Postpartum period is the time of vast change for women both physically and psychologically. During this time, primipara mothers need details about minor discomforts and how to cope. Aim of the study: To investigate the effectiveness of video assisted teaching program on postpartum minor discomforts of primipara mothers. Method: A quasi experimental research design pre and posttest one group was selected for this study. Sample: A purposive sample of 100 primipara mothers with minor discomforts during the postpartum period were selected. Settings: The study was conducted at the postpartum unit of Teaching Hospital and University Hospital, at Shebin El-Kom in Menoufia Governorate, Egypt. Instruments: A structured interviewing questionnaire, postpartum minor discomforts questionnaire (pre and post-test) and the postpartum minor discomforts follow up instrument were used for data collection. Results: There was a statistical significant difference among the study participants in terms of knowledge and practices regarding the postpartum minor discomforts in pre and post-test. Conclusion: The postpartum primipara mothers had an improvement in their knowledge and practices in posttest compared to pretest after watching the video assisted teaching program regarding the postpartum minor discomforts. Recommendations: Video assisted teaching Program should be offered to postpartum primpara mothers in clear and comprehensive explanation to improve their knowledge and practice concerning the postpartum minor discomforts before discharge from the hospital.
Postpartum or postnatal period is the period that begins immediately after the birth of a newborn and lasts for approximately six weeks. Most of the changes of pregnancy, delivery and labor have resolved and the body has reverted to the non-pregnant state. It is a very special phase in the life of a newly delivered woman and her newborn. It is the most critical, transition and life changing event which fills in strong emotions, physical changes and adjustments to the mother role 1.
Postpartum minor discomforts resulting from all systems adaptation. The common postpartum minor discomforts include after-pains, episiotomy pain, fatigue, breast engorgement, constipation, urinary retention, lactation problems. Immediate and effective care during and after labor for these problems can make differences in the postpartum adaptation 2.
The immediate postpartum period often starts in the hospital setting. During this time, the women are recovering from their labor. This period is used to make sure that the mother is stable and to educate her about the care of herself and her newborn (especially the first-time mothers). The major purpose of the postpartum care is to promote the health of the mothers and their newborns 3.
The nurse plays an important role in promoting and improving the minor discomforts in the postpartum period, not just a health care provider but also an administrator, a director, a teacher, a researcher and a counselor 4. The nurse needs accurate knowledge and skills to determine when to be proactive with regards to undertake specific observations where these might be required. Therefore, the nurse must be able to identify the signs of morbidity that require further investigations and discuss the future management of these with the women. The nurses never know the quality of care they offer until it is being assessed through patient satisfaction. Also, for providing vast teaching to the women after labor and before they discharged from the hospital based on bio-psychosocial needs further anticipatory assistance and counseling 5.
Video-assisted teaching program created awareness and empowered the women especially the primipara to take care of their own health and their newborns. This leaded the women to seek help for the disorder which is essential to promote health and helps for early recovery, video-assisted teaching program also established and enhanced the knowledge of primipara mothers about postpartum minor discomforts 6.
1.1. Significance of the StudyThe postnatal period is described by the World Health Organization (WHO) as the most important and overlooked stage in the lives of primiparous mothers and newborns; the majority of deaths occur during this period 7. Neonatal mortality rates are 27 neonatal deaths per 1,000 live births, according to the 2014 Egypt Demographic and Health Survey (2014 EDHS), slightly more than half of these deaths occurred in the first month of child life. Maternal mortality in 2013 was also 52 maternal deaths per 100,000 live births. Most maternal deaths occur during and after times of childbirth. However, postnatal care visit data show less promising patterns, with only 14% of newborns receiving the required postnatal health checks within 2 days of birth 8.
