Professional Documents
Culture Documents
Music Theraphy Asi
Music Theraphy Asi
POSTNATAL MOTHERS
GYNAECOLOGICAL NURSING
APRIL 2016
CERTIFICATE
This is to certify that the dissertation entitled “Effectiveness Of Music
Therapy On Level of Breast Milk Secretion among Postnatal Mothers in
Selected Hospital, Kanya Kumari District” is a bonafide work done by
Ms. Sharon Chellathangam, St. Xavier’s Catholic College of Nursing in
partial fulfillment of the University rules and regulations for award of M.Sc
Nursing Degree Course under my guidance and supervision during the
academic year 2014-2016.
Name and signature of the Guide:
Mrs. D. Shiny Mary, M.Sc. (N),
Assistant professor,
Obstetrics and Gynaecological Nursing,
St. Xavier’s Catholic College of Nursing,
Chunkankadai, Nagercoil, Kanya Kumari District,
Pincode: 629 003.
Name and signature of the Head of Department:
Mrs. S. Anita Mary Leena, M.Sc. (N),
Head of the Department,
Obstetrics and Gynaecological Nursing,
St. Xavier’s Catholic College of Nursing,
Chunkankadai, Nagercoil, Kanya Kumari District,
Pincode: 629 003.
Name and signature of the Principal:
Dr. A. Reena Evency, M.Sc. (N)., Ph.D.
Principal,
St. Xavier’s Catholic College of Nursing,
Chunkankadai, Nagercoil, Kanya Kumari District,
Pin code: 629 003.
CERTIFICATE
College Seal:
I greatly and sincerely indebted to the “God Almighty” for his endless
grace, love, care and blessings showered on me to complete and for presenting
this dissertation successfully.
(SHARON CHELLATHANGAM)
TABLE OF CONTENTS
17-26
II REVIEW OF LITERATURE
x Research approach 27
x Research design 27
x Variables in the study 28
x Settings 28
x Population 28
x Sample 29
x sample size 29
x Sampling technique 29
x Ethical consideration 34
IV DATA ANALYSIS AND INTERPRETATION 35-59
V DISCUSSION 60-63
REFERENCE 70-73
ANNEXURES i-xvii
LIST OF TABLES
LIST OF FIGURES
FIGURE TITLE PAGE NO
LIST OF ANNEXURES
ABSTRACT
A quasi experimental study was conducted to evaluate the effectiveness of
music therapy on level of breast milk secretion among postnatal mothers in
selected hospital, Kanya Kumari district.
Quasi experimental, pretest and post test control group design was adopted
for this study. Purposive sampling technique was used to assess the effectiveness
of music therapy. Out of the 60 samples, 30 samples were in study group and 30
samples in control group. The data was collected from the selected postnatal
mothers and the Modified Christi breast feeding assessment tool was used to
assess the level of breast milk secretion. Demographic variables like age,
education, occupation, Religion, type of food and parity were selected. The
researcher provided music therapy to the study group. The researcher conducted
the study for a period of 4 weeks. The post assessment was conducted in the study
group and control group.
The findings reveals that, in study group, the mean score on level of breast
milk secretion among postnatal mothers in study group was 2.47 in pre assessment
and 5.90 in post assessment respectively. The estimated ‘unpaired t’ value was
17.25 which was significant at p < 0.05. Hence the research hypothesis (H 1) is
accepted. The mean score on level of breast milk secretion among postnatal
mothers in study group was 7.34 and in control group was 5.90. The estimated
unpaired “t” value was 4.91 which is significant at p<0.05. It shows that Music
Therapy was effective and improved the level of milk secretion. Hence the
research hypothesis (H2) is accepted. In Study group and in control group the
Calculated value of demographic variables were lesser than the table value which
indicates that, there is no significant association between breast milk secretion and
demographic variables . Hence the hypothesis (H3) is not accepted. As per the
study the researcher concludes that the Music therapy had an effect on level of
breast milk secretion and improves it.
1
CHAPTER I
INTRODUCTION
postnatal period. It is the time after birth, a time in which the mother's body,
including hormone levels and uterus size, returns to a non-pregnant state. Lochia is
postpartum vaginal discharge, containing blood, mucus, and uterine tissue. A woman
giving birth in a hospital may leave the hospital as soon as she is medically stable and
can be as early as a few hours postpartum, though the average for a vaginal birth is 1–
2 days, and the average caesarean section postnatal stay is 3–4 days. During this time,
the mother is monitored for vital signs, bleeding, bowel and bladder function. The
babies health is also monitored. The mother is assessed for tears, and is sutured if
necessary. Also, the mother may suffer from constipation or hemorrhoids, which
would be managed. The bladder is also assessed for infection, retention, and any
problems in the muscles. The major focus of postpartum care is ensuring that the
mother is healthy and capable of taking care of her newborn, equipped with all the
information she needs about breastfeeding, reproductive health , contraception and
the imminent life adjustment.
