A Study to Assess the Effectiveness of Structured Teaching Programme on Childbirth Process Among Primi Gravida Mothers Admitted in Labour Ward, Rmmch

 

Dr. R. Priyadharshini1, Dr. Mrs. M. Gandhimathi2

1Professor, Sri Manakula Vinayagar nursing College, Puducherry.

2Vice Principal, Rani Meyyammai College of Nursing, Faculty of Medicine,

Annamalai University, Annamalai Nagar.

*Corresponding Author E-mail: priyagunalan@gmail.com

 

ABSTRACT:

Background: Child bearing in any society is a biological event and birth experience is socially constructed as it take place within a cultural context and gets shaped by the perceptions and practices. Objectives: The purpose of the study was to quantify the knowledge of primigravida mothers in labour ward. Materials and method: Quasi experimental design was adopted for the study with the independent variable being the child birth preparation and the dependent variable was level of knowledge of primi gravida mothers on child birth process and coping ability. The tool for data collection was prepared by the investigator and it was validated by experts. Results: In pre-test 75% of mothers were in experimental group and 50% in control group are had inadequate knowledge and 25% of mothers in experimental group and 50% in control group were moderately adequate knowledge where as in post-test the mean level is 29.2 compare to pre-test mean level 17.6 which showed that the structured teaching programme on child birth process was effective and coping ability was better in experimental group than control group. Conclusion: Fear associated with pregnancy and child-birth can have serious consequences. Women, who experience significant fear during the antenatal period, run an increased risk of suffering severe emotional imbalance after the baby is born, which can have negative impact on the relationship between the mother and the child. Child birth preparation, which deals with the information on pre-monitory signs, stages of labour, preparations for labor, relaxation techniques, bearing down techniques should be provided to the mothers for better coping during labour and to have a healthier labour experience.

 

KEYWORDS: primigravida, pre-monitory signs.

 

 


INTRODUCTION:

"Helping welcome babies from heaven to earth'

-Doula Wendy"

Basvanthappa (2006)'stated that Child bearing in any society is a biological event and birth experience is socially constructed as it takes place within a cultural context and shaped by the perceptions and practices.

 

Aditya Kumar (2003) stated that Labour is almost always painful, but the perception and response to pain varies from person to person. The variability of response to pain-perception may be made tolerable by the sympathetic attitude of the health personnel in labour room and relatives. Labour, purely in the physical sense, may be described as the process by which the foetus, placenta and membranes are expelled through the birth canal but, of course, labour is much more than a physical event.

 

Elizebeth (2002)19 stated that the 21 Century is the millennium of new thoughts, ideas and expansion of knowledge in sphere of life. Domiciliary delivery is one such concept and it is considered to be primitive, being under revision. Many researchers, predominantly in developed countries give a favourable rethinking on this age-old concept. A woman should have a favourable outcome of pregnancy with a healthy baby at the end of labour. Mothers need to be offered a suitable environment for parturition where the mother and baby would be absolutely safe and comfortable under the care of obstetricians and midwives. Shino (2004) stated that anthropologically, childbirth is an enigma because every woman experiences an identical physiological and biological process wherever the event takes place from a hut in the jungle to a modern hospital in the United States.

 

The experience of child-birth is an important life event for women and memories of which many follow them throughout their life.

 

Pain relief during delivery should have a humane approach. Experience has shown that providing pain relief to mothers drives away fear and anxiety, and provides a more favourable environment for improved obstetric outcome.

 

Since childbirth in a primi mother is a new experience composed of pain, strain for long hours, and events of labour and delivery. The mother needs to know the mechanism of the childbirth and the after effects what she can expect and what is expected of from her and by others.

 

Statement of the Problem:

A study to assess the effectiveness of structured teaching programme on childbirth process among primi gravida mothers in labour ward, RMMCH

 

OBJECTIVES:

       To assess the existing knowledge of mothers about child-birth process in control and intervention groups.

       To assess the effectiveness of structured teaching programme on child-birth process among mothers in intervention group.