Based on reviewing literature; there is limited studies were done about effectiveness of video assisted teaching program (VATP) on postpartum minor discomforts of primipara mothers in Menoufia governorate. there is limited studies that provide health teaching related to the minor discomforts which the postpartum women experienced during this period which may affect their health status that interfere with their family relations and dealing with their newborns. In Egypt, there are scattered published studies about the importance of video assisted teaching on improving the minor discomforts during the postpartum period and indirectly improving the women quality of life. Accordingly, by conducting this study, the researcher attempted to fill such a gap of knowledge and practice of the primpara mothers about the postpartum minor discomfort.
1.2. Aim of the StudyTo investigate the effectiveness of video assisted teaching program on postpartum minor discomforts of primipara mothers.
1.3. Research hypotheses1- Postpartum primipara mothers who receive video assisted teaching program exhibit a higher score of total knowledge about the postpartum minor discomforts than before.
2- Postpartum primipara mothers who receive video assisted teaching program exhibit a higher level of competency in practicing the management of postpartum minor discomforts than before.
A quasi-experimental research design (pre and posttest one group) was utilized in this study.
2.2. SettingsThis study was carried out at the Teaching Hospital and University Hospital postpartum unit at Shebin El-Kom in the Menoufia Governorate, Egypt. These settings were selected because there is a high flow rate of postpartum women who attend these hospitals for delivery from the different surrounding cities and villages which are near to Shebin El-Kom city.
2.3. SampleA purposive sample of 100 primipara mothers who attended the postpartum unit in the above mentioned settings were enrolled in the study.
Sample size: The total number were 100 postpartum primipara mothers recruited based on calculated formula (after exclusion of the mothers included in the pilot study).
The following equation determined the sample size:
Yamane's equation:
 |
n = sample size & N = Population size & e = Margin of errors which is 0.10 % & Confidence level = 90%. Then after excluding the pilot study participants, the sample size became 100 postpartum primipara mothers (50 from Teaching Hospital and 50 from Shebin El-Kom University Hospital in the Governorate of Menoufia, Egypt).
2.4. Inclusion CriteriaPostpartum primipara mothers, full-term pregnancy, vaginal delivery with or without episiotomy, free from any medical and obstetrics complications and at least can read and write.
2.5. InstrumentsIt included three instruments as the following:-
1- A Structured interviewing questionnaire: It was created by the research teams to gather the essential information, it included: socio-demographic data such as mothers age, educational level, occupation, residence, and telephone number (for continues follow up).
2- Postpartum minor discomforts questionnaire regarding the mothers knowledge (pre and posttest): The researchers designed it through a comprehensive review of current literatures to determine the level of mothers knowledge regarding the minor discomforts during the early postpartum period. It consisted of 30 items. The items were prepared based on the following aspects of postpartum minor discomforts: definition & causes: it included 9 items, general measures: it included 9 items, types & management: it included 12 items.
Scoring system of knowledge: Correct answer was scored "one" and incorrect answer was scored "zero". The total knowledge score were calculated by summation of the total scores for the known items. The maximum score was 30 and the minimum score was 0. The scores were converted into percent. The higher scores reflected the higher levels of knowledge about minor discomforts during early postpartum period. The total knowledge score was indicated as the following: Good ≥75% of total knowledge score, Fair 50% - <75% of the total knowledge score and poor if the percent score was less than 50%.
3-Postpartum minor discomforts follow up: This instrument was designed by the researchers through an extensive review of recent literature. This instrument include seven items of minor discomforts during the postpartum period which involved in the present study as breast engorgement, perineal discomfort, urinary retention, constipation, fatigue, cracked nipple and after-pains.
The scoring system as form of Likert scale for improving the symptoms from 2 scores. Score (1) means improved discomforts, score (0) means not improved discomforts. The researcher followed up each women every week through a period of 3 weeks postpartum through the phone calls.
Validity of the instruments:
The instruments were designed by the researchers and validated by five qualified experts (three professors in the department of Maternal and Newborn Health Nursing at the Faculty of Nursing as well as two professors from the Obstetrics and Gynecology department at the Faculty of Medicine) who examined the instruments for accuracy of content and internal validity. They were also asked to evaluate the items for comprehensiveness and clarification (content validity). Suggestions have been included in the instruments. According to the panel of judgment, the instruments underwent some modifications regarding the consistency of the sentences and the suitability of the text.
