A Study to Assess the Effectiveness of Lamaze Method in terms of Labour Pain Perception, Anxiety and Progress of Labour among Primi Mothers in active first stage of Labour

Kiruba Gnana Chitra. J
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Abstract

Background: Natural childbirth is a beautiful experience. Women dream of the perfect birth with less pain. But severe pain is a phenomenon embedded in the very nature of human existence. Though experiencing pain during labour is a universal feature of childbirth, the degree of pain perception can be reduced using many simple, effective, low cost non-pharmacological methods which also helps in improving labour progress and patient satisfaction. The concept of painless child birth gave rise to many scientific discoveries and research findings. Among that Lamaze method is one, which prepares mother for child birth and to tackle Labour pain. Objective: The objective of this study are to evaluate the effectiveness of Lamaze method in terms of pain perception, anxiety and progress of labour among primi mothers in first stage of labour admitted at Christian fellowship Hospital, Oddanchatram. Method: The research design used for the study was quasi experimental nonequivalent control group posttest only design. The sample size was 60 samples. Out of which 30 were in experimental group and 30 were in control group. The Samples were selected by using Non probability purposive sampling technique. Primi mothers at their term was selected and was given antenatal teaching on “Normal labor process and non-pharmacological labour pain management” in antenatal OPD for about 30 minutes. The same primi mothers who attended teaching were selected for experimental group during their labour period. During the first hour of active first stage of labour Lamaze intervention of visual stimuli was provided by showing natural sceneries during each contraction for the second hour auditory stimuli was provided by making the mother to listen to light music by using ear phone. During the 3rd hour of active first stage of labour abdominal effleurage stroke was done during each painful contractions. Followed by that hot water bag application on the sacral region was provided and was continued till delivery. Primi gravid mothers who did not undergo Lamaze teaching and interventions were selected for control group. Posttest was done on both experimental and control group after four hours of active stage of labor to assess the level of labor pain perception, the level of anxiety and progress of labor by using Universal pain assessment scale, modified Max Hamilton anxiety rating scale and Labor progress assessment scale. The level of satisfaction on Lamaze method among experimental group was assessed by using Likert scale on satisfaction of Lamaze method. Total time taken to perform posttest in both groups was 30 minutes. The gathered data were analyzed by using descriptive and inferential statistics. Results: Results: Independent “t” value for level of pain perception was 16.08(table value=2.001) which was significant at P<0.05 level. The independent “t” value for level of anxiety was 5.08(table value=2.001) which was significant at P<0.05 level. The independent “t” value for progress of labour was 9.86 (table value=2.001) which was significant at P<0.05 level. Regarding the level of satisfaction on Lamaze method of experimental group all 30(100%) primi mothers were adequately satisfied. There was no significant association existing between pain perception, anxiety and progress of labour with demographic variables such as age, education, occupation, monthly income and residence except for pain perception and demographic variables such as religion (χ2 = 45.44) and family type (χ2 = 4.33) among experimental group. The study findings revealed that Lamaze method was effective in reducing labor pain perception, anxiety and promote labour progress among primi mothers in active first stage of labour.
laamaze方法对第一产程产妇产痛感知、焦虑及产程的影响研究
背景:自然分娩是一种美丽的经历。女人梦想着少些痛苦的完美分娩。但剧烈的疼痛是人类存在的一种本质现象。虽然在分娩过程中经历疼痛是分娩的普遍特征,但可以使用许多简单,有效,低成本的非药物方法来减少疼痛感知的程度,这也有助于改善分娩过程和患者满意度。无痛分娩的概念产生了许多科学发现和研究成果。拉玛兹的方法中有一种是让母亲为分娩做好准备,并解决分娩疼痛。目的:本研究的目的是评价拉玛兹方法在奥丹查特拉姆基督教联营医院第一产程产妇疼痛感知、焦虑和分娩进展方面的有效性。方法:本研究采用准实验非等效对照组后验设计。样本量为60个样本。其中试验组30例,对照组30例。样本采用非概率目的抽样技术进行选择。选择初产产妇,在产前门诊进行“正常分娩过程和非药物阵痛处理”的产前教学,时长约30分钟。实验组选择在分娩期间参加过教学的同一批初级母亲。在第一产程主动分娩的第一个小时,通过每次宫缩期间展示自然景观来提供视觉刺激,第二个小时通过让母亲使用耳机听轻音乐来提供听觉刺激。在第一产程第3小时,每次宫缩疼痛时,均行腹部积液卒中。随后,提供了在骶骨区域的热水袋应用,并一直持续到分娩。选取未接受拉马兹教学和干预的初产妇作为对照组。实验组和对照组均于产程活跃期4 h后进行后测,采用通用疼痛评定量表、改良Max Hamilton焦虑评定量表和产程评定量表评估产痛感知水平、焦虑水平和产程。采用李克特拉马兹法满意度量表评估实验组拉马兹法满意度。两组进行后测的总时间均为30分钟。采用描述性统计和推理统计对收集到的数据进行分析。结果:疼痛感知水平的独立“t”值为16.08(表值=2.001),P<0.05水平差异有统计学意义。焦虑水平的独立“t”值为5.08(表值=2.001),在P<0.05水平上有显著性意义。分娩进度的独立t值为9.86(表值=2.001),P<0.05水平上有显著性意义。试验组30例(100%)原始母亲对拉马兹方法的满意度均为充分满意。实验组中除疼痛感与宗教信仰(χ2 = 45.44)、家庭类型(χ2 = 4.33)等人口学变量相关外,疼痛感、焦虑、劳动进度与年龄、学历、职业、月收入、居住地等人口学变量均无显著相关。研究结果表明,Lamaze方法能有效地减轻第一产程产妇的疼痛感、焦虑感,促进产程的顺利进行。
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