Breast milk is the milk produced by the breasts (or mammary glands)
of a human female for her baby offspring. Breast milk is a unique nutritional source
that cannot adequately be replaced by any other food, including baby formula.
It provides the ideal nutrition for babies. Breast milk has a nearly perfect mix of
vitamins, protein, and fat, everything baby needs to grow. All nutrients are provided
in a form more easily digested than baby formula. Breast milk contains antibodies
that help baby fight off viruses and bacteria. Although pollutants can accumulate in
breast milk, it remains superior to baby formula from the perspective of the overall
health of both mother and baby. Babies are fragile and susceptible to disease partly,
because their bodies are not fully developed. They must be treated with special care
and given adequate nourishment. Baby formulas are able to mimic a few of the
nutritional components of breast milk, but formula cannot hope to duplicate the vast
and constantly changing array of essential nutrients in human milk. Breast milk is the
primary source of nutrition for newborns before they are able to eat and digest other
3
foods; older Babies and toddlers may continue to be breastfed, either exclusively or in
combination with other foods.
Babies who are breast-fed longer have fewer dental cavities throughout
their lives. It is identified that babies who were breast-fed are significantly less likely
to become obese later in childhood. Formula feeding is linked to about a 20 to 30
percent greater likelihood that the baby will become obese. Babies who are
exclusively breast-fed during the first three months of their lives are 34 percent less
likely to develop juvenile, insulin-dependent diabetes than babies who are fed
formula. Breast feeding may also decrease the risk of babyhood cancer in babies
under 15 years of age. Formula-fed babies are eight times more likely to develop
cancer than babies who are nursed for more than six months. (It is important to note
that babies who are breast-fed for less than six months do not appear to have any
decreased cancer risk compared to bottle-fed babies). As babies grow into adults,
several studies have shown that people who were breast-fed as babies have lower
blood pressure on average than those who were formula-fed. Thus, it is not surprising
that other studies have shown that heart disease is less likely to develop in adults who
were breast-fed in infancy. Significant evidence suggests that breast-fed babies
develop fewer psychological, behavioral and learning problems as they grow older. It
also indicate that cognitive development is increased among babies whose mothers
choose to breastfeed. In researching the psychological benefits of breast milk, one
researcher found that breast-fed babies were, on average, more mature, assertive and
secure with themselves as they developed.
Babies have a sucking reflex that enables them to suck and swallow
milk. Experts recommend babies be breastfed within one hour of birth, exclusively
breastfed for the first six months, and then breastfed until age two with age-
appropriate, nutritionally adequate and safe complementary foods. Breastfeeding was
the rule in ancient times up to recent human history, babies were carried with the
mother and fed as required. With 18th and 19th century industrialization in the Western
world, mothers in many urban centers began dispensing with breastfeeding due to
4
their work requirements. Breastfeeding declined significantly from 1900 to 1960, due
to increasingly negative social attitudes towards the practice and the development of
baby formula. From the 1960s onwards, breastfeeding experienced a revival which
continues to the 2000s, though some negative attitudes towards the practice still
remain.
Music therapy has been shown to have positive effects in several areas,
such as mental health, special education, rehabilitation, and social development.
Amber A C et al (2015 ) conducted a study on the effect of music listening on
relaxation level and volume of breast milk pumped by mothers of babies in the
neonatal intensive care unit, Lexington .Results indicated that there was a significant
increase in relaxation scores in the music group. Studies have demonstrated that
music therapy can reduce maternal anxiety, helping mothers to cope with their babies
stay in the neonatal intensive care unit (NICU), and also influences preterm behavior,
providing greater periods of quiet sleep states, less crying, and an increase in weight
gain (Lai et al, 2006; Cevasco, 2008; Kemper & Hamilton, 2008; Keith, Russell &
Weaver, 2009).
Breast feeding not only the baby, it also provides benefits to the mother.
Breastfeeding reduces the risk of breast cancer. Women who breastfeed reduce the
risk of developing breast cancer by as much as 25 percent. The reduction in cancer
risk comes in proportion to the cumulative lifetime duration of breastfeeding. That is,
the more months or years a mother breastfeeds, the lower her risk of breast cancer. It
also reduces the risk of uterine and ovarian cancer. One of the reasons for the cancer-
fighting effects of breastfeeding is that estrogen levels are lower during breast milk
secretion. It is thought that the less estrogen available to stimulate the lining of the
6
uterus and breast tissues are less the risk of these tissues becoming cancerous. Non-
breastfeeding women have a four times greater chance of developing osteoporosis
than breastfeeding women and are more likely to suffer from hip fractures in the post-
menopausal years. Breast feeding benefits for baby spacing.
