Effects of Childbirth Preparation Nursing Intervention Integrating Islamic Praying Program on Labor Pain, Pain-Coping Behaviors, and Duration of Labor in Primiparous Muslim Women

Abstract

This experimental study design was conducted to test the effects of the Childbirth Preparation Nursing Intervention Integrating Islamic Praying (CPNsIIIP) program on labor pain, pain-coping behaviors, and duration of labor in primiparous Muslim women in Indonesia. The experimental group (n=41) received the program and usual care, while the control group (n=42) received only the usual care. The program based on Islamic Philosophy, Holistic Nursing Theory, and Labor Support Concept started at 32 weeks of pregnancy by providing childbirth education regarding positioning, breathing, stroking, and Islamic prayer which was then practiced at home every day until the first 3 hours of the active phase of labor. A Visual Analogue Scale (VAS) and Pain Behavior Observation Scale (PBOS) were used to measure labor pain and pain-coping behaviors, respectively, at pre-test and at the 1st, 2nd, and 3rd hour from 3-4 cm of cervical dilation. Duration of labor was measured in minutes from cervical dilation of 3-4 cm to full cervical dilation of 10 cm. Testing the assumption showed that the data sets of outcomes were normally distributed and similar in both groups. Repeated measures of ANOVA indicated that after receiving the intervention program, the women in the experimental group reported significant reduction in labor pain compared to the control group [F (1, 81) = 113, P = 0.00, 77 (effect size) = .58], there were significantly statistical differences of over four points in labor pain, [F(2, 182) = 82.84, P = 0.00, partial П]2 (effect size) = .50], and increased pain-coping behaviors in the experimental group compared to the control group [F (1, 81) = 147, P = 0.00, 1]2 = 0.64], there were significantly statistical differences of over four points in pain-coping behaviors, [F(2, 182) = 165.55, P = 0.00, partial 17 (effect size) = 0.67]. Post Hoc Test Multiple Comparisons of One Way ANOVA was conducted to analyze a comparison of mean differences of labor pain and pain-coping behaviors 3 times after the CPNsIIIP program was finished within the experimental group suggesting that labor pain was significantly reduced at pre-test and 1st hour, at pre-test and 2nd hour, and at pre-test and 3rd hour, while the labor pain at the 1st and 2nd hour, at the 1st and 3rd hour, at the 2nd and 3rd hour were not significantly lower. However, the pain-coping behavior significantly increased over time after receiving the program. The independent t-test was used to report the effects of the intervention program between the groups. The findings showed that the experimental group had significantly decreased pain, increased pain-coping behaviors at each posttest (P<0.05), and a shorter duration of the active phase of labor (t = 7.51; P = 0.00) than the control group. It is thus recommended to implement the program into maternity nursing practice because the program culturally fits Muslim women and showed evidence of its effectiveness in reducing labor pain, increasing pain-coping behaviors, and shorter duration of the active phase of labor.