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Vol.04, Issue 02, February 2019 Available Online: www.ajeee.co.in/index.php/AJEEE

A STUDY TO ASSESS THE EFFECTIVENESS OF ICE MASSAGE AT LI 4 POINT AMONG

PRIMIGRAVIDA MOTHERS IN REDUCING THE PAIN DURING THE ACTIVE PHASE OF THE LABOUR IN SELECTED HOSPITAL OF ALIGARH

Ms. Hina Haider

Research Scholar, Maharaj Vinayak Global University, Jaipur Prof. (Dr.) Maya Patliya, Guide

Professor, Department of Obstetrics and Gynaecology Nursing Govt. Nursing College Indore Abstract-

Background: A study to assess the Effectiveness of Ice massage at L I4 point among Primigravida Mothers in reducing the pain during the active phase of the labour in selected hospitals of Aligarh. The study was undertaken by Ms. Hina Haider as a partial fulfillment of the degree of Doctorate in Nursing, Maharaj Vinayak Global University, Jaipur, Rajasthan during the year 2014-2019.

Objectives of the Study

1. To assess the intensity of labour pain during active phase of labour among Study and control group.

2. To assess the effectiveness of Ice massage at L I 4 point in reducing perception of labour pain during active phase of labour among Experimental group.

3. To compare the effectiveness of Ice massage at L I 4 point with the control group in reducing the intensity of labour pain during active phase of labour.

4. To find association between labour pain level with selected demographic variables.

1 INTRODUCTION

The active phase is considered as the most powerful phase the active phase begins when the women in labour is 3cm dilated and end when she is 10cm dilated during this phase the contractions occurs every 2-3min and last upto 10cm of the cervical dilatation.

During the time of labor, most of woman faced pain resulting from mechanism of labor and delivery, associated with anatomical, physiological and hormonal contribution. As nurturing and protecting the woman‟s memory of her birth experience; enables the woman‟s partner to participate at his or her own comfort level.

Child bearing is a natural physiological event4. Women should have adequate information prior to labour to ensure comprehension of the changes labour will bring. Women in labour should be encouraged to trust their own instincts listen to Their body and verbalize feeling order to get help and support and to ensure the women has some control over the birth of the baby5.

The experience of labor pain varies markedly from woman to woman. It can also vary for the same woman in different parts of the labor and from one labor to another. Nearly all women experience lower abdominal pain during contractions. Many also experience low

back pain, either with contractions or, less often, continuously. Women may also feel pain throughout the belly; in the hips, buttocks, or thighs; or in some combination of these locations.

2 REVIEW OF LITERATURE

“Knowledge is of two kinds. We know a subject ourselves or we know where we can find information up on it” (Samuel Johnson) A literature review is a compilation of resources that provides the groundwork for further study. When the researcher is able to find the right number of quality resource article so guide the study, a doorway is opened.

This key group of articles may include research findings, theory articles and published reviews of literature. Review of literature is important for understanding and insight necessary for the development of a conceptual framework, which the problems fits and for the development of the tool. The investigator carried out an extensive review of literature on the research topic in order to gain deeper insight in to the problem and to collect maximum relevant information for building up the study in a scientific manner, so as to achieve the desired results. Purposes of literature review:

Define concepts; examine research design, methods, scales, instruments,

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measures and techniques of data

collection Examine difficulties reported by others Define ethical implications of similar studies. 24 The retrieved literature has been organized and presented under the following headings

1. Literature related to physiology of labour pain

2. Literature related to perception of labour pain

3. Literature related to fear of labour pain 4.

4. Literatures related to cesarean section and its causes

5. Literature related to non- pharmacological pain relief methods during labour and childbirth.

6. Literature related to Aromatherapy and its benefits

7. Literature related to Biofeedback and its benefits

8. Literature related to Visual Pain Analogue Scale.

9. Literature related to Partograph 3 RESEARCH APPROACH AND DESIGN This study is intended to assess the effectiveness of ice massage at LI 4 point in reducing the pain during the active phase of the labour among primigravida mothers at labour unit of District women‟s hospital, Aligarh.

An experimental research approach is found to be most suitable for the attainment of the objectives of the study .Research design selected for this study is a true experimental Research design (two group per test -post test).

