A study to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore
 

A study to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore

on

  • 488 views

The experience of pain during labour is a complex, individual and multifaceted response to sensory stimuli generated during childbirth. Despite the fact that labour is painful for most women, a ...

The experience of pain during labour is a complex, individual and multifaceted response to sensory stimuli generated during childbirth. Despite the fact that labour is painful for most women, a powerful myth of painless childbirth still prevails. Many alternative methods of pain relief are available that are safe and inexpensive. One of them is water birth. Water birth is the process of giving birth in a tub of warm water. The theory behind water birth is that the baby has been in the amniotic sac for nine months and birthing into a similar environment is gentler for the baby and less stressful for the mother. Adolescence is the time to prepare for understanding great responsibilities, a time for exploration and widening horizons, and a time to ensure healthy all round development. Puberty is also a time of behavioural changes when the reproductive capacities get established. Midwives are ‘with woman’, providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers nursing students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice.

Statistics

Views

Total Views
488
Views on SlideShare
488
Embed Views
0

Actions

Likes
0
Downloads
1
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

A study to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore A study to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore Document Transcript

  •                                                                                                   A t adol                                      study to teaching p lescent gi        assess th programm rls in a se e effectiv me on wa elected co      veness of ater birth a ollege at M planned among Mangalorre
  • Original Article A study to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore Darling Bibiana*, Jomy Cherian Principal, Shree Devi College of Nursing, Maina Towers, Ballalbagh, Mangalore 575003, India a r t i c l e i n f o Article history: Received 28 August 2012 Accepted 30 October 2013 Available online 18 November 2013 Keywords: Effectiveness Water birth Planned teaching programme Adolescent girls a b s t r a c t The experience of pain during labour is a complex, individual and multifaceted response to sensory stimuli generated during childbirth. Despite the fact that labour is painful for most women, a powerful myth of painless childbirth still prevails. Many alternative methods of pain relief are available that are safe and inexpensive. One of them is water birth. Water birth is the process of giving birth in a tub of warm water. The theory behind water birth is that the baby has been in the amniotic sac for nine months and birthing into a similar environment is gentler for the baby and less stressful for the mother. Adolescence is the time to prepare for understanding great responsibilities, a time for exploration and widening horizons, and a time to ensure healthy all round development. Puberty is also a time of behavioural changes when the reproductive capacities get established. Midwives are ‘with woman’, providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers nursing students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Aim: The aim of the study was to assess the effectiveness of planned teaching programme on water birth among adolescent girls in a selected college at Mangalore. Method: An evaluative approach with quasi experimental, pre-test post-test design without control group was used for the study. The data was collected from 60 adolescent girls using simple random sampling technique. The study was conducted in selected college at Mangalore. Results: There was significant difference between per-test and post-test knowledge score (t ¼ 44.23, p < 0.05). There was no association between the pre-test knowledge score and selected variables. Conclusion: All the subjects in the study group gained knowledge on water birth indicating that planned teaching programme was an effective method for increasing knowledge. Copyright ª 2013, Indraprastha Medical Corporation Ltd. All rights reserved. * Corresponding author. Tel.: þ91 9886932378 (mobile); fax: þ91 0824 2451108. E-mail addresses: bibiana_vijay@yahoo.co.in, vijaypt72@hotmail.com (D. Bibiana). Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/apme a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 8 4 e8 7 0976-0016/$ e see front matter Copyright ª 2013, Indraprastha Medical Corporation Ltd. All rights reserved. http://dx.doi.org/10.1016/j.apme.2013.10.011
