RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECT FORDISSERTATION

1. NAME OF THE CANDIDATE AND ADDRESS

: MRS. MALATHI KI YEAR M.Sc. NURSING, GOVERNMENT COLLEGE OF NURSING,BEHIND D.C RESIDENCE, B.M ROAD HASSAN

2. NAME OF THE INSTITUTION

: GOVERNMENT COLLEGE OF NURSING, HASSAN

3. COURSE OF STUDY AND SUBJECT

: M.Sc. NURSINGOBSTETRIC AND GYNAECOLOGICAL NURSING

4. DATE OF ADMISSION : 26. 07.2012

5. TITLE OF THE TOPIC

: “EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING MEASURES OF THERMOREGULATION IN NEWBORN AMONG POSTNATAL MOTHERS IN SHRI CHAMARAJENDRA HOSPITAL AT HASSAN”

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6. BRIEF RESUME OF THE INTENDED WORK

INTRODUCTION

“All Child Need a Lap”

Womb is ‘a secure receptacle” indicates an important feature where the

embryo completes its 9 months of development. The mother’s womb provides

insulation against external agents, light and sound, variations in temperature and

protects the baby against shock and pressure.1 In the womb, the fetus is protected

from internal and external pressures by a wealth of natural shields and the fetus is safe

in the womb because it is well-insulated and designed as the perfect baby carrier.2

During intrauterine life, the fetal temperature is 0.50c higher than the maternal

temperature due to methods reactions that generate heat. After birth the infant is

exposed to air and environment which have lower temperature.3 Thermoregulation in

adults is achieved by muscular activity and metabolic activity during fetal life. Above

mechanism in mother are responsible for maintaining the fetal body temperature.4

The birth of a newborn is one of the most

inspiring and marvelous joyful event that occurs in every women’s lifetime. Neonatal

period is characterized transition to extra uterine life.3 Newborn infants usually are

considered to be tiny and powerless, completely dependent on others for life.5

Newborn infants are unique in their physiology and health problems that they

experience.3 Newborns come from a warm environment to the cold and fluctuating

temperatures of this world. After delivery the newborn must adapt to its relatively

cool environment by production of heat metabolically as they are not able to generate

heat by an adequate shivering response.4 They are naked, wet, and have a large

surface area to mass ratio, with variable amounts of insulation, limited metabolic

reserves, and a decreased ability to shiver.6 Newborn babies have poor heat regulating

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mechanisms because of larger surface area of babies compared to their weight making

them prone to hypothermia and its ill effects. Heat loss in a newborn occurs through 4

routes- radiation convection, conduction and evaporation.3

Physiologic mechanisms for preserving core temperature include

vasoconstriction, maintaining the fetal position, jittery large muscle activity and "non-

shivering thermogenesis".6 On exposure to cold and wet environment the neonate tries

to generate heat by increased activity and a sympathetic surge that causes

vasoconstriction and non shivering thermogenesis.

Cold stress causes the release of norepinephrine that uncouples beta-oxidation

in fat, with resultant heat generation.3 Babies attempt to conserve heat by peripheral

vasoconstriction. This leads to increased anaerobic metabolism at the ill perfused

areas with acidosis. With severe hypothermia, hypoxemia, hypoglycemia and

metabolic acidosis develop, leading to mortality.3

A newborn baby is a God’s divine precious gift given to a mother. So

survival and health of the neonate is very important.7 The most effective management

strategy for hypothermia is its prevention. The temperature range during which the

basal metabolic rate of the baby is at a minimum, oxygen utilization is least and baby

thrives well is known as ‘Thermo-neutral range of temperature’ or Neutral Thermal

Environment’.3 So preventing hypothermia and maintaining a neutral thermal

environment is important to prevent other complications. It can be done by mothers of

the neonate and educating mother regarding measures of thermoregulation like

kangaroo care, rooming in, mummifying and promoting breast feeding can be attained

by providing education to the mothers

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6.1 NEED FOR THE STUDY

“Future destiny of the child is always the work of the mother”

