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International Journal ofObstetrics, Perinatal

& Neonatal Nursing

Jul–Dec 2016

eISSN: 2455-6424

IJOPNN

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International Journal of Obstetrics,

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International Journal of Obstetrics, Perinatal and Neonatal Nursing intends to publish research, review and

short articles related to women and child care. The goal of the Journal is to enhance the knowledge and

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Focus and Scope of the Journal Obstetrics and gynecology Amenorrhea, dysmenorrhea, menorrhagia Prenatal diagnosis and screening Prenatal nutrition Pregnancy and preventive care Prenatal nutrition Reproductive health Fertility Prematurity and preterm births Birth defects Basic neonatal care Special care newborn nursery Intensive neonatal care Neonatal nursing

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EDITORIAL BOARD MEMBERS

Dr. Sushma Kumari SainiNational Institute of Nursing Education,

PGIMER, Chandigarh

Dr. Smriti AroraRufaida College of Nursing, Jamia Hamdard,

Hamdard Nagar, New Delhi

Dr. Asha P. ShettyYenepoya Nursing College; Yenepoya

University, Deralakatte, Mangalore

Dr. Kedar G MehtaDepartment of Community Medicine, GMERS

Medical College, Gotri, Vadodara

Dr. S. VijayalakshmiVignesh Nursing College, Kizhanaikarai,

Tiruvannamalai

Dr. Bimla RaniBharat College of nursing

Dr. Ramesh KumariCollege of nursing, Opp. Income tax office,

Amritsar, India

Dr. H. Juliet SylviaSacred Heart Nursing College, Ultra trust,

Madurai, India

Mrs. Urmila D BhardwajDepartment of Nursing, Hamdard

University

Naveen Herold SimonShri Venketeshwara University, Gajrola

Dr. A. JudieSRM College of Nursing, SRM University, SRM

Nagar, Potheri, Tamil Nadu

Dr. Usha UkandeChoithram College of Nursing, CH&RC Indore

(M.P.), India

Stella Sagaya MaryMatha college of Nursing, Vaanpuram,

manamadurai, sivagangai Dt, Tamilnadu

Dr. H C L RawatUniversity College of Nursing, Baba Farid

University of Health Sciences, Punjab, India

Sibin Joy Vayalil Community Health Nursing Department & Research Coordinator Lourdes College of

Nursing

Mr. Shivarajkumar Rajkumar DandagiDepartment of Community Health Nursing,

KLE University Institute of Nursing Sciences, Nehru Nagar, Belgaum (Karnataka), India

Gita RazdanCollege of Nursing, All India Institute of

Medical Sciences (AIIMS)

Dharitri SwainAll India Institute of Medical Sciences

(AIIMS), Bhubaneswar, Sijua (Odisha), India

Dr. C. Susila Billroth College of Nursing, Chennai,

India

From the Editor's Desk

Dear Readers,

We would like to present, with great pleasure, the Second Volume of a new scholarly

journal, International Journal of Obstetrics, Perinatal and Neonatal Nursing. This

journal is part of the Applied Sciences, and is devoted to the scope of present Nursing

issues, from theoretical aspects to application-dependent studies and the validation of

emerging technologies.

This new journal was planned and established to represent the growing needs of Nursing as an emerging and

increasingly vital field, now widely recognized as an integral part of scientific and technical investigations.

Its mission is to become a voice of the Nursing Science community, addressing researchers and practitioners

in this area.

The core vision of International journal of Obstetrics, Perinatal and Neonatal Nursing in JournalsPub is to

propagate novel awareness and know-how for the profit of mankind ranging from the academic and

professional research societies to industry practitioners in a range of topics in Nursing in general.

JournalsPub acts as a pathfinder for the scientific community to published their papers at excellently, well-

time & successfully.

International Journal of Obstetrics, Perinatal and Neonatal Nursing focuses on original high-quality

research in the realm of Obstetrics and gynecology, Amenorrhea, dysmenorrhea, menorrhagia, Prenatal

nutrition, Basic neonatal care, Special care newborn nursery, Intensive neonatal care and Neonatal

nursing. The Journal is intended as a forum for practitioners and researchers to share the techniques of

Nursing and solutions in the area.

Many scientists and researchers have contributed to the creation and the success of the Nursing community.

