INTRODUCTION:

The mother is the all kind of calamities. The act of giving birth is the only moment when both pain and pleasure converge in a moment of time. This is a miracle .Before the childbirth, the lady was a women. After the child birth, the women transformed into a mother. this is a revoluntary act, an evolutionary happening: in the manner of the silkworm getting transformed into some winged angel: this is also a miracle.

NEED FOR THE STUDY:

Labour is a natural process by which a viable fetus, at the end of 28 weeks or more is expelled from the uterus. This is mainly manifested as cramping in the abdomen, groin and back, as well as a tired, achy feeling all over the body.

Some women experience pain in their sides or thighs as well. Other causes of pain during labour include pressure on the bladder and bowels by the head and stetching of the birth canal and vagina. Pain is always present in primigravida mothers. To ease the pain and to improve the behavioural response of the mother’s pharmacological and non pharmacological management are important. Pharmacological approaches are directed at eliminating the physical sensation of lobour pain. Non pharmacological approaches such as relaxation, breathing technicques, positioning, massage, hytrotheraphy, hot and cold theraphy, music guided imaginary, ect. It enhances the comfort of women and helps them to achieve an effevtive coping level for their labour experience without any maternal and fetal complications.

Maternal stress during pregnancy is associated with in- Creased occurrences of preterm birth, developmental de- Lays, low birth weight, birth defects, and an increased Risk for neurological and behavioral developmental im- Pairments in the offspring. However, much less is known About the effects of such stress in mothers. The adult rat Model is mirroring the human condition: cognitive im- Pairments¹, altered sexual behavior², increased Anxiety levels³, and symptoms akin to depression⁴. Researchers of prenatal stress have generally confined Themselves to only one aspect of stress or anxiety, such As the effects of life events, work load, or general stress Which was evaluated by using self-administered inventories. Physiologic and hormonal responses to stress in Pregnancy or the pregnancy-specific anxieties have been Sporadically investigated to date^5,6. On the other hand, lots of data have been reported on the pregnancy-associated oxidative stress. Oxidative stress is enhanced by smoking and alcohol⁷, pregnancy-induced hypertension ^8,9 and gestational diabetes mellitus¹⁰.

Biopyrrin (bpn) is an oxidative degradation product of Bilirubin and is generated under various stresses such as Infection, ischemia, and surgery. Stress converts oxygen To activated form of oxygen, which induces hemoxidase Activity, a rate-regulating enzyme of bilirubin. Hemoxi- Dase degrades heme to increase bilirubin production. Bilirubin acts as an active oxygen scavenger [antioxidant] And generates bpn. Stocker¹¹ et al. Reported the anti- Oxidant activity of bilirubin, and shimizu¹² et al. Pre- Pared the anti-bilirubin antibody 24g7. An unknown Substance that binds to this antibody 24g7 was found to Increase in the urine of patients undergoing abdominal Surgery. This substance, an oxidative metabolic product of bilirubin, was designated as biopyrrin. Seven isomers of bpn from x1 to x7 have been confirmed, and their 2 Molecular structures have been identified. Since 24g7 Antibody cross-reacts with conjugated bilirubin, the plasma Level of bpn could not be measured independently. In This study, urinary bpn was as

1. To assess the post test level of the pain among primigravida mothers in Experimental group and control group.

2. To assess the post test level of the comfort among primigravida mothers in Experimental group and control group.

3. To Compare the post test level of the pain between experimental and control group.

4. To Compare the post test of the level of Comfort between experimental and control group.

5. To correlate the level of pain with the level of comfort in both the groups.

6. To associate the level of pain with the selected demographic variables in experimental and control group.

7. To associate the level of Comfort with the selected demographic variables in experimental and control group.

HYPOTHESIS:

NH1- There will be no significant difference in the post test level of pain among the primigravida mothers between Experimental and control group at p<0.05 level. NH2- There will be no significant difference in the post test level of comfort among the primigravida mothers between Experimental and control group at p<0.05 level. NH3- There will be no significant relationship between the level of pain and the level of comfort in Experimental and control group at p<0.05 level. NH4- There will be no significant association in the post test level of pain with the selected demographic variables in Experimental and control group at p<0.05 level. NH5- There will be no significant association in the post test level of comfort with the selected demographic variables in Experimental and control group at p<0.05 level.

CONCEPTUAL FRAMEWORK:

Conceptual framework of study is based on Wiedenbach’s helping art clinical theory. Its consists of identification of need, ministration of need, validation of need.

ASSUMPTION:

1. Primigravida mothers in first stage of labour may have severe pain and discomfort during uterine contractions.

2. Sophrology may reduce the level of pain in the primigravida mothers.

DELIMITATION:

This study is delimited to our weeks only.

METHOLOGY:

Research Approach:

The research approach used in this study was quantitative research approach.

Research Design:

The research design adapted for the study is post test only design.

Variables of the Study:

Independent Variable:

The independent variables for the study was sophrology which includes breathing exercise, relaxation techniques and visualization of labour process.

Dependent Variable:

The dependent variables for the study were level of pain and level of comfort.

Setting of the study:

The study will be conducted in Kumaran hospital, polur.

Population:

The population comprises of primigravida mothers during first stage of labour admitted in selected hospital at Tiruvannamalai.