-NapoleonThe importance of maintaining the temperature of the newborn baby has been

known for centuries. Still thermal stress has been associated with an increase in

morbidity and mortality, making early detection an important part of monitoring in

sick infants.8 The temperature at which a baby can maintain its normal body

temperature is called "thermo neutral temperature”. This is the ideal temperature at

which a baby should be made to achieve optimal somatic growth. For a 2% fall in

environmental temperature below the normal range, the infant has to generate 25%

additional heat which requires more energy and glucose. The environmental

temperature at which this metabolic response becomes necessary is called the "critical

temperature” and this results in complications of hypothermia like increased oxygen

consumption, hypoglycemia, neonatal cold crisis, jaundice, kernicterus, poor weight

gain and high mortality.6 Neonatal survival is a very sensitive indicator of population

growth and socio-economic development.9

The WHO stated that approximately 125 million infant born every year,

8million die before reaching one year of life due to various complications among that

about 2.5% newborn die due to hypothermia.10 For these reasons, the issue of neonatal

deaths is a serious national health concern, especially in developing countries where

96% of the world’s approximate 5 million annual neonatal deaths occur each year in

India over one million newborns die before they complete their first month of life,

accounting for 30% of the world's neonatal deaths. India’s current neonatal mortality

rate of 44 per 1000 live births represents 1.2 million children who die each year.

Neonatal mortality is higher in rural areas at 49 per 1000 live births (vs 27/1000 in

urban areas).11

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Hypothermia is one of the main causes of neonatal morbidity and mortality in

developing countries. Neonatal hypothermia is caused more by lack of knowledge

than lack of equipment and it is an important cause of neonatal death. Newborn baby

has immature thermoregulatory controls during the early neonatal period. The head

constitutes a significant portion of the newborn surface area and can be a source of

great heat loss. Limited heat generating mechanisms, vulnerability to getting exposed,

being dependent on others for early detection and rectification contribute to heat loss.

Additional factors that contribute to heat loss in low birth weight babies and preterm

babies are decreased subcutaneous fat and brown fat, more permeable skin, even

larger surface area then term babies. Thus hypothermia is responsible for much of the

morbidity and mortality.3

A prospective study was conducted to determine the relationship between

hypothermia at birth and the risk of mortality or morbidity among neonates born in

Imam Hospital in Tehran, Iran. Nine hundred and forty neonates were enrolled into

the study. A significant relationship was found between hypothermia and respiratory

distress in the first six hours of birth and death, as well as with jaundice,

hypoglycemia and metabolic acidosis in the first three days of birth (P=0.0001).

Logistic regression showed that, hypothermia at birth alone could increase the risk of

neonatal death. Neonatal hypothermia at birth increases mortality as well as

significant morbidity and hospitalization period.10

Newborn hypothermia remains one of the most important contributors to

neonatal mortality and morbidity in both health facilities and communities of low-

resource settings. Recent data from the community in Nepal and India have expanded

our understanding of the population-based burden in South Asia, and the

hypothermia-mortality risk relationship is becoming increasingly clear. Neonatal

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health promotion programs for home births need to focus on the behavioral changes

necessary to optimize thermal care of newborns, especially in the hours immediately

after birth. Research to further elucidate both the impact of specific thermal care

interventions on hypothermia risk and the overall contribution of these practices in

improving survival of newborn is required.12

Basic techniques for keeping newborns warm include keeping them dry,

wrapping them in blankets or mummifying, giving them woolen and cotton caps and

clothing, or increasing the ambient temperature. More advanced techniques include

use of skin-to-skin "kangaroo mother care" “rooming in” etc.6 Indian mothers are not

aware about newborn hypothermia and measures of thermoregulation due to various

factors such as ignorance, lack of knowledge, low socioeconomic status, etc. Nurses

play a vital role in prevention of newborn hypothermia during the hospitalization of

postnatal mothers.7

Hassan is one of the coolest places in Karnataka, due to extreme cool

environment, and lack of awareness of the mothers to maintain thermoregulation in

neonates lead to hypothermia which may lead to neonatal mortality. The investigator

too had personal experience in hospital where mothers left their newborns unattended,

unwrapped and with wet napkins. This provoked the investigator to choose the topic

for her study. By enriching the mother’s knowledge of newborn hypothermia and

measures of thermoregulation being a nurse we can reduce newborn mortality and

morbidity.

