Effect of Educational Intervention on Knowledge, Attitude and Practice of Nursing Mothers of Babies Receiving Kangaroo Mother Care and its Impact on Weight Gain: A Randomised Controlled Trial

Abstract

Kangaroo Mother Care (KMC) has proven to be a humane, powerful, easy-to-use, and low-cost method to promote the health of Low Birth Weight (LBW) neonates. The level of Knowledge, Attitude and Practice (KAP) of nursing mothers on KMC is variable. The KAP of mothers on KMC can be improved through mass media communication, which In turn improves the outcome of LBW. Aim: To determine the level of KAP regarding KMC among the mothers admitted to the KMC ward and to assess the impact of educational intervention on babies’ weight gain during KMC stay and on follow-up. Materials and Methods: This was a Randomised Controlled Trial conducted in the KMC ward, Belagavi Institute of Medical Science (BIMS) (a tertiary care centre), Northern Karnataka, India, from March 2021 to February 2022. A total of 79 subjects were included in the study and randomised into two groups: the case group (n=39) and the control group (n=40). The case group received educational intervention on KMC using audiovisual aids, while the control group received standard KMC counselling. Mothers from both groups were assessed for KAP using a prestructured questionnaire. Babies were followed-up at the 1st, 2nd, and 3rd months after discharge for weight gain. Data were analysed using Statistical Package for Social Sciences (SPSS) software version 23.0. Chi-square tests and Mann-Whitney U tests were applied for analysis. Results: The study comprised 79 KMC mother-baby dyads, with 39 in the case group and 40 in the control group. Most mothers (91%) were in the age group of 20-30 years, and 92% of the mothers had an educational status of Secondary School Leaving Certificate (SSLC), and Pre-university Course (PUC). The mean birth weight was 2.1 kg, 57% of babies were delivered by Lower Segment Caesarean Section (LSCS), and the mean gestational age was 34.48 weeks. There were no significant differences in demographic characteristics between the two groups. At admission, there was no significant difference in knowledge scores between the case and control groups (20.83±1.89 vs 19.19±3.04, p-value=0.06), but there was a statistically highly significant difference at discharge (23.9±0.38 vs 21.63±3.31, p-value <0.001). Statistically significant differences were also found in attitude (6.98±0.16 vs 6.7±0.62, p-value=0.005) and practice scores (9.38±1.39 vs 6.0±1.97, p-value <0.001). The present study found that 89.74% of mothers in the case group and 90% in the control group had good knowledge at admission, and 100% and 95% at discharge, respectively. In terms of practice, 51.3% of mothers in the case group and 15% in the control group had good practices, while only 2.56% in the case group and 70% in the control group had poor practices, which was statistically significant across all grades. All mothers in the case group and 97.5% in the control group had a good attitude. The mean weight gain (grams per day) during follow-up was statistically significant at two months (25.32±8.09 g/day vs 22.43±4.99 g/day, p-value=0.005) and at three months (25.21±6.75 g/day vs 22.69±3.81 g/day, p-value=0.004). Conclusion: Kangaroo mother care is a very effective and easy-to-practice method to improve the outcomes of LBW babies. Counselling using educational audiovisual aids will improve the KAP of mothers. Therefore, improved counselling should be advocated to enhance the efficacy of KMC and promote better weight gain.

Keywords

• counselling
• follow-up
• low birth weight
• preterm
• questionnaire