A Thesis Presented to The Faculty of Nursing of the Philippine Women s University In Partial Fulfillment of the Requirements For the

Degree of Bachelor of Science in Nursing

y GROUP C y Garcia, Justine L.

Giltendez, Laura Jean P. Gonzales, Angeline A. y Rajas, Coleen S. Tacorda, Iris Jean A. Teodosio, Ernalou D. y Tomas, Marconi M. Vergara, Noemi V. Yadao, Jenila M.

Introduction
y WHO - teenage pregnancy adolescent girls occur

between 15 and 18 age group y about 16 million women 15 18 years old give birth each year y 11% of all births worldwide y 95% of these births - in low income countries. y Low income countries 2x as high as than high income countries

y one of the causes of neonatal death is due to

complications during childbirth especially from teenage pregnancy. y WHO strategies - appropriate home care and timely treatment of complications for newborns. - Coordinating research, with wide-scale application, that focuses on improving maternal health in pregnancy during and after childbirth.

y Statement of the Problem y The purpose of this study is to determine the compliance

of the teenage mothers in intranatal care regimen among patients of a selected government tertiary hospital. The hospital located at the Lope de Vega St. Sta Cruz Manila. Specifically, this study aims to answer the following research questions: y What is the demographic profile of the respondents in terms of the ff:
y Teenage Mothers,

y y y y y y y y

1.2.1. Age, 1.2.2. Civil Status, 1.2.3. Religion, 1.2.4. Educational Attainment, 1.2.5. Number of pregnancy, 1.2.6. Distance of the Hospital 1.2.7. Financial needs

Statement of the problem

y The purpose of this study is  to determine the compliance of the teenage mothers in intranatal care practices among patients of a selected government tertiary hospital.

Specifically this study aims to:

1.

What is the demographic profile of the respondents in terms of the following: 1.1. teenage mothers 1.1.1. age 1.1.2. civil status 1.1.3. Religion 1.1.4. Educational attainment 1.1.5. no. of pregnancy 1.1.6. distance from the hospital 1.1.7. financial needs

1.2. Health Care Providers;

y 1.1.1. Age, y 1.1.2. Gender, y 1.1.3. Civil Status, y 1.1.4. Educational attainment, y 1.1.5. Length of Service?

y 3. What the level of compliance of teenage mothers on Intranatal care as rated by themselves in terms of the following: y 2.1. First Stage of Labor y 2.2. Second Stage of Labor y 2.3. Third Stage of Labor

y What is the level of compliance of teenage mothers on Intanatal practices as rated by the health care providers in terms of: y 3.1. First Stage of Labor y 3.2. Second Stage of Labor y 3.3. Third Stage of Labor

y Is there a significant relationship between the demographic profile and level of compliance of teenage mothers? y Is there a significant difference between the rate of the Health Care Provider and the teenage mother in their level of compliance? y Based on the research of the study, what recommendation can be proposed?

Hypothesis
y There is no significant relationship between the

demographic profiles of the respondents to their level of compliance.

y There is no significant difference between the rate

given by the health care provider and the teenage mother s level of compliance.

Theoretical Framework
INPUT Demographic profile:

PROCESS

OUTPUT

Teenage Mothers
Age Educational Attainment Income Distance of the hospital Marital status Religion Occupation Number of pregnancy

Assessment through Questionnaires

Intranatal Care
Recommendation

Health Care Providers

Age Educational Attainment Length of service Area of assignment Marital Status

Intranatal Care First Stage  Second Stage Third Stage

Research Design
y descriptive design y to describe, observe and document aspects of a

situation as it occurs y is concerned with existing conditions, its meaning and significance and accurate interpretation of the data y English questionnaires were distributed to the health care provider of the hospital. y Tagalog version was answered by the participants

Research locale
y Dr. Jose Fabella Memorial Hospital

- Delivery, labor room, and OB ward

Sampling method
y The researchers utilized the purposive sampling

method. y Purposive sampling is the researcher chooses the sample based on who they think would be appropriate for the study y This is used primarily when there is a limited number of people that have expertise in the area being researched.

