RESEARCH PROPOSAL

A STUDY TO ASSESS THE HIGHRISK FACTORS OF

METABOLIC SYNDROME AND THE EFFECTIVENESS OF VIDEO

ASSISSTED TEACHING ON KNOWLEDGE AND ATTITUDE REGARDING

PREVENTION OF METABOLIC SYNDROME AMONG POSTNATAL

MOTHERS AT SRM GH

OBSTETRICS AND GYNAECOLOGY NURSING

SUBMITTED BY: Ms. SHAKELA. V

M.Sc NURSING I YEAR
SRM IST
KATTANKULATHUR

1
 SRM COLLEGE OF NURSING
SRM IST
KATTANKULATHUR

1 TITLE OF THE TOPIC A STUDY TO ASSESS THE HIGHRISK

FACTORS OF METABOLIC SYNDROME AND
THE EFFECTIVENESS OF VIDEO ASSISSTED
TEACHING ON KNOWLEDGE AND ATTITUDE
REGARDING PREVENTION OF METABOLIC
SYNDROME AMONG POSTNATAL MOTHERS
AT SRM GH

2 NAME AND Ms. SHAKELA . V

DEPARTMENT OF THE M.Sc NURSING I YEAR

INVESTIGATOR SRM IST

KATTANKULATHUR

3 NAME OF THE GUIDE DR. ABIRAMI

WITH DESIGNATION
PROFESSOR
AND DEPARTMENT
OBSTETRICS AND GYNAECOLOGY
DEPARTMENT

SRM CON, SRM IST, KATTANKULATHUR.

4. NAME OF THE CO Mrs. DEENAJOTHY

GUIDE WITH
ASSOCIATE PROFESSOR
DESIGNATION AND
DEPARTMENT OBSTETRICS AND GYNAECOLOGY
DEPARTMENT

SRM CON, SRM IST, KATTANKULATHUR.

5. SOURCE OF FUNDING NO

2
6. OBJECTIVES OF THE  To assess the high risk factors of metabolic
STUDY syndrome.
 To assess the pretest & post test level of
knowledge on prevention of metabolic
syndrome among postnatal mothers.
 To assess the level of attitude on prevention
of metabolic syndrome among postnatal
mothers.
 To determine the effectiveness of video
assisted teaching on prevention of metabolic
syndrome among postnatal mothers.
 To correlate the knowledge with attitude on
prevention of metabolic syndrome among
postnatal mothers.
 To associate the high risk factors on
metabolic syndrome among postnatal
mothers with their demographic variables.
 To associate the pre test and posttest level of
knowledge on prevention of Metabolic
syndrome among postnatal mothers with
their .demographic variables.

3
BACKGROUND OF THE STUDY:

Women with Diabetic Mellitus have increased risk of developing

metabolic syndrome after delivery. Recently, The prevalence of both GDM and
metabolic syndrome has increased world wide, in parallel with obesity. Investigated
whether the presentation of metabolic syndrome and its clinical features among
women with previous GDM differs from that among those with normal glucose
tolerating during pregnancy, and whether excess body weight affects the results.

A number of studies have been conducted to investigate the risk of metabolic

syndrome(MS) after gestational diabetes mellitus(GDM), but the results are
contradictory. Accordingly, YUHONG Xu (2014) performed a systemic review and
meta-analysis to assess the association between these two conditions. The aim was to
better understand the risk of MS with prior gestational diabetes, shows the results that
women with GDM had a significantly higher risk of MS than those who had a normal
pregnancy (OR, 3.96;95% CI,2.99 to 5.26), but had significant heterogeneity ( I2 =
52.6%). The effect remind robust( OR, 4.54; CI 3.78 – 5.46) in the sub group of
Caucasians, but no association ( OR, 1.28; 95% CI 0.64 – 2.56) was found in Asians.
Heterogeneity was reduced BMI matched group I2=14.2%, BMI higher in the GDM
group I2 =13.2% in subgroup of BMI. In addition mothers with higher BMI in the
GDM group had higher risk of MS than those in the BMI matched group

Hence BMI higher in GDM group OR,5.39;95% CI,4.47 – 6.50, BMI

matched group OR, 2.53; 95% CI,1.88- 3.41). This meta-analysis demonstrated
increased risk of MS in GDM mothers, particularly in Caucasian and obese mothers.