Experimental (Ice massage)

R O1 X O2 Control

group (no Intervention)

R O1 O2

Key words:

X= Intervention(Ice massage at LI 4 point) O1= pre test evaluation of the labour pain.

O2 = post test.

Population

All Primigravida mothers in District Women‟s hospital of Aligarh who meet the inclusion criteria were included in the Study.

Sampling Technique

Probability sampling will be used to select the primigravida Mothers.

Sample Size

The Sample consisted of 60 primigravida Mothers who satisfied the inclusion the inclusion criteria of the study. Of sixty (60) primigravida Mothers,(30) were selected for treatment with ice massage at LI 4 point (group A) and remaining (30) were kept in control group without any intervention (group B).

Inclusion Criteria

1. Primigravida Mothers having cervical dilatation between 3cm- 6cm.

2. Primigravida Mothers having single live fetus with vertex presentation.

3. Primigravida Mothers who are willing to participate in the study.

4. Primigravida Mothers who are able to speak Hindi.

Exclusion Criteria

1. Primigravida Mothers associated with obstetric complications

(eclampsia, CPD,

Malpresentations, fetal asphyxia, cord presentation)

2. Parturient mothers getting pharmacological or non- pharmacological for pain relief in 1st stage of labour.

3.1 Implementation Phase

In this phase, the sample was divided into two groups: group A and group B. Group A consisted of 30 women who received an LI4 massage on the hand with ice and group B consisted of 30 women who received standard routine care. The implementation phase started at the end of the assessment phase and continued until the end of the first stage of labor.

The LI4 massage was applied on thehands using ice between the thumb and forefinger where the large intestine energy point is found (LI4). The ice bag was wrapped in cotton before application to avoid any discomfort and skin damage to the patients. The researcher applied the ice alternatively on both hands every 10 min during each uterine contraction and discontinued at the end of the

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the woman‟s cervix had completely dilated

and effaced (10 cm). This is the end of the first stage of labor and the beginning of the second. In group B, the researcher

provided standard routine care that is provided to women in labor as per hospital care in the hospital.

Figure 1: Large intestine energy point four, also known as LI4 or Hoku point.

3.2 Evaluation Phase

In this phase, data on the effectiveness of LI4 massage on the hands on labor

duration was assessed by using the Numerical pain scale every hour by the researcher.

3.3 Experimental Research Design Schematic

REPRESENTATION OF THE STUDY DESIGN

DESIGN Pre-test –post-test Experimental design

GROUP A R O1 X O2 GROUP B R O1 O2

SAMPLING

Simple Random Sampling

TARGET POPULATION Intra natal Mothers, who are in

labour with 3-6 cm of the cervical dilatation, admitted in

the District womens hospital, Aligarh

SETTING OF THE STUDY District womens hospital,

Aligarh

RESEARCH VARIABLES

Age Education Occupation

Activity Antenatal Sessions etc.

TOOLS FOR DATA COLLECTION Numerical pain rating

Scale to assess the labour pain.

Sample 60 Intranatal Mothers, In the Group A(30) they receive the Ice massage at LI4 point and group B(30) were kept as the control

group without any intervention.

Data Collection 60 Intranatal Mothers randomly Selected.

Criterion Measures Pain assessment and application of Ice massage at LI 4 point for the duration of 15 minutes and the post test has been taken after 1 hour.

Analysis of effectiveness of ice massages at LI 4 point and compared it with the

control group.

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3.4 Results

The analysis of the data collected from a Sample of 60 Intra natal Mothers 30 Experimental Group A, and remaining 30 Control group B in this Chapter Study Findings grouped, Analyzed and presented under the following headings.

Section –A

Demographic data of 60 Intranatal Mothers were included in the Study.

Description of the frequency Percentage distribution for postnatal Mothers by demographic variables.

Section –B

Description of the assessment pre-test pain score and post- test score of labour pain scores, Pre-test and post-test biophysiological parameters of group A and group B.

SECTION A

Fig.1: The bar chart showing the percentage distribution according to the age of marriage of the Subjects (n=60)

Fig.2: The bar chart showing the percentage distribution of Emotional Status during labour (N=60)

Fig-3: Bar graph showing the percentage distribution of the Primigravida Mothers according to the Community.

