Effect of video assisted teaching on level of knowledge and attitude on human milk banking among women

Vineesha Vijayan¹, Reena Vincent², Angela Gnanadurai³, Manoj V. C.⁴

¹M.Sc. Nursing, Student, Jubilee Mission College of Nursing, Thrissur.

²Professor, Jubilee Mission College of Nursing, Thrissur.

³Principal cum Professor, Jubilee Mission College of Nursing, Thrissur.

⁴Professor and Head of Neonatology Department, Jubilee Mission Medical College Research Institute, Thrissur.

*Corresponding Author Email: reenavincent111@gmail.com

ABSTRACT:

Human milk bank mission is to promote and support breastfeeding by providing safe, high quality donor milk to fill a gap for those who need mother’s milk but cannot receive it. This service provides mothers to give their new born the nutrition they need for healthy growth. Objectives: Assess the level of knowledge and attitude on human milk banking among women before and after video assisted teaching, assess the effect of video assisted teaching on level of knowledge and attitude on human milk banking among women, correlate between the knowledge and attitude on human milk banking among women. associate between pretest level of knowledge on human milk banking with selected sociodemographic and clinical data variables among women and associate between pretest level of attitude on human milk banking with selected sociodemographic and clinical data variables among women. Methodology: Pre-experimental one group pretest- posttest design was adopted for the study. 40 women were selected by purposive sampling technique. Data were collected by using structured knowledge questionnaire and structured attitude rating scale. The collected data were analyzed by using descriptive and inferential statistics SPSS 25. Results: In the pre-test, 15(37.50%) of samples had inadequate knowledge and 12(30%) had unfavorable attitude, while in the post-test 25(62.50%) had adequate knowledge and 29(72.50%) of them had favorable attitude on human milk banking. The calculated paired t-test value on overall pre and post-test knowledge score was 19.08 and the calculated paired t-test value on overall pre and post-test attitude score was 10.63 which was higher than the table value (t39=2.023, p<0.05). There was a moderate positive correlation (r=0.638, p<0.001) between level of knowledge and attitude on human milk banking among women. This indicates that when knowledge increases their attitude also increases about human milk banking. There was a highly significant (p<0.001) association between selected sociodemographic and clinical data variables of education status (p=0.000) with pre-test level of knowledge and attitude on human milk banking among women. There was a significant association between selected sociodemographic and clinical data variables of occupation (p=0.030) with pre-test level of attitude on human milk banking among women. Conclusion: It is evident that video assisted teaching on human milk banking was effective method to improve knowledge and attitude among women.

KEYWORDS: Knowledge, Attitude, Human milk banking, Human milk, Donor milk, Video assisted teaching, Women.

INTRODUCTION:

Human breast milk is considered as the best source of all nutrients, beyond that it is the only living food source for infants especially during the first six months of their life.¹ According to WHO, breast feeding can save up to 80% of infant mortality as mother’s milk is the best source of nutrition for thebaby.² As  human milk is the best and safest feed for a baby, infants who don’t have access to mother’s milk due to clinical reasons, or those who are orphaned or abandoned, can receive mother’s milk from the milk bank. Feeding newborn, especially low birth weight babies with pasteurized breast milk can reducetheriskofinfectionsandboosttheimmunesystem.³

WHO and UNICEF issued a joint statement in 1979 stating “Where it is not possible for the biological mother to breast feed, the first alternative, if available, should be the use of human breast milk from other sources. Human milk banks should be made available inappropriate situations”^. Hence the Government, health experts and the civil society must join hands to propagate the concept of human milk banking.⁴

STATEMENT OF THE PROBLEM:

A study to assess the effect of video assisted teaching on level of knowledge and attitude on human milk banking among women in the tertiary hospital, Thrissur.

OBJECTIVES:

1. To assess the level of knowledge and attitude on human milk banking among women before and after video assisted teaching.

