A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge and Attitude Regarding Diet in Pregnancy among Antenatal Mothers


Bincy Mathew

Sister Tutor, Shri Vinoba Bhave College of Nursing, Silvassa, Dadra and Nagar Haveli, India.

*Corresponding Author Email: bincyam@gmail.com



In developing countries like India, the maternal and infant mortality and morbidity rate is still high. The slogan of the World Health Day 2005 “make every mother and child count” reflects the reality that today Government and community need to make the health of women and children a higher priority. The objective of this study was to assess the knowledge and attitude of antenatal mothers regarding diet in pregnancy and to determine the effectiveness structured teaching program by comparing the pretest and post test scores of knowledge and attitude. An evaluative approach with pre-experimental one group pretest posttest research design was adopted for this study. A total of 60 antenatal mothers were selected by convenient sampling method. Data were collected by using structured interview schedule. Impacted knowledge to mothers by using structured teaching program. The data collected were analyzed by using both descriptive and inferential statistical methods. The overall mean percentage of knowledge in the pre-test was 55.5 with standard deviation of 2.94 and of attitude were 85.3 with standard deviation of 2.3. In the post test the overall mean percentage of knowledge was 93.67 with standard deviation 1.19 with a positive difference of 38.17 and 1.43 and of attitude were 98.93 with standard deviation of 0.87 with a positive difference of 13.63 and 1.43. There was a significant improvement in knowledge and attitude of antenatal mothers regarding diet in pregnancy after the teaching programme.


KEYWORDS: Structured teaching programme, Diet in pregnancy, Knowledge, Attitude, Antenatal mother.




Nutrition is a basic human need that changes throughout the life cycle and among the wellness – illness continuum. It is the prime necessity of life. Nutrition is vital for life and health and it facilitates for the proper growth and development. Poor nutrition can seriously decrease one’s level of wellness.1


Nutrition is a key factor in national development. Nutritional well being is a sustainable force for health and development and for maximization of human genetic potential.


The term maternal nutrition focuses attention on woman as mothers, on their nutritional status as it relates to the bearing and nurturing of children. At the same time women also play vital roles in their families, communities and societies. Therefore general health and nutritional status of the mother is a significant factor for the development of a healthy future generation in the nation.2


Pregnancy is a remarkable anabolic process whereby out of food, vitamins, minerals and hormones, a 3.2 KG baby is born within 9 months. The fetus is in a sense a parasite to the mother and draws its nourishment from her diet. If the nourishment of the mother is inadequate, her body reserves are drawn upon and depleted.3 Pregnancy is a highly demanding period nutritionally This period takes care of the mother and fetus both, where extra food required to take care of baby’s weight followed by lactation, where once again extra nutrition is required for the production of milk. A healthy body tissue depends directly on essential nutrients in food. This is especially true during pregnancy because a whole new body is being formed.4


A well nourished healthy child is the outcome of combination of all the factors like literacy or numeracy or high economic status. Improving women’s nutritional status and empowering them with education and knowledge is very essential.5



The diet of a woman before and during pregnancy has immense influence on the course of pregnancy and health of a child--both after its delivery and in the future. Lack of dietary knowledge and the knowledge about consequences of malnutrition among mothers may result in a lot of dietary indiscretion, which in turn can cause deficiency or excess of energy and particular nutrients, as well as abnormal course of pregnancy. Hence, for keeping a proper diet during pregnancy a woman must not only know the healthy eating guidelines, but also realize how a diet influences the course of pregnancy and child's health.6


The mother’s diet during pregnancy has a direct influence on fetal growth and hence, the size and health of new born. Mothers eating inadequate food during pregnancy will give birth to Low Birth Weight babies which is the main cause of infant death rate in India. A large number of such babies are premature and rest suffer from Intra Uterine Growth Retardation. Inadequate diet during pregnancy also affects the health of the baby during early pregnancy and they develop nutritional deficiency diseases like anemia, rickets etc.7 Nutrition is the major intrauterine environmental factor that alters expression of the fetal genome and may have lifelong consequences. This phenomenon, termed “fetal programming,” has led to the recent theory of “fetal origins of adult disease.”


During the clinical postings, the investigator found that the women coming to the OPD were not able to follow the promotional health measures to bring healthier community due to their inadequate knowledge and some of the traditional believes. The inadequate health during the period of pregnancy will influence the mother as well as the baby. The family and community will feel satisfied and secured life when the women take initiative in caring themselves. So that, the women should have appropriate and adequate knowledge on nutritious diet, exercise and minor ailment occurs during pregnancy. Hence, the investigator planned to conduct a study to improve their knowledge on diet to promote health during pregnancy.