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Fig-4 Bar graph showing the percentage distribution of the Primigravida Mothers

according to the Education

Fig-5 Pie diagram showing the percentage distribution of the Primigravida Mothers according to their Occupation

Fig. 6: The bar chart showing the percentage distribution of the subjects according to the labour pain perception.

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Fig.7:The bar chart showing the percentage distribution of Spiritual belief of the

Subjects (N=60)

Fig.8: The bar chart showing the percentage distribution according to type of activity performed during pregnancy (n=60)

Fig.9: The bar chart showing the percentage distribution according to the frequency of antenatal checkup (n=60)

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Fig.10: The bar chart showing the percentage distribution according to type of Family

of the Subjects (n=60)

Fig.11: The bar chart showing the percentage distribution according to Accompany during Labour (n=60)

Fig.13: The bar chart showing the percentage distribution of the subjects according to (n=60) history of any operative procedure

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Fig.14: The bar chart showing the percentage distribution of the subjects according to

the planning of pregnancy(n=60)

Fig.15: The bar chart showing the percentage distribution of the subjects according to history of dysmennorhea(n=60)

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3.5 History of Dysmenorrheal

SECTION –B

Table 1: Showing the Distribution of the pre –test scores of the Subjects on pain level in control and Experimental group

Score range Frequency Percentage

Experimental group

Control group

Control Experimental group

Mild (1-3) 0 0 0 % 0 %

Moderate(7-10) 3 3 10% 10%

Severe(7-10) 27 27 90% 90%

TOTAL 30 30 100% 100%

Table 1: Represents that the pre test Score of the subjects in the Experimental group are 0 (Mild), 3 (Moderate), 27 (Severe) respectively, Similarly in the control group the pre test score of the subjects were 0 (Mild), 3 (Moderate), 27 (Severe) respectively which reveals that

there is no difference in the pre test score of the Subject among the Experimental and the control group (p>0.01). Thus both are equal. Hence, no Significant difference was observed in pain level between Experimental and control group (p>0.01).

Table 2: Comparison For pain assessment score between pre- test and post- test in Experimental and control group (By Paired-“t” test) *p<.01 shows a significant

difference at α=.01 level of significance

The Table 2 Represents that the Average pre test Score in pre –test and post test was 7.833 and 4.83334 for Experimental group as well as 7.9666 and 8.833 for control group. A reduction of 62.07% in pain assessment score was observed in Experimental Group which was significant at 1% level of Significance

(p<0.01). However in the control group there was Significant Increment of 9.8155% in the pain assessment score at 1% level of Significance (p<0.01). From this, we can conclude that the ice massage at LI 4 point is effective in reducing the pain during the Active phase of Labour.

SL.

NO. GROUPS Mean± S.D. PROBABLE

VALUE‟S

OF PAIRED „t‟

TEST

P VALUE SIGNIFICANCE

PRE

TEST POST TEST

%

Reduction/

Increasement 1. EXPERIMENT

AL 7.833±0

.94989 4.83334±1.

31525 - 62.07% 0.0000 P<0.01

(Significant)

2. CONTROL 7.9666±

0.9278 8.833±0.69

89 9.8155% 0.0000 P<0.01

(Significant)

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Table 3: Comparison in pain assessment scores for pre-test & Post test between

Experimental and control group

SL.

NO. TYPE OF

TESTS Mean± S.D. PROBABLE

VALUE OF UNPAIRED „t‟

TEST

P VALUE

SIGNIFICANC EXPERIMENTAL CONTROL Percentage E

reduction /Increment 1. PRE

TEST 7.833±0.94989 7.9666±0.927

8 1.6696% 0.0000 P<0.01

(Signficant) 2. POST

TEST 4.83334±1.3152

5 8.833±0.6989 45.29% 0.0000 P<0.01

(Signficant)

*p<.01 shows a significant difference at α=.01 level of significance.

The above table Shows that the pain assessment scores in experimental and Control group for pre-test was 7.833 and 7.9666 respectively and for post- test 4.83334 and 8.833 respectively. A significant Reduction /difference of

1.669% was observed in pre-test score between control and experimental group and 45.29% in post-test Score respectively (Significant at 1% level of Significance) (Ref table 3).