       To compare the obstetrical parameters on coping level of labour among mothers in control and intervention groups.

       To associate the level of pre-test knowledge of mothers in both groups with demographic variables such as age, education status, residence, occupation of mother religion.

 

HYPOTHESES:

H1: The mothers who are exposed to the structured teaching programme on child birth preparation will have better knowledge in the post-test

H2: The primigravida mothers who are exposed to the structured teaching programme on child birth preparation will have better coping than the primigravida mothers who are exposed to the structured teaching programme.

 

ASSUMPTIONS:

       The antenatal preparation will help mothers to have better knowledge and better coping during labour

       Mothers will be receptive for antenatal childbirth preparation.

 

LIMITATION:

1) The study has been limited to 40 mothers only

2) Only primi gravida mothers were included.

3) Primi gravida mothers without medical and obstetrical complications

 

Inclusion Criteria:

Primigravida mothers

       With 38-42 weeks of gestation

       Who knows Tamil

       Who were willing to participate in the research work

 

Exclusion Criteria:

       High risk mothers

       Multiparous mothers

       Mothers who develop complications during labour

 

MATERIALS AND METHODS:

Quasi experimental design was adopted for the study with the independent variable being the child birth preparation and the dependent variable was level of knowledge of primigravida mothers on child birth process and coping ability. The tool for data collection was prepared by the investigator and it was validated by experts.

 

The primigravida mother without any complication were selected in experimental group for n-20 and control group for n-20. Subjects were allotted to experimental and control by following randomization of days. Observation was done from 3-4 cm dilatation of the cervix for all subjects.

 

Experimental group alone received child birth preparation in small groups.

 

Both descriptive (frequency and percentage) and inferential I statistics (independent t test, chi-square, p' value) were used for analysing the data.

 

Description of The Data Collection Instrument:

Section I: Consisted of demographic variables such as age, educational qualification, residence, exposure to knowledge, religion, family income, mother occupation, type of family, duration of marriage in years.

 

Section II: It consisted of 39 knowledge related questions regarding child birth process for correct answer the marks given as '1' and for wrong answer O'. The total score is 39.

 

Scoring procedure:

       50%-Inadequate knowledge (13)

       51-75%-Moderately adequate knowledge (14-27)

       >75%-Adequate knowledge (28-39)

 

Section III: Coping scale:

This section consisted of a coping scale modified from the standardized non-coping response scale (Chacko-Alice, 1996) by the investigator as a checklist to assess the coping response of the mothers during contraction and in between contraction. The checklist consisted of 22 questions with yes or no response. It consisted of 9 questions manifestations during contractions and 13 questions for manifestations in between contraction

       For good coping response the score was '1'

       For non-coping response the score was D

       The maximum score given during contraction was 10.

       The maximum score given in between contraction was 13.

According to the level of coping response yes' was scored as 1 and response ho was scored as 0. The investigation observed the women's coping response every hour during the contraction and in between the contraction and filled the checklist. By adding all the items, the total score was obtained in each observation and adingly the level of coping of mother was assessed.

 

RESULTS:

In pre-test 75% of mothers were having inadequate knowledge among mothers in experimental group where as in control group 50% of mothers were having inadequate knowledge. Twenty five percentage of mothers having moderately adequate in experimental group is 50% mothers in control group. None of the mothers were adequate level of knowledge in both the groups. When compare the experimental and control group there is more of existing knowledge level in experimental group than in the control group. The present study also supported

 

The comparison of Mean level of knowledge in pre-test(17.6) and post-test(29.2) among mothers in the experimental group. P value was 8.8 and p value shows that the mothers in experimental group have gained knowledge in the post-test which shows that the structured teaching programme was effective

N= 40

 

Table1: comparison of pre-test knowledge among mothers in experimental and control group

Level of Knowledge

Experimental group

Control group

No.

%

No.

