APPROVAL SHEET
Research study entitled "knowledge and attitude regarding postnatal Exercise among postnatal
mother in Bharatpur hospital" is my work which is being submitted for approval to Shree medical
and Technical College, Bharatpur 10, Chitwan, affiliated to Purbanchal University for the partial
fulfillment of the requirements of Bachelor in nursing program.
Student
……………………….
Gauri Subedi
Research Approved by:
Research Advisor
…………………………
Mrs. Babita Devi Dahal
Assistant Professor
Shree Medical and Technical College
Bharatpur, Chitwan
Nursing Program Chief
………………………...
Mrs. Shobhana Nepal
Shree Medical and Technical College
Bharatpur, Chitwan
Date: ………………………...
ABSTRACT
Introduction: Postnatal exercise is the physical activities that are done in the postnatal period that is
beneficial for the mother. Postnatal exercise speeds up the recovery process and build valuable strength.
Postnatal exercises are regarded as basic therapy, which may improve the health of puerperal but during
the clinical supervision period the researcher observed that not a single postnatal mother had done postnatal
exercises which is a vital part of post-natal care.
Methodology: A cross sectional analytical study design was used to assess the knowledge and
attitude regarding postnatal exercise among postnatal mother in Bharatpur Hospital, Chitwan
between 14th to 24th Kartik. Non probability purposive sampling technique was used to collect
sample from 249 respondents where semi-structured interview schedule was used. Analysis was
done by using descriptive and inferential statistics.
Result: In this study out of 249 respondents, majority 126(50.6%) of respondents were in age
group of 15-25 years and the mean value and standard deviation of age was 25.57 and 4.821
respectively. Likewise, in religion majority of respondent 196(78.7%) were Hinduism and
regarding ethnicity majority 111(44.6%) were Janajati, regarding level of education, majority
242(97.2%) were literate where 98(40.49%) were secondary level of education. Regarding
Occupation 129(51.8%) were homemaker. Regarding family income (monthly), 181 (72.7%) had
(10000 to 50000) and majority 194(77.9%) of respondents got information from health personnel.
Respondents 4(1.6%) have adequate knowledge 91(36.5%) moderate knowledge and 154(61.9%)
had inadequate knowledge regarding postnatal exercise. Similarly, majority 128(51.4%) had
positive attitude and 121(48.6%) had negative attitude. Level of knowledge is statistically
significant with their religion (p=0.004), occupation (p=0.022) and type of family (p=0.01).
Likewise, level of attitude is statistically significant with their number of childbirths or parity
(p=0.024).
Conclusion: Most of the respondents have inadequate level of knowledge and positive attitude. If
respondents have inadequate knowledge, then midwife nurses should provide an awareness
program during the time of delivery and antenatal period about the postnatal exercise to the
mothers.
Keywords: Knowledge, Attitude, postnatal Exercise, Postnatal mother
AKNOWLEDGEMENT
The undertaking of this cross-sectional analytical study is not the single mind; it is the output of
many more helping hands. First and foremost, researcher would like to express her sincere
gratitude towards Purbanchal University and Shree Medical and Technical College for providing
golden opportunity to carry out this research study as a partial fulfilled of Bachelor in Nursing.
Researcher's pleasure to indebt her earnest gratitude and genuine thanks to Nursing Program Chef
Ms. Shobhana Nepal for valuable suggestion, untiring guidance through the course of study and
for providing permission to conduct the research study
Researcher feels privileged to complete this study under the intensive care and supervision of her
research advisor Ms. Babita Devi Dahal for her continuous guidance, valuable suggestion,
constructive feedback and tireless efforts to bring the study in this form.
Researcher is very thankful to the statistician Mr. Hari Prasad for providing guidance and support.
Researcher's sincere thanks goes to all the respondents for their co-operation, without whom this
study would have been impossible.
Researcher express her acknowledgement to all the library staffs for providing valuable literatures,
books, journals, etc., that laid a strong foundation for shaping this study
Researcher's sincere appreciation goes to the Bharatpur Hospital for granting permission to
conduct this research. Researcher would like to extent her gratitude to all respondents for providing
her an opportunity to carry out this study and for their help during the data collection period.
Gauri Subedi
TABLE OF CONTENT
CONTENT
TITLE PAGE
APPROVAL SHEET
ABSTRACT
ACKNOWLEDGEMENT
TABLE OF CONTENT
LIST OF TABLES
LIST OF FIGURES
CHAPTER I:
INTRODUCTION
1.1 Background of the study
1.2 Rationale of the study
1.3 Statement of the Study
1.4 Significance of the study
1.5 Objective of the study
1.6 Research Question
1.7 Study Variables
1.8 Conceptual Framework
1.9 Operational definition
CHAPTER II: LITERATURE REVIEW
2.1 Introduction
2.2 Review of Literature
2.3 Summary of Related
Literature
CHAPTER III: RESEARCH METHODOLOGY
3.1 Research design
3.2 Study Setting/ Area
3.3 Study Population
PAGE NO
3.4 Sample size
3.5 Sample Technique
3.6 Exclusion/Inclusion Criteria
3.7 Data collection Tool/ Instrument
3.8 Validity and Reliability
3.9 Ethical Consideration
3.10 Data Collection Procedure
3.11 Data Analysis Procedure
3.12 Disseminating the research Findings
CHAPTER IV: FINDING OF THE STUDY
CHAPTER V: DISCUSSION, CONCLUSION, AND
RECOMMENDATION
5.1 Discussion
5.2 Conclusion
5.3 Limitations
5.4 Recommendation
5.5 Dissemination the research Finding
REFERENCES
APPENDICES:
Appendix A-Informed Consent (English)
Appendix B- Informed Consent (Nepali)
Appendix C-Research Tools (English)
Appendix D-Research Tools (Nepali)
Appendix E- Approval Letter from SMTC-IRC
Appendix F- Administrative Letter from Authority
LIST OF TABLES
S.N
TITLE
PAGE
Respondents' Socio-demographic Characteristics
Respondents' Socio-demographic information Regarding
Prevention of Puerperal Sepsis on number of Pregnancies,
number of deliveries, previous place of delivery. Mode of
delivery, ANC check-up, duration of rupture of membrane
before delivery,duration of labor pain, history of puerperal
sepsis according to Time interval, Duration of Blood flow
& Source of Information
Respondents' Socio-demographic information
Respondents Knowledge Regarding Prevention of puerperal Sepsis
Respondents' Practice Regarding Prevention of Puerperal Sepsis
Level of Knowledge Regarding Prevention of Puerperal Sepsis
Level of Practice Regarding Prevention of Puerperal Sepsis
Association Between Level of Knowledge Regarding Prevention of Puerperal Sepsis Sociodemographic Characteristics
Association Between Level of Knowledge Regarding Prevention Of Puerperal Sepsis Sociodemographic variables
Association Between Level of Knowledge Regarding Prevention Of Puerperal Sepsis Sociodemographic variable
Association Between Respondents Level of Practice Regarding
Prevention of Puerperal Sepsis Socio-demographic Variable Association Between Respondents
Level of Practice Regarding Prevention of Puerperal Sepsis Socio-demographic Variable 12.
Association Between Respondents Level of Practice of Postnatal Mother Regarding Prevention
of Puerperal Sepsis Socio-demographic Variable
LIST OF FIGURES
S.N
TITLE
PAGE NO
CHAPTER I
INTRODUCTION
1.1Background of the Study
The postnatal period is defined as the period that begins immediately after the birth of the baby and extends
up to six weeks (42 days), is a critical time for women, newborn, partners, parents, caregivers and families
(World Health Organization [WHO],2022).
Postnatal exercise is the physical activities that are done in the postnatal period that is beneficial for the
mother. Postnatal exercise speeds up the recovery process and build valuable strength. The specific exercise
approach aims to improve the dynamic stability role of the local muscle in providing stiffness to the
segments of the spine and pelvic during functional posture and movements (Sreenivasan, 2017).
