RESEARCH PROPOSAL

KNOWLEDGE AND ATTITUDES OF PREECLAMPSIA AND ITS ASSOCIATES

FACTORS AMONG PREGNANT WOMEN IN BUNDUNG MATERNAL AND
CHILD HEALTH HOSPITAL

ALIMATOU MANNEH

MR. YUSUPHA SANYANG

INTRODUCTION TO NURSING RESEARCH

DEPARTMENT OF NURSING AND REPRODUCTIVE HEALTH SCIENCES

UNIVERSITY OF THE GAMBIA

15th JULY,2022.

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Table of contents

Introduction………………………………………………………………………3

Background and context………………………………………………………3-4

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Problem statement………………………………………………………………5

Relevant and important of the Research………………………………………..5

Aims and Objectives…………………………………………………………….6

Research Questions……………………………………………………………..7

Research design and methods…………………………………………..………….7

Research design …………………………………………………………………7

Method and Sources…………………………………………………………….7

Practical Consideration………………………………………………………….8

Implications and Contributions to knowledge……………………………………8

Practical Implications……………………………………………………………8

Theoretical Implications…………………………………………………………8

References………………………………………………………………………9-11

Research Schedule…………………………………………………………….11-12

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Introduction

Preeclampsia is a hypertension condition that occurs during pregnancy and is

manifested by high blood pressure and large amounts of protein excretion in the

urine[1]. It is one of the most prevalent causes of maternal morbidity and mortality,

that influence pregnant women disproportionately in poor and middle-income

countries when access to and quality of health treatments are limited[2,3]. In

developing countries, hypertensive conditions of pregnancy (HDP) trigger one-tenth

to one-quarter of maternal mortality[4,5]. Contrary to other direct causes of death

among mothers, such as abortion and prolonged labour, mortality associated with

HDP is on the rise[6]. An investigation carried out in a few government hospitals in

Addis Abeba revealed an upward trend in the prevalence of preeclampsia in Ethiopia.

The study found that the prevalence of preeclampsia rose from 2.2% in 2009 to 5.58

in 2013 [7].Numerous maternal and foetal morbidities have been linked to HDP,

particularly preeclampsia, according to research[8-10].

Premature birth, foetal growth constraints, intrauterine foetal mortality, kidney or

liver disease, hemorrhage, and stroke constitute some of the problems related to

preeclampsia[10,11]. In addition to increasing the number of surgical deliveries, a

study conducted in Iran indicated that among women with severe preeclampsia,

coagulopathy, placenta abruption, and the HELLP syndrome (hemolysis, elevated

liver enzymes, and low platelet count) occurred in 10.6%, 7.7%, and 0.3% of cases,

respectively [9]. As complications of preeclampsia, another study[8] highlighted

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cerebral infarction, congestive heart failure, pulmonary edema, renal failure, and

mortality.

Preeclampsia has a number of known risk factors. Preeclampsia is more likely to

develop among individuals who are older, primigravida, have a history of the

condition, have lived together for a short period of time, and have low financial

standing. [8,12,13]. Preeclampsia is also associated with obesity, long-term

hypertension, diabetes, adolescent pregnancy, and conditions resulting in

hyperplacentation and big placentas [4]. Preventive actions, health-seeking practices,

and management results in preeclamptic women are all affected either directly or

indirectly by perceptions about the cause, severity, and consequence of preeclampsia,

as well as perceived obstacles to prevention techniques. Different areas have different

preeclampsia perspectives, which influences when and where people seek healthcare.

Prediction and early recognition of the disease, which in turn improves maternal and

fetal outcomes, depend heavily on a positive perspective regarding the believed

etiology, perceived consequences, and avoidance of the disease [14]. While women

who delay seeking health care because of their negative views of preeclampsia may

suffer from serious issues [14].

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Problem Statements.

Looking at most of the studies conducted on this problem. It shows, many pregnant

women have low knowledge and moderate attitudes of preeclampsia and its associates

factors. This is due to many factors contributing to the increase risk of

preeclampsia.Some of the leading causes are Low educational background, A delay or

no early health care ( Antenatal visits), Poor road networking and poor socioeconomic

status too.

Base on reviewing other studies on preeclampsia, I found out that there is less

research conducted in our country when it comes to this case study .I will want to

make a further research on this problem in our country.

