A STUDY TO ASSESS THE EFFECTIVENESS OF REVERSE PRESSURE

SOFTENING TECHNIQUE ON BREAST ENGORGEMENT AMONG

PRIMI POSTNATAL MOTHERS IN SELECTED

HOSPITAL AT COIMBATORE.

BY
R. NIVEDHA
REG NO: 300322503501
A DISSERTATION SUBMITTED TO THE TAMILNADU DR. M.G.R MEDICAL UNIVERSITY,
CHENNAI IN PARTIAL FULFILLMENT FOR THE DEGREE OF MASTER OF SCIENCE IN
NURSIG.

i
 A DISSERTATION SUBMITTED TO THE TAMILNADU DR.M.G.R MEDICAL
UNIVERSITY,CHENNAI IN PARTIAL FULFILMENT FOR THE DEGEREE OF
MASTER OF SCIENCE IN NURSING.

FEBRUARY 2024

A COMPARATIVE STUDY TO ASSESS THE EFFECTIVENESS OF INFRARED

THERAPY VERSUS SITZ BATH ON EPISIOTOMY PAIN MANAGEMENT
AMONG NORMAL DELIVERY POSTNATAL MOTHERS IN SELECTED
HOSPITAL AT COIMBATORE.

ii
 BY

MRS.JAYAPRIYA.A

REG NO : 300321503501
A DISSERTATION SUBMITTED TO THE TAMILNADU DR.M.G.R MEDICAL
UNIVERSITY,CHENNAI IN PARTIAL FULFILMENT FOR THE DEGEREE OF
MASTER OF SCIENCE IN NURSING.
FEBRUARY,2024

iii
iv
A COMPARATIVE STUDY TO ASSESS THE EFFECTIVENESS OF INFRARED
THERAPY VERSUS SITZ BATH ON EPISIOTOMY PAIN MANAGEMENT AMONG
NORMAL DELIVERY POSTNATAL MOTHERS IN SELECTED HOSPITAL AT
COIMBATORE.

Approved by the Dissertation Committee on:………………..

RESEARCH ADVISER,

DR.MEENAKUMARI Msc(N),Ph.D

PRINCIPAL

CHERRAANS COLLEGE OF NURSING

COIMBATORE, TAMILNADU 641039.
RESEARCH GUIDE:
DR.MAHALAKSHMI, M.Sc (N), PH.D
PROFESSOR,
CHERRAAN‟S COLLEGE OF
NURSING,
COIMBATORE,TAMILNADU 641039.
RESEARCH AND SUBJECT GUIDE:
MRS.LINDSIE MARY. M.Sc (N),
PROFESSOR,
CHERRAAN’S COLLEGE OF NURSING,
COIMBATORE,TAMILNADU 641039

A DISSERTATION SUBMITTED TO THE TAMILNADU DR.M.G.R.MEDICAL

UNIVERSITY, CHENNAI IN PARTIAL FULFILMENT FOR THE DEGREE OF
MASTER OF SCIENCE IN NURSING.

FEBRUARY,2024

v
 DECLARATION

I hereby declare that the present dissertation titled “A COMPARATIVE STUDY TO

ASSESS THE EFFECTIVENESS OF INFRARED THERAPY VERSUS SITZ BATH ON
EPISIOTOMY PAIN MANAGEMENT AMONG NORMAL DELIVERY POSTNATAL
MOTHERS IN SELECTED HOSPITAL AT COIMBATORE”, outcome of the original
research work undertaken and carried out by me, under the guidance of Research guide
Mrs.Lindsie Mary, Professor,Cherraan’s college of Nursing and clinical speciality guide
Mrs.Daphine M.Sc(N),Professor, cherraan’s college of nursing.

I also declare that the material of this study has not found in anyway, the basis for the
award of any degree/diploma in this university or any other university.

BY
Mrs.Jayapriya.A
Reg No :
300321503501

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 ACKNOWLEDGEMENT

Greatest abuse of power is exercised in the name of service. Serving in love is the biblical
mandate not demanding service as in the caste hierarchy.

The journey from the basic search from statement up to this bound book is solitary .In a
project like this we require assistance ,encouragement and support from many .I am fortune to have
an abundance of all requisites at every step

I wish to acknowledge first, The lord almighty for his abundance blessings, willpower,
strength and health throughout the dissertation.

I thank our Chairman Mr.K.C.PALANISAMY (Agri.)., Ex. M.L.A. ,Ex.M.P.Cherraan’s

Group of Health Sciences, who has given a wonderful opportunity to complete my master degree
successfully in his well established institution.

I extend my sincere and heartful gratitude to my beloved Madam Dr.Meenakumari .N.

M.Sc(N),MPH,Ph.D(N),Principal ,Cherraan’s College of Nursing ,who motivated and inspired me
to enter into PG Course, without her help it could be impossible for me to complete my study
successful.

I would like to express my heartful gratitude to Dr.Mahalakshmi M.Sc (N).Ph.D.(N) Vice

Principal, Cherraan’s College of Nursing ,who made the completion of study easier by giving
valuable and precious ideas.