The major problems after pregnancy are fatigue, urinary incontinence, diastasis rectus abdominis, low back
pain, upper back pain, pubic pain, pelvic girdle pain and tiredness. The postnatal exercises plays an critical
role in improving maternal health. Various benefits of postnatal exercises include increased energy,
improved sense of well -being, decreased depression, weight reduction, increased lactation, and also
enhance the ability and capacity to perform physical activity regularly. The aerobic exercises are beneficial
to decrease the fatigue level and maximize the sleep quality. Aerobic and resistance training improve body
composition, lean body mass and decreases the risk of cardiovascular disease. Pelvic floor exercises are
used to strengthening of the muscles in conditions such as urinary incontinence. The strengthening of
transverse abdominis should be started since first trimester and should be continued after pregnancy to treat
diastasis rectus abdominis (Sekar et al. 2020).
A comparative survey conducted between urban and rural postnatal mothers on eight selected hospitals
(four urban and four rural) in Enugu, Nigeria among 351 mothers (200 urban and 151 rural women) revealed
that the Prevalence of non-practice of postnatal exercises was more among the rural women (79.5%) as
compared to urban women (54.5%). Insufficient information on postnatal exercises (urban = 85.3%; rural
= 94.2%) was the major barrier to postnatal exercise practice. Most of the women (urban-87.0%; rural–
94.7%) exercised for about 1-4 days per week, mainly based on self-prescription (urban-53.8%, rural54.8%). Majority(79.5%) of Nigerian postpartum mothers demonstrated poor practice of postnatal exercises
among rural women ( Petrolina et al., 2017).
1.2 Rationale of the Study
Postnatal period is the crucial for the mothers. During this period, the burden of maternal mortality and
morbidity remains unacceptably high, and opportunities to increase maternal well-being have not been fully
utilized. If the proper maternal care including postnatal exercise, is not performed then complications may
arise such as postpartum hemorrhage, postpartum depression, mortality and morbidity (WHO, 2022).
The study conducted on “knowledge, attitude and practice among postnatal mothers regarding postnatal
exercise in selected villages” Tamil Nadu among 73 women showed that 12.4% of the mothers had adequate
knowledge, 52% of mothers had moderate knowledge and 35.6% of mothers had inadequate knowledge. In
addition, 60.2% of mothers had negative attitude, 39.8% of mothers had undecided attitude and none of
mothers had positive attitude among postnatal exercise (Mageshwari, 2020).
The study on “knowledge and practice of postnatal exercises among postnatal mothers in selected hospital”
Pune, India among 60 mothers revealed that 15% of mothers had good knowledge, 60% of mothers had
average knowledge and 25% of mothers had poor knowledge (Mulay et al., 2016).
Postnatal exercise is crucial for the mother for preventing from different postnatal complications such as
postpartum infections, postpartum hemorrhage, postpartum depression, mortality and morbidity etc. which
directly or indirectly minimize the maternal mortality rate. As the research on postnatal exercise has not
been published yet in Nepal, it can be a baseline data for the future research as well as the previous review
of the studies showed the level of knowledge regarding the postnatal exercise among postnatal mothers is
poor and also the attitude towards the postnatal exercise is not so good (negative) that’s why researcher
have chosen this problem for the research.
1.3 Statement of the Study
Postnatal exercises are regarded as basic therapy, which may improve the health of puerperal but during
the clinical supervision period the researcher observed that not a single postnatal mother had done postnatal
exercises which is a vital part of post-natal care (Davidson et.al.,).
During pregnancy and the postnatal period many changes occur in a woman’s body, both in mental and
physical spheres. The birth of a child and a new role of a mother can sometimes be associated with numerous
negative emotions, uncertainty, fear, anxiety, disgust, depression, or sadness. In the puerperium period, the
development of baby blues or postpartum depression may occur. Postpartum depression develops within
one month of childbirth and may last up to one year. Depressive disorders that may develop in a young
mother affect both her and the newborn’s health (Bogucka & Bialli, 2019 )
The study conducted on knowledge and practice of pelvic floor muscle exercise in, Nigeria among 252
mother showed that majority (71.0%) of the women were taught about postnatal exercise but only 38.37%
practice the exercise. Major reasons by the respondents for noncompliance with the exercise routine
include, forgetting (40.4%), being too tired (35.9%), and being too busy (18.0%). Despite the relatively
high level of knowledge of postnatal exercise, level of practice was low (Okeke et al., 2020).
The total prevalence for practicing postnatal exercise among 139 Nigerian mothers was 79.0%. Exercise
frequency was mostly 1-2 times per week (40.8%). Exercise engagement based on self-prescription was
35.5% and nurse- prescription was 28.8%. The types of exercise practiced by respondents are, abdominal
exercise(16.5%), pelvic floor exercise(23.7%), muscle strengthening exercise(28.8%), Aerobic (43.5%)
and stretching (33.4%) were the most common type of physical exercise practiced by the respondents
(Emmanuel Mbada, 2015).
1.4 Significance of the Study
The findings of the study will be useful as the sources of baseline information for future researcher. The
findings of study will also be helpful to the health personnel, students and other concerned people of
different areas for planning and preparation of education regarding postnatal exercise. The data results from
this research study will serve as a reference value and can be used to collect the baseline information related
to the knowledge and attitude regarding postnatal exercise among postnatal mother.
1.5 Objectives of the study
General Objective
To assess knowledge and attitude about postnatal exercise among the postpartum mother.
Specific Objectives
To assess level of knowledge regarding postnatal exercise among postnatal mother.
To identify the level of attitude regarding postnatal exercise among postnatal mother.
To determine the association between level of knowledge regarding postnatal exercise among postnatal
mother and socio-demographic variables.
To determine the association between level of attitude regarding postnatal exercise among postnatal mother
and socio-demographic variables.
1.6 Research Question
What are the knowledge and attitude regarding postnatal exercise among postnatal mothers in Bharatpur
hospital?
1.7 Research Variables
Dependent Variable:
Knowledge and attitude regarding postnatal exercise among postnatal mothers.
Independent Variable
Sociodemographic Variables
Age
Religion
Ethnicity
Education
Occupation
Income
Type of family
province
Obstetric related Factor
No of Gravida
No of parity
Type of delivery
History of PNC visit
Source of information
Mass media
Health personnel
Friends\ Relatives
Others
1.8 Conceptual Framework
A conceptual framework is an analytical tool with several variations and contents. It is used to make
conceptual distinctions and organize ideas. This provides some insight about this research. In this
conceptual framework, the researcher is showing the relationship between the variables which provides the
prospective from which the researcher views the problems. Age, religion, ethnicity, education, occupation
income, type of family, Province, obstetric related Factor such as no of parity, no of child, type of delivery
and history of PNC visit are considered as the independent variables which affect the knowledge and
attitude regarding postnatal exercise among postnatal mother.
Sociodemographic
variables
Level of
Knowledge
Age
- Adequate
Religion
Ethnicity
Education
Occupation
Income
Type of family
Knowledge and
attitude regarding
postnatal exercise
among postnatal
mothers.
-
Moderate
-
Inadequate
Residence
Source of
information
Level of attitude
Obstetric Factor
- Positive
Gravida
- Negative
Parity
Type of delivery
History of PNC visit
Figure – 1: Conceptual framework
1.9 Operational Definition
Knowledge regarding postnatal exercise: - It refers to the information poses by its term of meaning, purpose,
advantages, contraindications, types (abdominal exercise, breathing exercise, pelvic floor exercise) of
postnatal exercise.
The level of knowledge will be measured by calculating the total score which will be classified into three
categories:
Adequate Knowledge= >75%
Moderate Knowledge = 51 – 75%
Inadequate Knowledge= ≤ 50%
(Mageshwari, 2020)
Attitude regarding postnatal exercise:- It refers to the general feeling or a expressed opinion of mothers
regarding postnatal exercise on meaning, purpose, advantages, types (abdominal exercise, pelvic floor
exercise, breathing exercise).
