Because teenage pregnancies and deliveries often have disastrous consequences for both the mother and the child, they represent a serious public health concern. This thesis looks at how nursing could help identify the underlying causes of these iatrogenic pregnancies using a mixed-methods approach. Both qualitative and quantitative methods will be used in the study to gather information and provide a full picture of this complex issue. There are dangers to the health of the pregnant mother and her unborn child associated with delayed prenatal treatment start times and lower rates of prenatal treatment attendance, which are connected to the high prevalence of unplanned births. No research has looked at the effects of prenatal planning on women' postpartum health, even though free prenatal care and abortion are readily available in Malaysia. This study looked at the connections between Malaysian women's utilisation of prenatal care and outcomes and their ability to plan their pregnancy. Medical records were used to gather information on variables such patients' level of education, marital status, lifestyle choices, and the date of their first prenatal visit. The mother's age was calculated by summing up the years of her life before giving birth. Women between the ages of 20 and 34 served as a comparative category for women of every age.
The incidence of teenage pregnancy and delivery poses a danger to the health and well-being of young women worldwide. The unwanted and unplanned nature of these births may be the cause of many of the negative results for the mothers and their offspring. Examining the underlying reasons of adolescent pregnancy is crucial to finding solutions to the issue. Given the significant role nurses play in the support, treatment, and education of young parents, it is imperative to comprehend the factors that contribute to unwanted pregnancies. There are dangers to the health of the mother and child linked with the high prevalence of unexpected pregnancies, including delayed start times and lower rates of attendance at prenatal treatment appointments. There is no research on the effects of pregnancy planning on mother health in a country where both abortion and prenatal care are permitted. Finding out whether and how much pregnancy planning impacted women's usage of prenatal treatments and the results of their pregnancies was our main goal. Primary care physicians are essential in educating their young patients about the value of responsible sexual activity and in having candid conversations with them about reproductive health. In addition to urgent contraception and other methods of preventing unintended births, their services have to provide contraceptive guidance that supports socially acceptable practises. Adolescent pregnancy rates may be reduced in underdeveloped nations by interventions if more is known about the causes of teenage pregnancies. Our ultimate goal is to utilise the knowledge we gather to create outreach programmes that may be used to adopt preventative measures and lessen the harmful impacts of adolescent pregnancy. Our goal is to use university-based adolescent reproductive health activities to spread the word about our studies on sexual health. In low- and middle-income nations, babies delivered to mothers under the age of 20 had a 50% greater risk of stillbirth or neonatal mortality than babies delivered to women between the ages of 20 and 29. Although some evidence indicates that these outcomes might be avoided with full coverage and high-quality treatment for mothers, adolescent pregnancies have been linked to birthweight, preterm delivery, foetal or neonatal mortality. Insufficient treatments for moms increased the risk of problems such as eclampsia, UTIs, stillbirths, and infant mortality, according to research conducted on teenage mothers. Teen mothers who were alone and continued to smoke throughout the first trimester of their pregnancy were linked to poor maternal care. Adolescent pregnancy is defined by the World Health Assembly (WHO) as any pregnancy that a girl between the ages of 10 and 19 experiences. Adolescent pregnancies have a profound impact on young people's health and social wellbeing, as well as the wellbeing of their families and the greater society. According to one estimate, 18,000 young women in Malaysia get pregnant annually, or 14 per 1,000. The Welfare Department reports that there are six births for every 1000 Malaysian women between the ages of 15 and 19. This translates to around 111 unmarried pregnancies among young women. The Ministry of Health in Malaysia reports that 18,847 births were place at public health clinics in 2012 among girls between the ages of 10 and 19. This accounted for 3.2% of the 580,536 pregnant women in Malaysia as of 2020. A sample size of 32/1,000 births is quite tiny. The true prevalence of adolescent pregnancy in Malaysia may be greater than previously believed due to an increase in illicit abortions and baby abandonment (Almaghaslah et al., 2017).