Relevant and important of the Research.

Since research data on Knowledge and attitudes of preeclampsia and its associates

factors among pregnant women in the Gambia is limited or perhaps non-existent, this

study would be informative to the health care workers and general public at large

regarding of preeclampsia and its associates factors among pregnant women.The

findings from this study can be used to develop policies and guidelines in order to

prevent further complications among pregnant women .The findings from this

research can also be a foundation for future research on this topic.

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Research Aim and Objectives

Aim:

To assess the knowledge and attitudes of preeclampsia and its associates factors

among pregnant in Bundung Maternal and Child Health hospital.

Objectives:

1. To evaluate the knowledge levels of pregnant women regarding pre-eclampsia, its

symptoms, and associated risk factors.

2. To assess the attitudes of pregnant women towards pre-eclampsia, including their

perception of its seriousness and their willingness to engage in preventive

measures.

3. To identify the factors influencing knowledge and attitudes towards pre-

eclampsia among pregnant women.

Research Questions:

1. How will pregnant women attending antenatal care in Bundung Maternal and

child health hospital have to knowledge about preeclampsia and it associates

factors.

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2. what attitudes will the pregnant women possess towards preeclampsia and its

associates factors.

Methodology

This chapter contains the study design, study setting, study population, sampling
technique and sample size, inclusion and exclusion criteria, data collection technique,
data analysis and ethical consideration.

Study Design:

This research is a quantitative research type and will utilize a cross-sectional study
design to be conduct on 100 pregnant antenatal women above 20weeks gestational
age and attending antenatal clinical in Bundung maternal and child health hospital.

Inclusion criteria :

Only antenatal mothers of above 20 weeks of gestational age , mentally and

emotionally stable and are willing to participate in the study.

Exclusion Criteria:

Those pregnant women less than 20weeks gestational age, Pregnant women
visiting the hospital for diagnosis of pregnancy and pregnant women on admission
will be exclude in the study sample.

Study Population:

The study will target pregnant women attending antenatal care clinics in
selected healthcare facilities.

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Sampling Technique:

A convenient sampling technique will be employed to recruit participants.

Data Collection:

A structured questionnaire will be developed to collect data on participants'

socio-demographic characteristics, knowledge levels, attitudes, and potential
influencing factors. The questionnaire will be pre-tested and validated prior to data
collection.

Data Analysis:

Descriptive statistics will be used to summarize participants' socio-

demographic characteristics, knowledge levels, and attitudes. Inferential statistics,
such as chi-square tests and logistic regression, will be conducted to explore
associations between variables and identify factors influencing knowledge and
attitudes

Ethical Considerations:

Ethical approval will be obtained from the relevant institutional review

board prior to conducting the study. Informed consent will be obtained from all
participants, ensuring their privacy and confidentiality. Participants will have the right
to withdraw from the study at any time without consequences.

Implications and contribution to knowledge.

Implications:

The findings of this research will provide valuable insights for healthcare

providers, policymakers, and relevant stakeholders in developing targeted

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interventions to improve knowledge and attitudes towards pre-eclampsia among

pregnant women. Educational campaigns and interventions can be designed to raise

awareness, emphasize the importance of early detection, and promote healthy lifestyle

behaviors to reduce the incidence and impact of pre-eclampsia.

Contribution to knowledge.

The study expects to identify gaps in knowledge and

attitudes among pregnant women regarding pre-eclampsia and its associated factors. It

is anticipated that a significant proportion of pregnant women may lack adequate

knowledge about pre-eclampsia, its symptoms, and risk factors. Furthermore, the

study aims to highlight factors that may influence knowledge and attitudes, such as

educational level, socioeconomic status, and access to healthcare.

References:

1. Pennington, K.A.,Schlitt, J.M.,, Jackson D. L.,, Schulz L.C.,Schust D.L.,(2012)

Preeclampsia: multiple approaches for a multifactorial disease. Disease models &

mechanisms.; 5(1):9–18. https://doi.org/10.1242/ dmm.008516 PMID: 22228789

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2. World Health Organization. A global brief on Hypertension: Silent killer, global

public health crisis: WHO 2013.

3. WHO/RHR. WHO recommendations for Prevention and treatment of pre-

eclampsia and eclampsia Implications and Actions2013.