RAVI RETNAKARAN (2010) reports that women with GDM and mild
glucose intolerance in pregnancy predict an increased likelihood of metabolic
syndrome at 3 years of postpartum. Therefore supporting the women with gestational
dysglycemia may have an underlying latent metabolic syndrome.

EVA WENDER –OZEGOWSKA (2009) says that mothers suffered from

GDM are at high risk for carbohydrate disturbances and metabolic syndrome in the
following year. Therefore, they should be under continuous medical surveillance that
would enable early detection and treatment of the metabolic disturbances.

4
 BARIS AKINCI (2010) says that the MS prevalence was higher in women
with previous GDM, suggested that early prediction of women with GDM who are at
the risk for developing MS is possible, and it is vital to prevent MS – related
complications.

Gestational diabetes mellitus is a perfect window of opportunity for the

prevention of DM in two generations , and its incidence is increasing in our country .
Knowledge of the condition among mothers will translate into prevention and early
diagnosis of the diseases.

NEED FOR THE STUDY

“The past you cannot change, but today is yours. Live it to the fullest of
your awakened awareness”

Nowadays pregnant mothers are unaware about Metabolic syndrome

which is more prevalent. A substantial proportion of the worldwide burden of
Metabolic Syndrome could be prevented through the application of existing
knowledge and by implementing programs for control and early detection and
treatment is important to prevent long term sequel and to develop a positive attitude
and follow healthy life style, as well as public health campaigns promoting physical
activity and a healthier dietary intake. Worldwide the incidence of overweight, type 2
iabetes and other conditions associated with cardiovascular disease is rapidly
increasing and having a major impact on public health. Therefore, knowledge of
pathogenesis and risk groups is urgently needed to target preventive strategies.
Metabolic syndrome is a cluster of metabolic disorders associated with increased risk
of cardiovascular disease.

An research result says that women with a history of gestational diabetes

had a significantly higher risk of Metabolic syndrome(MS) than those who had a
normal pregnancy.

SACHDEV MEENAKSHI (2019) cross-sectional study, randomly selected adults

(aged 20 years or more) attending the diabetology or cardiology OPD were included,
MetS was classified based on the modified Adult Treatment Panel(ATP-III) and
International Diabetes Federation (IDF)criteria. Results, A total of 668 patients were
included . A cross several subgroups, around two-thirds had MetS and low high-
density lipoprotein was the major contributing factor for MetS .High Prevalence of

5
Metabolic Syndrome found MS is highly prevalent among patients, identifying the
high risk individuals using simple approach and act upon the possible risk could
prevent complications.

ALKA PAWALIA (2017) Conducted an experimental study (pre-post comparison)

with 45 pregnant women having singleton pregnancy of >16 weeks of gestation,
BMI>18.5 Kg/m2 and having a mobile phone. They were randomly divided into 3
groups (n=12 each; compliance rate 80%) (i.e.) exercise (n=12), exercise with diet
advise (n=12) and control (n=12) group. Exercise groups attended weekly antenatal
exercise sessions at the hospital during pregnancy; diet group received regular diet
counseling followed by mobile text-messages to maintain adequate diet. The data was
analyzed using IBM-SPSS software. Resulted that Exercise groups gained less weight
then control. Similarly, had mean GWG less as compared to control group though not
statistically significant. The mean WC changes were significant amongst the groups
with the exercise groups having least gain in WC ( p<0.05). Concluded Adopting an
active lifestyle along with proper diet care can prevent development of abdominal
obesity and metabolic syndrome in Indian pregnant women which could prevent them
from other associated lifestyle diseases in future.

TINNA VILMI(2015) Performed hospital – based cohorts study among 120 women
with a history of GDM and 120 women with a history of normal glucose metabolism
during pregnancy. They all underwent physical examination and had baseline blood
samples taken. The risk of developing Metabolic syndrome after pregnancy
complicated by GDM was significantly higher than after normal pregnancy, 19 vs.8
cases . He concluded that Cardiovascular risk factors were common in participants
with high BMI than in those with previous GDM.

