A study to Assess the Effectiveness of back Massage on Pain during Labour among Mothers in selected Maternity Hospitals of Nagpur

 

Ms. Komal Jibhakate, Mr. Kamlesh Kirnahake, Ms. Neethu Nair, Ms. Nikhila Varghese,

Mrs. Mercy Anjore*

 

ABSTRACT:

Background:-Each year about 500,000women die due to pregnancy and childbirth, 7 million have serious long term complications and 50 million have negative outcomes following delivery. Most of these issues occur in developing world. Labour pain and labour pain relief play at best a minor role in satisfaction ratings, except when expectations go unmet. Each woman comes into labour   room with her own set of expectations, fears, preparation, pain thresholds, personality and behavioral makeup and ways of experiencing what is happening to her which has to be managed effectively according to them.Women are now requesting for a pain free labour. The cochraine review summarizes the efficacy and safety of pharmacological and non pharmacological interventions to manage pain during labour. Considerable evidence from large placebo controlled trials and comparative studies suggest the epidurals (including controlled spinal epidural) and inhaled analgesia are more effective in controlling pain but have severe adverse effect. When a woman feels she is successfully meeting a challenge and she is centre of loving attention, she may experience a sense of exhilaration and zest even while in great pain. If she feels helpless and unable to cope up or people are not treating her with respect she will suffer regardless of the pain level. OBJECTIVES: To assess the pain intensity during labour among mothers of both the group. 1To determine the effects of back massage on experimental group. 2To compare the pain intensity among both groups. 3To associate the labour pain with selected demographic variables of both group. METHODOLOGY: In this study research design used was true experimental two group pretest and post test research design is used the sample size consist of 60 reproductive age (18-34) group mothers in selected maternity hospital at nagpur. The sampling technique used in the study was purposive sampling technique was used and numerical pain rating scale was used for data collection tool was used. Result: Paired t-test was applied to compare the pain intensity among both groups mothers. The t-test was found to be 5.46 and corresponding p-value was 0.0. There will be significant difference in post assessment level of pain perception between both group is accepted. Conclusion: The study concluded that back massage was effective on labor pain and that the demographic variables such as age, education, occupation, religion, gravida had no association with the labour pain.

 

 

BACKGROUND OF THE STUDY:

Each year about 500,000women die due to pregnancy and childbirth, 7 million have serious long term complications and 50 million have negative outcomes following delivery. Most of these issues occur in developing world. Labour pain and labour pain relief play at best a minor role in satisfaction ratings, except when expectations go unmet. Each woman comes into labour   room with her own set of expectations, fears, preparation, pain thresholds, personality and behavioral makeup and ways of experiencing what is happening to her which has to be managed effectively according to them. Women are now requesting for a pain free labour. The cochraine review summarizes the efficacy and safety of pharmacological and non pharmacological interventions to manage pain during labour. Considerable evidence from large placebo controlled trials and comparative studies suggest the epidurals (including controlled spinal epidural) and inhaled analgesia are more effective in controlling pain but have severe adverse effect. There  are many non pharmacological methods used to relieve labour pain such as continuous labour support, baths, touch and massage, maternal movement and positioning, intra-dermal water blocks, aromatherapy, hypnosis, music therapy,  yoga, accupuncture, slow rhythmic repetitive breathing pattern, trans-cutaneous electrical nerve stimulation.

 

MATERIAL AND METHOD:

This study was based on evaluative approach and Pre-experimental study, one group pre and post test design” is used. The sample consisted of sixty mothers in selected maternity hospital at Nagpur. quantitative research approach was used with  probability purposive sampling technique was used and and numerical pain rating scale was used for data collection tool was used. first day pre test was done By giving back massage to experimental group in form of mild stroke is given to experimental mothers for 30 minute than immediate posttest was done.

 

RESULT:

 Distribution of mothers according to their age in years reveals that each 30% of them in both the groups were in the age group of 18-22 years, 40% in control group and 46.7% in experimental group were in the age group of 23-26 years and 30% in control group and 23.3% in experimental group were in the age group of 27-30 years respectively.

 

Distribution of mothers according to their religion shows that 73.3% in control group and 60% in experimental group were hindus, 6.7% in control group and 3.3% in experimental group were Christian, 13.3% in control group and 20% in experimental group were muslim and 6.7% in control group and 16.7% in experimental group were Buddhist.

 

According to their educational status reveals that 10% each of them in both the groups were illiterate, 6.7% in experimental group were educated upto primary, 3.3% in control group and 6.7% in experimental group were educated upto high school, 73.3% in control group and 66.7% in experimental group were educated upto higher secondary and 13.3% in control group and 10% in experimental group were educated upto graduates respectively.

 

Distribution of mothers according to their occupational status shows that 3.3% in control group and 10% in experimental group were performing heavy work, 6.7% of them in control group were doing moderate work, each 6.7% in both the groups were performing sedentary work an each 83.3% of the mothers in both the groups were housewife.

 

Distribution of mothers according to their gravida shows that 70% of the mothers in control group and 63.3% in experimental group were primigravidas and 30% of the mothers in control group and 36.7% in experimental group were multigravidas respectively.