Research Instruments
y structured questionnaire to measure the compliance of

intranatal care practices of teenage mothers. y The questionnaire is formulated based on the to be gathered and was translated to tagalog for the respondents to understand. y 5 point likert scale was utilized to sum up with the points and was then interpreted using the weighted mean. y T- test was used to test the significance at the level .05

Thesis Validation
y The Thesis was validated by the thesis adviser. The

questionnaire was followed after the related literature was validated by a Masteral and Doctoral Degree Professors, Chief Nurse and Assistant Chief Nurse in Fabella and a statistician to know if the questions were indeed reliable and measurable. All the suggestion by the validators was conducted. y The validated questionnaire was then subjected to test its validity by using a pilot study to 10 respondents from the research locale.

Data Gathering Procedure

y Permission to pursue the research was sent to the Director of the Dr. Jose Fabella Memorial Hospital through a formal letter. y After the consent was obtained from the institution and the participants, the researcher afterwards will conduct a pilot study to Dr. Jose Fabella Memorial Hospital. y It was conducted from the 2nd week of July for five (5) days. y The researcher coordinated with the supervisor on duty to conduct the study. y After administering the questionnaire, the researcher compiled the raw data and reduced to usable form then applied an appropriate test of significance. y After analyzing the data gathered, the researchers were able to formulate conclusions and recommendations.

Statistical Treatment of Data

y The following statistical tools were utilized to interpret

the data obtained for the study: y Frequency is the number of tallies corresponding to a certain item. y Weighted mean takes into consideration the proper weight of each item according to their relative importance. In item within the highest value is the most important while the items with the lesser value represent the least significance.

y Unweighted Mean was also used to interpret the

results of the survey by getting the Grand Total mean of the respondents mean scores on the different areas in the study

Results

Scale

Description

Weighted Mean range

Interpretation

Fullest extent

4-51-5.00

Generously comply with the prescribed treatment

Full extent

3-51-4,50

Generous comply with the prescribed treatment but fails once in a while

Moderate extent

2,51-4,50

Comply with the prescribed treatment but fails most of the time

Least Extent

1,51-2,50

Comply with the prescribed treatment only when desired

No compliance

1,00-1,50

Does not comply prescribed treatment

with

y T-Test is any statistical test in which the test statistic

follows a student s distribution if the null hypothesis is true. y It is most commonly applied when the test statistic follow a normal distribution if the value of a scaling term in the test statistic were known. y When the scaling term is known and is replaced by an estimate based on the data. y The test statistic under certain conditions follows a student s distribution.

y Percentage Distribution indicates the percentage of subjects in a sample whose scores fall into a specific group and the number of scores in that group. They are particularly useful for comparing the comparing the present data w/findings from the studies. y Chi Square is useful for measuring how close counts of categorical variables are to what would be expected under some assumption called the null hypothesis. It is used when participants do not give numerical scores on a chisquare test are frequencies. In this study, this statistical treatment was used to determine if there is a significant relationship between the teenage mothers.

PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA table 1 demographic profile of teenage mothers
Adolescent Mothers A. Age 12-13yrs 14-15yrs 16-18yrs Total B. Civil Status Single Married Total C. Religious Affiliation Roman Catholic Total D. Educational Attainment Elementary High School College Total E. Number of Pregnancies 1 >1 Total F. Distance to the Hospital Near from home Far from home Total G. Financial Resources Self Others Total 9 26 35 26 74 100 7 28 35 20 80 100 31 4 35 89 11 100 13 13 9 35 37 37 26 100 35 35 100 100 24 11 35 69 31 100 1 7 27 35 3 20 77 100 F %