JATA PUHKALA( 2013) followed study with 150 women of one year postpartum
(mean age 33.1 years, BMI 27.2kg/m2) for evaluating Metabolic syndrome. Result
shows the prevalence of Metabolic syndrome was 18% according to the International
Diabetes Federation(IDF) criteria and 16 % according to National Cholesterol
Education Program(NCEP) criteria of Metabolic Syndrome and concluded that nearly
one-fifth of the women with an increased risk of GDM in early pregnancy fulfilled the
criteria of Metabolic syndrome at one year postpartum. The most important factors
associated with Metaboilc syndrome was pregnancy overweight.

6
REVIEW OF LITERATURE

A literature review is a critical summary of the research on a topic of interest,

often prepared to put research problem in contest’.

The literature reviewed has been presented under the following headings:
1. Studies related to prevalence of Metabolic Syndrome
2. Studies related to prediction of developing Metabolic Syndrome after
Gestational Diabetes
3. Studies related to knowledge regarding metabolic syndrome

1. Studies related to prevalence of Metabolic Syndrome

AL.Ghareeb( 2007) conducted a study to estimate the prevalence of Metabolic
Syndrome among selected Kuwaiti patients in Ahmedi and Mubark attending primary
health centre. A cross sectional research design was used and 495 participated and
were interviewed in detail about their social demographic, socio-economic, lifestyle
and health disease status . The study analysis showed that total number who met the
ATP III guidelines for diagnosis of metabolic syndrome was ( 39.79%) b and
Metabolic Syndrome significantly increased with age. The study concluded that the
prevalence of metabolic syndrome is high among Kuwaiti participants attending
primary dhealth centre and it recommended that doctors in PHC setting should be
aware of the risk factors related to metabolic syndrome with the view point of offering
appropriate treatment.
2. Studies related to prediction of developing Metabolic Syndrome after
Gestational Diabetes Mellitus.
Sena Yesei (2009) conducted a study on prediction of developing Metabolic
Syndrome after Gestational Diabetes Mellitus. It was a qualitative approach and an
experimental design. The sampling technique used was simple random sampling in
which 164 women with previous gestational diabetes were evaluated after a mean
follow up of 40 months from the index pregnancy. Data analysis findings revealed
that univariate analysis showed pregnant obesity, weight gain during the follow up
and fasting glucose level at the oral glucose tolerance test
( OGTT) of the index pregnancy were the predictors of developing Metabolic
Syndrome. Multivariate analysis showed that fasting glucose level of >100mg/dl at
the OGTT of index pregnancy was an independent predictor for the development of

7
metabolic syndrome. The study concluded that early prediction of women with
previous gestational diabetes mellitus who are at risk of developing metabolic
syndrome related complications.
3. Studies related to knowledge regarding metabolic syndrome
Binitha Jose ( 2012) conducted a study on assessing the knowledge
regarding metabolic syndrome with GDM. It was a quantitative approach and an quasi
experimental design. The sampling techniques used was simple random sampling in
which 100 samples with GDM and concluded that the knowledge about metabolic
syndrome was poor.

STATEMENT OF THE PROBLEM

A study to assess the high risk factors of Metabolic Syndrome and the
effectiveness of video assisted teaching on knowledge and attitude regarding
prevention of Metabolic Syndrome among postnatal mothers at SRM GH.

OBJECTIVES OF THE STUDY

 To assess the high risk factors of metabolic syndrome.

 To assess the pretest & post test level of knowledge on prevention of
metabolic syndrome among postnatal mothers.
 To assess the level of attitude on prevention of metabolic syndrome among
postnatal mothers.
 To determine the effectiveness of video assisted teaching on prevention of
metabolic syndrome among postnatal mothers.
 To correlate the knowledge with attitude on prevention of metabolic syndrome
among postnatal mothers.
 To associate the high risk factors on metabolic syndrome among postnatal
mothers with their demographic variables.
 To associate the pre test and posttest level of knowledge on prevention of
Metabolic syndrome among postnatal mothers with their .demographic
variables.

