THESIS

Chapter - І
INTRODUCTION
“Pregnancy is a beautiful phase because it gives a woman the joy and

fulfilment which comes from bringing a new life into the world.”
-William Penn
Pregnancy is a normal physiological process, which constitutes a unique

period in the life of the women and her family. In most cases, pregnancy does not
show abnormalities, however, in some cases it could be affected by some
complications that impose-stress in both the mother and fetus. So pregnancy is a
normal physiological process when there is any deviation from the normal then
its effects on well-being of the mother, one of the most common complication
occur during pregnancy is gestational diabetes mellitus. (Gestational Diabetes
Mellitus). It is described as glucose intolerance of varying severity with the onset
of first recognition during pregnancy and disappears with delivery. 1
Gestational diabetes generally occurs during between the 20 th and 24th

weeks of pregnancy, mostly caused by positive family history, previous birth of
an overweight baby, unexplained perinatal loss, presence of polyhydramnios,
persistent glycosuria, age over 30 years, obesity. And the signs and symptoms of
(Gestational Diabetes Mellitus) are feeling thirsty, being tired, dry mouth, blurred
vision, nausea, frequent bladder, vaginal or skin infections, frequent urination,
sugar in the urine. When the mother is having (Gestational Diabetes Mellitus)
there is a chance of maternal and fetal complications like abortion, preterm labor,
pre-eclampsia, polyhydramnios, nephropathy, hypo and hyperglycemia are the
maternal complications. And fetal complications are congenital abnormalities,
increased neonatal and perinatal-mortality, macrosomia, birth-trauma, late
stillbirth, neonatal hypoglycemia, jaundice, hyperbilirubinemia.2
Incidence of gestational diabetes mellitus (Gestational Diabetes Mellitus)
varies globally from 2% to 14%. These cases in India are also increasing and
emerging as a major public health problem. The prevalence of Gestational
Diabetes Mellitus among urban population of India has been reported as 16% and
17.8%, respectively. Screening strategy for detection of Gestational Diabetes
Mellitus are Low risk: absence of any risk factors. Average risk: presence of some
risk factors should perform screening test. High risk: blood glucose test as soon
as possible. The method employed is by using 50gm oral glucose challenge test
without regard to time of day or last meal, between 24 weeks and 28 weeks of
pregnancy. A plasma glucose value of 140mg% or that of whole blood of 130
mg% at 1 hour is considered as cut off point for consideration of a 100gm (WHO-
75gm) glucose tolerance test. Management of (Gestational Diabetes Mellitus) to
reduce the maternal and fetal mortality and morbidity rates. Preconception
counselling goal is to achieve tight control of diabetes before the onset of
pregnancy. Ideally a diabetic woman should be seen jointly by the diabetologist,
obstetrician, and dietician. Fetal congenital malformations are low in woman who
receives preconception counselling. The mother should done Early registration,
regular antenatal checkups, consultation with dietician, and life style modification
like regular exercises, water intake, aerobic exercise with resistance training 2
times a week, and adequate sleep and rest. The woman should perform self-blood
glucose monitoring using reflectance meter. Woman with well controlled
Gestational Diabetes Mellitus have reduced risk of complications. The control of
high blood glucose is done by restriction of diet, exercise with or without insulin.
Human insulin should be started if fasting plasma glucose level exceeds 90mg/dl
and 2 hours postprandial value is greater than 120mg/dl(repetitive) even on diet
control. 3
Prevention of gestational diabetes is not always possible, but certain risk

factors make it more likely that a woman develop Gestational Diabetes Mellitus
2
during pregnancy. However, maintaining a healthy weight before and after
conception, eating well like plenty of whole fruits and vegetables, moderate
amount of lean proteins and healthy fats, moderate amount of whole grains, such
as soft drinks, fruits, juices, and pastries. and exercising regularly like walking,
stationary cycling, swimming 30min per day of any of these activities should raise
your heart rate and leave you sweating, by doing all these during pregnancy can
all reduce the risk of Gestational Diabetes Mellitus. So it is very important to
mothers to know the condition and how to overcome the risk of pregnancy and
how to prevent the maternal and fetal complications.
Need for study:
Diabetes is a major public health problem in India with prevalence rates

reported to be between 4.6% and 14% in urban areas, and 1.7% and 13.2% in
rural areas. India has an estimated 62 million people with Type 2 diabetes mellitus
(DM); this number is expected to go up to 79.4 million by 2025. Not surprisingly,
in parallel with the increase in diabetes prevalence, there seems to be an
increasing prevalence of Gestational Diabetes Mellitus that is, diabetes diagnosed
during pregnancy. The prevalence of gestational diabetes has been reported to
range from 3.8% in Kashmir, to 6.2% in Mysore, 9.5% in Western India and
17.9% in Tamil Nadu. In more recent studies, using different criteria, prevalence
rates as high as 35% from Punjab and 41% from Lucknow have been reported.
The geographical differences in prevalence have been attributed to differences in
age and/or socioeconomic status of pregnant women in these regions. It is
estimated that about 4 million women are affected by Gestational Diabetes
Mellitus in India, at any given time point.
Pregnancy is also known as gestation, is the time during which one or more
offspring develops inside a woman. Antenatal care, is a type of preventive health
care, its goal is to provide regular check-ups that allow doctors or midwives to
treat and prevent potential health problems throughout the course of the
3
pregnancy and to promote healthy lifestyles that benefits both mother and child.
Gestational diabetes mellitus as the glucose intolerance during pregnancy.
Treatment of Gestational Diabetes Mellitus is important to avoid maternal and
fetal complications. Women with Gestational Diabetes Mellitus and their
offspring’s are At increased risk of future type 2 diabetes and metabolic
abnormalities.
As pregnancy brings physical as well as emotional changes in a women

life, it is considered an additional demand on the individual. So during pregnancy
the mother may effect the risk factors associated with gestational diabetes
mellitus. Gestational Diabetes Mellitus is a serious health concern because it not
only pose immediate maternal complications like (pre-eclampsia, caesarian
delivery) and fetal complications like(macrosomia, shoulder dystocia, birth
injuries, hypoglycemia, respiratory distress syndrome).
The prevalence of Gestational Diabetes Mellitus is on the rise globally. The

global increase is occurring mostly in low and middle income countries like India
where access to maternal care is often limited. There were an estimated 204
million woman world wide had gestational diabetes mellitus. WHO estimated that
prevalence of Gestational Diabetes Mellitus in India was about 40.9million
in2009 and is expected to rise to 69.9 million by 2025. Thus making it an
important public health problem in India. In India with reported prevalence rate
between 4.6% to 14% in urban areas and 1.7 to 13.2% in rural areas. With
increasing prevalence of diabetes, there seems to be an increase in the prevalence
of gestational diabetes mellitus. So there is a need to conduct the study regarding
gestational diabetes among antenatal mothers.
4
Table – 1 : Incidence of gestational diabetes mellitus
Gestational diabetes mellitus Year incidence rate
Global 2019 204 million
In India 2019 40.9 million
Urban areas 2019 4.6% to 14%
Rural areas 2019 1.7% to 13.2%
Source of Data: Centers for disease control and prevention
Figure 1: Prevalence of Gestational Diabetes in the Year of 2018.
Source: Springer Current Diabetes Reports 16(1) 2018.
5
Table 2: Data of GDM from different sources in 2019
Source of Data GDM cases

DHBs 4385
Ministry of Health 6453
Laboratories 4741
Self-Report 6815
All sources combined 6818
Source: Article Number 349 (2019) from BMC.
The prevalence of diabetes is increasing globally in India. A major

challenge in evaluating the evidence on gestational diabetes mellitus screening
an treatment is the range of adverse maternal and neonatal outcomes associated
The prevalence of diabetes is increasing globally in India. A major

challenge in evaluating the evidence on gestational diabetes mellitus screening
an treatment is the range of adverse maternal and neonatal outcomes associated
with untreated gestational diabetes mellitus. So the researcher is interested to
conduct this study.4
Statement of the problem:
Effectiveness Of Selected Nursing Interventions Package On Knowledge

And Glycemic Control Among Antenatal Mothers With Gestational Diabetes
Mellitus At Selected Maternity Hospitals, Hyderabad, Telangana.
Objectives of the study:
• Assess the knowledge on Selected Nursing Interventions Package and

glycemic control among antenatal mothers with Gestational Diabetes mellitus.
• Plan and administer the Selected Nursing Interventions Package on

knowledge and Glycemic control among antenatal mothers with Gestational
Diabetes mellitus
6
• Evaluate the effectiveness of Selected Nursing Interventions Package on
knowledge and glycemic control among antenatal mothers with Gestational
Diabetes mellitus
• Find the correlation between the knowledge on Selected Nursing Interventions

Package and glycemic control among antenatal mothers with gestational
diabetes mellitus
• Identify the Association between Selected Nursing Interventions Package on

knowledge and glycemic control among antenatal mothers with gestational
diabetes mellitus with selected demographic variables.
Operational Definitions:
Effectiveness: Improvement of post-test knowledge scores over pre-test

knowledge scores of antenatal mothers with gestational diabetes mellitus
regarding selected nursing interventions package and Glycemic control.
Selected Nursing interventions package: Measures used to reduce the blood

sugar level by planned teaching on causes, signs and symptoms, precautions,
prevention of complications, diet modifications, demonstration and return
demonstration of exercises (walking, sit to stand, side lying leg raise, wall
slides/snow angles, arm circles, pelvic floor breathing exercises) and assessment
of pre and post test FBS and PLBS values.
Knowledge: Responses of the mother with Gestational Diabetes Mellitus to the

structured questionnaire on selected nursing interventions package and glycemic
control.
Glycemic control: Reduction of FBS and PLBS levels in post-test compared

with pre-test FBS and PLBS Levels.
7
Antenatal mothers with gestational diabetes mellitus: Pregnant women under
the age group of 20 – 35 years with elevated blood sugar level more than FBS 72-
99mg/dl PLBS Up to 140mg/dl at selected maternity hospitals.
Conceptual frame work:
In the present study, the conceptual frame work is based on clinical nursing,
a helping art, 1964 by Ernestine Wiedenbach and also nursing process. According
to her, needs for help are defined as measures or actions required and desired by
the individual and which have potential for restoring or extending her ability to
cope with the demands implicit in her situation. She says the nurse is a
functioning human being. She not only cats but also thinks and feels as she goes
about with nursing care. Art is individualized action. Nursing art then is carried
out by the nurse in a one to one relationship with the client’s immediate situation.
Widenbach’s explanation of prescriptive theory is that “Account must be
taken to the motivation factors that influences the nurse not only in doing what
she does but also in doing it the way she does it with the realities that exist in the
situation in which she is functioning”.
Nurses central purpose in nursing is the nurses professional commitment.