Table 4: Comparison in assessment score‟s for different parameters (viz. Blood pressure, pulse, respiration) between pre test and post tests scores in Experimental

group

Sl.

No. Parameter Mean± S.D. Prob. Value‟s

of paired t test

P value

significance Pre-test Post test % Reduction

/Increaseme nt

1. Blood pressure

(Systolic) 124.866±8.

8463 122.2±6.7333 -2.18% 0.0000 P<0.01 (Signficanct) 2. Blood pressure

(Diastolic) 80.066±6.0

4542 79±2.766798 -1.3494% 0.0000 P<0.01 (Signficant) 3. Pulse 84.866±3.8

1226 81.4±1.58875 -4.2527% 0.0000 P<0.01 (Signficant) 4. Respiration 24.8±1.963

69 22.5333±1.65

53 -10.059% 0.0000 P<0.01

(Signficant)

*p<0.01 shows a significant difference at 0.01 level of Significance.

The above table shows that in the Experimental group, the average pre-test Score and the post-test Score of the blood pressure (Systolic) was 124.866, in post test score was 122.2, for blood pressure (Diastolic) was 80.066 and 79, for pulse rate was 84.866 and 81.4, Respiratory rate 24.8 and 22.5333 Further the

reduction in Blood pressure (Systolic) is 2.18%, blood pressure (Diastolic) 1.3494%,Pulse rate 4.253% and for Respiratory rate 10.059%. All of the above difference/ Reduction were Statistacally Significant at 1% level of Significance (p<0.01). (Refer table -4).

Table 5: Comparison in assessment Score‟s for different parameters (blood pressure, pulse, respiration) between pre test and post tests scores in Control group

Sl. No. Parameter Mean± S.D. Prob. Value’s

of paired „t‟

test

P value significance Pre-test Post test Percentage

reduction/

Increment 1. Blood pressure

(Systolic) 127.6±7.582

1 128.333±6.5

196 0.5712% 0.28592 P<0.01

(Signficant) 2. Blood pressure

(Diastolic) 82.73333±3.

87684 82.8±2.7593

1 0.0809% 0.897256 P<0.01

(Signficant)

3. Pulse 83.733±2.71

5642 81.6666±1.9

71055 -2.5310% 0.00023964 P<0.01 (Signficant) 4. Respiration 26±1.741977 25.06667±1.

460593 -3.7233% 0.028121 P<0.01 (Signficant)

The above table shows that in the Control

group the average pre-test Score and the (Systolic) was 127.6, post test score was 128.333, blood pressure (Diastolic) was

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83.733 and 81.6666, Respiratory rate 26

and 25.06667 Further the Incensement‟s in Blood pressure (Systolic) is 0.5712%, blood pressure (Diastolic) 0.0809%, and reduction in Pulse rate 2.5310% and for

Respiratory rate 3.7233%. All of the above Reduction/ Incensement‟s were Statistically Significant at 1% level of Significance (p<0.01).

Table 6. Between group comparison for B.P. (Systolic) in pre-test and post -test scores

Sl. No. Type of Test BP (Systolic ) Mean± S.D. Prob. Value‟s of (unpaired)- „t’

test

P-value / Significance Experimen

tal Control Percentage reduction 1 Pre test 124.866±8.

8463 127.6±7.582

1 2.1426% 0.204034 P<0.01

(Signficant) 2. Post test 122.2±6.73

3 128.33±6.51

964 4.7767% 0.0006939 P<0.01 (Signficant)

Table 6 Represents the Between group comparison for B.P. (Systolic) in pre-test and post -test scores that the pre test score of Blood pressure (Systolic) in the Experimental Group 124.866 and in the control group it is 127.6 which shows that there was Significant difference in

the pretest score between Experimental and Control group as well as a significant difference was observed for post test score between Experimental and Control group 122.2 and 128.33 at 1% level of Significance (p<0.01).

Table- 7. Between group comparison for B.P. (Diastolic) in pre-test and post –test

Sl.

