Master Thesis

This study aimed to assess the effectiveness of music therapy among primigrivida patient during active phase of labor based on the proposed pain management program. Specially, the study sought to answer the following problems: 1. What is the personal and socio-demographic profile of the primigrivida patients in terms of: 1.1 age; 1.2 civil status; 1.3 religion; 1.4 level of education; 1.5 occupation; 1.6 preferred music; 1.6.1 types of music; 1.6.2 forms; 1.7 number of ours spent in listening to music? 2. What is the degree of physiological pain reaction of primigrivida patients in terms of: 2.1 blood pressure; 2.2 pulse rate; 2.3 respiratory rate; 3. As measured by the musculo-skeletal and psychic reactions, what is the observed levels of overt pain reactions of primigrivida patients during the active phase of labor? 4. Is there a significant difference between the pain level of primigrivida patients before, during and after listening to music? 5. Is there a significant difference on pain level of primigrivida patients during the active phase of labor among those exposed to music and not exposed to music ? 6. based on the findings of the study, what pain management program can be proposed? Findings The study revealed the following findings : 1. Socio-Demographic Profile 1.1 Age. There were 2 groups of respondents, 15 for the experimental and 15 for the control group. For the control group 5 or 31.25% were 22-23 years old, 5 or 31.25% were 20-21 year old, 3 or 18% were 28-29 years old , 1 or 6.25% were 30-31 years old, 1 or 6.25 were 26-27 years old and 1 or 6.25% were 24-25 years old. For the experimental group, 6 or 40% were22-23 years old , 3 or 20% were 20-21 years old, 2 or 13.33% were 26-27 years old and 24-25 years old, 1 or 6.67% were 28-29 and 30-31 years old. The modal age of both groups is 24 years old. This age is considered to be safe pregnancy bracket. 1.2 Civil Status. From the control group 1 or 6.25% is widow, 2 or 13.33% were single. From the experimental group 13 or 86% were married, 2 or 13.33% were single. Most of the respondents were married. Obviously, husbands can be a tool in ceasing anxiety and pain level of the patients. This can also boost the morale of the patients. 1.3 Religion. From the control group, 10 or 66.6% were catholic, 2 or 13.33% were born again, 2 or 13.33% wee pentecostal, 1 or 6.67% were Iglesia ni Cristo , while from the experimental group 12 or 80% were catholic, 1 or 6.67% were Pentecostal. 1.4 Level of Education. It revealed that 8 or 50% were college, 6 or 40% were high school, 1 or 25% were elementary from the control . While 10 or 66.67% were college, 3 or 20% were high school, and 2 or 13.33% were from the experimental group. 2. Physiologic Reaction of Primigrivida Patient as to Blood Pressure, Pulse and Respiratory 2.1 Blood Pressure. The average blood pressure of the control group is 126/90. While the experimental group blood pressure is 120/70. 2.2 Pulse Rate. The average pulse rate of the control group is 92/min. while the experimental group is 87/min. 2.3 Respiratory Rate. The mean average of respiratory rate of control group is 26/min. while experimental group is 22/min. 3. Observed Musculo-Skelital and Psychic Reaction The total mean of musculo-skeletal and psychic reaction of patients during the active phase of labor is moderate for the experimental group while severe for the control group. 4. There is no significant difference between the pain levels of primigrivida patients before, during and after listening to music. 5. There is no significant difference on the pain levels of privigrivida patients during the active phase of labor among those exposed to music and not exposed to music. Conclusion Based on the findings, the following conclusions were made: 1. For the experimental and control groups majority of the respondents aged years and are married, are in college of level of education and belong to Roman Catholic. Majority of the respondents{92} occupation for the control group are housewives while the experimental group is operators. Both groups like classical and instrumental music. 2. Generally, the average blood pressure for the control group is 128/87 while the experimental group is 124/70. The average pulse rate is 92/min. for the control group while 87 for the experimental group. The average respiratory rate of the control group is 26/min. while the average respiratory of the experimental group is 22/min. It can be concluded that pain reaction significantly decreased to patients who are exposed to preferred music. 3. Consequently, most of the patients experienced moderate pain reactions both the musculo-skeletal and psychic reactions of the experimental group, while most of the patients experienced severe pain reactions to both musculo-skeletal and psychic reactions of the control group. It can be intended that therapeutic music can be a strategy for redirecting attention and feelings during painful experienced and can reduced the perceived intensity pain. 4. There is significant difference between the physiologic pain reaction and musculo-skeletal and psychic reaction of primigrivida patients during the active phase of labor before and after listening to music . 5. In summary, there is significant difference on the physiologic pain reaction and the musculo-skeletal and psychic reaction of patients among those exposed to music. Therefore, music is effective. However, pain in particular labor, is such a complex, special and subjective phenomenon which can not be measured by the standard rating scale at the moment. Recommendations Guided by the findings and conclusions of this study, the following recommendations are hereby presented for consideration: 1. Hospital and Lying-In Administrator 1.1. Provide facilities for playing music e.g. automatic revising cassette player, varied collection of sound tapes in labor and delivery rooms and allow patients to choose their preferred music. 2.Health Workers Attending to Pregnant Women 2.1 Strengthen patient education during pre-natal visits to include: 2.1.1. Explanation of the physiology of labor in simple and understandable terms so that the patients can prepare themselves psychologically and become active participants during labor. 2.1.2. Demonstration and encouragement for practice rhythmic breathing relaxation exercise among pre-partum patients. 2.1.3 Introduction of the idea of music intervention in labor during pre-natal visits. 3. Clinical Practice 3.1 Utilize music and other non-pharmacologic methods, e.g. relaxation and breathing exercise of modulating pain. 3.2 Determine the personal characteristics of patients, e.g. education and cultural background who may benefit more with music intervention. 3.3 Prepare varied collection of sound tapes and allow patients to select their preferred music , e.g. those that are appealing and have meaning to them, make it more effective. 3.4 Provide cassette players for music intervention. 3.5 Realizing the subjectivity of pain, nurse and midwives should render individualized care basing their nursing approach on the psychosomatic view of pain. 4. To {93}Would Be {93}Mothers 4.1 Determine their preferred music, particularly the soothing and relaxing tape, and make it a part of their childbirth preparation for them to be psychologically receptive to it. 4.2. Encourage mothers to bring their own type of music to see if this can relieve pain.