 

Table 1: Assessment of pre-test pain intensity score among mothers of both the groups N=60

Pre Test Pain Intensity Score
Control Group	Experimental Group
0(0%)	0(0%)
18(60%)	20(66.7%)
5(16.7%)	3(10%)
7(23.3%)	7(23.3%)
30(100%)	30(100%)
0.60,p=0.73,NS,p>0.05

 

The above table shows that each 7(23.3%) of the mothers in both the groups had severe pain, 60% of the mothers in control group and 66.7% in experimental group had mild pain, 16.7% of the mothers in control group and 10% in experimental group had moderate pain. By using chisquare test statistically no significant difference was found in pain intensity score at pre test in both the groups(א2-value=0.60,p=0.73).

 

Table 2: Assessment of post-test pain intensity score among mothers of both the groups N=60

Diagnosis	Score Range	Post Test Pain Intensity Score
		Control Group	Experimental Group
No Pain	0	0(0%)	0(0%)
Mild Pain	1 to 3	8(26.7%)	9(30%)
Moderate Pain	4 to 6	18(60%)	0(0%)
Severe Pain	7 to 10	4(13.3%)	21(70%)
Total		30(100%)	30(100%)

 

The above table shows that each 4(13.3%) of the mothers in control group and 70% in experimental group  had severe pain, 26.7% of the mothers in control group and 30% in experimental group had mild pain, 60% of the mothers in control group  had moderate pain. By using chi-square test statistically significant difference was found in pain intensity score at post test in both the groups(א2-value = 29.62, p=0.0001).

Table 3: Effect of back massage on experimental group N=30

	Mean	N	Std. Deviation	Std. Error Mean	Mean Difference	t-value	p-value
Pre-Test	1.86	30	0.57	0.10	0.56±0.56	5.46	0.0001,S
Post-Test	1.30	30	0.46	0.08

 

This table shows the effect of back massage on experimental group. The mean pain intensity score at pre-test was 1.86±0.57 and at post-test it was 1.30±0.46. The tabulated‘t’ value  was 2.05(df=29) which is much less than the calculated ‘t’ i.e. 5.46 at 5% level of significance. Also the calculated ‘p’= 0.0001 which was much less than the acceptable level of significance i.e. ‘p’=0.05. Hence it is interpreted that back massage is effective in experimental group.

 

DISCUSSION:

In present study it was observed that back massage was effective on labor pain.  The mean pain intensity score at pre-test was 1.86±0.57 and at post-test it was 1.30±0.46. The tabulated ‘t’ value  was 2.05(df=29) which is much less than the calculated ‘t’ i.e. 5.46 at 5% level of significance. Also the calculated ‘p’= 0.0001 which was much less than the acceptable level of significance i.e. ‘p’=0.05. Hence, H₁Hypothesis There will be significant difference in post assessment level of pain perception between both group is accepted.H₀ Hypothesis There will not be significant difference in post assessment level of pain perception between both group is rejected.

 

ACKNOWLEDGEMENT:

I extend my sincere thanks to all parents and neonates mothers for their whole hearted co-operation during the time of data collection.

Last but not the least we would like to extend our honest gratitude to our parents, brothers, sister, relatives and friends for their prayers, unending love and continuous encouragement

 

REFERENCE:

JOURNAL:

1.     Abhu;shaika L. (2005), “labour Pain experience and intensity” Inf. Jouranl of Nursing practive II (1).

2.     Alberts (2001), “The Relationship of Ambulation in Labour to Operative Delivery”, Journal of Nurse Midwirery.

3.     Andrews (2002), “Maternal Position, Labour and comfort”, Journal of Applied Nurse.

4.     Expert Review of Obstetrics and Gynecology, Volume 5, 2010.

5.     Journal of Psychosomatic Obstetrics and Gynecology, Volume 18, 1997.

6.     Pilevar Zadeh M. Salari S., Shafie N. Effect of Massage on Reducing Pain and Anxiety During Labour, Journal Reproduction and , Infertility, 2002.

7.     Women’s Health, Volume 3.2010.

 

BOOKS:

1.     Albers (1998), “Midwifery Management of Pain”, J. Nursing Midwifery.

2.     Annamma Jacob, “A comprehencive text book midwirery”, 2^nd edition, New Delhi, Jaypee Brothers Medical Publishers, 2005.

3.     Adele Pilliteri . “Maternal and child health nursing”Care of the child bearing and child rearing family.1^st edition .Philadelphia:Lippincott,2003

4.     Basavanthappa B. T., “Nursing Theories”, 1^st edition, New Delhi, Jaypee Brothers, Medical Publishers (P) ltd.; 2005

5.     Kamali Fard M, Allahverdi Zade.S .H. “Non pharmacological methods of relieving labour pain”1^st edition. Techran :Ghahazi Jabani publication.2008

6.     Podden. P. D, Peery A G.”Fundamentals of nursing.”7^th edition .Philadelphia:Elsevief Mossby 2009.

 

NET REFERENCE:

1.     www.rguhs.ac.in/onlineecdc/uploads

2.     www.rguhs.ac.in/onlineecdc/uploads

3.     www.crdeef.com

 

 

 

 

 

 

Received on 24.06.2017           Modified on 18.09.2017

Accepted on 25.10.2017     © A&V Publications all right reserved