The level of attitude will be measured by calculating the total score which will be classified according to
mean into two categories:
Positive attitude = Mean (> 49.90)
Negative attitude = Mean (< 49.90)
CHAPTER II
REVIEW OF LITERATURE
2.1 Introduction of review literature
Literature Review is a process that involves findings regarding understanding and forming conclusion about
the published research and theory on a particular topic. Related research study and other related literatures
were review thoroughly to gain in depth knowledge into the study. The literature review can be carrying
out from books, journals, reports, newspaper, previous research and documents. The main purpose of
review of literature is to gain deeper knowledge about the study.
2.2 Review Of Literature
Majeed (2022) The study “Knowledge, Attitude and Practice among Women Regarding Postnatal
Exercises” Lahore among 120 participants shows, 44.2 % believed that PNE exercises should start
immediately after childbirth, 52.5% start after 2 weeks of childbirth, 2.5% believe that PNE should start
after 1 months while only 0.8% start after 6 months. In addition, 65% needed once a day, 17.5 % think it is
needed once a week ,17.5% needed 4-5 days a week. Meanwhile, 74.2% of the participants think that
postnatal exercises are beneficial for preventing uterine prolapse, 13.3% believed that urinary incontinence
can be prevented, 9.2% believe that it can prevent diastasis recti, 3.3% believes it is beneficial for preventing
bowel incontinence. Uniformly, 80.8%, 15% and 4.2% believed that weight gain, back pain and postpartum
depression was the most prevalent disadvantages of omitting PNE.
Sarkar et al(2014) half of the mothers (52%) had moderately adequate knowledge, 28% mothers had
inadequate knowledge and lowest (20%) mothers had adequate knowledge regarding postnatal exercises.
Similarly, 53% mothers had moderately adequate practice of postnatal exercises and 47% of mothers had
inadequate practice of postnatal exercises. Significant association between knowledge score with education
and occupation of mothers; and between practice score with age, parity, education, occupation of mothers
and source of information on postnatal exercises were observed.
Sundaramurthy (2020) total 58.8% of this study participants revealed health care professions were the
commonest source of information. More than half of them had adequate knowledge but still many were not
aware of full benefits of PNE as only 3-5% aware of other benefits like prevention of urinary incontinence.
98.8% of the women’s felt PNE is essential and 62.5% felt household work hinder them doing. 92.5% said
they will emphasize the importance of PNE to others. No significant correlation found between sociodemographic characters and knowledge, attitude and practice of PNE.
2.3 Summary of Review Literature
After reviewing of literature it can be concluded that some country or state mothers had moderate level of
knowledge and attitude regarding postnatal exercise . There are various factor including sociodemographic
characteristics like age, educational status, income, occupation, religion, ethnicity, source of information
are associated with knowledge and attitude regarding postnatal exercise among postnatal mother.
CHAPTER III
RESEARCH METHODOLOGY
Research methodology refers to the sequential arrangement of the steps involve during the research work.
The section describes the research design, study population, sample size, sampling technique, sampling
procedure, tool for data collection, validation of the tool, plan for data collection and method of data analysis
and interpretation.
3.1 Research Design:
A descriptive (cross-sectional) analytical study design was used to assess the knowledge and attitude
regarding postnatal exercise among postnatal mother.
3.2 Study Setting / Area:
The study was conducted in the PNC ward of Bharatpur Hospital. In the PNC ward all the mothers after
delivery is admitted for a day, I choose so that i can meet my study population there.
3.3 Study Population
The population for this study was postnatal mother The population for this study was the postnatal mother
who have delivered the baby up to six weeks, having both normal delivery and caesarian section .
3.4 Sample Technique
Non probability purposive sampling technique was used for this research study.
3.5 Sample Size
The sample size was calculated based on prevalence 18%
Sample size(n) =
𝑍𝛼 2 pq
𝑒2
Here, Za = 1.96
Error(e) = 0.5% = 0.05%
Prevalence (p) = 18% =0.18
q = (1-p) = (1-0.18) = 0.82
By using the formula, the sample size is calculated as,
Sample Size(n) =
𝑍𝑎 2 pq
𝑒2
=
(1.96)2 ×0.18× 0.82
52
=
3.8416×0.18 ×0.82
0.052
=
0.56702016
0.0025
= 226
Adding 10% non-response rate = 226+23 = 249
Required sample size will be 249
3.6 Selection Criteria
Inclusion Criteria
Postnatal mother who has delivered the baby in Bharatpur hospital was included.
Exclusion Criteria
Mother who are pregnant and does not have baby was excluded or provide the consent will be excluded.
3.7 Data collection Tool\ Instrumentation
A semi structured interview schedule was developed to collect the data for research study. Research
instruments consist of three parts:
Part I: Question related to socio – demographic information
Part II: Question related to knowledge regarding postnatal exercise
Part III: Attitude scale (Likert scale to assess the attitude regarding postnatal exercise)
3.8 Validity and Reliability
The content validity of instrument was maintained on the basis of literature review, consulting with research
advisor, research expertise and subject experts. The tool was translated from English to Nepali language
and the questions was back translated into English language.
Reliability of instruments was tested by pretesting the instrument among 10% of the study population who
meet the similar criteria from same setting. Necessary modification was done.
3.9 Ethical Consideration
Administrative approval was taken from Shree Medical and Technical College (SMTC) and ethical
approval was obtained from Institute Review Committee of Shree Medical and Technical College (IRC –
SMTC). Approval was taken from the concerned authority of Bharatpur hospital. Written consent was
obtained from each respondent. Respondent was explained about the goal and objectives of the study in the
clear and understandable term, they were assured that information will be kept confidential and inform that
they can withdrawal at any time if they wish.
3.10 Data Collection Procedure
Formal permission for the study was taken from concern authority after submitting request from college.
The data was collected through face-to-face interview among the mothers who are admitted in PNC ward
of Bharatpur hospital. The researcher herself collected the data. Objective of the study was clearly stated.
Interview was taken around 10-15 minutes for each respondent. In one day 25 to 30 respondents was taken
for the interview. The researcher made every possible attempt to reduce bias in data collection.
3.11 Data Analysis Procedure
The collected data was checked, reviewed, organized for the accuracy and completeness. Then all collected
data was entered in MS Excel, analyzed by Statistical Package for Social Science (SPPS) version20 and
interpreted by using descriptive statistical methods in term of frequency, mean, percentage. Inferential
statistics by chi square test was used to measure the association. After that conclusion of the data was
presented in tables.
CHAPTER IV
DATA ANALYSIS AND INTERPRETATION OF DATA
The chapter deals with the analysis and interpretation of data regarding knowledge and practice
regarding prevention of puerperal sepsis among postnatal mother attending Bharatpur Hospital.
270 respondents were included in the study. All the data obtained were analyzed and interpreted
based on research objectives and are presented in different tables.
Table-1 shows Respondents' Socio-Demographic Characteristics (Age group, Religion, Ethnicity,
Province, Education, Level of education. Table-2 shows Respondents' Socio-Demographic
information (Occupation, family monthly income and type of family) Table-3 shows Respondents'
Socio-Demographic information (number of pregnancies, number of childbirths, Mode of
delivery, PNC visit). Table-4 shows Respondents' Sources of Information. Table-5 shows
Respondents' knowledge regarding postnatal exercise among postnatal mothers. Table-6 shows
Multiple response of Respondent's knowledge regarding postnatal exercise among postnatal
mothers. Table-7 shows Level of knowledge regarding postnatal exercise among postnatal mothers
Table-8 shows Respondents attitude regarding postnatal exercise. Table-9 Level of Attitude
regarding postnatal exercise among postnatal mothers. Table 10 shows Association between level
of knowledge regarding postnatal exercise and socio-demographic characteristics. Table-11 shows
Association between level of knowledge regarding postnatal exercise and socio-demographic
variables. Table-12 shows Association between level of knowledge regarding postnatal exercise
and socio-demographic variables. Table-13 shows Association between level of attitude regarding
postnatal exercise and socio-demographic variables. Table-14 shows Association between level of
attitude regarding postnatal exercise and socio-demographic variables. Table 15 shows
Association between level of attitude regarding postnatal exercise and socio-demographic
variables.
