Jerlin Shiny, D (2014) Effectiveness of selected nursing intervention on the level of pain, anxiety and quantity while expressing breast milk among mothers of hospitalized neonate in selected hospitals, Chennai. Masters thesis, Omayal Achi College of Nursing, Chennai.
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Abstract
INTRODUCTION: Expressing breast milk enables a woman to feed her baby with the substance which provides optimal nutrition at same rate as in breast milk even though she is separated from the baby. Expressing breast milk refers to the act of expressing the milk from the breast by manually or using breast pump. Expressing breast milk may be difficult and disheartening experience faced by the mother but still expression of breast milk often need to be sustained over a prolonged period of time till the new born is in neonatal units. It becomes increasingly hard for the mother to sustain milk production in the absence of direct feeding from the breast, often resulting in poor weight gain and growth of newborn. Mother’s motivation towards expressing breast milk in neonatal units is lacking because of maternal stress, stressful environment and the lack of skills in expressing milk for their vulnerable neonate which result in inconsistent and ineffective care. OBJECTIVE: To assess the effectiveness of selected nursing intervention on the level of pain, anxiety and quantity while expressing breast milk among mothers of hospitalized neonate. METHODOLOGY: Research Design: Quasi experimental non equivalent control group design. Variables: Independent variable: The Independent variable is selected nursing intervention. Dependent variable: Level of pain, anxiety and quantity while expressing breast milk among mothers of hospitalized neonates. Setting: Kanchi Kamakoti child Trust Hospital, Nungambakam and Sundaram Medical Foundation, Anna nagar. Population: Target population - Mothers of hospitalized neonate on expressed breast milk. Accessible population - Mothers of hospitalized neonate on expressed breast milk at Kanchi Kamakoti Child Trust Hospital and Sundaram Medical Foundation. Sampling: The mothers of hospitalized neonate on expressed breast milk who fulfills the inclusion criteria were selected by using purposive sampling technique. Intervention: The selected nursing intervention included A) Warm compress: Warm compress was given before expressing breast milk. A kettle of water at temperature of 104oF was poured into the bowl. 1. First step- clean the nipple with wet gauze piece to remove the crust over the nipple. 2. The next step- dip and squeeze the sponge cloth, place it over the breast such that it covers the whole breast for 3to5 minutes. Warm compress was to reduce pain and improve the quantity of milk expressed. B) Video assisted teaching on breast massage followed by demonstration of Breast massage for 1minute to each breast before expressing breast milk. 1. First step - support the breast with one hand and with another hand massage the areola by providing a soft and smooth circular motion with middle and index fingers. 2. Second step- gently massage the breast using pad of fingers with kneading-like motion [lifting and pressing movement] in clockwise direction and then in anti-clockwise direction. Breast massage is to increase blood supply to lymphatic vessels and milk ejection reflex. C) Visual stimulation technique: Mother was made to wash hand, wear a sterile gown and sit in front of their neonate’s incubator and express breast milk until the full breast is emptied by seeing their neonate, as presence of newborn induces milk let down reflex. Measurement and tool: The pre and post test level of pain, anxiety and quantity while expressing breast milk was assessed using numerical rating scale, modified Hamilton anxiety scale and Calibrated container with the capacity of 125 ml respectively. RESULTS: The findings of the study revealed that the overall pre and post test level of pain, anxiety and quantity while expressing breast milk in experimental group was that 15(50%) had moderate level of pain in pretest and 15(50%) of them had mild pain in post test;18 (60%) had severe anxiety in pretest and 16 (53.33%) of them had mild anxiety in post test; 25(83.33%) mothers expressed 1to 10 ml of breast milk in pretest and 21 (70%) of them expressed 21 to 30 ml of breast milk in post test. The unpaired ‘t’ test value of pain, anxiety and quantity while expressing breast milk among mothers of hospitalized neonate between experimental and control group was compared and it was t= 8.250, t=6.455 and t= 11.947 respectively, which was significant at p<0.001 level in experimental group. The correlation of post test level of pain and anxiety with quantity of expressed breast milk showed (r=-0.802 and r=-0.564) a moderate negative correlation at p<0.01 level. The result showed that the selected nursing intervention had significant effect in reducing the level of pain, anxiety and improving the quantity while expressing breast milk. DISCUSSION: There was a significant reduction in the level of pain, anxiety and improvement in the level of quantity while expressing breast milk in the post test after administration of selected nursing intervention. Thus the selected nursing intervention which included warm compress, video- assisted teaching on breast massage followed by demonstration of breast massage, visual stimulation technique was effective in minimizing the pain, anxiety and improve the quantity while expressing breast milk among mothers of hospitalized neonate. IMPLICATIONS: The midwives have a vital role to work with lactating mothers to build their confidence, knowledge, understanding and decision-making in relation to their feeding choices. The research based practice is a hall mark of professional nursing. The nursing intervention was implemented to the mothers of hospitalized neonate while expressing breast milk and to maintain lactation and meet the demand of newborn in NICU in KKCTH and SMF.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | selected nursing intervention ; pain ; anxiety ; quantity of expressed breast milk ; warm compress ; breast massage ; visual stimulation technique. |
| Subjects: | NURSING > Obstetrics and Gynaecology Nursing |
| Depositing User: | Ravindran C |
| Date Deposited: | 09 Oct 2017 06:14 |
| Last Modified: | 22 Dec 2018 07:35 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/3651 |
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