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Abstract— Th The present study was aimed to assess the effect of structured teaching program on labor care guide among 

staff nurses at a selected hospital Perinthalmanna, Kerala. The objectives of the study were to assess the knowledge regarding 

labor care guide among staff nurses, to find out the effect of structured teaching program on knowledge regarding labor care 

guide among staff nurses and to find out the association between the pretest knowledge levels regarding labor care guide with 

their selected demographic variables. A quasi-experimental research design was used to study 50 staff nurses from a selected 

hospital at Perinthalmanna, selected by purposive sampling technique. The data was collected by using structured 

knowledgequestionnaire on labor care guide.Pretest was conducted and the same day itself planned teaching program given to 

the staff nurses regarding labor care guide and posttest was done after one week. The data collected was analyzed to achieve the 

objectives of the study and to test the research hypotheses.  

The results revealed that in pretest most of the subjects had average knowledge (62%), 30 % had poor knowledge whereas only 

8% had good knowledge regarding labor care guide where is in the posttest 100% of them having good knowledge and none of 

them are having poor and average knowledge. The range, mean, median and standard deviation of pretest was 12, 8.92, 9.5 and 

3.45 respectively. The range, mean, median and standard deviation of posttest was 5, 16.78,17, and 1.36 respectively. Results 

showed that significant association was found between age and year of experience whereas no association between educational 

qualification and the level of knowledge scores. The calculated χ2value for age- 8.13 with  p-value is 0.0044, year of 

experience- 14.966 with  p-value is 0.0001 and for educational qualification -2.91 with  p-value is 0.0877 at 0.05 level of 

significance.  

The present study helped to identify the knowledge of staff nurses on labor care guide. The study shows that the structured 

teaching program is effective to improve in knowledge of labor care guide.  

Keywords: Effect, Knowledge, Structured Teaching Program, Labor Care Guide 

Chinese Traditional Medical Journal 
 

 

Assess the Effect of Structured Teaching Program on Knowledge 

Regarding Labor Care Guide Among Staff Nurses at a Selected 

Hospital, Perinthalmanna. 
1. Dr. Tamil Selvi P, Principal, Al Shifa College of Nursing, Perinthalmanna, Kerala 

2.Mrs. Rincy Alex, Assoc. Prof, Al Shifa College of Nursing, Perinthalmanna, Kerala 

3. Dr. Sheeba, Asst Prof, Al Shifa College of Nursing, Perinthalmanna, Kerala 

4. Mrs. Shinu Xavier, Asst Prof, Al Shifa College of Nursing, Perinthalmanna, Kerala 

5. Mrs. Anjali Mohan, Lecturer, Al Shifa College of Nursing, Perinthalmanna, Kerala 

6. Mrs.Harishma.P. N, lecturer, Al Shifa College of Nursing, Perinthalmanna, Kerala 

7. Mrs. Azhagurani, Lecturer, Al Shifa College of Nursing, Perinthalmanna, Kerala 



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INTRODUCTION  

The Labor Care Guide (LCG) is a clinical tool 

developed by the World Health Organization (WHO) 

as part of efforts to improve the quality of care during 

childbirth. It replaces the previously used Partograph 

and aims to provide a simpler, more practical 

approach to monitoring labor progression while 

promoting individualized, respectful maternity care. 

NEED FOR THE STUDY 

The LCG serves as a vital resource for healthcare 

workers in diverse settings, promoting safer 

deliveries and improving maternal and neonatal 

outcomes.Recent research has explored the 

implementation and impact of the World Health 

Organization's (WHO) Labor Care Guide (LCG) in 

various healthcare settings. 

A study was conducted to examine the effect of the 

WHO LCG on primary cesarean delivery rates. The 

findings indicated that utilizing the LCG significantly 

reduced the number of primary cesarean deliveries 

without increasing perinatal complications or the 

duration of hospital stay. The study also noted a 

minimal learning curve for healthcare providers 

adopting the LCG. 

A study was conducted to evaluate the LCG’s 

usability, feasibility, and acceptability among 

maternity care practitioners in clinical settings. 

Mixed-methods evaluation with doctors, midwives, 

and nurses in 12 health facilities across Argentina, 

India, Kenya, Malawi, Nigeria, and Tanzania. 

Purposively sampled and trained practitioners applied 

the LCG in low-risk women during labor and rated 

experiences, satisfaction, and usability. Practitioners 

were invited to focus group discussions (FGDs) to 

share experiences and perceptions of the LCG, which 

were subjected to framework analysis. The study 

results show that Practitioner satisfaction with the 

LCG was high and median usability score was 

67.5%. Practitioners described the LCG as supporting 

precise and meticulous monitoring during labor, 

encouraging critical thinking in labor management, 

and improving the provision of woman-centered care. 

