الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The postpartum period is defined as one hour following the delivery of baby and placenta through the first six weeks of an infant’s life. It involves managing of minor discomfort and common complication that occurs after normal vaginal delivery. It is divided in to three sections: immediate (24 hr after delivery-at the ward), short term care and counseling (2-7 days post partum), long term care and counseling (six week post partum)(Cunningham, 2005).
Counseling for post partum (pp) women is the skilled and principled use of relationship to facilitate post partum women’s self- knowledge, emotional acceptance of their new role as mothers, and the optimal development of personal resources. The overall aim is to provide an opportunity to work towards living more satisfyingly and resourcefully (Cunningham, 2005).
Likewise, Gladding, (2004) reported that counseling -for postpartum women- is a helping relation during which, the counselor facilitates an individual to consider the aspects of their life they wish to change. It is a process with beginning, middle and an end. The basic steps of counseling involve: gaining recognition for their skills and experience, being confronted, from a caring position, by the ways they used to discover themselves and others, re-experiencing, in the present, any relevant events from the past.In modern streamlined maternity care, including shortened postpartum care time and fewer resources. The possibility of offering women a postpartum consultation is reduced. A population-based Egyptian study showed that small percentage of the women had postpartum counseling either with a nurse or an obstetrician from the delivery ward, another Egyptian study shows that 66% of the primipara women and 74% of the multipara’s women wanted postpartum counseling (Egyptian National Maternal Mortality Study,2005).Summary19The aims of Care in the Postpartum Period as the following: Support of the mother and her family in the transition to new family constellation, and response to their needs, Prevention, early diagnosis and treatment of complications of mother and including the prevention of vertical transmission of diseases from mother to neonate, Referral of mother and neonate for specialist care when necessary, Counseling on baby care, Support of breastfeeding, Counseling on maternal nutrition, and supplementation if necessary, Counseling and service provision for contraception, birth spacing and the resumption of sexual activity, Immunization of the infant (Crum, 2006).The present study was carried out with the aim of examining the effect of nursing counseling on post partum women regarding their needs and expectations. The researcher useda quasi-experimental (pre-post- test) design in carrying out this study.
Setting:
The study was conducted at two settings in Menofia Governorate, namely University Hospital and Shebin El-Kom Teaching Hospital.
*University Hospital: It is University – affiliated hospital, with a primary role of medical and nursing education. It provides free and paid services during pregnancy, labor and postpartum. The flow rate for normal deliveries in this hospital ranges from 1100 to 1200 case annually. The investigators recruited the cases from the hospital at delivery unit.
*Shebin El -Kom Teaching Hospital: It is affiliated to Organization of Teaching hospitals and Institutions. It provides free services to public clients and provides care for women during pregnancy and labor, as well as for fertility and gynecological problems, in addition to family services. The annual flow rate ranges from 3600 to 5000 cases.Sample:A purposive non probability sample of 200 women who attended for delivery - at the time of conducting the study-, at the University HospitalSummary19 and the Teaching Hospital were included in the current study. The participation was on voluntary basis. Then the selected subjects were randomly assigned to:1. Experimental group which consisted of 100 postpartum women, 30 women from the University hospital and 70 women from Shebin El- Kom teaching hospital. The experimental group received post partum counseling,2. The control group consisted of70 women from the University hospital and 30 from the Teaching hospital. The control group received routine care and a copy of the guide booklet.Inclusion criteria of the postpartum women: Primipara. Free from any disease. Free from any complications during pregnancy.
Had normal delivery.Data collection tools:Throughout the course of the present study data were collected using the following tools:
1. Structured Interview questionnaire ( Appendix I):It was developed by the researcher. The tool consisted of the following parts:Part (I) Socio-demographic Data: It included such data as: Name, age, educational level, occupation, and marital status.Part (II): Knowledge regarding postpartum for assessment of women’s knowledge and needs regarding hygiene, nutrition, lactation, baby bath, cord care, breast care, vaccination and contraception use, sexual relation and managing some pp complications Part (III) A guide Booklet: It was prepared before the study. It was distributed and explained to women during the first session. It covers Summary 19knowledge about postpartum care as: exercise, postpartum nutrition, personal hygiene , perineal care, postpartum bleeding, breast care, how to manage postpartum minor discomforts like sub involution, constipation and hemorrhoid, cord care, baby bath, breast feeding and finally identify all family planning methods.The main study finding as follow:
- There was no statistically significant difference between the two groups (p> 0.05). Their age ranges from 20 to less than31 years old. The highest percentage of the study group and control group are not working (64%, 50% respectively).- There are significant differences at the post test between the two groups regarding to knowledge about episiotomy caring.- There was no significant difference between the two groups (>0.05) regarding knowledge about lochia, where 42% and 52% of the study group and the control group do not know the lochia and only 27% and 26% of the study group and control group respectively know the characteristics of lochia.- There was statistically significant improvement in the study group’s knowledge regarding all variables of postpartum sexual relation with a statistical significant difference between the study and control group.- There was no significant difference between the knowledge of the two groups (>0.05).<- There was statistical significant improvement in the knowledge of the study group at the post test compared with that of the control group in all the items related to breast feeding.- There was no statistically significant difference between the two groups regarding their knowledge.
- There was statistically significant improvement in the study group than that of the control group in all items related to baby bath.
- There was statistically significant improvement in knowledge regarding cord care among the study group at the post test than that of the control group. The difference is significant at p05.Summary19- There was statistically significant improvement in the study postpartum.