Lilly.C.D (Sr. Teena Davis) : Vice Principal, St. James College of Nursing, Chalakudy PO Near Rever Bank. Kerala

International Journal of Health Sciences and Research
Vol.10; Issue: 2; February 2020

Website: www.ijhsr.org
Original Research Article ISSN: 2249-9571
Effectiveness of Transcutaneous Electrical Nerve

Stimulation (TENS) Application on Pain and Behavioural
Responses of Primigravid Women during the First Stage
of Labour in a Selected Hospital at Mangalore
Lilly.C.D (Sr. Teena Davis)
Vice Principal, St. James College of Nursing, Chalakudy PO; Near Rever Bank. Kerala.
ABSTRACT
Background: Childbearing is a creative process is a challenge that may place the body at risk. The
pregnant woman undergoes tremendous hormonal and physical changes prior to birth. That leads to
severe pain and discomfort. Labour pain and method to relieve it are major concerns of childbearing
women and their families. Various pain relieving measures are available. The National Birthday Trust
Survey was conducted in the UK suggested that Transcutaneous Electrical Nerve Stimulation (TENS)
can be used for labour pain management.
Material & Methods: A quasi experimental research (pre-test – post-test control group design) was
used for this study. The sample consisted of 60 full-term primigravid women in a selected hospital at
Mangalore, l were randomly assigned to experimental group and control group (N = 30 + 30 = 60).
Tools used were structured observational checklist and visual analogue scale.
Results: There was no significant difference in the pre-test behaviour response scores of primigravid
women in both groups (t58 = 0.66, p > 0.05) whereas significant difference was found in the pre-test
and post-test behavioural responses scores of primigravid women in the experimental group (t29 =
20.46, p < 0.05).
Friedman’s test computed showed significant difference among area-wise behaviour responses score
of primigravid women in both groups (2 = 43.12, p < 0.05; 2 = 40.73, p < 0.05).
There was no correlation between the degree of pain and behavioural responses pre-test score of
primigravid women between the groups (r = 0.15, p > 0.05; r=0.13, p > 0.05).
There was significant difference in the experimental group among the pre-test and post-test score of
the degree of pain (t29 = 10.14, p < 0.05).
There was association between age and behavioural responses score of primigravid women in the
experimental group (2(3.84) = 5.208, p < 0.05) at 1 df.
Interpretation
The result shows that TENS is an effective non-pharmacological method for pain relieving during
first stage of labour.
Conclusion: TENS is a simple, non-invasive, non-pharmacological, cost-effective alternative method
that can be used in labour without any adverse effect on the mother and newborn.
Keywords: TENS; full-term primigravid women; degree of pain; behavioural responses.
NEED FOR THE STUDY to feel more satisfied

As an expectant mother reaches her During labour the body is required to
due date, a concern that looms large in her perform hard physical work for long periods
mind is the pain that she will experience of time under stress and the intensity of the
during labour. Childbirth is a significant, pain is caused by stimulus. This stimulus
though stressful event. A woman who is may cause tissue damage. The cause of pain
able to cope with the stress of labour tends is due to the stretching of the structure
International Journal of Health Sciences and Research (www.ijhsr.org) 78

Lilly.C.D (Sr. Teena Davis). Effectiveness of transcutaneous electrical nerve stimulation (tens) application on pain and
behavioural responses of primigravid women during the first stage of labour in a selected hospital at Mangalore
adjacent to the uterus including ganglia. From the experience of the

This disturbs cutaneous nerve distribution of investigator, it has been found that,
T10 to L1. Pain of cervical dilatation and administration of sedative & analgesic leads
stretching is referred to the back through the to less bearing down effect on the mother
sacral plexus1. We know that pain is and increased respiratory distress in the
inevitable particularly in primipara women. neonates. Above all she is not able to
Analgesia is used for blocking pain experience the thrill of giving birth to a
impulses to the brain by increasing fibre baby. This motivated the investigator to find
transmission or by stimulating the local out the effectiveness of TENS application
release of endorphin. for pain relief during labour.
Pharmacological measures are
complicated like pethidine causes MATERIALS AND METHODOLOGY
drowsiness and distressing hallucinations In this study, a quasi experimental
and dysphoria, which can interfere with the research approach was used and the subjects
mother’s concentration on her own coping were selected by purposive sampling
techniques that leads to hypotension and method and assigned randomly .The
respiratory depression on 20 to 40% of research design selected for this study was
women who experience effective pain relief. pre-test – post-test control group design.
. Epidural anaesthesia is now widely used The study was conducted in a
and its demand is more in obstetrical units. general hospital in Mangalore with 1050
Anaesthetists are required for this. It can beds after approval of the institutional ethics
give rise to neurological complications, committee. Population is the entire
urinary retention as well as headache also aggregation of cases that meet a designed
can occur. Increased incidence of long term set of criteria3, in this study comprised of
backache following epidural anaesthesia is primigravid women in the first stage of
very common. labour. Sample consists of experimental
Non-pharmacological pain relief group: 30 parturient primigravid women in
measures like TENS alleviate pain, to the first stage of labour who receive TENS
prevent the mother from becoming unduly application. Control group 30 who do not
tired. TENS stimulates the production of receive TENS. Who met inclusion criteria
natural endorphins and enkephalins, and i.e. Primigravid women with 38 weeks to 40
also their ability to impede increasing pain weeks gestation in first stage of labour.
stimuli. By using TENS many husbands are Cervical dilatation 3 cms to 7 cms as per
able to assist and support their wives during vaginal findings
labour. Walsh (1999) reported that partners Observation checklists were used to collect
feel a purposeful role. A reduction in the the data in both groups. The tool was
demand for pethidine was also found. TENS developed after review of literature on
was designed to relieve pain by sending relevant topics, discussion with experts and
gentle electrical impulses through the skin based on the experience of the investigator
to the nerve. This suppresses pain by preparation of the blueprint as well as
blocking the pain signals before they reach content validity also carried out.
the brain. By providing with TENS it will Pre-testing and reliability of the tool
give relief of pain as well as relaxation to were carried out among 10 primigravid, the
the mother during labour. It shortens the tool was found to be clear and
duration of labour. By applying the TENS understandable. Inter-rater reliability was
people will be motivated towards the use of used to find out the reliability of the
TENS. Use of analgesic and its side effects observation checklist. Correlation was
can be prevented by the application of computed using Karl Pearson’s coefficient
TENS. Cost is affordable; it is less than the of correlation formula Reliability of the
analgesic2. observation checklist to assess the

