EFFECTIVENESS OF VIDEO ASSISTED TEACHING ON SELF ASSESSMENT OF DAILY FETAL MOVEMENT COUNT(DFMC), AMONG PRIMIGRAVIDAE, IN SELECTED MATERNITY HOSPITALS AT BENGALURU.

Maternal perception of fetal movement is a valuable tool for early detection of fetal compromise. Fetal movement is a reliable sign of fetal well being. These early signs of fetal movement may at first be confused as simply gas, but actually growing baby is rocking and rolling inside the belly. Fetal movement counting often called 'kick counting' represents a maneuver whereby a mother can help monitor the movements of her unborn baby by counting the number of kicks in a given time period. This is an indicator of fetal health and the novice mothers can identify and prevent the complications before the child birth. In order to educate and encourage the primigravidae to improve their knowledge regarding fetal movement counting, the study was conducted to evaluate the Effectiveness of video assisted Teaching on knowledge regarding self assessment of daily fetal movement (DFMC), among primigravidae in selected maternity hospitals at, Bengaluru. Methods: Pre-experimental design, with non probability purposive sampling method was used. Information was collected from 50 primigravidae attending antenatal OPD regarding self assessment of daily fetal movement count (DFMC) using the structured knowledge questionnaire.

Maternal perception of fetal movement is a valuable tool for early detection of fetal compromise. Fetal movement is a reliable sign of fetal well being. These early signs of fetal movement may at first be confused as simply gas, but actually growing baby is rocking and rolling inside the belly. Fetal movement counting often called 'kick counting' represents a maneuver whereby a mother can help monitor the movements of her unborn baby by counting the number of kicks in a given time period. This is an indicator of fetal health and the novice mothers can identify and prevent the complications before the child birth. In order to educate and encourage the primigravidae to improve their knowledge regarding fetal movement counting, the study was conducted to evaluate the Effectiveness of video assisted Teaching on knowledge regarding self assessment of daily fetal movement (DFMC), among primigravidae in selected maternity hospitals at, Bengaluru. Methods: Pre-experimental design, with non probability purposive sampling method was used. Information was collected from 50 primigravidae attending antenatal OPD regarding self assessment of daily fetal movement count (DFMC) using the structured knowledge questionnaire. VAT was implemented and post-test was conducted after 7 days to find the effectiveness. Results: Regarding effectiveness of VAT, the overall mean knowledge score in the pre-test was 31.92 % and 83.58 % in the post test with enhancement of 51.66 % and it was significant at 5% level. Analysis of socio-demographic variables showed significant association between age in years, occupational status, with knowledge score at 5% level (P>0.05). Interpretation And Conclusion:Overall findings showed that pre-test knowledge scores were found to be 31.92 % and after VAT, knowledge of primigraviadae was enhanced by 51.66 % regarding DFMC. Hence the result has proved that VAT was effective in improving the knowledge of primigravidae attending antenatal OPD regarding DFMC.

ISSN: 2320-5407
Int. J. Adv. Res. 6(2), 1612-1618 1613 Introduction:-"Giving birth and being born brings us into the essence of creation, where the human spirit is courageous and bold and the body, a miracle of wisdom." -Harriette Hartigan Pregnancy is considered as a very precious event in every woman's life. It is filled with happiness, joy and surprises. Every parents hopes for a healthy baby, but sometimes become sorrowful when danger sets in either to the mother or to the fetus. Pregnancy links mother and fetus together and is the basis for regenerating the generation. Most pregnancies and with work of a live baby to a healthy mother. In high risk pregnancies the mother may sometimes escape death but fetus and neonates often become the victim 1 .
According to the recent statistics it estimates above 75% of the fetal death occur in the antepartum it is obvious that that limiting fetal surveillance to intrapartum period will not achieve optimal perinatal outcome. Yet for every 1000 birth the perinatal mortality is 37.7, varies from 24.8 in Kerala to 75.5/1000 in Orissa. It is higher in rural(54.4) and( 20.3)in urban, which is lower. It is estimated that 7.3 million perinatal deaths occur annually in the world and most of these in the developing countries. In India alone about 8,90,000 perinatal deaths occur annually and that of Karnataka the stillbirth rate is 20/1000 deliveries, which is highest among all the other states 2 .
Decreased fetal movement count are present in 5% to 15% of pregnancies and are associated with intrauterine fetal death and intra uterine growth restriction(Obstetrical and Gynecological survey-England,2008) 3 .
The current scientific research conference about decreased fetal movement count in Norway revealed that fetal deaths are not sudden; 50% of unexplained stillbirths are growth restricted and, suggesting that there is time window for intervention and prevention of deaths. In recently completed "MOMS STUDY"(Maternal Observations and Memories Of Stillbirths)data from 5000 women who had stillbirth is currently being analysed. The result reveals the following , 50% of the women reported gradual decreased fetal movement count, several days prior to the fetal death, 56% of women reported decreased fetal movement count as the first reason to believe that the baby was not doing well. Only about 50% of women were told to do fetal kick counts by their doctors 4 .
FEMINA(fetal movement intervention assessment) is an ongoing International Research Collaboration to improve the pregnancy outcome. The findings reveal that women still do not get enough information on importance of fetal activity to act in such a way to protect their baby. Public relation in Norway as well as in the U.S. are on the way educating the public regarding fetal movement count 4 .
In June 2014WHO, UNICEF and partners issued the first ever global plan to end stillbirths by 2035 by providing high quality affordable services to all women 5 .
A prospective observational study was conducted in St. Martha"s Hospital Bengaluru, Karnataka over a period of 13 months. It included 50 pregnant women after 32 weeks of gestation and singleton pregnancies with < 12 fetal movements in 24 hours. They underwent a cardiotocogram(CTG) and biophysical profile test(BPP) and results were analysed statistically. A non -reactive CTG on admission was encountered in 2/50(04%) vs 21/50(42%); (p<0.001) of women with reduced fetal movements at delivery. Majority 20/50(40%) of the caesarean sections were emergency due to non reassuring CTG. Neonatal birth weight <2500 grams was recorded in 25/50(50%) and 10/26(38.46%) had meconium staining of liquor indicating an unfavorable intra uterine environment. The study concluded although, daily fetal movement counting is subjective, with onset of maternal perception of reduced fetal movements. It is prudent to advocate close fetal monitoring even in the presence of a reactive admission CTG. Hence a timely obstetric intervention is needed 6 .
Discussion with the experts and review of literature helped the investigator to realize that providing a effective education on the importance of daily fetal movement count is essential to reduce the perinatal mortality and morbidity rates. During the review literature the investigator found that studies related to this in India is less, which has shown the increasing need of the study. Investigator felt effective education provides the primigravidae to have a good time to be spent for the child before its born by the movements and have a healthy baby.