BACKGROUND OF THE STUDY
Teenage pregnancy is a severe issue that may impede the growth of young ladies and reduce their opportunities in the future, particularly with regard to their education. The aforementioned study and data points demonstrate the extent of this problem, particularly in less developed nations. The high rates of adolescent pregnancy are caused by a number of factors, such as peer pressure, poverty, social vulnerability, media exposure, economic hardship, and school dropout. The correlation between adolescent pregnancy and less formal education is an important finding. Teenage parents have a worse chance of finding a decent job and ending the cycle of poverty since they are more likely to leave school before graduating. The drawbacks of adolescent pregnancy include unplanned pregnancies, dropping out of school, rejection from family, less prospects, and not being able to sustain a child. The results emphasise how important it is to have wide support systems in order to get through these challenges. The aforementioned analysis illustrates the unique conditions and issues that Malaysia faces. Early pregnancy has been associated with school abandonment among Malaysian girls living in rural regions. The cultural and geographic circumstances in which adolescent pregnancies occur may account for regional variations in these rates. Establishing focused interventions requires an understanding of the complexity surrounding the relationship between adolescent pregnancy and educational achievement in Malaysia. Research carried out in the Kpando Municipal of the Volta Region in Malaysia focused on teenage pregnancies, the difficulties experienced by young moms in and out of school, the rates at which teen mothers return to school, and the overall effect of adolescent pregnancies on girls' education. The results of this research may be used by policymakers, social service workers, and health care providers to better understand the particular problems faced by young women in the community and develop more useful solutions. A successful plan to minimise adolescent pregnancies must include social support networks, thorough sexual education, access to reproductive health care, and economic empowerment initiatives (Moron-Duarte et al., 2014). If young women are given the resources they need to succeed, the negative impacts of adolescent pregnancies may be mitigated, and their personal and professional growth may benefit. The lack of sex education in schools may be the reason for a greater percentage of teenage pregnancies. Unwanted pregnancies are more likely to happen among youth who get inadequate information about sexual conduct, contraception, and reproductive health. In addition to the factors previously mentioned, cultural norms and societal expectations have a major role in affecting the incidence of adolescent pregnancy. Cultural perspectives on gender roles, sexuality, and reproductive health may have a significant influence on the decisions and actions of young women. The stigma attached to discussing sex and contraception may make it more difficult for people to get accurate information and quality reproductive health care. Teenage pregnancy has wide-ranging effects on the community as a whole. Early motherhood may strain a woman's income and limit her ability to pursue other life objectives. This might impede social and economic development and perpetuate cycles of poverty. Many individuals and organisations, such as lawmakers, parents, educators, and community leaders, must become involved in addressing the issue of adolescent pregnancies (Neal et al., 2012).
PROBLEM STATEMENT
"Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter's or sculptor's work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God's spirit? It is one of the Fine Arts: I had almost said the finest of Fine Arts”.
A deeper understanding of the underlying causes of the startlingly high incidence of unwanted adolescent pregnancies is necessary. Numerous studies have been conducted on adolescent pregnancy, but additional studies are required to fully comprehend the part nurses play in this problem. From a nursing perspective, knowing these characteristics might help develop tailored interventions to lower the rate of unintended births among young women. Thus, the topic of Factors Contributing to Teenagers Pregnancy and the Role of Nurses in Understanding them was presented in the current inquiry (Neal et al., 2015). Young women who get pregnant face significant challenges to their future success and well-being, particularly if the pregnancy is not planned. Despite the abundance of research on the subject of adolescent pregnancy, further investigation is required to determine the role that nurses play in clarifying the causes of this issue. Acquiring insights from the perspective of nurses is crucial for effectively preventing unplanned pregnancies and supporting young women coping with them. When it comes to providing adolescents with reproductive health information, counselling, and support, nurses play a crucial role in the healthcare system. Because of their special place in the healthcare system, they may interact with young women directly and get personal knowledge of the problems that contribute to adolescent pregnancies. Understanding the importance of nurses' perspectives will help us comprehend the problem better and come up with more accurate solutions. It is essential for nurses to understand how to assist patients comprehend the causes of adolescent pregnancies for a variety of reasons. First off, when it comes to teaching youth about reproductive and sexual health, nurses are often in the forefront. They might conduct conversations with young ladies about STDs, healthy relationships, and contraception to fill up any gaps in their knowledge and dispel any misconceptions they might have. Analysing the views and experiences of nursing practitioners may help us understand the effectiveness of present educational initiatives and point up areas for improvement. Second, by building reliable relationships with youth, nurses may effectively promote candid conversations about reproductive and sexual health (WHO, 2015). Working with these young people may teach nurses a lot about the social, cultural, and economic factors that contribute to adolescent pregnancies. A number of variables, including socioeconomic status, family dynamics, peer pressure, and access to healthcare, may have a significant impact on the decisions made by young women. The perspectives of nursing professionals may aid us in identifying challenges and chances for enhancing care related to reproductive health. Thirdly, since nurses provide both postnatal and prenatal care to teenage mothers, they have a comprehensive understanding of the challenges these young ladies face. By taking in their wisdom, we may develop therapies that are tailored to the requirements of pregnant teens and get a deeper understanding of the difficulties they confront. This includes parenting workshops, emotional support, knowledge about prenatal care, and linkages to other social services (Pradhan et al., 2015).