We are very thankful to everybody within that community who supported the idea of creating an innovative

platform. We are certain that this issue will be followed by many others, reporting new developments in the

field of Nursing.

This issue would not have been possible without the great support of the Editorial Board members, and we

would like to express our sincere thanks to all of them. We would also like to express our gratitude to the

editorial staff of JournalsPub, who supported us at every stage of the project.

It is our hope that this fine collection of articles will be a valuable resource for Nursing readers and will

stimulate further research into the vibrant area of Nursing.

Puneet Mehrotra

Managing Director

1. Effectiveness of Progressive Muscle Relaxation Technique on Pre-menstrual Symptoms among the Hostel Students Lathavenkatesan, B. Annapoorani 1

2. Systematic Perioperative Instruction and Anxiety in Hysterectomy Women K. Thilagavathi, R. Vaidyanathan 7

3. A Quasi Experimental Study on the Effectiveness of Self-Instructional Module on Knowledge Regarding Teratogens Among Married Women Residing in Selected Areas of Dera Bassi District Mohali, PunjabManpreet Kaur 12

4. Effect of Sitz Bath on Intensity of Pain at Episiotomy Site among Postnatal Mothers Admitted in Obstetrics Units of Nehru Hospital, PGIMER, and Chandigarh in the Year 2010–2011Pamila, Sukhwinder, Vanita Jain, Navjeet 18

5. A Quasi Experimental Study to Assess the Effect of Different Types of Music Therapy on Physiological Parameters of Preterm Babies in a Tertiary Hospital of North IndiaArun Thomas Mohandas, Sukhwinder Kaur, Parveen Kumar, Sanjay Munjal 26

6. Effect of “Heat Therapy” on Intensity of Labor Pains among Primigravida Mothers, Chandigarh: A Quasi Experimental Study Shashi Kumari, Sukhwinder Kaur, Seema Chopra 37

Contents

IJOPNN (2016) 1-6 © JournalsPub 2016. All Rights Reserved Page 1

International Journal of Obstetrics, Perinatal and Neonatal Nursing eISSN: 2455-6424

Vol. 2: Issue 2 www.journalspub.com

Effectiveness of Progressive Muscle Relaxation Technique on Pre-menstrual Symptoms among the Hostel Students

Lathavenkatesan, B. Annapoorani*

Apollo College of Nursing, Chennai, Tamil Nadu, India

ABSTRACT Premenstrual symptoms are commonly affecting 80% of women. Among the youngsters the premenstrual symptoms commonly affects the daily activities and frequent absenteeism among the college students. So the investigator was interested in providing intervention to reduce the symptoms. Written consent was obtained from the samples and PMS Diary was distributed and instructed to maintain for a month. Among the 200 population, 50 samples with PMS were selected by lottery method. Progressive muscle relaxation was given to the samples for a duration of 30 minutes every day for 5 days in a week for a duration of 2 months. Again PMS diary was distributed to all the samples and monitored for a month. The outcome of this study was there is significant reduction in the severity of premenstrual symptoms. In the psychological symptoms 66% of samples severely affected with PMS but after the intervention, it was reduced to 68% moderately and 32% of the samples with mild symptoms. In the pain symptoms 56% were severely affected and 44% were moderately affected, but after the intervention, 82% of the samples had moderate symptoms and 8% of them affected mildly. Hence, there was significant difference in the PMS score before and after the intervention at p < 0.05 level. This study proved the effectiveness of PMR technique in the reduction of PMS symptoms. Keywords: PMS, PMDD, PMR. INTRODUCTION The first person to name and describe the premenstrual syndrome was Robert T. Frank. Premenstrual disorders namely premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are a group of physical, cognitive, affective, and behavioural symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolve at or within a few days of the onset of menstruation. The World Health Organization estimates that 199 million women have premenstrual syndrome as of 2010 (5.8%) of the female population. While 80% of menstruating women have experienced at least one symptom that could be attributed to PMS,

estimates of prevalence range from as low as 3% to as high as 30%.[1–5] Objectives (1) To assess the level of premenstrual

symptoms before the intervention among the hostel students.

(2) To assess the level of premenstrual symptoms after the intervention among the hostel students.

(3) To associate the relationship with the level of premenstrual symptoms and demographic variables.