1.      To assess the knowledge of the antenatal mothers regarding diet in pregnancy.

2.      To assess the attitude of antenatal mothers regarding diet in pregnancy.

3.      To determine the effectiveness planned teaching program on diet in pregnancy by comparing the pretest and post test scores of knowledge and attitude.



H1 - The mean post test knowledge score of the mothers is significantly higher than the mean pre test knowledge score.

H2 - The mean post test attitude score of the mothers is significantly higher than the mean pre test attitude score.



5.1 Research Approach and Design:

The research approach adopted for this study is evaluative approach. The research design used in this study is the quantitative, pre-experimental design i.e. “Pre-test, post test with one group”8 was used for assessing the effectiveness of structured teaching program on knowledge and attitude regarding diet in pregnancy among antenatal women attending OPD


5.2. Variables:

In the present study independent variable is structured teaching program on diet in pregnancy. In the present study dependent variable is knowledge and attitude of antenatal mother regarding diet in pregnancy


5.3. Setting and Sampling technique:

The study was conducted at a selected hospital of Vapi. The population comprise of antenatal mothers who were attending OPD at Haria L.G. Rotary Hospital, Vapi. Samples are the 60 antenatal mothers (who fulfill the selection criteria). The sample size of the study is 60. In this study, non-probability, purposive sampling technique was used for the selection of the samples.


5.4. Inclusive criteria:

1     Antenatal mothers having gestational age from 12 to 32 weeks.

2     Mothers who are willing to participate in this study.

3     Mothers who are available during the period of data collection.

4     Mothers who are able to understand and speak Hindi.


5.5. Data Collection Method:

The data collection method used for the study is the interview schedule. Structured interview schedule and likert scale were prepared to assess the knowledge and attitude of antenatal mothers, based on objectives of the study by the investigator after reviewing literature on diet in pregnancy and considering the opinion of the nursing subject experts.


5.6. Validation of the Tool:

Content validity of the instrument was assessed by obtaining opinion from obstetrical gynecological health experts and nutritional experts as per their suggestions. The investigator had made necessary modifications in the tool.



The data collected were analyzed according to the plan for data analysis which included both descriptive and inferential statistics. The data findings have been tabulated and are organized and finalized according to the plan for data analysis and presented under the following sections:



6.1. Comparison of pre and post-test of knowledge of the mothers regarding diet in pregnancy N = 60

Table 1: Comparison of Pre and Post-Test Knowledge

S. No

Knowledge Variables

Pre-test Mean

Post-test Mean

Mean Difference

‘t’ value


General Aspects






Physiological Adaptation During Pregnancy






Diet Modifications






Dietary Sources






Overall Knowledge





Note:  ** statistically significant (t >1.67)


6.2. Comparison of pre and post-test of attitude of the mothers regarding diet in pregnancy N = 60

Table 2: Comparison of Pre and Post-Test Attitude

Knowledge Variables

Pre-test Mean

Post-test Mean

Mean Difference

‘t’ value


Physiological Aspects






Social Aspects






Overall Attitude





Note:  ** statistically significant ( t >1.67)


6.3. Comparison of total score of pre and post-test knowledge and attitude of the mothers regarding diet in pregnancy N = 60

Table 3: Comparison of total score of pre and post-test knowledge and attitude.

S. No


Pre-test Mean

Post-test Mean

‘t’ value











Note:  ** statistically significant ( t >1.67)9


The gain in knowledge and attitude score is significant (t =22.5055 for knowledge, t=18 for attitude) since calculated value is higher than the table value (1.67)at 59 df, therefore the research hypothesis H1andH2 are accepted. Hence findings reveals that STP on diet in pregnancy is effective.



The present study shows that the mean difference of pretest post test knowledge score is 7.73 with t value of -22.51 at df 59, 0.05 and attitude score is 5.75 with t value of -18 at df 59, 0.05. It reveals the effectiveness of STP. This finding are supported by the study findings of P. Kavitha, et al on effectiveness of STP on warning signs of pregnancy where the mean difference in the knowledge score is 6 with t value of 38.2 and in the attitude score is 9.4 with t value of 19.9 at df 59, 0.05.10

Based on the findings of the study the following conclusion was drawn. The existing knowledge regarding diet in pregnancy among antenatal mothers was inadequate and moderately adequate. The existing attitude regarding the social aspects was moderately favorable attitude. The structured teaching program significantly increased the knowledge (‘t’ value is 21) and attitude (‘t’ value is 18) regarding diet in pregnancy among the antenatal mothers. Based on the statistical findings it is evident that provision of such kind of structured teaching program will motivate the antenatal mothers and help them to acquire knowledge and  develop positive attitude.



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Received on 27.08.2016                Modified on 19.02.2017

Accepted on 14.03.2017                © A&V Publications all right reserved

Asian J. Nur. Edu. and Research.2017; 7(3): 345-347.

DOI: 10.5958/2349-2996.2017.00069.6