Research Objective
To determine the frequency with which nursing professionals encounter young women facing unplanned and unwanted pregnancies in their practice.
To understand the experiences of nursing professionals in interacting with young women facing unplanned and unwanted pregnancies.
To assess the level of awareness among nursing professionals regarding the primary causes of adolescent pregnancies and childbirths.
To identify the common challenges nursing professionals encounter when discussing reproductive health with adolescents
LITERATURE REVIEW
Nursing professionals are essential in determining the causes of teenage pregnancies and assisting young moms in avoiding them due to the intricate and interwoven nature of the issue. Through an analysis of educational, psychological, cultural, and access-related factors, nurses can enable young women to make informed decisions, prevent unwanted pregnancies, and support adolescent mothers along their reproductive journey. In the United States and other rich nations, teenage moms (10–14 years old) are disproportionately made up of Black women. It's critical for nurses to consider how a pregnancy can impact a young mother's education while providing care. The psychological and emotional impacts of adolescent pregnancy have been extensively studied. Adolescent mothers are more likely to experience depression and other mental wellness issues, according to Maswikwa et al., (2015) study. The stress and feelings of inadequacy that often accompany becoming a parent may negatively impact young mothers' health and sense of value. According to Toska et al., (2015), young moms experience social isolation and stigma, which exacerbate their emotional distress. Nurses may support adolescent mothers by giving them the mental and emotional care, counselling, and therapies they need. Adolescent mothers face a distinct set of psychosocial challenges. The cultural and religious circumstances in which adolescent pregnancies occur may have a significant impact on attitudes surrounding these cases. Young age pregnancy is more prevalent in cultures where childbearing and early marriage are accepted norms (Habib et al., 2017). The beliefs of their religious groups may have an impact on the reproductive health choices made by young women. In order to reduce unwanted adolescent births, access to reproductive health care is essential. According to UNFPA (2019), reducing the global incidence of teenage pregnancies requires universal access to contraception and comprehensive sex education. Nurses may be essential in both pushing for more access to reproductive wellness programmes and informing and advising patients about contraceptives. Finally, social networks and support groups are a huge help to young women who get pregnant at a teenage age. Families' support is very beneficial to adolescent mothers in Southeast Asian countries. Through the coordination of family members and local groups, nurses may assist new mothers in creating a secure and supportive environment.