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6.2 REVIEW OF LITERATURE

Review of literature is a key step in research process. Review of literature

refers to a critical summary of research on a topic of interest, often prepared to put

a research problem in context.13 Before any research can be started a literature

reviews of previous studies and experiences related to the proposed investigations

should be done.

A pre

experimental study conducted to evaluate the effectiveness of planned teaching

programme on knowledge of mothers on prevention of hypothermia among

newborns in selected hospitals of Belgaum, Karnataka. 30 postnatal mothers were

selected as samples and pretest questionnaire was administered through structured

interview schedule. The result revealed that PTP was the best teaching strategy in

imparting knowledge to postnatal mothers on prevention of hypothermia which is

commonly encountered in developing countries, can be prevented if mothers are

educated through ongoing in service program by nurses.7

The retrospective study was conducted to evaluate the efficacy of kangaroo

method on thermoregulation and weight gain of a preterm newborn in Dakar.56

preterm babies were randomly selected to assess the mean weight and gestational

weight. Mean gestational age was 33 +/- 7,6 weeks and mean birth weight, 1488 +/-

277,6 g. Mean temperature was satisfying during follow up and was stable around

37 +/- 0,5o C at discharge of program with mean daily weight gain of 33 +/- 7,6

g/day. The result of this study point out efficacy of kangaroo method on the

thermoregulation, weight gain and survival of preterm babies14

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A pre experimental research study conducted in Manipal medical college of

Nursing, Udupi, Karnataka, in to evaluate the effectiveness of planned teaching

program on prevention of hypothermia for the mother of Neonates the sample size

was 30 postnatal mothers. The study concluded that planned teaching program with

appropriate AV aids was an effective strategy in imparting knowledge to postnatal

mothers of prevention of hypothermia.15

A descriptive study was conducted to describe infant temperature in the home

environment and explore factors, particularly weight and gestational age at birth,

associated with maintenance of thermal neutral temperatures in the home. Twenty-

four preterm and 16 full-term infants were studied at approximately 44 weeks age in

the home environment. Thermal care of infants in the home may be influenced by

parental perception of thermal vulnerability relative to weight and gestational age at

birth.16

An experimental study conducted to assess the effectiveness of mummifying and

rooming in to maintain thermoregulation among neonates immediately after birth in

Hassan. 80 neonates were selected as samples divided into experimental and control

group and the result revealed that mummifying and rooming in is effective in

maintaining neonatal temperature.17

An experimental study was conducted to evaluate the knowledge, attitude, and

practice about neonatal hypothermia among medical and paramedical staff dealing

with newborn care at SMS Medical College Jaipur. 160 subjects were selected

randomly and data were analyzed. The present study reveals the gross lacunae in the

knowledge, regarding various aspects of neonatal hypothermia among pediatric and

obstetric residents and paramedical staff working in labour room and postnatal wards

and it concluded that to reduce the neonatal morbidity and mortality due to neonatal

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hypothermia, greater emphasis should be laid on this problem while designing

curriculum for training of undergraduate and postgraduate doctors, paramedical staff

and traditional birth attendants.18

A pre experimental study conducted to assess the effectiveness of information

booklet on knowledge regarding kangaroo mother care among staff nurses in Sri

Aurobindo Hospital and CHL Apolo Hospital, Punjab. The study conducted on 60

staff nurses and the researcher concluded that after the implementation of information

booklet, there was a significant increase in knowledge of staff nurses regarding the

kangaroo mother care.19

A research study conducted to assess the knowledge and practice of health

professionals about thermal control of newborn in Gujarat, Italy, Indonesia, Nepal,

Brazil and Mozambique on a sample of 260 health professionals. An assessment of

thermal control practices carried out by using a mailed questionnaire method. The

researcher concluded that awareness of the importance of thermal control and basic

knowledge on thermal regulation and thermal protection were insufficient and this

basic knowledge can be acquired through ongoing in-service education

programmes.20

An experimental study was conducted on the impact of newborn bathing on the

prevalence of neonatal hypothermia in Uganda. Non-asphyxiated newborns after

vaginal delivery (n = 249) in a Ugandan referral hospital were consecutively enrolled

and randomized either to bathing at 60 min after birth (n = 126) or no bathing (n =