  • 1. Introduction Childbirth is a biological process which gives joy to the mother and the family, and it is the culmination of a human pregnancy or gestation period with the birth of one or more child from a woman’s uterus. It is a crucial moment in a woman’s life. It changes entire life of a woman. She becomes a mother e a nurturer. Though the end result is rewarding e seeing the face of her child, her flesh e the process is very exacting. Due to the original sin, womankind was cursed to go through thispain. This was the redemption for women. Today childbirth need not be a painful process, where a woman has to undergo unendurable pain.1 Birth is a normal, healthy part of a woman’s life. The amount of pain a woman experiences during her labour is influenced by many individual, physical, emotional, and environmental factors. Some of these factors can be antici- pated and actively controlled by the woman and/or her sup- port team with preparation and information. Relaxation skills and accurate knowledge about the birth process give a woman confidence in her ability to work with her body.1,2 Alternative approaches to childbirth are more popular than ever. Water, acupuncture and acupressure, and hypnosis are some of the ways expectant mothers are coping with labour pain. Underwater delivery or simply ‘water birth’ is becoming increasingly popular worldwide. Water birth is a safe method for painless delivery, which takes place in a pool or a tub filled with warm water. Water being a cooling agent helps the mother to relax physically and mentally. Water birth is a safe method for painless delivery, which takes place in a pool or a tub filled with warm water. Water being a cooling agent helps the mother to relax physically and mentally.3 “Water birth has psychological benefits for the foetus. It reduces ‘birth trauma’ in the child”. When a child enters the world, it finds itself in a completely different environment and setting. The change from a protective fluid-filled sac to a dry, airy environment can trigger shock or trauma in the child. And as in an underwater delivery the shift is from fluid to fluid, the baby does not experience any trauma. Rather, a water baby adapts to the environment better.4 A descriptive study was conducted in Tanzania among 135 adolescent girls to assess knowledge of pregnancy and child- birth. The study finding revealed that only 33% of girls could correctly identify the age at which a woman can conceive. Regarding the duration of pregnancy, 77.3% could answer the correct nine months. None of them have known about alter- native birthing method. Knowledge about childbirth and other related aspects were unknown to the adolescent girls. The researcher concluded that poor knowledge of childbirth among adolescence is related to lack of effective and coordinate in- terventions to address reproductive health and motherhood and they must provide with appropriate information regarding childbirth through innovative school based programme.5 A comparative study was conducted in Switzerland among 5953 to assess the safety of alternative birth methods in general and of water births. The results shows that 2014 spontaneous births were water births, 1108 were Maia-birthing stool births and 2362 were bed births. Results revealed that an episiotomy was performed in only 12.8% of the births in water. Themothers’ blood loss is the lowest in water births. Fewer painkillers are used in water births and the experience of birth itself is more satisfying after a birth in water. The average arterial blood pH of the umbilical cord as well as the Apgar scoring at 5 and 10 min were significantly higher after water births. The researchers concluded that water births and other alternative forms of birthing such as Maia-birthing stool do not demonstrate higher birth risks for the mother or the child than bed births.6 An evaluative study was conducted in London among 189 mothers about the responses to water birth who had experi- enced water birth. The results showed that water birth is a consumer-led trend, mainly pursued by educated middle class women. The researcher concluded that better antenatal preparation is needed to reduce the need for other forms of analgesia when women are in water. Women’s responses to the survey suggested that mothers perceived water birth as therapeutic. Mothers demonstrated a strong desire for water in labour. There were no significant behaviour differences between water-born babies and non-water-born babies.7 Study findings revealed that the most commonly used complimentary therapy was water birth and the decision making regarding this was made with the help of midwives.8 Episiotomy needed for the water birth is very low.9 Water birth is to be considered a safe method for a healthy mother and a healthy full-term foetus with cephalic presentation.10 Water birth in India is also gaining popularity. In India it is emerging as a promising