Document Type : Research articles

Authors

1 Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia & Ministry of Health Malaysia Training Institute Sungai Buloh, Selangor, Malaysia

2 Associate Professor, Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

3 Department of Nursing Science, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

4 Consultant Gynecology and Gynea Oncologist, Ramsay Sime Darby Health Care, Subang Jaya, Selangor, Malaysia

5 Faculty of Business and Management, UCSI University, Cheras, Kuala Lumpur, Malaysia

6 Computing Department, School of Computing & Creative Media, UOW Malaysia KDU University College, Jalan Kontraktor, Seksyen U1, Shah Alam, Selangor, Malaysia

7 Nursing ad Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Poor self-perineal care (SPC) by new mothers due to inadequate knowledge can result in perineal pain and poor wound healing outcome.
Objectives: This study aimed to evaluate the effectiveness of self-perineal care education on knowledge and practice among primigravida mothers in Malaysia.
Methods: This quasi-experimental study was conducted in two public tertiary care hospitals from September 2019 to March 2020. In total, 125 mothers were recruited using consecutive sampling procedures from two tertiary care hospitals. The intervention group consisted of 62 mothers who received SPC education supplemented by the mobile app, while the other 63 mothers in the control group received only routine hospital care. The knowledge of mothers regarding SPC was assessed at 32 to 33 weeks of gestation and then at 4 h post-delivery. The mothers of both groups reported their perineal care practices on Day 1, Day 3, Day 5, and Day 7 post-childbirth using the SPC education mobile app.
Results: There was no significant difference in the SPC knowledge scores between the two groups at baseline (P=0.155). Post-analysis showed a significant increase in the SPC knowledge score in the intervention group (P<0.001) but not in the control group (P=0.133). At all-time points, the mothers in the intervention group performed better SPC practice than those in the control group (P<0.001). There were significant associations between changes in knowledge and practice on all four days (P<0.001).
Conclusion: The increased knowledge of SPC was significantly associated with improved SPC practice among the primipara mothers postnatally.