123). All mothers practiced skin-to-skin care of their newborns. Four rectal and

tympanic recording of newborn temperatures were carried out in both groups directly

after drying at birth, and at 60, 70 and 90 min postpartum. Bathing newborn babies

shortly after birth increased the risk of hypothermia despite the use of warm water.21

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Longitudinal cohort study conducted to quantify incidence, age distribution, and

seasonality of neonatal hypothermia among a large population cohort in Sarlahi,

Nepal.   A total of 23 240 newborns born between September 2, 2002, and February 1,

2006 were selected.  Measurements lower than 36.5°C were observed in 21 459

babies (92.3%); half (48.6%) had moderate or severe hypothermia, and risk peaked in

the first 24 to 72 hours of life. In the hot season, one-fifth of the babies (18.2%) were

observed below the moderate hypothermia cutoff. Researcher concluded that mild or

moderate hypothermia was nearly universal, with substantially higher risk in the cold

season. However, incidence in the hot season was also high; thus, year-round thermal

care promotion is required.22

6.3 STATEMENT OF THE PROBLEM

“A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE REGARDING MEASURES

OF THERMOREGULATION IN NEWBORN AMONG POSTNATAL

MOTHERS IN SHRI CHAMARAJENDRA HOSPITAL AT HASSAN”

6.3.1. OBJECTIVES OF THE STUDY

1. To evaluate the existing knowledge regarding measures of thermoregulation

in newborn among postnatal mothers in Shri Chamarajendra hospital at

Hassan

2. To determine the effectiveness of structured teaching programme on

knowledge regarding measures of thermoregulation in newborn among

postnatal mothers in Shri Chamarajendra hospital at Hassan

3. To find the association between the post test knowledge score and selected

demographic variables

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6.3.2. HYPOTHESES

H1- There will be significant difference between mean pre test and post test

knowledge score regarding measures of thermoregulation in newborn among

postnatal mothers.

H2-There will be significant association between post test knowledge score and

selected demographic variables.

6.3.3. VARIABLES

a. Independent Variable: Structured teaching programme on knowledge regarding

measures of thermoregulation in newborn.

b. Dependent Variable: Knowledge of postnatal mothers regarding measures of

thermoregulation in newborn.

c. Extraneous variable: Age, education, occupation, family income, family type,

religion, parity, previous source of health information.

6.3.4. OPERATIONAL DEFINITIONS

a) Effectiveness: It refers to the measure of the ability of structured teaching

programme on measures of thermoregulation in newborn to enhance

knowledge among postnatal mothers that can be quantitatively measured.

b) Structured teaching programme: It refers to systematically organized

teaching programme in Kannada language for 45minutes, regarding measures

of thermoregulation in newborn which includes kangaroo care, mummifying,

rooming in etc.

c) Knowledge: It refers to awareness and understanding of postnatal mothers

regarding measures of thermoregulation in newborn as measured by structured

interview schedule.

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d) Postnatal mother: It refers to the women admitted in the postnatal wards

after delivering a live baby in Shri Chamarajendra hospital at Hassan.

e) Measures of thermoregulation in newborn: It refers to the methods like

kangaroo care, mummifying, rooming in etc, which is used to maintain normal

temperature in newborn.

f) Thermoregulation: It is the ability of a newborn to keep its body

temperature within certain boundaries. Normal range i.e 36.50 C to 37.50 C

(97.70 F to 98.6 o F) even when temperature surrounding is very different.

g) Newborn: It refers to neonates until 28 days after birth, includes both normal,

low birth weight and pre-terms in Shri Chamarajendra hospital at Hassan

6.3.5. ASSUMPTIONS

The study assumes that:

1. Postnatal mothers may have some knowledge regarding measures of

thermoregulation in newborns.

2. Postnatal mothers may be willing to express their response and also to

improve their knowledge regarding measures of thermoregulation.

3. Increased level of knowledge on measures of thermoregulation in newborn

among postnatal mothers may help them to prevent the complications in

newborn.

6.3.6 DELIMITATIONS:

1. The study is delimited to 50 postnatal mothers in Sri Chamarajendra

hospital at Hassan

2. The study is delimited to postnatal mothers who are willing to participate in

the study.