I express my heartful gratitude to one of the most important persons that was rememberable
in my research study the counselor and guide ,Mrs.Lindsie Mary,M.Sc.(N),HOD OBG for her
expert guidance ,create and valuable suggestions, corrections and advises to carry out this study and
my great privilege to have worked under her.

I express my special sense of gratitude and thanks to Mrs.Daphine, Professor for her support
and guidance during the study.
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 I extend my sincere gratitude and whole hearted thanks to Mrs.Dhanalakshmi, lecturer
Cherraan’s College Of Nursing, Coimbatore ,who helped me from beginning to the completion of
the study with her valuable suggestions and guidance.

Some flowers are meant to bloom for a reason while other blossom beautifully throughout
the years ,some people come and go in our life and friends are always with us every dear. I thank all
of my friends.

I extend my sincere thanks to Dr.Rubha ,Chief Medical Officer of Rubha medical Center
And Hospital and Dr.Balamurugan at Coimbatore for giving me the permission to conduct the
study.

My heartfelt thanks to all the experts who spent their valuable time in validating the
instrument and offered healthy suggestions.

My heartful thanks to all faculty members of Cherraan’s College of nursing for their full
support and prayer throughout the course of my study.

I would like to express my grateful and sincere acknowledgement librarian -------------

Cherraan’s Institute of health science Coimbatore, the support of during the study.

My sincere thanks to Mrs. Geetha ,Professor in English for doing the editorial work.

Words are beyond expressions to extend my heartful thanks to my Friends & colleagues
who act as a motivating factor right from the beginning of my course of my study.

Its pleasure to thank my beloved parent’s Mr. J.Ayyadurai and Mrs .Thangapushpam and
my husband Mr. Josam Darwin Joel For their love ,encouragement and valuable prayers in all the
way.

Thanks to all

INVESTIGATOR

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 INDEX-TABLE OF CONTENTS

CHAPTER CONTENT
PAGE NO

INTRODUCTION
20

Need for the Study 26

Statement of the problem 26
Objectives of the study 27
1
Hypothesis 27
Operational definitions 28
Assumptions 28
Delimitations 28
Projected outcomes 29
Conceptual Framework

II REVIEW OF LITERATURE 34

III RESEARCH METHODOLOGY 45

Research Approach 46
Research Design 46
Setting of the study 47
Population 47
Sample 48
Criteria for Selection of Sample 48
Inclusion criteria
Exclusion Criteria
Sampling Technique 48
Development of the Instrument
Scoring procedure 49
Validity and Reliability 49
Pilot study 50
Data Collection procedure 50
Plan For Data Analysis 51
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 Protection of human rights 51
DATA ANALYSIS AND
IV 56
INTERPRETATION
V DISCUSSION 78
84
SUMMARY AND RECOMMENDATION

Summary of the Study 84

Major Study Findings 86
VI
Conclusion 89
Implication of the Study 89
Limitations 90
Recommendations 91
BIBLIOGRAPHY 93
APPENDICES

LIST OF TABLES
TABLE TITLE PAGE NO
NO
1 Frequency and Percentage Distribution of postnatal 58
mothers according to their Demographic Variables
Experimental group 1 and 2.
2 Frequency and Percentage Distribution of Pretest and 66
post test Level of Pain Perception among Postnatal
Mothers in Experimental Group 1.

3 Frequency and Percentage Distribution of Pretest and 68

Post test Level of Pain perception among Postnatal
Mothers in Experimental Group 2.
4 Mean and standard deviation of the pre test and post test 70
level of pain perception among normal delivery
postnatal mothers in Group 1.

5 Comparison of mean and standard deviation of the pre 71

and post test level of pain perception among postnatal

x
 mothers in Group 2.
Comparison of mean and standard deviation and ‘t’ 72
6 value of the post test level of pain perception among
postnatal mothers in Group 1 & 2.

7 Association of Post test level of pain perception among 73

postnatal Mothers in Group 1 with Age, ,Monthly
Income ,Religion, Educational Status, Area of residence,
parity, mode of delivery, type of episiotomy, week of
gestation during delivery and indication for episiotomy.
8 Association of Post test level of pain perception among 75
postnatal Mothers in Group 2 with Age, ,Monthly
Income ,Religion, Educational Status, Area of residence,
parity, mode of delivery, type of episiotomy, week of
gestation during delivery and indication for episiotomy

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 LIST OF FIGURES
FIGURES TITLE PAGE NO
NO
1 Conceptual Framework Based on Modified J.W. Kenny’s 32
Open System Model On effectiveness of infrared therapy
versus sitz bath on episiotomy pain management among
normal delivery postnatal mothers
2 Schematic representation of Research Design 46

3 Schematic representation of Research Methodology. 60

4 Percentage distribution of age among postnatal mothers in Group 61

1 and Group 2

5 Percentage distribution of Monthly Income among postnatal 61

mothers in Group 1 and Group 2

Percentage distribution of Religion among postnatal mothers 61

6 in Group 1 and Group 2

7 Percentage distribution of Mother Educational Status among 72

postnatal mothers in Group 1 and Group 2.