Reliability of the instruments:
The researchers tested the internal consistency of the instruments for the accuracy using test retest reliability. It was achieved on one or more instances by applying the same instruments to the same participants under similar circumstances. Repeated testing scores have been compared to test the consistency of the results over time. Its reliability was evaluated by piloting and measuring the alpha value of the associated Cronbach's (Alpha = 0.88).
Letters Approvals: A formal document was taken from the Dean faculty of Nursing, Menoufia University and submitted to the directors of the study settings to carry out the study. An official permission was obtained to carry out the study from the directors of the above mentioned settings for data collection.
2.6. Ethical ConsiderationsA written permission was given from the hospitals managers. The investigators introduced themselves to the women who met the criteria for inclusion and told them about the purpose of the study to gain their acceptance to participate in this study. The researchers assured that the study did not pose any health risks or hazards, and their involvement in the study is voluntary. The researchers approached the women who were willing to participate in the study and fulfilled the inclusion criteria and asked for written consent to verify their acceptance, and all activities that occurred during the collection of data were regarded secret.
2.7. Pilot StudyIt was carried out to test feasibility, instruments applicability and intervention maneuver. It was also used to estimate the time required for data collection. It was performed on 10% of the total sample (10 postpartum primipara mothers). All women who took part in the pilot study were removed from the study sample because some instruments modifications were made by the researchers. The piloting results were used to finalize the instruments and plan the necessary field work time. Based on the professors' opinions and piloting results, several changes have been made to the data collection instruments.
2.8. Field WorkThe study was conducted through 4 phases:
1-Assessment Phase: It is a preparatory phase which included:- an official permission to conduct the proposed study was obtained from the hospital administrators. The data collection was carried out among the postpartum primipara mothers. The mothers were selected based upon the inclusion criteria. As well as the purpose, significance and benefits of the study were told orally to all participants and healthcare providers. It also included examining the recent literature to establish and plan data collection instruments. In this phase, data collected to cover a period of 6 months from the beginning of March 2019 to end of August 2019 in the postnatal ward from 9 AM to 2 PM, three days per week.
Development of video assisted teaching program:
Based on the assessment phase, analysis of related research literature, the video- assisted teaching program was created.
The following steps were adopted to develop the video assisted teaching program.
1. Preparation of 1stdraft of video assisted teaching program.
2. Content validity of the video assisted teaching program.
3. Preparation of final draft of video assisted teaching program.
Preparation of the 1stdraft of video assisted teaching program.
A first draft of video assisted teaching program was developed keeping in mind the purpose, criteria, literature reviewed and opinions of the experts, also the level of understanding of the mothers, simplicity of language and relevant audio-visual aids.
Content validity of video assisted teaching program.
The initial drafts of the video assisted teaching program was given to 5 experts comprising of four nursing educators from the maternal and newborn health nursing department and along with criteria checklist here was 100% agreement on meeting the criteria of the content. The suggestions given by the experts was accepted and ensured the clarity and the validity of the instruments.
Preparation of the final draft of video assisted teaching program:
Suggestions from the experts were taken into considerations and modifications of the instruments were made. Upon integrating the recommendations of the experts, the final version of the video assisted teaching program was created.
Description of video assisted teaching program: The video assisted teaching program was entitled “the postpartum minor discomforts”. It consists of the following contents: -
- Definition and causes.
- General measures.
- Types and management.
2-Interviewing phase: The researchers introduced themselves to the mothers and explained the purpose and nature of the study to obtain their informed consent as well as to gain their cooperation. It was implemented in 2 steps:
A) History taking. B) Knowledge assessment.
A. History taking: Each postpartum primipara mothers was interviewed to collect the data related to:
-Personal and demographical data such as age, place of residence, educational level, occupation, sources of knowledge about postpartum minor discomforts management and telephone number (for continues follow up).