2. To assess the effect of video assisted teaching on level of knowledge and attitude on human milk banking among women.

3. To correlate between the knowledge and attitude on human milk banking among women

4. To associate between pretest level of knowledge on human milk banking with selected sociodemographic and clinical data variables among women

5. To associate between pretest level of attitude on human milk banking with selected sociodemographic and clinical data variables among women

HYPOTHESES:

H₁:   There is significant difference in the pre and post-test level of knowledge and attitude towards human milk banking among women

H₂:   There is significant correlation between knowledge and attitude on human milk banking among women

H₃:   There is significant association between pretest level of knowledge regarding human milk banking with selected sociodemographic and clinical variables among women

H₄:   There is significant association between pretest level of attitude regarding human milk banking with selected socio demographic and clinical variables among women

MATERIAL AND METHODS:

Quantitative research approach with pre-experimental one group pre-test post-test design was adopted for the study. The study was conducted in St Joseph and St George ward of Jubilee Mission Medical College and Research Institute, Thrissur. Purposive sampling was used to select the samples. The sample size was 40.

Description and development of the tool:

The tool consists of three sections

Section A – Sociodemographic and clinical data questionnaire of women

Section B -Structured knowledge questionnaire to assess the knowledge on human milk banking among women. The tool consisted of 26 questions with multiple choices. The total scores range from 0 to 26. The scores are interpreted as adequate (>75%), moderately adequate (50-75%) and inadequate knowledge (<50%). The content validity index of the tool was > 0.8. The reliability of tool was calculated by Guttman split half co-efficient [r = 0.80].

Section C- Structured four-point rating scale to assess attitude on human milk banking among women. The tool consisted of 22 statements with strongly agree (4), agree (3), disagree (2) and strongly disagree (1). Maximum score was 88 and minimum score was 22. The scale consists of 11 positive items which were scored as 4,3,2,1 and whereas 11negative items scored reversely. The score was categorized as favourable (>75%), moderately favourable (50-75%) and unfavourable attitude (50%). The content validity index of the tool was > 0.8. The reliability of rating scale was assessed by Cronbach’s alpha [r=0.85].

Video assisted teaching:

The video on human milk banking was prepared on the basis of objectives, review of research, non-research literatures and guidance of experts in the subject area. It was validated by 5 subject experts. Translation of the lesson plan was done in English and Malayalam. The content was modified according to the suggestions given by the experts in consultation with the guide.

Data collection process:

Investigator obtained informed consent from the participants. pre-test was conducted by administering structured knowledge questionnaire and attitude rating scale on human milk banking. This was followed by video assisted teaching on human milk banking provided on individual basis for a duration of 20 minutes. Post-test was done on the fourth day of intervention by using same knowledge questionnaire and rating scale on human milk banking among women. The data obtained was analysed using both descriptive and inferential statistics on SPSS 25.

RESULTS:

Table 1: Frequency and percentage distribution of women based on sociodemographic and clinical variables such as age, education, occupation, type of family and income      (n=40)

Sociodemographic and clinical variables	Characteristics	Frequency(f)	Percentage (%)
Age	18-21	6	15
	22-25	12	30
	26-29	13	32.50
	30-40	9	22.50
Education	Primary school education	3	7.50
	High school education	6	15
	Secondary school education	7	17.50
	Diploma	8	20
	Graduation and above	16	40
Occupation	Private	8	20
	Government	3	7.50
	Homemaker	29	72.50
Type of family	Nuclear Family	18	45
	Joint Family	20	50
	Extended family	2	5
Income per month	1000 – 5000	4	10
	5001-10000	16	40
	10001-20000	18	45
	Above20000	2	5

The data in the table 1 depicts that among 40 samples13 (32.50 %) of them were in the age group of 26-29 years. Nearly half of the samples 16 (40%) had graduation and above. Majority of samples 29 (72.50%) were homemakers. Half of the samples 20(50%) were belonged to joint family. Almost half of the samples 18(45%) had monthly income between Rs 10001 – 20000.