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Objectives Of The Study:-1. To assess the existing knowledge of primigravidae regarding self assessment of daily fetal movement count. 2. To evaluate the effectiveness of video assisted teaching on self assessment of daily fetal movement count. 3. To find the association between the post test knowledge scores and selected demographic variables.

Material and Method:-
The research design selected for the study was Pre-experimental, Single group pre-test and post-test design. The independent variable was video assisted Teaching on self assessment of daily fetal movement count (DFMC) and the dependent variable was post-test knowledge scores of primigravidae attending antenatal OPD.
The sample of this study comprised of 50 primigravidae attending antenatal OPD in Vanivilas Maternity hospital at, Bengaluru. Non probability purposive sampling technique was used to draw the samples of the study. The tool developed and used for the data collection was structured knowledge questionnaire. 11 experts validated the content validity of the tool and the tool was found to be reliable and feasible. The video assisted teaching consisted of various aspects on DFMC. The video assisted teaching was developed with a view to enhance the knowledge of primigravidae.
Pilot study was conducted at Jayanagar General Hospital, Bengaluru. As a part of the major study, tool proved to be comprehensible, feasible and acceptable. Data collection procedure for main study began after obtaining permission from the concerned authorities of Vanivilas maternity hospital, Bengaluru. The investigator personally explained the need to the respondents and assured them of confidentiality of their responses.
The pre-test was administered followed by a video assisted teaching; post-test was administered 7 days after teaching by using the same questionnaire used in the pre-test.
The data gathered were analysed and interpreted according to objectives. Descriptive statistics mean and standard deviation were used. And inferential statistics paired"t" test and chi-square were included to test the hypotheses at different levels of significance and the data obtained are presented in the graphical form.
Results:-Section 1:-Aspect wise pre-test mean knowledge scores of respondents on self assessment of daily fetal movement count (dfmc)  Table 1 : reveals that the aspect wise pre-test knowledge of respondents regarding self assessment of daily fetal movement count. The highest mean % was seen in the aspect perception of fetal movement counting 37 %, importance of fetal movement counting with 36.80, conditions for decreased fetal movements with 36.50 %, home coping skills with mean % of 25.60% and the lowest mean 25% was seen in the self assessment of fetal movement.  Table 1a: reveals that the aspect wise post-test knowledge of respondents regarding self assessment of daily fetal movement count. The highest mean % was seen in the aspect of importance of fetal movement counting and home coping skills with 85.60%, followed by conditions for decreased fetal movements 84.50 % followed by self assessment of daily fetal movement with 82.33% and the lowest score mean in the aspect perception of fetal movements with 80% was seen in knowledge regarding self assessment of daily fetal movement count.

Section 1a:-Aspect wise post -test mean knowledge scores of respondents on self assessment of daily fetal movement count
Section 2:-Over all pre -test and post-test mean knowledge on self assessment of daily fetal movement count Figure 1:-Depicts that pre-test mean knowledge score was 31.92 % and post-test value was 83.38 % with enhancement of 51.46%, with paired "t" test value of 19.57*. It is significant at 5% level. Section 3:-Aspect wise mean pre-test and post-test knowledge scores of respondents on self assessment of daily fetal movement count (dfmc) comparison of pre test and post test knowledge scores (paired t test).    Table 3:-Revealed there was significant association between post-test knowledge scores and selected sociodemographic variables such as age in years, occupational status at 0.05 levels. The findings of the study revealed that there was no significant association between post-test knowledge score and few selected socio-demographic variables such as educational status, monthly income, years of married life, gestational age in weeks, type of family and source of information at 0.05 levels.

Discussion:-
The pre-test knowledge score among majority of primigravidae were found to be moderate and post-test knowledge score is enhanced.There was significant enhancement in knowledge of primigravidae attending antenatal OPD after conducting video assisted Teaching on self assessment of daily fetal movement count (DFMC).There was significant association between post-test knowledge scores and selected socio-demographic variables such as age in years, occupational status at 0.05 levels.The findings of the study revealed that there was no significant association between post-test knowledge score and few selected socio-demographic variables such as educational status, monthly income, years of married life, gestational age in weeks, type of family and source of information at 0.05 levels.