8 Percentage distribution of Area of Residence among 62

postnatal mothers in Group 1 and Group 2
9 Percentage distribution of Parity among postnatal mothers in 63
Group 1 and Group 2
10 Percentage distribution of Mode Of delivery among 63
postnatal mothers in Group 1 and Group2
Percentage distribution of Type of Episiotomy among
postnatal mothers in Group 1 and Group 2
11

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12 Percentage distribution of Week of Gestation among 64
postnatal mothers in Group 1 and Group 2
13 Percentage distribution of Episiotomy Indication among 65
postnatal mothers in Group 1 and Group
14 Frequency and Percentage Distribution of Pretest and Post 67
test Level of Pain Perception among Postnatal Mothers in
Experimental Group 1
15 Frequency and Percentage Distribution of pre & post test 69
Level of Pain Perception among Postnatal Mothers in Group
2.

xii
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 LIST OF APPENDICES
S.N DESCRIPTION
O
1 Letter Seeking Permission to conduct study

2 Letter Seeking expert opinion and suggestion for

content validity
3 Certificates of Content validation

4 List of experts for content validity

5 Tool
Section A: Demographic Variables
Section B Standardised integrated Pain Rating scale

6 Photographs

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 ABSTRACT

Statement of the problem was“A Comparative Study to Assess the

effectiveness of infrared therapy and sitz bath on episiotomy pain management
among normal delivery postnatal mothers in selected hospital at
Coimbatore,was conducted by Mrs.A.Jayapriya as a partial fulfilment of
requirement for the Degree of Master of science in Nursing at Cherraan’s
College of Nursing,Coimbatore under the Tamilnadu Dr.M.G.R.Medical
University ,Chennai ,during the year 2023-2024

Objectives Of The Study were ,

 To evaluate the effectiveness of infrared therapy on episiotomy pain among

group 1 of postnatal mothers with normal vaginal delivery.
 To evaluate the effectiveness of Sitz bath on episiotomy pain among group 2
of postnatal mothers with normal vaginal delivery.
 To compare the effectiveness of pain management on episiotomy by infrared
therapy and Sitz bath among group 1, group 2 postnatal mothers.
 To find out the association between the Posttest level of pain management
after Infrared therapy among group 1 of postnatal mothers with with normal
vaginal delivery selected demographic variables among postnatal mothers.
 To find out the association between the posttest level of pain management
after sitz bath among group 2 of postnatal mothers with normal vaginal
delivery with selected demographic variable among postnatal mothers
The following Hypothesis were stated for the study
The hypothesis of the study were:

H1: There will be significant difference between pre & post test level of
episiotomy pain after infrared therapy among Postnatal mother in experimental
group 1.

H2: There will be significant difference between pre & post test level of
episiotomy pain after sitz bath among Postnatal mother in experimental group
2

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H3: There will be significant difference between the infrared therapy and sitz
bath on episiotomy pain management among postnatal mothers in
experimental group 1 and experimental group 2.

H4: There will be a significant association between the post test level of
episiotomy pain among postnatal mothers in Group 1 and 2 with their selected
demographic variables

Conceptual Framework for the study was based based on based on J.W.
Kenny’s Open System Model. Its subject matter is formulation of principles
that are valid for "systems" in general, whatever the nature of their component
elements and the relations or "forces" between them. General system theory,
therefore, is a general science of "wholeness" . Reasearch design used for the
study was post test only design .

The study was conducted in RMCH and Annai hospital at Coimbatore.The

population for this study consisted of Normal Delivery Postnatal Mothers.with
Episiotomy by Purposive sampling technique was used to select the sample.

Data collection instrument consisted of demographic variables , self

administered Integrated Pain Scale to assess on intervention of infrared
therapy and sitz bath which includes positive and negative statements
regarding postnatal normal delivery vaginal delivery episiotomy mothers.

The collected data were tabulated ,analysed and interpreted using

descriptive and inferential statistical methods .Establishment of content
validity of data collection instrument and structured teaching programme was
done by experts.

Pilot study was conducted in Dharani hospital at Coimbatore to find out

the feasibility of the study.

Major findings of the study

xi
x
 Infra red light therapy was effective in reducing the level of pain perception
among postnatal mothers in Group 1.(t=5.49, p=0.05).
 There was a significant difference between the mean pre and post test level of

pain perception among postnatal mothers in Group 1 (p<0.05).

 There was a significant difference between the mean pre and post test level of
episiotomy among postnatal mothers in Group 2 (p<0.05).
 There was no significant association between the post test level of episiotomy
in Group 1 mothers with their selected demographic variables at p<0.05 level.

 In Association of Posttest Level of Episiotomy Pain Perception among

Postnatal Mothers in Group 2,.Among the demographic variables only area of
residence was significant association with the post test value of episiotomy
pain among postnatal mothers.

The above findings support that the Integrated Pain Scale will help to gain
knowledge on pain and develop effective practice to relieve episiotomy pain
by practice of infrared therapy and sitz bath.The above said findings portray
that there was a positive relationship of pain reduction with infrared therapy
and sitz bath among postnatal normal vaginal delivery epiiotomy mothers

Based on findings ,the recommendation drawn for Nursing Service, Nursing

Education ,Nursing administration and Nursing research.

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