8
Operational definitions

Assess: In this study, assess it refers to evaluate the risk factors , to identify the
effectiveness of the video assisted teaching and to identify the behavioural
activities based on the extending criteria for an individual .

High risk factors for Metabolic syndrome: High risk for metabolic syndrome
refers to the factors such as central obesity, insulin resistance, age factor, family
history, polycystic ovary syndrome which is assessed by the check list and clinical
parameters prepared by the Investigator.

Effectiveness: In this study, it refers to the extent to which the educational

intervention package will have desired effect in gaining knowledge regarding
prevention of Metabolic Syndrome in terms of difference between pretest and
posttest knowledge measured by structured questionnaire developed by the
investigator.

Knowledge regarding Prevention of metabolic syndrome: In this study, it refers to

the facts, the information acquired through education by antenatal and Postnatal
mothers regarding exercise, healthy diet, lifestyle modifications to reduce weight ,
control blood pressure, balance cholesterol and blood sugar level to prevent the
Metabolic Syndrome as elicited through a structured questionnaire developed by the
investigator.

Attitude : In this study attitude refers to identify individuals response of action on

prevention of metabolic syndrome is assessed with Likert scale developed by the
investigator.

Postnatal mothers: In this study it refers to the mothers who have the Past history(0-
3 yrs) of gestational diabetes mellitus.

9
Research Hypotheses

RH1 : There will be a significant difference between pretest and post test level of
knowledge regarding Prevention of Metabolic syndrome.

RH2: There will be a significant relationship between knowledge and attitude on

Prevention of Metabolic syndrome.

RH3: There will be a significant association on high risk factors of metabolic

syndrome with their demographic variable.

RH4: There will be a significant association on level of knowledge and attitude

regarding prevention of metabolic syndrome with their demographic variables.

ASSUMPTIONS

• All mothers with the past history of GDM may not aware about
Metabolic syndrome disorder.

• All postnatal mothers with the past history ( 0 -3 ) years of GDM

will not have increased body mass index.

• Video assisted teaching may improve the knowledge and attitude

level on prevention of Metabolic syndrome among mothers with
the past history of GDM (0-3 years).

DELIMITATIONS

1. The study is delimited to a period of 4 weeks of data

collection

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RESEARCH METHODOLOGY

RESEARCH APPROACH The research approach adopted for the present

study is Quantitative approach, Evaluative in
Nature.

RESEARCH DESIGN The research design adopted for the present

study is pre experimental method one group
pretest post test method.

• Study variable: high risk factors of

metabolic syndrome
VARIABLES OF THE • Independent variable: video assisted
STUDY teaching on prevention of metabolic
syndrome.
• Dependent variable : knowledge and
Attitude on prevention of metabolic
syndrome
• Demographic variables: Age,
education, area of living, income of the
family, occupation, socioeconomic
class.
• Clinical variables: Gravida , para,
weight gain during pregnancy,
Abortion, pregnancy length, Type of
delivery, mode of delivery, birth weight
of the baby, infection during pregnancy.
• Extraneous variable: Mass Media

SETTING OF THE The study would be conducted in selected

STUDY hospitals in potheri

POPULATION TARGET POPULATION: The population for

the present study comprises all the postnatal
mothers with past history (0-3) years of GDM

ACCESSIBLE POPULATION: Postnatal

Mothers with past history of GDM attending
OPD at SRM GH.

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SAMPLE Postnatal mothers with past history (0-3 years)
of GDM and who fullfills the inclusion criteria.

SAMPLING The proposed sampling technique adopted for

TECHNIQUE the present study is Non probability convenient
sampling technique.

SAMPLE SIZE According to Sample size calculation sample

size is 89
n= ztPq/d2
Z=1.96
p=0.18
d2=0.0025
=3.8416/0.0025=0.567020/0.0025=226/-
Z= 1.96
p=0.18
q=0.82
d2=0.08
=0.567020/0.0064=88.5 n=89
study sample is 100.

12
SAMPLING CRITERIA

• The postnatal mothers with the

INCLUSION CRITERIA past history (0-3) years of GDM
who are present at the time of
visit.

• Who are attending OPD at

SRMGH.

• Who are willing to participate in

the study.