B. Knowledge assessment: The researchers obtained the baseline assessment to each mother using the women knowledge regarding the postpartum minor discomforts questionnaire (pre and posttest). Pre and posttest for each mother was taken 10–15 min.
3-Developing and implementing phase: The study was conducted as follows: A pre-test was conducted by the postpartum minor discomforts questionnaire to each mother. Duration of 10-15 minutes was given for each mother to complete the questionnaire. The video assisted teaching program was administered regarding the postpartum minor discomforts among the postnatal primipara mothers for 15 minutes using video. The video sent to all mothers in their mobiles telephone to be available to the mother for watching again all time. Post-test was conducted by using the same postpartum minor discomforts questionnaire immediately after the video education.
4- Postpartum minor discomforts follow-up: Follow up of the mothers every week for three consecutive weeks from the discharge using post-partum minor discomforts follow up instrument by phone calls. The responses monitoring as follows: If the symptoms present (yes or no), symptoms relieved (yes or no), symptoms detected (yes or no), compliance for given data (yes or no) & the reason for incompliance.
2.9. Statistical AnalysisThe data collected were tabulated and analyzed by using SPSS version 20 on IBM compatible computer. Descriptive as well as nonparametric statistics were utilized to analyze the data pertinent to the study. The level of significance was set at p < 0.05. The data were evaluated using an unbiased t-test.
Table 1 displays the study participants socio-demographic characteristics. It indicates that58% of the study participants had a secondary education, where 30% had a higher education, 37% of the family members were the source of knowledge for the postpartum mothers in management of their postpartum minor discomforts. The mothers' mean age was 20.51±1.64.
Table 2 Postpartum minor discomforts knowledge distribution of the primipara mothers (pre and posttest) . It reveals that the postpartum primipara mothers knowledge regarding the postpartum minor discomforts in pretest was episiotomy pain, after pain, fatigue, breast engorgement, constipation, retention of urine and cracked nipple was (5%, 7%, 7%, 10%, 5%, 0%and 1% receptively), while the posttest knowledge of the mothers regarding episiotomy pain, after pain, fatigue, breast engorgement, constipation, retention of urine and cracked nipple was (89%, 95%, 97%, 95%, 93%, 90%, 98% respectively). These results showed a substantial difference between pretest and posttest (p<0.001).
Figure 1 shows the pre and post-test knowledge scores of postpartum primipara mothers regarding the postpartum minor discomforts. It reveals that 92% of the primipara mothers in this study had poor knowledge regarding the postpartum minor discomforts in pretest followed by 8% with fair knowledge. While in the post test the mothers had 97% of good knowledge followed by 3% of fair knowledge.
Table 3 reveals the effects of video assisted teaching program on primipara mothers knowledge regarding breast engorgement. It demonstrates that there was a significance improvement of primipara mothers knowledge regarding the breast engorgement after conducting the video assisted teaching program, during the three consecutive weeks of assessment as reported by 32% in the first week, 65% in the second week and 98% in the third week. The findings of the present study reported a significant effect of video assisted teaching program on the mothers knowledge regarding breast engorgement given with the progress of time follow up (p<0.001).
Table 4 shows the effects of video assisted teaching program on the primipara mothers knowledge regarding after-pains. It shows that there was a significance improvement of primipara mothers knowledge regarding the after-pains after conducting the video assisted teaching program during the three consecutive weeks of assessment as reported by 35% in the first week, 54% in the second week and 99% in the third week. The findings of the present study reported a significant effect of video assisted teaching program on mothers knowledge regarding after-pains given with the progress of time follow up (p<0.001).
Table 5 reveals the effects of video assisted teaching program on the primipara mothers knowledge regarding urinary retention. It reveals that there was a significance improvement of primipara mothers knowledge regarding the urinary retention after conducting the video assisted teaching program during the three consecutive weeks of assessment as reported by 51% in the first week, 80% in the second week and 99% in the third week. The findings of the present study reported a significant effect of video assisted teaching program on the mothers knowledge regarding urinary retention given with the progress of time follow up (p<0.001).