4. World Health Organization. WHO recommendations for Prevention and treatment

of pre-eclampsia and eclampsia. Geneva, Switzerland: World Health Organization

2011.

5. Noubiap JJ, Bigna JJ, Nyaga UF, Jingi AM, Kaze AD, Nansseu JR, et al.

(2019).The burden of hypertensive disorders of pregnancy in Africa: A systematic

review and meta-analysis. Journal of clinical hypertension.; 21(4):479–88.

https://doi.org/10.1111/jch.13514 PMID: 30848083

6. Berhan Y, Berhan A.,(2014).Causes of maternal mortality in Ethiopia: A

significant decline in abortion related death, Systematic Review Ethiop J Health Sci.

(special issue): 15–28. https://doi.org/10.4314/ ejhs.v24i0.3s PMID: 25489180

7. Wagnew M, Dessalegn M, Worku A, Nyagero J.,(2016). Trends of

preeclampsia/eclampsia and maternal and neonatal outcomes among women

delivering in addis ababa selected government hospitals, Ethiopia: a retrospective

cross-sectional study. The Pan African medical journal.; 25(Suppl 2):12. https://doi.

org/10.11604/pamj.supp.2016.25.2.9716 PMID: 28439336

8. Sibai B.,(2012). Etiology and management of postpartum hypertension-

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preeclampsia. American Journal of Obstetrics & Gynecology :470–5.

https://doi.org/10.1016/j.ajog.2011.09.002 PMID: 21963308

9. Nankali A, Malek-khosravi S, Zangeneh M, Rezaei M, Hemati Z, Kohzadi M.,

(2013).Maternal Complications Associated with Severe Preeclampsia. The Journal of

Obstetrics and Gynecology of India; 63 (2):112–5. https://doi.org/10.1007/s13224-

012-0283-0 PMID: 24431616

10. Duley L.,(2009).The Global Impact of Pre-eclampsia and Eclampsia. Elsevier Inc

Semin Perinatol 2009; 33:130–7. https://doi.org/10.1053/j.semperi..02.010 PMID:

19464502

11. Mol B, Roberts CT, Thangaratinam S, Magee LA, de Groot C, Hofmeyr GJ.,

(2016).Pre-eclampsia. Lancet.; 387(10022):999–1011. https://doi.org/10.1016/S0140-

6736(15)00070-7 PMID: 26342729

12. Bartsch E, Medcalf KE, Park AL, Ray JG.,(2016). High Risk of Pre-eclampsia

Identification G. Clinical risk factors for pre-eclampsia determined in early

pregnancy: systematic review and meta-analysis of large cohort studies. Bmj.;

353:i1753. https://doi.org/10.1136/bmj.i1753 PMID: 27094586

13. 13.Mekie M, Mekonnen W, Assegid M.,(2020). Cohabitation duration, obstetric,

behavioral and nutritional factors predict preeclampsia among nulliparous women in

West Amhara Zones of Ethiopia: Age matched case control study. PloS one.;

15(1):e0228127. https://doi.org/10.1371/journal.pone.0228127 PMID: 31986179

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14. Akeju DO, Vidler M, Oladapo OT, Sawchuck D, Qureshi R, von Dadelszen P, et

al.,(2016).Community perceptions of pre-eclampsia and eclampsia in Ogun State,

Nigeria: a qualitative study. Reprod Health.; 13 Suppl 1:57.

https://doi.org/10.1186/s12978-016-0134-z PMID: 27357695

Research Schedule

Research phase Objectives Deadline

Background research and  Meet with supervisor 21st July.

literature review for initial discussions.

 Read and analyze

relevant literature.

 Use new to refine

research questions.

 Develop theoretical

framework.

Research Design planning  Design questionnaires. 13 August.

 Identify channel for

recruiting participants.

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  Finalize sampling

method and data

analysis method.

Data Collection and  Recruit participants 24 September.

preparation. and send out

questionnaire.

 Clear data.

Data analysis  Statistically analyze 22 October.

survey data.

 Draft results and

discussions chapters.

Writing  Complete full 17 December.

dissertation draft..

 Meet with supervisor

to discuss feedback

and revision

Revision  Complete 2nd draft 28 January.

base on feedback.

 Get supervisor

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 approve final draft.

 Proofread.

 Print and bind final

work .

 Submit.

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