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Assessment of Knowledge and Practices of Pregnant Women towards
Danger Signs of Pregnancy at Tertiary Care Hospitals Karac...
i
To,
The Sher Alam,
School of Nursing
Kharadar General Hospital.
Subject: Application for Mentorship
Respected Sir,
We ar...
ii
To,
Miss Talat Parveen Shah,
Principle of School of Nursing,
Kharadar General Hospital,
Karachi, Pakistan.
Subject: Req...
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  1. 1. Assessment of Knowledge and Practices of Pregnant Women towards Danger Signs of Pregnancy at Tertiary Care Hospitals Karachi, Pakistan. SYNOPSIS Of EVIDENCE BASED RESEARCH PROJECT POST RN BSN, YEAR II, SEMESTER IV, SESSION 2019-21 Supervisor: Sher Alam Submitted by 1. Noureen 2. Quratulain 3. Ayesha 4. Ume Farwa 5. Hanif 6. Shahzad 7. Rahat shah 8. Sadam 9. Deedar Date of Submission: September 11, 2021 SCHOOL OF NURSING KARACHI, KHARADAR GENERAL HOSPITAL
  2. 2. i To, The Sher Alam, School of Nursing Kharadar General Hospital. Subject: Application for Mentorship Respected Sir, We are a student of the Post RN BSN. Year II, Semester IV at School of Nursing, Kharadar General Hospital Karachi, aiming to conduct our research based project to fulfill the mandatory requirement of ,School of Nursing Karachi, Kharadar General Hospital academia to be awarded our degree. As a part of the research protocol, we would be requiring immense guidance and regular consultations by a credible research faculty to help us in this accomplishment. We shall be highly obliged if you accept us in your Mentorship and master our research based project. On completion of all the orientations and introductory discussions on final research project with our School Management, here is our selected topic. “Assessment of Knowledge and Practices of Pregnant Women towards Danger Signs of Pregnancy at Tertiary Care hospital; Karachi, Pakistan” We would be deeply honored to work under your wing. Thanking you in advance. Sincere regards, 1. Noureen____________ 2. Quratulain __________ 3. Ayesha ____________ 4. Ume Farwa _________ 5. Hanif ______________ 6. Shahzad ____________ 7. Rahat shah __________ 8. Sadam _____________ 9. Deedar _____________
  3. 3. ii To, Miss Talat Parveen Shah, Principle of School of Nursing, Kharadar General Hospital, Karachi, Pakistan. Subject: Request for approval of Synopsis Dear Madam, The Evidence Based Research Project synopsis entitled “Assessment of Knowledge and Practices of Pregnant Women towards Danger Signs of Pregnancy at Tertiary Care hospital, Karachi, Pakistan” has been submitted by Post RN BSN Year, II, Semester IV, students (Research group D). As per review and evaluation by the research evaluation representatives and our endorsement of the review given from our competent expertise, this synopsis fulfills the requirements of the Research Based Project and is capable of being worked upon to be reported and presented as part of the project requirement. Your approval shall be appreciated. Kind regards, __________________ Sher Alam Research Supervisor School of Nursing Kharadar General Hospital Karachi.