alternative to painful traditional delivery.11 Midwives are ‘with woman’, providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers nursing students need to develop reflective skills and valid midwifery knowledge grounded in their personal expe- riences and practice. Midwife educators and practitioners can assist nursing students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. Nursing students have high expectations for gaining skills and knowledge to prepare them to enter professional practice. Through the experiences of learning and applying doula skills to their professional nursing practice, new graduates will be better prepared to enter the real world of nursing practice. Objectives of the study were to:  Determine the existing knowledge score of adolescents regarding water birth using a structured knowledge questionnaire.  Find the effectiveness of planned teaching programme on water birth among adolescents.  Find the association between pre-test knowledge score and selected demographic variables The conceptual frame work adopted for this study was based on general system theory by Ludwig Von Bertalanffy. 2. Materials and methods An evaluative approach with quasi experimental, pre-test post-test design without control group was adopted for the a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 8 4 e8 7 85
  • study. Sixty adolescent girls from Shree Devi College of Nursing, Mangalore were selected using simple random sampling technique. Sample size was determined based on the pilot study finding. The instrument used was a self- administered knowledge questionnaire prepared by the investigator. It consists of total 26 items related to knowledge regarding water birth. There were two sections. Section A consists of three items assessing the knowledge related to female reproductive system. Section B consists of twenty three items assessing the knowledge related to basic concepts of water birth. The knowledge score were classified based on the score obtained as poor ( 40%), moderate (41e60%), good (61e80%) and very good (81e100%). The prepared tool was validated by seven experts. Reliability of structured knowledge question- naire was assessed by split half method and the ‘r’ value was r ¼ 0.89 and the tool was found reliable. A systematically developed planned teaching programme was designed to provide information on water birth with a view to improve their knowledge on water birth, which in- cludes criteria, preparation, benefits, risks, and labour care. Pilot study was conducted among six subjects by using random sampling technique. The subjects for pilot study possessed the same characters that of the samples for final study. It was found that the study was feasible, the ques- tionnaire and PTP were relevant and time and cost of the study was within the limit. Prior permission was obtained from the concerned authority of the college. Data was collected after informed consent of the sample. Pre-test was conducted followed by the teaching programme. After seven days a post-test was conducted using the same questionnaire to evaluate the effectiveness of planned teaching programme. 3. Results Descriptive and inferential statistics were used to analyse the data. For the present study the significant findings were most of them (61.1%) were in the age group of 20 years, about 88.3% adolescent girls belonged to nuclear family. The highest per- centage (46.6%) of the girls belonged to family income group of Rs. 8001e10,001 and above and 48.3% of the girls received health information from mass media (Table 1). The total mean percentage of pre-test knowledge score was 44.6% with mean Æ SD of 13.4 Æ 4.01 and the mean post- test knowledge score was 89.3% with mean Æ SD was 23.22 Æ 1.20 showing an effectiveness of 44.5% with mean Æ SD 11.57 Æ 1.73. Significance of difference between pre-test and post-test was statistically tested by using paired ‘t’ test. The significance difference suggesting that the PTP was effective in increasing the knowledge of the adolescent girls t(59) ¼ 44.23, p < 0.05. There was no association between pre- test knowledge score and demographic variables. 4. Discussion In pre-test it has been found that majority (70%) of the adolescent girls had average knowledge. The mean post- test knowledge score (23.22 Æ 1.20) was higher than the pre-test knowledge score (11.57 Æ 1.73) which revealed that gain in knowledge on water birth, by reducing the poor knowledge category and increasing the excellent category. The significance difference suggesting that the PTP was effective in increasing the knowledge of the adolescent girls t(59) ¼ 44.23, p < 0.05. It is evident that PTP was effective in improving the knowledge of adolescent girls regarding water birth. The finding of this study is consistent with the study conducted among 50 adolescent girls in the age group of 16e18 years on