Table 2: Frequency and percentage distribution of women based on sociodemographic and clinical variables such as area of residence, religion, previous knowledge on human milk banking, parity and type of initial feeding prefers for new born.                  (n=40)

Socio-demographic and clinical variables	Characteristics	Frequency(f)	Percentage (%)
Area of residence	Rural	28	70
	Urban	12	30
Religion	Hindu	21	52.50
	Christian	11	27.50
	Muslim	8	20.00
Previous knowledge on human milk banking	Yes	17	42.50
	No	23	57.50
If yes, source of information	Massmedia	3	17.70
	Magazines	0	0
	Newspaper	8	47
	Friends/Relatives/ Family Member	1	5.90
	Health Professionals	5	29.40
Parity	Primipara	23	57.50
	Multipara	17	42.50
Type of initial feeding prefer for new born	Breast feed	40	100
	Cow's milk	0	0
	Formula feed	0	0

Table 2 shows that most of the samples 28(70%) were residing in rural area. Majority of the samples 21(52.50%) were Hindus. More than half of the samples 23 (57.50%) had no knowledge on human milk banking and 17(42.50%) had knowledge on human milk banking. 8(47%) of samples had source of information from newspaper. More than half 23(57.50%) of the samples were primigravida mothers and 17(42.50%) were multigravida mothers. All samples 40(100%) preferred only breast feed.

Table 3: Frequency and percentage distribution of women based on pre and post-test level of knowledge on human milk banking     (n=40)

S. No	Domain of knowledge		Adequate	Moderately adequate	Inadequate
			f (%)	f (%)	f (%)
I	Breast feeding	Pre test	25 (62.50)	10 (25.00)	5 (12.50)
		Post test	39 (97.50)	1 (2.50)	0
II	Human milk banking	Pre test	16 (40.00)	10 (25.00)	14 (35.00)
		Post test	30 (75.00)	8 (20.00)	2 (5.00)
III	Breast milk expression	Pre test	0	16 (40.00)	24 (60.00)
		Post test	9 (22.50)	25 (62.50)	6 (15.00)
IV	Storage and transporta-tion	Pre test	3 (7.50)	10 (25.00)	27 (67.50)
		Post test	12 (30.00)	16 (40.00)	12 (30.00)
	Over all	Pre test	0	25(62.50)	15 (37.50)
		Post test	25 (62.50)	15 (37.50)	0

Data from table 3 reveals that the overall level of knowledge in pre test shows that 15(37.50%) of samples had inadequate knowledge, while in the post test 25 (62.50%) of samples had adequate knowledge on human milk banking.

Table 4: Frequency and percentage distribution of women based on pre and post-test level of attitude on human milk banking              (n=40)

S. No	Domain of attitude		Favorable attitude	Moderately favorable attitude	Unfavorable attitude
			f (%)	f (%)	f (%)
I	Human milk banking	Pre test	20 (50.00)	19 (47.50)	1 (2.50)
		Post test	40 (100)	0	0
II	Donating milk	Pre test	5 (12.50)	26 (65.00)	9 (22.50)
		Post test	25 (62.50)	15 (37.50)	0
III	Accepting donating milk	Pre test	8 (20.00)	22 (55.00)	10 (25.00)
		Post test	23 (57.50)	17 (42.50)	0
	Over all	Pre test	1 (2.50)	27(67.50)	12 (30.00)
		Post test	29 (72.50)	11(27.50)	0

Table 4 shows that the overall level of attitude shows that in pre-test12 (30%) of samples had unfavourable attitude, while in post-test 29 (72.50%) had favourable attitude on human milk banking.

Data on figure 1 shows that the mean post-test knowledge score obtained in each domain of knowledge on human milk banking was higher than the mean pre-test knowledge score. The overall mean post-test knowledge score19.10 was higher than the mean pre-test knowledge score 13.88 which indicates that video assisted teaching enhances knowledge of women.

Figure 1: Domain wise distribution of mean pre and post-test knowledge score on human milk banking among women    (n=40)

Figure 2: Domain wise distribution of mean pre and post-test attitude score on human milk banking among women (n=40)

Data on figure 2 reveals that the mean post-test attitude score obtained in each domain of human milk banking was higher than the mean pre-test attitude score. The overall mean post-test attitude score on human milk banking was 68.58 which was higher than the mean pre-test score was 55.68 which indicates video assisted teaching enhanced the attitude of women.