• Who speak Tamil or English.

• Teenage pregnancy
7.1.8 EXCLUSION CRITERIA
• Multiple pregnancy

• The postnatal mothers who are

already taking medicines for
cardiovascular disease and
Diabetes.

• Treatment of or known clinical

history of Psychiatric illness.

• Substance abuse.

• Mothers who have attended any

class regarding metabolic
syndrome

7.1.9 PERIOD OF One month

RECRUITMENT

13
DATA COLLECTION TOOL

DESCRIPTION OF TOOL
TOOL FOR DATA
PART A : Demographic and Clinical
COLLECTION
variables

PART B : Checklist and clinical

parameters to assess risk factors.

PART C : Attitude scale on

prevention of Metabolic syndrome.

PART D: structured questionnaire to

assess the knowledge regarding
prevention of metabolic syndrome

DESCRIPTION OF INTERVENTION

Video assisted teaching on prevention of

METABOLIC SYNDROME among
antenatal and postnatal mothers those who
have high risk factors of MS by in a group
with 20 members for 15 minutes .The
contents are

• Criteria of metabolic syndrome

• Definition of metabolic syndrome

• Incidence of metabolic syndrome

• Risk factors of metabolic syndrome

• Etiology of metabolic syndrome

• Signs and symptoms of metabolic

syndrome

• Diagnostic evaluation of polycystic

ovarian syndrome

• Prevention

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 • Life style modification

• Medical management

• Surgical management

• complications

• A prior formal permission will be

PROCEDURE OF DATA obtained from the higher authorities
COLLECTION of the schools.
• The purpose of the study will be
explained to the concerned authorities
and participants.
• The investigator will administer
structured knowledge questionnaire
to obtain the pre – test, subsequently
administer intervention on the same
day. Post test would be conducted
after 7 days using the same tool.
• The proposed study duration is 30
days

METHOD OF DATA
• The investigator will obtain data
ANALYSIS
by using descriptive and
inferential statistics and the plan
of data analysis will be as
• DESCRIPTIVE
follows.
STATISTICS

• Mean and standard deviation,

frequencies and percentage for the

15
• INFERENTIAL data analysis of the background of
STATISTICS the data.

• Paired “t” test will be used to test

the significant difference in the
pre-test and post- test knowledge
scores.
• Correlation and covariance test
will be used to find out relation
between the selected variables.
• Chi-square test will be used to
find out the association between
selected variables and knowledge
scores.

16
8. LIST OF REFERENCES.

• A.Duran , S. Saenz, M.J. Torrejon et al.,(2014) “Introduction of IADPSG

criteria for the screening and diagnosis of gestational diabetes mellitus: results
in improved pregnancy outcomes at a lower cost in a large cohort of pregnant
women: the st carlos gestational diabetes study”, Diabetes Care, Vol. 37, no. 9,
pp. 2442 – 2450

• Okolie Uchenna, Ehiemere Ijeoma, et al,(2010) “ contributory factors to

diabetes dietary regimen non adherence in adults with diabetes.” International
journal, vol:4,pg.no-9.

• Dabelea D, Snell- Bergeon JK, et al,( 2005) “ permanente of Colorado GDM

screening program: increasing prevalence of gestational diabetes mellitus(
GDM) over time and by birth cohort”: Diabetes care. Pp: 579 – 84.

• Xu y, Shen S, et al (2014)“ Metabolic syndrome risk after gestational diabetes:

a systematic review and meta – analysis.

• Isomaa B, Almgren P, et al (2001) “cardiovascular morbidity and mortality

associated with the metabolic syndrome. Diabetes care, pp; 683- 9.

• Bagchi and shreejayan (1st ed) (2012) “The diabetes and metabolism in
pregnancy”, London, Elsevier publication.

• Christopher. D. Byren (2nd ed) “Overcoming metabolic syndrome”, Chicago,

Addicus books publication.

• Vassilaki (2002) A study of gestational diabetes in early pregnancy and risk

for metabolic syndrome. Clinical obstetrics. Pp-432-441.

• Gaillard (2004) A study to investigate the relationship between Gestational

diabetes and Metabolic syndrome. Pp-44-52.

