maternity wards of selected hospitals, Bangalore, Karnataka. Objectives: 1. To assess the pretest knowledge scores of staff nurses regarding Post Abortion Care (PAC). 2. To assess the posttest knowledge scores of staff nurses regarding Post Abortion Care (PAC). 3. To assess the effectiveness of self-instructional module on Post Abortion Care (PAC). 4. To determine the association between post-test knowledge scores of staff nurses and their demographic variables. Methods: Quantitative approach was used with pre-experimental design. The target population for the study were Staff Nurse’s working in maternity wards at Selected Hospital, Bangalore. This population was selected by convenient sampling technique. The total samples under the study were 60 Staff Nurse’s. The data collection was made through self-administrated questionnaire which was designed to assess the knowledge of Staff Nurse’s regarding Post Abortion Care. The pretest was followed by implementation of self-instructional module programme and post test conducted after 8days using the same self-administrated questionnaire to find the effectiveness of self- instructional module. The results were analyzed by using descriptive and inferential statistics. Results: Regarding the demographic variables, 27.5% of them were in age group of 25-30 years, majority (37.5%) of them were graduates, 88% of them were had mixed diet habit, majority 80% of the respondents were more than 2 years of experience in maternity ward, maximum number of respondents (90%) belonged to Hindu religion. Regarding the effectiveness of self- instructional module, the overall pret est m e a n knowledge score was 48.15% and post test score of 77.02%, with mean enhancement of knowledge score of 28.87% which is statistically significant as observed between pre and post test score (P<0.05). The paired’ test which was computed indicates that there is enhancement in knowledge with the value of 19.603 which is significant at 5% level. The Association between mean percentage knowledge score and demographic variables were computed by using Chi-square test. There was a significant association found between knowledge scores and selected demographic variables such as, religion and dietary habits, except age, education, type of family, occupation, and work experience in computed maternity ward of the respondents. Conclusion: The overall findings of the study clearly showed that the self-instructional module was significantly effective in improving the knowledge scores of Staff Nurse’s Post Abortion Care.

 

 

 

INTRODUCTION:

The post-abortion period is the third and final part of the continuum of care for abortion. Post- abortion care includes optional follow-up check-up, management of residual side-effects or complications, and contraception services. When done safely, abortion complications are rare, but they can include incomplete abortion, hemorrhage, infection, uterine perforation, anesthesia-related complications, and uterine rupture. In line with international human rights law and medical best practice, post-abortion care should always be provided regardless of whether abortion is restricted in a particular setting.¹Post abortion care is an integrated service delivery model that includes Post abortion care (PAC) is an integral service delivery model that includes both maternal health and family planning intervention. The study aims to examine improvement in abortion related practices through the implementation of the PAC model at all tiers of public health services delivery systems in the two most popular provinces- Punjab, Islamabad, and Sindh.²

 

Post-abortion care (PAC) is an integrated service delivery model that has five elements including (1) treatment, (2) counseling, (3) contraceptive and family planning services, (4) reproductive and other health services, and (5) community and service provider partnerships. This model includes both uterine evacuations (UE) through safe methods of manual vacuum aspiration (MVA) and medical use of misoprostol and post-abortion family planning (PAFP). Interventions, which are both curative and preventative. As unplanned pregnancy plays a vital role in defining the unmet need for family planning, to the extent that the termination of an unwanted pregnancy is a motivating factor for induced abortion.³

 

NEED FOR THE STUDY:

Post Abortion Care (PAC) is defined as a service-delivery strategy that includes: Emergency health services (treatment of complications of spontaneous or unsafely induced abortion); Post abortion counseling and family planning services; and links to other reproductive health care services. Individually and in collaboration, the PAC Consortium agencies implement post abortion care programs around the world, and also encourage technical agencies, governments and donors to incorporate post abortion care into their own programs and policies as a critical step in reducing deaths and injuries of women from complications related to miscarriage and abortion- related consequences.⁴

 

The investigator during her clinical experience found that the mothers, who had abortion either spontaneous or induced, do not receive adequate information regarding follow up and family planning guidance. As health care providers staff nurses play a vital role in educating those mothers on above side aspects. Health education regarding post abortion care helps to prevent or treat early, also prevents repeated unwanted pregnancies.⁵Hence the investigator prepared a self-instructional module on post abortion care and would like to test its effectiveness among staff nurses who in turn can educate the mothers.