Table 2 Demographic Profile of the Health Care Providers

Health Care Providers A. Age 21 -25 26 30 31 35 36 40 41 above Total B. Gender Male Female Total C. Civil Status Single Married Total D. Educational Attainment BS in Midwifery BS in Nursing BS in Nursing witrh MA units MAN OB-Gyne MD Total E. Length of Service 1 - 3 years 4 -6 years 7 -9 years 10 - 12 years 13 - 15 years 16 years above Total f 6 6 5 0 8 25 6 19 25 9 16 25 6 10 3 3 3 25 11 3 4 1 0 6 25 % 24 24 20 0 32 100 24 76 100 36 64 100 24 40 12 12 12 100 44 12 16 4 0 24 100

Table 3 Level of Compliance of the Teenage Mothers

I FI S S G OF BO I WM
T

I
M

WM
T

I
FCP

1. Uses massage therapy and relaxation technique including deep breathing exercises to distract from pain of contractions as instructed by health care provider 2. Uses effective labor positions as guided by the health care provider 3. Assume frequent position changes and ambulation for comfort. 4. Voids bladder every two (2) hours as instructed by health care provider 5. Takes ice chips, hard candy or other clear fluid to relieve mouth dryness and for hydration as advised by the health care provider 6. Cooperates with fetal monitoring and vital signs monitoring 7. Requests for pain medication for pain relief Grand Weighted Mean

3.66

FE

4.32

FE

3.80 4.06

FE FE

4.52 4.20

FuE FE

3.14

ME

3.72

FE

3.14

ME

3.52

FE

3.94 3.63 3.62

FE FE FE

4.60 4.08 4.14

FuE FE FE

INTRANATAL CARE PRACTICE WM SECOND STAGE OF LABOR

T

INT
M

WM
T

INT
FCP

1. Cooperates in assuming the proper labor position

4.14

FE

4.16

FE

2. Uses nipple stimulation to fasten labor

3.46

ME

3.72

FE

3.Cooperates in doing correct maternal pushing as coached by the health care provider

3.89

FE

4.24

FE

4. Rests in between uterine contraction

4.00

FE

4.52

FuE

5. Sips small amount of fluids or ice chips to relive dry mouth and dehydration as advised by the health care provider

3.00

ME

3.64

FE

6. Cooperates in fetal heart rate monitoring and blood pressure.

3.97

FE

4.52

FuE

7. Uses cool cloths to face or forehead to relive from heat involved in intense physical exertion of pushing as advised by the health care provider

2.83

ME

4.12

FE

Grand Weighted Mean

3.61

FE

4.13

FE

INTRANATAL CARE PRACTICE WM THIRD STAGE OF LABOR

T

INT
M

WM
T

INT
FCP

1. Allows the baby to be on a skin to skin contact with the mother for a certain period

4.49

FE

4.96

FuE

2. Allows baby to suck her breast for uterine contraction

4.34

FE

4.76

FuE

3. Participates in massaging her uterus after placental delivery

4.11

FE

4.52

FuE

4. Cooperates in blood pressure monitoring

4.20

FE

4.48

FE

5. Remains in lithotomy position during repair of episiotomy (if with episiotomy) and not becoming impatient

4.06

FE

4.24

FE

6. Cooperates in the transfer from the Delivery Room table to the stretcher

4.49

FE

4.52

FuE

Grand Weighted Mean

4.28

FE

4.58

FuE

*** 1.00 -1.50 Non Compliance (NC) 1.51 -2.50 Least Extent (LE) 2.51-3.50 Moderate Extent (ME) 3.51 -4.50 Full Extent (FE) 4.51 - 5.00 Fullest Extent (FuE)***

Table 4 Relationship between the Socio-demographic Variables and Level of Compliance of the Teenage Mothers

