Knowledge Of Hypertension In Pregnancy And It’s Control Measures Among Women Of Child Bearing Age (18-45 Years) In Asaba Specialist Hospital Delta State

Project and Seminar Material for Nursing (Science)

Knowledge Of Hypertension In Pregnancy And It’s Control Measures Among Women Of Child Bearing Age (18-45 Years) In Asaba Specialist Hospital Delta State


Abstract


This study was carried out to examine the assessment of the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age (18-45 years) in Asaba specialist hospital Delta State. The study was specifically carried out to ascertain knowledge of women of child bearing age on the factors which contributes to hypertension in pregnancy; ascertain knowledge of women of child bearing age on the effects of hypertension in pregnancy; and ascertain knowledge of women of child bearing age on the control measures of hypertension in pregnancy. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of women of child bearing age (18-45 years) in Asaba specialist hospital Delta State. In determining the sample size, the researcher conveniently selected 100 respondents and validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses were tested using Chi-square statistical tool. The result of the findings reveals that the respondents does not have adequate knowledge of the factors associated with hypertension in pregnancy which include; obesity, a family history of hypertension, alcohol intake, heart failure, stroke and left ventricular hypertrophy and smoking. The study also revealed that the control measures of hypertension in pregnancy include; attending pre-pregnancy counselling, attending antenatal care, use of anti-hypertensive drugs, and participating in physical exercise. However the findings of the study showed that the respondents are not adequately aware of these control measures. Therefore, it is recommended that there is need for increased awareness of pregnant women about pregnancy complications especially pregnancy induced hypertension through educational programs and mass media. To mention but a few.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background of the Study

High blood pressure is referred to as hypertension in medical terminology. When someone has hypertension, their systolic blood pressure (SBP) is more than 140 millimeters mercury (mm Hg), and their diastolic blood pressure (DBP) is greater than 90 millimeters mercury (mm Hg), according to the American Heart Association (Kofi, 2015). Individuals’ hypertension-related knowledge and actions have a critical role in managing hypertension and preventing the development of long-term consequences. People with hypertension must be equipped with the knowledge they need to cope with themselves, to be able to identify their illness, to analyze risk factors, and to recognize the need of long-term medication administration (Malik, Yoshida, Erkin, Salim, & Hamajima, 2016).

Patients’ knowledge and attitudes have an impact on the care of their illnesses, and increasing patient knowledge is beneficial. It has been shown to improve adherence to therapy in illnesses such as hypertension and hyperlipidemia. The information and attitude of the patients may have an influence on their condition, blood pressure management, morbidity rate, and mortality rate, among other things (Jimoh et al., 2017). Aside from that, knowledge is an important factor of behavior change and healthy lifestyle behaviors in the context of high blood pressure. Controlling hypertension requires consideration of a variety of social, economic, and environmental issues. Higher levels of information gained via health education and health promotion have a significant impact on lifestyle changes in the context of hypertension. As a result, individuals should choose behaviors or lifestyles that will help them maintain an optimum level of health (Zungu & Djumbe, 2019). Furthermore, it is thought that many individuals are unaware of the dangers of high blood pressure and how to prevent it. Inadequate understanding may result in severe patient concern and the incorrect use of medical care. If hypertension is allowed to go uncontrolled, particularly in rural areas where the majority of the population is illiterate, it will increase the incidence of stroke, heart failure, glaucoma, and renal failure, among other diseases.

Hypertensive disorder in pregnancy is a condition in which the pregnant woman presents an elevated blood pressure during pregnancy or puerperium as defined in 1986 by the American College of Obstetricians and Gynecologists and adopted by the World Health Organization (WHO) (Malik, Yoshida, Erkin, Salim, & Hamajima, 2016). Previous reports defined hypertension in pregnancy as a condition presented with a diastolic blood pressure of at least 90 mmHg or a systolic blood pressure of at least 140 mmHg, or a rise in diastolic blood pressure of at least 15 mmHg or a rise of 30 mmHg in systolic blood pressure. In the obstetric condition, the Working Group recently defined hypertension in pregnancy as a condition in which, the diastolic blood pressure is at 90 mmHg or above, or a systolic blood pressure is at 140 mmHg or above. Moreover, WHO considers only an elevated value of diastolic blood pressure as a criterion for defining the disorder. The disorder complicates 4-10% of pregnancies(Malik, Yoshida, Erkin, Salim, & Hamajima, 2016). The American College of Obstetricians and Gynecologists and the United Nations Organization recognize four categories of hypertension in pregnancy. These include chronic hypertension, gestational hypertension, preeclampsia/eclampsia, and super-imposed preeclampsia/eclampsia, a condition defined as chronic hypertension complicated by pre-eclampsia/eclampsia.


1.2 Statement of the Problem

According to World Health Organization (WHO) systematic analysis, hypertensive disorders of pregnancy attributed to 14% of maternal mortality and it is the second leading cause of maternal death after hemorrhage in sub-Saharan Africa which accounts for 16.0% of maternal mortality(Asnake, 2009). Similarly, WHO review identified hypertensive disorders of pregnancy were annually responsible for about 25,000 maternal deaths in Africa, 22,000 maternal deaths in Asia, 3,800 maternal deaths in Latin America and the Caribbean and 150 maternal deaths in industrialized countries(Hutcheon, 2011). Studies conducted on the global impact of preeclampsia and eclampsia showed that preeclampsia was associated with higher rates of preterm delivery, small for gestational age babies, stillbirth and low birth weight(Duley Lelia, 2009). Fetal morbidity and mortality increase substantially in women with preeclampsia and it is one of the leading causes of stillbirths and neonatal deaths (Khalid, 2006, and Asheber, 2011). Hypertensive disorders of pregnancy are among the five leading causes of maternal deaths in Nigeria which account for over 11% of deaths(Markos, 2016).

