الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 423 |  |  |
| | | from | 423 | | |
Abstract
After childbirth, women start to experience the postpartum period, which is the period in which the female body changes caused by pregnancy return as they were, i.e. the body returns to its pre-pregnancy state. These changes strongly impact on women’s lives, as they not only interfere in their biological and physical state, but also on their interpersonal and family relationships, thus the need for puerperal adaptability. This period demands physiological and psychosocial care, so that women can foster self-care and at the same time is able to provide skilled care to her child (Alan et al., 2017).
According to Dutta, (2018), both mother and newborn are vulnerable during first 24 hours following delivery. So Postnatal care is the important part of maternal health as it helps to assess the health status of mother and institute an effective therapy to rectify the defect and to note the progress the baby and solve the problems and to formulate any preventive measure to be taken. It also helps to provide necessary information to the mother regarding maternal and newborn care.
Nursing as a profession and nurses as main performers are responsible for being aware and sensitive with primary emphasis on diagnosis and treatment of postpartum needs to prevent and improve postpartum problems and complication. Paying attention to present healthcare services at home for mother and her baby is one of such measures. Observing mother’s health and health of newborn to reduce health risks and to promote health is among the main duties of community health nurses (Giger, 2016).
Michele, (2018), mentioned that postpartum home visit is a suitable method to obviate the educational and supportive needs of mothers because it is often difficult for them to go somewhere during the first day after delivery and it would be best if they could be provided with care services at the convenience of their home. Postpartum home care refers to the measures taken to prevent complications and promote the health of mothers during this period and improve the quality of their relationship with their newborns.
Aim of the study:
This study aimed to evaluate the effect of self-care program on health practices of postpartum women in rural areas through:
1. Assessing postpartum women’s knowledge related to self-care.
2. Assessing postpartum women’s practice related to self-care.
3. Designing and implementing self-care program for postpartum women in rural areas.
4. Evaluating the effect of designed self-care program on health practices of postpartum women toward postpartum self-care during home visits.
Research Hypothesis:
• Self- care program will improve postpartum women’s knowledge about self -care.
• Self- care program will improve self -care practices among postpartum women.
Research design:
A quasi experimental design was used to explore the effect of self- care program on health practices of postpartum women toward postpartum self care in rural areas.
Technical design:
Setting:
The study was conducted at family medicine centers affiliated to shesht El- Enaam health unit at El-Behara Governorate; namely shesht El- Enaaam center, Abo Shady center, El- Hawata center and EL- Shaira center and postpartum women’s homes in rural area.
Sampling: A purposive sample was used for choosing the study sample; The study sample included sixty seven (67) postpartum women representing 10% from the total number of postpartum women who registered in previous family medicine centers during the year of 2017 was 674 postpartum women affiliated to the ministry of health and were attending the centers for vaccinating their infants on the assigned vaccinated days for hepatitis B and T.B and for thyroid test.
Family health centers Total number Sample
Shesht El- Enaaam 226 23
El- Hawata center 221 22
EL- Shaira center 124 12
Abo Shady center 103 10
Subject Criteria: Study subjects include the following criteria; postpartum women were Primipara and multipara postnatal mothers, during first two weeks of postpartum period, women who delivered normally or by cesarean section and women free from any medical or gynecological disease or disability and their babies free from anomalies.
Tools of data collection:
Three tools were used for data collection:
First tool: An interviewing questionnaire: (Appendix I):
It was prepared and designed by the researcher based on the recent related literature review and experts’ opinion. It included five parts:
Part one: Socio- demographic characteristics.
Part two: Obstetric history.
Part three: Postpartum woman’s cultures and beliefs related to postpartum period.
Part four: Postpartum woman’s knowledge regarding postpartum self-care.
Part five: Postpartum woman’s self-care during postpartum period as reported.
Second tool: Review of Infant’s Growth and development measurements sheet: (Appendix II):
This includes infant’s weight, height and chest and head circumferences which available at family medicine centers records.
Third tool: Home environmental assessment observational checklist: (Appendix III):
It was abstracted from (Department of Housing and Urban Development. 2012) and modified by investigator to assess home environment of postpartum woman.
The results of the present study could be summarized as follows:
The study sample age ranged between less than or equal 20 to more than or equal 35 years, with mean age (24.8 ± 5.61years). There was a highly statistically significant difference between pre and post program implementation related to postpartum women’s knowledge and self-care practice related to postpartum self-care in rural areas.
Approximately one quarter of postpartum women were gravida two and less than one third of them were para two. Less than three quarter of postpartum women had negative total cultures and beliefs regarding postpartum self-care which include nutrition, exercise, personal hygiene, breast feeding, sexual activity and baby care.
More than two fifth of postpartum women had satisfactory knowledge toward total postpartum self-care in preprogram implementation improved to less than three quarter of them postprogram implementation meanwhile there was highly statistically significant difference between pre & post program implementation at P value < 0.001.
The total score level for self-care practice revealed that the majority of study sample unaware of adequate self-care practice preprogram implementation. On the other hand post program implementation approximately two third reported adequate self-care practice pattern with a highly statistically significant difference at P value < 0.001. Approximately one third of postpartum women had good sanitary environment.
In conclusion, self-care program reported remarkable improvement in postpartum women’s knowledge and self-care practices toward postpartum self-care in rural areas.
The findings of this study highlight the following recommendations:
1. Applying health education programs about maternal health issues in family health centers.
2. Continuity of health education programs about cultural values for nurses and other health care professionals in rural areas to increase their cultural awareness and their possibilities to provide culturally congruent care.
3. Health educational package on postpartum self-care should be given on discharge plan about postpartum issues supported to raise the awareness of postpartum women about these issues especially in rural communities of Egypt.
4. Raising public awareness through home visit and educational campaigns about postpartum self-care especially in rural areas.
5. Policy makers must build up a national strategy for enhancement health services provided about perinatal care into family centers especially in rural areas through coordination with the related ministries of higher education and scientific research and youth.