Central purpose in nursing is to motivate the individual and facilitate her efforts
to overcome the obstacles that may interfere with her ability to respond capably
to the demands on her by the realities in her situation.
Nurses goal: It is grounded in the nurse’s philosophy that “those beliefs and
values that shape her attitude towards life, towards fellow human beings and
towards herself.” The three concepts that project the essence of such a philosophy
are
• Reverence for the gift of life

• Respect for dignity, autonomy, worth and individuality of each human
being
8
• Resolution to act dynamically in relation to ones belief
Prescription: Indicates the broad general action that the nurse deems appropriate
to fulfil the central purpose. The nurse will have thought the kind of results to be
sought and will take action to obtain these results, accepting accountability for
what she does and for the outcomes of her action.
Nursing action is deliberate action that is mutually understood and agreed upon
and that is both patient directed and nurse directed.
Realities: are the aspects of the immediate nursing situation that influence the
results the nurse achieves through what she does. This include physical,
psychological, emotional, and spiritual factors in which nursing action occur.
• Agent: Nurse giving nursing interventions package for gestational

diabetes mellitus.
• Recipient: antenatal mother’s with gestational diabetes mellitus
• Frame work: comprised situational factors that effects the nurse’s ability
to achieve nursing results
• Goal: To assess the effectiveness of Selected nursing interventions
package on knowledge and Glycemic control among antenatal mothers
with gestational diabetes mellitus.
• Means: Selected nursing interventions package will reduce the blood
glucose levels.
• Environment: “Niloufer hospital”, Hyderabad.
Direct services with its 3 concepts:
1. Identification of samples
2. Ministering of needed help
3. Validation of the help provided fulfilled its purpose
According to widenbach’s a need something the individual require to maintain
or sustain herself comfortably or capably in her situation.
9
Identification:
It determines mothers need help based on their existence of a need, whether

the patient realize the need, what prevents the patient from meeting the need,
whether the mother cannot meet the need alone. Antenatal mothers need help
which is need to reduce the sugar levels. Hence they have a lot of factors affecting
that they are age, religion, education, occupation, income of the family, gravida,
previous history of gestational diabetes.
Ministration:
The nurse act according to the need, which Is assessed in identification

phase. Nursing interventions package will give for the mothers with gestational
diabetes mellitus.
Validation:
The investigator take up her theory adopted for this study is the modified
form of wedenbach’s validate the interventions before and after giving the
nursing interventions package and assuming that there is reduced sugar levels
after giving the interventions.
Helping art of clinical theory, Researcher adopted this theory to assess the
effectiveness of nursing interventions package on knowledge and glycemic
control among antenatal mothers with gestational diabetes.
10
Central purpose
IDENTIFICATION MINISTRATION VALIDATION
Demographic variables: PRETEST POSTTEST Below average

Below average
• Age Assessment Assessment of
of knowledge knowledge on Average
• Religion on selected
Average
Administration selected nursing
• Education nursing of selected interventions
Above average Above average
interventions Nursing package.
• Income of the family
package. interventions
• Family History package, and
• Gravida Demonstration Mild
• Source of Assessment Mild of exercises. Assessment of
Information of FBS and FBS and PLBS.
Moderate Moderate
PLBS
• Previous
complications severe
- severe
Feed Back
KEY : Under the study,:, Not under the study---------
Figure : 2 Conceptual framework Based on Ernestein widen Bach’s Theory
11
Assumptions:
It is assumed that Antenatal mothers with gestational diabetes

mellitus,
1. Will have some knowledge regarding gestational diabetes
mellitus.
2. Selected Nursing Interventions Package will improve
knowledge of antenatal mothers with Gestational Diabetes
Mellitus.
3. Demonstration of exercises may help the mothers to maintain
the normal blood sugar levels.
4. Will honestly respond to questionnaire.
Hypothesis:
H1– There will be a significant difference in pre-test and post-test

knowledge scores on selected nursing interventions package and glycemic
control among antenatal mothers with Gestational Diabetes Mellitus at
0.05level of significance.
H2 – There will be the significant association between level of knowledge

on selected nursing interventions package and the glycemic control among
antenatal mothers with Gestational Diabetes Mellitus with their selected
demographic variables at 0.05 level of significance.
Delimitations:
The study is delimited to, antenatal mothers with Gestational Diabetes

Mellius
• Who are willing to participate in the study.
• Who are attending OPD at Niloufer, hospital, Hyderabad.
• Who can understand Telugu and English.
• Who are available at the time of Data collection.
12
Epilogue:
This chapter deal with introduction, need for the study, problem
statement, objectives, operational definition, conceptual framework, hypothesis,
assumption and delimitation.
13
Chapter ІІ
Review of Literature
The review of literature is an essential part of every research project

for many reasons. A research review is a written summary of the state of
evidence on a research problem. Researchers usually undertake a thorough
literature review to familiarize themselves with that knowledge base.
Polit and beck (2008)
Review of the literature is an essential part of every research project.

A Literature Review involves systematic identification, scrutiny and
summary of written materials that contain information on a research
problem. A research literature is a written summary of the state of evidence
on the problem. Researchers usually undertake a thorough literature review
to familiarize themselves with knowledge base.
Reviewing of various research studies the researcher was reviewed

literatures which are relevant and useful for the study is as follows:
• Studies related to Gestational Diabetes Mellitus.
• Studies related to self-care management of Gestational Diabetes

Mellitus.
• Studies related to Diet and Physical Activity in Gestational Diabetes

Mellitus.
Studies related to Gestational Diabetes Mellitus.
Dr.susila.c, amuthavalli.c 2019 Conducted quantitative study on

effectiveness of comprehensive nursing intervention package on
knowledge and glycemic control among antenatal mothers with GDM. The
sample was 30 antenatal mothers with GDM, selected through purposive
14
sampling technique, pre-experimental one group pre-test and post-test
design was used. A structured questionnaire was used to assess the pre-test
level of knowledge and glycemic level was assessed by FBS, PPBS blood
specimen. Comprehensive nursing intervention package regarding self care
management of GDM were educated to antenatal mothers with GDM. A
post-test was conducted by using same set of tools. Results analysis
revealed that the paired test value of knowledge at 18.38, was very highly
significant at p<0.001 level. The study conducted that comprehensive
nursing intervention package had significant effect on knowledge and
glycemic control.8
Nasiya Wani1, Muneera Bashir2,(2019) Conducted a

quantitative study on assess the effectiveness of structured teaching
program on knowledge regarding management of Gestational Diabetes
Mellitus (GDM) among pregnant women. At maternity hospital, Srinagar.
A pre- experimental one group pre-test post-test design with non-
probability and 60 antenatal mothers were selected through purposive
sampling technique, Results, The mean post-test knowledge level
(98.842±4.1604) was higher than the mean pre-test knowledge level
(26.783±7.0653). This indicates the effectiveness of the Structured
Teaching Programme in increasing the level of knowledge of pregnant
women regarding management of gestational diabetes mellitus at 0.05 level
of significance. The Structured Teaching Programme was found effective
in increasing the knowledge level of study subjects.8
Nabila E. saboula, 2018 Conducted quasi experimental study on to

assess the effect of nursing intervention on knowledge, attitude and self-
care activities among gestational diabetic women. at MCH centers India.
A purposive sample of 60 pregnant women with controlled gestational
diabetes for three months duration were recruited. (pre and post) research
15
design was used. Three instruments were used in this study, a structured
interviewing questionnaire which consist of three parts, Results The total
mean score of knowledge pre educational interventions was 20.2±0.4, it
improved to become 36.4±5.5 post intervention. There was a highly
statistical significant difference between pre and post educational
intervention regarding to all attitude scale factors among studied GD
women.4
Vaishnavi Murugaraj, Saranya Nagalingam2018 Conducted

a cross-sectional study on prevalence and commonest predictors of
gestational diabetes mellitus at velammalam medical college. The study
period was one year and during which 150 antenatal mothers participated
in the study. The prevalence of GDM was 76 (9%) and 74 (11%) in rural
and urban health centers respectively. The maximum number of GDM
Mothers to be 26-30years of age with a peak indicating 42% and 39% of
GDM mothers were found to be in primigravida, 48% of GDM mothers
were primipara. About 65% of GDM pre-pregnant mothers were
overweight according to BMI, 53% of GDM mothers had positive family
history of DM. Majority of the study population 100 (67%) had HBA1C
less than 6% and the remaining 50 (33%) had more than 6% value. The
variables like age, gravida, parity, family history of diabetes, pre-pregnant
BMI, history of PCOS, history of hypertension, history of hypothyroidism
was compared with the glycemic status (HBA1C values) and it was found
to be statistically significant at P<0.05. The commonest risk factors which
increases the incidence of GDM were family history of diabetes mellitus,
overweight pre-pregnant BMI, history of PCOS, hypothyroidism,
increasing gravidity and parity respectively.5
UsharaniBathula1,AnuragamayiYelamanchili2(2018) Conducted a
observational study on pregnant women attending antenatal op, and were
16
screened for gestational diabetes according to DIPSI. At rangaraya medical
college at Kakinada India. In this study, 85 pregnant women were
diagnosed to have gestational diabetes. The mean age group was 26 years.
Out of them 53 (62.5%) were multigravida and 32(37.5%) were primi
gravida, 47(55.3%) pregnant women were delivered by LSCS, 32(37.6%)
were delivered vaginally and 6(7.1%) were delivered by assisted forceps
delivery. Most common neonatal complication was hypoglycemia
accounting for 9.4% that was 8 cases out of 85 deliveries. 10 babies were
delivered with birth weight more than 4 kg which accounts for 11.7%.
Gestational diabetes complicating pregnancy has adverse fetal and
maternal outcome by means of higher rate of operational deliveries and
increased incidence of still birth when compared to normal population.
Early diagnosis and prompt treatment can minimise these complications.6
STUDIES RELATED TO SELF-CARE MANAGEMENT OF GDM
Moradi F, Enjezab B, (2020) Conducted a study on COVID-19