Table 6 reveals the effects of video assisted teaching program on the primipara mothers knowledge regarding constipation. It reveals that there was a significance improvement of primipara mothers knowledge regarding to constipation after conducting the video assisted teaching program during the three consecutive weeks of assessment as reported by 69% in the first week, 90% in the second week and 99% in the third week. The findings of the present study reported a significant effect of video assisted teaching program on the mothers knowledge regarding constipation given with the progress of time follow up (<0.001).
Table 7 reveals the effects of video assisted teaching program on the primipara mothers knowledge regarding episiotomy pain. It reveals that there is a significance improvement of primipara mothers knowledge regarding to episiotomy pain after conducting the video assisted teaching program, during three consecutive weeks of assessment as reported by 81% in the first week, 91% in the second week and 99% in the third week. The findings of the present study reported a significant effect of video assisted teaching program on mothers knowledge regarding episiotomy pain given with the progress of time follow up (p<0.001).
Figure 2 shows the primipara mothers self-reported practices in relieving the postpartum minor discomforts in the posttest was higher regarding the episiotomy pain, after-pains, fatigue, breast engorgement, retention of urine, cracked nipple which was (77.89±0.97, 60.5±0.50, 69.6±0.50, 77.3±1.17, 71.17±0.14, 69.89±0.18 and 78.1±1.14) respectively.
The first step of any educational program is the recognition and prioritization of the educational requirements. The educational needs reflect the gap between what an individual knows and what he or she must know and do. The gap may be due to lack of knowledge. Awareness of the mothers towards the postpartum minor discomfort has a lots of lacunae, so there is scope for improvement by providing better care and health education for the mothers 9. Therefore, through this study, the researchers tried to investigate the effect of video assisted teaching program on postpartum minor discomforts of primipara mothers.
The present study revealed that half of the primipara mothers in this study had a secondary education and the mean age of them was 20.51±1.64. This may be interpreted as the rural residents usually prefer to have secondary education and then got married. In the same line, Timilsina and Dhakal 10, reported in their study which conducted in Emirates about "knowledge on postnatal care among postnatal mothers” and mentioned that, most of the mothers had a secondary education and the age of them between twenty to twenty five years old.
Regarding the primipara mothers knowledge toward the postpartum minor discomforts, the present study revealed that, the majority of the mothers didn’t have any knowledge regarding the postpartum minor discomforts in pre-test. This finding is in agreement with Kumbani and Mclnerney 11 about "a study to test the efficacy of video teaching program on postpartum primigravida mothers admitted to urban maternity centers" and found that the majority of the participants didn’t know any problems that could occur during and after the birth. Also, Missiriya 12 who conducted a study about "utilization of postnatal care among rural women in Nepaland" and reported that seventy percent of the postnatal mothers had poor knowledge and thirty percent had fair knowledge and no one had good knowledge. In addition to a study conducted by Adam 13 about “assessment of knowledge and practice of mothers regarding self- care during puerperium” and reported that the majority of the participants responded with poor knowledge regarding after-pains, episiotomy pain, breast engorgement.
Concerning breast engorgement there was statistical significant improving in the primipara mothers knowledge regarding the breast engorgement after conducting the video assisted teaching program. This result could be due to the effect of video assisted teaching program that given to the mothers in the present study. Similarly, Menaka 9 who reported that, video assisted teaching program was effective in improving the level of knowledge on the management of breast engorgement among the postnatal mothers and the difference between pre and posttest scores was highly significant at p-value < .05 level.
In relation to after-pains, the present study findings revealed that, there was statistically significant improvement of the primipara mothers knowledge regarding after-pains and constipation. This finding is in agreement with Kirandeep et al., 14, and found that, the intervention which aimed to teaching, support, and counsel the women who had recently given birth has a good effect to manage the postpartum minor discomforts especially after-pains and constipation.