Intranatal Care practice

Computed

Tabulated

Interpretation

Decision

r-value

r-value

First Stage of Labor

0.971

0.349

Very Significant

Reject

Second Stage of Labor

0.9 2

0.349

Very Significant

Reject

Third Stage of Labor

0.9343

0.349

Very Significant

Reject

Level of Compliance of the Teenage Mothers as Rated by the Mothers and the Health Care Providers

i I i

I tr

t l

ti

Fir t St g

fL b r

2.1301 pt Acce

Second Stage of Labor

3.244 pt Rejec

Third Stage of Labor

11.158 t

Legend: =9.488 @ df = 4

NS= Not significant

S=Significant

Acce NS

NS

Summary findings
y y y y y y y y y y

1. Sociodemographic Profile of the Participants Most of the teenage mothers were on the ages 16 to 18 years old which is 27 or 72 percent. Majority of the teenage mothers were single, because it can be clearly stated that, there were 24 or 69 percent who were single and 11 or 31 percent who were married. It is also revealed that 13-37 percent reached elementary and high school level while 9 or 26 percent reached college. However, there were 31 or 89 percent of the respondents who had their first baby and 4 or 11 percent who had more than one child. Furthermore, approximately 80 percent who lived far from the hospital. In addition, the data says that 9 or 26 percent were earning on their own and 26 or 74 percent were dependent on their husbands and families. On the other hand, the statistics showed that there were 6 or 24 percent who belong to ages 21 25 and 26 -30 years old. There were 5 or 20 percent who were ages 31 35 years old and 8 or 32 percent who ages 41 years old and above. There were 19 or 76 percent who belongs to female, and 6 or 24 percent belongs to male. Among them, there were 6 or 24 percent who obtained degree in Midwifery, 10 or 40 percent who obtained degree in Nursing, 3 or 12 percent who earned units in Master of Arts in Nursing and those who obtained a Masteral degree in Nursing and who were medical experts in Obstetrics and Gynecology. There were 11 or 44 percent who worked in the hospital for 1 -3 years, 3 or 12 percent who worked for 4 6 years, 4 or 16 percent who worked for 7 9 years, 1 or 4 percent who worked for 10 12 years and 6 or 24 percent who served in the hospital for 16 years and still counting. 2. The compliance of the teenage mothers as rated by them showed full compliance. 3. The compliance of teenage mothers as rated by the health care providers showed full extent. 4. It was determined that there is significant relationship between the demographic profiles of the respondents to their level of compliance: 5. It was determined also, that there is a significant difference between the rate of the health care provider and the teenage mother s level of compliance. 6. Lastly, It was determined that the teenage mothers are complying to the full extent as rated by them and by the health care providers in terms of intranatal care regimen

conclusion
y The study conducted has yield some conclusions based on the findings that the

researchers summarized in the previous section. Based on the findings, it is showed that teenage mothers are mostly single, reached high school, on her first pregnancy and lived far from the hospital. This only means that sociodemographic factors didn t affect the level of compliance of the teenage mother. y As mentioned above, Most of the patients reached high school. Therefore, Most of them have somewhat idea of what intranatal care regimen is. y As a result, teenage mothers can easily follow instructions by the health care provider during the labor process. On the other hand, teenage mothers and the health care providers have a significant relationship in compliance of intranatal care regimen, and was determined that majority of the teenage mothers complied to the full extent as rated by themselves and the health care provider rated them with the Fullest Extent. y This means that most of the teenage mothers are aware on the labor process. Thus, there is a lesser need in improving their level of compliance due to the result of the statistics as shown mentioned in the previous chapter.

Recommendation
y For the Teenage Mothers: It is recommended that the mother should y

y y

improve their knowledge about the labor process so they have knowledge on what to do and not always to depend on the instructions of the health care providers during the intranatal stage. Health Care Providers: It is recommended that a health care provider should instruct young mothers during this period, in order to help the teenage mothers to cope up easily from giving birth and to comply in the intra natal care regimen to have an effective and safe delivery. Healthcare Institutions: The researchers recommend that they should observe proper handling of patients most especially in the Delivery room pertaining to the teenage mothers. Nursing Students: It is recommended that the nursing students should have more knowledge about the labor process for them to share information and to give proper care for their patients specifically in giving care to the teenage mothers. Future Researchers: The researchers recommended that they should discuss more thorough in the related literature and should branched out the questionnaires for them to interview the respondents.