Music therapy has shown that it reduces stress for parents and
premature babies in the NICU. Music therapy can improve physiological parameters
of newborns, reduce weight loss and decrease the length of stay in ICU and in
hospital. Music therapy may increase breastfeeding rates among mothers of
premature newborns.
The advantages for the mother during Breast milk secretion are that it
stimulates the production of oxytocin hormone, uterus to contract and return to its
pre-pregnancy size, helps to burn extra calories, lowers fat stores, helping to go back
9
pituitary gland. The posterior pituitary gland produces the oxytocin hormone which
stimulates the contraction of the myoepithelial cells surrounding the alveoli, which
holds the milk and produces breast milk secretion.. Thus the breast milk is secreted by
the influence of Music therapy.
1. To asses and compare the pre assessment and post assessment on level of
breast milk secretion among postnatal mothers.
HYPOTHESES
H1: There is a significant difference between pre assessment and post assessment
level of breast milk secretion among postnatal mothers in study group and control
group.
H2: There is a significant difference between post assessment level of breast milk
secretion among postnatal mothers in study group and control group.
H3. There is a significant association between post assessment level of breast milk
secretion among postnatal mothers with the selected demographic variables in study
group and control group.
OPERATIONAL DEFINITION
Breast milk secretion: It refers to through hearing music, the ejection of breast milk
that is produced by the mammary gland of the mother in the postnatal period which is
measured by Modified Christi Breast Feeding Assessment Tool.
Postnatal Mothers: It refers to all mothers who underwent lower segmental cesarean
section.
ASSUMPTION
12
x Music Therapy may have some effect on level of breast milk secretion among
postnatal mothers.
x The level of breast milk secretion may vary from mother to mother.
DELIMITATION
PROJECTED OUTCOME
x The study will enable the nurse to identify the effectiveness of music therapy
on level of breast milk secretion in study group.
x It provides an opportunity for the nurse to encourage mothers to hear music
during their postnatal period to improve breast feeding.
x The study will help the mothers to know the importance of music therapy.
CONCEPTUAL FRAMEWORK
In this study the Investigator identifies the need for help by assessing the
demographic variables (Annexure VII) and the pre assessment of the level of breast
milk secretion among postnatal mothers using modified Christi breast feeding
assessment tool( Annexure VII).
Ministering the needed help refers to the provision of required help to fulfill
the identified needs. It has 2 components.
This step involves the assessment of level of breast milk secretion after
rendering Music Therapy. Post assessment involves the assessment of level of breast
milk secretion using modified Christi breast feeding assessment tool (Annexure VII).
Level of breast milk secretion is categorized as adequate, moderate and inadequate
breast milk secretion. Two possible outcomes are improving the level of breast milk
secretion in the study group and not inducing the breast milk secretion of control
group.
Feed Back
The level of breast milk secretion had moderate and adequate progress in
Postnatal mothers after giving Music Therapy in study group. There was inadequate
and moderate progress in level of breast milk secretion in control group. At the end of
the study, the researcher explained about the effectiveness of Music Therapy to the
postnatal mothers in inadequate and moderate level of breast milk secretion in in
study and control group. The researcher provided CD for the postnatal mothers of the
study group and control group to practice at home.
15
16
CHAPTER II
REVIEW OF LITERATURE
studies were identified that provided data on the relationship between breastfeeding
and SBDS risk. Two teams of 2 reviewers evaluated study quality according to preset
criteria. Univariable and multivariable odds ratios were extracted. The result stated
that Breastfeeding is protective against SBDS, and this effect is stronger when
breastfeeding is exclusive. The recommendation to breastfeed Babies should be
included with other SBDS risk-reduction messages to both reduce the risk of SBDS
and promote breastfeeding for its many other baby and maternal health benefits.
Congo. All 66 mothers interviewed were breastfeeding. The study result was before
initiating breastfeeding, 23 gave their Babies something other than their milk,
including: sugar water (16) or water (2). During the twenty-four hours prior to
interview, 26 (39%) Babies were exclusively breastfed (EBF), whereas 18 (27%), 12
(18%), and 10 (15%) received water, tea, formula, or porridge, respectively, in
addition to human milk. The main reason for water supplementation is heat and
cultural beliefs that water is needed for proper digestion of human milk. The study
concluded that facilities lacked any written policy about breastfeeding. Addressing
cultural beliefs, training healthcare providers adequately on breastfeeding support
skills, and providing structured breastfeeding support after maternity discharge is
needed.