and self-care strategies for women with gestational diabetes mellitus Aim: The
outbreak of the emerging coronavirus disease 2019 (COVID-19) is a global
public health emergency. They have taken 25 related articles from 2011 to 2020
and 3 guidelines were reviewed with the keywords of gestational diabetes
mellitus, pregnancy and COVID-19 in combination with self-care and self-
management in PubMed, Google Scholar, Scopus, Science Direct, Elsevier,
Springer, Wiley Online Library and SID. The findings of the study According to
the results of the studies, face-to-face visits should be limited and instead,
telemedicine services recommended. Self-care throughout telemedicine services
were improved maternal and neonatal outcomes in women with GDM.
Conclusion: Although self-care program through telemedicine services is
beneficial for women with GDM, performing clinical trials are recommended to
assess maternal and neonatal outcomes in this condition.
17
Anjali shrivastva, Sameer phadnis, (2020) Conducted A study on
knowledge and self-care practices about Diabetes Mellitus among mothers with
GDM at selected tertiary healthcare facilities in coastal Karnataka. Objective: To
assess knowledge and self-care practices about Diabetes among mothers with
GDM attending selected tertiary health care institutions. Methods Cross-
sectional study was conducted to assess the knowledge and self-care practices
about Diabetes among mothers with GDM attending the out-patient facilities of
Medicine Department at selected tertiary healthcare institutions of Udupi Taluk.
The data collection occurred from January to March 2017. A total of 166
participants were included in the study and they were selected using consecutive
sampling. Knowledge about Diabetes Mellitus was assessed using structured
pre-tested questionnaire. Diabetes Self-Management Questionnaire-Revised
version was used to assess self-care practices regarding Diabetes Mellitus.
Results Most of the participants (>65%) had knowledge about different aspects
of Diabetes. The Mean total score of self-care practices among participants
without and with intensive insulin treatment was 6.25 ± 1.25SD and
6.20 ± 1.01SD respectively. Conclusion This study emphasizes the need to
strengthen the initiatives related to generating awareness about diabetes and
improving self-care practices related to it.
Rasha El Sayed Ibrahim , Nahed Mousa Saber (2019) Conducted

a study on Impact of Self-care Program for Gestational Diabetic Women on
Pregnancy Outcomes. Patient teaching is one of the most significant aspects in
improving women knowledge, and self-care. Aim: This study was developed to
evaluate the effect of self-care program for gestational diabetic women on
pregnancy outcomes. They have taken 80 samples through purposive sampling
technique, aged between (≥ 18 to ≤ 40), and pregnant at not less than 24 weeks
of gestations who admitted to antenatal clinic, labor unit and postnatal unit of
general hospital. The study instruments included Women interviewing
assessment sheet, Diabetic knowledge questionnaire, Self-care behavior,
Attitude about diabetes, Maternal observation, and Pregnancy outcome with
previously tested content validity and reliability. Results: Significant enhance in
18
the level of the women knowledge, attitudes, and self-care behavior was
observed after implementation of the self-care program among the women in the
study group.
• STUDIES RELATED TO DIET AND PHYSICAL ACTIVITY IN

GDM.
Oluwafemifola Onaade, Samantha (2021) Conducted a study on

Physical activity for blood glucose control in gestational diabetes mellitus:
rationale and recommendations for translational behavioral interventions
Gestational Diabetes Mellitus (GDM) is associated with adverse health
outcomes during pregnancy and beyond. Previous randomized controlled trials
of exercise interventions have demonstrated that exercise, conducted primarily
during supervised sessions, improves maternal glycemic control in women with
GDM. However, additional research is needed to develop physical activity
interventions that are easily implemented in healthcare settings (e.g.,
recommendations and strategies to increase non-supervised physical activity).
This narrative review presents: current physical activity recommendations for
pregnancy and women with GDM; (e.g., lifestyle interventions that include
behavioral counseling with a health coach); and the strategies employed by
previous, successful lifestyle interventions for pregnant and postpartum women
that were based in clinical settings. Therefore, we suggest that future trials
examine lifestyle interventions that promote unsupervised walking with
evidence-based behavioral strategies (e.g., goal setting, monitoring, and
feedback) and consider incorporating the use of physical activity tracking
devices to support these strategies.
Saeideh Zareei, Mohammad mehdi Naghi (2018) Conducted a study

on Dietary pattern in pregnancy and risk of gestational diabetes mellitus (GDM)
Aim: Among the most common metabolic disorders during pregnancy
is gestational diabetes mellitus (GDM). This research was conducted to examine
the dietary pattern in women with GDM. Material and methods In this case-
study, 204 pregnant women (104 cases and 100 control women) were chosen
19
through convenient sampling and random sampling. The subjects' food intakes
were assessed using semi-quantitative food frequency questionnaire, while their
activities evaluated by physical activity questionnaire. Anthropometric
indices were measured based on standard instructions, and the body mass
index was calculated. The dietary patterns were determined using principal
component analysis and its relationship with preeclampsia was tested
using logistic regression method. Results: Unhealthy and healthy dietary
patterns were found among the pregnant women. In the unhealthy group, after
modifying the effect of confounding variables, a significant relationship was
observed between dietary pattern and having gestational diabetes
(OR = 2.838,95% CI:1.039–7.751).
Carla Assaf-Balut , Alejandra Durán(2018)Conducted a study on

Medical nutrition therapy for gestational diabetes mellitus based on
Mediterranean Diet principles: a sub analysis of the St Carlos GDM Prevention
Study Objectives: To assess whether Mediterranean Diet (MedDiet)-based
medical nutrition therapy facilitates in women with gestational diabetes mellitus
(GDMw) and observe the effects on adverse pregnancy outcomes. They have
taken 100 samples through purposive sample technique were included before 12
weeks of gestation. Out of these 68 women were diagnosed with gestational
diabetes mellitus (GDM) and 32 had normal glucose tolerance. All GDMw
received MedDiet-based medical nutrition therapy with a recommended daily
extra virgin olive oil intake ≥40 mL and a daily handful of nuts. The primary
goal was comparison of hemoglobin A1c (HbA1c) levels at 36-38 GWs in
GDMw and women with normal glucose tolerance (NGTw). Results: GDMw as
compared with NGTw had higher HbA1c levels at 24-28 GWs (5.1%±0.3%
(32±0.9 mmol/mol) vs 4.9%±0.3% (30±0.9 mmol/mol), p=0.001).
Conclusions: Using a MedDiet-based medical nutrition therapy as part of GDM
management is associated with achievement of near-normoglycemia,
subsequently making most pregnancy outcomes similar to those of NGTw.
20
Michelle F Mottola , Raul Artal (2016) Conducted a study on Role of
Exercise in Reducing Gestational Diabetes Mellitus Exercise plays an important
role in reducing the prevalence of gestational diabetes mellitus (GDM) in women
with or without risk factors. GDM risk factors include obesity, family history of
diabetes, high-risk ethnicity, increased maternal age, history of GDM, delivering
a macrosomic infant, excessive gestational weight gain early in pregnancy
(before glucose screening), sedentary behavior, low physical activity, and
vitamin D deficiency. Most GDM patients can be managed with lifestyle
modifications that include medical nutrition therapy and physical activity. When
adherence is high and women are fully engaged in the exercise program, GDM
can be effectively managed and prevented.
Neda Shamim1, Virginia Paul2, (2016) Conducted A Study on

Dietary and Physical Modification among Gestational Diabetes Mellitus
mothers. Aim: The objective of the study is to assess the food habits and daily
nutrient intake of GDM women, to assess the change in physical activity and to
assess the perceived dietary changes occur in GDM patients. They have taken 60
samples through random sampling technique of Allahabad district.
Anthropometric measurements were taken for calculating BMI. Dietary intake
and physical activity levels were collected by interviewing the subjects using a
validated questionnaire. The results indicate that majority of women had a higher
pre-pregnancy weight and BMI. Presence of family history of Type 2 diabetes
was 60%. The mean Energy and Protein intake was slightly lower than the RDA.
There was excess consumption of Fat and CHO. Calcium and Iron was also
deficit by 12% and 26% respectively. Sedentary lifestyle was seen in majority of
women. Conclusion: The glaring fact was the consumption of energy-dense diet,
high in saturated fat, low in unrefined CHO, deficit Calcium and Iron intake
contributed to nutritional inadequacy in GDM women. Lifestyle was sedentary
among these women; hence, the emphasis is on physical activity levels, because
it is known to be beneficial and safe during pregnancy.
21
C. Zhang, M. B. Schulze, F. B. Hu (2008) Conducted a study on A
prospective study of dietary patterns, meat intake and the risk of gestational
diabetes mellitus. Aims/hypothesis The aim of this study was to prospectively
examine whether dietary patterns are related to risk of gestational diabetes
mellitus (GDM). Methods This prospective cohort study included 13,110 women
who were free of cardiovascular disease, cancer, type 2 diabetes and history of
GDM. Subjects completed a validated semi-quantitative food frequency
questionnaire in 2002, and reported at least one singleton pregnancy between
2002 and 2008 in the Nurses’ Health Study II. Two major dietary patterns.
Results We documented 758 incident cases of GDM. After adjustment for age,
parity, pre-pregnancy BMI and other covariates, the relative risk (RR) of GDM,
comparing the highest with the lowest quintile of the Western pattern scores, was
1.63 (95% CI 1.20–2.21; p trend=0.001), whereas the RR comparing the lowest
with the highest quintile of the prudent pattern scores was 1.39 (95% CI 1.08–
1.80; p trend=0.018). The RR for each increment of one serving/day was 1.61
(95% CI 1.25–2.07) for red meat and 1.64 (95% CI 1.13–2.38) for processed
meat. Conclusions/interpretation These findings suggest that pre-pregnancy
dietary patterns may affect women’s risk of developing GDM. A diet high in red
and processed meat was associated with a significantly elevated risk.
Epilogue:
This review of literature helped the investigator in selecting and

understanding the problem, in selecting the research design and
conducting the study.
22
Chapter -ІІІ
Methodology
Research methodology deals with the method of investigation

to be adopted by the investigator. It is the act of methods and principles
used to perform particular activity. Research methodology deals with the
method of investigation to be adopted by the investigator. It is the set of
methods and principles used to perform a particular activity. The selection
of the research methodology deals with research approach, research design,
variables, setting, population, sample, sampling technique, criteria for
sample selection, method of data collection, development and description
of tool, plan for data collection and plan for data analysis.
The present study was to assess the effectiveness of selected nursing

interventions package on knowledge and glycaemic control among
antenatal mothers with Gestational Diabetes Mellitus at selected
government maternity hospitals Hyderabad, T.S.
Research approach:
According to polit (2010), the research approach is the broad based

procedure of studying the selected problem drawing conclusions.
In the present study research approach adopted as quantitative

research approach. The present study aims at effectiveness of selected
nursing interventions package on knowledge and glycemic control among
antenatal mothers with Gestational Diabetes Mellitus.
Research design:
According to polit (1999) research design is the researcher overall
plan for obtaining answers to the research questions or for testing the
research hypothesis is referred to as the research design.
23
Research design helps the researcher in selection of subject, manipulation
of experimental variable, procedure of data collection and the type of statistical
analysis to be used to interpret the data. The research design was adopted for the
present study is Pre-experimental type of one group- pre-test-post-test design
being used to test the effectiveness of Nursing interventions package on
Diabetes Mellitus.
One group pre-test and post-test.
O1 X O1
Assessment of Administration of Assessment of

knowledge on Selected Nursing knowledge on
selected nursing interventions selected nursing
interventions package and interventions
package and demonstration of package and
glycemic control exercises. glycemic
before control after
interventions interventions
Figure: 3 Schematic presentation of One group Pre-test and
Post-test design.
24
Research approach Quantitative approach
Pre-experimental
Research design
One group Pre-test and Post-test.
Setting of the study Niloufer Hospital, Hyderabad, TS
Antenatal mothers with Gestational