TABLE 1
Respondents’ Socio-Demographic Information Regarding Postnatal Exercise (Age,
Religion, Ethnicity, Province, Education, Educational level)
n= 249
Variables
Age (Years)
15-25
25-35
35-45
Mean ± S.D
Min
Max
Religion
Hinduism
Buddhism
Christian
Islam
Ethnicity
Dalit
Janajati
Madhesi
Muslim
Brahmin/Chhetri
Province
Province 1
Province 2
Province 3
Province 4
Province 6
Province 7
Education
Literate
Illiterate
If literate (n= 242)
General literate
Primary level
Secondary level
Bachelor and above
Frequency
Percentage
126
117
6
25.57 ± 4.821
16
41
50.6
47
2.4
196
28
20
5
78.7
11.2
8
2
33
111
8
4
93
13.3
44.6
3.2
1.6
37.3
2
17
163
64
2
1
8
6.8
65.5
25.7
0.8
0.4
242
7
97.2
2.8
54
43
98
47
22.33
17.76
40.49
19.42
Table 1: show respondents’ socio-demographic characteristics of respondents. Out of 249
respondents regarding age majority 50.6% respondents belongs to age group of (15-25) years and
least 2.4% respondents belong to (35-45) years of age group. Mean value and SD of age were
25.57±4.821. Regarding religion majority of respondents were Hinduism 78.7% by religion and
least 2% belongs to Islam. Regarding ethnicity, majority of respondent 44.6% belongs to Janajati
and least were Muslim. Regarding province majority 65.5% respondents were from province 3
whereas, the least 0.4% were from province 7. Regarding education of respondent’s majority
97.2% were literate and minority 2.8% were illiterate. Similarly, as for literate respondent’s
educational level covers 22.33% for general literate, bachelor and above is 19.42%. Highest
40.49% for secondary level while lowest 17.76% for primary level.
TABLE 2
Respondents’ Socio-Demographic Information Regarding Postnatal Exercise (Occupation,
Income, Type of family)
(n=249)
Variables
Frequency
Percentage
Occupation
Homemaker
Business
Student
Service holder
Agriculture
129
22
12
43
43
51.8
8.8
4.8
17.3
17.3
Family monthly income
10000-50000
50000-100000
Above 100000
Mean ± S.D
Min
Max
181
59
9
47032.13± 32360.60
10000
200000
72.7
23.7
3.6
Type of family
Nuclear family
Joint family
Extended family
103
130
16
41.4
52.2
6.4
Table 2: show respondent’s socio-demographic characteristics of respondents. Regarding
occupation majority 51.8% were homemaker whereas minority 4.8% were involved in business.
Highlighting the income of the respondents, highest 72.7% was in the range of ten thousand- fifty
thousand while lowest 3.6% above one lakh. Concerning with type of family greater 52.2% were
from joint family whereas least 6.4% were extended family.
TABLE 3
Respondents’ Socio-Demographic Information Regarding Postnatal Exercise (Number of
pregnancies, Number of childbirths, Mode of delivery, PNC visit)
(n=249)
Variables
Number of pregnancies
Primigravida
Multigravida
Number of childbirths
One child
Two children
More than two children
Mode of delivery
Caesarian section
Spontaneous vaginal delivery
Episiotomy
Vacuum or instrumental delivery
PNC visit (if multiparous n=101)
No
Yes
Frequency
Percentage
148
101
59.4
40.6
155
80
14
62.2
32.1
5.7
63
123
55
8
25.3
49.4
22.1
3.2
61
40
60.40
39.60
Table 3: shows respondents Obstetrical information regarding postnatal exercise. With regards to
number of pregnancies most of the mothers 59.4% were primigravida whereas 40.6% of mothers
were multigravida. Regarding number of childbirths 62.2% had one child while 5.7% mothers had
more than two children. In contest of mode of delivery highest 49.4% of mothers had spontaneous
vaginal delivery while 3.2% of mothers had vacuum or instrumental delivery. Regarding PNC visit
majority 60.40% of mothers had not gone for PNC visit while least 39.60% of mothers had gone
for PNC visit.
TABLE 4
Respondents’ Sources of information
(n=249)
Variables
Source of information
Mass media
Health professional
Friends/relatives
Newspaper
Frequency
Percentage
45
194
46
10
18.1
77.9
18.5
4
Table 4: Respondents’ Socio-demographic information regarding Postnatal Exercise. With respect
to sources of information, most of the respondents 77.9% had got information through health
professional and least of them 4% had got information from newspaper.
TABLE 5
Respondents’ Knowledge Regarding Postnatal Exercise
n=249
Knowledge items
Meaning of Postnatal exercise
Consideration to start postnatal
exercise
Immediate exercise after delivery
Perfect time to exercise in vaginal
delivery
Ideal time to exercise in CS
Intensity for postnatal exercise
Ideal time of the day for exercise
Ideal duration to exercise
Frequency to do exercise
Common exercise done during PNC
period
Exercise that prevents pelvic organ
prolapse
Procedure to pelvic floor exercise
performed
Times at least Pelvic floor exercise
done
Exercise to reduce cardio risk in
mother
Postnatal exercise needs to be avoided
If moderate intensity done beyond
required duration
Condition to hold PNC exercise
Precautions taken during PNC
exercise
Correct answer
Exercise done from delivery to 6
weeks
Frequency Percentage
100
40.2
Mode of delivery
gentle exercise (such as walking)
196
231
78.7
92.8
Immediately after childbirth
Within one week
Mild to moderate
Morning
20-30min/day
daily
106
217
215
217
97
159
42.6
87.1
86.3
87.1
39
63.9
Pelvic floor exercise
95
38.2
Pelvic floor exercise
Squeeze, hold and relieve perineal
muscle
187
75.1
122
49
10-15 times
68
27.3
Aerobics exercise
Sits up and crunches
81
62
32.5
24.9
Hypoglycemia
Heavy vaginal bleeding
58
142
23.3
57
Avoid exercising in high humidity
140
56.2
Table 5 shows respondents’ knowledge regarding postnatal exercise. Out of 249 respondents 40.2%
answered Exercise done from delivery to 6 weeks. Regarding the consideration 78.7% of respondents knew
the consideration before starting postnatal exercise. Regarding Immediate exercise after delivery 92.8%
knew exercise done Immediate after delivery. With respect to Perfect time to exercise in vaginal delivery
42.6% recognize the perfect time to start postnatal exercise in vaginal delivery and 87.1% respondent
perceive the ideal time to exercise in caesarian section. However, 86.3% of the respondent had knowledge
on Intensity followed for postnatal exercise. Regarding Ideal time of the day for exercise 87.1% recognize
the Ideal time of the day for exercise. Similarly, 39%, 63.9%, 38.2% respondent knew the Ideal duration to
exercise, how frequently exercise done, Common exercise done during PNC period. Likewise, 75.1% knew
exercise that prevents pelvic organ prolapse, 49% knew how pelvic floor exercise is performed, 27.3%
knew the times at least Pelvic floor exercise is performed. Uniformly, 32.5% knew exercise to reduce cardio
risk in mother, 24.9% knew the postnatal exercise must be avoided, 23.3% knew what happen if moderate
intensity done beyond required duration and 57% knew the condition to hold postnatal exercise. Lastly,
56.2% knew the Precautions taken during postnatal exercise.
TABLE 6
Respondents’ Knowledge Regarding Postnatal Exercise
n=249
Knowledge items (Multiple Response)
Frequency
Percentage
To prevent postnatal depression
101
40.6
Prevent urinary incontinence
71
28.5
Improves muscle strength
Helps to revert back organ in prepregnant stage
Increase lactation
135
54.2
165
66.3
27
10.8
Improve sense of well-being
49
19.7
Abdominal exercise
184
73.9
Pelvic floor exercise
106
42.6
Breathing exercise
74
29.7
Stretching exercise
25
10
Aerobics exercise
66
26.5
Purpose of postnatal exercise
Types of postnatal exercise
Table 7 shows the respondent’s knowledge regarding postnatal exercise. In regarding to purpose
of postnatal exercise, 40.6% answer to prevent postnatal depression, 28.5% answer prevent urinary
incontinence, 54.2% answer improves muscle strength, 66.3% answer helps to revert back organ
in pre-pregnant stage, 10.8% answer increase lactation and 19.7% answer improve sense of wellbeing. On the other hand, regarding, types of postnatal exercise, 73.9% perceive abdominal
exercise, 42.6% perceive pelvic floor exercise, 29.7% perceive breathing exercise, 10% perceive
stretching exercise, 26.5% perceive aerobics exercise.