Recent evidence suggests that the presence of complications related to hypertension disorder of pregnancy was the result of inadequate knowledge; negative attitude towards hypertension in pregnancy and lack of preventive practice(Prabhanja, 2015). In addition, studies showed that women with a good awareness of pregnancy induced hypertension were more likely to promptly report symptoms and seek health care (Derege, 2007, & Mulugeta, 2016). Poor awareness of pregnant women is one of the potential factors for delay in seeking care and decision and a bottleneck for early diagnosis and management of critical illnesses. However, there was no evidence about the awareness of pregnant women regarding pregnancy induced hypertension in Nigeria. Hence the aim of this study is to assess the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age (18-45 years) in Asaba specialist hospital Delta State.


1.3 Objectives of the Study

The primary objective of this study is to assess the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age (18-45 years) in Asaba specialist hospital Delta State. Specifically, other objectives of this study are:

  1. To ascertain knowledge of women of child bearing age on the factors which contributes to hypertension in pregnancy.
  2. To ascertain knowledge of women of child bearing age on the effects of hypertension in pregnancy.
  3. To ascertain knowledge of women of child bearing age on the control measures of hypertension in pregnancy.

1.4 Research Questions

The following research questions will be answered in this study:

  1. What are the factors which contributes to hypertension in pregnancy?
    1. Obesity,
    2. A family history of hypertension,
    3. Alcohol intake,
    4. Heart failure,
    5. Stroke and left ventricular hypertrophy,
    6. Amoking
  2. What are the effects of hypertension in pregnancy?
    1. Decreased blood flow to the placenta,
    2. Low birth weight,
    3. Premature birth,
    4. Pre-eclampsia
  3. What are the control measures of hypertension in pregnancy?
    1. Attending pre-pregnancy counselling,
    2. Attending antenatal care,
    3. Use of anti-hypertensive drugs,
    4. Participating in physical exercise

1.5 Research Hypothesis

  • Ho: Women of child bearing age in Asaba specialist hospital Delta State do not have adequate knowledge on the control measures of hypertension in pregnancy.
  • Ha: Women of child bearing age in Asaba specialist hospital Delta State have adequate knowledge on the control measures of hypertension in pregnancy.

1.6 Significance of the Study

The findings of this study would primarily contribute to the existing limited evidence in this area and also have a great significance for program coordinators and health care facilities to design and implement effective strategies for the prevention and early management of pregnancy-induced hypertension. In addition, the data will be used as a baseline for other researchers who want to investigate further studies in this area.


1.7 Scope of the Study

This study focuses on the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age in Asaba specialist hospital Delta State. The study will be conduction among women within the age group of 18-45 years) in Asaba specialist hospital Delta State.


1.8 Limitations of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.


1.9 Definition of Terms

Prevalence:

In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition at a specific time.

Hypertension:

A condition in which the force of the blood against the artery walls is too high. Usually hypertension is defined as blood pressure above 140/90, and is considered severe if the pressure is above 180/120. High blood pressure often has no symptoms. Over time, if untreated, it can cause health conditions, such as heart disease and stroke. Eating a healthier diet with less salt, exercising regularly and taking medication can help lower blood pressure.

Pregnant Women:

Pregnant woman means a woman determined to have one or more embryos or fetuses in utero.


1.10 Organizations of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, abnd selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the assessment of the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age (18-45 years) in Asaba specialist hospital Delta State. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was to assess the knowledge of hypertension in pregnancy and it’s control measures among women of child bearing age (18-45 years) in Asaba specialist hospital Delta State. The study is was specifically set to ascertain knowledge of women of child bearing age on the factors which contributes to hypertension in pregnancy; ascertain knowledge of women of child bearing age on the effects of hypertension in pregnancy; and ascertain knowledge of women of child bearing age on the control measures of hypertension in pregnancy.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent are women of child bearing age (18-45 years) in Asaba specialist hospital Delta State.


5.3 Conclusions

In the light of the analysis carried out, the following conclusions were drawn.

  1. The rate at which hypertension is prevalent in pregnant women is very high.
  2. The respondents does not have adequate knowledge of the factors associated with hypertension in pregnancy which include; obesity, a family history of hypertension, alcohol intake, heart failure, stroke and left ventricular hypertrophy and smoking.
  3. Hypertension in pregnancy has severe effects which include; decreased blood flow to the placenta, low birth weight, premature birth, and Pre-eclampsia.
  4. The control measures of hypertension in pregnancy include; attending pre-pregnancy counselling, attending antenatal care, use of anti-hypertensive drugs, and participating in physical exercise. However the findings of the study showed that the respondents are not adequately aware of these control measures.

5.3 Recommendation

With respect to the findings and the aim of this study, the researchers therefore recommend that;

  1. There is need for increased awareness of pregnant women about pregnancy complications especially pregnancy induced hypertension through educational programs and mass media.
  2. Primary care physicians should effectively assume their role so as ensure the early identification and management of hypertension during early antenatal care.
  3. Pregnant women should endeavour to seek for the services of a physician when having hypertension, and not rely on self medication and traditional treatments.

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