Population Diabetes Mellitus aged between 20 –
45 years
Antenatal mothers with Gestational

Sample Diabetes mellitus who are attending
the OPD, at Niloufer Hospital.
30 Antenatal Mothers with

Sample Size
Gestational Diabetes mellitus.
Sampling Technique Purposive sampling
Tool for Data collection Structured questionnaire
Method of Data Self-administered Structured

Collection Questionnaire
Descriptive and inferential

Data Analysis statistical analysis
Figure : 4 Schematic Design of the Research Study
25
Description of Variables:
According to polit and Beck 2008, Variable are qualities, properties, or

characteristics of person, things or situations that change or vary.
Independent variable:
In the present study the independent variable was Selected nursing

interventions package on knowledge and glycemic control among antenatal
mothers with Gestational Diabetes Mellitus
Dependent variable:
knowledge of antenatal mothers with Gestational Diabetes Mellitus

on selected nursing interventions package and glycemic control.
Demographic variable:
Demographic variable like age, religion, education, income, family

history, gravida, source of information, complications of previous
pregnancy.
Setting of the study:
According to polit and Hungler (2008) “Setting” refers to physical

location and conditions in which data collection takes place in the study. The
type of setting selected depends on the research problems and purpose.
The setting for the present study selected by the investigator was
Antenatal OP at Niloufer women and children Hospital Hyderabad, Telangana
State. Niloufer women and children Hospital which is a teaching hospital
situated at Redhills with 1000 bed strength. It is a quaternary care hospital for
Obstetric, Paediatrics, Neonatology and Maternal foetal medicine. It is one of
the largest hospitals of its kind in Asia with advanced training for the faculties.
The hospital is mainly concerned for the neonatal and obstetrics and
26
gynaecological services not only twin cities and various other districts of
Telangana.
Population:
According to polit and Hungler(2008),Population is the entire set of
individual having some common characteristics.
The target population for the present study was antenatal mothers with
gestational diabetes mellitus aged between 21 – 35 years and above.
Sample and sampling:
According to Polit and Hungler (2008),a sample is a subject set of the

total population that is selected for the particular study and the members of the
sample are subjects.
Sample refers to the process of selecting a portion of the population to

represent the entire population. Sample for the present study is Antenatal
mothers with Gestational Diabetes Mellitus who are attending the Antenatal OP
at Niloufer Hospital, Hyderabad, Telangana state. The sampling was done based
on the availability and willingness of the antenatal mothers with Gestational
diabetes mellitus to participate in the study.
Sample size:
Sample size is number of the subjects in a sample. The sample size

for the present study was 30 antenatal mothers with Gestational Diabetes
Mellitus, who are available at the time of data collection at Niloufer
hospital.
Sampling technique:
According to polit and Beck (1984),sampling refers to the process of

selecting a portion of the population from the entire population.
27
Here purposive sampling, a form of non-probability sampling technique
is used and the subjects are selected as per availability of sample at the time of
data collection at Niloufer Hospitals, Hyderabad, Telangana state.
Criteria for Sample Selection:
The criteria specify the characteristics that the people in the population
must be possess. The purpose is to control extraneous variables as far as possible
hence the criteria for the sample selection for the study werePurposive
sampling technique used for the present study to select the samples at who
are attending OPD, Niloufer Hospital, Hyderabad.
Inclusive criteria:
• Antenatal mothers with gestational diabetes mellitus.
• Antenatal mothers with gestational diabetes mellitus age
between 20 – 35 years and above.
• Who are Willing to participate in the study.
Exclusive criteria:
• Antenatal mothers comorbid conditions other than Gestational
Diabetes Mellitus.
Description of the sample:
The sample is described in terms of demographic data which include age,
Religion, Education, family income per month in rupees, Gravida, Family
history of diabetes, Source of information and Previous pregnancy complications
of the antenatal mothers.
Method of data collection:
The method of data collection is a method of gathering information from
the respondents in standardized fashion. In the present study, the investigator
used a structured questionnaire to assess the knowledge of antenatal mothers in
the pre-test and assessment of FBS and PLBS levels and conducted structured
teaching then after 7days of pre-test, post-test was conducted and data was
28
collected. Data is a method of gathering information from the respondents,
through self-administered questionnaire.
Development and Description of Tool:
The tool was designed with the help of review of literature from various
text books, journals, and internet and suggestions with experts in the field of
obstetric and gynaecological, Nursing, Research. The investigator was adopted
a structured questionnaire method to asses the knowledge of antenatal mothers
regarding Selected Nursing Interventions Package and Glycemic control. The
questionnaire was constructed for the present study is structured type with part
A and Part B.
The tool has 2 parts:

Part A: Deals with demographic data like age, Religion, Education, Occupation,
family income per month in rupees, Gravida, family history of Diabetes Mellitus
and history of any complications during previous pregnancies.
Part B: Deals with the knowledge on Selected Nursing Interventions Package
and Glycemic Control, consist of 50 multiple choice questions each question
carry 1 mark for correct answer, total score is 50. This part is divided into 3
Sections A, B, and C.
Section-A- knowledge on self-care management of Gestational Diabetes
Mellitus.
Section-B- knowledge on Dietary modifications in Gestational diabetes
Mellitus.
Section –C – knowledge on Exercises used in Gestational Diabetes Mellitus.
29
Score Interpretation:
The knowledge scores are categorised into Below average, average, and average.
Below Average : ( 0 – 17 )
Average : ( 18 – 36 )
Above Average: ( 37 - 50 )
Glycemic Levels are Categorised into Mild, Moderate and Severe.
FBS PLBS
Mild : (96 – 100mg/dl) (<140mg/dl)
Moderate : (101 – 125mg/dl) (140 – 200mg/dl)
Severe : (>126mg/dl) (>200mg/dl)
Source: American Diabetes Association
Validity of the tool:
According to Polit and Hungler (2008), validity refers to the degree to

which an instrument measures, what it is supposed to measure. The constructed
tool was given to the experts in the field of Nursing and obstetric and
gynaecological, experts. The suggestions are taken from the experts for the
modification of the tool. The modifications and suggestions of experts were
incorporate in final preparation of the tool.
Reliability of the tool:
According to Polit and Hungler (2008), reliability refers to accuracy and

consistency of the information obtained in the study. It is concerned with how
consistently the measurement techniques measure the concepts of interest. The
reliability was tested by Split half method. The correlation coefficient was
30
calculated by using cronbachs‟ alpha formula. The obtained (r)value is 0.865 it
shows that tool was reliable, feasible and practicable.
Pilot Study:
To observe the practicability and feasibility of the study and to plan for
the statistical analysis of the data. Pilot study was conducted in the month of May
11th 2021 to May 17th 2021 at Nampally Area Hospital, Hyderabad, Telangana
State. The pilot study conducted on 5 antenatal mothers who fulfilled the
inclusion criteria. The techniques of data collection used as self-administered
structured was used to collected the data for pre and post-test. Structured
teaching was given after pre-test and Demonstrated exercises. Hence the study
was found feasible, practicable and appropriate. Reliability of the tool was tested
with Spearman Brown correlation coefficient according to Spearman Brown
formula the (r)value is .865 it was indicated that the tool was reliable, feasible
and practicable for conducting the final study.
Data Collection Procedure:
According to Polit and Hungler (2008), specify that the method of data
collection is a method of gathering from respondents in a standardized fashion.
Formal permission was obtained from Nursing superintendent Niloufer
Hospitals to conduct the study. In order to collect the data the investigator was
obtained willingness from the sample at Niloufer hospital. The purpose of the
study was explained and obtained consent from the sample. Data was collected
from 12-06-2021 to 25-06-2021. Each sample spent 30 – 40 minutes to answer
the self-administered structured questionnaire. Same questionnaire was used for
pre-test and post-test. After completion of pre-test assessed FBS and PLBS.
Structured teaching was given on Selected nursing interventions package and
Glycemic control and Demonstrated exercises. Then the post-test was conducted
after 7 days of pre-test with the help of same structured questionnaire, which is
used in pre-test.
31
Data Analysis:
According to Polit (2014) analysis is a process of organizing and

synthesizing data in such a way that research questions can be answered and
hypothesis is tested. As per curriculum plan after collecting data, the investigator
had planned to do the data analysis with the help of descriptive and inferential
statistics that was mean, standard deviation, standard error and chi square and ‘t’
test for obtained scores in pre-test and post-test.
Section 1: Description of sample according to their demographic Data.
Section 2: Cumulative knowledge scores of samples before and after

administration of selected nursing interventions package on knowledge and
Glycemic control.
Section 3: Mean knowledge scores of the sample regarding Selected nursing

interventions package on knowledge and Glycemic control.
Section 4: Correlation between Knowledge and Glycemic control among

samples regarding Gestational Diabetes Mellitus.
Section 5: Association between knowledge and Glycemic control among sample

regarding Gestational Diabetes Mellitus with selected Demographic Variables.
Ethical consideration
The investigator has obtained permission to conduct the study from