TABLE 7
Respondents’ Knowledge Regarding Postnatal Exercise
n=249
Level of knowledge
Frequency
Percentage
Adequate knowledge (above75%)
4
1.6
Moderate knowledge (50-75%)
91
36.5
Inadequate knowledge (below 50%)
154
61.9
Total
249
100%
Table 7 shows level of knowledge regarding postnatal exercise. Out of 249 respondents, 4(1.6%)
had adequate knowledge, 91(36.5%) had moderate knowledge and 154(61.8%) had inadequate
knowledge.
Table 8
Respondents’ Attitude Regarding Postnatal Exercise
n= 249
Strongly
Attitude items
Agree
Postnatal exercise is practiced soon
after delivery with simple exercise and
gradually progress.
158(63.5)
Postnatal exercise mostly promotes
quick postnatal recovery, posture and
prevents excess weight gain.
89(35.7)
Aerobic postnatal exercise decreases
the risk of cardiovascular disease.
45(18.1)
Superstition and customs in society
prohibit women from practicing
postnatal exercise.
46(18.5)
While performing postnatal exercise,
exercising in high humidity should be
avoided
51(20.5)
Pelvic floor exercise means squeezing
holding and relieving perineal muscles 57(22.9)
Type of pregnancy and mode of
delivery should be considered while
starting postnatal exercise.
83(33.3)
Swimming and cycling are not a type
of postnatal exercise.
70(28.1)
Household works are better than
postnatal exercise to prevent pelvic
organ prolapse.
39(15.7)
Women with heavy bleeding during
postpartum period also can perform
postnatal exercise.
39(15.7)
Women with vertigo also can perform
postnatal exercise.
41(16.5)
Postnatal exercise is not helpful in
preventing postnatal depression.
28(11.2)
Postnatal
exercise
should
be
performed occasionally.
29(11.6)
Postnatal exercise is suitable to
perform at night
16(6.4)
Agree
Undecided Disagree
Strongly
Disagree
78(31.3)
1(0.4)
7(2.8)
5(2)
99(39.8)
26(10.4)
29(11.6)
6(2.4)
147(59.0)
31(12.4)
22(8.8)
4(1.6)
103(41.4)
34(13.7)
46(18.5)
20(8.0)
152(61.0)
24(9.6)
17(6.8)
5(2.0)
86(34.5)
86(34.5)
16(6.4)
4(1.6)
127(51.0)
22(8.8)
12(4.8)
5(2.0)
62(24.9)
74(29.7)
29(11.6)
14(5.6)
49(18.5)
28(11.2)
115(46.2)
21(8.4)
44(17.7)
22(8.8)
68(27.3)
76(30.5)
45(18.1)
25(10.0)
55(22.1)
83(33.3)
59(23.7)
29(11.6)
97(39.0)
36(14.5)
55(22.1)
29(11.6)
110(44.2)
26(10.4)
30(12.0)
24(9.6)
103(41.4)
76(30.5)
Table 8 shows the respondent attitude regarding postnatal exercise, out of 249 respondents’
majority 63.5% were strongly agree and minority 0.4% were undecided with the statement
“Postnatal exercise is practiced soon after delivery with simple exercise and gradually progress”.
Regarding the statement “Postnatal exercise mostly promotes quick postnatal recovery, posture
and prevents excess weight gain” highest 39.8% were agree and lowest 2.4% were strongly
disagree. Similarly, 59% were agree while 1.6% were strongly disagree with the statement
“Aerobic postnatal exercise decreases the risk of cardiovascular disease”. Highlighting the
statement “Superstition and customs in society prohibit women from practicing postnatal
exercise”, 41.4% were agree and 8% were strongly disagree. Covering the statement “While
performing postnatal exercise, exercising in high humidity should be avoided” 61.0% were agree
whereas 6.8% were disagree. Likewise, 34.5% were agree and 6.4% were disagree in the statement
“Pelvic floor exercise means squeezing holding and relieving perineal muscles”. Uniformly in the
statement “Type of pregnancy and mode of delivery should be considered while starting postnatal
exercise” 33.3% were strongly agree, 51% were agree, 22% were undecided, 4.8% were disagree
and 2% were strongly disagree. Majority 29.7% were undecided and minority 5.6% were strongly
disagree with the statement “Swimming and cycling are not a type of postnatal exercise.”.
Regarding the statement “Household works are better than postnatal exercise to prevent pelvic
organ prolapse” 46.2% were disagree and 15.7% were strongly agree. Similarly, 30.5% were
strongly disagree while 8.8% were undecided with the statement “Women with heavy bleeding
during postpartum period also can perform postnatal exercise.”. Highlighting the statement
“Women with vertigo also can perform postnatal exercise”, 33.3% were strongly disagree and
10.5% were strongly agree. Covering the statement “Postnatal exercise is not helpful in preventing
postnatal depression.” 39.0% were disagree whereas 11.2% were agree. Likewise, 44.2% were
disagree and 11.6% were strongly agree in the statement “Postnatal exercise should be performed
occasionally.”. Uniformly in the statement “Postnatal exercise is suitable to perform at night” 6.4%
were strongly agree, 12.0% were agree, 9.6% were undecided, 41.4% were disagree and 30.5%
were strongly disagree.
TABLE 9
Respondents’ Attitude Regarding Postnatal Exercise
n=249
Level of attitude
Frequency
Percentage
Positive attitude (> Mean)
128
51.4
Negative attitude (< Mean)
121
48.6
249
100%
Total
Note- Mean value (49.90)
Table 9 shows level of attitude regarding postnatal exercise. Out of 249 respondents, majority
128(51.4) had positive attitude, minority 121(48.6) had negative attitude.
TABLE 10
Association Between Level of Knowledge regarding postnatal exercise and Sociodemographic Variables
n=249
Level of Knowledge
Variables
Adequate
Age
15-25
2(1.6)
25-35
2(1.7)
35-45
0(0.0)
Religion
Hinduism
1(0.5)
Buddhism
3(10.7)
Christian
0(0.0)
Islam
0(0.0)
Ethnicity
Dalit
1(3.0)
Janajati
3(2.7)
Madhesi
0(0.0)
Muslim
0(0.0)
Brahmin/Chhetri
0(0.0)
Province
Province 1
0(0.0)
Province 2
1(5.9)
Province 3
3(1.8)
Province 4
0(0.0)
Province 6
0(0.0)
Province 7
0(0.0)
Note- Likelihood ratio
chisquare
Moderate
Inadequate
p-value
46(36.5)
44(37.6)
1(16.7)
78(61.9)
71(60.7)
5(83.3)
1.481
0.83*
74(37.8)
12(42.9)
2(10.0)
3(60.0)
121(61.7)
13(46.4)
18(90.0)
2(40.0)
19.387
0.004*
11(33.3)
35(31.5)
2(25.0)
2(50.0)
41(44.1)
21(63.6)
73(65.8)
6(75.0)
2(50.0)
52(55.9)
8.291
0.406*
1(50.0)
5(29.4)
68(41.7)
15(23.4)
1(50.0)
1(100.0)
1(50.0)
11(64.7)
92(56.4)
49(76.6)
1(50.0)
0(0.0)
13.411
0.202*
Table 10 shows association between levels of knowledge regarding postnatal exercise and sociodemographic variables. There was significant association between level of knowledge regarding
postnatal exercise with religion (p= 0.004*).
