Browsing by Author "Shrestha, Uma"
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Publication Effect of Group Psycho-Educational Interventions on Child birth fear and Child birth Self-efficacy among Primiparous women(Nepal Health Research Council, 2022) Bista, Archana Pandey; Shrama, Chandrakala; Shrestha, Uma; Timalsina, Punjita; Devkota, Kavita; Piya, Kalpana; Neupane, BeenaAbstract Background: Child birth related fear and low self-efficacy for child birth found common among primiparous women. Antenatal group psycho-educational interventions have been used as important strategies to address child birth fear and self-efficacy. Thus, this study aimed to find out the status of child birth fear among antenatal women and effect of group psycho-educational interventions among primiparous women. Methods:One group pretest-posttest design was adopted. Total 307 primigravida women attending antenatal outpatient department of two hospitals within Kathmandu valley were selected through purposive sampling technique. Data was collected from March to July 2020. Child birth fear was assessed by using validated tool i.e.Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Child birth self-efficacy was assessed by using childbirth self- efficacy tool. Primigravida women with moderate level of child-birth fear, were intervened for group psycho-education based on PRIME Model by nurses who were research team members. Paired t-test was used to compare differences in mean scores on child birth fear and child birth self-efficacy before and after intervention. Results: Moderate level of child birth fear was found among 24.8% of participants. Low child-birth self-efficacy was found among 42.0% participants. The overall mean score before providing group psycho-educational interventions to experimental group on child-birth fear was 54.0±2.09 and on child birth self-efficacy was 78.0±28.64 with p<0.001 and after providing group psycho-educational interventions child-birth fear was reduced to 47.8±2.44 and child birth self-efficacy was 105.2±19.6 with p<0.001. Conclusions: Group psycho-educational interventions based on PRIME approach led by nurses have significant effects in reducing child-birth fear and increasing child-birth self-efficacy. Therefore, provision of group psycho-educational interventions along with routine antenatal service need to be considered in clinical settings in Nepalese context. Keywords: Child birth fear; child birth self-efficacy; primiparous womenPublication Elderly Great Grand Multipara with Gestational Hypertension and Anemia Managed in a Rural Tertiary Hospital: A Case Report(Institute of Medicine, 2019) Shrestha, UmaABSTRACT Introduction Parity more than five is grand multiparity and more than 10 is great grand multiparity. Women with high birth order are at increased risk for adverse obstetric outcomes. The risk is even higher for great grand multiparous women than grand multiparous women. Grand and Great grand multiparity predispose for adverse maternal and perinatal outcomes such as malpresentation, labor dystocia, caesarean delivery, postpartum hemorrhage, maternal anemia, congenital malformations and perinatal mortality. Grand and Great grand multiparty is also independent risk factor for labor dystocia and perinatal mortality. However, most of the adverse outcomes that have been associated with grand multiparity may actually be confounded by advanced age, less antenatal care and low socioeconomic level. Although pregnancy hypertension is more commonly seen among young primigravidas, hypertension is equally common in elderly women. This is a unique case of elderly great grand multiparous women with moderate anemia who developed gestational hypertension and underwent emergency cesarean section resulting into normal maternal and fetal outcome. Keywords: Elderly, gestational hypertension, great grand multiparity, pregnancy outcome