Medical superintend and nursing superintend of Selected Govt Maternity
Hospitals, Hyderabad, T.S. Consent was taken from participants in the study.
Epilogue:
This chapter deals with research methodology, approach, research design,

setting of the study, population, sample, sampling technique, criteria for sample
32
selection and method of data collection, development and description of tool,
validity and reliability of tool, pilot study, data collection procedure and data
analysis.
33
Chapter IV
Analysis and Interpretation
Statistical analysis is a method of rendering quantitative information

meaningful and intelligible. Without the aid of statistics, the quantitative
data collected in a research project would be little more than chaotic ,ass
of numbers. The results of the analysis need to be interpreted with dur
considerations of the overall aims of the project, its theoretical framework,
the specific hypothesis being tested, the existing body.
This chapter deals with analysis and interpretations of Data collected

from the 30 sample. Data was collected from 30 antenatal mothers with
Gestational Diabetes Mellitus. who met the selection criteria with the help
of Self administered Questionnaire and FBS/PLBS samples was entered in
the master sheet for analysis and interpretation. Analysis and
Interpretations was done with the help of descriptive and inferential
statistics to examine the objectives and test the hypothesis of the study.
Problem statement:
Effectiveness of Selected Nursing Interventions package on

knowledge and glycemic control among antenatal mothers with
Gestational Diabetes Mellitus at selected maternity hospitals, Hyderabad,
Telangana.
Objectives:

glycemic control among antenatal mothers with Gestational Diabetes
mellitus.
34
knowledge and Glycemic control among antenatal mothers with
Gestational Diabetes mellitus
• Evaluate the effectiveness of Selected Nursing Interventions Package

on knowledge and glycemic control among antenatal mothers with
Gestational Diabetes mellitus
• Find the correlation between the knowledge on Selected Nursing

Interventions Package and glycemic control among antenatal mothers
with gestational diabetes mellitus
• Identify the Association between Selected Nursing Interventions

Package on knowledge and glycemic control among antenatal mothers
with gestational diabetes mellitus with selected demographic variables.
Data was computed by using descriptive and inferential statistical

procedure such as frequencies, percentages, mean, standard deviation, t test
and chi square tests. The analysis and interpretation of the data collected
from the clients is organized and presented in three parts
Section 1: Description of sample according to their demographic Data.
Section 2: Cumulative knowledge scores of samples before and after

administration of selected nursing interventions package on knowledge and
Glycemic control.
Section 3: Mean knowledge scores of the sample regarding Selected nursing

Section 4: Correlation between Knowledge and Glycemic control among

samples regarding Gestational Diabetes Mellitus.
Section 5: Association between knowledge and Glycemic control among sample

regarding Gestational Diabetes Mellitus with selected Demographic Variables.
35
SECTION – I
Demographic data of the sample which includes Age, religion,

education, income, family history of diabetes, gravida, any information
regarding Gestational diabetes mellitus, history of complications during
previous pregnancy.
Table 3
Frequency and percentage Distribution of Sample according to Age
N=30
Age Frequency Percentage%
21 – 24 18 60
25 – 29 10 33.3
30 – 34 2 06.7
35 years and above 0 00
Total 30 100
Table 2 shows that out of 30 sample, Eighteen (60%) belongs to the

age group of 21- 24 years, 10 (33.3%) mothers belongs to the age group
of 25 - 29 years, 2(6.7%) mothers belongs to the age group 30 - 34 years
and 0 (0%) of them were in age group 35 and above years.
36
Age in years
60.0
60.0
50.0
40.0 33.3
Axis Title
30.0
20.0
10.0 6.7
0.0
0.0
21 - 24 25 - 29 30 - 34 35 and above
Figure 5: Frequency and percentage Distribution of sample

according to Age
37
Table - 4
Frequency and percentage Distribution of Sample according to Religion
N=30
Religion Frequency Percentage%
Hindu 14 46.7
Muslim 10 33.3
Christians 6 20.0
Others 0 0.0
Total 30 100
Table 3 shows that data regarding religion out of 30 sample 14(46.7%)

are belongs to Hindus, 10(33.3%) are belongs to Muslims, 6(20%) are belongs
to Christians and 0(0%) are others.
38
Religion
50.0
46.7
45.0
40.0 33.3
35.0
Axis Title
30.0
25.0 20.0
20.0
15.0
10.0
5.0 0.0
0.0
Hindu Muslim Christian Others
Axis Title
Figure 6: Frequency and percentage Distribution of sample according to

Religion
39
Table - 5
Frequency and percentage Distribution of Sample according to Education
N=30
Education Frequency Percentage%
Illiterate 10 33.3
Primary education 14 46.7

Secondary education 6 20.0
Higher secondary education 0 0.0
Graduation and above
0 0.0
Total 30 100
Table 4 shows that data regarding Education out of 30 sample 10(33.3%)

are belongs to illiterate, 14(46.7%) are belongs to primary education, 6(20%) are
belongs to secondary education and 0(0%) are higher secondary education and
graduation and above.
40
Education
50.0
46.7
45.0
40.0
33.3
35.0
Axis Title
30.0
25.0 20.0
20.0
15.0
10.0
5.0 0.0 0.0
0.0
Illiterate Primary Secondary Higher Graduation
Education Education Secondary and above
education
Axis Title

Education
41
Table - 6
Frequency and percentage Distribution of Sample according to income per
month
N=30
Income in Rupees Frequency Percentage%
>199,862 6 20
999,932 – 199,861 14 46.7
74,756 – 99,930 7 23.3
49,962 – 74,755 1 3.3
29,973 – 49,961 1 3.3
10,002 – 29,972 0 0.0
<10,001 1 3.4
Total 30 100
Table 5 shows that data regarding Income out of 30 sample 6(20%) are
belongs to >199,862, 14(46.7%) are belongs to 999,932 – 199,861, 7(23.3%) are
belongs to 74,756 – 99,930, 1(3.3%) are 49,962 – 74,755, 1(3.3%) are belongs to
29,973 – 49,961, 0(0%) are belongs to 10,002 – 29,972, 1(3.4%) are belongs to
<10,001.
42
Income per Month in rupees
50.0 46.7
45.0
40.0
35.0
30.0
Axis Title
23.3
25.0 20.0
20.0
15.0
10.0
3.3 3.3 3.4
5.0 0.0
0.0
Axis Title

Income
43
Table - 7
Frequency and percentage Distribution of Sample according to family
history of diabetes
N=30
Family history of Frequency Percentage%
diabetes
Yes 11 36.7
63.3
No 19
Total 30 100
Table 6 shows that data regarding Income out of 30 sample 11(36.7%) are
having a family history of diabetes, 19(63.3%) are not having any history of
diabetes.
44
Family history of Diabetes mellitus
36.7%
63.3%
Yes No

Family History
45
Table - 8
Frequency and percentage Distribution of Sample according to Gravida
N=30
Gravida Frequency Percentage%
Primi 15 50
Multi gravida 12 40
Grand multi gravida 3 10
High parity 0 0
30 100
Table 7 shows that data regarding Gravida out of 30 sample 15(50%) are
belongs to primi, 12(40%) are belongs to multi gravida, 3(10%) are belongs to
grand multigravida and 0(0%) belongs to high parity.
46
Gravida
50.0
50.0
45.0 40.0
40.0
35.0
Axis Title
30.0
25.0
20.0
15.0 10.0
10.0
5.0 0.0
0.0
Primi Multi gravida Grand multi High Parity
gravida
Axis Title

Gravida
47
Table - 9
Frequency and percentage Distribution of Sample according to source of
information
N=30
Source of information Frequency Percentage%
Yes 15 50
No 15 50
Total 30 100
Table 8 shows that data regarding source of information out of 30 sample

15(50%) are having some information regarding diabetes, 15(50%) are not
having any information regarding diabetes.
48
Weather you have any information regarding
Gestational diabetes mellitus
50% 50% Yes
No

source of information
49
Table - 10
Frequency and percentage Distribution of Sample according to
complications during previous pregnancy
N=30
Complications Frequency Percentage%
Yes 11 36.7
No 19 63.3
30 100
Table 9 shows that data regarding complications during previous

pregnancy out of 30 sample 11(36.7%) are having complications, 19(63.3%) are
not having any complications.
50
History of any complications during previous
pregnancy
36.7%
Yes
63.3%
No

complications
51
Section 2:
Cumulative knowledge scores of samples before and after administration of

selected nursing interventions package on knowledge and Glycemic control.
Table - 11
Effectiveness of selected nursing interventions package on knowledge
regarding Gestational Diabetes Mellitus.
N=30
Pre-test Post-test
Level of Knowledge F % F %
Below average 3 10 0 0
Average 27 90 13 43.3
Above average 0 0 17 56.7
30 100 30 100
Table 10 shows that data regarding knowledge levels out of 30 antenatal

mothers in pre-test 3(10%) of mothers having below average, 27(90%) of mothers
having average knowledge and 0(0%) mothers having above average knowledge
levels. And in the post test (0%) are having below average 13(43.3.%) are having
average knowledge, 17(56.7%) are having above average Which shows there is
increase in the knowledge levels.
52
90.0%
90.0%
80.0%
70.0%
56.7%
60.0%
Below
Axis Title
50.0% 43.3%
Avg(<=33.3%)
40.0%
30.0% Avg(33.4%-
66.67%)
20.0%
10.0%
10.0% Above
0.0% 0.0%
Avg(>66.67%)
0.0%
Pre test Post test
Axis Title
Figure 13: Effectiveness of selected nursing interventions package on

knowledge regarding Gestational Diabetes Mellitus.
53
Table - 12
Effectiveness of Glycemic Control among Sample regarding Gestational
Diabetes Mellitus.
N=30
Mild Moderate Severe
Glycemic
FBS PLBS FBS PLBS FBS PLBS
Control
F % F % F % F % F % F %
Pre-test 2 6.7 0 0 24 80 25 83.3 4 13.3 5 16.7
Post-test 25 83.3 10 33.3 5 16.7 20 66.7 0 0 0 0
FBS : Mild (70 – 100mg/dl), Moderate (101 – 125mg/d), Severe (>126mg/dl)

PLBS: Mild (<140mg/dl), Moderate (140 - 200mg/d), Severe (>200mg/dl).
Table 11 shows that data regarding FBS levels out of 30 antenatal mothers
with Gestational diabetes mellitus2(6.7%) are having mild 24(80%) are having
moderate, 4(13.3%) are having severe in the pre-test, and in post-test out of 30
antenatal mothers with Gestational diabetes mellitus 25(83.3%) are having mild
5(16.7%) are having moderate, 0(0%) are having severe. And data regarding
PLBS levels out of 30 antenatal mothers with Gestational diabetes mellitus0(0%)
are having mild 25(83.3%) are having moderate, 5(16.7%) are having severe in
the pre-test, and in post-test out of 30 antenatal mothers with Gestational diabetes
mellitus 10(33.3%) are having mild 20(66.7%) are having moderate, 0(0%) are
having severe.
54
90.0% 83.3% 83.3%
80.0%
80.0%
66.7%
70.0%
60.0%
Mild
Axis Title
50.0%
Moderate
40.0% 33.3%
Severe
30.0%
16.7% 16.7%
20.0% 13.3%
6.7%
10.0%
0.0% 0.0% 0.0%
0.0%
Pre test Post test Pre test Post test
FBS LEVEL PLBS LEVEL
Axis Title
Figure 14: Effectiveness of Glycemic Control among Sample regarding

