Labour is a series of events that takes place in the genital organs in an effort to expel the viable products of conception through the vagina in to outer world. During labour, the women experience some degree of stress, discomfort and severe pain as her system responds to the effects of physical changes that prepare her to give birth. Labour process is a actual phenomenon. During the labour period mother have stress, anxiety, discomfort and severe pain. A scientific definition of pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The investigator had seen several primigravida mothers during first stage of labour with severe pain and discomfort. During the clinical experience. So that minimizing maternal discomfort and severe pain perception poor outcome of labour. And promoting the maternal comfort the nurse can help the mother to get relief from pain and suffering.
The nursing management with ambulation has significant effect on improve maternal comfort, outcome of labour and reduce pain perception which helps to promote the comfort of the mother and its use is simple and has an significant therapeutic care.
The main study was conducted at Maternal and child healthy GOSHA hospital, vizianagaram district Andhra Pradesh. The 60 primi gravida mothers who fulfilled the inclusive and exclusive criteria were selected for the study, out of which 30 mothers were experimental group and 30 of them control group and sample selected by using simple random sampling method by lottery method. Mother who came under group A lottery will come under the experimental group and mother who came under group B lottery will come under control group. After assessing the pre test level of maternal comfort, pain perception the investigator provided ambulation technique for experimental group. Ambulation is a slow walking for 15mts with the interval of 15mts assessment of each primi gravida mothers in experimental group. Routine hospital intervention for control group. After the third application the post test level of maternal comfort, pain perception and out come of labour was assessed by using maternal comfort assessment tool and graphic rating scale and scored.
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The findings of the study revealed that the calculated ‘t’ value was The ‘t’ value of the level of maternal comfort between experimental and control group is8.13.The ‘t’ value of the level of pain perception between experimental and control group is15.1. The’t’ value of the outcome of labour between experimental and control group is 8.63 which showed low statistical significant at (p<0.05) in the comparison of level of maternal comfort, pain perception and outcome of labour of experimental group and control group.
Association of post assessment level of maternal comfort, pain perception and outcome of labour with selected demographic variables of experimental group with experimental and control group showed that there was no statistical significance.
CONCLUSION
The present study assessed the effectiveness of ambulation to improve maternal comfort, outcome of labour and reduction of pain perception during first stage of labour among primi gravida mothers in Mch gosha hospital vizianagaram district, Andhra Pradesh. The results of the study concluded that rendering the ambulation during first stage of labour to the primi gravida mothers was effective to improve maternal comfort, outcome of labour and reducing the labour pain perception. The ambulation is easy to apply, not painful and can enhance comfort in mother with first stage of labour. So, could easy to adopt a regular intervention. Therefore, the investigator felt that more importance should be given to the assessment of labour pain using standard scale following the intervention of ambulation can be given as non-pharmacological measures to enhance improvement of maternal comfort, outcome of labour and reduction of labour pain perception.
IMPLICATION:
The investigator has derived from the study, the following implications, which are of vital, concern in the field of nursing practice, nursing education, nursing administration and nursing research.
NURSING PRACTICE
The midwives who are working in maternity unit have a vital role to play in providing effective and safe nursing care to the labouring mother. Enhance to improve maternal comfort, out come of labour and reduction of labour pain perception. This can be facilitated by motivating the nurse midwives to
Have an in depth knowledge on physiological changes during labour and management during labour.
Learn about accurate assessment of maternal comfort, outcome of labour and pain with the use of standard and appropriate assessment and pain scales.
Develop skill in providing efficient nursing care for effective pain management during labour and promote comfort.
Teach the primi mothers during antenatal period about the effectiveness of various non pharmacological measures for reduction of pain during labour.
NURSING EDUCATION
Ensure that the students learn the normal physiological changes during labor and its management.
Provide adequate clinical exposure for the students to give effective and safe nursing care in reduction of labour pain perception .and promotes maternal comfort and improve outcome of labour.
Make use of available literatures and studies related to non-pharmacological measures for pain relief and maternal comfort during labour.
Educate the students about various complementary and alternative therapies for pain management in labour, maternal comfort and outcome of labour.
Encourage the students for effective utilization of research based practices.
NURSING ADMINISTRATION
Collaborative with governing bodies to formulate standard policies and protocols to emphasize nursing care during labour.
Conduct in-service programme and continuing education programme for effective pain management and promote comfort during labour
Ensure and conduct workshops, conferences, seminars on non-pharmacological methods to reduce labour pain perception during first stage of labor.
NURSING RESEARCH
As a nurse researcher, promote more research on effective pain management and promote maternal comfort during labour
Disseminate the finding of the research through conferences, seminars and publishing in nursing journal.
Promote effective utilization of research findings on labour pain management.
RECOMMENDATION
The study recommends the following future research…
The similar study can be conducted with larger samples for better generalization.
A comparative study can be conducted to assess the maternal comfort labour pain perception and outcome of labour between primi and multi mothers.
A study to assess the knowledge and practice of nurse midwives with regard ambulation for maternal comfort, labour pain management.
A study to assess the knowledge and attitude of nurse midwives on complementary and alternative therapies for labour pain management.
A study can be conducted to assess the effectiveness of other nursing measures such as massage, music, warm water bath, breathing exercise on maternal comfort, pain perception and outcome labour. During first stage of labour.
LIMITATION
Only limited literatures and studies was obtained from the Indian context.
The study would have been better if large samples for better generalization.
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