  4. 4. iii Supervisor Approval letter To, 1. Noreen 2. Quratulain 3. Ayesha 4. Ume Farwa 5. Hanif 6. Shahzad 7. Rahat shah 8. Sadam 9. Deedar Topic: “Assessment of Knowledge and Practices of Pregnant Women towards Danger Signs of Pregnancy at Tertiary Care hospital; Karachi, Pakistan” Department : School of Nursing, Kharadar General Hospital Year : Post Rn BSN Year II, Semester IV, Session 2019-21 This is to certify that I have agreed to be the Supervisor of these students. I accept the research Based Project synopsis’ topic and have read, reviewed and approved. After due approval from the competent authority of the Kharadar General Hospital, School of Nursing Karachi. Students are hereby directed to carry on with the data collection and analysis of the above mentioned topic to be completed as part of her research based project synopsis. Name of supervisor: Sher Alam Signature: ________________ Date: ________________
  5. 5. iv CONTENTS CHAPTER 1_______________________________________________________________1 INTRODUCTION ___________________________________________ Error! Bookmark not defined. 1.0 INTRODUCTION AND BACKGROUND __________________________________________________1 1.1 OBJECTIVE OF THE STUDY__________________________________________________ 3 1.2 RATIONALE OF THE STUDY _________________________________________________ 3 1.3 SIGNIFICANCE OF THE STUDY_______________________________________________ 3 1.6 OPERATIONAL DEFINITIONS ________________________________________________ 4 CHAPTER 2_______________________________________________________________5 LITERATURE REVIEW _________________________________________________________ 5 CHAPTER 3_______________________________________________________________8 RESEARCH METHODOLOGY ___________________________________________________ 8 3.1 STUDY DESIGN________________________________________________________________________8 3.2 STUDY SETTING ______________________________________________________________________8 3.3 STUDY DURATION ____________________________________________________________________8 3.4 SAMPLING TECHNIQUE _______________________________________________________________8 3.5 SAMPLE SIZE _________________________________________________________________________8 3.6 INCLUSION CRITERIA_________________________________________________________________8 3.7 EXCLUSION CRITERIA ________________________________________________________________8 3.8 ETHICAL CONSIDERATION____________________________________________________________8 3.9 DATA COLLECTION TOOL AND MEASUREMENT_______________________________________9 REFERENCES ___________________________________________________________10 ANNEXURE A____________________________________________________________13 QUESTIONNAIRE ________________________________________________________13 Demographic Data_________________________________________________________13 ANNEXURE B______________________________________________________________18 INFORMED CONSENT____________________________________________________18
  6. 6. 1 CHAPTER 1 1.0 INTRODUCTION AND BACKGROUND World Health Organization (WHO) estimates that about 300 million women in the developing countries suffer from short and long-term illnesses due to complications related to pregnancy and childbirth (Dasanayake et al., 2018). An estimated 15% of pregnant women in developing countries experience pregnancy related complications (WHO, 2005 & WHO 2004). About 529,000 mothers die each year from maternal causes, out of which 99% of deaths being from the developing world (Dasanayake et al., 2018). In 2005, 535,900 women died from causes related to pregnancy and childbirth; half of these deaths occurred in sub-Saharan Africa (Hill, 2007). In Ethiopia, the levels of maternal mortality and morbidity are among the highest in the world and the current estimate of MMR (Maternal mortality Rate) is 673 per 100, 000 live births and it is reported that Maternal deaths accounted for 21% of all deaths (WHO, 2015). In Ethiopia, the levels of maternal mortality and morbidity are among the highest in the world and the current estimate of MMR (Maternal Mortality Rate) is 673 per 100, 000 live births and it is reported that Maternal deaths accounted for 21% of all deaths (CSA, 2011). Pregnancy is a very exciting event and it is the period every woman wants to treasure throughout her lifetime. So, significant attention and care from the family, society and medical system should also be provided to pregnant women (Yibalih, Dugassa &Alemu, 2019). Providing timely and appropriate treatment that reduces maternal mortality and morbidity ensures taking the right health care action. As a result, when attending an antenatal care clinic, women should receive health education about pregnancy including outcomes, danger signs of pregnancy as well as other services (Ketema, et al., 2020; Yibalih, Dugassa and Alemu, 2019).
  7. 7. 2 A pregnant woman is a unit of two individuals that consists of the mother and the fetus which starts after conception and continues through all the phases of pregnancy and after delivery. Women's knowledge of the danger signs of pregnancy is highly necessary in order to increase the use of skilled care during pregnancy and childbirth and to obtain timely emergency obstetric services (Bintabara, 2017). It is also necessary to minimize delays in obtaining medical attention and in reaching a health facility. Lack of awareness on these warning signs disserves the willingness of women to engage in healthy motherhood initiatives (El-Nagar, Ahmed and Belal, 2017). Knowledge of danger signs among pregnant women is the first essential step in accepting appropriate and timely referral. Also, it is important in improving maternal and fetal health outcomes (Nurgi, Tachbele, Dibekulu& Wondim, 2017). The present study aimed to assess knowledge and practices of pregnant women toward danger signs of pregnancy. WHO recommended Danger Signs of Pregnancy are, 1. Excessive vomiting, 2. Excessive abdominal pain, 3. Vaginal bleeding during pregnancy, 4. Swelling of the face, Fingers and feet, 5. Blurred vision, 6. Pregnancy fits, 7. Extreme frequent frontal headache, 8. Elevated grade fever, 9. Marked changes in fetal movement, 10. Elevated blood pressure.