Gestational Diabetes Mellitus.
55
Section 3:
Mean knowledge scores of the sample regarding Selected nursing interventions

package on knowledge and Glycemic control.
Table – 13
Mean knowledge scores of the sample regarding Selected nursing

interventions package on knowledge.
Knowledge mean SD Mean % Mean Paired P – value

Difference
‘t’ value
Pre-test 23.40 4.22 46.8 11.03 13.548 .0001
Post-test 34.433 5.137 68.8
Table 12. Show that obtained mean score of level of knowledge of the sample
are 23.40 in pre-test and 34.433 in post-test knowledge scores, standard deviation are
4.22 in pre-test and in post-test 5.137. The mean percentage of sample in pre-test 46.8
and in post-test 68.8, the mean difference is 11.03 and The calculated “t” value was
13.548, which is higher than the table value 2.76 at 29 df with 0.01 level of significance.
It shows that there is significant difference in pre and post test knowledge scores of
sample. Hence the research Hypothesis (H1) was accepted.
56
34.433
35.000
30.000
23.400
25.000
Mean
Axis Title
20.000
15.000 Std. Deviation
10.000
5.137
4.223
5.000
0.000
Pre test Post test
Axis Title
Figure 15: Deals with cumulative scores of pre-test and post-test knowledge
assessment.
57
Table – 14
Mean knowledge scores of the sample regarding Selected nursing interventions

package Glycemic control.
Mean SD Mean Paired P – value

Difference
Glycemic ‘t’ value
Control
FBS PLBS FBS PLBS FBS PLBS FBS PLBS FBS PLBS
Pre-test 113.63 189.93 9.404 10.779 20.700 41.933 13.548 11.110 .001 .001
Post-test 92.933 148.00 9.062 15.863
Table 13. Show that obtained mean score of FBS and PLBS Levels of the sample
are FBS (113.63 in pre-test and 92.933 in post-test scores, standard deviation are 9.404
in pre-test and in post-test 9.0627. Mean Difference of FBS is 20.700 and The calculated
“t” value of FBS 13.548, which is higher than the table value 2.76 at 29 df with 0.00
level of significance. PLBS obtained mean score is 189.93 in pre-test and 148.00 in
post-test, standard deviations was 10.779 in pre-test and 15.863 in post-test and mean
difference of PLBS 41.933 The calculated ‘t’ value is 11.110 which is higher than the
table value 2.76 at 29 df with 0.00 level of significance. It shows that there is significant
difference in pre and post test FBS and PLBS scores of antenatal mothers with
gestational diabetes mellitus. Hence the research Hypothesis (H2) was accepted.
58
FBS and PLBS
200.000 189.933
180.000
160.000 148.000
140.000
113.633
120.000
Axis Title
92.933 Mean
100.000
80.000
60.000
40.000
10.780 15.864 Std. Deviation
20.000 9.405 9.063
0.000
Pre Post Pre Post
FBS PLBS
Axis Title
Figure 16: Mean knowledge scores of the sample regarding Selected nursing
interventions package Glycemic control.
59
Section 4:
Correlation between Knowledge and Glycemic control among samples regarding

gestational Diabetes mellitus.
Table 15
Variable Knowledge Glycemic control
Knowledge 0.731 0.081
Glycemic control 0.081 0.731
The above table shows that correlation [r=0.731] positive and significant
correlation between knowledge and Glycemic control.
60
Section 5:
Association between knowledge and Glycemic control among sample regarding

Gestational Diabetes Mellitus with selected Demographic Variables.
Table – 16
Association between level of knowledge of samples on selected nursing

interventions package with their age
N=30
Age in years Below Average Average Above average
F % F % F %
20 – 25 0 0 6 33.3 12 66.7
26 – 35 0 0 6 60 4 40
36 – 40 0 0 1 50 1 50
41 – 45 0 0 0 0 0 0
Characteristics x2 df table value inference

Age 6.667 2 5.991 there is a Association
Table 15 shows that obtained chi square value 6.667 was significantly higher
than the table value 5.991 at df 2 with 0.10 level of significance. It shows that there is
a significant association between the sample knowledge on selected nursing
interventions package on knowledge with their age.
61
70.0% 66.7%
60.0%
60.0%
50.0%50.0%
50.0%
40.0% Below
Avg(<=33.3%)
Axis Title
40.0%
33.3%
30.0% Avg(33.4%-
66.67%)
20.0%
Above
10.0% Avg(>66.67%)
0.0% 0.0% 0.0%
0.0%
20 - 25 years 26 - 35 years 36 - 40 years
Axis Title
Figure:17 Association between level of knowledge of sample on selected

nursing interventions package with their age
62
Table 17
Association between level of knowledge of sample on selected nursing
interventions package with their Religion
N=30
Religion Below Average Average Above average
F % F % F %
Hindu 0 0 8 57.1 6 42.9
Muslim 0 0 4 40 6 42.9
Christian 0 0 1 16.7 5 83.3
Other 0 0 0 0 0 0
Characteristics X2 df table value inference

Religion 1.693 2 5.991 there is no association
Table 16 shows that obtained chi square value 1.693 was significantly lower than
the table value 5.991 at df 2 with 0.429 level of significance. It shows that there is no
significant association between the mothers knowledge on selected nursing
interventions package on knowledge with their religion.
63
90.0% 83.3%
80.0%
70.0%
60.0% Below
57.1%
60.0% Avg(<=33.3%)
Axis Title
50.0% 42.9% Avg(33.4%-

40.0%
66.67%)
40.0%
30.0% Above
Avg(>66.67%)
16.7%
20.0%
10.0%
0.0% 0.0% 0.0%
0.0%
Hindu Muslim Christian
Axis Title
Figure: 18
interventions package with their Religion
64
Table 18
interventions package with their Education
N=30
Below Average Average Above average
Education F % F % F %
Illiterate 0 0 8 80 2 20
Primary education 0 0 4 28.6 10 71.4
Secondary education 0 0 1 16.7 5 83.3
UG and above 0 0 0 0 0 0

Education 6.667 2 5.991 there is association
no significant association between the mothers knowledge on selected nursing
interventions package on knowledge with their education.
65
90.0% 83.3%
80.0%
80.0%
71.4%
70.0%
Below
60.0% Avg(<=33.3%)
Axis Title
50.0% Avg(33.4%-
66.67%)
40.0%
28.6% Above
30.0% Avg(>66.67%)
20.0%
16.7%
20.0%
10.0%
0.0% 0.0% 0.0%
0.0%
Illiterate Primary Education Secondary
Education
Axis Title
Figure: 19
interventions package with their Education
66
Table 19
interventions package with their income
N=30
Income Below Average Average Above average
F % F % F %
>199,862 0 0 5 83.3 1 16.7
999,932-199,861 0 0 5 35.7 9 64.3
74,756-99,930 0 0 0 0 7 100
49,962- 74,755 0 0 1 100 0 0
29,973-49,961 0 0 1 100 0 0
<10,0001 0 0 1 100 0 0

income 15.185 5 11.07 there is association
interventions package on knowledge with their income.
67
100.0% 100.0% 100.0% 100.0%
100.0%
90.0% 83.3%
80.0%
70.0% 64.3%
Below
60.0% Avg(<=33.3%)
Axis Title
50.0%
Avg(33.4%-
35.7% 66.67%)
40.0%
30.0% Above
Avg(>66.67%)
20.0% 16.7%
10.0%
0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0%
>199,862 999,932 – 74,756 – 99,930 49,962 – 74,755 29,973 – 49,961 <10,001
199,861
Axis Title
Figure: 20
interventions package with their income
68
Table 20
interventions package with their Family history
N=30
Family history Below Average Average Above average
F % F % F %
Yes 0 0 5 45.5 6 54.5
No 0 0 8 42.1 11 57.9

Family history 1.292 1 3.841 there is no association
interventions package on knowledge with their family History.
69
57.9%
60.0% 54.5%
50.0% 45.5%
42.1%
40.0%
Below
Avg(<=33.3%)
Axis Title
30.0%
Avg(33.4%-
20.0% 66.67%)
10.0%
Above
0.0% 0.0% Avg(>66.67%)
0.0%
Yes No
Axis Title
Figure : 21
interventions package with their Family history
70
Table 21
Association between level of knowledge of mothers on selected nursing
interventions package with their Gravida
N=30
Gravida Below Average Average Above average
F % F % % F
Primi 0 0 7 46.7 8 53.3
Multi gravida 0 0 5 41.7 7 58.3
Grand multi gravida 0 0 1 33.3 2 66.7

Gravida .556 2 5.991 there is no association
Table 20 shows that obtained chi square value .556 was significantly lower than
interventions package on knowledge with their gravida.
71
70.0% 66.7%
58.3%
60.0%
53.3%
Below
50.0% 46.7%
Avg(<=33.3%)
41.7%
Avg(33.4%-
Axis Title
40.0%
33.3% 66.67%)
30.0% Above
Avg(>66.67%)
20.0%
10.0%
0.0% 0.0% 0.0%
0.0%
Primi Multi gravida Grand multi
gravida
Axis Title
Figure-22
interventions package with their Gravida
72
Table 22
interventions package with their source of information
N=30
Source of Below Average Average Above average
information F % F % F %
Yes 0 0 5 33.3 10 66.7
No 0 0 8 53.3 7 46.7

Source of information 1.222 1 3.841 there is no association
interventions package on knowledge with their source of information.
73
66.7%
70.0%
Below
60.0% 53.3% Avg(<=33.3%)
46.7%
50.0% Avg(33.4%-
66.67%)
Axis Title
40.0% 33.3%
Above
30.0% Avg(>66.67%)
20.0%
10.0%
0.0% 0.0%
0.0%
Yes No
Axis Title
Figure 23
interventions package with their source of information
74
Table 23
interventions package with their complications during previous pregnancy
N=30
Complications Below Average Average Above average
During previous
F % F % F %
pregnancy
Yes 0 0 3 27.3 8 72.7
No 0 0 10 52.6 9 47.4

