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Study Protocol

A study to assess the effectiveness of planned teaching regarding the harmful effect of oil application on anterior fontanels of newborn among post-natal mothers

[version 1; peer review: 1 approved with reservations]
PUBLISHED 23 Apr 2024
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This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

The anterior fontanelle, sometimes known as the “soft spot,” is an important anatomical component in neonates that allows brain growth and development. Possible harm is caused by such practices, as they may result in unfavorable outcomes, such as skin irritation and a delay in fontanelle closure. The goal of this study was to see how effective pre-planned education was at informing postpartum women about the dangers of applying oil to newborns’ anterior fontanelles.

The study was conducted with the goal of increasing the understanding of the adverse effects of oil application on the anterior fontanels of newborns among postnatal mothers, The study will be thoroughly described to the participants, and their written Consent will be taken for the participate in the study and publishing the information. Sampling technique will be convenient. Population and sampling techniques will be examined. Mothers will be the target group with a sample size of 60 postnatal mothers. The sample will be drawn using The Purposive sampling approach. Prior authorization will be acquired from the designated hospitals’ higher authority. The inclusion criteria will be used to select samples. Information will be gathered from the hospital’s obstetric ward. First, pretest knowledge of the adverse effects of applying oil to newborns’ anterior fontanels among postnatal mothers was assessed. Postnatal mothers will be taught about the detrimental effects of placing oil on the anterior fontanels of their newborns. The post-test assessment of knowledge regarding the adverse effects of applying oil to anterior fontanels was performed after 7 days. If the hypothesis of our study is helpful in improving mothers’ knowledge in the post-test rather than pre-test following the intended training.

Keywords

Newborn, Anterior, Fontanelles, Application, Harmful.

Introduction

The fragile, delicate bodies of babies necessitate extra care and attention throughout their first few days of life. The infant’s anterior fontanelle, a soft part of the skull where the cranial bones have not yet fused, must be maintained.1 Despite the fact that this area is already delicate and sensitive, some cultural norms or well-meaning but wrong views have encouraged the use of oils in the anterior fontanelle.2

The purpose of this introduction is to highlight the need for adequate infant care practices and shed light on the detrimental consequences of oil application on babies’ anterior fontanelles. The anterior fontanelle, also known as the “soft spot,” is a membrane-covered space in the baby’s skull that allows it to grow and bend throughout the early stages of development.3 Oils or other substances applied to the anterior fontanelle in many cultures can improve brain development, increase brain growth, or even fend off evil spirits.4

First, certain oils may include allergens or irritants that might result in skin reactions or infections when in contact with a baby’s sensitive skin. Second, oils can hinder sweat from normal evaporation, increase body heat retention, and increase the newborn’s vulnerability to heat-related disorders. In addition, improper soft spot handling during oil delivery may result in mechanical injuries such as pressure on the fontanelle or an inadvertent puncture, which can lead to serious problems such as infections or brain damage.5 Promoting evidence-based practices and educating parents and communities about the dangers of applying oils to the anterior fontanelle are crucial tasks for healthcare providers and caregivers.

Encouragement of suitable infant care practices, such as routine washing, keeping the environment clean, and avoiding superfluous practices, can significantly lower the risk of neonatal injuries. Finally, the anterior fontanelle of a newborn is a delicate and vulnerable structure that requires special care and preservation.6 Applying oils to this sensitive part of the baby’s head may have negative consequences, including skin difficulties, heat-related disorders, and the possibility of mechanical harm. By raising awareness of the negative consequences of oil application on the anterior fontanelle, we may work to protect newborn’s health and safety and develop evidence-based practices for baby care.7

Aim

The purpose of this study was to assess how well postpartum mothers understood the harmful effects of oil application on their newborn’s anterior fontanelles through a structured education session.

Objective

  • 1. To improve knowledge regarding the harmful effects of oil application on the anterior fontanels of newborns among postnatal mothers.

  • 2. To Evaluate the effectiveness of planned teaching regarding the harmful effects of oil on anterior fontanels of newborn postnatal mothers.