Conceptual Framework
RESEARCH DESIGN
Sample size was estimated using Rao-soft software as 1177; 1350 questionnaires were sent out; 1280 were returned; and 80 were discarded due to incomplete responses. There were 1200 participants in the research. All residents of That Place were randomly contacted for the survey. Before beginning the study, participants are given knowledge about it and the researcher is available for questions they may have while they wait to complete the paperwork. Researchers read both survey questions and answer categories aloud to respondents who were illiterate or wheelchair-bound, and afterwards recorded their replies verbatim. In certain areas, residents are handed a batch of questionnaires at once. Adolescent pregnancies and deliveries are often unplanned and unwanted for many young women; therefore researchers performed a comprehensive cross-sectional study to better understand the role of nursing in this issue. Due to the nature of the cross-sectional architecture, only data from a single point in time needed to be collected. Because of the short timeline and restricted resources, the researcher opted for a quantitative method. For example, to better understand "A Study to Identify that Role of Healthcare in Determining the Causes behind Adolescent Pregnant women and Childbirths Mostly Being Unintended and Unwanted since Many Young Women," researchers may conduct a mixed-methodologies study that combines quantitative and qualitative methods. Understanding the complexities of unintended pregnancies and births, as well as the role of professional nurses in resolving this issue, may need a multi-pronged approach. For this study's methodology, we'll be using a convergent parallel design, whereby we'll collect and analyse our mixed-method data simultaneously. By contrasting and comparing findings from the two methods, a fuller picture of the phenomenon under investigation might emerge. Second Stage: Quantitative Analysis In the quantitative phase, researchers will poll or quiz a substantial sample of nurses working in different medical facilities. Statistical data on a wide range of issues, such as: the attitudes and beliefs of the general public towards adolescent pregnancy and childbirth; the age, gender, and level of experience of the nursing staff; and similar matters; and the demographics of the health care system. Knowledge of what causes pregnancies that weren't planned for, and how they turn out. Recognising and making advantage of current diagnostic methods and therapeutic options. How comfortable are you providing care and support to young women who find themselves in an unplanned pregnancy? In-depth surveys or interviews would be administered to a subset of the quantitative sample of nurses during the qualitative phase. We could look at the following issues using qualitative methods: Meeting and seeing young ladies who had unexpected pregnancies firsthand. Awareness of the political, cultural, and social factors that contribute to the occurrence of adolescent pregnancies. Inadequacies in nursing education that prevent nurses from serving the needs of young women. Challenges and opportunities for implementing interventions. Improvements that may be made to nursing and other social services for young women. Quantitative data would be subjected to various statistical analyses, such as analysis of variance, linear regressions, and other statistical tests. Such an analysis may provide quantitative insights on nurses' perceptions, knowledge, and care for pregnant teenagers. Researchers would go through transcripts of interviews and focus groups to identify overarching themes, patterns, and recurring concepts.
RESULT
Factor Analysis
For a set of measurable variables, factor analysis (FA) is often used to validate the latent component structure. Latent factors are variables that are not seen and are usually not measurable directly. However, they are thought to be the reason behind the observed scores on the measured or indicator variables. FA is a method based on models. Its focus is on modelling the interactions of error, hidden factors, and measured variables.
One way to determine if data is suitable for factor analysis is to use the Kaiser-Meyer-Olkin (KMO) Test. The test assesses the suitability of sampling for each variable in the model as well as the model as a whole. The statistic indicates how much of the volatility in a set of variables may be common variance. The more appropriate factor analysis is for the data, the smaller the percentage.
Values between 0 and 1 are returned by KMO. A general guideline to understanding the statistic is:
• A sufficient amount of sampling is indicated by KMO values between 0.8 and 1.
• KMO values less than 0.6 suggest that corrective action is necessary since the sample is insufficient. Use your own discretion when determining values between 0.5 and 0.6, since some writers set this value at 0.5.
• Large partial correlations relative to the total of correlations are indicated by KMO values that are near to zero. Put differently, there are pervasive correlations that provide a significant challenge to component analysis.
Kaiser assigned the following values to the outcomes as a point of reference:
• 0.00 to 0.49 unacceptable.
• 0.50 to 0.59 miserable.
• 0.60 to 0.69 mediocre.
• 0.70 to 0.79 middling.
• 0.80 to 0.89 meritorious.
• 0.90 to 1.00 marvelous.
Finding out whether the data contains the necessary properties is the first stage in the factor analysis process. Factor analysis should not be performed on data if there is little to no association between the variables. To determine if the data are appropriate for factor analysis, the researcher will apply the following criteria: Bartlett and KMO for each variable.
Together, the KMO and Bartlett test assess all of the relevant data. There seems to be a significant association in the data if the KMO value is more than 0.5 and the Bartlett's test significance threshold is less than 0.05. It is also possible to compute KMO measurements for every variable. A value of more than 0.5 is suitable.