Complications 1.824 1 3.841 there is no association
interventions package on knowledge with their complications.
75
80.0% 72.7%
70.0% Below
Avg(<=33.3%)
60.0% 52.6%
47.4% Avg(33.4%-
50.0% 66.67%)
Axis Title
40.0%
Above
27.3%
30.0% Avg(>66.67%)
20.0%
10.0%
0.0% 0.0%
0.0%
Yes No
Axis Title
Figure 24
interventions package with their complications
76
CHAPTER-V
Summary
The present study was undertaken to assess the Effectiveness of Nursing

Interventions Package on Knowledge and Glycemic control among antenatal mothers
with Gestational Diabetes Mellitus at Selected Government Maternity Hospitals,
Hyderabad Telangana State”.
Review of literature related to the present study helped the investigator to get an
insight in to the selected health problems, to gain advanced knowledge of the content to
develop the conceptual framework for the study and to develop the tool, for data
collection and analysis.
Objectives:

glycemic control among antenatal mothers with Gestational Diabetes mellitus.

knowledge and Glycemic control among antenatal mothers with Gestational
Diabetes mellitus
• Evaluate the effectiveness of Selected Nursing Interventions Package on

Diabetes mellitus
• Find the correlation between the knowledge on Selected Nursing Interventions

Package and glycemic control among antenatal mothers with gestational
diabetes mellitus
• Identify the Association between Selected Nursing Interventions Package on

knowledge and glycemic control among antenatal mothers with gestational
diabetes mellitus with selected demographic variables.
77
The investigator observed that this study had helped in finding out structured
teaching and demonstration of exercises on knowledge and glycemic control of
antenatal mothers with Gestational Diabetes Mellitus was helpful for the mothers.
A related literature review helped the investigator to get an insight and an in-
depth knowledge of the content, to develop the conceptual frame work, and the tool for
the data collection.
The research approach adopted for the present study was quantitative approach.
The research design was one group pre – test and post -test. The setting of the study was
Niloufer Hospitals Hyderabad. The developed tool was given for content validity to
experts including, nursing research, Obstetrics and Gynecology, and in the field of
nursing. Questionnaire was used to assess the knowledge of antenatal mothers regarding
Gestational Diabetes Mellitus. Pilot study was conducted on 11th may samples at
Nampally Area hospital, Hyderabad, Telangana State. The pilot study results revealed
that the study was feasible. Reliability of the tool was tested with Spearman Brown
correlation coefficient. According to Spearman Brown correlation coefficient pre test
‘r’ value isvalue is .865,it is indicated that tool is highly reliable. The data collection
was conducted in the month of June from 12-6-2021 to 24-06-2021. The data was
analyzed with the help of descriptive and inferential statistics and the findings were
interpreted.Data was collected by using questionnaire to assess the knowledge of
antenatal mothers regarding Gestational Diabetes Mellitus. The data was analyzed with
the help of descriptive and inferential statistics and the findings were interpreted.
Findings
The investigator observed that knowledge on selected nursing interventions and

planned exercises are more useful to control the blood sugar and improve the health
status of the mother and child. Indirectly it is also helpful to reduce the maternal and
mortality rate.
Section 1
The findings with the distribution of demographic data was shows that out of 30
antenatal mothers 18 were in the age group of 20-25 years,10 were 26-35 years and 2
78
were 36-40 years. Out of 30 antenatal mothers 14 were Hindu, 10 were Muslim, 6 were
Christian. Out of 30 antenatal mothers 10 were unable to read and write , 14 were
Primary education were, 6 were secondary education. Out of 30 antenatal mothers 6
family income were >199,862, 14 were of 999,932-199,861,7 family income were
74,756-99,930, (1) family income in rupees were 49,962-74,755, (1) family income
were 29,973-49,961 and (1) <10,001 family income. Family history out of 30 antenatal
mothers (11) were having the history of diabetes and (19) were not have. Gravida out
of 30 antenatal mothers (15) were primi, (12) were multi gravida, and (3) were grand
multi gravida.
Source of information out of 30 antenatal mothers (15) mothers have information

regarding Gestational Diabetes Mellitus and (15) were not there any information.
Complications of previous pregnancy out of 30 antenatal mothers (11) were having the
complications and (19) were not having any complications during previous pregnancy.
Section 2
The analysis which deals with cumulative scores of knowledge on Selected

nursing intervention package and glycemic control in pre-test and post-test knowledge
scores of sample regarding Gestational Diabetes Mellitus. The findings show that the
out of 30 antennal mothers 3 were having below average, 27 were having average and
None of them had above average level of knowledge in pre test . In post test 13 were
average level of knowledge. 17were having above average level of knowledge in post
test. Standard error was .77103 in pre-test and .93794 in post-test. and the „t‟ value was
13.548. This value found to be significant at 0.05 the level of df 29 which is more than
the table value of 2.045 which shows that there is an increase in knowledge scores of
antenatal mothers related to Gestational Diabetes Mellitus.
Section 3
Deals with the mean knowledge scores of sample on selected nursing

interventions package on Glycemic control. obtained mean score of level of knowledge
of the sample are 23.40 in pre-test and 34.433 in post-test knowledge scores, standard
deviation are 4.22 in pre-test and in post-test 5.137. The mean percentage of sample in
79
pre-test 46.8 and in post-test 68.8, the mean difference is 11.03 and The calculated “t”
value was 13.548, which is higher than the table value 2.76 at 29 df with 0.01 level of
significance. It shows that there is significant difference in pre and post test knowledge
scores of sample. Hence the research Hypothesis (H1) was accepted.
The obtained mean score of FBS and PLBS Levels of the sample are FBS (113.63 in
pre-test and 92.933 in post-test scores, standard deviation are 9.404 in pre-test and in
post-test 9.0627. Mean Difference of FBS is 20.700 and The calculated “t” value of
FBS 13.548, which is higher than the table value 2.76 at 29 df with 0.00 level of
significance. PLBS obtained mean score is 189.93 in pre-test and 148.00 in post-test,
standard deviations was 10.779 in pre-test and 15.863 in post-test and mean difference
of PLBS 41.933 The calculated ‘t’ value is 11.110 which is higher than the table value
2.76 at 29 df with 0.00 level of significance. It shows that there is significant difference
in pre and post test FBS and PLBS scores of antenatal mothers with gestational diabetes
mellitus. Hence the research Hypothesis (H2) was accepted.
Section 4
Deals with correlation of knowledge and Glycemic control among antenatal
mothers with gestational Diabetes mellitus. It shows that correlation [r=0.635] positive
and significant correlation between knowledge and FBS levels, similarly there is
significant correlation between knowledge and PLBS levels.
Section 5
Deals with the association between the knowledge on selected nursing

interventions package on knowledge and glycemic control with their selected
demographic variables of the sample. It shows obtained chi square value, and it was
showed the table value, at df 2 with the 0.10 level of significance. It shows that there is
a significant association between the sample knowledge on selected nursing
80
Discussion
First objective was to assess the knowledge on selected nursing

intereventions package and glycemic control among antenatal mothers with
gestational diabetes mellitus.
30 antenatal mothers with Gestational Diabetes Mellitus are selected to and

conducted the pre-test on knowledge and Glycemic control. Assessed the knowledge
through structured questionnaire and Glycemic control measured by testing of FBS and
PLBS. Out of 30 samples 3 were having below average, 27 were having average and
None of them had above average level of knowledge in pre-test. I n post test 13 had
average level of knowledge. 17 had above average level of knowledge.
Second objectives was to plan and implement the nursing interventions

package on knowledge and Glycemic Control among antenatal mothers with
gestational diabetes mellitus..
It dealt with preparation of lesson plan regarding Selected nursing interventions

package. which was prepared by the investigator with the help of text books, journals
and other related literature, internet on related to subjects and consultation with the
experts. It was conducted on 30 antenatal mothers at Niloufer hospital with the
structured teaching includes introduction, meaning, definition, diagnostic criteria, risk
factors, signs and symptoms, complications, prevention, prepared and conducted with
the help of Lesson plan and Avaids.
Third objective was evaluate the effectiveness of the nursing interventions

package on knowledge and Glycemic control among antenatal mothers with
gestational diabetes mellitus.
Giving structured teaching among 30 sample 3% were having below average, 27%
were having average and None of them had above average level of knowledge in pre
test. in post test 13% of had average level of knowledge. 17% had above average level
of knowledge. In pre-test the obtained mean value 23.4, standard deviation 4.22and
standard error .77103, post test mean was 34.4, standard deviation 5.13 and standard
error .93794. To see if the value was statistically significant paired t test was computed
81
and the calculated t value is 10.455. This value is found to be significant at 0.00 level
with 29 df, higher than the table value 2.045 at df 29 which shows that there is an
increase in knowledge score of antenatal mothers regarding Gestational Diabetes
Mellitus.
Fourth objective is find the correlation between knowledge on selected

nursing interventions package and glycemic control among antenatal mothers
with gestational diabetes mellitus.
After the structured teaching program the mothers knowledge levels were
improved and there is a significant correlation between the knowledge of antenatal
mothers and the Glycemic control. correlation [r=0.635] positive and significant
correlation between knowledge and FBS levels, similarly there is significant correlation
between knowledge and PLBS levels.
Fifth objective was find the association between the knowledge and
Glycemic control among antenatal mothers with Gestational Diabetes Mellitus
with selected demographic variables.
The knowledge of antenatal mothers regarding Gestational Diabetes Mellitus with

selected demographic variables at Niloufer hospital was assessed with the help of self-
administered questionnaire.
There is significant association between knowledge and age regarding

Gestational Diabetes Mellitus. The obtained χ2 value is 6.66 with df 2 and 0.10
significance which is less than 0.05.
There was no significant association between knowledge and Religion regarding

Gestational Diabetes Mellitus. Since the obtained χ2 value is 1.693 with df 2 and 0.429
no significance which is greater than 0.05.
There is significant association between knowledge and education regarding

Gestational Diabetes Mellitus. Since the obtained χ2 value is 6.667 with df 2 and 0.01
significance which is less than 0.05.
82
There was a significant relationship between knowledge and income regarding
Gestational Diabetes Mellitus, since the obtained χ2 value 15.185 with df 5 and 0.10
which is less than 0.05
There was no significant relationship between knowledge and family History

regarding Gestational Diabetes Mellitus, since obtained χ2 value is 1.292 with df 1 and
0.256 no significance which is greater than 0.05.
There is no significant association between knowledge and Gravida of