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3. The study is delimited to postnatal mothers with live baby.

7. MATERIALS AND METHODS OF THE STUDY

7.1 Source of Data : Postnatal mothers admitted in Sri

Chamarajendra hospital at Hassan

7.2 Methods of data collection

7.2.1 Definition of the study

subject

: Postnatal mothers admitted in Sri Chamarajendra

hospital at Hassan

Research approach : Quantitative Evaluative approach

7.2.2 Research design : Pre experimental one group Pre test and Post

test design

Group Pretest InterventionPost test

G O1 X O2

7.2.3. Setting : Postnatal ward of Sri Chamarajendra hospital

Hassan

Population : Postnatal mothers in Sri Chamarajendra hospital

at Hassan.

7.2.4. Sampling technique : Non probability Purposive Sampling technique

will be adapted

7.2.5. Sampling Criteria : Inclusion and Exclusion Criteria

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Inclusion criteria

1) Postnatal mothers who are admitted to

postnatal ward at Sri Chamarajendra hospital

Hassan

2) Postnatal mothers who are available at the

time of data collection.

Exclusion criteria

1) Postnatal mothers who are suffering from

postnatal complication during the time of data

collection.

2) Postnatal mothers who are not able to

understand Kannada and English.

7.2.6 (a) Sample size

(b)Duration of the study

: 50 postnatal mothers

: 30days

7.2.7 Tools of research : Structured interview schedule will be used to

collect data from the subjects.

It consists of 2 parts

Part1: Demographic data

Part II: Structured interview schedule to assess

the knowledge regarding measures of

thermoregulation in newborn among postnatal

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mothers.

Pilot study Pilot study will be conducted on 10% samples to

find out the feasibility of conducting the study,

design and plan of statistical analysis. The

samples of the pilot study will not be included in

the main study.

7.2.8 Collection of data : The data will be collected after getting

permission from the concerned authority. The

researcher will introduce herself to the

participants and 50 postnatal mothers will be

selected based on inclusion criteria. The

objectives of the study will be explained and

then the written consent will be taken before the

data collection.

The investigator collects the data by administering

structured interview schedule and conducts

structured teaching programme on the same day.

The post test will be conducted after 7 days using

the same structured interview schedule.

7.2.9. Method of data analysis :Descriptive statistics

Frequency and percentage distribution will be

used to analyze the demographic variables of

postnatal mother. Mean median range and

standard deviation will be used to analyse the

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level of knowledge of postnatal mothers

Inferential statistics

Paired “t” test will be used to assess the

effectiveness of structured teaching programme.

Chi square test will be used to find the

association between post-test knowledge score

and demographic variables

7.3 Does the study require any investigations or interventions to be conducted

on patients, or other animals? If so please describe briefly.

Yes, the investigation needs to assess the knowledge regarding measures of

thermoregulation in newborn among postnatal mothers.

7.4 Has ethical clearance been obtained from your institution?

Yes. The written permission will be obtained from the concerned authority and

informed consent will be obtained from the subjects. Subject’s privacy,

anonymity and confidentiality of the data will be guarded. Scientific

objectivity of the study will be maintained with honesty and impartiality.

8. LIST OF REFERENCES

1. Harun Yahya. The mother’s womb with its secure protection.2009[cited on 23

Jan 2009] Global Publication Ltd. Co. Available at URL:

http://harunyahya.com/en/works/12376/the-mothers-womb-with-its

2. Martin Green. How Protected Is a Baby in the Womb?.[cited on Mar 28,

2011] Available at URL: http://www.livestrong.com/article/226943-how-

protected-is-a-baby-in-the-womb/#ixzz2GiHkr100

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3. Ghai OP, Paul K Vinod, Bagga Arvind. Ghai Essential Pediatrics. Seventh

edition. New Delhi: CBS Publishers and Distributers Pvt Ltd;2009. p.96 to 122

4. Mishra Jayanti , Pati Sanghamitra. Importance of thermoregulation in the

Newborn: role of brown fat. Orissa Journal of medical biochemistry

[abstract].2004;(1). Available from URL:

http://www.saihp.org.in/articles/biomerarticle2.pdf

5. Basavanthappa BT. Textbook of Midwifery & Reproductive Health Nursing.

New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2006. p. 441

6. Wikipedia, the free encyclopedia. Adaptation to extra uterine life. (document

from the internet)(Last modified on 22 November2012at15:06.) Available at

URL: http://en.wikipedia.org/wiki/Adaptation_to_extrauterine_life

7. Bhandari M Usha, Kharde N Sangeetha, Raddi A Sudha. A study to Evaluate

the Effectiveness of Planned Teaching Program On Knowledge of Mothers on

Prevention of hypothermia among Newborns in Selected Hospitals of

Belgaum, Karnataka. Journal of SAFOG.[serial online]2010[ January – April

2010];(1):89-92 Available from URL:

http://www.jaypeejournals.com/eJournals/ShowText.aspx?

ID=456&Type=FREE&TYP=TOP&IN=_eJournals/images/

JPLOGO.gif&IID=45&isPDF=YES

8. Neonatal Care Practice-Thermoregulation-temperature. Baby first newsletter.

Available at URL: www.babyfirst.com/en/neonatal-care/temperature.php

9. Lalita Behl,Neelam Grover,Shyam L. Kaushik. Perinatal and Neonatal

Mortality- A Hospital Based Study. Indian Pediatr[serial online]. 1998; 35:683-

684. Available at URL: http://indianpediatrics.net/july1998/july-683-684.htm

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10. Nayeri F, Nili F. Hypothermia at Birth and its Associated Complications in

Newborns: a Follow up Study. Iranian J of Publ health[Serial online].

2006;35(1): pp.48-52. Available from URl: http://journals.tums.ac.ir/

11. Lalita Behl, Neelam Grover, Shyam L. Kaushik. Perinatal and Neonatal

Mortality- A Hospital Based Study. Indian Pediatr 1998; (35):683-684.

Available at URL: http://indianpediatrics.net/july1998/july-683-684.htm

12. LC Mullany. Neonatal hypothermia in low-resource settings. Semin

Perinatol[serial online]. 2010 [December 1]; 34(6): 426–433.Available at

URL:http://www.ncbi.nlm.nih.gov/sites/entrez?

cmd=search&db=pubMed&term=%20Mullany%20L%5Bauth%5D

13. Denise F. Polit, Cheryl Tatano Beck. Nursing Research: Generating and

Assessing Evidence for Nusing Practice. Ninth edition. New Delhi. Wolters

Kluver(India) Pvt. Ltd. 2012. Pp 732

14. Ndiaye O, Diouf S, Diouf NH, Cisse BathilyA, Cisse CT, Sylla A, Et al

Efficiency of kangaroo care on thermoregulation and weight gain of a preterm

newborn cohort in Dakar[abstract].2006; 51 (3): 155-60. Available at URL:

http://www.ncbi.nlm.nih.gov/pubmed/17628903

15. Tesline. Effectiveness of planned teaching programme on prevention of

hypothermia for mothers of neonates in Manipal , Udupi Dist, Karnataka, India.

Journal of neonatology, 2007. Available from URL:

http://www.jaypeejournals.com/eJournals/ShowText.aspx?

ID=456&Type=FREE&TYP=TO

16. Thomas KA. Infant weight and gestational age effects on thermo neutrality in

the home environment [serial online]. 2003 [Nov-Dec2003];32(6):745-

52.Available from URL: http://www.ncbi.nlm.nih.gov/pubmed/14649594

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17. S.Deepa. A study to assess the effectiveness of mummifying and rooming in

to maintain thermoregulation among neonates immediately after birth in

selected hospital at Hassan RGUHS 2008.Available from URL:

http://119.82.96.198:8080/jspui/handle/123456789/2194

18. Chouduri KC. A study to evaluate the knowledge, attitude and practices of

neonatal hypothermia among medical and paramedical staff at SMS medical

college, Jaipur. Indian Journal of Pediatrics[serial online].2000 [July 2000];67.

(7): 491-96 Available at URL:

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ID=456&Type=FREE&TYP=TOP&IN=_eJournals/images/

JPLOGO.gif&IID=45&isPDF=N

19. Bala Kiran. Knowledge about Kangaroo mother care among nurses. Indore,

Punjab. Nightingale Nursing Times. 2012; 8.( 3):p 21-23,55.