No. Type of

Test BP (Diastolic ) Mean± S.D. Prob. Value of (unpaired) – „t‟ test

P - value / Significance Experimental Control Percentage

Reduction/

Increment 1 Pre test 80.0666±6.0

454 79±2.76679

8 -1.3494% 0.047363 P>0.01 ( Not Signficant) 2. Post test 82.7333±3.8

7684 82.8±2.7593

1 0.0809% 0.0000 P<0.01

(Signficant)

Table 7 Represents the Between group comparison for B.P. (Diastolic) for pre-test and post -test scores that the pre test score of Blood pressure (Diastolic) in the Experimental Group was 80.0666 and in the control group 79 Respectively which shows that there is no Significant

difference in the pretest score between Experimental and Control group.

However a significant difference was observed for post test score between Experimental and Control group 82.7333 and 0.0809% at 1% level of Significance (p<0.01)

Table 8. Between group comparison for (Pulse rate) in pre-test and post –test

Sl.

No. Type of Test BP (pulse rate)

Mean± S.D. Prob.

Value‟s of (unpaired) -„t‟ test

P - value / Significan Experimental Control Percentage ce

reduction 1 Pre test 84.86667±3.8

1226

79±2.7667 -7.4262% 0.19051 P>0.01 N.S.

2. Post test 83.7333±2.71

5 81.666±1.97105

5 -2.5314% 0.566315 P>0.01

N.S.

Table 8: Represents the between group comparison in Pulse rate for pre-test and post -test scores between Experimental and Control group. The pre test score of Pulse rate in the Experimental Group was 84.86667 and in the control group was 79 which shows that there reduction of 7.4262% between Experimental and

Control group, No Significant difference in the pretest score between Experimental and Control group and No significant difference was observed in post test score between Experimental and Control group 83.7333 and 81.666 which shows that there reduction of 2.5314% at 1% level of Significance.

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Table 9. Between group comparison for (Respiratory rate) in pre-test and post –test

Sl.

No. Type of Test BP (Respiration)

Mean± S.D. Prob. Value

of (unpaired) -

„t‟ test

P - value / Significan Experimental Control Percentage ce

reduction

1 Pre test 24.8±1.9369 26±1.741977 4.6154% 0.014429 P>0.01 N.S.

2. Post test 22.53333±1.6

55 23.333±1.4223 3.4286% 0.04944721 P>0.01 N.S.

Table 9: Represents the Between group comparison for Pulse rate for pre-test and post -test scores that the pre test score of Respiratory rate in the Experimental Group 24.8 and in the control group 26which shows a reduction of 4.6154%

thus there is No Significant difference in

the pretest score between Experimental and Control group and No significant difference was observed in post test score‟s between Experimental and Control group which shows that there reduction of 3.4286% at 1% level of Significance(p<0.01).

Table10 (a): Presenting the details of demographic variables in Experimental group

Sl. No. Demographic variables

Mean± S.D.

1. Age 24.7333±2.6

5784

2. Height 151.06623±

3.829128

The above table shows the average values of age and Height for 30 Subjects in the Experimental group.

Table10 (b): Presenting the details of demographic variables in Control group:

Sl. No. Demographic

variables Mean± S.D.

1. Age 24.05882±2.

398752

2. Height 150.8235

±4.502327

The above table shows the average values of age and Height for 30 Subjects in the Control group.

Table11: Presenting the details of demographic variables: General History

Sl. No. Type of Variable Z-Score (double- proportion) between Exp. And control group

Z (0.01) P-Value /Significance

1. Age of Marriage 3.59(a)* 2.58 (p<0.01) Sig.

2. Educational Status 3.88(a)*,4.10(b)* 2.58 (p<0.01) Sig.

3. Occupation 2.10(a)** 2.58 (p>0.01) N.S.

4. Type of activity performed 4.38(b)* 2.58 (p<0.01) Sig.

5. Type of Family 4.59(b)* 2.58 (p<0.01) Sig.

6. Community to which you

belong 3.03(a)*,b(3.32)* 2.58 (p<0.01) Sig.

7. Spiritual belief 3.99(a)*,4.039(b)* 2.58 (p<0.01) Sig.

*p<0.01 shows a significant difference at 0.01 level of Significance Table11The application of Z test (Double

Proportion)for different type of variables in general history between Experimental group and Control group revealed Significant difference for the age of the

marriage(a), Educational Status(a,b), Type of activity performed during antenatal period (b), Type of Family(b), Community (a,b) and Spiritual belief (a,b) of 1 % level of significance.