Keywords

  1. Jones K, Webb S, Manresa M, Hodgetts-Morton V, Morris RK. The incidence of wound infection and dehiscence following childbirth-related perineal trauma: A systematic review of the evidence. Eur J Obstet Gynecol Reprod Biol. 2019;240:1-8. doi: 10.1016/j.ejogrb.2019.05.038. [PubMed: 31202973].
  2. Pillitteri A. Maternal & child health nursing: Care of the childbearing & childrearing family. Lippincott Williams & Wilkins; 2010.
  3. Missiriya S. Knowledge and practice of postnatal mothers regarding personal hygiene and newborn care. Int J Pharm Sci. 2016;40(1):89-93.
  4. Mankar S, Manmode N, Meghe S, Meshram A, Sakle P. To evaluate the effectiveness of self instructional module regarding perineal care among primipara postnatal mothers. JPRI. 2021;33(59B)587-95. doi: 10.9734/jpri/2021/v33i59B34418.
  5. Mathews S. To assess the effect of the structured teaching program, regarding perineal care among primipara mothers in postnatal ward in selected hospitals in Maharashtra, 2019.
  6. Wiseman O, Rafferty AM, Stockley J, Murrells T, Bick D. Infection and wound breakdown in spontaneous second‐degree perineal tears: An exploratory mixed methods study. Birth. 2019;46(1):80-9. doi: 10.1111/birt.12389. [PubMed: 30136338].
  7. Steen M, Cummins B. How to alleviate perineal pain following an episiotomy. Nurs Stand. 2016;30(31):34-7. doi: 10.7748/ns.30.31.34.s43. [PubMed: 27027195].
  8. Joseph T, Jose TT, Titus T, Joseph T, Suthan T, Suman V, et al. Knowledge on practice of self perineal care among postnatal mothers in a selected hospital at mangaluru with a view to develop information booklet. IJPHRD. 2020;11(4).
  9. Gadade MM, Sujit MD, Philip MM, Priyanka MJ, Chavan MA. A study to assess the knowledge regarding perineal care among the post natal mothers in selected hospitals of Pune city. J Med Sci Clin Res. 2018;6(1):32517-22. doi: 10.18535/jmscr/v6i1.174.
  10. Mohamed HA, El-Nagger NS. Effect of self perineal care instructions on episiotomy pain and wound healing of postpartum women. J am Sci. 2012;8(6):640-50.
  11. Limbachiya N, Parmar N. Evaluate the Effectiveness of perineal care on episiotomy pain and wound healing among postpartum women. J Pharm Negat Results. 2022:509-18. doi: 10.47750/pnr.2022.13.S06.070.
  12. Amsalu G, Talie A, Gezimu W, Duguma A. Non-utilization of postnatal care and its associated factors among women who gave birth in rural districts of Northern Ethiopia: A community-based mixed-method study. Womens Health (Lond). 2022;18:17455057221125091. doi: 10.1177/17455057221125091. [PubMed: 36113137].
  13. Salunkhe J, Katti A. Assessment of knowledge regarding perineal care among postnatal mothers. The Pharma Innovation. 2015;4(9): 94-6.
  14. Salgaonkar RP. Effect of planned health teaching on knowledge of perineal care among postnatal mothers admitted in postnatal unit of selected hospitals pune city. IJNS. 2020;5:130-8. doi: 10.31690/ijns.2020.v05i02.002.
  15. Praveen S, Priya JP, Gomathi B. Effectiveness of structured teaching programme on knowledge of practice regarding perineal care among primi mothers. Int J Med Sci Public Health. 2018;7(4):301-4. doi: 10.5455/ijmsph.2018.0102102022018.
  16. Gadiya P, Koshy S, Ravindra HN. Effectiveness of planed teaching programme on episiotomy care. J. Nurs Health Sci. 2014;3(6):31-2.
  17. Lazarus LM, Chong MC, Ramoo V, Adenan NA, Chinna K, Li LF, et al. The effects of structured self-perineal care education on episiotomy pain score and wound healing outcome among primigravida mothers in Malaysia urban area. IRCMJ. 2022;24(10). doi: 10.32592/ircmj.2022.24.10.2130.
  18. Farrag R, Eswi A, Badran H. Effect of postnatal kegel exercises on episiotomy pain and wound healing among primiparous women. IOSR-JNHS. 2016;5(3):24-31.
  19. Raman S. Effectiveness of self perineal care and aseptic perineal care towards healing of episiotomy wounds among postnatal mothers. Int J Curr Res Aca Rev. 2015;3(8):359-66.
  20. Ari ES, Sotunsa JO, Leslie T, Inuwa Ari S, Kumzhi P. Impact of an educational intervention on postpartum perineal wound care among antenatal mothers in Jos: A quasi-experimental study. Clin Pract. 2019;16(6):1409-22. doi: 10.4172/clinical-practice.1000409.
  21. Sarona G, James S, Anil J, Joseph SP. A Study to assess the knowledge and perineal self-care practices on episiotomy wound among primiparous women. IJONC. 2023;11(1):42-4. doi: 10.37506/ijonc.v11i1.18931.
  22. Oleiwi S. Effectiveness of instruction-oriented intervention for primipara women upon episiotomy and self-perineal care at ibn Al-Baladi Hospital. Iraqi Sci J Nursing. 2010;23(1):8-17. doi: 10.58897/injns.v23i1.66.
  23. Calvillo-Gãmez EH, Grimaldo-Martinez AI, Gonzãlez VM, Contreras RL. Pamphlet vs. mobile: Sensemaking of health information. Proceedings of the 10th Brazilian Symposium on Human Factors in Computing Systems and the 5th Latin American Conference on Human-Computer Interaction; 2011.
  24. Şat SÖ, Sözbir ŞY. Use of mobile applications and blogs by pregnant women in Turkey and the impact on adaptation to pregnancy. Midwifery. 2018;62:273-7. doi: 10.1016/j.midw.2018.04.001. [PubMed: 29738988].
  25. Ledford CJ, Canzona MR, Cafferty LA, Hodge JA. Mobile application as a prenatal education and engagement tool: a randomized controlled pilot. Patient Educ Couns. 2016;99(4):578-82. doi: 10.1016/j.pec.2015.11.006. [PubMed: 26610389].
  26. El-Lassy RB, Madian AA. The effect of infrared lamp therapy on episiotomy wound restorative besides pain relief among post-partum women. JNEP. 2019;9(2):20-30. doi: 10.5430/jnep.v9n2p20.
  27. Zaki NH, L-Habashy MME, Aziz NIA, Elkhatib HM. Effect of Perineal Self Instructions on Episiotomy Pain and Healing Among Post Partum Women. IJNRHN. 2019;6(3):789-802.
  28. Louis Shanthi R. Effectiveness of Self Perineal Care Practices on Episiotomy Wound among the Primi Postnatal Mothers at Selected Maternity Hospital, Trichy (Doctoral dissertation, Dr G.Sakunthala College of Nursing, Trichy.
  29. Rahayu YP, Saputri R, Rahmadaniah N. Analysis of knowledge and attitudes on perineal wound healing in postpartum mother in the area of pekauman public health center in south banjarmasin. In2nd Sari Mulia International Conference on Health and Sciences 2017 (SMICHS 2017)–One Health to Address the Problem of Tropical Infectious Diseases in Indonesia; 2017.
  30. Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. J Med Internet Res. 2012;14(5):e128. doi: 10.2196/jmir.1994. [PubMed: 23017375].
  31. Malli P, Ergin AB. The Effect of Mobile Application Support for Postpartum Women on Postpartum Quality of Life. Clin Exp Health Sci. 2021;11(2):242-50. doi: 10.33808/clinexphealthsci.731557.