  8. 8. 3 1.1 OBJECTIVE OF THE STUDY  To assess knowledge and practices of pregnant women towards danger signs of pregnancy. 1.2 RATIONALE OF THE STUDY  Significant number of mothers had no information on danger signs of pregnancy.  Negligence was the main reason for not having good awareness of danger sign of pregnancy. 1.3 SIGNIFICANCE OF THE STUDY Knowledge of these signs will encourage women to make the right choices and take timely steps to access health care, while obtaining prompt and adequate care to reduce maternal mortality and morbidity (Ketema, et al., 2020; Yibalih, Dugassa and Alemu, 2019).  Moreover, practices toward danger signs of pregnancy will save lives of women from preventable diseases and maternal death and reduce maternal mortality and morbidity.  Maternal morbidly and mortality could be prevented significantly if women and their families recognize obstetric danger signs and promptly seek health care (Bintabara, 2017).  The knowledge will ultimately empower them and their families to make prompt decisions to seek care from skilled birth attendants (Nurgi, Tachbele, Dibekulu& Wondim, 2017).
  9. 9. 4 1.4 NULL HYPOTHESIS There is no significant knowledge and practices of pregnant women toward danger signs of pregnancy. 1.5 ALTERNATE HYPOTHESIS There is a significant knowledge and practices of pregnant women toward danger signs of pregnancy. 1.6 OPERATIONAL DEFINITIONS 1. KNOWLEDGE The knowledge is to learn about something on specific area through observation, experience or Practice. 2. PRACTICE The actual application or use of an idea, belief, or method, as opposed to theories relating to it. 3. MOTHER Health care of mother during pregnancy. 4. DANGER The possibility of something unwelcome or unpleasant happening. 5. SIGN Any objective evidence of disease, as opposed to a symptom, which is, by nature, subjective.
  10. 10. 5 CHAPTER 2 LITERATURE REVIEW One of the main public health concerns worldwide is maternal health that lays a strong foundation to the health of the nation in general. Around 80% of maternal deaths worldwide are due to direct complications during pregnancy such as extreme bleeding, obstructed labor, infections, hypertension induced pregnancy and/or unsafe induced abortion. Maternal death are also thought to occur due to three delays, delay in deciding to seek appropriate care, delay in reaching appropriate health facility and delay in receiving adequate emergency care (GCMD, 2014). Delays in the search for effective health care due to lack of understanding can be decreased by enhancing access to health care services and education through the adoption of community outreach services that actually provide information on child-bearing issues that are especially serious indicators of pregnancy and practice guidelines for women. In order to facilitate their cooperation when care is needed, individual women and their families should be given such information (Wassihun et al., 2020). One of the eight-millennium developmental goals (MDGs) is to enhance maternal health. The aim of the MDG 5 was to reduce the (MMR between 1990 and 2015) by 75 % (UNMP, 2017). In the Sustainable Development Goals, the reduction of maternal mortality to 70 by 2030 is set as goal 3(UNMP, 2017). Maternal mortality is a major public health issue worldwide, with 800 women dying every day due to health care services and education through the adoption of community outreach services that actually provide information on child-bearing issues that are especially serious indicators of pregnancy and practice guidelines for women. In order to facilitate their cooperation when care is needed, individual women and their families should be given such information (UNMP, 2017).
