The Effects of Structured Self-Perineal Care Education on Episiotomy Pain Score and Wound Healing Outcome among Primigravida Mothers in Malaysia Urban Area

Keywords

Episiotomy pain score
Primigravida mothers
Self-perineal care education
Wound healing

Categories

How to Cite

Lazarus, L. M. ., Chong , M. C., Ramoo, V. ., Bin Mat Adenan, N. A. ., Chinna, K. ., Li , L. F. ., & Mohajer, S. (2022). The Effects of Structured Self-Perineal Care Education on Episiotomy Pain Score and Wound Healing Outcome among Primigravida Mothers in Malaysia Urban Area. Iranian Red Crescent Medical Journal, 24(10). https://doi.org/10.32592/ircmj.2022.24.10.2130

Abstract

Background: Pain and wound dehiscence cause physical and emotional traumas, impacting the mothers' quality of life, mental health, and maternal-child bonding.

Objectives: The present study aimed to examine the effect of self-perineal care (SPC) education on episiotomy pain scores and wound healing outcomes.

Methods: A quasi-experimental design was used in this study. In the third trimester, 125 primigravida mothers attended the antenatal clinic and were assigned to a SPC education group (n=62) and a control group (n=63). The intervention group received two phases of SPC education apart from the study hospital’s routine care, and the mothers in the control group received only routine care. The primigravida mothers in the treatment group were provided SPC education content on their smartphones using the “SPCE” mobile application. Mothers in both groups self-reported their episiotomy pain score and wound healing outcome over 7 days post-childbirth using this mobile application.

Results: The overall pain and REEDA scores (redness, oedema, ecchymosis, discharge, approximation) were significantly lower in the intervention group than in the control group for the first 7-days post-delivery with P < 0.001 except for 4 h of baseline observation. For each activity of daily living, the scores were lower in the intervention group for the 7 days post-delivery.

Conclusion: Self-perineal care education positively reduced episiotomy pain scores and enhanced wound healing outcomes. This study empowered the primigravida mothers to take responsibility for their health by involving in a self-care education program.

https://doi.org/10.32592/ircmj.2022.24.10.2130

References

Selvadurai T, Tan C, Tan C, Karalasingam S, Jegasothy R. Selective episiotomy as a practice in Malaysia and rate of third and fourth degree perineal tear; 2010.

Pillitteri A. Maternal & child health nursing: Care of the childbearing & childrearing family. Lippincott Williams & Wilkins; 2010.

Shaban IA, Al-Awamreh K, Mohammad K, Gharahbei H. Postnatal women’s perspectives on the feasibility of introducing post-partum home visits: a Jordanian study.

Home Health Care Serv Q. 2018;247(3):247-58. doi: 10.1080/01621424.2018.1454865. [PubMed: 29558322].

Gadade M, Sujit D, Philip M, Priyanka J, Chavan A. 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.

Sat SO, Sozbir 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].

Ledford CJ, Canzona MR, Cafferty LA, Hodge JA. Mobile application as a antenatal education and engagement tool: a randomized controlled pilot. Patient Educ Couns. 2016;99(4):578-82. doi: 1016 /j.pec.2015.11.006. [PubMed: 26610389].

Kang H. Sample size determination and power analysis using the G* Power software. J Educ Eval Health Prof. 2021;18:1-12. doi: 10.3352/jeehp.2021.18.17. [PubMed: 34325496].

Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. doi: 10.1002/nur.20147. [PubMed: 16977646].

Hill PD. Psychometric properties of the REEDA. J Nurse Midwifery. 1990;35(3):162-5. doi: 10.1016/0091-2182(90)

-3. [PubMed: 2366098].

McCaffery M, Beebe A. The numeric pain rating scale instructions. pain: clinic manual for nursing practice. St. Louis: Mosby; 1989.

Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. 2005;

(1):9-19. doi : 10.1016/j.pain.2004.09.012. [PubMed: 15621359].

