Development of Maneeveda-Integrated-Care in primigravida at Suratthani Hospital

Abstract

              Labour pain is a significant problem especially in the primigravida. Symptoms are fear and anxiety. Pain management is due to drug diffusion, passing through a placenta and a baby; effecting to press breathing. Hence alternative care as Maneeveda was integrated in a care context. This study was the research and development design that aimed to develop Maneeveda- Integrated -Care (MIC) in primigravida with labour pain at Suratthani
hospital and to study outcomes of the developed care. There were 3 phases of study: preparation phase, operation phase, and evaluation phase. Preparation phase studied of phenomena of Maneeveda. Operation phase was implemented by a pilot study in primigravida with labour pain for developing a nursing practice guideline with Maneeveda. Evaluation phase was evaluation outcomes in terms of pain score, duration of labour, and satisfaction. This study was conducted during May 1, 2015 to March 31, 2016. Instruments were 1) 5 questions for Maneeveda expert interview consensus, 2) an eight-postures-Maneeveda handbook, 3) demographic data record form, 4) a pain numeric scale, and 5) a nursing practice guideline with Maneeveda. Data from interview
were analyzed using a content analysis. Quantitative data were analyzed using descriptive statistic: frequency, percent, mathematic mean and standard deviation, also inferential statistic (t- test).
              Findings of this study showed 2 significant themes form Maneeveda that were balance and flexibility. Piloting of an eight-postures-Maneeveda handbook was conducted as a quasi experimental research. Results were 16 primigravida with usual care and Maneeveda could reduce duration of labour as compared with 16 primigravida with usual care and 31 primigravida with syntocinon. Resulting in a developed nursing practice guideline with Maneeveda, focused on collaboration among a pregnant woman, a nurse, a physician, and a caregiver as a care team. Evaluation 3 outcomes revealed that 30 primigravida with usual care and Maneeveda (experimental group) could significantly reduce pain score (cervix dilation less than 3 and 6-8 centimeter;
respectively) and duration of labour as compared with 30 primigravida with usual care (control group) (p<.05). Moreover, satisfaction in the control group and the experimental group were presented of 86% and 88%, respectively.
              Development of MIC in primigravida with labour pain responded to a health policy of safe motherhood. Therefore, results of this study could be applied to pain relief, reduced labour duration, and reduced complication.