• Darki (2001) A study to determine the association between metabolic

syndrome in early pregnancy and risk of pre term birth, journal of gynecology
and obstetrics. Pp- 158-165.

17
 SECTION A

I DEMOGRAPHIC VARIABLES

1.Age
a.20 to 25 years
b. 26 to 30 years
c. Above 30 years

2. Religion
a. Hindu
b. Muslim
c. Christian
d. Others

3. Educational status
a. Profession or honours
b. Graduate
c. Intermediate or diploma
d. High school education
e. Middle school education
f. Primary school education
g. No formal education

18
4.Occupation
a.Legislators senior officials and managers
b.Professionals
c.Technicians and associate professional
d. Clerks
e.Skilled workers and shop sales workers
f. Crafts and related trade workers
g.Plant & machine operators and assemblers
h. Elementary occupation
I. Unemployed.

5.Income
a. Rs 47348 and above
b. Rs 23674 - 47347
c. Rs 17756 -23673
d. Rs 11837- 17755
e. Rs 7102 -11836
f. Rs 2391 - 7101
g. Less than 2391

6. Socioeconomic class
a. Upper
b. Upper middle
c. Lower middle
d. Upper lower
e. Lower

19
7. Type of family
a. Joint family
b. Nuclear family
8. Residential area
a. Rural
b. Urban

2.CLINICAL VARIABLES

9. Gravida
a. Primi
b. 2
c. More than 2

10 . Para
a. Primi
b. 2
c. More than 2

11. Abortion
a.1
b.2
c.3

12.Weight gain during pregnancy

a.1.5 – 2kg / month
b. 2 - 3.5kg/month
c. 3.5 -4.5 kg/month

20
13. Pregnancy Length
a. Term
b. Preterm
c. Postterm

14.Type of Delivery
a. Vaginal
b. LSCS
c. Vaginal birth after C section

15. Mode of Delivery

a. Normal Delivery
b. Forceps
c.Vaccum

16.Birth weight of the Baby

a. Above 3.5 kg
b. 2 .5 to 3.5 kg
c. Less than 2kg

17. Infections during pregnancy

a. Genito urinary tract infection
b. Puerperal sepsis
c. others

21
 SECTION B
Check list to Assess Risk Factors Of Metabolic Syndrome

S.NO RISK ASSESSMENT OF MS YES (1) NO (0)

1 Are you diagnosed with DM?

2 Are you diagnosed with High Blood

Pressure (>130/90)?

3 Do you have a history of PCOD?

4 Do you have a Family history of

CHD?

5. Do you have a family history of DM?

6 Do you have a family history of

CVD?

7 Do you have the habit of smoking?

8 Are you gained excess weight after

delivery?
9 Have you got any complication during
delivery?

10 Have you delivered over weight

baby?
More than 3.5 kg!

11 Do you have the habit of eating fast

foods?

12 Do you exercise daily?

Scoring
a. 0-4 Low risk
b. 5-8 Moderate risk
c. 9 – 12 High risk

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 Clinical parameters to assess risk factors of metabolic syndrome

RISK FACTORS LOW RISK MODERATE HIGH RISK

(1) RISK (3)
(2)
Waist 80-89cm 90-109 >110cm
circumference
>80cm
Body mass index 30-35 36-40 >40
Weight in kg/
height in m2
Blood pressure 140 – 159/90- >160/>100 >180/>110
>140/>90 99
Heart rate 70-75 74-82 82+
>70

Scoring
a. 0-4 Low risk
b. 5-8 Moderate risk
c. 9 – 12 High risk

23
 SECTION B
Likert Scale to assess the Attitude on Prevention of Metabolic
Syndrome

Strongly Moderately Slightly Slightly Moderately Strongly

S.No Items Disagree Disagree Disagree Agree Agree Agree
1 2 3 4 5 6

1 Individuals with increased

blood pressure prone for
metabolic syndrome (yes)
2 Increased blood pressure is
the result of postnatal period
,so treatment is unnecessary
(no)
3 The best type of meat for
individuals with metabolic
syndrome is red meat( no)
4 The best type of meat for
individuals with metabolic
syndrome is white meat
(yes)
5 Individuals prone to
metabolic syndrome should
eat fruits and vegetables(yes)
6 Changing lifestyle behavior
will cut down my chances of
developing metabolic
syndrome(yes)
7 Increased blood pressure can
cause cardiac problems(yes)
8 Severely obese people are
prone to develop Metabolic
syndrome(yes)