  11. 11. 6 One of the eight-millennium developmental goals (MDGs) is to enhance maternal health. The aim of the MDG 5 was to reduce the MMR between 1990 and 2015 by 75 %. In the Sustainable Development Goals, the reduction of maternal mortality to 70 by 2030 is set as goal 3. Maternal mortality is a major public health issue worldwide, with 800 women dying every day due to pregnancy or childbirth complications (UNMP, 2017). The maternal mortality ratio is still high in Egypt, with 1400 women and 50 percent of their newborns dying yearly due to pregnancy and childbirth complications. There are a variety of practices that women may perform to overcome their danger signs during pregnancy. Some women visit a health facility while others contact with health personnel, consult a friend or relative, make self-care, consult traditional healer or do nothing during such conditions. This disparity may be attributable to the difference in understanding the seriousness of pregnancy danger signs among women, the level of awareness or the difference in cultural context that might influence their practices (Mwilike, 2018). Providing timely and appropriate treatment that reduces maternal mortality and morbidity ensures taking the right health care action. As a result, when attending an antenatal care clinic, women should receive health education about pregnancy including outcomes, danger signs of pregnancy as well as other services (Ketema, et al., 2020; Yibalih, Dugassa and Alemu, 2019). Each woman should be able to identify danger signs that occur during pregnancy, because these signs typically mean the existence of complications that occur during pregnancy at any time.
  12. 12. 7 LITERATURE REVIEW PRINCIPAL INVESTIGATOR STUDY Country RESULTS Woldeamanuel, G. W., Lemma, G., Zegeye, B., (2019). Knowledge of obstetric danger signs and its associated factors among pregnant women in Angolela Tera District, Northern Ethiopia Ethiopia A total of 563 pregnant women were included in the study. About 211 (37.5%) women were knowledgeable about obstetric danger signs. Zaki, E.S.A., Fouad, S., Khedr, H.F.N., (2021) Assessment of knowledge and practices of pregnant women toward danger signs of pregnancy Ethiopia 242 pregnant women chosen for this study. Pregnant women total knowledge score of danger signs was poor in 57.9% whereas More than two thirds (65.3%) of pregnant women had inadequate practices regarding danger signs of pregnancy. Bolanko, A., et al., (2021) Knowledge of obstetric danger signs and associated factors among pregnan women in Wolaita Sodo town, South Ethiopia: A community-based cross- sectional study. Egypt A total of 740 pregnant women participated in the study with the response rate of 97.5%. One hundred twenty our (16.8%) of the respondents were knowledgeable about obstetric danger signs. Tesfaye, B., Jawed, A., (2021) Assessment of knowledge and practices of pregnant women toward danger signs of pregnancy. Ethiopia A total of 280 study subjects were included. This study found that 80 (38.5%) were heard about obstetric danger signs. The study showed that More than two fourth of the study participants had good knowledge about danger signs
  13. 13. 8 CHAPTER 3 RESEARCH METHODOLOGY 3.1 STUDY DESIGN Descriptive Cross sectional study design will be conducted. 3.2 STUDY SETTING The study will be performed at Tertiary Care Hospitals Karachi, Pakistan. 3.3 STUDY DURATION The duration will be from 1st August to 30th Oct 2021. 3.4 SAMPLING TECHNIQUE Convenient sampling type will be applied. 3.5 SAMPLE SIZE Sample size will be calculated through standard method, by using openepi.com by using the prevalence of parent’s knowledge related to danger signs. 3.6 INCLUSION CRITERIA All pregnant women who will agree to participate in the study will be included. 3.7 EXCLUSION CRITERIA Women in the pilot study and who did not sign consent form will be excluded from the study. 3.8 ETHICAL CONSIDERATION  Ethical approval will be obtained from Research Ethics Committee of the – Kharadar General Hospital.  Participants will be informed about the purpose of the Study and written informed consent will be taken.  They will be also informed that each participant has the right to withdraw from the study at any time without any consequences.
  14. 14. 9  Anonymity, privacy, safety and confidentiality will absolutely be assured throughout the study. 3.9 DATA COLLECTION TOOL AND MEASUREMENT Data will be collected through structure questionnaire and interview by visiting the selected Hospitals and formal permission will be taken through official correspondence. 3.10 DATA ANALYSIS The collected data will be coded, tabulated and analyzed using Statistical Package of Social Science (SPSS). The data will be analyzed on SPSS licensed V-16 software. Percentages and Frequencies will be used to describe sociodemographic characteristics. The qualitative variables results will be shown by pie-chart and bar graph. The Mean, Median and Standard Deviation will be calculated for quantitative variables. The results will be shown by using Charts, Graphs and Frequency tables. 3.11 PILOT STUDY The study tools will be applied on 10% (25 pregnant women) of the total study sample to test the objectivity and applicability of the study tools and the feasibility of the research process as well as to estimate the time needed to answer them. 3.12 VALIDITY AND RELIABILITY Validity and Reliability of the tools will be checked through the IRB of the Kharadar General Hospital and a panel of three experts in maternity nursing specialty will analyzed the content validity of the tools before using it to ensure that all questions will consistently convey and carry the anticipated meaning that they prepared.