Table 12: Presenting the details of demographic variables: Obstetrical History:

Sl. No. Type of Variable Z-Score (DOUBLE - SAMPLE) between Exp.

And control group

Z (0.01) P-Value /Significance

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2. History of operative

procedure b(1.72) 2.58 (p>0.01) N.S.

3. Category of operation d(1.65) 2.58 (p>0.01) N.S.

4. Frequency of Antenatal

checkup a(1.37),b(1.43),c(1.51) 2.58 (p>0.01) N.S.

5. History of practicing Exercises/yoga/Antenata l sessions

c(0),d(2.03) 2.58 (p>0.01) N.S.

6. Mental acceptance regarding labour pain

a(1.27),b(3.18*),c(4.02*) 2.58 (p<0.01) Sig.

7. Who has accompanied you during labour

a(3.17*),b(2.78*),d(0) 2.58 (p<0.01) Sig.

8 Emotional status a(3.36*),c(1.92) 2.58 (p<0.01) Sig.

9. Planned pregnancy a(2.99*),b(2.76*) 2.58 (p<0.01) Sig.

*p<0.01 shows a significant difference at 0.01 level of Significance.

Table 12: The application of Z test for double Sample proportion for different type of Variables in obstetrics history between the Experimental and the control group ,A highly significant difference was observed for complain Dysmenorrheal (b,c), Mental acceptance regarding labour pain(b,c), Accompanied during labour(a,

b), Emotional Status(a), Planned pregnancy(a,b) at 1%level of Significance i,e (p<0.01) further, No significant difference was observed for History of operative procedure, category of operation, and History of practicing Exercises /Yoga/Antenatal Sessions at 1%level of significance.

Table 13: Presenting the details of demographic variables: Obstetrical History

Position acquired

during labour Z- Score (double

sample proportion) P value Significance (a) Semisetting 1.22 (p>0.01) N.S.

(b) Sideline 0.5764 (p>0.01) N.S.

(c) Lithotomy 0.2505 (p>0.01) N.S.

*p<0.01 shows a significant difference at 0.01 level of Significance.

The application of Z test(double Sample proportion) for different type of Variables in obstetrics history between the Experimental and the control group revealed that there is no significant difference observed between the position acquired during labour viz. Semisitting, Side line, Lithotomy i, e (p>0.01) .

3.6 Inter Reliability

First reading: 130/88mmhg Second reading: 128/84 mmhg Third reading: 126/80 mmhg

Difference of the first two reading of Systolic Blood pressure =130-128=2 Difference of the second and third reading of Systolic Blood pressure =128-126=2 Reliability of the Sphygmomanometer for Systolic Blood pressure is =2/2*100

=100%

Thus, the reliability of the Sphygmomanometer for systolic Blood pressure is 100%.

4 DISCUSSIONS

An Experimental Study was conducted to assess the effectiveness of the Ice massage at LI 4 point in Reducing the pain during the Active Phase of Labour

among primigravida Mothers. Data was Collected from 60 full term Mothers, without any complication who are in the Active phase of Labour in District Women‟s Hospital.

4.1 Instrument Used Was Consisting of the Two Parts

Part I-Demographic data.

Part II-Numerical pain rating Scale.

The data collection period was confined for the duration of the four weeks.

The Mothers of the experimental group A were treated with the Ice massage at LI 4 point who are in the Active phase of the labour between 3 cm-6cm. of the cervical dilatation. It was noticed that both the groups were matching in respect to age, parity, occupation and Educational status activity, mental perception regarding the labour pain.

The first Objective of this Study was to determine the intensity of labour pain during active phase of labour among the Experimental and control group, the pain was assessed objectively by numerical pain rating Scale.

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5 CONCLUSIONS

The result of this Study revealed that Application of the Ice massage at LI 4 point helps in reducing the Labour pain during the active phase of labour. In the Given Study the Subjects were assigned to two groups. By Simple Random Sampling In Experimental group(A) Receives Ice massage at LI 4 point and Control Group (B) had not receives any intervention pain score both pre-test and post-test were taken, Post test score of the Experimental group after1 hour shows reduction in the pain score were as in the Control group there is Significant Increment in the pain score Thus Ice massage at LI4 Point is effective Strategy in reducing the labour pain.