24
9 Most obese people can
reduce their weight by
regular exercise(yes)

10 Metabolic syndrome is not

preventable(no)
11 It is good to know you are at
risk(yes)
12 I do not believe that physical
exercise is important(no)
13 Nurses have important role
to manage obese
patients(yes)
14 Mothers with increased BMI
are healthier than normal
BMI (no)
15 Only adults with increased
BMI exercise daily (no)
16 Mothers with GDM should
be offered treatment for
Metabolic syndrome (no)
17 Not important that GDM
mothers to check their Blood
sugar level after delivery
(no)
18 Small weight loss can
produce important medical
benefit (yes)
19 Management of obesity is
difficult(no)
20 All GDM mothers are prone
to develop MS (no)

25
Scoring
S.NO SCORING RATING
1 1-40 (1-33%) Unfavorable
2 41-80 (34-66%) Moderately
Favorable
3 81-120 (67-100%) Strongly Favorable

26
 SECTION C
Structured questionaire to assess the knowledge regarding prevention
of Metabolic syndrome

Definition

1. What is diabetes during pregnancy?

a. Increased hemoglobin level during pregnancy
b. Increased blood sugar level first detected during pregnancy
c. Increased bilirubin level during pregnancy
d. Increased cholesterol level during pregnancy

2..What is metabolic syndrome ?

a. Combination of medical disorders that includes obesity, hyper Triglyceridemia,
reduced high density lipoprotein, hypertension and impaired fasting glucose
b.Increased hemoglobin during pregnancy
c. Increased urea during pregnancy
d. Increased cholesterol level during pregnancy

3.How is metabolic syndrome diagnosed?

a. Bloodpressure> 140/90 mmhg , Triglyceride > 1.695 mmolL ,Waist circumference
>80 cm
b.Blood sugar level > 120mg/dl, Bloodpressure > 140/90
c. Hemoglobin < 12gm/dl, OGTT > 75gm/dl.
d.Heart rate >70b/m, obesity

27
Etiology

4.What are the causes for metabolic syndrome?

a. Obesity
b.Genetics
c. Aging
d.Sex

5. What are the causes for gestational diabetes mellitus?

a. History of Thyroid
b. Previous stillbirth
c. Positive family history of diabetes
d.Late pregnancy

Manifestations

6. What are the signs and symptoms of gestational diabetes mellitus?

a. Increased urination
b. Increased sweating
c. Increased heart rate
d.Increased palpitation

7. What are the signs and symptoms of metabolic syndrome?

a. Fever
b. Vomiting
c. Polyuria and polydipsia
d.Constipation

28
8. What are the common investigation done to detect gestational diabetes mellitus
a. Hemoglobin
b. Urine test
c. OGTT
d. Blood pressure

9. What is the level of blood sugar for mothers with gestational diabetes mellitus?
a. Blood sugar more than 126mg/dl
b.Blood sugar between 80 – 130 mg/dl
c. Blood sugar less than 80mg/dl
d. Blood sugar less than 126mg/dl

10. How many times the mother with gestational diabetes check the blood glucose
level?
a. Four
b.One
c. Two
d. Three

Management
11. How can you manage metabolic syndrome?
a. Life style changes and calorie restriction
b. Pre conceptional counseling
c. Induction of labour
d.Exercise
12. Which is the commonest medication taken by a mother with gestational diabetes
mellitus?
a. Injection iron
b. Tablet folic acid
c. Insulin
d. Oral hypoglycemic medication

29
Dietary
13.What are the food items that needs to be avoided by a mother with gestaional
diabetes mellitus?
a.High in fibre
b. High in carbohydrate(rice)
c. High in fluid intake
d. High in protein

14. What type of fibre food will lower the blood cholesterol?
a. Unrefined whole grains
b. Fruits
c. Vegetables
d.Green leaves

