Quasi Experimental Study to determine the Effectiveness of Music Therapy on Pain Level of Primigravida Mothers during First Stage of Labour in selected Maternity Hospitals at Metropolitan City

 

Ms. Shweta Kishor Naik

K J Somaiya College of Nursing, Mumbai

 

ABSTRACT:

Effectiveness – outcome or result of the music therapy, Primigravida -normal full term woman admitted for first delivery and inactive 1^st stage of labour, Stage of labour –period of true labour pain with regular rhythmic contraction and cervical dilatation of 4cms to 8cms, Pain – unpleasant bodily sensation produced due to contraction of uterus during labour. Level of labour pain assessed in control and experimental group pre and post intervention as follows: The subjective data assessed with word descript or visual analog scale as follows---0=No pain,1=Mild pain, 2=Distressing pain, 3=Severe pain, 4=Horrible pain, 5=Excruciating pain. The objective data assessed with Behavioural pain scale including parameters such as face, restlessness, muscletone, vocalization, and consolability. Finally pain scored as: 0=No pain, 1-3=Mild pain, 3-6=Moderate pain, >6=Severe pain. Music therapy: Playing the instrumental music (Garbhankur 9^th month CD) through earphone for 25 mins to the primigravida mothers which is devised by Pt.Shashank Kattiasan intervention to reduce pain level during the first stage of labour. “Pain is inevitable, suffering is optional”

 

 

 

 

INTRODUCTION AND BACKGROUND OF THE STUDY:

Pain during labour is a universal experience, although the intensity of the pain may vary. Although labour and childbirth are viewed as natural process, both can provide significant pain and discomfort. Nurses are in ideal position to provide childbearing women with clear, concise information about effective nonpharmacologic and pharmacologic measures to relieve pain.

 

Music Therapy, as broadly defined by the American Music Therapy Association, is "the prescribed use of music by a qualified person to effect positive changes in the psychological, physical, cognitive, or social functioning of individuals with health or educational problems." Music therapy is the application of music in the treatment of physiological and psychological aspects of suffering, illness or disability. Music has been shown to modulate the anxiety level, pain perception, stress response and relaxes individual in labour, minor operations, intensive care units and other various hospital settings.

 

OBJECTIVES OF THE STUDY:

§  To assess the level of labour pain during 1st stage of labour among   primigravida mothers in control and experimental group.

§  To compare the difference in the level of 1st stage labour pain post intervention in experimental and control group.

§  To associate the level of 1^st stage of labour pain with selected demographic variables of both groups before music therapy.

 

METHODOLOGY:

This study adopted an evaluative approach. Sample of 50 primigravida mothers who were in first stage of labour consented to participate and fulfilling inclusion criteria were taken for the study using non probability purposive sampling. 25-25 primigravida mothers were taken in control and experimental group respectively. Experimental group mothers received music therapy for 25 mins whereas for control group mothers there were no music therapy. Data was collected using standardized word descriptor visual analog scale and behavioural pain scale, opinionnaire on music therapy and postdelivery observation data. The data was analyzed in terms of the objectives and hypothesis using descriptive and inferential statistics.

 

Major findings of the study:

The findings of the study shows that in the experimental group music therapy had an effect on reducing pain level of primigravida mothers in first stage of labour. The mean VAS score in observations (1 and 2) of the control group was 2.8 and 3.76 respectively and that of experimental group mean VAS score was 3.64 and 1.84 respectively with a mean difference of 0.96 for control group and 1.8 for experimental group.

 

 

Figure 1: Schematic research design

 

 

Figure 3 : Behavioural pain scale score meam comparison between observation 1 and observation 2 ofControl and Experimental group

 

 

Figure 2: Comparison between observations (1 and 2) mean of VAS score in Control and Experimental group.

Table 1: Post delivery observation data:

Data	Participants Response	Control Group (n=25)		Experimental Group (n=25)
		f	%	f	%
Patient demanded for analgesia.	Yes	13	52%	05	20%
	No	12	48%	20	80%
Doctor ordered for analgesia.	Yes	Nil	0%	Nil	0%
	No	25	100%	25	100%
Patient requested for caesarean section.	Yes	08	32%	01	4%
	No	17	68%	24	96%

 

Also the mean behavioural pain scale score in observations (1 and 2) of the control group was 5.12 and 7.08 respectively with a mean difference of 1.96 and that of experimental group mean score was 6.76 and 3.36 with a mean difference of 3.4. Level of significance checked by using pair and unpaired t- test. The result was significant as calculated value was more than table value with p < 0.05.

 

Association of selected demographic variables including age, religion, education, activity, economic status, pregnancy resolution and addiction done with observation 1 VAS score and observation 1- behavioural pain scale score using chi square. In all cases chi square table value was greater than calculated value at p<0.05, thus results showed non significant except behavioural pain scale with religion. With regard to religion, calculated chi squre value (27.2) was greater that table value (12.59) with 6 df at p <0.05. Thus result was significant that indicates association between level of labour pain (behavioural pain scale score) and religion.

 

More than 85% participant had given a positive response for music therapy and they also reported that they would like it to repeat in future pregnancy as well for other mothers as it was very relaxing and diverted them from pain.

 

Overall, rate of normal delivery was more in experimental group (92%) than that of control group (76%).  Rate of instrumental and operative (L.S.C.S) delivery was more in control group than that of experimental group  i.e. instrumental delivery was 8% in control group and 4% in experimental group whereas operative delivery (LSCS) 16% in control and 4% in experimental group.

 

INTERPRETATION:

Music therapy is an effective complementary therapy which reduces level of first stage labour pain. There was no association between first stage labour pain level and selected demographic variables except for religion.

 

CONCLUSION:

The findings of the study proved that in the experimental group music therapy, that music therapy has effect in reducing pain level of primigravida mothers during first stage of labour as in experimental group observation 2 mean pain score was less than that of observation 1 mean pain score.

 

REFERENCES:

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7.       Bobak, Jensen, Lowdermilk. Maternity Nursing. 4^th ed. Missouri: Mosby; 1995. p. 291,235.

8.       Cheryl Dileo. Music therapy and medicine: theoretical and clinical applications. 1^st ed. USA: American Music Therapy Association; 1999 Oct.

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Received on 10.07.2017           Modified on 31.08.2017

Accepted on 09.11.2017     © A&V Publications all right reserved