Gestational Diabetes Mellitus. Since the obtained χ2 value is .556 with df 2 and 0.903
no significance which is greater than 0.05.
There is no significant association between knowledge and Source of

information regarding Gestational Diabetes Mellitus. Since the obtained χ2 value is
1.222 with df 1 and 0.269 no significance which is greater than 0.05.
There is no significant association between knowledge and complications

regarding Gestational Diabetes Mellitus. Since the obtained χ2 value is 1.824 with df 1
and 0.900 no significance which is greater than 0.05.
The present study also shows that there was significant association between knowledge
and Age and education, income after administration of Nursing Interventions Package
among antenatal mothers at selected government maternity hospitals. So, the hypothesis
(H2),”There will be a significant association between level of knowledge and Glycemic
Control among antenatal mothers with Gestational Diabetes Mellitus.
Conclusions
The Nursing Interventions Package was effective in improving the knowledge

scores of antenatal mothers regarding Gestational Diabetes Mellitus, where there highly
statistically significant improvements in their knowledge scores of post-test.
Implications
The findings of the study have several implications for Nursing education,
Nursing Practice, Nursing Administration, and Nursing Research.
83
Implications nursing practice
The Nurses can plan and conduct the health education programs regarding
various aspects of Gestational Diabetes Mellitus is one of the high risk pregnancy
condition need a lot of nursing care. If appropriate nursing care is not provided to the
antenatal mothers it leads to high risk for the mother and foetus. The nursing
implications in educating the antenatal mothers about prevention and complications of
Gestational Diabetes Mellitus, the nurses can help the antenatal mothers in recognition
causes, signs and symptoms, complications and prevention of Gestational Diabetes
Mellitus, about diet, rest , exercises for antenatal mothers to control Diabetes.
Nursing administration
The nurses are vital persons in meeting needs of the society. Adequate facilities
and supplies must be available in the hospital setting to implement the selected
structured teaching. The nurse administration need to encourage and plan staff
development programmes regarding prevention and complications among antenatal
mothers with Gestational Diabetes Mellitus to the nursing personnel who are working
in hospital and community health centre. This will promote efficient use of health care
resources to adopt different methods of teaching and encourage cost effectiveness in the
institution and nursing personnel.
Nursing education
Nursing education should prepare nurses with the potential for imparting health
information effectively and assist the people in the community and hospital setting in
developing self care potentials. The nurse educator can plan workshop or in service
education programmes on Gestational Diabetes Mellitus. Educational institutional can
arrange seminars and workshops on Gestational Diabetes Mellitus.
Nursing research:
Research provides nurses the credibility to influence decision making to meet

the specific needs to the mothers more researcher has to be undertaken to improve the
knowledge regarding Gestational Diabetes Mellitus. Evidence based research activities
84
by the nurses in the health care settings will help to solve the problems, to take right
decision in meeting the needs of the mothers during the antenatal periods. Researcher
may be done continuously on care of the mother during antenatal periods
Limitations
The study was limited due to:
1. Due to COVID-19 pandemic data collection procedure and teaching was done in
Niloufer hospital, Hyderabad, Telangana State.
2. Difficulty in gathering mothers.
3. The antenatal mothers who are available at the time of data collection.
4. Findings are limited to statistical result which were used for the study
Recommendations for further study
1. The similar study can be replicated on a large sample.
2. A comparative study may be under taken between the rural and urban mothers.
3. The similar study can be conducted in other private hospital settings.
4. The similar study can be conducted to assess the knowledge of staff nurse in antenatal
wards.
Epilogue
This chapter dealt with summary, findings of the study, discussion, conclusion,
Implications, limitation and Recommendations.
85
Bibliography
1. Journal of obstetrics and gynecological nursing “TNNMC” volume 7 th

, Issue 2/ July-Dec2019 published by Tamilnadu nurses and midwives
council, Chennai.
2. D.c Dutta “ A text book of obstetrics and gynecology” eighth edition

2015, published by Jaypee publications.
3. Myles “A text book for midwives” sixteenth edition, published by

Elsevier publications.
4. main.eulc.edu.eg
5. International journal of advances in medicine published in the year of

2019, volume No 6 page no. 5
6. “International Archives of integrated medicine”, published in the year

of 2019, Vol 6, Issue 6, page number 2-7.
7. “International journal of nursing & midwifery Research” (E-

ISSN:2455-9318) Page no. 2-7.
8. Polit &HD Hunger P.B (2008) “Nursing research principles and

methods” 6th edition, published by J.B. Lippincott publications
9. Nima basker “A text book of midwifery and obstetrical nursing” 3 rd

edition, published by EMMESS publications.
JOURNALS:
1. Journal of obstetrics and gynecological nursing “TNNMC” volume

7th , Issue 2/ July-Dec2019 published by Tamilnadu nurses and
midwives council, Chennai.
86
2. Alden, B. Dawson. (2005). The effects of lactation on the postpartum
involution of the uterus. American Journal of Nursing, 58(20): 23-26.
3. Dawson, A.B. (1946). The effects of lactation on the postpartum
involution of the uterus of the cat.American Journal of Anatomy, 79(15):
241–265.
4. Duignan, N.M., Studd, J.W.W & Hughes, A.O. (2004). Characteristics of
normal labour in different racial groups. British Journal Obstetrics and
Gynaecology, 82(8):593-98.
5. Gabbe, S.G., Niebyl, J.R. & Simpson, (2007). Obstetrics Normal and
Abnormal Pregnancies.British Journal Obstetrics and Gynaecology, 54(6):
67-68.
6. Gahres, E. Albert, S.N, &Dodek, (1999). Intra-partum blood loss
measurements with Cr5 I-tagged erythroevies.American Journal of
Obstetrics and Gynaecology, 19(8): 455-62.
7. Gilbert L, Porter, W. Brown, V.A. (2000). Postpartum hemorrhage a
problem. British Journal of Obstetrics and Gynaecology, 94 (67): 67-71.
8. Hall Mill, Halliwell, R. Carr-Hill, R. (1985). Concomitant and repeated
happenings of complications of the third stage of labor.British Journal
Obstetrics and Gynaecology, 92(13): 732-38.
9. Harrison, K. (2004). The influence of maternal on child bearing health aid
social priorities a Survey.British Journal Obstetrics and Gynaecology,
85(5): 23-31.
10. Klapholz (2000). It blood transfusion in contemporary obstetric practice
British Journal Obstetrics and Gynaecology, 75(7): 940-43.
11. St. Louis (2003). Uterine involution after Labour.American Journal of
Physiology, 32(10):
87
Website:
32. http://en.wikipedia.org/ wiki/ Gestational Diabetes Mellitus.
33. http://journals.Iww.com /greenjournal /Abstract/2003/01000/ Gestational

Diabetes Mellitus and cerebral blood volume.19.
34.www.google.com.
35. http://www.popline.org/taxonomy/term/55685 page no.25.
36. http://hdl.handle.net/10646/960.
37.http://www.nlm.nih.gov/pmc/articles/PMC2841017.
38.htt://www.medical research: gynaecological and obstetrics
39.www.pubmed.com 40.www.medscap.com
40. www.tamilnadunursingcouncil.com
41. www.encyclopedia.com
42. www.pubmed.com
43. www.ijcm.org.in
44. http://journelselsiever.com
11
11

THESIS

Uploaded by

Copyright:

Available Formats

THESIS

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

THESIS

Uploaded by

Copyright:

Available Formats

Chapter - І

“Pregnancy is a beautiful phase because it gives a woman the joy and

Pregnancy is a normal physiological process, which constitutes a unique

Gestational diabetes generally occurs during between the 20 th and 24th

Prevention of gestational diabetes is not always possible, but certain risk

Need for study:

Diabetes is a major public health problem in India with prevalence rates

As pregnancy brings physical as well as emotional changes in a women

The prevalence of Gestational Diabetes Mellitus is on the rise globally. The

Gestational diabetes mellitus Year incidence rate

Global 2019 204 million

In India 2019 40.9 million

Urban areas 2019 4.6% to 14%

Rural areas 2019 1.7% to 13.2%

Source of Data: Centers for disease control and prevention

Figure 1: Prevalence of Gestational Diabetes in the Year of 2018.

Source: Springer Current Diabetes Reports 16(1) 2018.

Source of Data GDM cases

The prevalence of diabetes is increasing globally in India. A major

The prevalence of diabetes is increasing globally in India. A major

Statement of the problem:

Effectiveness Of Selected Nursing Interventions Package On Knowledge

Objectives of the study:

• Assess the knowledge on Selected Nursing Interventions Package and

• Plan and administer the Selected Nursing Interventions Package on

• Find the correlation between the knowledge on Selected Nursing Interventions

• Identify the Association between Selected Nursing Interventions Package on

Effectiveness: Improvement of post-test knowledge scores over pre-test

Selected Nursing interventions package: Measures used to reduce the blood

Knowledge: Responses of the mother with Gestational Diabetes Mellitus to the

Glycemic control: Reduction of FBS and PLBS levels in post-test compared

Conceptual frame work:

Nurses central purpose in nursing is the nurses professional commitment.

• Reverence for the gift of life

• Agent: Nurse giving nursing interventions package for gestational

It determines mothers need help based on their existence of a need, whether

The nurse act according to the need, which Is assessed in identification

IDENTIFICATION MINISTRATION VALIDATION

Demographic variables: PRETEST POSTTEST Below average

Figure : 2 Conceptual framework Based on Ernestein widen Bach’s Theory

It is assumed that Antenatal mothers with gestational diabetes

H1– There will be a significant difference in pre-test and post-test

H2 – There will be the significant association between level of knowledge

The study is delimited to, antenatal mothers with Gestational Diabetes

The review of literature is an essential part of every research project

Polit and beck (2008)

Review of the literature is an essential part of every research project.

Reviewing of various research studies the researcher was reviewed

• Studies related to Gestational Diabetes Mellitus.

• Studies related to self-care management of Gestational Diabetes

• Studies related to Diet and Physical Activity in Gestational Diabetes

Studies related to Gestational Diabetes Mellitus.

Dr.susila.c, amuthavalli.c 2019 Conducted quantitative study on

Nasiya Wani1, Muneera Bashir2,(2019) Conducted a

Nabila E. saboula, 2018 Conducted quasi experimental study on to

Vaishnavi Murugaraj, Saranya Nagalingam2018 Conducted

STUDIES RELATED TO SELF-CARE MANAGEMENT OF GDM

Moradi F, Enjezab B, (2020) Conducted a study on COVID-19

Rasha El Sayed Ibrahim , Nahed Mousa Saber (2019) Conducted

• STUDIES RELATED TO DIET AND PHYSICAL ACTIVITY IN