A Pre Experimental Study to Assess the Effect of Selected Maternal Positions upon Non Stress Test Parameters among Antenatal Women at Selected Hospital, Chennai.
OBJECTIVES:
1. To determine the effectiveness of positions upon the non stress test parameters among antenatal women.
2. To compare the effectiveness of various positions upon the non stress test parameters among antenatal women.
3. To find out the association between the selected demographic variables and non stress test parameters in various positions among antenatal women.
4. To find out the association between the selected obstetrical variables and non stress test parameters in various positions among antenatal women.
5. To assess the level of satisfaction of the nurses regarding effect of positions upon the non stress test parameters among antenatal women.
The conceptual framework for the study was developed on the basis of “King’s Goal Attainment Model” (1981) which was modified for the present study. The variables of the study were non stress test parameters and selected maternal positions. Null hypothesis were formulated. The level of significance selected was P<0.05. An extensive review of literature was made based on the opinion of experts. A pre experimental study of time series design was used. The study included 60 antenatal women who were selected by non probability purposive sampling technique. The study was conducted at St. Antony’s Hospital, Chennai.
Demographic variable proforma, Obstetric variable proforma, Observational checklist and Rating scale on level of satisfaction of nurses regarding positions on non stress test parameters were the various tools used by the researcher.
After making the antenatal women comfortable the experiment started with the antenatal women in supine position for 20 minutes followed by left lateral position for 20 minutes followed by semi fowlers position for 20 minutes. During each position non stress test parameters (fetal heart rate, fetal movement and fetal reactivity) was recorded at 5 and 15 minutes interval when the antenatal women came to outpatient department. Finally the effectiveness of each positions upon non stress test parameters was computed.
Then the level of satisfaction of nurses regarding positions on non stress test parameters was assessed among the experimental group of antenatal women. The data obtained were analyzed using Descriptive and inferential statistics.
MAJOR FINDINGS OF THE STUDY:
All of them (100%) were housewives, vegetarian, worked in indoor area as moderate workers with no any bad personal habits. Majority of them were Hindus (81.7%), most of them resided in semiurban area (63.3%) and had nuclear family (60%). Significant percentages of the antenatal women were between the age group of 21 - 25 years (45%), were graduates and above (41.7%) with a family income per month between 5001-10,001 rupees (41.6%).
• All of them (100%) had regular antenatal check up, majority of them were primipara (73.3%), anemic (85%), with no any previous obstetrical history (75%), most of them had weight between 61-80 kg (66.6%) were primigravida (68.3%) and significant percentage of the antenatal women were in a height of 141 – 160 cm (56.7%) with a gestational age above 37 weeks (41.7%).
• The mean and standard deviation of antenatal women assessed at 5 minutes the mean fetal heart rate was (M = 134.5 , SD = 12.5) and at 15 minutes (M = 133.9, SD = 11.8), the mean fetal heart rate of them was between 134.5 to 133.9 beats/minute in supine position, similarly in left lateral position mean fetal heart rate at 5 minutes was (M = 143.06 ,SD = 8.53) and at 15 minutes was (M = 143.2 , SD = 8.37), so the mean fetal heart rate in left lateral position was between 143.06 to 143.2 beats /minute. In semi fowlers position the mean fetal heart rate at 5 minutes was (M = 143.2 , SD = 9.12) and at 15 minutes was (M = 142.6 ,SD = 8.96), so the mean fetal heart rate was between 143.2 to 142.6 beats / minute in semi fowlers position. It shows that antenatal women in left lateral position had highest mean fetal heart rate than in other positions respectively. Hence the null hypothesis H01 was rejected.
• Mean and standard deviation of antenatal women assessed at 5 and 15 minutes was (M = 1.08, SD = 1.09) and (M = 1.91, SD = 1.95) in supine position, (M = 2.11, SD = 2.29) and (M = 3.11 ,SD = 3.62) in left lateral position and (M = 2.13, SD = 2.12), (M = 2.96, SD = 3.07) in semi fowlers position respectively. It reveals that antenatal women in left lateral position had highest mean fetal movement than in other positions. Hence the null hypothesis H01 was rejected.
• Mean and standard deviation fetal reactivity among antenatal women assessed at 5 and 15 minutes was (M = 1.23, SD = 0.74) and (M = 1.73, SD = 1.05) in supine position, (M = 1.6, SD = 1.05) and (M = 2.51, SD = 1.30) in left lateral position and (M = 1.35, SD = 0.81), (M = 2.55, SD = 1.41) in semi fowlers position respectively. It proves that antenatal women in left lateral position had highest mean fetal reactivity. Hence the null hypothesis H01 was rejected.
• There was a significant association between family income per month in rupees of antenatal women (χ2 = 5.24, df = 1) and fetal heart rate in supine position and no significant association between other demographic and obstetrical variables at the level of confidence P < 0.05, hence hypothesis H02 and H03 was rejected with regard to family income.
• There was a significant association between complication during antenatal period of antenatal women (χ2 = 4.56, df = 2) and fetal heart rate in left lateral position and no significant association between other demographic and obstetrical variables at the level of confidence P < 0.05, hence hypothesis H02 and H03 was rejected with regard to complication during antenatal period.
• There was a significant association between complication during antenatal period of antenatal women (χ2 = 4.64, df = 2) and fetal heart rate in semi fowlers position and no significant association between other demographic and obstetrical variables at the level of confidence P < 0.05, hence hypothesis H02 and H03 was rejected with regard to complication during antenatal period.
• There was no significant association between selected demographic and obstetrical variables and fetal movement in supine position at the level of confidence P < 0.05, hence hypothesis H02 and H03 was retained.
• There was no significant association between selected demographic and obstetrical variables and fetal movement in left lateral position at the level of confidence P < 0.05, hence hypothesis H02 and H03 was retained.
• There was no significant association between selected demographic and obstetrical variables and fetal movement in semi fowlers position at the level of confidence P < 0.05, hence hypothesis H02 and H03 was retained.
• There was a significant association between complication during antenatal period of antenatal women (χ2 = 6.41, df = 2) and fetal reactivity in supine position and no association between other demographic and obstetrical variables at the level of confidence P < 0.05, hence hypothesis H02 was retained and H03 was rejected with regard to complication during antenatal period.
• There was no significant association between selected demographic and obstetrical variable and fetal reactivity in left lateral position at the level of confidence P < 0.05, hence hypothesis H02 and H03 was retained.
• There was a significant association between type of family (χ2 = 5, df = 1) and fetal reactivity in semi fowlers position and no association between other demographic and obstetrical variable at the level of confidence P < 0.05, hence hypothesis H02 was rejected with regard to type of family and H03 was retained.
• Repeated measure of analysis of variance of mean fetal heart rate assessed at 5 and 15 minutes was (-53.1, -53.1), mean fetal movement was (-62.8, -62.9) and mean fetal reactivity was (-54.9, -54.7). This revealed that the result of analysis of variance of non stress test parameters among antenatal women between three positions varied significantly. This finding was not consistent with H01, hence the null hypothesis H01 was rejected.
• The study findings revealed that all the nurses were highly satisfied (100 %) with left lateral position and none of them reported dissatisfaction towards the position.
RECOMMENDATIONS:
1. The same study can be conducted on a large sample to generalize the results.
2. A comparison can be made between primipara and multipara.
3. A similar study can be conducted by using true experimental design.
4. The same study can be conducted in different settings with similar facilities.
5. A similar study can be conducted by using cross – over design