The above research studies shows that the LCG is 

feasible and acceptable to use across different clinical 

settings and can promote woman-centered 

care.Implementing the LCG should be accompanied 

by the necessary initial and ongoing training, and 

supportive supervision, and strategies to promote an 

enabling environment for practitioners to use LCG 

efficiently.  

So the researcher is intrested to assess the knowledge 

of staff nurses regarding Labor Care Guide. 

STATEMENT OF THE PROBLEM 

A study to assess the effect of structured teaching 

program on knowledge regarding labor care guide 

among staff nurses at a selected hospital at 

Perinthalmanna. 

OBJECTIVES OF THE STUDY 

1. To assess the pretest knowledge regarding 

labor care guide among staff nurses 

2. To find out the effect of structured teaching 

program on knowledge regarding labor care 

guide among staff nurses and 

3. To find out the association between the 

pretest level of knowledge scores regarding 

labor care guide with their selected 

demographic variables. 

HYPOTHESES 

H1: There is significant difference between the mean 

pretest and posttest knowledge score of staff nurses 

regarding labor care guide 



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H2: There is a significant association between pretest 

knowledge scores of staff nurses with selected 

demographic variables. 

SETTING OF THE STUDY 

The study was conducted at KIMS Al Shifa Hospital, 

Perinthalmanna. 

POPULATION 

Population consists of staff nurses who are working 

at KIMS Al Shifa Hospital, Perinthalmanna. 

SAMPLE 

The samples consist of 50 staff nurses who are 

working at KIMS Al Shifa Hospital, Perinthalmanna. 

SAMPLING TECHNIQUE 

Purposive sampling technique  

CRITERIA FOR THE SELECTION OF THE 

SAMPLES 

Inclusion Criteria 

▪ Staff nurses who are working at KIMS Al 

Shifa Hospital, Perinthalmanna  

▪ Staff nurses who are available during the 

data collection period. 

Exclusion Criteria 

▪ Staff nurses who were not willing to 

participate in the study. 

▪ Staff nurses at who had attended previous 

classes on labor care guide 

Data collection instruments 

The tools used for the study were, 

Section A: Demographic Proforma. 

Section B: A structured knowledge questionnaireto 

assess the Knowledge of Staff nurses regarding labor 

care guide 

 

 

Data collection process 

After getting permission from ethical committee, 

researcher taken consent from the subjects and 

collected data from the participants. Using the tool on 

the first day pre-test was conducted and on the same 

day itselfstructured teaching program was given. On 

the 7th day post-test was done. 

RESULTS 

Section A: Description of the Demographic 

Variable 

Table 1:Frequency and Percentage Distribution of 

students on Demographic Variable  

      

    N=60 

Sl No Demographic variables Frequency Percentage (%) 

1 

Age in years 

a) 20-25 yrs 

b) 26-30 years 

c) More than 30 yrs 

 

22 

15 

13 

 

 

 

44 

30 

26 



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2 

Qualification  

a) Undergraduate  

b) Graduate  

c) Postgraduate 

 

 

28 

22 

0 

 

 

56 

44 

0 

 

3 

Year of experience  

a) Less than 1 year 

b) 1-5 years 

c) More than 5 years 

 

 

13 

30 

7 

 

26 

60 

14 

 

Most of the subjects (44%) were in the age group 

between20-25 yrs 

Most of the subjects (56%) were under graduates  

Most of the subjects (60%) were between1-5 years of 

experience 

Section B: Knowledge of of staff nurses regarding 

labor care guide 

Table 2: Frequency and Percentage Distribution of 

Knowledge Scores of staff nurses regarding labor 

care guide 

      

     N=60 

Level of Knowledge 

Pretest Post test 

(n) (%) (n) (%) 

Good (14-20) 4 8 50 100 

Average   (7-13) 31 62 0 0 

Poor (0-6) 15 30 0 0 

 

 



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Figure 1: Bar Diagram showing the Percentage 

Distribution of Staff nurses according to their 

Pretest and Posttest Knowledge Scores 

Data presented in the Table 2 and Figure 1 show that, 

in pretest most (62%) of staff nurses had average 

knowledge, 30% had poor knowledge whereas only 

few (8%) of them had good knowledge. Where as in 

the post-test all the staff nurses (100%) had good 

knowledge. 