The table 5 depicts that there was a moderate positive correlation(r=0.638) between level of knowledge and attitude on human milk banking among women at (p<0.001)

Table 5: Correlation between post-test level of knowledge and attitude on human milk banking among women.                  (n =40)

Variables	Karl Pearson Correlation coefficient(r)	p value
Level of knowledge	0.638	<0.001***
Level of attitude

*** Highly significant (p<0.001)

Table 6: Chi square (χ²), degree of freedom (df) and p values of association between pre-test level of knowledge and attitude on human milk banking with education and occupation                (n=40)

Socio demographic and clinical variables	Pre-test Level of Knowledge and attitude				χ^2	df	p value
	Moderately adequate		Inadequate
	f	%	f	%
Level of knowledge
Education
Below Degree	3	18.80	13	81.30	21.778	1	<0.001***
Above Degree	22	91.70	2	8.30
Level of attitude
Education
Below Degree	5	31.30	11	68.80	16.11	1	<0.001***
Above Degree	23	95.80	1	4.20
Occupation
Employed	11	100.0	0	0	4.681	1	0.030*
Unemployed	17	58.60	12	41.40

*Significant(p<0.05) *** Highly significant(p<0.001)

Table 6 reveals that there was a highly significant (p<0.001) association between sociodemographic and clinical variables of education with pretest level of knowledge on human milk banking among women. There was a highly significant (p<0.001) association between the sociodemographic and clinical variables of education and a significant association between the sociodemographic and clinical variables of occupation with pre-test level of attitude on human milk banking among women. There was no statistically significant association found with other sociodemographic and clinical variables such as age, occupation, type of family, income per month, area of residence, previous knowledge on human milk banking, parity and type of initial feeding prefer for new born with pre-test level of knowledge on human milk banking among women.

DISCUSSION:

Section 1: Description of sociodemographic and clinical data variables of women:

From the table 1 and 2 reveals that 13 samples (32.50 %) were in the age group of 26-29 years,12(30%) were in the age group of 22-25 years, 9 (22.50%) were in the age group of 30-40 years and 6 (15%) were in the age group of 18-21 years. Regarding education status 16 (40%) of them had graduation and above 8(20%) had diploma, 7(17.50%) had secondary school education, 6 (15%) had high school education and only 3 (7.50%) of them had primary school education. The data in the present study shows that only 17(42.50%) samples had previous knowledge on human milk banking and more than half 23(57.50%) samples had no knowledge on human milk banking 8(47%) of samples had source of information from newspaper.

Section 2: Analysis of knowledge and attitude on human milk banking among women before and after the video assisted teaching:

In the pre-test 15(37.50%) of samples had inadequate level of knowledge and none of the samples had adequate level of knowledge regarding human milk banking. While in the post-test, 25(62.50%) had adequate level of knowledge and none of the samples had inadequate knowledge regarding human milk banking. The finding was supported by a pre-experimental study to assess the effectiveness of structured teaching programme on knowledge regarding human milk banking showed that 52(86.70%) of mothers had inadequate knowledge, 7(11.70%) had moderate knowledge and 1(1.70%) had adequate knowledge. While in the post-test 52(86.70%) of them had adequate knowledge 18(13%) were having moderate knowledge³.

Regarding pre-test level of attitude, 12(30%) of them had unfavourable attitude and 1(2.50%) had favourable attitude on human milk banking. Whereas in the post-test, 29(72.50%) had favourable attitude and none of the samples had unfavourable attitude on human milk banking. The findings were supported by a non-experimental study to assess the knowledge and attitude of postnatal mothers showed that 67% of postnatal mother had unfavourable attitude and33% had favourable attitude towards human milk banking.⁵

Section 3: Effect of video assisted teaching on knowledge and attitude on human milk banking among women:

The mean post-test knowledge score on human milk banking was (19.10±2.50) which was higher than the mean pre-test knowledge score (13.88±2.90). The mean post-test attitude score on human milk banking (68.58±6.83) which was higher than the mean pre-test attitude score (55.68±10.12). The calculated paired t-test value on overall pre and post-test knowledge score was 19.08 and the calculated paired t-test value on overall pre and post-test attitude score10.63 was higher than the table value (t39=2.023, p<0.05). It is inferred that the video assisted teaching was effective in improving the knowledge and changing the attitude on human milk banking among women. Hence there search hypothesis H₁: There is significant difference in the pre-test and post-test level of knowledge and attitude on human milk banking among women, was accepted.