  15. 15. 10 REFERENCES Bolanko, A., et al., (2021). Knowledge of obstetric danger signs and associated factors among pregnant women in Wolaita Sodo town, South Ethiopia: A community-based cross-sectional study. SAGE Open Medicine. 9, 1-9. Bintabara, D., Mpembeni, R.N.M., Mohamed, A.A., (2017).Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: A cross-sectional study. pp. 1–10. [PMC free article] [PubMed] [Google Scholar] CSA. (2011). Ethiopia Demographic and Health Survey 2011 Addis Ababa, Ethiopia and Calverton, Maryland, USA. Dasanayake, D., Ganewatta, S., Rathnayaka, N. (2018). Knowledge and practices on birth preparedness and complication readiness among antenatal mothers: A study from southern provinc. Sri Lanka Journal of Obstetrics and Gynecology. 40(1). El-Nagar, A. E., Ahmed, M., & Belal, G. (2017). Knowledge and Practices of Pregnant Women Regarding Danger Signs of Obstetric Complications. IOSR Journal of Nursing and Health Science, 6, 30-41. Hill, K., Thomas, K., Abou, Z. C., Walker, N., Say, L., Inoue, M., et al. (2007): Estimates of maternal mortality worldwide between 1990 and 2005: An assessment of available data. Lancet 2007, 370(9595):1311-9. Ketema, D. B., Leshargie, C. T., Kibret, G. D., Assemie, M. A., Petrucka, P., & Alebel, A. (2020). Effects of maternal education on birth preparedness and complication readiness among Ethiopian pregnant women: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20(1), 1-9.
  16. 16. 11 Mwilike, B., Nalwadda, G., Kagawa, M., Malima, K., Mselle, L., & Horiuchi, S. (2018). Knowledge of danger signs during pregnancy and subsequent healthcare seeking actions among women in Urban Tanzania: A cross-sectional study. BMC pregnancy and childbirth, 18(1), 4. Nurgi, S., Tachbele, E., Dibekulu, W., & Wondim, M. A. (2017). Knowledge, Attitude and Practice of Obstetric Danger Signs during Pregnancy in Debre Berhan, Ethiopia. Health Science Journal, 11(6), 1-7. Say, L., Chou, D., Gemmill, A., Tunçalp, O., Moller, A.B., Daniels, J.D., et al. (2018). Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health. 2(6): e323- e333. Tesfaye, B., Jawed, A., (2021). Knowledge, Attitude and Practice of Danger Signs during Pregnancy among Mothers Attending Antenatal Care at Melka Oda Hospital, Southeast Ethiopia. 29 (3), 41-46. UNFPA. (2017). World population dashboard—Papua New Guinea Retrieved 3rd Sept, 2018, from: ttps://www.unfpa.org/data/worldpopulation/PG WHO. (2005). the world health report 2005— make every mother and child count, Tech. Rep., WHO, Geneva, Switzerland. WHO. (2004). Maternal mortality in 2000: estimates developed by WHO, UNICEF and UNFFA, Tech. Rep., WHO, Geneva, Switzerland, 2004. WHO. (2015). Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division Excutive summary.
