Bhuvana, G (2012) Effectiveness of clinical pathway for intrauterine insemination upon the knowledge and practice of nurses and patient outcome. Masters thesis, Apollo College of Nursing, Chennai.
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Abstract
A Quasi Experimental Study was conducted to Assess the Effectiveness of Clinical Pathway for Infertile Women Undergoing Intra Uterine Insemination Upon the Knowledge and Practice of Nurses and Patient Outcome at Apollo Hospital, Chennai. The Objectives of the Study were 1. To assess the pre test and post test level of knowledge and practice of nurses regarding clinical pathway for infertile women undergoing intra uterine insemination. 2. To evaluate the effectiveness of clinical pathway for infertile women undergoing intra uterine insemination upon the knowledge and practice of nurses. 3. To assess and compare patients outcome in control and experimental group of Infertile women. 4. To determine the level of satisfaction upon nursing care control and experimental group of infertile women. 5. To determine the association between the selected demographic variables of nurses with their pre and post test level of knowledge regarding clinical pathway for intra uterine insemination. 6. To determine the association between the selected demographic variables with patient outcome and level of satisfaction in control and experimental group of infertile women. 7. To determine the association between the selected clinical variables with patient outcome and level of satisfaction in control and experimental group of infertile women. 8. To determine the association between the selected psychosocial variables with patient outcome and level of satisfaction in control and experimental group of infertile women. The conceptual framework of the study was developed on the basis of Rosentoch’s and Becker and Maiman’s Health Belief model. The study variables were effectiveness of clinical pathway and knowledge and practice of nurses working in ART unit. Hypotheses were formulated. An extensive review of literature and guidance by experts formed the foundation to the development of clinical pathway, structured knowledge questionnaire, practice check list, satisfaction scale and Patient outcome check list. An evaluative research with quasi experimental of control and experimental group design was used to achieve the objectives of the study. The present study was conducted in the Apollo Hospital, Chennai in ART unit, The Sample were Nurses working in IUI Unit. Infertile women undergoing Intra uterine insemination was selected through purposive sampling technique. The investigator used Demographic variable proforma for infertile women, Clinical variable proforma for infertile women, Psychosocial proforma for infertile women, Satisfaction scale for infertile women, Outcome check list for infertile women Demographic variable proforma , Structured Knowledge questionnaire and Practice Check list for Nurses were used to collect the data. The data collection tools were validated and the reliability was established. After the pilot study, the data collection for the main study was done. Major findings of the study were Most the nurses working in IUI unit (50%, 50%) of the age group 18 - 29 years and 30- 40 years and GNM & ANM respectively. Majority of them (75%) has experience between 1-10 years. Most of the infertile women in control and experimental group belonged to 21- 29 years (67%, 60%) respectively. Majority of them were less than 29 years of age (97%) in control group and almost all of them were less than 29 years (100%) in experimental group at the time of marriage. Most of them belong to house wife (70%, 67%) in control group of infertile women and experimental group of infertile women respectively. Majority of them had non consanguineous marriage (83%, 93%) in both control and experimental group of infertile women. Almost all of the nurses (100%, 100%) had moderately adequate knowledge and adequate knowledge after the post-test respectively. All nurses (100%) had moderately practice in the control group of infertile women. In the experimental group of infertile women, almost all of the nurse had adequate practice in experimental group (100%). All infertile women (100%) has moderately satisfied in the control group. In the experimental group, almost all of the infertile women (100%) has highly satisfied after administering clinical pathway for Intra uterine insemination for infertile women. Infertile women were (47%) of them conceived in control group and (66%) of them conceived in experimental group of infertile women. None of them developed OHSS complication. Mean and standard deviation of level of knowledge of nurses were low in the pre-test (M= 14.25, SD=1.63) in comparison to the post-test (M=22.50, SD-0.52). The difference was found statistically significant at 12.92% level of confidence and can be attributed to the level of knowledge at 99.9 %. Mean and standard deviation of level of practice of nurses were low in the control group (M= 41.76, SD = 4.25) in comparison to the experimental group (M= 91.06, SD = 3.90) 98.7%. Mean and standard deviation of level of satisfaction of infertile women were low in the control group (M= 43.3, SD= 3.11) in comparison (M= 88.23, SD= 5.33) to the experimental group. This shows that the patient’s satisfaction improved after administering clinical pathway for infertile women undergoing Intra uterine insemination. The result was statically significant at 99.9% level of significance. Mean and standard deviation of Patient outcome of infertile women were low in the control group (M= 0.73, SD= 0.888) in comparison (M= 0.83, SD=0.960) to the experimental group. There was no significant association between the selected demographic variables such as Age, Religion, Educational qualification and Years of experience in the Level of knowledge for the nurses in the pre and post test. It has proven that there is no association between the selected demographic variables and level of knowledge. Hence the null hypothesis Ho1 was retained. No statistics could be calculated for association between selected demographic variables and level of knowledge. There was no association between age, education, occupation, type of family, type of marriage, religion, duration of infertility, economical support, family size with the level of satisfaction in the control group and experimental group of infertile women. Hence null hypothesis Ho4 was retained. No statistics could be applied to find the association between selected demographic variables and the level of satisfaction. There was a significant association between the Age in years and their treatment outcome (χ2 = 8.0972) in control group. This shows that age in years and patient outcome not influencing each other. There was no association between Age at menarche, Reproductive age, Menstrual history, Health history, Surgical history, Married years, Use of contraception, Infertility years, Cause of infertility, Treatment, No of Intra uterine insemination with the level of satisfaction in the control group and experimental group of infertile women. Hence null hypothesis Ho4 was accepted. No statistics could be applied to find the association between selected clinical variables and the level of satisfaction. There was a significant association between the menstrual history, (χ2 = 15.934), Surgical illness (χ2 =3.844) . Hence the null hypothesis Ho5 is partially rejected. Hence no statistics could be calculated for association between selected clinical variables of control group and patient outcome. There was a significant association between the level of satisfaction (χ2=13.4419) Gynecological illness. Hence the null hypothesis Ho5 is partially rejected. No statistics could be calculated for association between selected clinical variables of experimental group and patient outcome. There was no association between psychological variables such as Get together at home, Comfortable take part in social activities, instrument, emotion, support from husband, maternal and law’s support, Job & work support in control and experimental group. Hence the null hypothesis Ho6was retained. No statistics could be applied to find the association between selected psychosocial variables and the level of satisfaction. The patient outcome is not related to social variables. Hence no statistics could be calculated for association between selected psychological variables and patient outcome.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | clinical pathway; intrauterine insemination; knowledge; practice; nurses; patient outcome |
| Subjects: | NURSING > Obstetrics and Gynaecology Nursing |
| Depositing User: | Ramakrishnan J |
| Date Deposited: | 20 Nov 2017 06:32 |
| Last Modified: | 20 Nov 2017 06:32 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3984 |
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