Published Paper Details:

Background: Episiotomy is a common surgical procedure performed during second stage of labor to enlarge the vaginal introitus and facilitate delivery. Although episiotomy aids in safe delivery of the child, the discomfort of episiotomy is an added concern in the already over stressed situation of puerperium. Considering the high rates of episiotomy, following vaginal deliveries, we need to offer patients treatment alternatives for perineal pain, based on scientific evidence. Sitz bath relieves discomfort as well as significantly promotes wound healing, also reduces surface contaminants which contribute in wound healing process. Cold application is also an another simple and common method used to relieve pain. It is safe, effective, low-cost and gives immediate pain relief. Objectives: 1. To assess the level of episiotomy pain reduction (experimental group 1- sitz bath and experimental group 2- cold ice pack) before and after the interventions among the postnatal mothers who are admitted in the selected hospitals of Goalpara, Assam. 2. To compare the pre-test and post-test level of pain score who received sitz bath as an intervention to reduce episiotomy pain among the postnatal mothers who are admitted in the selected hospitals of Goalpara, Assam. 3. To compare the pre-test and post-test level of pain score who received cold ice pack as an intervention to reduce episiotomy pain among the postnatal mothers who are admitted in the selected hospitals of Goalpara, Assam. 4. To compare the post-test level of pain scores of both sitz bath vs cold ice pack group among the postnatal mothers who are admitted in the selected hospitals of Goalpara, Assam. 5. To find out the association between the pre-test level of episiotomy pain reduction among the postnatal mothers who received sitz bath with selected socio-demographic variables. 6. To find out the association between the pre-test level of episiotomy pain reduction among the postnatal mothers who received cold ice pack application with selected socio-demographic variables. Methods: Quasi-experimental one group pre-test post-test design was used to accomplish the objectives. Study was undertaken on 42 postnatal mothers (21 for sitz bath and 21 for cold ice pack) admitted in the postnatal ward in Goalpara Civil Hospital, Assam by using non-probability purposive sampling technique and quantitative approach was adopted to achieve the study objectives. Postnatal mothers were selected on the basis of inclusion criteria. Pre-test pain score was assessed using Visual Analogue Scale before each intervention. Intervention was conducted for 20mins twice a day in two consecutive days for both the groups. Post-test pain score was assessed after each intervention using Visual Analogue Scale. Results: Descriptive and inferential statistics were used to analyze the data. A total of 42 postnatal mothers, majority of the respondents that is 26(61.9%) belongs to the age group of 21-25 years, 32(76.19%) were having the first delivery, 28(66.6%) have high school level of education, all 42(100%) were unemployed, 22(52.38%) belonged to Islam religion, 41(97.61%) were non vegetarian, all the 42(100%) family monthly income was Rs. 6768-20273, 39(92.8%) resides in rural area, 36(85.71%) live in a joint family, 38(90.47%) present pregnancy was planned and all the 42(100%) have not received any education related with coping on episiotomy pain. On assessment of effectiveness of sitz bath and cold ice pack in reducing episiotomy pain, the calculated paired t-test of pre-test and post-test pain score among postnatal mothers who received sitz bath and cold ice pack was 33.6 and 62.16 respectively which was more than the tabulated value 2.09 at 20 degrees of freedom. The study further revealed that the unpaired t-test of post-test level of pain score of both sitz bath and cold ice pack group was 0.011 which was less than the tabulated value 2.02 at 40 degrees of freedom. It was observed that demographic variables such as number of delivery (p=0.029) and planned pregnancy (p=0.014) showed statistically significant association with the pre-test level of episiotomy pain among postnatal mothers who received sitz bath at p<0.05 level and there was no association between pre-test level of episiotomy pain reduction among postnatal mothers who received cold ice pack application with none of the demographic variables. Conclusion: After analyzing the collected data, this study showed that sitz bath and cold ice pack application were highly effective in reducing episiotomy pain among postnatal mothers. There was no significant difference on the effectiveness of sitz bath versus cold ice pack application on episiotomy pain reduction among the postnatal mothers. After this study, it is recommended that there should be more awareness programmes for nurses regarding importance of the use of cold ice pack and sitz bath for postpartum women to reduce episiotomy pain, encourage the postnatal women to apply the cold ice pack and sitz bath at the hospital as well as home to improve their episiotomy wound healing and maintain their comfort and educate the pregnant mothers during antenatal visits about the importance of cold ice pack and sitz bath and how to take it after delivery.