Protocol

The participants’ written agreement will be sought from their mothers at Sawangi Meghe Hospital in Wardha, Maharashtra, as this study is cantered on postnatal mothers. Pre- and post-test knowledge will be collected after obtaining ethical approval with the inclusion and exclusion criteria based on creating planned instructions for mothers to impart knowledge. Mothers were the study’s target demographic for the interventional approach research design, which consisted of a single group pre- and post-test. The target population of this study will be mothers. participants In the study will be new mothers. A non-probability sampling technique will employed in this investigation. 60 mothers will make up a convenient sample size for this investigation. The study tools consisted of structured lectures and questionnaires. The variable consists of two variables: independent and dependent. The awareness of mothers regarding the detrimental impact of oil application on a newborn’s anterior fontanelles will the dependent variable, while the planned education of postnatal mothers on this knowledge will the independent variable. We plan to gather this information using questionnaires. Descriptive and inferential statistics will used for interpretation, followed by report-writing.

Inclusive criteria

  • Postnatal mothers admitted and presenting in ward.

  • Postnatal mothers who can read and write English and Marathi.

  • Mother available during data collection.

Exclusive criteria

  • Postnatal mothers who are known cases of psychiatric illness.

  • Postnatal mothers who had already been a part of a similar study from 6 months to 1 year.

  • Mother who is not willing to participate in the study.

Interventions

In this study, an interventional method will be used in conjunction with a pretest and post-test design. We recruited 60 postpartum mothers. The total knowledge of postnatal mothers will be measured using a structured knowledge questionnaire. Sections A and B constitute the two sections that constitute the tool. The demographic information in Section A includes age, education level, type of home, monthly income, and prior awareness of the harmful effects of oil application on a newborn’s anterior fontanel. Ten items comprise Section B’s structured knowledge questionnaire on negative impacts. Experts received the instrument to guarantee content authenticity. Following consultation with the guide and expert guidance, the instrument underwent necessary modifications. The details will be gathered between October 5, 2023, and November 5, 2023.

Pre-intervention assessment

A standardized questionnaire will be used to assess the participants’ current knowledge of the detrimental effects of oil application on the anterior fontanels of newborns among postnatal mothers.

Implement planned teaching intervention

We will create a 30-minute teaching plan on the adverse effects of oil application on newborn anterior fontanels.

Post-test assessment

A post-test questionnaire will be administered after seven days to assess the success of the intended education on the adverse effects of oil application on the anterior fontanels of newborns.

Primary outcome

The primary goal of this study was to improve postnatal mothers’ understanding of the adverse effects of oil application on the anterior fontanels of newborns. This was determined by comparing postnatal pre- and post-test results.

Secondary outcome

A feedback survey and questionnaires used to assess participant satisfaction with the planned educational program and their assessment of its worth in terms of knowledge improvement were used to assess participant satisfaction. Planned instruction had little effect on postnatal moms’ practice of administering oil to their newborns’ anterior fontanels. It monitors whether there is a decrease in the amount or frequency of oil applied to this sensitive spot, indicating an improvement in the procedures.

Sample size calculation

“Eligibility criteria are the postnatal mothers who are interested in participating in the study.”

The sample size calculation is based on a similar study.

In the present study, the sample is postnatal mothers selected hospitals.

Sample size – 60

I took this sample size from this reference to obtain the sample size.

Cochran’s formula for sample size (this formula is referred as per Cochran W.G. et al)8

n=Z2p1pd2

Z = 1.96

P = Subjects received jaundice education

= 11% = 0.11

d = Desired error of margin = 8% = 0.08

n=1.9620.1110.10.082=58.76=60participants needed in each group

Data analysis and statistical plan

T-tests and other analytical tests will be also performed. All statistical analyses will be performed using SPSS version 27.09 p0.05 as the significance threshold. This research will be conducted at the A.V.B.R.H. hospital Sawangi Meghe Wardha.

Data source measurement

The pre-test and post-test will be used to assess knowledge levels; knowledge will change as a result of the intended training, and knowledge will improve.

Bias

Bias is conceivable at the statistical analysis level and can be mitigated by utilizing appropriate analytical software and double checking of the outputs.

Dissemination

When the study is completed, it will be published in Scopus, Web of Science, PubMed, and other nursing-related indexed journals.

Study status

Currently, the study is yet to be started.