 

OBJECTIVES:

1.     To assess the pretest knowledge scores of staff nurses regarding Post Abortion Care (PAC).

2.     To assess the posttest knowledge scores of staff nurses regarding Post Abortion Care (PAC).

3.     To assess the effectiveness of self-instructional module on Post Abortion Care (PAC).

4.     To determine the association between post-test knowledge scores of staff nurses and their variables.

 

 

HYPOTHESIS:

H1: There will be a significant difference between pre-test and post-test knowledge scores on Post abortion care among staff nurses.

H2: There will be a significant association between post-test knowledge scores on post abortion care among staff nurses and their demographic variables.

 

 

METHODOLOGY:

Research Design:

Pre experimental design with one group pretest posttest design was adopted.

 

Sampling technique:

Non probability convenient sampling technique was adopted to select samples. Sample: sample size was 60staff nurses working in maternity wards in selected hospitals, Bangalore.

 

Study variable:

The Effectiveness of Self-Instructional Module on Post Abortion Care (Pac) Among Staff Nurses.

 

Demographic variables:

Age, gender, type of family, religion, education, area of working, occupation, and dietary habits are the socio demographic variables.

 

SETTING:

The Present Study Was Conducted In Nelamangala Rural Areas Under Nelamangala Rural Hospital And Primary Health Care Nelamangala, Bangalore.

 

DATA COLLECTION TECHNIQUE:

Section A: It deals with socio demographic characteristics which include Age, gender, type of family, religion, education, area of working, occupation, and dietary habits are the socio demographic variables

 

Section B: Structured knowledge questionnaire was prepared to assess The Effectiveness of Self-Instructional Module on Post Abortion Care (PAC) Among Staff Nurses.

 

RESULTS:

Section 1: Demographic characteristics of the post abortion care (PAC) among staff nurses.

TABLE 1: Frequency and percentage distribution of selected personal variables of post abortion care (PAC) among staff nurse                                                                                                  n= 60

Variables	Frequency	Percentage
1. Age in years
a. 20-25 yrs.	14	22.5
b. 25-30 yrs.	16	27.5
c. 30-35 yrs.	15	25.0
d. 35 yrs. and above	15	25.0
2. Religion
a. Hindu	54	90.0
b. Muslim	1	2.5
c. Christian	5	7.5
d. others	00	00.00
3. Type of Family
a. Nuclear Family	48	80.0
b. Joint Family	9	15.0
c. Extended Family	3	5.0
4. Education
a.   GNM	9	15.0
b. B.SC (N)	19	32.5
c. P B. B.SC (N)	23	37.5
d. M. Sc (N)	9	15.00
5. Dietary Habits
a. Vegetarian	7	12.00
b. Mixed	53	88.00
6. Occupation
a. Staff Nurse (BSC)	15	25.0
b. In charge Nurse	6	10.0
c.Nursing Superintendent	15	25.0
d. staff Nurse (PBBSC)	24	40.0
7. Gender
a. Male	16	26.7
b. Female	44	73.3
8.Working Area
a. Casualty and emergency	8	13.3
b. ICU	24	40.0
c. General wards	28	46.7

 

 

Section 2: knowledge level of staff nurses regarding post abortion care (PAC).

Table 2: pretest and posttest knowledge level of staff nurses.

n=60

 

Table 3: analysis of pretest and posttest knowledge scores of staff nurses                                                                                              n=60

Knowledge Aspects	Pre-test			Post-test			Percent age
	Mean	Mean%	SD	Mean	Mean%	SD
Knowledge regarding Abortion	3.92	56	1.288	5.90	84.28	0.777	28.28
Abortion Complications.	4.17	46.33	1.517	6.57	73	1.129	26.67
Prevention and Management of Abortion Complications.	2.80	56	1.114	3.97	79.40	0.767	23.4
Knowledge regarding Post Abortion Care	3.40	37.77	1.498	6.60	73.33	1.127	35.56
Post Abortion Complications.	1.30	32.5	1.042	2.70	67.5	1.042	35
Management of Post Abortion Care.	2.70	67.5	0.911	3.52	88	0.640	20.5
Overall	18.30	48.15	4.363	29.27	77.02	2.207	28.87

 

Section 3: comparison of knowledge level of staff nurses.