TABLE 11
Association Between Knowledge regarding postnatal exercise and Socio-demographic
Variables
n=249
Level of Knowledge
Variables
Education
Literate
Illiterate
If literate
General literate
Primary level
Secondary level
Bachelor and above
Occupation
Homemaker
Business
Student
Service holder
Agriculture
Family monthly
income(Nrs)
10000-50000
50000-100000
Above 100000
Type of family
Nuclear family
Joint family
Extended family
Note- Likelihood ratio*
Chisquare
Adequate
Moderate
Inadequate
p-value
4(1.7)
0(0.0)
89(36.8)
2(28.6)
149(61.6)
5(71.4)
0.465
0.792*
0(0.0)
0(0.0)
3(3.1)
1(2.1)
22(40.7)
15(34.9
31(31.6)
21(44.7)
32(59.3)
28(65.1)
64(65.3)
25(53.2)
7.334
0.501*
2(1.6)
0(0.0.)
1(2.3)
1(2.3)
0(0.0)
47(36.4)
10(45.5)
8(66.7)
18(41.9)
8(18.6)
80(62.0)
12(54.5)
3(25.0)
24(55.8)
35(81.4)
17.95
0.022*
4(2.2)
0(0.0)
0(0.0)
66(36.5)
19(32.2)
6(66.7)
111(61.3)
40(67.8)
3(33.3)
6.42
0.17*
2(1.9)
1(0.8)
1(6.3)
46(44.7)
44(33.8)
1(6.3)
55(53.4)
85(65.4)
14(87.5)
13.175
0.01*
Table 11 shows association between levels of knowledge regarding postnatal exercise and sociodemographic variables. There was significant association between level of knowledge regarding
postnatal exercise and occupation (p=0.022*) and type of family (p=0.01*) of the postnatal
mothers.
TABLE 12
Association Between Level of Knowledge regarding postnatal exercise and Sociodemographic Variables
n=249
Level of Knowledge
Variables
Adequate
Moderate
Inadequate
Primigravida
3(2.0)
55(37.2)
90(60.8)
Multigravida
1(0.0)
36(35.6)
64(63.4)
One child
3(1.9)
56(36.1)
96(61.9)
Two children
1(1.3)
28(35.0)
51(63.8)
More than two children
0(0.0)
7(50.0)
7(50.0)
Caesarian section
Spontaneous vaginal
delivery
Episiotomy
Vacuum or instrumental
delivery
PNC visit (if multiparous)
1(1.6)
22(34.9)
40(63.5)
2(1.6)
46(37.4)
75(61.0)
1(1.8)
22(40.0)
32(58.2)
0(0.0)
1(12.5)
7(87.5)
No
4(1.9)
76(36.4)
129(61.7)
Yes
0(0.0)
15(37.5)
25(62.5)
chisquare
p-value
Number of pregnancies
0.529
0.768*
1.685
0.793*
3.136
0.792*
1.416
0.493*
Number of childbirths
Mode of delivery
Note- Likelihood ratio*
Table 12 shows association between levels of knowledge regarding postnatal exercise and sociodemographic(obstetric) variables. There were no any association between level of knowledge and
any socio-demographic variables.
TABLE 13
Association Between Level of Attitude regarding postnatal exercise and Socio-demographic
Variables
n=249
Variables
Level of Attitude
Positive
Negative
Attitude
Attitude
Age
15-25
69(54.8)
25-35
58(49.6)
35-45
1(16.7)
Religion
Hinduism
100(51.0)
Buddhism
16(57.1)
Christian
9(45.0)
Islam
3(60.0)
Ethnicity
Dalit
18(54.5)
Janajati
60(54.1
Madhesi
4(50.0)
Muslim
2(50.0)
Brahmin/Chhetri
44(47.3)
Province
Province 1
1(50.0)
Province 2
9(52.9)
Province 3
84(51.5)
Province 4
34(53.1)
Province 6
0(0.0)
Province 7
0(0.0)
Note- Likelihood ratio*
Chi- square
p-value
57(45.2)
59(50.4)
5(83.3)
3.867
0.145*
96(49.0)
12(42.9)
11(55.0)
2(40.0)
0.86
0.835*
15(45.5)
51(45.9)
4(50)
2(50)
49(52.7)
1.076
0.898*
1(50.0)
8(47.1)
79(48.5)
30(46.9)
2(100.0)
1(100.0)
4.424
0.49*
Table 13 shows association between levels of attitude regarding postnatal exercise and sociodemographic variables. There were no association between level of attitude regarding postnatal
exercise and any socio-demographic variables.
TABLE 14
Association Between Level of Attitude regarding postnatal exercise and Socio-demographic
Variables
n=249
Variables
Education
Literate
Illiterate
If literate
General literate
Primary level
Secondary level
Bachelor and above
Occupation
Homemaker
Business
Student
Service holder
Agriculture
Family monthly
income
10000-50000
50000-100000
Above 100000
Type of family
Nuclear family
Joint family
Extended family
Level of Attitude
Positive
Negative
Attitude
Attitude
Chi- square
p-value
125(51.7)
3(42.9)
117(48.3)
4(57.1)
0.211a
0.716***
28(51.9)
20(46.5)
52(53.1)
25(53.2)
26(48.1)
23(53.5)
46(46.9)
22(46.8)
0.789
0.94*
66(51.2)
15(68.2)
2(16.7)
22(51.2)
23(53.5)
63(48.8)
7(31.8)
10(83.3)
21(48.8)
20(46.5)
8.355a
0.079**
87(48.1)
34(57.6)
7(77.8)
94(51.9)
25(42.4)
2(22.2)
4.394
0.111*
54(52.4)
66(50.8)
49(47.6)
64(49.2)
8(50.0)
8(50.0)
0.077a
0.962**
Note- Likelihood ratio-*, Pearson Chi-square- **, Fisher’s Exact Test-***
Table 14 shows association between levels of attitude regarding postnatal exercise and sociodemographic variables. There were no association between level of attitude regarding postnatal
exercise and any socio-demographic variables.
TABLE 15
Association Between Level of Attitude regarding postnatal exercise and Socio-demographic
Variables
n=249
Variables
Level of Attitude
Positive
Negative
Attitude
Attitude
Number of
pregnancies
Primigravida
74(50.0)
74(50.0)
Multigravida
54(53.5)
47(46.5)
Number of
childbirths
One child
79(51.0)
76(49.0)
Two children
More than two
children
Mode of delivery
37(46.3)
43(53.8)
12(85.7)
2(14.3)
Caesarian section
Spontaneous vaginal
delivery
Episiotomy
Vacuum or
instrumental delivery
PNC visit (if
multiparous)
No
30(47.6)
33(52.4)
58(47.2)
65(52.8)
37(67.3)
18(32.7)
3(37.5)
5(62.5)
30(49.18)
31(50.82)
22(57)
18(43)
Yes
Chi- square
p-value
0.289a
0.591**
7.460a
0.024**
7.551
0.056*
0.709a
0.400**
Note- Likelihood ratio-*, Pearson Chi-square- **, Fisher’s Exact Test-***
Table 15 shows association between levels of attitude regarding postnatal exercise and sociodemographic variables. There were association between level of attitude regarding postnatal
exercise and number of childbirths.
CHAPTER V
DISCUSSION, CONCLUSION AND RECOMMENDATION
This chapter deals with the discussion, conclusion and recommendations based on the findings of
the study. Discussion presents all the findings of the study in comparison to those studies from the
review of literature. Conclusions are drawn from each of findings in lights of limitations of the
study. Recommendation present suggestions for future study to improve the current study for better
generalization present suggestion for further study to improve the current study for better
generalization and deeper interpretation.
5.1 Discussion
The major findings of the study are discussed in this chapter with comparison of findings of the
relevant studies survey reports and other documented literature. Knowledge and attitude regarding
postnatal exercise among postnatal mothers were assessed in 249 mothers.
5.1.1 Findings related to socio-demographic and Obstetric Variables
Present study shows the socio-demographic characteristics, Majority 50.6% respondents belongs
to age groups of 15-25 years with Mean value and standard deviation as 25.57±4.821. which is
inconsistent than the study conducted by Kaur et.al, (2020) which revealed that majority (44%)
belongs to age group of 25 to 31 years.