Navarro-Prado S, Sánchez-Ojeda MA, Martín-Salvador A, Luque-Vara T, Fernández-Gómez E, Caro-Morán E. Development and Validation of a Rating Scale of Pain Expression during Childbirth (ESVADOPA). Int J Environ Res Public Health. 2020;17(16):1-14. doi: 10.3390/ijerph17165826. [PubMed: 32806536].

Davidson N. REEDA: evaluating post-partum healing. J Nurse Midwifery. 1974;19(2):6-8. [PubMed: 17338109].

Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe

vera gel and cesarean wound healing; a randomized controlled clinical trial. Glob J Health Sci. 2015;7(1):203-9. Doi: 10.5539/gjhs.v7n1p203. [PubMed: 25560349].

Zaki NH, L-Habashy MME, Aziz NIA, Elkhatib HM. Effect of perineal self care instructions on episiotomy pain and healing among post-partum women. Int J Novel Res Healthc Nurs. 2019;6(3):789-802.

Dube J. Effect of application of ice on episiotomy. AJNER. 2013;3(4):207-10.

Francisco AA, Kinjo MH, Bosco Cde S, Silva RL, Mendes Ede P, Oliveira SM. Association between perineal trauma and pain in primiparous women. Rev Esc Enferm USP. 2014;48:39-44. doi: 10.1590/S0080-623420140000600006. [PubMed: 25517833]

Mohamed H, El-Nagger NS. Effect of self perineal care instructions on episiotomy pain and wound healing of post-partum women. Am J Sci. 2012;8(6):640-50.

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 doi: 10.9790/1959-0503032431.

Kaur P, Sagar N, Deol R, Kaur J. Effectiveness of infra-red therapy upon level of episiotomy pain and wound healing among postnatal mothers. IEAB. 2015;8(2):2184.

Khosla P. Effect of sitz bath on episiotomy wound healing and level of pain among post natal mothers. IJANM. 2017;5(3):227-30. doi: 10.5958/2454-2652.2017.00048.8.

Mathews MSM. To assess the effect of the structured teaching program regarding perineal care among primipara mothers. Int J Med Sci Public Health. 2018;4:301-4.

Padmavathi P. A study to assess the effectiveness of planned teaching module on practice of episiotomy care among post natal mothers with episiotomy in selected hospital at salem. AJNER. 2011;1(3):76-8.

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;1(23):8-17.

Raman S. Effectiveness of self perineal care and aseptic perineal care towards healing episiotomy wounds among postnatal mothers. Int J Curr Res Acad Rev. 2015;3(8):359-66.

Rabea A, Sajidah 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(2):1-12.

Ari ES, Sotunsa JO, Leslie T, Inuwa Ari S, Kumzhi P.

Impact of an educational intervention on post-partum perineal wound care among antenatal mothers in Jos: A quasi-experimental study. Clin Pract. 2019;16(6):1409-22. doi: 10.37532/fmcp.2019.16(6).1409-1422.

Mohamed H, El-Ngger N, Lamadah SM. Women’perspectives regarding the quality of post-partum nursing care in Ain Shams Maternity Hospital–Cairo, Egypt. Am J Sci. 2012;8(2):366-77.

Moudi Z, Edozahi M, Emami SA, Asili J, Pour MS. Effects of mastic oleoresin on wound healing and episiotomy pain: A mixed-methods study. J Ethnopharmacol. 2018;214:225-31. doi: 10.1016/j.jep.2017.12.028.

Dorai AA. Wound care with traditional, complementary, and alternative medicine. Indian J Plast Surg. 2012;45(02):418-24. doi: 10.4103/0970-0358.101331 [PubMed: 23162243].

Eghdampour F, Haseli A, Kalhor M, Naghizadeh S. The impact of aloe vera on episiotomy pain and wound healing in primiparous women. Adv Environ Biol. 2014;1:552-8.

Maver T, Maver U, Stana Kleinschek K, Smrke DM, Kreft S. A review of herbal medicines in wound healing. Int J Dermatol. 2015;54(7):740-51. doi: 10.1111/ijd.12766.