  17. 17. 12 Wassihun, B., Negese, B., Bedada, H., Bekele, S., Bante, A., Yeheyis, T., & Hussen, E. (2020). Knowledge of obstetric danger signs and associated factors: A study among mothers in Shashamane town, Oromia region, Ethiopia. Reproductive Health, 17(1), 18. Woldeamanuel, G. W., Lemma, G., Zegeye, B., (2019). Knowledge of obstetric danger signs and its associated factors among pregnant women in Angolela Tera District, Northern Ethiopia. BMC Research Notes, 12(606), 6. Yibalih, N. K., Dugassa, W., & Alemu, A. (2019). Awareness of obstetric danger signs and associated factors among Pregnant Women Who Attend Antenatal Care in Public Health Institutions of Adama City, Oromia, Ethiopia. International Medical Science Research Journal, 1(3), 79-92 Zaki, E.S.A., Fouad, S., Khedr, H.F.N., (2021). Assessment of knowledge and practices of pregnant women toward danger signs of pregnancy. Mansoura Nursing Journal. 8, 1-202
  18. 18. 13 ANNEXURE A QUESTIONNAIRE Serial No: ___________ Demographic Data 1. Name (optional) ____________ 2. Age at first pregnancy a. Less than 20 years b. 20 – 29 Years c. 30 – 39 Years d. Greater than 40 Years 3. Gestational age of current pregnancy a. Ist Trimester b. 2nd Trimester c. Last Trimester 4. Gravida a. 1 b. 2 c. 3 d. Greater than 3 5. Maternal education a. Illiterate b. Primary c. Middle d. Matriculation e. Intermediate f. Graduation g. Other_________ 6. Maternal occupation a. Hose wife b. Working lady 7. Religious a. Muslim b. Christian c. Hindu d. Other ____________ 8. Ethnicity a. Baloch b. Punjabi c. Pakhtoon d. Urdu Speaker e. Other ___________ 9. Family monthly income in PKR a. Less than 20, 000 b. 20,000 – 29000 c. 30,000 – 39,000 d. Greater than 40,000 K.1. among following danger signs please tick those which you know or heard about 1. Excessive vomiting 2. Excessive abdominal pain 3. Vaginal bleeding during pregnancy 4. Swelling of the face Fingers and feet 5. Blurred vision 6. Pregnancy fits 7. Extreme frequent frontal headache
  19. 19. 14 8. High grade fever 9. Marked changes in fetal movement 10. Elevated blood pressure. P.1. What did you do when you had developed any danger sign of the following? S.NO Tick (√) the below mention signs and your response) Responses 1. High grade fever  Take Panadol  Went to hospital  Do nothing 2. Excessive vomiting  Went to hospital  Do nothing 3. Excessive abdominal pain  