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Mini Review Volume 3 Issue 2
Effectiveness of Selected Nursing Interventions on After-Pain among the Postnatal Mothers in the Selected Hospital in Puducherry
Manjubala Dash
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Professor in Nursing, India
Correspondence: Manjubala Dash, Professor in Nursing, MTPG & RIHS, Puducherry, India
Received: December 10, 2015 | Published: December 28, 2016
Citation: Dash M (2016) Effectiveness of Selected Nursing Interventions on After-Pain among the Postnatal Mothers in the Selected Hospital in Puducherry. Int J Vaccines Vaccin 3(2): 00062. DOI: 10.15406/ijvv.2016.03.00062
Abstract
Childbirth is one of the most important events in a woman’s life. A mother, even though she is born earlier in this world, perceives an experience of rebirth by giving birth to a child. The wonder of motherhood is the enjoyable journey that is felt only by the mother after giving birth. It brings about remarkable changes in her normal life and introduces an exposure to a new role within her.1 Many mothers experience physiological, psychological and social changes during this period. There are many types of postnatal ailments experienced by the mother such as after-pains, irregular vaginal bleeding, leucorrhoea, cervical ectopic (erosion), backache, retroversion, anaemia, breast problems and episiotomy discomforts etc.2
Methodology: The research approach used for this study was quantitative approach and design selected was Pre Experimental design among 50 postnatal mothers in a selected hospital, Puducherry.
Results and findings: The results shows that 21(42%) , 18(36%), 11(22%) mothers were in the age group of 21-25, 18-20, 26-30years respectively. The results shows that there is a statistically significant (p<0.05) difference in the pain level among the mothers before and after the intervention. It is recommended that as the entire mother feels some level of pain, the selected nursing intervention were necessary to provide to all to relive the after-pain of postnatal mothers.
Keywords: nursing intervention, after pain, postnatal mother
Introduction
Childbirth includes different stages, and in every stage, the mother plays a unique role in experiencing the important events that occur throughout her journey. The different stages are broadly classified into three main aspects namely - Antenatal period, Intranatal period and Postnatal period.3 Postnatal period is the most vulnerable period for the mother and the new-born baby. The extent of postnatal health problems warrants close attention. It is estimated that approximately about 58% women experience tiredness, 23% perineal problems, 42% backache, 24% hemorrhoids, 13% bowel problems, 23% sexual problems, 20% vaginal bleeding, 46% urinary incontinence, and 43.5% women experience after-pains.4
After-pain refers to the infrequent, spasmodic pain felt in the lower abdomen after delivery for a variable period. These abdominal cramps are caused by postpartum contractions of the uterus as it shrinks back to its pre-pregnancy size and location. Presence of blood clots or bits of the afterbirth leads to hypertonic contractions of the uterus in an attempt to expel them. The uterus loses muscle tone during pregnancy due to its contraction-relaxation cycle and causes after-pain.5 There are varieties of non-pharmacological methods for pain relief which are important for postnatal period. Among non-pharmacological methods, Bladder emptying, Ambulation, Abdominal muscle exercise, lying flat on abdomen and oil massage is more effective.6
The objectives of the study were
- To assess the existing level of after-pain among the postnatal mothers.
- To evaluate the effectiveness of selected Nursing interventions among the postnatal mothers.
- To associate the post-test level of after-pain with the selected demographic and obstetrical variables among the postnatal mothers.
Methodology
The research approach adopted for the study was Quantitative Research Approach and the design selected for this study was Pre Experimental Design.6 The study was carried out in the selected postnatal ward of the Hospital, Puducherry, among 50 postnatal mothers selected by purposive sampling technique as per the inclusion criteria. Data was collected by interview and observation technique. The tool used in this study was Visual analogue Pain Scale. Mother’s general health condition were assessed after four hours of vaginal delivery and written consent was obtained to include in the study. The interventions was explained to all the mothers. . Nursing interventions such as lying flat on abdomen, emptying the bladder and oil massage were given to reduce the after-pains. The intervention were like bladder emptying was instructed for every 2nd hours, oil massage and lying flat on abdomen for 10sec, repeated for 10times, twice a day for 3 consecutive days. It took around 20minutes for each mother for this intervention. Post-test was conducted with the help of pain scale to assess the level of after-pain at the end of third postnatal day among the postnatal mothers.7
Description of the tool
Pain scale
Visual Analog Scale was used for assessing the type of pain experienced by the mothers. The scale consists of 10 points (0-10). The score was categorized as 1-2, 3-7, and 8-10 were interpreted as brief, intermittent, continuous respectively.