20. Dragovich D, Tamburlini G, Kambarani R, et al. A study to assess the

knowledge and practice o health professionals about thermal control of the

newborns. Journal of Nursing practice and Research Feb 1997;10(5):213-15.

Available at URL: http://www.jaypeejournals.com/eJournals/ShowText.aspx?

ID=456&Type=FREE&TYP=TOP&IN=_eJournals/images/

JPLOGO.gif&IID=45&isPDF=YES

21. Bergström A, Byaruhanga R, Okong P. The impact of newborn bathing on the

prevalence of neonatal hypothermia in Uganda: a randomized, controlled trial.

Acta Paediatr[abstract]. 2005[Oct]; 94. (10):1462-7. Available from URl:

http://www.ncbi.nlm.nih.gov/pubmed/16299878

22. Mulllany LC,Katz J, Khatry SK, Leclerq SC, Darmstadt GL, Tielsch JM .

Incidence and seasonality of hypothermia among newborns in southern Nepal.

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Arch Pediatr Adolesc Med. 2010[Jan]164(1|)71-7 . Available at URl:

http://www.ncbi.nlm.nih.gov/pubmed/20048245

9. SIGNATURE OF THE CANDIDATE:

10. REMARK OF THE GUIDE:The study selected is appropriate as it supports newborn health and its survival by preventing hypothermia related complications and reduces perinatal mortality rate

11.NAME AND DESIGNATION OF

11.1 GUIDE:MRS. JAYAMMA. A.ULECTURER AND HODDEPARTMENT OF OBSTRETRIC AND GYNECOLOGICAL NURSING GOVERNMENT COLLEGE OF NURSING, HASSAN.

11.2SIGNATURE :

11.3 CO-GUIDE(IF ANY) :MRS. PREMALATHA .J.LECTURERDEPARTMENT OF OBSTRETRIC AND GYNECOLOGICAL NURSINGGOVERNMENT COLLEGE OF NURSING, HASSAN

11.4SIGNATURE :

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11.5 HEAD OF THE DEPARTMENT:MRS. JAYAMMA. A.ULECTURER AND HOD DEPARTMENT OF OBSTRETRIC AND GYNECOLOGICAL NURSING GOVERNMENT COLLEGE OF NURSING, HASSAN

11.6 SIGNATURE :

12 REMARK OF THE PRINCIPAL: This study is bonafide and genuine research and helpful to the society. MRS. DAMAYANTHI S MOBILE NO: 9886506426Email: gcnhprincipal@yahoo.com

12.1 SIGNATURE :

ETHICAL COMMITTEE CLEARANCE

1.TITLE OF THE DISSERTATION : EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING MEASURES OF THERMOREGULATION IN NEWBORN AMONG POSTNATAL MOTHERS IN SHRI CHAMARAJENDRA HOSPITAL AT HASSAN

2. NAME OF THE CANDIDATE AND ADDRESS:

MRS. MALATHI K1st YEAR M Sc NURSING. GOVERNMENT COLLEGE OF NURSING, HASSAN

3. SUBJECT: OBSTRETRIC AND GYNECOLOGICAL NURSING

4. NAME OF THE GUIDE :MRS. JAYAMMA. A.ULECTURER AND HOD DEPARTMENT OF OBSTETRIC AND GYNECOLOGICAL NURSING GOVERNMENT COLLEGE OF

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NURSING, HASSAN.APPROVED /NOT APPROVED(If not approved, suggestions)

MRS. DAMAYANTHI SPrincipal and HOD Medical Surgical Nursing Government College of Nursing, Hassan.

MRS. JAYAMMA A UHOD Obstetric Gynecological NursingGovernment College of Nursing, Hassan.

MRS. SHOBHA DEVAMANEHODChild Health Nursing Government College of Nursing, Hassan.

MRS. G K ANITHAHODCommunity Health Nursing Government College of Nursing, Hassan.

MR. RAVINDRA KUMAR K VHODPsychiatric nursingGovernment college of nursing, Hassan.

LAW EXPERTMRS DAMAYANTHI SPrincipal and HOD Medical Surgical Nursing Government College of Nursing, Hassan

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