5.1 Limitations

1. The study is limited only to the Primigravida Mothers.

2. The Study was limited only to 60 Subjects (30) in Experimental and (30) in Control group

5.2 Implication

The present Study emphasized on the effectiveness of the Ice massage at LI 4 point in reducing the pain during the active phase of labour among primigravida Mothers. The findings of the Study here implication in nursing practice, using Education, nursing Administration and nursing Research.

5.3 Nursing Practice

Midwives are in continuous interaction with the patients then the other member of the health team .It is apparently necessary that a midwife should have adequate knowledge in various Systems of medicine.

In India, the practice of providing the women with information, interpreting the labour data, treatment and word of encouragement, preserving human dignity in care and demonstrating regard for the individual care are in the state of infancy, so it has to be develop further.

The role of the midwife helps to encourage and assist women to anticipate positive child birth .The midwife Must taught to assess the level of labour pain in an accurate manner. In an attempt to offer comfort, pain control and symptom management midwifes need to offer Ice massage at LI 4 point as a part of

should be encouraged to use Ice massage at LI point in labour pain Management.

5.4 Nursing Administration

 Nurses are challenged to play the role of efficient administrators as well as practitioners.

 To perform the role of an efficient administrator as well as practitioners. To perform the role of an efficient administrator, apart from knowledge in the administration, nurses must have good decision making and reasoning abilities.

In Service Education can be conducted for nurses regarding the non pharmacological Interventions, which is some self help comfort measures for women to achieve an effective Coping level for their labour experience. Hospital system must incorporate such system of Relaxation methods in the child birth centers.

5.5 Nursing Research

In nursing research there is lack of literature and research done on effects of ice massage at LI4 point in reducing the labour pain. Reserch should be conducted to assess the effect of ice massage and other non pharmacological interventions for reducing the labour pain.

Nurses should take initiative to conduct research on effect of non pharmacological intervention on Intranatal Mothers in Indian settings.

6 SUMMARIES

The study was to determine the effectiveness of Ice massage at LI point in reducing the pain during the Active phase of labour among primigravida Mothers.

This was a Experimental study conducted for the period of four weeks in District women hospital, Aligarh. A total 60 Intranatal Mothers who are in active phase of labour (3-6cm of cervical dilatation), who meet the inclusion criteria were selected from the Labour ward of District women‟s hospital, Aligarh by using simple random sampling technique. The Mothers were divided into two groups, Experimental group who receives the Ice massage at LI 4 point, and Control group without any interventions.

The investigator first introduced

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obtained consent for the present study.

The investigator selected 2-3 Mothers every day. The Conceptual framework of the study was based on System model by von Bertalanffy (1968).

6.1 The Instrument Consist Of Two Parts

Part –I: Demographic data.

Part –II: Numerical pain rating scale.

Prepared instruments were submitted to experts and the content validity was established reliability of the observation was identified analyzed using descriptive Statistics percentage, mean, Standard deviation, Z –test, Chi square test to find out the association between selected variables and Labour pain for both Experimental and the control group.

6.2 The Findings of the Study Are Summarized Below

1. There is severe degree of labour pain experienced by the Mother during labour both in the control and The Experimental group, thus there is no difference in the pain level in both group.

2. There is significant pain reduction in the Experimental group of 62.07% after the application of the Ice massage at LI 4 point thus it is helpful in reducing the labour pain.

3. There is significant correlation between the pain and biophysiological parameters, i.e BP, pulse, Respiration.

4. There is significant correlation between selected demographic variables (Age of Marriage, Educational Status, Type of activity performed, Type of Family, Community to which you Belong, Spiritual belief) and level of pain.

Thus with increasing knowledge of non pharmacological pain relieving intervention it is possible for the Nurses to give maximum comfort to the intranatal Mothers. Nurses must take responsibility to obtain a working knowledge of the various pain relieving strategies like ice massage application at LI 4 point, and thus help them to decrease the suffering of Intranatal Mothers Appropriately.

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