The study findings were supported by a pre-experimental study to assess the effectiveness of information booklet on knowledge and attitude regarding human milk banking among postnatal mothers showed that the mean post-test knowledge score on human milk banking (32.7±2.18) which was higher than the mean pre-test knowledge score (9.8±4.13) and the mean post-test attitude score on human milk banking (36.76±2.06) was higher than mean pre-test attitude score (19.76±5.11). These results shown that the intervention had shown a very good impact in improving the knowledge and attitude of women regarding human breastmilk banks and donation of breastmilk.⁶

Section 4: Correlation between the level of knowledge and attitude on human milk banking among women:

There was a moderate positive correlation (r=0.638, p<0.001) between level of knowledge and attitude on human milk banking among women. This indicates that when knowledge increases their attitude also increases about human milk banking. Hence the formulated hypothesis H₂: There is significant correlation between level of knowledge and level of attitude on human milk banking among women was accepted.

The findings of the present study were controversial to the findings of a descriptive study conducted to assess mother’s knowledge and attitude on feeding of banked human milk among infants” with view to develop an information booklet shows that there was no correlation (r=0.113) between knowledge and attitude scores of mothers toward feeding of banked human milk among infants.⁷

Section 5: Association between pre-test level of knowledge on human milk banking with selected sociodemographic and clinical data variables among women:

There was a highly significant(p<0.001) association between selected sociodemographic and clinical data variables of education status with pre-test level of knowledge on human milk banking among women. This indicates that women who had education status above degree had more knowledge on human milk banking compared to women with below degree education. Hence, H₃: There is significant association between pretest level of knowledge on human milk banking with selected socio demographic and clinical data variables among women, was accepted.

The findings of the present study are consistent with a descriptive study conducted to assess the knowledge regarding human milk banking among mothers admitted in the labour room and post-natal wards revealed that the association of level of knowledge among mothers with selected sociodemographic and clinical data variable of education(p=0.001) was statistically highlysignificant.⁸

Section 6: Association between pre-test level of attitude on human milk banking with selected sociodemographic and clinical data variables among women:

There was a highly significant (p<0.001) association between selected sociodemographic and clinical data variable of education and a significant (p<0.05) association between occupation with pre-test level of attitude on human milk banking among women. Hence, H₄: There is significant association between pretest level of attitude on human milk banking with selected socio demo graphic and clinical data variables among women was accepted.

The findings of the present study were supported by a cross-sectional study conducted to determine the views of mothers on donor milk and human milk banks revealed that there was statistically significant association was found between selected sociodemographic and clinical data variables of number of children (p=0.013) and employment status (p=0.018) with the mother’s view on donor milk banking.⁹

CONCLUSION:

From this study findings it was concluded that video assisted teaching on human milk banking was very effective in improving the level of knowledge and attitude regarding human milk banking among women. The present study identified the need for inculcating more awareness programs on human milk banking to the mothers.

CONFLICT OF INTEREST:

The author declares no conflict of interest.

ETHICAL CLEARANCE:

The ethical clearance was taken from the institutional research and ethical committee, JMMC and RI, Thrissur on 06/07/2021 with IEC study reference number: 76/21/JMCON RC

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Received on 26.09.2025         Revised on 28.10.2025

Accepted on 27.11.2025      Published on 21.02.2026

Available online from February 23, 2026

Asian J. Nursing Education and Research. 2026;16(1):33-38.

DOI: 10.52711/2349-2996.2026.00008

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