Home treatment  Went to hospital  Do nothing 4. Vaginal bleeding during pregnancy  Home treatment  Went to hospital  Do nothing 5. Swelling of the face, finger and feet  Home treatment  Went to hospital  Do nothing 6. Blurred vision  Home treatment  Went to hospital  Do nothing 7. Pregnancy fits  Home treatment  Went to hospital  Do nothing 8. Extreme frequent frontal headache  Home treatment  Went to hospital  Do nothing 9. Marked changes in fetal movement  Went to hospital  Do nothing 10. Elevated blood pressure.  Home treatment  Went to hospital  Do nothing
  20. 20. 15 P.II Reason for not taking to health facility? 1. Illness was not serious 2. Had no enough money 3. Long distance to health facility 4. Busy / No time
  21. 21. 15 ‫سوالنامہ۔‬ ___________ : ‫ر‬ ‫نمی‬ ‫یل‬ ‫ر‬ ‫سی‬ ‫معلومات‬ ‫بنیادی‬ 1 ____________ ‫نام‬ . 2 ‫عمر۔‬ ‫ر‬ ‫می‬ ‫حمل‬ ‫پہےل‬ ‫۔‬ ‫الف‬ 20 ‫کم۔‬‫ےس‬ ‫سال‬ ‫ب‬ - 20 - 29 ‫سال۔‬ ‫ج‬ - 30 - 39 ‫سال۔‬ ‫د‬ - 40 ‫زیادہ۔‬ ‫ےس‬ ‫سال‬ 3 ‫عمر۔‬ ‫یک‬‫حمل‬ ‫موجودہ‬ . ‫مایہ۔‬ ‫سہ‬ ‫پہیل‬ .‫الف‬ ‫مایہ‬ ‫سہ‬ ‫دورسی‬ ‫ب‬ ‫مایہ۔‬ ‫سہ‬ ‫آخری‬ ‫ج‬ 4 ‫گریویڈا‬. ‫الف‬ - 1 ‫۔‬ ‫ب‬ 2 ‫ج‬ - 3 ‫د‬ - 3 ‫زیادہ۔‬ ‫ےس‬ 5 ‫تعلیم‬ ‫یک‬ ‫ن‬ ‫ر‬ ‫خواتی‬ ‫حاملہ‬ . ‫الف‬ - ‫خواندیک‬ ‫نا‬ ‫ب‬ - ‫ائمری‬‫ر‬‫پ‬ ‫ج‬ - ‫۔‬ ‫ن‬ ‫درمیان‬ ‫د‬ - ‫ک۔‬ ‫ر‬ ‫میی‬ ‫ای‬ - ‫میڈیٹ‬ ‫ر‬ ‫انی‬ f - ‫گریجویشن‬ g - _________‫دیگر‬ 6 ‫پیشہ۔‬ ‫کا‬‫زچگ‬ . ‫الف‬ - ‫بیوی۔‬‫گھریلو‬ ‫لیڈی۔‬ ‫کنگ‬ ‫ور‬ ‫ب‬ 7 ‫۔‬ ‫مذہب‬ . ‫الف‬ - ‫مسلمان‬ ‫عیسان‬ ‫ب‬ ‫ہندو۔‬ ‫ج‬ ____________‫دیگر‬ ‫د‬ 8 ‫نسل‬ . ‫بلوچ‬ .‫الف‬ ‫ر‬ ‫پنجان‬ ‫ب‬ ‫پختون۔‬ ‫ج‬ ‫د‬ - ‫اسپیکر‬‫اردو‬
  22. 22. 16 ___________‫دیگر‬ ‫ای‬ 9 ‫ر‬ ‫می‬ ‫ے‬ ‫روپ‬ ‫ن‬ ‫پاکستان‬ . ‫۔‬ ‫ن‬ ‫آمدن‬ ‫ماہانہ‬ ‫یک‬‫خاندان‬ ‫الف‬ - 20,000 ‫کم۔‬‫ےس‬ ‫ب‬ - 20،000 - 29000 ‫ج‬ - 30،000 - 39،000 ‫د‬ - 40،000 ‫زیادہ۔‬ ‫ےس‬ K.1 ‫ن‬ ‫ست‬ ‫یا‬ ‫ر‬ ‫ہی‬ ‫ے‬ ‫جانت‬ ‫آپ‬ ‫ر‬ ‫می‬ ‫بارے‬ ‫ےک‬ ‫جن‬ ‫ر‬ ‫لگائی‬ ‫نشان‬‫پر‬ ‫ان‬ ‫کرم‬‫اہ‬‫ر‬‫ب‬ ‫ےس‬ ‫ر‬ ‫می‬ ‫عالمتوں‬ ‫یک‬‫خطرے‬ ‫ذیل‬ ‫مندرجہ‬ . ‫۔‬ ‫ر‬ ‫ہی‬ 1 ‫۔‬ ‫ے‬ ‫ق‬ ‫زیادہ‬ ‫ےس‬ ‫ورت‬ ‫ن‬ ‫ض‬ . 2 ‫ےس‬ ‫ورت‬ ‫ن‬ ‫ض‬ ‫ر‬ ‫می‬ ‫پیٹ‬ . ‫درد۔‬ ‫زیادہ‬ 3 ‫بہنا۔‬ ‫خون‬ ‫ےس‬ ‫ن‬ ‫نہان‬ ‫اندام‬ ‫ان‬‫ر‬‫دو‬ ‫ےک‬ ‫حمل‬ . 4 ‫۔‬ ‫سوجن‬ ‫یک‬‫پاؤں‬‫اور‬ ‫انگلیوں‬ ‫چہرے‬ . 5 ‫نظر۔‬ ‫ہوا‬ ‫دھندال‬ . 6 ‫فٹس‬ ‫حاملہ‬ . 7 ‫رسدرد۔‬‫بار‬‫بار‬ . 8 ‫بخار۔‬ ‫گریڈ‬‫ہان‬ . 9 ‫تبدیلیاں۔‬ ‫نمایاں‬ ‫ر‬ ‫می‬ ‫کت‬ ‫حر‬‫و‬ ‫نقل‬ ‫یک‬ ‫ن‬ ‫ر‬ ‫جنی‬ . 10 ‫پریش‬ ‫بلڈ‬ ‫بلند‬ . ‫جوابات‬ ‫نشان‬‫پر‬ ‫جواب‬ ‫ےک‬ ‫آپ‬‫اور‬ ‫نشانات‬ ‫گت‬ ‫ے‬ ‫ی‬ ‫د‬ ‫ے‬ ‫نیچ‬ ‫۔