%

Inadequate

15

75

10

50

Moderately adequate

5

25

10

50

Adequate

-

-

-

-

Total

20

100

20

100

 

Table 2 Comparison of pre- test level of knowledge among mothers in experimental and control group

 

Mean

SD

t value

p value

Experimental group

17.6

5.3

 

4.11

0.177

(NS)

Control group

19.6

3.73

NS= Non- significant

Maximum score=39

 

Table 3: Comparison of mean level of knowledge score between pre test and post among mothers in experimental group

Pre test

Post test

Paired t test

p value

Mean

SD

Mean

SD

 

8.8

 

< 0.001

17.6

5.3

29.2

4.6

Maximum score= 39

 

Table 3 shows the comparison of mean level of knowledge in pre test (17.6) and post test (29.2) among mothers in the experimental group. P value was 8.8 and p value shows that the mothers in the experimental group have gained knowledge in the post test which shows that the structured teaching programme was effective.

 

Table 4: Mean level of coping of mothers during contraction in experimental group N=40

During contraction

Mean

SD

t value

p value

Experimental

24.20

3.67

 

2.616

 

0.019

Control

14.27

14.24

 

The above table shows the mean level of coping among mothers during contraction it was 24.20 in the experimental group where as the mean level of coping of the mothers in control group was 14.27 statistically it inferences p value is 0.019 indicates that there was highly positive and statistically significant difference in the level of coping of mothers in the experimental group than the control group during contraction. So the hypotheses was supported on mothers who are exposed to the structured teaching programme than the control group.

 

Table 5: Mean level of coping of mothers in between contraction in experimental and control group N=40

In between contraction

Mean

SD

t value

p value

Experimental

23.47

6.81

 

1.972

 

0.062

Control

15.60

13.87

 

The above table shows the mean level of coping among mothers in between contraction was 23.47 in the experimental group whereas the mean level of coping of the mothers in control group was 15.60 statistically it inferences p value is 0.062 indicates that there was no highly positive and no statistically significant difference in the level of coping of mothers in the experimental group and control group in between contraction. So the hypotheses was not such supported on mothers in between contraction.


 

Table 6: association of pre- test knowledge with selected demographic variables of mothers in control group

S. no

Variables

Mean

S.D

Kruskal- Wallis*/ Mann Whitney test

p value

1

Age

18-20 years

21-25 years

26-30 years

 

21.571

18.069

17.250

 

5.159

4.579

2.363

 

 

2.682*

 

 

0.262

2

Religion

Hindu

Christian

 

18.543

19.000

 

4.693

4.743

 

82.500*

 

0.837

3

Residence

Rural

Urban

Semi urban

 

17.4555

17.444

22.556

 

4.416

3.678

4.287

 

 

8.003*

 

 

0.018(S)

4

Education

Illiterate

Graduate

 

17.864

19.500

 

5.148

3.884

 

150.500*

 

0.195

5

Occupation

Coolie

Private employee

Self employee

Govt. employee

House wife.

 

17.864

19.500

18.429

11.000

18.901

 

5.148

3.884

4.392

-

4.826

 

 

 

7.006*

 

 

 

0.023(S)

 


Table 6 shows the association of pre-test knowledge with selected demographic variables of mothers in control group. There was statistically significant positive association between pre-test level of knowledge with mothers residence and occupation, but there was no association between pre-test level of knowledge of mothers with age, religion and education.

 

CONCLUSION:

Fear associated with pregnancy and child birth can have serious consequences. Women who experience significant fear during the antenatal period run an increased risk of suffering severe emotional imbalance after the baby is born, which can have negative impact on their relationship with their child. The child birth preparation, which deals with the information of premonitory signs, stage of labour, preparations for labor, relaxation techniques, bearing down techniques if provided to the mothers can release fear and positive birth experiences and coping during labour and delivery

 

In this study, the better coping ability among the women who received child birth preparation in experimental group were better than the mothers in the control group who did not receive. It showed that the structured teaching programme was very effective.

 

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Received on 14.06.2023 Modified on 23.06.2023

Accepted on 29.06.2023 A&V Publications All right reserved

A and V Pub Int. J. of Nursing and Medical Res. 2023; 2(2):30-34.

DOI: 10.52711/ijnmr.2023.09