Lilly Mary, G.P Lazarus (2023) The effect of self-perineal care education on knowledge, episiotomy pain and wound healing among primipara mothers / Lilly Mary G.P Lazarus. PhD thesis, Universiti Malaya.
Abstract
A nurse-midwife ensures all mothers receive the best care to be safe and healthy throughout pregnancy and childbirth. However, it is challenging for midwives to provide holistic nursing care as postpartum mothers spend only a brief period in the postnatal ward due to the high demand for the facilities there. The primary objective of this study was to investigate the effect of self-perineal care education (SPC education) on knowledge, episiotomy pain, and wound healing outcomes among primipara mothers and explore their opinions regarding self-perineal care education and their challenges and practices at home. Mixed-methods research using the embedded design was conducted to address the research questions. A quasi-experimental study with a non-equivalent control group pre-test and post-test design was employed, supported by a qualitative study. A total of 130 primipara mothers were selected using consecutive sampling and were placed into the intervention group (n=65) and the control group (n=65). The structured self-perineal care education was given in two phases during the antenatal and postnatal periods. Self- perineal care knowledge was assessed using 16 multiple-choice questions with a single response. The Numerical Pain Rating Scale (NPRS) was used to record pain scores, and the REEDA scale (Red, Oedema, Ecchymosis, Discharge, Approximation) was used to assess wound healing outcomes. As for the qualitative, a face-to-face, in-depth interview session was done. Structured questions were asked to 12 primipara mothers from the intervention group to explore their self-perineal care practice and the challenges they faced at home. This interview was carried out six weeks post-delivery follow-up in Maternal Child Health Clinic. The findings showed no significant difference in the SPC knowledge iv scores between the two groups at baseline (p=.155). Post-analysis, there was a significant increase in the SPC knowledge score in the intervention (p < .001) but not in the control group (p= .133). There was no significant association between the primipara mothers� demographical variables and the change in their knowledge score in the intervention group. The overall pain score and REEDA score were significantly lower in the intervention group than in the control group for the first seven days post-delivery, with a p-value < .001 except for 4 hours of baseline observation. For each activity associated with daily living, the scores were lower in the intervention group for the seven days post- delivery. Two main themes emerged from the study: "perceived benefit� and �challenges of self-perineal care.� Seven sub-themes identified from the main themes such as �self- awareness,� �boosted confidence level,� �self-empowerment, �enhancement of wound healing,� �lack of family support, �and �lack of knowledge and resources in using mobile applications,� and �traditional beliefs.� The primipara mothers perceived the benefit of self-perineal care education during antenatal as increasing their knowledge and improving their practice. However, some barriers to good practice persisted. These should be anticipated in the future to facilitate self-perineal care education in the clinical setting and to improve outcomes. Using a mobile application to provide accurate, reliable, consistent information and to allow self-reporting on pain scores and wound healing outcomes empowers women to take responsibility for their own health.
Actions (For repository staff only : Login required)
![[img]](http://studentsrepo.um.edu.my/style/images/fileicons/application_pdf.png)