effectiveness of PTP on normal vaginal delivery in a selected rural area, Udupi. Findings revealed that the mean differences between the post-test and pre- test knowledge score of adolescent girls on normal vaginal delivery found to be significant t ¼ 16.20, (p < 0.05). This suggested that the PTP was effective in improving knowl- edge of adolescent girls.12 5. Implications Planned teaching programme also helps the future nurses to practice the alternative birth method and to guide their patients to the appropriate treatment centres. Nursing stu- dents as future nurses and midwives have a role in pre- paring their clients for childbirth through proper guidance and education. Planned teaching programme also helps the future nurses to practice the alternative birth method and to guide their patients to the appropriate treatment centres. Nursing students as future nurses and midwives have a role in preparing their clients for childbirth through proper guidance and education. Nurse administrator plays a vital role in the supervision and management of nursing profession. The nursing admin- istrator can plan and conduct education programmes which are beneficial to nursing faculty, staff nurses and students. There are only very few studies conducted on water birth. More innovative teaching methods like reproductive health issues package can be implemented and its effectiveness can be evaluated. Limitations of the study were that the sample size was small so the generalization of the finding is limited. Table 1 e Frequency and percentage distribution of samples according to their demographic variables. Demographic variables Frequency Percentage Age a) 19 yrs 18 30 b) 20 yrs 37 61.67 c) 21 yrs 5 8.33 Type of family a) Nuclear 53 88.3 b) Joint 7 11.7 Family monthly income a) Rs. 5001e8000/- 15 25.0 b) Rs. 8001e10,000/- 28 46.7 c) More than 10,001/- 17 28.3 Source of information a) Mass media 29 48.3 b) Parents/relatives/friends 8 13.3 c) No information 23 38.3 a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 8 4 e8 786
  • 6. Conclusion The study supports the concept that planned teaching pro- gramme for adolescent girls are an effective strategy to improve knowledge on water birth. Water birth is an option chosen by some women for pain relief during labour and childbirth, and studies have reported that water birth in an uncomplicated delivery helps to reduce the need for anal- gesia, without evidence of increased risk to mother or newborn. Hot water tubs are available in many hospitals and birthing centres. It is the belief of midwives, birthing centres and a growing number of obstetricians, that reducing the stress during labour and delivery also reduces foetal complications. Conflicts of interest All authors have none to declare. r e f e r e n c e s 1. Negi N. Water birth for safe, less painful child delivery. [online]. Available from URL: http://www.lifestyle.merinews.com. 2. What the research says about water birth. [online]. Available from: http://www.babycentre.co.u.k/midwives/.com. 3. Alternative methods of birth. [online]. Available from URL: http://www.first_time_pregnancy.com. 4. Nath T. Water birth in India gaining popularity one world south Asia. [online]. Available from URL: http://southasia.oneworld. net/OWSAinfo/functionalarea.com. 5. Mushil Declare L. Knowledge about safe motherhood among school pupils in a rural area in Tanzania. BMC Pregnancy Childbirth. 2007;7:5. 6. Geissbuehler V, Stein S, Eberhard J. Water births compared with land births. J Perinatal Med. 2004;32(4):308e314. 7. Richmond H. Women’s experience of water birth. Pract Midwife. 2003 Mar;6(3):26e31. 8. Munstedta K, Sehrtotera C, Bruggmanna, Tinniberg RH, Georgib VR. Use of alternative therapies and birthing methods in departments of obstetrics in Germany. Available from URL: http://www.ncbi.nlm.nih.gov/pubme; 2009 April 16. 9. Meyer SL, Weible CM, Woeber K. Perceptions and practice of water birth: a survey of Georgia midwives. J Midwifery Womens Health. 2010;55(1):55e59. JaneFeb. 10. Water Birth. American Pregnancy Association. Available from URL: http:/www.americanpregnancy.org/labornbirth/ waterbirth.html. 11. Da Silva FM, de Oliveira SM, Nobre MR. A randomised controlled trial evaluating the effect of immersion bath on labour pain. Midwifery. 2009 Jun;25(3):286e294. Pub 2007 Jul 25. 12. Thomas Sara. Effectiveness of PTP on Normal Vaginal Delivery in a Selected Rural Area in Udupi. unpublished MSc thesis. Bangalore: RGUHS; 2008. a p o l l o m e d i c i n e 1 1 ( 2 0 1 4 ) 8 4 e8 7 87
  • Apollohospitals:http://www.apollohospitals.com/ Twitter:https://twitter.com/HospitalsApollo Youtube:http://www.youtube.com/apollohospitalsindia Facebook:http://www.facebook.com/TheApolloHospitals Slideshare:http://www.slideshare.net/Apollo_Hospitals Linkedin:http://www.linkedin.com/company/apollo-hospitals Blog:Blog:http://www.letstalkhealth.in/