The sample size was 883 low income mothers. The study result was 88% mothers had
adequate knowledge, 70%mothers had moderate knowledge. The study concluded
that urban mothers had adequate knowledge about breast feeding.
cluster randomized trial was used. The sample size was 17046 healthy breastfeed
Babies. The outcome was measured by intelligent quotient scores. The study, based
on the largest randomized trial ever conducted in the area of human Breast milk
secretion, provide strong evidence that prolonged and exclusive breastfeeding
improves babies’ cognitive development.
basis for the increased volume of expressed milk (improved milk production v more
efficient milk ejection) are appropriate topics for future research.
rates among mothers of premature newborns at the first follow-up visit, and also a
positive influence (although not significant) that lasted up to 60 days after baby
discharge. Music therapy may be useful for increasing breastfeeding rates among
mothers of premature newborns.
CHAPTER III
RESEARCH METHODOLOGY
RESEARCH APPROACH:
RESEARCH DESIGN:
Quasi experimental pre test and post test control group design was
adapted for this study. A pre test –post test control group design is usually a quasi-
experiment were participants are studied before and after the experimental
manipulation.
Study group O1 X O2
Control group O1 - O2
X - Music Therapy
VARIABLES
SETTING:
The setting adopted for this study is P.P.K Hospital which is a 300
bedded Multispecialty Hospital, Marthandam, Kanya Kumari District. It is located 35
kilometers away from St. Xavier’s Catholic College of Nursing, Chunkankadai. It has
all facilities such as Casualty, Labour Ward, Operation Theatre, Antenatal Ward,
Postnatal Ward, Post-Operative Ward and Other Specialities. The Hospital records 60
– 70 normal deliveries, 90 – 100 Lower Segmental Cesarean Section Deliveries and
5-10 instrumental deliveries per month. Totally 160 – 180 deliveries were conducted
per month. This hospital is well known for its maternal and child health care.
POPULATION:
Target population
The population under study constituted all the postnatal mothers who
underwent Lower Segmental Cesarean Section.
Accessible population
29
SAMPLE:
The researcher selected postnatal mothers who underwent Lower
Segmental Cesarean Section and fulfilling inclusion and exclusion criteria in P.P.K
Hospital.
SAMPLE SIZE:
SAMPLING TECHNIQUE
SAMPLING CRITERIA:
Inclusion criteria:
Exclusion criteria:
DESCRIPTION OF TOOL:
The tool consists of five criteria on level of breast milk secretion such as
Latch-On, Length of time before latch-on, suckling, audible swallowing and mother’s
evaluation and consists of three observed assessment including inadequate, moderate,
adequate. Each assessment was observed and evaluated based on the score.
0 - 2: Inadequate
3 - 6: Moderate
7 – 10: Adequate
DESCRIPTION OF INTERVENTION
Step I:
Sampling done based on the inclusion criteria. An informed consent got from
postnatal mothers who had participated in this study. Demographic data (Annexure
VII) was collected. Pre assessment done by Modified Christi breastfeeding
assessment tool (Annexure VII)
Step II:
31
for the mother and music therapy was provided in morning for 30 minutes every day
for a period of 6 days from the day of delivery.
Step III:
Step IV:
CONTENT VALIDITY
For content validity five experts - three experts from the department of
Obstetrics and Gynaecological nursing and two from senior doctors of obstetrics and
gynaecological department were requested to give their opinion about the content and
its relevance appropriateness of the items. Expert for music therapy was requested for
opinion and obtained consent to use Instrumental music of Anandhabairavi Ragam
(Annexure VI) for the study. The tool was modified based on suggestions.
RELIABILITY
Inter rater reliability assessment was done. The ‘r’ value was 0.85 for the
Modified Christi Breast Feeding assessment tool (Annexure VII), which concluded
that the tool was reliable.
32
The researcher obtained permission from the Principal, St.Xavier’s Catholic College
of Nursing and the Director of Caroline John Hospital to conduct the pilot study. Oral
consent was obtained from six samples, in that three in study group and three in
control group. Study group received Music Therapy (Annexure VI) and control group
did not receive Music Therapy. The intervention was given in the morning for 30
minutes for 6 days from the day of delivery. Then the post assessment was conducted
on all the 6 days with Christi Breastfeeding Assessment Tool (Annexure VII) and the
mean value was taken. Analysis of the data was done by using descriptive and
inferential statistics. No changes were made and the researcher proceeded to the main
study.