Ethical consideration
Permission was obtained from the concern authority of the Hospital. The selection of the sample was based on inclusion criteria. Moreover, informed consent was obtained from the samples in both oral and written. The client had the freedom to withdraw from the study at any time.
Reliability
The reliability of the tool was checked by using inter-rater reliability technique (‘r=0.9) and it was found that the tool was reliable. The formula used to find ‘r’ value
Result and findings
The demography variable of the mother shows that most of the mothers 21(42%) were in the age group of 21-25yrs, 30(60%) belongs to lower class, 25(50%) were primi mothers. The pain of the postnatal mothers exhibits that during the pre-test 4(8%), 46(92%) mothers had intermediate, continuous type of pain none of them (0%) had brief pain whereas in post-test 7(14%), 30(60%), 13(26%) mothers had brief, intermediate, continuous type of pain.
The pre-test mean level of pain shows 0.49±0.17 whereas the post-test pain level highlights 0.24±0.12 with the ‘t’ value 5.09(p<0.05) showing statistically highly significant difference. There was no significant association (p>0.05 N.S) found between the post test pain level with the demographic variables.
Discussion
The present study is supported by Declercq et al.,8 conducted a study to determine women’s experience of after-pain in United States among 300 postnatal women. The study results revealed that afterbirth pain is one of the most common obstetrical problems in most of the women. Between 50% and 80% of the women reported some level of discomfort associated with after-pain and 10% to 18% reported severe pain. Further it is supported by Karpagavalli et al.,9 conducted a study on effectiveness of nursing interventions in reduction of after-pain among 60 postnatal mothers in Chennai. Data was collected using Visual Analogue Scale and Categorical Pain Scale. Postnatal mothers showed a highly significant decrease in the level of after-pain following nursing interventions (P<0.001), in comparison to the pre-assessment level of after-pains. The study result is more or less similar to the present study.
Conclusion
The study result showed that selected nursing intervention was effective in reducing pain level among the postnatal mothers. All the subjects had reduced pain level further days after the intervention. This is also a convenient measure. So, these selected nursing interventions can be administered as an adjunct therapy by nurses in their day to day caring the mother in hospital setting.
Acknowledgments
None.
Conflicts of interest
Author declares there are no conflicts of interest.
Funding
None.
References
- Adele Pillitteri. Maternal and Child Nursing. (5th edn), Lippincott Williams and Wilkins Publication, Philadelphia, USA. 2009. P.637‒645.
- Dutta DC. Textbook of Obstertrics. (6th edn), Central book agency, Culcutta, India. 2004. P.652.
- Annamma Jacob. Comprehensive textbook of midwifery. (2nd edn), Jaypee Publishers, Bangalore, India. 2008. P.752.
- Grary F. Williams obstetrics test book. (2nd edn), Mc Graw-Hill publisher, New York, USA. 2001. P.405.
- Polit DF, Beck CT. Nursing Research principles and Methods. (7th edn), Lippincott Williams’s publications, Philadelphia, USA. 2004. P.152.
- Lowdermilk DL. Maternity Nursing. (8th edn), Mosby publication, Philadelphia, USA. 2010. p.524.
- Gardosi J. Compare the effectiveness of chiropractic adjustment vs fundal massage in reduction of abdominal cramps after vaginal birth. Indian Journal of nursing. 2000;3:4‒8.
- Declereq ER, Sakala. Listening to mothers, Report of the Survey of women’s child bearing experiences. Indian Journal of Paediatric. 2002;12:12‒14.
- Karpagavalli G, Judie. Effectiveness of nursing interventions in reduction of after-painamong postnatal mothers. British Medical Journal. 2008;2(6):59‒60.
©2016 Dash. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.