Nursing support perceived by primagravidas delivering vaginally and by cesarean




Payne, Rhonda Keen

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The concepts addressed in this ex post facto study were caring, nursing process, needs of women in labor, and support as a nursing intervention. The 10 research hypotheses tested postulated that a difference in perceived nursing support between primagravidas delivering vaginally and by cesarean would be measured on the 10 support subscales of the Nursing Support Checklist (Gardner & Wheeler, 1985).

The setting for the study was a large proprietary hospital; the convenience sample consisted of 20 primagravidas delivering vaginally and 20 primagravidas delivering by cesarean. Data were collected with a demographic instrument and the Nursing Behavior Checklist (Gardner & Wheeler, 1985) which contains 52 Likert scaled items which are grouped into 10 subscales. The hypotheses were tested with an independent t-test to determine if differences in subscale means existed according to route of delivery.

Only one of the hypotheses was not rejected, indicating that women delivering by cesarean ranked information giving higher than did women delivering vaginally. None of the demographic variables were significantly associated with support scores except mode of monitoring and type of labor onset. There were no significant differences in the rank ordering of the subscale means by delivery group as measured by the Mann-Whitney U-test. Several subscales were ranked similarly by the groups, including ranking the control subscale highest and the problem solving subscale lowest. The internal consistency of the instrument in this sample was r = .86.

Several problems were identified with the instrument which may have influenced the findings. Subjects may have been confused by the wording of items and ranked frequency of support behavior rather than perceived support of behaviors. The conclusions of the study are limited to: (1) Primagravidas have similar support needs or receive similar nursing actions regardless of delivery route. (2) Primagravidas experiencing unplanned cesareans may have greater informational needs to receive more information from nurses. (3) Perceived support and type of nursing actions may vary according to specific labor events.

The major recommendation of the study is to modify the instrument or generate new instruments to describe support.



Women in labor, Caring, Support, Nursing process, Labor and delivery