15.What are the food items should a mother with gestational diabetes take?
a. Bitter gourd , chapatti
b. Cabbage , potato
c. Cauliflower and carrot
d. Beetroot and pumpkin

Exercise
16.What are the common exercises that can be practiced by a mother with gestational
diabetes mellitus?
a. Walking
b. Jogging
c. Weight lifting
d. Swimming

30
17.How often must the exercises be practiced by a mother with gestational diabetes
mellitus?
a. 4- 5 days/ week
b. 1 day/ week
c. 2 days/ week
d. Daily

18. When should the mother stop doing exercise?

a. Sweating
b. Tired
c. Shortness of breath
d. Pain

Yoga
19. What are the yogic program to control the clinical parameters of metabolic
syndrome?
a. Yogis position
b. Twist yoga poses
c. Ustasana ( Camel posture)
d.Suriyanamaskaram

20. How many times the yoga therapy must be practiced?

a. Daily
b. Once in a day
c.Twice in a day
d. Once in a month

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Risk Factors

21. What are the risk factors of gestational diabetes mellitus?

a. Previous still birth
b. Obesity.
c. Cardiac problems
d.CVD

22. What are the risk factors of metabolic syndrome?

a. Overweight and obesity
b. Hyperthyroidism
c. Gestational Diabetes Mellitus
d. Anemia

Prevention
23. How can you prevent metabolic syndrome
a. Enhancing physical activity
b. Early diagnosis
c. Vaccination
d.Medication

24. What food item reduces blood pressure?

a. Low sodium (1/4 tsp salt/ day)
b. Low sugar ( ½ spoon/day)
c. High carbohydrate diet( rice)
d.High protein (meat)

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25. What food reduces the risk of metabolic syndrome?
a. Meat and Fish
b. Roots and Nuts
c. Milk and dairy products
d.Fruits and vegetables

26.What are the advantages of exercises?

a. Increases weight
b. Lowers blood sugar level
c. Decreases liver glucose production
d.Increases blood sugar level

27. How many times the postnatal mother with metabolic syndrome visit the postnatal
clinic.
a.Once in a week
b. Once in a month
c.Once in a three month
d.Depends on mothers health status

28.How many hours of rest and sleep does a gestational diabetes mother need per
day?
a.8 - 10 hours
b.10 -12 hours
c.6-8 hours
d.< 8 hours

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29. What are all the foot care practices that should be followed by a mother with
gestational diabetes mellitus?
a. Examining the nails for cuts
b. Polishing the nails
c. Washing with cold water
d.Ice application

30. What are the life style changes that needs to be followed by a mother with
gestational diabetes mellitus?
a. Meditation
b. Diet
c. Medication
d.Yoga

31. What are the commonest effect of diabetes during post natal period?
a. Postpartum hemmorrhage
b. High blood pressure
c. Cancer
d. Fibroid

Complications
32. What is the complication of gestational diabetes mellitus if not promptly detected
and treated?
a.Metabolic syndrome
b.Asthma
c. Dermatitis
d. CKD

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33. What are the postnatal complications of mothers with obesity?
a. Lactation failure
b. Secondary infertility
c. Prone to cardiac problems
d. PPH

34.What are the fetal complications of metabolic syndrome?

a. Congenital anomalies
b. Respiratory distress syndrome
c. Hyperbilirubinemia
d.Hypothermia
35.What are the complication of metabolic syndrome?
a. Cardiac disorders
b.Stroke
c.Cancer
d.CVA

SCORING INTERPRETATION:

S.NO SCORINGS RATINGS

1 0 – 17( 0 – 50%) Inadequate
knowledge
2 18-25 (51-75%) Moderately
adequate knowledge
3 26 -35( 76 -100%) Adequate
Knowledge

35
 BLUEPRINT

Q.NO Answers S.NO Answers

1 B 18 C
2 A 19 A
3 A 20 B
4 A 21 B
5 C 22 C
6 A 23 A
7 C 24 A
8 C 25 D
9 B 26 C
10 D 27 D
11 A 28 B
12 C 29 A
13 B 30 B
14 D 31 B
15 A 32 A
16 A 33 C
17 A 34 B
35 A

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