International Journal of Obstetrics, Perinatal & Neonatal Nursing eISSN: 2455-6424


Systematic Perioperative Instruction and Anxiety in Hysterectomy Women

K. Thilagavathi1*, R. Vaidyanathan2

1College of Nursing and Allied Health Sciences, Jazan University, Ministry of Education, Kingdom of Saudi Arabia

2National Consortium for Ph.D. in Nursing, Bangalore, India

ABSTRACT

Background: Uterus is the symbolic organ of womanhood. Hysterectomy is the second most common surgery done next to caesarean section. This surgery has a direct impact on psychological and emotional issues among women. Anxiety is a common manifestation. Studies indicate that systematic perioperative instruction helped them to cope with surgery and decreased levels of anxiety aided to a faster postoperative recovery, without complications. In the present clinical study we evaluated the effect of systematic perioperative instruction on the level of anxiety among women who undergo hysterectomy. Methods: Women who undergo hysterectomy admitted to the Gynecological department of District Headquarter Government Hospital, Salem from September 2012 to January 2014 were selected to either study group (n=184) or a control group (n=95) by convenience sampling. Women’s levels of anxiety were assessed in the preoperative period, discharge and at 4 months after surgery with State-Trait Anxiety Inventory. Study group received systematic perioperative instruction and control group had routine nursing care. Descriptive and Inferential statistics applied in analysis. Results: It was found that the anxiety level were similar in both groups in the preoperative period. However, in discharge and at 4 months after surgery there was a significant reduction in anxiety levels in study group as compared to control group (p˂0.05). There was a significant association found between level of preoperative anxiety with their age, preoperative diagnosis and type of surgery undergone (p˂0.05). Conclusion: Providing systematic perioperative instruction was found to be beneficial in reducing anxiety levels in the postoperative period. It is highly recommended in all surgical settings as a mandatory. Keywords: anxiety, hysterectomy, routine nursing care, systematic perioperative instruction INTRODUCTION Any surgery triggers certain level of stress in the individual which produce physiological and psychological changes. Anxiety is a symptom often experienced irrespective of type of operation. The prospect of hysterectomies said to endanger more stress than other comparable surgeries. Evidence from literature figured, 79.2% of women experienced anxiety before undergoing hysterectomy.[1] An explorative study

revealed, that women felt anxiety because "uterus is a very important organ for them", "losing their uterus will reduce their self-confidence", "their sexual lives would end", "their spouses would not be interested in them anymore" and "their relationships would come to an end."[2] Lack of information, reduction in self-respect, reduction in the quality of life and loss of social functions were the reasons


International Journal of Obstetrics, Perinatal & Neonatal Nursing eISSN: 2455-6424


A Quasi Experimental Study on the Effectiveness of Self-Instructional Module on Knowledge Regarding Teratogens

Among Married Women Residing in Selected Areas of Dera Bassi District Mohali, Punjab

Manpreet Kaur*

Silver Oaks College of Nursing, Abhipur, Mohali, India

ABSTRACT

Teratogens are certain agents which when exposed during pregnancy could harm the embryonic and fetal development to produce permanent alterations of structure and functions. There are many sources of potential harm to both developing baby and mother, ranging from environmental concerns such as toxic chemicals, fumes and poisons to drugs including smoking and alcohol. The research project was undertaken on the effectiveness of self-instructional module on knowledge regarding teratogens among married women residing in Selected Areas of Dera Bassi, District Mohali, Punjab. Conceptual framework of the study was based on modified Imogene M. Kings Goal Attainment Theory (1981).Quantitative research approach and quassi experimental design was adopted. The sample size for the study was 80 married women which were selected by random sampling technique. The gathered data was analyzed by calculating frequency and percentage, mean, standard deviation and Z test. ANOVA and ‘t’ test was used to find the association between posttest knowledge score and their selected demographic variables. The mean posttest knowledge score (21.13) was higher than the mean pretest knowledge score (11.12). The calculated Z value was 19.71 which was more than the tabulated value, indicating the effectiveness of self-instructional module on knowledge regarding teratogens. Keywords: married women, self-instructional module, teratogens INTRODUCTION Pregnancy is one of the wonderful and noble services imposed by nature. The development of the fetus brings changes in women’s physical and mental health. While carrying baby, the women needs to learn a lot regarding pregnancy. Pregnancy is the crucial period of a woman and the fetus, it is the time where the woman gives shelter to another life and wide range of changes takes place in the fetomaternal system.[1]