After obtaining formal permission from the Principal of St. Xavier’s Catholic
College of Nursing, Chunkankadai (Annexure I) and Mr. Mathivanan MBA,
Administrator, P.P.K. Hospital, Marthandam (Annexure II), the participants were
selected based on the inclusion and exclusion criteria. The researcher obtained oral
consent from each samples and proceeded with the data collection.
The data was collected from the selected participants and the Modified Christi
breast feeding assessment tool (Annexure VII) was used to assess the level of breast
milk secretion. Averages of 2-3 samples per day were selected for the study group
33
Study group received Music Therapy and control group did not receive Music
Therapy. The intervention was given in the morning for 30 minutes for 6 days from
the day of delivery.
The post assessment was conducted on all the 6 days with Christi
Breastfeeding Assessment Tool (Annexure VII) and Mean value was taken. Analysis
of the data was done by using descriptive and inferential statistics. (Annexure XII).
Descriptive statistics
¾ Mean and standard deviation was used to assess the effectiveness of Music
therapy on level of breast milk secretion among postnatal mothers.
Inferential statistics
9 Paired’t’ test was used to compare post assessment level of breast milk
secretion on control group and study group.
34
9 Chi-square test was used to find out the association of post assessment level
of breast milk secretion in study group and control group with the selected
demographic variables.
ETHICAL CONSIDERATION
CHAPTER IV
This chapter deals with the analysis and interpretation of the data
collected among postnatal mothers who underwent lower segmental caesarean
section. This chapter also represents the findings of the study. The data collected from
the samples were tabulated, analyzed and preserved in the tables and interpreted
under the following sections based on the objectives and hypotheses of the study.
Section A:
Section B:
2. Pre and post assessment on level of breast milk secretion in study and
control group:
2.1 Pre assessment frequency and percentage distribution on level of breast milk
secretion of postnatal mothers in study group and control group.
Section C:
3.1 Comparison of pre assessment and post assessment level of breast milk secretion
among postnatal mothers in study group and control group.
3.2 Comparison of post assessment level of breast milk secretion among postnatal
mothers in study group and control group.
3.3 Comparison of pre and post assessment level of breast milk secretion among
postnatal mothers in study group and control group.
Section D:
4. Association between the post assessment level of breast milk secretion with the
selected demographic variables in study and control group
4.1 Association between the post assessment level of breast milk secretion among
postnatal mothers in study group with the selected demographic variables.
4.2 Association between the post assessment level of breast milk secretion among
postnatal mothers in control group with the selected demographic variables.
39
40
SECTION: A
N = 60
1 Age
a) 18-23years
b) 24-28years 10 33.33 6 20
c ) 29-33years 12 40 16 53.33
2 Educational status
a) Illiterate
b) School education 0 0 0 0
c) Under Graduate 7 23.33 5 16.67
d) Post Graduate
17 56.67 18 60
6 20 7 23.33
3 Occupation
a) Unemployed
41
Religion
4
a) Hindu 13 43.33 13 43.33
b) Christian
15 50 15 50
c) Muslim
2 6.67 2 6.67
5 Type of Food
a) Vegetarian 0 0 0 0
b) Non-Vegetarian
30 100 30 100
6 Parity
a) Primi para 16 53.33 16 53.33
b) Multi para
8 26.67 11 36.67
c) Grand multi para
6 20 3 10
With regard to Type of food, none were vegetarian and 30 (100%) were
non-vegetarian. Likewise in control group none were vegetarian and 30 (100%) were
non- vegetarian.
Section-B
PRE ASSESSMENT
f % f % f % f % f % f %
3 Suckling 9 30 21 70 0 0 15 50 15 50 0 0
Table 2.1 represents that in study group, according to Latch-on 12(40%) had
inadequate, 18 (60%) had moderate and none of them had adequate breast milk
secretion. With regarding to Length of time before latch on and suckling 16(53.33%)
had inadequate, 14 (46.67%) had moderate and none had adequate level of breast
milk secretion. Considering to suckling , 9 (30%) had inadequate , 21 (70%) moderate
and none of them had adequate secretion. With relevance to audible swallowing, 19
(63.33%) had inadequate, 11 (36.67%) had moderate and none had adequate breast
milk secretion. Analysing the mothers evaluation, 19 (63.33%) had inadequate, 11
(36.67%) had moderate and none had adequate breast milk secretion .