Table 1: KMO and Bartlett's
EFA begins with a validation of the data's appropriateness for factor analysis. Regarding this, Kaiser suggested that factor analysis only be conducted if the KMO (Kaiser-Meyer-Olkin) indicator of sample adequacy coefficient value was larger than 0.5. It has been determined that the KMO value for the data used in this investigation is.858. Additionally, a significance level of 0.00 was found using Bartlett's test of sphericity.
Test for Hypothesis
There is a correlation between adversity in society, such as poverty and a lack of education, and teen pregnancies. In industrialised nations, teen pregnancies often occur outside of wedlock and carry a heavy social shame. Most teen pregnancies in developing nations occur inside marriage, and around half of them are deliberate. Care for people of all ages, in their homes, communities, and institutions, whether they are ill or well, is at the heart of nursing. Care for the sick, the crippled, and the dying are all a part of public health. The nursing profession is a field that has been traditionally dominated by women. But in recent years, a growing number of males have entered the field. According to research by the Royal College of Nursing, the gendered construction of value within the nursing profession has resulted in the undervaluation of the profession and the persons who work in it. The study also assesses the standing of nurses and the value they provide to society.
H01: “There is no significant relationship between Age and Gender of Nursing Professionals moderate the relationship between the Role of Nursing and Understanding the Causes of Adolescent Pregnancies and Childbirths”.
H1: “There is a significant relationship between Age and Gender of Nursing Professionals moderate the relationship between the Role of Nursing and Understanding the Causes of Adolescent Pregnancies and Childbirths”.
Table 2: ANOVA Sum
In this study, the result is significant. With a p-value of.000 (less than the.05 alpha level), the value of F, which is 2356.855, approaches significance. This means the “H1: Age and Gender of Nursing Professionals moderate the relationship between the Role of Nursing and Understanding the Causes of Adolescent Pregnancies and Childbirths.” is accepted and the null hypothesis is rejected.
CONCLUSION
Lastly, they would want to propose three general standards by which researchers worldwide might evaluate the quality of their work. Two examples of these standards are their representativeness and rigour. We define anything as relevant when it is noteworthy, useful, engaging, and practical. For example, it is better to preserve the status quo in human resource management (HRM) than to pursue innovation, improvement, replication, or competitive advantage. To what extent do the events under consideration's location, historical period, culture, legal system, and institutions affect their significance? Representativeness. This begs the issue of whether the variations in survey responses really reflect variations in management phenomena between nationalities. Concerning the authors' efforts to ensure linguistic comparability, concept equivalency, setting/context equivalency, and other aspects, the second issue is more methodological in character. To what extent was the sample representative? How did they choose them? How was the coverage conducted? In addition to evaluating the validity and reliability of the measurements, the applicability of the technique, and the quality of the data, we also need to evaluate the design, the preliminary test, the management, the interpretation, and other aspects of the research strategy. They may then choose how much trust to place in the outcomes, and only then. They are happy to have reached the positive conclusion that, as a consequence of our assessment of the areas of Chinese human resource management that have been explored and the methods used to do so, the research quality of these studies is rapidly improving. This result gives us reason for optimism. Even though these studies have never been fully examined by scholars from outside of China, human resource management (HRM) research published in Chinese sources are starting to become increasingly comparable to one another and to HRM literature generated in the Test. This is the case even though Chinese academics have never completed any significant evaluations of HRM research that has been published in Chinese media. Despite the linguistic divide that exists between Chinese academics studying HRM and the global HRM community, they fervently believe that Chinese researchers have the potential to significantly impact that group. But the communication gap that still exists between HRM instructors in China and the rest of the world doesn't go away. To summarise, Vogel et al., (2015) claim that their research is the first of its kind to conduct a thorough analysis of studies on management that has been published in Chinese academic periodicals.
Limitation of the Study
In this research, we will only talk to a small sample of people. This research will include both written surveys and in-person interviews. If a poll were performed by phone instead of the internet, the results may be different. According to the study's subtitle, its principal concern is answering the issue of whether or not informing young women about the repercussions of teenage pregnancies and deliveries, the vast majority of which are unintended, is helpful. The goal of this cross-sectional research is to better understand how young women and nurses see the prevalence of unintended pregnancies. Without a trial plan in place, we can't go forward (Salami & Ayegboyin, 2015).
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