Table 3: Mean, Standard Deviation, Paired‘t’ test 

values of pretest and posttest level of knowledge 

regarding labor care guide. 

      

     N=60 

Level of knowledge Paired ‘t’ test 

Pretest Posttest 

t-value p-value 
 

Significance 
Mean 

Standard 

deviation 
Mean 

Standard 

deviation 

8.92 3.45 16.78 1.36 17.29 0.00001 Significant 

 

Data in the Table 3 shows that the pre=test mean was 8.92 with a standard deviation 3.45 and post-test mean was 

16.78 with a standard deviation 1.36. The calculated ‘t’ value is 17.29 which was statistically significant at p<0.05. 

Section C: Association of Knowledge Scores with selected Demographic Variables 

Table 4: Chi-Square Test Showing Association of Level of Knowledge Scores with Selected Demographic 

Variables 

0

20

40

60

80

100

120

pre test post test

poor

good

average



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Sl. No. Demographic Variables χ 2 Inference 

1.  Age (in years) 8.13 Significant 

2.  Year of experience 14.966 Significant 

3.  Educational qualification 2.91 Not significant 

 

The data in the Table 4 shows that, significant 

association was found between age, year of 

experience and the level of knowledge scores, 

whereas no significant association educational 

qualification. Hence the research hypothesis was 

accepted at 0.05 level of significance for age. 

Discussion 

A mixed-method research was conducted to evaluate 

the usability, feasibility, acceptability, and satisfaction 

of midwives using WHO LCG in rural practice.  

During February to April 2024, research data were 

gathered from three rural hospitals.Data were 

collected from 41 midwives in three rural hospitals. 

Midwives observed labor in 123 patients using LCG. 

According to the questionnaire, 49.6% of the 

midwives were satisfied with the use of LCG, 65% 

were satisfied with how LCG was designed, and 

68.3% thought LCG was useful. According to the 

midwives' interviews, the LCG design was detailed; 

however, in its implementation, the midwives agreed 

that more time, information, and effective 

communication were needed to complete. 

A study was conducted to explore opinions of skilled 

health personnel on the frst version of the WHO 

Labour Care Guide.Skilled health personnel 

(including obstetricians, midwives and general 

practitioners) of any gender from Africa, Asia, 

Europe and Latin America were identifed through a 

large global research network.A total of 110 

participants from 23 countries completed the 

survey.Participants agreed or strongly agreed with the 

overall design, structure of the LCG, and the 

usefulness of reference thresholds to trigger further 

assessment and actions. They also agreed that LCG 

could potentially have a positive impact on clinical 

decision-making and respectful maternity care. 

The present study also revealed that health care 

professionals are lack knowledge regarding labor 

care guide. The above studies are supporting the 

present study that health care professionals should 

receive training and classes to improve their 

knowledge and practice. 

Limitations 

* The study was limited only at one setting. 

* There is a small sample size will reduce the 

generalization of findings. 

Conclusion 

The study concluded that structured teaching 

program is effective in terms of improving 

knowledge of staff nurses regarding labor care guide  

Recommendations 

* Futurestudies can be conducted to assess the both 

knowledge and practice on labor care guide  



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* In-service education can be given to the staff nurses 

to update their knowledge. 

* The study can be conducted at different settings by 

using large sample size to improve the generalization 

of findings 

References 

1. World Health Organization. WHO Labour Care 

Guide: User's Manual. Geneva: World Health 

Organization; 2021. 

2. Kumar S, Gupta R, Sharma P. Awareness of WHO 

Labour Care Guide among nursing professionals in 

India. Indian J Nurs Midwifery. 2020;8(2):56-62. 

3. Sharma N, Patel V, Joseph S. Effectiveness of 

planned teaching programs on obstetric care tools: A 

quasi-experimental study. J Nurs Educ Pract. 

2019;9(3):78-84. 

4. Thomas R, George K, Varghese A. Evaluating 

interactive teaching interventions for improving 

knowledge of labor management among nurses. 

Asian J Nurs Educ Res. 2020;10(4):567-71. 

5. George R, Thomas L, Abraham A. Impact of labor 

progress monitoring tools on decision-making during 

delivery. Int J ObstetGynecolNurs. 2018;6(1):45-50. 

6. Patel R, Shukla K, Desai M. Role of trained 

nursing staff in reducing labor-related complications. 

J Clin Nurs. 2019;28(11-12):2510-6. 

7. Rani A, John P, Nair S. Effect of a planned 

teaching program on maternal care tools in Kerala: A 

pre-post study. South Asian J NursMidwifery Res. 

2021;3(2):125-30. 