The present study findings revealed that, there was statistically significant improvement of the primipara mothers' knowledge regarding urinary retention. This finding is in accordance with Nigia 15 who reported that, the practice measures consist of early ambulation, providing the mother with privacy, warm baths. These measures alone have been shown to resolve temporary urinary retention in sixty percent of the postpartum women. Similarly, Wan and his colleagues 16, 17 regarding the postpartum urinary retention: systematic review of management and adverse effects and reported that continuous primary nursing care increased satisfaction with nursing care and reduced postpartum problems for hospitalized women and showed a significantly lower occurrence of postpartum urinary retention.
As regards to the episiotomy pain; the present study findings revealed that after conducting the video assisted teaching program, the majority of the primipara mothers reported the improvement in their knowledge about the episiotomy pain. While only, one mother not improved in their knowledge. This finding is in congruent with the study findings of Gadiya et al., 17 who conducted a study about “Effectiveness of Planed Teaching Program on Episiotomy care” on sixty primipara women; the findings of the present study indicated that there was a highly significant difference between pretest and posttest scores (p-value = .000). This could be attributed to the sufficient basic information gained from the video assisted teaching program on the episiotomy care was effective. All of the above supported the first research hypothesis.
The findings of the present study revealed that, there were statistically significant improvement regarding the mother’s practice in relieving the postpartum minor discomforts in posttest compared to pretest. The researchers point of view that, the video assisted teaching program had a significant effect on primipara mothers by increasing their level of knowledge which leads to improving the mothers practice. This result is in agreement with Santhi and Kokilavani 18 about “best practices in management of postpartum minor discomfort” and found that, the video assisted teaching program that proved to the primipara mothers was significantly effective in improving the practices of postnatal mothers regarding the postpartum minor discomforts. This supported the second research hypothesis. Therefore, the study findings succeeded to prove the research hypotheses.
In the same line, Timilsina and Dhakal 9, reported in their study which conducted in Emirates about "knowledge on postnatal care among postnatal mothers” that there was a significant association between level of knowledge regarding the postpartum minor discomforts and selected demographic variables as educational level and age. Moreover, Namutebi et al., 19 reported that the maternal age and educational level were found to be positively associated with knowledge of at least one maternal minor postpartum problem. On the contrary, the study conducted by Tiwari et al., 20 and his colleagues on postnatal mothers in India about "exclusive breast feeding determinants in urban slums: a community-based study" and showed that there was no significant relationship between the age in years and knowledge scores of postnatal mothers.
Based on the findings of the present study and research hypotheses, the study concluded that: postpartum primipara mothers have no knowledge about the postpartum minor discomforts and did not know the management before the video assisted teaching program. After the interventional program the study participant’s knowledge about the postpartum minor discomforts was highly improved which leads to improving the mothers practice in posttest compared to pretest. It means that the postnatal primipara mothers had an improvement in their knowledge and practices in the post-test compared to the pretest after watching the video assisted teaching program regarding the postpartum minor discomforts. Therefore, the study findings succeeded to prove the research hypotheses.
The following recommendations are suggested based on the findings of this study:-
1- Improving the primipara mothers knowledge and practices concerning the postpartum minor discomforts before discharge from the hospital through education in clear and comprehensive explanation supported by videos.
2- Incorporate the postpartum minor discomforts measures into all mother classes during the postpartum period.
1- Providing the postpartum primipara mothers in hospitals and private clinics with watching videos about the postpartum minor discomforts and its management.