It notices that majority of respondents were Hinduism 78.7% which is similar to the study
conducted by Sundaramurthy et.al. (2020) which revealed that 82.5% belong to Hinduism.
Similarly, majority of respondents 65.5% were from province 3 and this finding is contrast from
the study conducted by Sahu & dash (2019) which revealed that minority (15%) of mothers living
in rural area.
Study shows that majority of the respondents 97.2% were literate and 40.49% received secondary
level of education which is contrast from the study by Kaur et.al (2020) revealed that (32%) of
mother’s education had secondary educational level.
It observed that majority of respondents 51.8% were homemaker, this finding is opposite from the
study conducted by Mbada et.al. (2015) which revealed that (13.1%) were homemaker.
Majority 72.7% of the respondent’s family monthly income was ten thousand-fifty thousand which
is contrast from the study by Sahu& dash (2019) which revealed that (40%) had income more than
ten thousand.
It spots that majority of respondents 52.2% were belonged to joint family which is incongruity
from study by Sundaramurthy et.al. (2020) which revealed that minority (16.2%) belongs to joint
family.
It depicts that 59.4% respondents were primigravida that is similar to the study by Sahu& dash
(2019) which revealed that (75%) were primigravida. Majority 62.2% had one child which is
opposite to the study (45.5%) by Mbada et.al. (2015).
It observed that majority of respondents 49.4% had spontaneous vaginal delivery and among
multiparous mothers and this finding is supported by the study conducted by Mbada et.al., (2015)
which revealed that (92.6%) had spontaneous vaginal delivery.
5.1.2 Findings related to Knowledge regarding postnatal exercise among postnatal mothers
Concerning knowledge regarding postnatal exercise, in current study 40.2% answered exercise
done from delivery to 6 weeks and this finding is inconsistent with the study conducted by Kaur
et.al., (2020) which revealed that (18%) had answered meaning of postnatal exercise.
This study revealed majority 66.3% answered helps to revert back organ to its prepregnant stage,
regarding purpose of postnatal exercise which is supported by the study conducted by Mbada et.al.,
(2015) which revealed that (66.6%) answered the correct answer.
This study revealed majority 73.9% answered abdominal exercise, regarding types of postnatal
exercise which is inconsistent to the study conducted by Mbada et.al., (2015) which revealed that
(25.6%) answered the correct answer.
This study revealed 92.8% of respondents answered immediate after delivery which is contrast to
the study conducted by Sundaramurthy et.al., (2020) which revealed that (55%) answered the
correct answer.
This study revealed that 63.9% recognize correct answer daily, regarding frequency of exercise
which is supported by the study conducted by Sundaramurthy et.al., (2020) which revealed that
(66.3%) answered the correct answer.
This study revealed that 75.1% knew exercise that prevents pelvic organ prolapse which is
supported by the study done by Majeed et.al (2020) that revealed 74.2% respondents answer the
correct answer i.e., pelvic floor exercise.
This study revealed that 57% answered the correct answer heavy vaginal bleeding for question i.e.
Condition to hold the postnatal exercise and this finding is contrast from the study conducted by
Mbada et.al., (2015) which revealed that (11.5%) answered the correct answer.
5.1.3 Attitude regarding postnatal exercise among postnatal mothers
In this study, most of the respondents 51.4% had positive attitude. This findings is supported by
the study conducted by the Alharqi and Albattawi (2018) which revealed that 52% had positive
attitude regarding postnatal exercise.
In is observed that, 63.5% respondents agreed that postnatal exercise is practiced soon after
delivery with simple exercise and gradually progress which is nearly inconsistent to the study
conducted by Alharqi and Albattawi (2018) which revealed that 98.8% agreed to the statement.
In this study it showed that, 39.8% agreed that postnatal exercise mostly promotes quick postnatal
recovery, posture and prevents excess weight gain. This finding is inconsistent to the study
conducted by the Mbada et.al., (2015) which revealed that 66.6% agreed to the statement.
In this study, 28.1% agreed that swimming and cycling are the types of postnatal exercise which
is comparable with the study (23.3%) Alharqi and Albattawi (2018).
It is observed that, 46.2% disagreed that household works are better than postnatal exercise to
prevent pelvic organ prolapse which is supported by the study (56%) Ashok & Mohammed (2019).
In this study 30.5% disagreed that women with vertigo also can perform postnatal exercise which
is contrast from the study (93%) conducted by the Alharqi and Albattawi (2018).
In the current study, 39.0% disagreed that postnatal exercise is not helpful in preventing postnatal
depression which is contrast from the study (87.5%) done by Sundaramurthy et.al., (2020).
In this study, 41.4% disagreed that postnatal exercise should be performed occasionally which is
contrast from the study (82.5%) conducted by the Majeed et.al (2020).
5.2 Conclusion
The study was conducted for the purpose of determining knowledge and attitude, Association
between socio-demographic characteristic with level of knowledge and attitude regarding
postnatal exercise among postnatal mothers in Bharatpur hospital. Based on the finding and
interpretation of the study, conclusion has been drawn. This study found that less than one-tenth
(1.6%) of respondents had adequate knowledge, and more than two quartiles (61.9%) of them had
inadequate knowledge. Similarly, around third quartile (51.4%) of respondents had positive
attitude while, more than two-fifth (48.6%) of respondents had negative attitude. There was
significant association between level of knowledge regarding postnatal exercise with religion,
occupation and type of family. Likewise, there was significant association between level of attitude
regarding postnatal exercise with number of childbirths.
5.3Limitation
This study was carried out only one setting i.e., Bharatpur hospital, Chitwan. So, it can't be
generalized to other setting.
5.4 Recommendation
Since, this study has covered only a small sample, a large-scale study can be done to generalize
the study findings to different settings. Postnatal exercise guidelines can be introduced to the
women from Antenatal Period which can be further used during their postnatal period. The rising
of awareness regarding Postnatal exercise among postnatal women at large is highly recommended
to improve the quality of life of postnatal mothers. The Obstetric nurse could play a vital role and
implement as health educator, Counselor, coordinator, and supervisor to help postnatal mother to
improve their knowledge and attitude regarding postnatal exercise.
5.5 Disseminating the Research Findings
The final report of the study was submitted to self, College library, advisor and data collection
area.
References
World Health Organization, (2022): WHO recommendations on maternal and newborn care for a positive
post- natal experience, available at: https://www.who.int/publications/i/item/9789240045989
Sreenivasan, A. (2017). study to assess the knowledge, practice and attitude of postnatal mother regarding
postnatal exercise in government headquarters hospital, Kumbakonam Asha Sreenivasan. International
Journal of Advanced Scientific Research, 2(4), 32-35.
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Purbanchal University
SHREE MEDICAL & TECHNICAL COLLEGE
Bharatpur, Chitwan
Knowledge and attitude regarding postnatal exercise among the postnatal mother
in Bharatpur hospital.
INFORMED CONSENT FORM
Objectives: To assess knowledge and attitude regarding postnatal exercise among
postnatal mother in Bharatpur hospital.
Namaskar,
Researcher, Gauri Subedi student of Bachelor of Nursing 3rd year of Shree Medical
& Technical College, Bharatpur, Chitwan. As a part of course and for partial
fulfillment of PBBN 3rd year program, researcher going to conduct research on
Knowledge and attitude regarding postnatal exercise among the postnatal mother in
Bharatpur hospital
This study may not benefit you directly but your valuable information helps in
understanding the level of knowledge and attitude regarding postnatal exercise
among postnatal mother in Bharatpur hospital. Researcher will appreciate your cooperation in answering the question.
If you volunteer to participate, you will have to respond to semi structured interview
schedule that will take about 10-15 minutes to complete. Researcher would like to
assure you that information will be kept confidential, used for research purpose only
and your identity will not be disclosed. You can withdraw from study anytime.
Researcher hope you will participate in this study by providing your authentic
response to the questions.
Respondents written agreement: In signing this consent form, I state that I have
read this document completely and I understand the objectives of this study and my
participation in this study is voluntary.