Table 4: comparison of knowledge scores of staff nurses

Aspect wise analysis of knowledge	Pre-test knowledge scores		Post-test knowledge scores		Paired t-value	P-value and Inference
	Mean	SD	Mean	SD
Knowledge regarding Abortion	3.92	1.288	5.90	0.777	19.603	<0.05*
Abortion Complications.	4.17	1.517	6.57	1.129
Prevention and Management of Abortion Complications.	2.80	1.114	3.97	0.767
Knowledge regarding Post Abortion Care	3.40	1.498	6.60	1.127
Prevention of Post Abortion Care Complications.	1.30	1.042	2.70	1.042
Management of Post Abortion Care.	2.70	0.911	3.52	0.640
Overall	18.30	4.363	29.27	2.207

Note: *: significant.

 

SECTION-4: Association between of knowledge of staff nurses with selected Demographic variables.

The selected demographic variables such as Age, gender, type of family, education, area of working, occupation, religion and dietary habits ,The total number of staff nurses having significant association with the knowledge scores regarding selection of post abortion care at the problitiy level of P<0.05.

 

CONCLUSION:

In the present study pre-test knowledge score of Staff Nurse’s on Post Abortion Care, 26(65 %) nurse’s had inadequate knowledge and 14(35%) had moderate knowledge. Where as in the post test, there were no subjects under inadequate category, 21(52.5%) subjects had moderate knowledge and remaining 19(47.5%) had adequate knowledge.

 

After The mean post-test knowledge score was 29.27 which is higher than mean pretest score of 18.30. The scores denoted that the self-instructional module program was effective regarding post abortion care of staff nurses.

 

The overall Mean difference of pretest and posttest was 10.97. The significant difference between the pre- test and post-test were tested by using paired ‘t’ and level of significance was set at 0.05. The computed ‘t’ value of 19.603 indicates that there is significant difference between pre-test and post-test knowledge score. Thus, it clearly says that the SIM was effective in increasing the knowledge of subjects.

 

RECOMMENDATIONS:

On the basis of the findings of the study following recommendations have been made:

1.     Asimilar study may be conducted on a larger sample for wider generalization.

2.     Asimilar studycan be conducted among Health Professionals.

3.     A similar study may be conducted in other back ward districts, taluks, villages etc.,

4.     Manuals, information booklets and self-instruction module may be developed.

 

The comparative studycan be conducted on mothers of urban and rural mothers.

 

The similar study may be replicated among other staff nurses.

 

A comparative study can be conducted on staff nurse’s working in maternity wards and community health nurse.

 

A long-term study can be done to assess the impact of post abortion care on staff nurse’s working in maternity wards.

 

REFERENCES:

1.      Tanner LM. Blackmon HE, Stanley I. English NK In-hospital care and post-hospital follow- up Clinical Obstet Gynecol. 1971 Dec; 14(4): Pp1278-88.

2.      Emily Slone McKinney, Jean Weiler Ashwill, Maternal Child Nursing 1^stedition, Hascourt: India Private Limited Publication. 2000.

3.      Schuilling Durnell Kerri and Likis Frances. Women’s gynecologic health. Jones and Bartlett: Publishers. Boston (2000).

4.      International Center for Diarrheal Diseases Research, An International Journal of Obstetrics and Gynecology, Blackwell Publications 2001.

5.      Lucy Gilson and Nika, Raphaely, Healthy policy analysis in low and middle a in some countries. Healthy Policy Plan: Sep 2008.

 

 

 

 

Received on 01.07.2025         Revised on 22.07.2025 Accepted on 06.08.2025         Published on 18.08.2025 Available online from August 30, 2025 A and V Pub Int. J. of Nursing and Med. Res. 2025;4(3):171-175. DOI: 10.52711/ijnmr.2025.32 ©A and V Publications All right reserved
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