Fig2.7: Percentage distribution of pre assessment level of breast milk secretion among postnatal mothers
52
N= 60
POST ASSESSMENT
f % f % f % f % f % f %
3 Suckling 0 0 0 0 30 100 0 0 6 20 24 80
4 Audible 0 0 0 0 30 100 0 0 6 20 24 80
swallowing
Level of Breast 0 0 9 30 21 70 0 0 15 50 15 50
53
Table 2.2represents that in study group, according to Latch-on none had inadequate,
none had moderate and 30(100%) had adequate breast milk secretion. With regarding
to Length of time before latch on and suckling none had inadequate, none had
moderate and none 30(100%) had adequate level of breast milk secretion.
Considering to suckling, none had inadequate, none had moderate and 30(100%) had
adequate secretion. With relevance to audible swallowing, none had inadequate, none
had moderate and none30(100%) had adequate breast milk secretion. With relevance
to mothers evaluation, none had inadequate, none had moderate and 30(100%) had
adequate breast milk secretion.
Fig 2.8: Percentage distribution of post assessment level of breast milk secretion among postnatal mothers.
55
SECTION C
TABLE 3.1 Comparison of mean, standard deviation and independent ‘t’ value
on pre and post assessment level of breast milk secretion among postnatal
mothers in study group and control group.
N=60
Level of Breast
milk secretion Study group (n=30)
Pre assessment 2.43 1.79
17.25*
Post assessment 7.34 0.54
*significant at p<0.05.
Table 3.1 represents the comparison of mean, standard deviation and independent‘t’
value on pre and post assessment level of milk secretion among postnatal mothers in
study group and control group. The mean score on level of milk secretion among
56
mothers was 2.47 in pre assessment and5.90 in post assessment respectively. The
estimated paired ’t’ value for Breast milk secretion was 11.16 which was also
significant at p < 0.05 due to normal physiology of breast milk secretion. But
comparing both the values, the music therapy was more significant.
Table 3.2 Comparison of mean, standard deviation and paired ‘t’ value on post
assessment level of breast milk secretion among postnatal mothers in study
group and control group
N=60
Table 3.2 represents the comparison of mean, standard deviation and paired ‘t’ value
on post assessment level of breast milk secretion among postnatal mothers in study
group and control group. The mean score on level of milk secretion among postnatal
mothers study group was 7.34 and in control group was 5.90. The estimated paired
“t” value was 4.91 which is significant at p<0.05. It shows that Music Therapy was
effective and improved the level of milk secretion. Hence the research hypothesis
(H2) is accepted.
57
o milk secretion n = 30 n = 30
Table 3.3 represents the comparison of music therapy according to level of breast
milk secretion among postnatal mothers in study group and control group, In study
group the mean value of Latch- on is 0.9, standard deviation is 1.75 and ‘t’ value is
2.9. Which is significant at p<0.05, the mean value of length of time before latch-on
is 1, standard deviation is 2.03 and ‘t’ value is 2.7. Which is significant at p<0.05, the
mean value of suckling is 0.76, standard deviation is 1.66 and ‘t’ value is 2.53. Which
is significant at p<0.05, the mean value of audible swallowing is 1.13, standard
58
SECTION D
Table 4.1 Association between the post assessment level of breast milk secretion
among postnatal mothers in study group with the selected demographic
variables
n=30
STUDY GROUP
f % f % f %
Private 1 3.33 3 10 6 20
Employed
5 Type of Vegetarian 0 0 0 0 0 0 F2 = 0
food
Non- 5 16.6 12 40 13 43.3 df = 0
Vegetarian 7 3
Table
value = 0
Table 4.2Association between the post assessment level of breast milk secretion
among postnatal mothers in control group with the selected demographic
variables.
n = 30
CONTROL GROUP
34-40 yrs 0 0 0 0 0 0
Employed 3
5 Type of Vegetarian 0 0 0 0 0 0 F2 = 0
food
Non- 6 20 18 60 6 20 df = 0
Vegetarian
Table
value = 0
Table 4.2 represents that in control group the calculated value of the selected
demographic variables such as age, education, occupation, religion, type of food and
parity is lesser than the table value which indicates that there is no significant
association with level of breast milk secretion and demographic variables . Hence the
research hypothesis (H3) is not accepted.
63
CHAPTER V
DISCUSSION
This chapter deals with the discussion of the data analyzed based on the
objectives and hypotheses of the study. Quasi experimental study was used to
evaluate the effectiveness of Music therapy on level of breast milk secretion among
postnatal mothers in selected hospital, Kanya Kumari district. The discussion was
based on the objectives and hypotheses mentioned in the study.
Analyzing the Type of food, none were vegetarian and 30 (100%) were
non-vegetarian. Likewise in control group none were vegetarian and 30 (100%) were
non- vegetarian.
