Knowledge and Practice Regarding Prevention of Puerperal Sepsis among Postnatal Mothers in Selected Areas of Kamrup (M), Assam

Abstract

Background: Postpartum period or puerperium is the period following childbirth during which the body tissues especially the pelvic organs revert back approximately to the prepregnant state both anatomically and physiologically. Each mother has to adjust the physical changes in her own body due to involution and lactation as well as puerperal complication which may occur. Title of the study: A study to assess the knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam. Methodology: A quantitative survey approach was adopted to assess the knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam. 81 postnatal mothers were selected using multistage simple random sampling technique from selected areas (Lalganesh, Bank Colony, Adagudam, Sankar Nagar, Kailashpur, Sreebhumi Nagar, Hillview Road, Odalbakra, Gobinda Nagar under Odalbakra MPHC of Dhirenpara zone) Kamrup(M), Assam. A structured interview questionnaire and checklist were used to assess the knowledge and practice of the postnatal mothers regarding prevention of puerperal sepsis. Result: The result reveals that majority 63(77.8%) of the postnatal mothers has moderately adequate knowledge, 11(13.6%) has adequate knowledge and 7(8.6%) has inadequate knowledge regarding prevention of puerperal sepsis among postnatal mothers. Knowledge mean is 12.02 and SD is 3.384. Majority 62(76.5%) of the postnatal mothers has average practice, 10(12.3%) has good practice and 9(11.2%) has poor practice regarding prevention of puerperal sepsis among postnatal mothers. Practice mean is 8.01 and SD is 2.261.There was a moderately positive correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers. There was significant association between the knowledge level and demographic variables i.e., parity and previous source of information. And also significant association between the practice level and demographic variables i.e., parity and type of present delivery. Conclusion: Majority of the mothers had moderately adequate knowledge and average practice regarding prevention of puerperal sepsis. There was a moderately positive correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers. Significant association was found between the knowledge and demographic variables i.e., parity and previous source of information. Significant association was also found between the practice and demographic variables i.e., parity and type of present delivery.

Introduction

I. INTRODUCTION

Puerperium is the period following childbirth during which the body tissues especially the pelvic organs revert back approximately to the prepregnant state both anatomically and physiologically which lasts for approximately six weeks. Puerperal infection is a dreadful disease and puts economic burden on family as well as on society. According to 2019 GBD (Global Burden of Disease) data estimated almost 21 million incident cases and 17 thousand deaths from maternal sepsis and other maternal infections worldwide. India has the highest number of maternal deaths (50,000 maternal deaths in 2013), and within India, the north-eastern state of Assam has a high maternal mortality ratio (MMR= 301/10,000) live births in 2012-2013, higher than the national average (MMR=178/10,000) live births in 2010-2012. Considering the present statistical scenario made the student researcher felt the need to assess the knowledge and practice of postnatal mother regarding prevention of puerperal sepsis.

A. The Statement of Problem

A study to Assess the Knowledge and Practice regarding Prevention of Puerperal Sepsis among Postnatal Mothers in Selected Areas of Kamrup (M), Assam.

 

B. Specific Objectives

1. To assess the level of knowledge regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam.
2. To assess the level of practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam.
3. To find out the correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers in selected areas of Kamrup (M), Assam.
4. To find out the association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables in selected areas of Kamrup (M), Assam.
5. To find out the association between practice regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables in selected areas of Kamrup (M), Assam.

 

C. Hypotheses

H1 : There is significant correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers at 0.05 level of significance.

H2 : There is significant association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables at 0.05 level of significance.

H3 : There is significant association between practice regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables at 0.05 level of significance.

 

II. RESEARCH METHODOLOGY

A quantitative survey approach was used for the study. Descriptive correlational research design was adopted for the study. In this study, multistage simple random sampling technique was adopted to select 81 samples for the study. The tools used for the study were demographic variables, structured interview questionnaire and checklist. The analysis was done by using descriptive and inferential statistics in terms of frequency and percentage distribution, mean, mean percentage and standard deviation, Karl Pearson correlation coefficient and Chi-square.

 

III. RESULTS

A. Findings Related to demographic data

 

Table 1: Frequency and percentage distribution of the postnatal mothers according to their demographic variables

n=81

Demographic variables	Frequency (f)	Percentage (%)
Age (in years) 21-25 26-30 31-35 Above 35	20 29 25 7	24.7 35.8 30.9 8.6
Religion Hindu Islam Christian Others	45 30 6 -	55.6 37 7.4 -
Educational qualifications Illiterate Primary school certificate Middle school certificate High school certificate Intermediate or diploma Graduate Profession or honors	10 25 15 20 6 5 -	12.3 30.9 18.5 24.7 7.4 6.2 -
Occupational status Professional Semi-profession Clerical/shop/farm Skilled worker Semi skilled worker Unskilled worker Unemployed	- 6 11 - 4 25 35	- 7.4 13.6 - 4.9 30.9 43.2
Parity 1 2 3 4 and above	25 30 18 8	30.9 37 22.2 9.9
Type of present delivery Normal vaginal delivery Cesarean delivery	30 51	37 63
Family type Joint family Nuclear family Extended family	29 47 5	35.8 58 6.2
Monthly family income ≤ 9226 9232 – 27648 27654 – 46089 46095 – 68961 68967 – 92185 92192 – 184370 ≥18,4376	10 33 31 7 0 0 0	12.3 40.7 38.3 8.6 0 0 0
Previous source of information Health personnel Social media Relatives and friends All of the above	41 17 15 8	50.6 21 18.5 9.9

