INTRODUCTION:

Motherhood is the only act that manifests in human form the cosmic wonder of creation. Imagine a life growing within the body of the mother, nurtured with her life blood. The fulfilment of the motherhood is acquired through labour. Labour is one of the greatest events in every woman’s life. Even though labour is the fulfillment of her dreams the suffering due to pain in the perineal area after the delivery is unbearable. Childbirth and labour are never the same but different for different women may. Pain and suffering is an ever present image and experience among women from the dawn of history to the present time.¹

The acronym REEDA is used as a reminder that the site of episiotomy or a perineum laceration should be assessed for these five signs. Redness of the wound may indicate the usual inflammatory response to injury. If it is accompanied by pain or tenderness, it may indicate beginning of localized infection.

Ecchymosis or edema indicates soft tissue damage that can delay healing. There should not be discharge from the wound and rapid healing necessitates the edges of the wound should be clearly approximate. ¹

OBJECTIVES OF THE STUDY:

· To assess the condition of episiotomy wound among post natal mothers.

· To evaluate the effectiveness of infrared therapy on episiotomy pain and wound healing.

· To compare the effectiveness of infrared therapy between the experimental and control group

· To correlate the study findings with selected demographic variables

NEED FOR THE STUDY:

The worldwide episiotomy rate is about 27% and;54% are nulliparous and 6% in multiparous women. Use of episiotomy varies across the world.¹

In India the birth rate is very high. Fifty six percentage of Indian women had an episiotomy compared to the forty six percentage of White women. Perineal soreness or pain is a common occurrence and is frequently reported following episiotomy. Episiotomy is an incision in the perineum during a vaginal delivery¹. In normal process of delivery perineum has stretched for beyond its ordinary limits , most women body is capable of achieving this but some are not and the skin gives a way and tears. Episiotomy is used widely today because it prevents many complications like laceration, reduced incidence of uterine Prolapse ¹. WHO describes that the higher birth rate indicate that a large number of episiotomies are being performed every day. In most of the hospitals, there is a 100% incidence of episiotomy in primigravida women. Episiotomy warmed by heat is wonderful to help stimulate the healing of wound and relief of pain especially in the case of anal sphincter repair, which is much like healing form of episiotomy. ²

All in the name of perineal care, derived to prevent infection, promote healing and provide comfort to mother often based on little psychological rationale or research data. Perineal pain is the most distressing to most of the mother in the first week of post partum. Because of the early discharge practices in midwifery area, only brief term is available for quickly assessing, planning and implementing episiotomy and wound healing. Being very effective in healing of post operative superficial wounds like episiotomy. Nurses can use infrared lamps as a dry heat modality for quicker wound healing and thereby enhancing comfort²

METHODOLOGY:

A quasi experimental research design with pre-test and post-test design was used to achieve the objectives of the study. The researcher had chosen a group of primipara mothers with episiotomy admitted in postnatal wards for experimental group and group of primipara mothers with episiotomy admitted in postnatal wards for comparison group .The experimental treatment (IR therapy) was administered to the experimental group and the episiotomy wound was assessed, while the control group had received no treatment only the episiotomy wound was assessed.

Interpretations of the Symbols Were as Follows:

Q1- Assessment of episiotomy wound without giving treatment. (pre-test)

Q2- Assessment of episiotomy wound after giving treatment. (post- test)

X-Intervention (application of infrared therapy on episiotomy wound) in experimental group

METHODOLOGY:

The research methodology adopted for the study was Quantitative research approach.⁴ The data collection was done with present study comprised of 60 postnatal mothers who had normal delivery with episiotomy and of which 30 will be assigned to the experimental group and 30 will be assigned to the control group in selected hospitals of Pune city using Convenient sampling technique. The technique adopted was self administered checklist. The collected data was analysed by descriptive and inferential statistics.

MAJOR FINDINGS OF THE STUDY:

1)Analysis of data related to condition of episiotomy wound among postnatal mothers in selected hospital In experimental group 6.66% postnatal mothers having mild condition and 93,33% postnatal mothers having poor condition. In control group 3.33% postnatal mothers having mild condition and 96.66% having poor condition.

Table 1 significant difference of pre-test score between experimental and control group with regard to assessment of score by REEDA scale without application of infrared therapy .

	Experimental		Control
	frequency	percentage	frequency	percentage
Good	0	0	0	0
Mild	2	6.66%	1	3.33%
Moderate	0	0	0	0.00%
Poor	28	93.33%	29	96.66%

The above table mentioned that before giving infrared therapy in the experimental group at 1^st day 2 sample had good, 28 samples had poor episiotomy wound. In the control group at 1^st day 1 sample had mild, and 29 samples had poor episiotomy wound.

In Table 2 significant difference of post- test score between experimental and control group with regard to assessment of score by REEDA scale after application of infrared therapy. Post-test N=30

	Experimental		Control
	frequency	percentage	Frequency	Percentage
Good	11	36.66%	0	0
Mild	0	0	27	90%
Moderate	19	63.33	2	6.66%
Poor	0	0	1	0

The above table mentioned that after giving infrared therapy in the experimental group at 4^th day 11 sample had good, 19 samples had moderate episiotomy wound. In the control group at 4^th day 27 sample had mild, and 2 samples had moderate and 1 sample had poor episiotomy wound.

Table 3:Significant difference between pre-test and post -test score with regard to comparison of score by REEDA scale before and after application of infrared therapy in experimental and control group n=30

	MEAN	SD	SE	T	P value
Experimental	7.56	1.7	0.31	24.38	<0.0001
Control	4.4	1.53	0.28	15.71	<0.0001

Since calculated chi square values corresponding to age, education, weight, hereditary disorder, haemoglobin level are less than tabulated value at significance of (0.5) so they do not have a significant association with study findings and null hypothesis is rejected.

CONCLUSION:

The findings of the study revealed that there was a statistically significant difference between experimental and control group, in relation to episiotomy wound.

This showed that the application of infrared therapy on episiotomy wound played an important and beneficial role in producing better episiotomy wound (REEDA).

REFERENCE:

1. D. C Datta, The Text Book of Obstetrics, 4^thedition, Calcutta: New Central Book agency Pvt. Ltd.Pp.605.

2. Bobak, Maternity Nursing 4^th edition, Boston: Mosby Publisher Pp302-309

3. Basavanthappa B.T, Nursing research, 1^st edition, New Delhi: Jaypee Brothers Medical Publishers pp 93-219

4. Burns N. and Groove S. k. The Practice of Nursing Research: Conduct, critique and utilization 5^th edition Calcutta Dawn Publication pp562

5. Guyton, A. (1981), "Textbook of Medical Physiology”, 6^th edition, Philadelphia: W.B. Saunders Company,Pp.389-341.

Received on 14.08.2017 Modified on 25.09.2017

Int. J. Adv. Nur. Management. 2017; 5(4):320-322.

DOI: 10.5958/2454-2652.2017.00067.1