Respondents signature:
……………………. (date)
Researchers signature:
……..……………………(date)
APPENDICE C: Research Instrument
PURBANCHAL UNIVERSITY
SHREE MEDICAL AND TECHNICAL COLLEGE
BHARATPUR-10, CHITWAN
Semi structured interview schedule on “knowledge and attitude regarding postnatal
exercise among postnatal mothers in Bharatpur Hospital”. It will consist of part I,
II and III.
Code no: - ……….
Date of data Collection…………….
Direction: Researcher will tick (✓) in the box for the appropriate answer provided
to the close ended question according to respondent view point and fill the answer
within the space provided to the open-ended questions according to respondent
viewpoint.
Part I – Questions related to socio-demographic variables
1) What is your age? (In completed year) ………………
2) Which religion do you belongs to?
1. Hinduism
2. Buddhism
3. Christianity
4. Islam
5. Others (please specify) ………
3) What is your ethnicity?
1. Dalit
2. Janajati
3. Madhesi
4. Muslim
4. Brahmin/ Chhetri
5. Others (Thakuri, puri, Giri) ….
4) Where do you live? (district) …………......
5) What is your educational Status?
1. Literate
2. Illiterate
If, literate what is your educational level?
1. General literate (can read and write)
2. Basic level (class 1-8)
3. Secondary level (9- 12)
4. Bachelor and above
6) What is your occupation?
1. Homemaker
2. Business
3.
7) What is your family income per month? …………… (In Nepalese currency)
8) Which type of family do you belongs to?
1. Nuclear
2. Joint
3. Extended
4. Others (please Specify)
9) Where did you get the information about Postnatal exercise? (Multiple
Response)
1. Mass media
2. Health personnel
3. Friends\ Relatives
4. Newspaper
5. Others (please specify) ……...
Obstetric Variable
10) How many times you have got pregnant?........................
11) How many childbirths have you given?............................
12) What was the mode of last delivery?
1. Caesarean section
2. Spontaneous vaginal delivery
3. Vaginal delivery with episiotomy
4. Instrumental (forceps) or vacuum delivery
13) Have you ever gone for PNC visit? (If multiparous)
1.Yes
2. No
Part II – Questions related to knowledge regarding postnatal exercise
1) What do you mean by postnatal exercise?
1. Exercise done from delivery to 1 year
2. Exercise done from delivery to 6 weeks
3. Exercise done from 6 weeks to 8 weeks of delivery
4. Exercise done from 8 weeks to 1 year of delivery
2) What is the purpose of postnatal exercise? (Multiple Response)
1. Prevent postnatal depression
2. Prevent urinary incontinence
3. Improves muscle strength
4. Helps to revert back the organ in pre-pregnant stage
5. Increase risk of sepsis or infection
6. Increase lactation
7. Improve sense of well-being
8. Others (please specify) …………...
3) What are the types of exercise that should be performed during postnatal
periods? (Multiple response)
1. Abdominal exercise
2. Pelvic floor exercise
3. Gymnastic exercise
4. Breathing exercise
5. Stretching exercise
6. Aerobics
7. Others (Please specify) ……….
4) What is the typical consideration that should be made before starting the
postnatal exercise?
1. Mode of delivery
2. Mothers weight
3. Perineal muscle weakness
4. Mood swings
5) Which type of postnatal exercise should be started immediately after delivery?
1. Gentle exercise (such as walking)
2. Gymnastic exercise
3. Aerobics
4. Butterfly exercise
6) What is the perfect time to start the postnatal exercise in spontaneous vaginal
delivery?
1. Immediately after childbirth
2. After a week
3. After 2 weeks
4. After 3 weeks
7) Which one is the ideal time to start the postnatal exercise in caesarian section
delivery?
1. Immediately after delivery
2. Within one week
3. After one week
4. After two weeks
8) What is the intensity to be followed during postnatal exercise?
1. Mild to moderate
2. Moderate to strong
2. Strong to vigorous
4. Moderate to Vigorous
9) Which time of the day is most ideal for postnatal exercise?
1. Morning
2. Afternoon
3. Evening
4. Night
10) What is the ideal duration to perform postnatal exercise?
1. 10 -20min/day
2. 20-30 min/day
3. 30 – 40 min/day
4. 40-50 min/day
11) How frequently the postnatal exercise needs to be performed?
1. Daily
2. 4-5 days/week
3. Alternative day
4. Occasionally
12) Which postnatal exercise is most common during postnatal period?
1. Pelvic Floor exercise
3. Breathing exercise
2. Abdominal exercise
4. Ankle exercise
13) Which type of postnatal exercise is useful to prevent pelvic organ prolapse?
1. Gymnastic exercise
2. Pelvic floor exercise
3. Aerobics
4. Crunch exercise
14) How the pelvic floor exercise can be performed?
1. Squeeze, hold and relieve perineal muscle
2. Squeeze and relieve abdominal muscle
3. Squeeze perineal muscle
4. Squeeze abdominal muscle
15) How many times at least the pelvic floor exercise needs to be performed?
1. 5 – 10 times
2. 10-15 times
3. 15- 20 times
4. 20 – 25times
16) Which postnatal exercise is most appropriate to reduce cardiovascular risk in
mothers?
1. Pelvic floor exercise
2. Abdominal exercise
3. Gymnastic exercise
4. Aerobics exercise
17) Which postnatal exercise should be avoided during postnatal period?
1. Sits up & Crunches
2. Swimming and Cycling
3. Walking and dancing
4. Yoga and Pilates
18) What happens when moderate intensity postnatal exercise is performed more
than required duration?
1. Hypoglycemia
2. Hypertension
3. Hyperglycemia
4. Hypotension
19) Which is the condition where postnatal exercise should be hold?
1. Postnatal depression
2. Heavy vaginal bleeding
3. Sleep deprivation
4. Hypertension
20) Which one is the precautions that should be followed during postnatal
exercise?
1. Avoid exercising in high humidity
2. Avoid exercising in non-congested area
3. Avoid exercising in well ventilated rooms
4. Avoid exercising in empty stomach
Attitude scale regarding postnatal exercise during postnatal period
Direction: respondent is requested to respond to each of the following statement while researcher
ask, and researcher placing the tick mark to indicate, strongly agree, agree, undecided, disagree
and strongly disagree. It will assess by the score obtain through the attitude (Likert scale). The
scale included 10 attitude items with the total score 50; a score greater than mean will be consider
to reflect a positive attitude and a score less than or equal to mean negative attitude. The scoring
procedure for attitude will base on 5-point Likert scale where positive statements were score as
strongly agree=5, agree = 4, undecided =3, disagree = 2, strongly disagree = 1, reverse scoring will
be done for negative statement.
S
N.
1.
(+)
Statement
Postnatal exercise is practiced soon after
delivery with simple exercise and gradually
progress.
2.
(+)
Postnatal exercise mostly promotes quick
postnatal recovery, posture and prevents
excess weight gain.
3.
Swimming and cycling are not a type of
(-) postnatal exercise.
4.
Aerobic exercise decreases the risk of
(+) cardiovascular disease.
5.
Household work are better than postnatal
(-) strengthening exercise.
6.
Women with heavy bleeding during
(-) postpartum period also can perform
postnatal exercise.
7.
Superstition and customs in society prohibit
(+) women from practicing postnatal exercise.
8.
Women with vertigo also can perform
(-) postnatal exercise.
9.
Postnatal exercise is not helpful in
(-) preventing postnatal depression.
10. Exercise is contraindicated for women with
(+) breathing problems.
11.
(-)
12.
(+)
13.
(+)
14.
(-)
Postnatal exercise should be performed
occasionally.
Pelvic floor exercise means squeezing holding
and relieving perineal muscles
Type of pregnancy and mode of delivery should
be considered while starting postnatal exercise.
Postnatal exercise is suitable to perform at night
Strongly
Agree
Agree
Neutral
Disagree
Strongly
Disagree
Budget Planning
APPENDICES
APPENDICE A: Work plan