The data table 1 shows the frequency and percentage distribution of selected demographic variables of the postnatal mothers. Majority of the postnatal mothers i.e., 29(35.8%) were from the age group of 26-30 years, Majority were Hindus i.e., 45(55.6%), Majority i.e., 25 (30.9%) postnatal mothers were primary school certificate, Majority were Unemployed i.e., 35(43.2%), Majority of postnatal mothers were parity 2 i.e., 30(37%), Majority i.e., 51 (63%) of the postnatal mothers had caesarean section,  Majority of the postnatal mothers were from nuclear family i.e., 47(58%), Majority i.e., 33(40.7%) belonged to monthly family income group of  9232 – 27648 and majority i.e., 41(50.6%) of the postnatal mothers had received the previous source of information from health personnel.

 

B. Finding related to level of knowledge regarding prevention of puerperal sepsis among postnatal mothers

The knowledge of postnatal mothers regarding prevention of puerperal sepsis were assessed through Structured interview questionnaire. The overall knowledge was categorized into inadequate knowledge, moderately adequate knowledge and adequate knowledge. The frequency and percentage distribution is presented on fig 1.

Figure 1

Bar Diagram Showing Distribution Of Level Of Knowledge Regarding Prevention Of Puerperal Sepsis Among Postnatal Mothers

The data presented on the figure 1 depicts that majority i.e., 63(77.8%) of the postnatal mothers had moderately adequate knowledge, 11(13.6%) had adequate knowledge and 7(8.6%) of postnatal mothers had inadequate with median score of 12, mean knowledge score of 12.02 and SD of 3.384.

 

C. Findings Related to Level of Practice Regarding Prevention of Puerperal Sepsis Among Postnatal Mothers

The practice of postnatal mothers regarding prevention of puerperal sepsis were assessed through checklist. The overall practice was categorized into poor practice, average practice and good practice. The frequency and percentage distribution is presented on fig 2.

FIGURE 2

Bar Diagram Showing Distribution Of Level Of Practice Regarding Prevention Of Puerperal Sepsis Among Postnatal Mother

 

The data presented on the figure 2 depicts that majority i.e., 62(76.5%) of the postnatal mothers had average practice, 10(12.3%) had good practice and 9(11.2%) had poor practice with median score of 8, mean knowledge score of 8.01 and SD of 2.261.

 

D. Table 2: Findings related to correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers

It presents the correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers.

The null hypothesis H01 was formulated against the stated research hypothesis H1.H01: There is no correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers at 0.05 level of significance.       karl pearson correlation co-efficient was computed to determined the correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers.

n=81

VARIABLES	MEAN	SD	‘r’ VALUE	‘ p’ VALUE
Knowledge	12.02	3.384	0.390	0.001*
Practice	8.01	2.261

*p<0.05 level of significance

 

 

 

 

Data presented on the table 2 depicts the values of ‘r’ 0.390 and ‘p’ 0.001 which indicate moderately positive correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers and was found to be statistically significant at p<0.05 level of significance.

The investigator found that there was a correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers at 0.05 level of significance. Hence, the null hypothesis H01 is rejected and the research hypothesis H1 is accepted.

 

E. Table 3: Association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables

The null hypothesis H02 was formulated against the stated research hypothesis H2.

H02: There is no significant association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables at 0.05 level of significance.

Chi square was computed to determined the significant association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with their selected demographic variables                                                                                                                                                  

n=81

Sl No	Demographic Variables	Knowledge			?2	df	‘p’ value	Tabulated value	Inferences
		Inadequate	Moderately adequate	Adequate
1.	Age (in years)   21-25 26-30 31-35 Above 35	3 2 1 1	14 21 22 6	3 6 2 1	5.207	6	0.518	12.59	NS
2.	Religion Hindu Islam Christian Others	3 3 1 -	35 24 4 -	7 3 1 -	1.283	4	0.864	9.49	NS
3.	Educational qualifications   Illiterate Primary school certificate   Middle school certificate High school certificate   Intermediate or diploma Graduate Profession or honors	1 1     2   -     2   1 -	8 21     12   14     4   4 -	1 3     1   6     -   - -	14.26	10	0.161	18.31	NS
4.	Occupational status   Professional Semi-profession Clerical/shop/ farm Skilled worker Semi skilled worker Unskilled worker Unemployed	- 1 2   - -   1 3	- 5 8   - 2   19 29	- - 1   - 2   5 3	19.448	8	0.306	15.51	NS
5.	Parity   1 2 3 4 and above	2 1 - 4	21 26 13 3	2 3 5 1	24.08	6	0.001	12.59	S
6.	Type of present delivery   Normal vaginal delivery Cesarean delivery	5   2	21   42	4   7	3.923	2	0.141	5.99	NS
7.	Family type   Joint family Nuclear family Extended family	2 3 2	23 37 3	4 7 -	7.026	4	0.135	9.49	NS
8.	Monthly family income (in rupees)   ≤ 9226 – 27648 27654 – 46089 46095 – 68961 68967 – 92185 92192- 184370 ≥18,4376	1 2 4 - - - -	8 25 24 6 - - -	1 6 3 1 - - -	2.572	6	0.860	12.59	NS
9.	Previous source of information   Health personnel Social media Relatives and friends All of the above	1 1 2   3	32 15 11   5	8 1 2   1	13.47	6	0.036	12.59	S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*p<0.05 level of significance                      S-Significant             NS-Non significant                               