‬ ‫ر‬ ‫لگائی‬ ‫ر‬ ‫نمی‬ ‫یل‬ ‫ر‬ ‫سی‬  ‫کیا‬‫استعمال‬ ‫پیناڈول‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا۔‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫بخار‬ ‫گریڈ‬‫ہان‬ 01  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫آنا۔‬ ‫ے‬ ‫ق‬ ‫زیادہ‬ ‫ےس‬ ‫ورت‬ ‫ن‬ ‫ض‬ 02  ‫عالج‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫درد۔‬ ‫زیادہ‬ ‫ر‬ ‫می‬ ‫پیٹ‬ 03  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫بہنا۔‬ ‫خون‬ ‫ےس‬ ‫ن‬ ‫نہان‬ ‫اندام‬ ‫ان‬‫ر‬‫دو‬ ‫ےک‬ ‫حمل‬ 04
  23. 23. 17  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫سوجن۔‬ ‫یک‬‫پاؤں‬‫اور‬ ‫انگیل‬ ، ‫چہرے‬ 05  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫نظر‬ ‫دھندیل‬ 06  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫فٹس‬ ‫ان‬‫ر‬‫دو‬ ‫ےک‬ ‫حمل‬ 07  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫رسدرد۔‬‫بار‬‫بار‬ ‫انتہان‬ 08  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫تبدیلیاں۔‬ ‫نمایاں‬ ‫ر‬ ‫می‬ ‫کت‬ ‫حر‬‫و‬ ‫نقل‬ ‫یک‬‫ائیدہ‬‫ز‬‫نو‬ 09  ‫عالج۔‬‫گھریلو‬  ‫گیا۔‬‫ہسپتال‬  ‫کیا‬ ‫ر‬ ‫نہی‬ ‫کچھ‬ ‫۔‬ ‫ر‬ ‫پریش‬ ‫بلڈ‬ ‫بلند‬ 10  ‫ر‬ ‫نہی‬ ‫ن‬ ‫ر‬ ‫سنگی‬ ‫بیماری‬ ‫تیھ‬  ‫تیھ‬ ‫ر‬ ‫نہی‬ ‫ن‬ ‫کاف‬‫رقم‬  ‫یک‬‫صحت‬ ‫سہولت‬ ‫تک۔‬ ‫دوری‬ ‫ر‬ ‫لمب‬  ‫وقت‬ ‫کون‬/ ‫مرصوف‬ ‫ر‬ ‫نہی‬ P.II ‫وجہ؟‬ ‫یک‬ ‫ن‬ ‫لین‬ ‫نہ‬ ‫سہولت‬ ‫یک‬‫صحت‬ P.11
  24. 24. 18 ANNEXURE B INFORMED CONSENT I have read the invitation letter from ______________ and understood the nature of his/her propose study titled: “Assessment of Knowledge and Practices of Pregnant Women towards Danger Signs of Pregnancy at Tertiary Care Hospital Karachi, Pakistan” I consent to participate in the study. I understand my participation in this research would be voluntary and I can withdraw from the study if I wish so or I can also withhold any information if I want so. I understand that I will be required to fill up a questionnaire. I also understand that all information that I will share with the researchers through questionnaire and interviews will be kept confidential. Furthermore, this information will be only used for academic purposes. I understand that my participation in this study will not lead to any financial benefits. Participant’s Signature: ________________________________ Signature of person obtaining consent: ____________________ Date: _______________________________________________
  25. 25. 19

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