2- Increasing the postpartum primipara mothers awareness and enhancing their level of knowledge and practice related to the postpartum minor discomforts.
| [1] | Adele Pillitteri, Maternal and child health nursing, 6th edition lippincott Williams and wilkins publication, Philadelphia, 2017, 233-280. | ||
| In article | |||
| [2] | Annama Jacob, A Comprehensive Textbook of Midwifery and Gynocological Nursing, 5th Edition, Jaypee Brothers Medical Publishers, 2018, 220-250. | ||
| In article | |||
| [3] | Catherin’s, A Study to Assess the Effectiveness of selected nursing measures on after birth pain among postnatal mothers in selected hospital, Punjap. M.Sc Nursing, thesis of Omayal Achi College of Nursing, submitted to Dr. M.G.R. Medical University, Chennai, 2016. | ||
| In article | |||
| [4] | Brown SJ, Davey MA, Bruinsma FJ., Women's views and experiences of postnatal hospital care in the Victorian Survey of Recent Mothers, Midwifery, 21 (2). 109-126. 2015. | ||
| In article | View Article PubMed | ||
| [5] | Myles, Textbook for midwives, 14th edition Churchill livingstone, publication, London, 2016, 219-220. | ||
| In article | |||
| [6] | Thomas, M., A study to assess the effectiveness of structured teaching program on knowledge and practice regarding management of minor disorders of pregnancy among primigravida mothers in district hospital, Tumkur, 2017, 2-11. | ||
| In article | |||
| [7] | WHO., WHO Recommendations on Postnatal Care of the Mother and Newborn., Geneva, WHO, 2017. | ||
| In article | |||
| [8] | Egypt Demographic and Health Survey (EDHS), Ministry of Health and Population, El-Zanaty and Associates. Cairo, Egypt, The DHS Program, ICF International, Rockville, Maryland, USA, 2015. | ||
| In article | |||
| [9] | Menaka, Assess the effectiveness of structured teaching programme on newborn care among primigravida mothers in Bangalore. [internet document]cited on 2016. April 20, Available from: https://119.82.96.198:8080/jspui/bitstream/123456789/1412/1/CD NNOBG00018.pdf. | ||
| In article | |||
| [10] | Timilsina, R. Dhakal, Knowledge on postnatal care among postnatal mothers. Med. Pharm. Sci., 1 2017, 88. | ||
| In article | |||
| [11] | Kumbani and Mclnerney A study to assess the effectiveness of video teaching programme on postpartum primigravida mothers admitted in urban health maternity centers, Coimbatore, Tamilnadu. Reviews of progress. 1(8). 2017. 19. | ||
| In article | |||
| [12] | Missiriya, utilization of postnatal care among rural women in Nepal; Dentocafe: 16(3). 2016. 103-67. | ||
| In article | |||
| [13] | Adam, L.A., Assessment of knowledge and practice of mothers regarding self-care during puerperium, Ribat University, 2017, 22. | ||
| In article | |||
| [14] | Kirandeep Kaur, Avinash Kaur Rana, ShaliniGainder, Effect of video on postpartum minor discomfort Among Primigravida Mothers, Nursing and Midwifery Research Journal, 9(1). 2016. | ||
| In article | |||
| [15] | Nigai, F.W., A quasi experimental study on effects of a postpartum minor discomfort education using videos. International Journal of Obatetrics and gynaecology, 23(1). 2017. 412-23. | ||
| In article | |||
| [16] | Wan, Postpartum urinary retention: A systematic review of adverse effects and management. IntUrogynecol J. 2016. | ||
| In article | |||
| [17] | GadiyaT,Vieira F, Mota DD, Castral TC, Guimaraes JV, Salge AK, Bachion MM., Effectiveness of Planed Teaching Program on Episiotomy care: a randomized clinical trial. J Midwifery Womens Health, 62. 2017. 572-9. | ||
| In article | View Article PubMed | ||
| [18] | Santhi MD, Kokilavani, Best practices in management of postpartum minor discomfort. J Perinat Neonatal Nurs, 31. 2017. 126-36. | ||
| In article | View Article PubMed | ||
| [19] | Namutebi Varney, H., Kreibs, J.M. &Gegor, C.L. (2017); Varney’s Midwifery, Jones and Bartlett Publishers, London. pp. 571. | ||
| In article | |||
