DETERMINING THE USE OF RECREATIONAL HEALTH SERVICES BY EXPECTANT WOMEN

1.1 Introduction

Recreational Health activities according to McLean, Hurd and Rogers (2005) are activities often done for enjoyment, amusement, or pleasure and which are considered to be of health benefit to the individual undergoing it. Most modern definition of recreation fits into one of these three categories Recreation has been seen as an activity carried on under certain conditions or with certain motivations. Recreation has been viewed as a process or state of being-something that happens within the person while engaging in certain kinds of activity, with a given set of expectations and recreation has been perceived as a social institution, a body of knowledge, or a professional field. Recreation as defined by Boye (2009) is any form of free activity that an individual performs at his or her leisure hours. It could be done indoors or outdoors and it could be passive or active. Recreation can be done for mental, physical, emotional and social development, recreational health activities have been found to be of immense benefit to both the pregnant woman and the unborn child.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

1.2 Background of Study

Pregnancy is the development of one or more offspring, known as an embryo or fetus, in a woman’s uterus. This spans a period from fertilization of the female sex cell by the male sex cell to the birth of the offspring. This period is also called gestation period. The cells undergo rapid division and growth according to Jukic, Baird, Weinberg, McConnaughey and Wilcox (2013) such that in eight weeks it becomes stable and big enough to be called a fetus. The continuous growth of this fetus results in physiological changes in the pregnant woman.

Shrock (2008) stated that during the childbearing period, from conception through postpartum recovery, a woman’s body undergoes extensive changes which frequently necessitate many adaptations. Physical and hormonal changes occur gradually throughout the nine months of pregnancy, and these are reversed in a matter of weeks during postpartum recovery. Skeletal tissue, muscle and connective tissues, blood volume, cardiac output, body weight and posture are affected. The effect it has can bring positive or negative impact on the unborn child and/or the mother.

It is one aspect for the care givers to recommend the recreational practices and it is another for pregnant women to adhere to it. Adherence would depend on several factors of which an awareness of the benefits is one. A study carried out among pregnant women attending antenatal clinic by Sarfraz et al., (2013) showed that 95.2% of the women agreed that physiotherapy has positive role in ante-natal care although only 30% were currently following the exercise programme. Where awareness is lower, adherence to the exercise would be very much lower. Another very important aspect of recreational practices by pregnant women undergoing antenatal care clinics is that of monitoring. Makinde et al (2014) found that 294 (58.8%) of respondents in their study wanted prenatal exercise to be performed by the expert while 116 representing 23.3% of the total respondents did not prefer expert to perform exercise for them.

Recreational activities can be in the form of physical exercises, rest and relaxation. Such activities for rest and relaxation include watching television, reading of magazine or newspaper, playing of games like Ludo and cards games. Similarly different exercise programmes are available for pregnant women. These exercises include aerobic exercises such as dancing, walking and swimming. Another type is Kegel exercise, this involves tightening of pelvic muscles to control urine flow (Sarfraz et al, 2013).

According to Makinde et al., (2014), professional health workers need to carefully design recreational and physical exercise programme to enable the pregnant woman remain healthy. Recreational health practices do wonders for the woman during pregnancy. It helps to prepare her for childbirth by strengthening her muscles and building endurance (Ministry of Health, Brazil 2001).

Shrock (2008) observed that as more pregnant women engage in demanding occupations, physical activities, and sports, the obstetrician and midwives who take care of them must become knowledgeable about the physical changes of pregnancy and the effects of exercise on the mother and fetus. Because prevention is the best approach to health care, understanding both the bodily stresses that may result from pregnancy changes and the means to prevent unnecessary problems enables health care to be instituted early in pregnancy and continued through the postpartum period. Therefore a properly organized antenatal care classes would have a physiotherapist or midwife teach pregnant women the rudiment of recreation during pregnancy, telling them the benefits derivable and the limits they should go. Such benefits include that recreational exercise improves blood circulation, strengthens the pelvic floor muscles and prevent backaches (Dianne & Myles, 2004).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Perception, and Effect of Physical Activity and Exercise during Pregnancy on Pregnancy Outcomes among Women.

1.3 Statement of Problems

Investigation revealed that the adherence to exercise was found to have a protective effect against macrosomia which may reduce the risk of prolonged labour, operative deliveries, shoulder dystocia and fetal hypoxia. In antenatal clinics in the study area, there are no recreational facilities and there are no trained physiotherapists to demonstrate perfectly the actual position of the various exercises suitable for women during pregnancy. These have caused the pregnant women to show a general non-challant attitude towards recreational health practices (Henriksen, 2008).

This study determine the awareness of benefits of recreational health practices by pregnant women attending ante-natal clinics in the study area as well as assess their level of adherence to the available exercises.

1.4 Aim and Objectives of Study

The aim of the study is to determine the Use of Recreational Health Services by Expectant Women in selected Antenatal Clinics. In achieving this aim, the following specific objectives were laid out as follows:

1. To assess the Use of Recreational Health Services by Expectant Women in the study area;
2. To examine the level of recreational health activities awareness among pregnant women in the study area;
3. To find out if pregnant women adhere to recreational health activities; and
4. To determine the extent of recreational health activities promotion and it’s beneficial towards pregnant women in the area under study.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are recreational activities practiced by pregnant women in the study area?
• What are the instructions pregnant women adhere to during recreational health activities?
• What is the level of recreational health activities awareness among pregnant women in the study area?
• What is the extent of recreational health activities promotion and it’s beneficial towards pregnant women in the area under study?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant factors influencing recreational health practices by pregnant women in the area under study
• H1: There are significant factors influencing recreational health practices by pregnant women in the area under study

1.7 Significance of Study

The significance of this research will be of immense benefit to Nurses, midwives and other health staff in health institutions which may rely on the findings of this study in recommending recreational activities for pregnant women in their antenatal clinics. Health Education unit of the Ministry of Health will rely on the findings of this study when planning training and retraining programmes for nurses, midwives and Traditional Birth Attendants.

Researchers in related areas will benefit from this study as a reference material in their study. It will also provide information for further research. It focuses specifically on the recreational health activities recommended for pregnant women who are attending antenatal care service in the primary health centres. The study concentrates on the awareness, benefits, adherence, promotion and practices of recreational health activities by pregnant women.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on Determining the Use of Recreational Health Services by Expectant Women in selected Antenatal Clinics. The study is limited to some Women in Nigeria using a Primary Health Care located in Warri-South District of Delta State as a case study.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint:The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies:Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Research material: availability of research material is a major setback to the scope of the study.
4. Frequent power failure:This made the researcher append more money on fuel to ensure sustainable power.
5. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.10 Definition of Terms

Recreation: It is any form of free activity that an individual performs at his or her leisure hours.

Recreational Health Activities: Are activities often done for enjoyment, amusement, or pleasure and which are considered to be of health benefit to the individual undergoing it (McLean et al., 2005)

Perception: To notice something in a particular way or hold a view about something.

Access to Healthcare Programs: Access to healthcare programs is defined as one’s ability to obtain and appropriately use good quality health technologies and commodities when needed for good health (Frost & Reich, 2008).