Target Population:

All Primigravida mother who are in first stage of labour.

Accessible Population:

Primigravida mothers who are in first stage of labour in Kumaran hospital, polur.

Sample:

Primigravida mothers who are in first stage of labour admitted in Kumaran hospital who full fill the sample criteria.

Criteria for Sample Selection:

1. Inclusive Criteria:

Primigravida mothers:

· Who is in first stage of normal labour.

· Who are willing to participate in the study

· Who are in cervix dilatation above 4cm - 8cm

· Who are able to communicate in Tamil, and English.

2 Exclusive Criteria:

Primigravida mothers:

· Who are at high risk pregnancy like hypertension, diabetes, multiple pregnancy.

· Who have fetal distress/fetal anomaly.

· Who have prolonged and precipitated labour.

Sample Size:

60 primigravida mothers (30 in experimental group and 30 in the Control group).

Sampling Technique:

Sample refer to a subject of a population selected in a research study. In the present study, the sample are 60 who are under first stage of labour admitted in Kumaran hospital during the period of data collection. In this study, simple random sampling techniques by using lottery method was adopted to select the primi mothers who met the sampling criteria.

Simple random sampling procedure was employed to select the study participants. There were pieces of paper that written E and C, the word E was used to represent the experimental group, and C was used to represent the control group. Once the piece was chosen, it was not included in the sample again and each participant was allowed to pick only once.

Development and Description of the Tool:

An instrument in research refers to the tool or equipment used for data collection. It may take the form of observation check list, questionnaires an interview schedule, a projective desire or some other type of tool for eliciting information. The investigator may use an instrument that has been developed or designed as an original tool or she may take parts of one or more instruments from which she develops a new one.The tool used for the present study, was numerical pain intensity scale and comfort scale.

It constructed in this study has two parts

SECTION - A:

Demographic Variables

Structure interview schedule to assess the demographic variables such as age, educational status, Work pattern, income of the family, type of family, type of physical activity, leisure activity, gestational week.

SECTION B:

Numerical Pain Intensity Scale:

The Numerical Pain Intensity Scale comprises of 0-10 rating where 0 indicate no pain and 10 indicate worst imaginable pain.

Scoring Key:

1- No pain

1-3 Mild pain

3-7 Moderate pain

7-10 Severe pain

SECTION C:

Comfort scale:

Assess the level of comfort by using four point Likert’s scale. The comfort scale is developed by investigator. This description categorized Discomfort, Mild comfort, Moderate comfort, Comfort.

Scoring Key:

· 0-20 Discomfort

· 21-40 Mild comfort

· 41-60 Moderate comfort

· 61-80 Comfort

RESULTS:

On analysis, in experimental group, majority 17(57%) had moderate pain and the remaining 13(43%) had mild pain. In control group, majority 19(63%) had severe pain and the remaining 11(37%) had moderate. on analysis, in experimental group, majority 10(33%) had mild comfort and 18(60%) had moderate comfort and the remaining 2 (7) had moderate comfort. In control group, majority 20(67%) had discomfort, 7(23%) had moderate comfort and the remaining 3(10%) had mild comfort.

On analysis, the post test mean value of pain was 2.9 with S.D 2.3 in experimental group. The posttest means value of pain was 3.6 with S.D 1.2 in control group. The calculated unpaired t values is t = 2.13 was found statically significant p< 0.01 level.

On analysis, the post test mean value of comfort was 62 with S.D 5.04 in experimental group. The posttest means value of comfort was 24 with S.D 15.12 in control group. The calculated unpaired t values is t = 6.37 was found statically significant p< 0.01 level.

In experimental group, the post test level of pain mean score was 2.9 with S.D 2.3 and the posttest level of comfort mean value was 62 with S.D 5.04 which shows that when the value of pain level decreases then the value of comfort level increases. The calculated karl person’s correlation value of r= -0.33 show a negative correlation which was found to be statistically significant at p<0.005 level.

In control group, the post test level of pain mean score was 3.6 with S.D 1.2 and the posttest level of comfort mean value was 24 with S.D 15.13 which shows that when the value of pain level increases then the value of comfort level decreases. The calculated karl person’s correlation value of r=-0.12 show a negative correlation which was found to be statistically significant at p<0.005 level.

CONCLUSION:

The sophrology techniques an intervention was given to the primigravida mothers in experimental group which showed a significant reduction in the posttest level of pain and promoting the comfort than the control group. It can be concluded that the sophrology techniques is a cost effective, non –invasive and non pharmacological method in the management of pain among primigravida mothers during first stage of labour. Hence the nurse midwifes can practice this techniques in alleviating the labour pain and promotes comfort.

REFERENCES:

1. Basbarm. H, Fields, (1984). Endorphin Medical Analgesia System, Text Book of Pain Management (2^ndedition). Edinburgh Churchill Livingstone.

2. Bernath. T, et. al (2002) Deparment of Obstetrics and Gynecology, brazil, Elesvier Publication.

3. http://www.livestrong.com

4. http://www.planababy.com

5. http://www.rcog.org.uk

6. httt://www.spinningbaby.com

Received on 30.10.2020 Modified on 03.12.2020

Asian J. Nursing Education and Research. 2021; 11(2):205-208.

DOI: 10.5958/2349-2996.2021.00049.5