The 1st trimester or first 60 days are very important, as all the fetal parts are laid down in rudimentary form and start

functioning. It was previously believed that the mammalian embryo developed in the uterus of the mother, protected from all extrinsic factors, however after the thalidomide disaster of the 1960s it becames apparent and more accepted that the developing embryo could be highly vulnerable to certain environmental agents that have negligible or non-toxic effects to adult individuals.[2] Every woman has a 3-5% risk of having a baby born with a birth defect. Some teratogens will increase that risk, depending upon when in the pregnancy a woman has the exposure, the




Effect of Sitz Bath on Intensity of Pain at Episiotomy Site among Postnatal Mothers Admitted in Obstetrics Units of Nehru

Hospital, PGIMER, and Chandigarh in the Year 2010–2011

Pamila1, Sukhwinder1*, Vanita Jain1, Navjeet1 National Institute of Nursing Education, PGIMER, Chandigarh, India

ABSTRACT

Objective: To determine the effect of sitz bath on intensity of pain at episiotomy site among postnatal mothers. Methods: 100 patients with episiotomy were enrolled in the study with purposive sampling. Then divided into two groups: control and experimental group. Sitz bath was given to experimental group after 12 hours of postnatal period for twice in a day for 1-4 days. Control group received routine care of the ward. Assessment of the pain was done by modified pain rating scale in both groups. Pain was assessed in experimental group immediately after sitz bath and after one hour of the sitz bath. Results: The results showed that education, occupation, income, religion and locality of the mother in the experimental groups were not different from those in the control groups as p value is always >0.05 which depicts that both the groups were homogenous in nature and comparable. Whereas in mean pain score there was a significant difference between control and experimental group as p value was <0.0001. Pain level was same in immediate and after one hour of sitz bath. Conclusion: Mean pain score significantly decreasing in the experimental group after every intervention however in control group mean pain score was decreasing but that was statistically less significant as compare to the experimental group. Keywords: episiotomy, intensity of pain, sitz bath INTRODUCTION Puerperium is the period when great changes take place in a woman’s physical and mental set up that may pose a challenge to postnatal woman. An episiotomy can make the process of childbirth much easier and the mother doesn’t need to put in much effort in pushing to deliver the baby. Both a first birth and assisted vaginal delivery are associated with greater use of episiotomy.[1,2] Within the first hours, days, and perhaps even weeks following childbirth, postnatal mothers have pain and feel discomfort after episiotomy. Pain following episiotomy appears to be a universal phenomenon. Women who delivered without an episiotomy had significantly lower perineal pain scores at

weeks 1, 2 and 6 postpartum compared to women who had an episiotomy.[3] Episiotomy may increase the risk of chronic perineal pain which is estimated to occur in 13% to 23% of women after episiotomy.[4] An episiotomy can be painful for few days after delivery. Usually the pain will peak around the 4th or 5th day and then gradually it reduces.[5] According to Reading et al the persistent perineal pain was found in 10 to 20 % of patients even after 3 months of delivery and it increases during walking, sitting, urinating or defecating.[6] Sitz bath is frequently recommended by physicians for




A Quasi Experimental Study to Assess the Effect of Different Types of Music Therapy on Physiological Parameters of Preterm

Babies in a Tertiary Hospital of North India

Arun Thomas Mohandas1, Sukhwinder Kaur2*, Parveen Kumar3, Sanjay Munjal4 1Faculty of SNC SOA, University Bhubaneswar, India

2Faculty of National Institute of Nursing Education, PGIMER, Chandigarh, India 3Division of Neonatology, Department of Pediatrics, PGIMER, Chandigarh, India