| [20] | Tiwari R, Mahajan PC, Lahariya C., The determinants of exclusive breast feeding in urban slums: a community based study. Journal of Tropical Pediatrics, 2018, 3-9. | ||
| In article | |||
Published with license by Science and Education Publishing, Copyright © 2020 Amany Ali Abd El-Salam and Eman Seif Soliman Ashour
This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit
https://creativecommons.org/licenses/by/4.0/
| [1] | Adele Pillitteri, Maternal and child health nursing, 6th edition lippincott Williams and wilkins publication, Philadelphia, 2017, 233-280. | ||
| In article | |||
| [2] | Annama Jacob, A Comprehensive Textbook of Midwifery and Gynocological Nursing, 5th Edition, Jaypee Brothers Medical Publishers, 2018, 220-250. | ||
| In article | |||
| [3] | Catherin’s, A Study to Assess the Effectiveness of selected nursing measures on after birth pain among postnatal mothers in selected hospital, Punjap. M.Sc Nursing, thesis of Omayal Achi College of Nursing, submitted to Dr. M.G.R. Medical University, Chennai, 2016. | ||
| In article | |||
| [4] | Brown SJ, Davey MA, Bruinsma FJ., Women's views and experiences of postnatal hospital care in the Victorian Survey of Recent Mothers, Midwifery, 21 (2). 109-126. 2015. | ||
| In article | View Article PubMed | ||
| [5] | Myles, Textbook for midwives, 14th edition Churchill livingstone, publication, London, 2016, 219-220. | ||
| In article | |||
| [6] | Thomas, M., A study to assess the effectiveness of structured teaching program on knowledge and practice regarding management of minor disorders of pregnancy among primigravida mothers in district hospital, Tumkur, 2017, 2-11. | ||
| In article | |||
| [7] | WHO., WHO Recommendations on Postnatal Care of the Mother and Newborn., Geneva, WHO, 2017. | ||
| In article | |||
| [8] | Egypt Demographic and Health Survey (EDHS), Ministry of Health and Population, El-Zanaty and Associates. Cairo, Egypt, The DHS Program, ICF International, Rockville, Maryland, USA, 2015. | ||
| In article | |||
| [9] | Menaka, Assess the effectiveness of structured teaching programme on newborn care among primigravida mothers in Bangalore. [internet document]cited on 2016. April 20, Available from: https://119.82.96.198:8080/jspui/bitstream/123456789/1412/1/CD NNOBG00018.pdf. | ||
| In article | |||
| [10] | Timilsina, R. Dhakal, Knowledge on postnatal care among postnatal mothers. Med. Pharm. Sci., 1 2017, 88. | ||
| In article | |||
| [11] | Kumbani and Mclnerney A study to assess the effectiveness of video teaching programme on postpartum primigravida mothers admitted in urban health maternity centers, Coimbatore, Tamilnadu. Reviews of progress. 1(8). 2017. 19. | ||
| In article | |||
| [12] | Missiriya, utilization of postnatal care among rural women in Nepal; Dentocafe: 16(3). 2016. 103-67. | ||
| In article | |||
| [13] | Adam, L.A., Assessment of knowledge and practice of mothers regarding self-care during puerperium, Ribat University, 2017, 22. | ||
| In article | |||
| [14] | Kirandeep Kaur, Avinash Kaur Rana, ShaliniGainder, Effect of video on postpartum minor discomfort Among Primigravida Mothers, Nursing and Midwifery Research Journal, 9(1). 2016. | ||
| In article | |||
| [15] | Nigai, F.W., A quasi experimental study on effects of a postpartum minor discomfort education using videos. International Journal of Obatetrics and gynaecology, 23(1). 2017. 412-23. | ||
| In article | |||
| [16] | Wan, Postpartum urinary retention: A systematic review of adverse effects and management. IntUrogynecol J. 2016. | ||
| In article | |||
| [17] | GadiyaT,Vieira F, Mota DD, Castral TC, Guimaraes JV, Salge AK, Bachion MM., Effectiveness of Planed Teaching Program on Episiotomy care: a randomized clinical trial. J Midwifery Womens Health, 62. 2017. 572-9. | ||
| In article | View Article PubMed | ||
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