Discussion

In this study, a descriptive research design was adopted. Purposive sampling was used to obtain 157 samples from a single institution. A structured dichotomous questionnaire and demographic data were used to gather the subjects’ data. Results: The information acquired from 157 samples was analyzed using descriptive statistics. (149) Of the mothers, 95% massaged their infants with oil before bathing. (83) 53% of mothers have given their infants over-the-counter medications. When their babies’ skin turned yellow, (87) 55% of the mothers gave their children ash, soot, powder, or dried cow dung; (115) 73% of the mothers exposed their children to sunshine. (129) To avoid bad eyesight, 82% of mothers apply “Kajal” to their infant’s face. (92%). 59% of mothers follow the adage “An empty cradle should not be moved.” In summary, the study’s conclusions showed a significant correlation between parents’ cultural practices and beliefs about baby care and demographic traits, including family structure and religion. The postnatal ward should offer regular health education on the dos and don’ts of newborn care. This will help curtail the detrimental customs.10 To determine the customary remedies Turkish mothers utilized to treat their newborns’ jaundice, a cross-sectional descriptive study was conducted. In one university hospital and one public children’s hospital in Sanliurfa, 229 mothers of newborns aged 0-28 days were assessed using knowledge questionnaires on the customs and beliefs of mothers regarding jaundice. Data were analyzed using descriptive and inferential methods. According to this study, mothers apply traditional practices when dealing with health issues such as jaundice, and these methods are important to them. In addition, mothers mentioned employing dangerous traditional therapies for neonatal jaundice, such as severing the space between the infant’s brows with a knife, which is not customary in other societies. The study’s conclusions were used to support the recommendation that families should receive education regarding the consequences of conventional techniques and that future research examining the effects of this type of education should be guided by these findings.3 All babies admitted to the paediatrics department at SVP PGIP & SCBMCH, CUTTACK, or those who presented to the outpatient department at SVPPGIP, CTC, were eligible for this descriptive study a two-year span beginning on August 1, 2014, and ending on July 31, 2016. Critically ill neonates were excluded from the study. A structured dichotomous questionnaire was developed, verified, and used to gather, examine, and aggregate the data. Of the 170 mothers, 64.1% were under 25 years of age, and 61.8% were part of a combined or extended family. Over 40% (40.6%) of mothers had a family income of less than Rs. 9794, the majority (>80%) were in Matric, and 91.2% of mothers were identified as Hindu. Eleven infants were wrapped in old fabric within 30 min of delivery, making up the bulk of newborns (69.4%). A total of 95.9% of mothers massaged their infants with oil prior to bathing, and 92.4% massaged their infants with oil. week on earth. Of the mothers who began breastfeeding, 54% did so within one hour, 24.7% did so between one and four hours, and 15.9% did so more than that. Ethic-related issues.11

Ethical considerations

The institutional ethics committee approved the title of the Study with reference number DMIHER (DU)/IEC/2023/1133 ON DATE 01/07/2023 this approval has been granted on the assumption that the proposed research work will be carried out in accordance with the ethical guideline prescribed by central ethics committee on human research (C.E.C.H.R.).

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Raut K and mahakarkar MM. A study to assess the effectiveness of planned teaching regarding the harmful effect of oil application on anterior fontanels of newborn among post-natal mothers [version 1; peer review: 1 approved with reservations]. F1000Research 2024, 13:346 (https://doi.org/10.12688/f1000research.144857.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Current Reviewer Status: ?
Key to Reviewer Statuses VIEW
ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 1
VERSION 1
PUBLISHED 23 Apr 2024
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Reviewer Report 01 Jul 2024
Mary Ani-Amponsah, Maternal and Child Health Department, University of Ghana, Accra, Greater Accra Region, Ghana 
Approved with Reservations
VIEWS 3
The protocol has relevance for practice and potential to improve newborn health but it has several gaps. 
Harmful practices are best addressed before they happen; hence will the researchers sample mothers with newborns who have applied the oil to ... Continue reading
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HOW TO CITE THIS REPORT
Ani-Amponsah M. Reviewer Report For: A study to assess the effectiveness of planned teaching regarding the harmful effect of oil application on anterior fontanels of newborn among post-natal mothers [version 1; peer review: 1 approved with reservations]. F1000Research 2024, 13:346 (https://doi.org/10.5256/f1000research.158710.r285281)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.

Comments on this article Comments (0)

Version 1
VERSION 1 PUBLISHED 23 Apr 2024
Comment
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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