With regard to Parity, 16 (53.33%) were primi para, and 6 (20%) were
grand multi para. In control group 16 (53.33%) were primi para, 11 (36.67%) were
multi para and 3 (10%) grand multi para.
The first objective was to assess and compare the pre and post assessment level
of breast milk secretion among postnatal mothers in study and control group
The first objective was supported by the study of Federal do Rio J (2009)
conducted a Randomized Controlled Trial to evaluate the effects of music therapy on
Breastfeeding Rates among mothers of Premature Newborns in Brazil. A sample size
of 120 (60 control group and 60 interventional group) were selected.. Music therapy
sessions systematically offered to all mothers in the intervention group, three times a
65
The second objective was to evaluate the effectiveness of Music Therapy on level
of breast milk secretion among postnatal mothers
It shows that, in Study group and in control group the calculated value of
demographic variables such as age, education, occupation, religion, type of food and
parity is lesser than the table value which indicates that there is no significant
association with breast milk secretion and demographic variables. Hence hypothesis
(H3) is not accepted.
This chapter deals with the discussion of the study with reference to the
objective and supportive studies. Among the three objectives and hypotheses, two
objectives have been obtained and two hypotheses were accepted in this study.
67
CHAPTER VI
This chapter deals with the summary of the study and conclusion. It clarifies
nursing implications for nursing practice, limitations and recommendations for further
research in the field.
SUMMARY
The aim of the study is to assess the effectiveness of music therapy on level of
breast milk secretion among postnatal mothers. A review of related literature enabled
the researcher to develop the conceptual framework and methodology for the study.
The conceptual framework adopted for this study was based on Einstein Widenbach’s
Prescriptive Helping Art of clinical Nursing Theory(1964) . Quantitative research
approach was used. Quasi Experimental pretest - post test Control group design was
adopted to evaluate the effectiveness of music therapy on level of breast milk
secretion among postnatal mothers. The study was conducted in PPK hospital. The
purposive sampling technique was used to select 30 samples for Control group and 30
samples for study group.
FINDINGS
breast milk secretion. During post assessment, in study group none of them had
inadequate breast milk secretion, 9 (30%) of them had moderate breast milk secretion
and 21 (70%) had adequate breast milk secretion. In control group none had
inadequate breast milk secretion, 15 (50%) had moderate Breast milk secretion and
15 (50 %) had adequate Breast milk secretion.
CONCLUSION
Based on the data collected the mean score on the level of breast milk
secretion in study group was 2.43 in pre assessment and 7.34 in post assessment the
paired ‘t’ value is 17.25* which is significant at P < 0.05. It shows that music therapy
is effective in improving the breast milk secretion among postnatal mothers. From the
result, the researcher concluded that providing Music therapy was effective in
improving the breast milk secretion among postnatal mothers. Therefore the
researcher felt that more important should be given to Music therapy for postnatal
mothers to improve the level of breast milk secretion.
NURSING IMPLICATIONS
The finding of the study enables us to conclude that music therapy is effective
in improving breast milk secretion among postnatal mothers which is of vital concern
to the field of nursing profession including nursing practice, nursing administration,
nursing education and nursing research.
71
NURSING EDUCATION
NURSING ADMINISTRATION
NURSING RESEARCH
LIMITATION
¾ Since there were very few studies done on the effectiveness on music
therapy on level of breast milk secretion, the investigator had lot of
difficulties in collecting the study materials for the review.
¾ The study was conducted among the postnatal mothers, so the
investigator had lot of difficulties in coping up with the timing of
hospital routine.
RECOMMENDATION
TEXT BOOKS
18. Pairman,S et al. (2010). Midwifery: Preparation for Practice. Sydney: Elsevier
Health Science.
19. Peggy, L. (1994). Theory and Nursing.(3rd edi.). New Delhi: St.Louis
Publication.
20. Polit and Hungler. (2007).Nursing Research. (7thedi.) .New Delhi:Lippincott
Williams and Wilkin.
21. Prabhakara, G. N. (2006). Biostatistics. New Delhi: Jaypee Brothers Medical
Publishers Pvt.Ltd.
22. Rao, S.P.SS. (1996). An Introduction to Biostatistics- A Manual for Students
in Health Sciences. (3rd edi.).New Delhi: Prentice Hall of India Private Ltd.
23. Ruth, B, Linda,K and Brown. (1996).Myles Text Book of Gynecology (12th
edi.). New York: Mary Law Churchill Livingstone.
24. Sundar Roa , C. (1998). An Introduction to Bio-Statistics . (2nd edi.). Vellore:
Perographic Printers.
