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Research Tool
Research Tool
OBJECTIVES:-
1. To assess fear related to pregnancy and childbirth among primigravidae
mothers.
SECTION – A
Sociodemographic Variables
INSTRUCTIONS:
• It is purely for research purpose and your answers will be kept
confidential therefore you are requested not to write your name.
• Complete the following by placing tick mark (√) in the appropriate place.
1. Age in years.
21-25 years
26-30 years
31-35 years
2. Religion.
Hindu
Muslim
Sikh
Christian
3. Residence.
Urban
Rural
No formal education
Up to matriculation
Up to senior secondary
Graduation or above
Working
Non-working
6. Type of family.
Nuclear
Joint
7. Duration of marriage.
Below 2 years
2 – 4 years
More than 4
8. Maternal status.
Married
Divorced
Widow
Single
25 Do you have fear that you may go into labor much before your
due date?
26 Do you have fear that you may not have labor pain even after you
cross your due date?
27 . Do you have fear that no will be there to take care of you in the
hospital at the time of labor?
28 Do you have fear that you may give birth at home and on the way
to hospital?
29 Do you have fear that no doctor and nurse attend to me when you
reach the hospital?
30 Do you have fear that your labor may be too long?
31 Do you have fear that you may feel lonely and helpless during
labor?
32 Do you have fear that sudden complications may arise during
labor?
33 Do you have feel afraid/ tense thinking about childbirth?
34 Do you have feel that you may not have enough money for the
delivery?
35 Do you have fear that you may lose control over your bowel and
bladder activity during labor?
36 Do you have fear that you may have increase blood pressure
during labor?
4. FACTORS RELATED TO FEAR DURING
CHILDBIRTH
42 Do you have fear that you may have any birth injury due to
instrumental delivery?
43 Do you have fear that you may lose your self-control during
labor pains?
44 Do you have fear that you may die as a result of childbirth?
45 Do you have fear that your baby may have some complications
during childbirth?
46 Do you have fear that you may deliver to an abnormal child?
47 Do you have fear that your baby may be die during childbirth?
I am certifying that tool is valid for the conduction of the study,” A descriptive
study to assess the fear related to pregnancy and childbirth and its associated factors
among primigravidae mothers with a view to develop an informative booklet on
childbirth preparation at selected hospitals of district Kangra ( HP )”
SUGGESTION………………………………………………………………….
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Section 1
Socio
demographic
variables
Section 11
Self-structured
checklist
DESIGNATION:
PLACE:
DATE :