Overall statistical findings of data presented on the table 3 shows that there is  significant association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with demographic variables such as parity (c2  24.08 and  ‘p’ 0.001) and previous source of information (c2  13.47 and ‘p’ 0.036) and there is no association between knowledge regarding prevention of puerperal sepsis among postnatal mothers with demographic variables such as age, religion, educational qualification, occupational status, type of present delivery, family type and monthly family income. Hence, the null hypothesis H02 is rejected and the research hypothesis H2 is accepted in demographic variables such as parity and previous source of information. The null hypothesis, H02 is retained for the demographic variables such as age, religion, educational qualification, occupational status, type of present delivery, family type and monthly family income.

 

F. Table 4: Association between Practice regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables

The null hypothesis H03 was formulated against the stated research hypothesis H3.

H03: There is no significant association between practice regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables at 0.05 level of significance.

Chi square was computed to determined the significant association between practice regarding prevention of puerperal sepsis among postnatal mothers with selected demographic variables.

n=81

Sl No	Demographic Variables	Practice			?2	df	‘p’ value	Tabulated value	Inferences
		Poor	Average	Good
1.	Age (in years)   21-25 26-30 31-35 Above 35	4 3 2 -	13 22 20 7	3 4 3 -	4.355	6	0.629	12.59	NS
2.	Religion   Hindu Islam Christian Others	4 4 1 -	36 22 4 -	5 4 1 -	0.857	4	0.931	9.49	NS
3.	Educational qualifications   Illiterate Primary school certificate Middle school certificate High school certificate   Intermediate or diploma Graduate Profession or honors	2 1   1   3     1   1 -	8 22   10   13     5   4 -	- 2   4   4     -   - -	10.35	10	0.410	18.31	NS
4.	Occupational status   Professional Semi-profession Clerical/shop/ farm Skilled worker Semi skilled worker Unskilled worker Unemployed	- 2 1   - 1   1 4	- 4 9   - 2   20 27	- - 1   - 1   4 4	6.716	8	0.568	15.51	NS
5.	Parity   1 2 3 4 and above	2 4 - 3	22 22 13 5	1 4 5 1	13.97	6	0.029	11.07	S
6.	Type of present delivery   Normal vaginal delivery Cesarean delivery	6   3	23   39	1   9	6.523	2	0.038	5.99	S
7.	Family type   Joint family Nuclear family Extended family	5 3 1	19 39 4	5 5 -	4.296	4	0.367	9.49	NS
8.	Monthly family income (in rupees)   ≤ 9226 – 27648 27654 – 46089 46095 – 68961 68967 – 92185 92192- 184370 ≥18,4376	1 6 2 - - - -	8 23 25 6 - - -	1 4 4 1 - - -	3.317	6	0.768	12.59	NS
9.	Previous source of information   Health personnel Social media Relatives and friends All of the above	6 1 1   1	30 15 11   6	5 1 3   1	2.832	6	0.830	12.59	NS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*p<0.05 level of significance                      S-Significant             NS-Non significant                               

Overall statistical findings of data presented on the table 7 shows that there is significant association between practice regarding prevention of puerperal sepsis among postnatal mothers with demographic variables such as parity (c2  13.97 and  ‘p’ 0.029) and type of present delivery  (c2  6.523 and ‘p’ 0.038) and there is no significant association between practice regarding prevention of puerperal sepsis among postnatal mothers with demographic variables such as age, religion, educational qualification, occupational status, family type and monthly family income, previous source of information. Hence, the null hypothesis H03 is rejected and the research hypothesis H3 is accepted in demographic variables such as parity and type of present delivery. The null hypothesis H03 is retained for the demographic variables such as age, religion, educational qualification, occupational status, family type and monthly family income, previous source of information.

Conclusion

The findings revealed that most of the postnatal mothers had moderately adequate knowledge and average practice regarding prevention of puerperal sepsis. There was a moderately positive correlation between knowledge and practice regarding prevention of puerperal sepsis among postnatal mothers. There was significant association between the knowledge regarding prevention of puerperal sepsis among postnatal mother and demographic variables i.e., parity and previous source of information. And also there was significant association between the practice regarding prevention of puerperal sepsis among postnatal mother and demographic variables i.e., parity and type of present delivery.

References

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Copyright

Copyright © 2024 Ms. Sagarita Thakuri , Mrs. Rikupar Iawim, Mrs. Sangeeta Paul. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.