4Department of Otolaryngology, PGIMER, Chandigarh, India

ABSTRACT

Preterm infants are vulnerable to a range of diseases associated with immaturity of organ system and stress stimuli during their stay in NICU. The music have a positive effect on their physiological measurements. Main objective of this study was to assess the effect of music therapy on the physiological parameters (BP, HR and SpO2) of preterm babies admitted in a tertiary care hospital of North India. One group pretest – posttest quasi experimental research design was adopted in this study. Six different type of music therapies (two active music therapies, two passive music therapies and two high frequency music therapies) were administered to identify the effect of music therapy on the physiological parameters of preterm babies. Thirty preterm babies who met the inclusion criteria were selected as study subjects by using purposive sampling technique. Result of the study shows that all music therapies except high frequency type2 music therapy produced a significant decrease in the BP and HR( p<0.05) and improved the SpO2 of preterm babies (p<0.05). The Indian passive music therapy was found to be more effective in decreasing the BP of preterm babies (p<0.01). The active music therapy (vocal) was found to be highly effective in decreasing the HR (p<0.01) and all music therapy significantly improved the SpO2 of preterm babies (p<0.05). This study also revealed that an increase in frequency of music negatively affect the physiological parameters of preterm babies. Music therapy was found to be effective in decreasing the BP and heart rate and improving the SpO2 of preterm babies. Thus the present study supports the use of music therapy in NICU. Keywords: music therapy, physiological parameters, preterm babies INTRODUCTION The use of music in medicine is not a new concept. Music stimulation has been shown to provide significant benefits to preterm infants. Live music therapy was more beneficial to preterm and might improve physiological and behavioral parameters of preterm including HR, BP, respiratory rate, oxygen saturation, caloric intake, resting energy expenditure (REE) and weight gain and visual function, motor and tactile/adaptive maturation, limb movement, maturation at discharge, stress

behaviors, arousal state, weight gain, feeding rate, reducing the length of hospital stay and parent-infant bonding.[1] Over the past decade, music has been introduced into the NICU as a therapy designed to enhance treatment and facilitate growth and development of premature infants. The 2002 meta-analysis




Effect of “Heat Therapy” on Intensity of Labor Pains among Primigravida Mothers, Chandigarh: A Quasi Experimental Study

Shashi Kumari1, Sukhwinder Kaur2*, Seema Chopra3

1Fortis Morality Hospital Mohali, Punjab, India 2National Institute of Nursing Education, PGIMER, Chandigarh, India

3Obstetrics and Gynaecology Department, Nehru Hospital, PGIMER, Chandigarh, India

ABSTRACT

Background: Childbirth, while primarily a joyful event, also exposes the mother to one of the most severe forms of pain reported. Continuous labor pain affects respiratory system, blood circulation, endocrine glands and other activities of the body. Labor pain is a distressing and psychologically traumatizing experience to the parturient but little data exist regarding pain relief in labor, despite of its advantages. Objective: To determine the effect of heat therapy on intensity of labor pains among primigravida mothers. Design: An quasi experimental study Setting: Clean Labor Room of Nehru Hospital, Postgraduate Institute of Medical Education and Research. Participants: Sixty study subjects were purposively selected from the Clean Labor room, PGIMER, Chandigarh and divided into experimental and control group. Methods: The experimental group received heat therapy over lower back during the active phase of labor and the control group received the routine care. Data first collected from the experimental group followed by the control group. Pre and post intervention pain scores were assessed with the modified visual analogue scale. Results: The results of the study revealed that the mothers in the experimental group had statistically significant lower mean score of labor pain than the control group (p<0.05). Conclusion: Heat therapy is one of the effective methods for labor pain management. Keywords: childbirth, first stage of labor, labor pain, primigravida mothers, quasi experimental study INTRODUCTION What is already known about the topic? A study of laboring women in the

United Kingdom indicated that 93.5% of the women described the pain as severe or unbearable (Steer 1983), while in Finland 80% described it as very severe or intolerable (Ranta1995).

Whirlpool baths in labor have been demonstrated to have a positive effect on analgesia requirements, condition of the perineum, instrumentation rates, and personal satisfaction.

The non-pharmacological measures such as respiratory exercises, muscular relaxation, lumbosacral massage, & shower washing showed a satisfactory

acceptance and applicability rates in relieving labor pains

What this paper adds This study suggests that the non-

pharmacological methods such as local heat therapy is simple, easy and cheap and can be used easily by the labor room midwives or nurses.

Heat therapy is significantly beneficial for the laboring mothers in promoting the comfort to them thereby decreasing the labor pain intensity.

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Article 2

017

International Journal ofObstetrics, Perinatal

& Neonatal Nursing

Jul–Dec 2016

eISSN: 2455-6424

IJOPNN

www.journalspub.com

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