25. Walsh, D & Downey, S. (2010). Essential Midwifery Practice: Intrapartum
Care. Iowa:Wiley Blackwell.
26. Whitefield,C.G. (1989).Dewhurst’s Textbook of Obstetrics and Gynaecology
for Postgraduates. (4th edi.). Singapore: Blackwell Scientific Publications.
75
JOURNALS
NET REFERENCE
36. http://www.ajog.org
37. http://www.bensomhentryinstitute.org
38. http://www.biomedical.com
39. http://www.biomedcenter.com
40. http://www.complementarytherapiesinmedicine...
41. http://www.globalizationhealth.com
42. http://www.hyper.ahajournals.org/232
43. http://www.ije.oxfordjournals.org/
44. http://www.mind tools.com/stress/relaxation technique
45. http://www.nature.com/jhh/journal/v26/n7/abs/html.
46. http://www.nchi.nlm.nih.gov.
47. http://www.ncbi.nlm.nih.gov/pubmed.
76
54. http://www.nmahp-ru.ac.uk/
55. http://www.ncbi.nlm.nih.gov/pubmed/18458209
56. http://www.hindawi.com/journals/isrn/2014/510793/
57. https://fds.duke.edu/db/nurse/faculty/marilyn.oermann
58. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164447/
59. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117512
60. http:// www.unicef.org /publicpartnerships /files/ 2014 Annual Results Report
Nutrition pdf.
1
ANNEXURES I
ANNEXURES II
ANNEXURES III
Sub: Requisition to expert opinion and suggestion for the content validity.
I request you to go through the items and give your valuable suggestions
and opinions to develop the content validity of the tool. Kindly suggest
modifications, addition and deletions if any in the remarks column.
Thanking You,
ANNEXURES IV
Name:
Designation:
Address:
5
Instruction:
PART-I
9
6
PART-II
INADEQUATE
MODERATE
ADEQUATE
ANNEXURE V
7
ANNEXURE VI
ANNEXURE VII
TOOL FOR DATA COLLECTION
PART - I
9
DEMOGRAPHIC VARIABLES
INTERVIEW SCHEDULE
Instructions
The investigator will ask the item listed below and place the tick mark (ᅚ)
against the response given by the respondents.
1. Age
a) 18 – 23 years ( )
b) 24 – 28 years ( )
c) 29 – 33 years ( )
d) 34 - 40 years ( )
2. Educational status
a) Illiterate ( )
b) School education ( )
c) Under graduate ( )
d) Post graduate ( )
3. Occupation
a) Unemployed ( )
b) self employed ( )
c) government employed ( )
d) private employed ( )
4. Religion
a) Hindu ( )
b) Christian ( )
c) Muslim ( )
5. Type of food
a) Vegetarian ( )
b) Non vegetarian ( )
6. Parity
10
a) Primi para ( )
b) Multi para ( )
c) Grand multi para ( )
PART II
Score 0 1 2 Day
Pr 1 2 3 4 5 6 Pos
e t
Latch on after Eagerly
Latch-on No repeated grasped
latch on attempts breast to
achieve latch on
d
11
Length of
time Over 10 4-6 min 0-3 min
before min
latch-on
and
suckle
Suckled but Suckle
Suckling Did not needed rhythmicall
suckle encouragemen y with lips
t flanged
ANNEXURE VIII
Table 3.2: Data collection period, number of sample and method of sample
selection
6 07-07-2015 03 Purposive
7 08-07-2015 02 sampling technique
8 09-07-2015 02 used
9 10-07-2015 03
10 11-07-2015 03
11 13-07-2015 02
12 14-07-2015 03
13 15-07-2015 02
14 16-07-2015 02
15 17-07-2015 03
16 20-07-2015 03
17 21-07-2015 02
18 22-07-2015 04
19 23-07-2015 03
20 24-07-2015 03
21 25-07-2015 03
22 27-07-2015 02
23 29-07-2015 02
24 31-07-2015 01
ANNEXURE IX
ANNEXURE X
CERTIFICATE OF EDITING
14
ANNEXURE XI
Music therapy
Produce oxytocin
DESCRIPTIVE STATISTICS
ϥx
x
Mean N
2
s
xϥx
Standard deviation n1
16
INFERENTIAL STATISTICS
| x1 x 2|
t
2 2
Independent 't' test s1 s2
n1 n2
s
n11 s12 n21 s 22
n 1n 22
dϥ n
t
Paired ‘t’ test s
2
s
ddϥ
n1
2
oe
x
2
Chi-Square test e
ANNEXURE XIII