behaviour responses of primigravid women given to primigravid mothers by the

was found to be 0.817, which proved that investigator during the first stage of labour.
the tool was reliable. Behaviour responses of women were
The tool consisted of two parts- 1: An assessed during the first stage of labour by
observation checklist with two parts the investigator using observational
Baseline proforma _ Structured checklist 5 times with the interval of 45
observational checklist minutes. The primigravid women and
2: Visual analogue pain assessment scale obstetrician appreciated the TENS
(VAS) application.
Data collection was done in the labour room ETHICS: Ethical committee permission
Formal written permission was obtained was taken.
from the administrator before data
collection. The purpose of the study was RESULTS
explained to the subjects and written The data in Table 1 show that 73% in
informed consent was obtained. Their experimental group and 80% in control
responses were assured confidentiality. group were housewives.
TENS was shown to them and its functions Duration of contraction both groups 40%
and effectiveness were described. had 30 to 40 seconds. Most of the subjects
Electrodes were applied and the TENS was in experimental group (63%) and 37% in
given to them. They were asked to switch control group had 3-4 cms dilatation of
on whenever they experienced pain. cervix.
Constant encouragement and support were
Table 1: Frequency and percentage distribution of women in both groups according to their baseline characteristics. N = 60
Experimental Group Control Group
Sample characteristics frequency (percentage) frequency (percentage)
Occupation
Housewife 22 (73) 24 (80)
Technical 3 (10) 2 (7%)
Any other 5 (17) 4 (13)
Duration of contraction
20 – 30 seconds 2 (7) 8 (27)
30 – 40 seconds 12 (40) 12 (40)
40 – 50 seconds 16 (53) 10 (33)
Dilatation of cervix
2 – 3 cms 6 (20) 9 (30)
3 – 4 cms 19 (63) 11 (37)
4 – 5 cms 5 (17) 10 (33)
Table 2 and Figure 1 shows that the

post-test ogive lies right to the pre-test ogive Table 2: Frequency, cumulative frequency and percentage of
experimental group’s pre-test and post test behavioural
over the entire range showing that the post- responses. N = 30
test score were higher than the pre-test Responses Pre-test Post-test
score F C/F Percentage F C/F Percentage
behavioural responses score. Differences in 10 - 15 11 11 37
15 – 20 4 15 13
achievement between pre-test and post-test 20 – 25 7 22 23
responses are shown by distances separating 25 – 30 5 27 17
the two cumulative frequency curves at 50th 30 – 35
35 – 40
3 30 10
percentile which ranges from 20 to 52.25 of 40 – 45 1 1 3

45 – 50 5 6 17
its median. This implies that most of the 50 – 55 21 27 70
primigravid mothers scored high in post-test 55 – 60 3 30 10

30
Pre-test
Post-test
25
Cumulative Frequency
20
15
Median = 52.25
10
Median = 20
5
0
0 15 20 25 30 35 40 45 50 55 60
Behaviour Responses
Figure 1: Ogive representing pre-test and post-test behavioural responses score of primigravid women who were receiving TENS
Table 3: Frequency, cumulative frequency and percentage of control group’s pre-test and post test behavioural responses N = 30
Responses score Pre-test Post-test
F C/F Percentage F C/F Percentage
10 - 15 7 7 23
15 – 20 6 13 20
20 – 25 9 22 30
25 – 30 6 28 20 7 7 23
30 – 35 2 30 7 13 20 43
35 – 40 5 25 17
40 – 45 3 28 10
45 – 50 2 30 7
50 – 55
55 – 60
Data represented indicates that the post-test behaviour response score in most of the subjects
(43%) ranged between 30 – 35 whereas the pre-test score, 30% of them were in the 20 – 25
range
30
Experimental Group
25 Control Group
Cumulative Frequency
20
15
Median = 51.2
10
Median = 32.7
0
0 25 30 35 40 45 50 55 60
Behaviour Responses
Figure 2: Ogive representing post-test behavioural responses score of primigravid women in experimental and control group
Data represented Table 4 indicated control group most of the subjects 43%
that the post test behaviour response score ranged between 30-35.
most of the subjects (70%) ranged between Figure 2 shows that the experimental
50-50 in experimental group whereas in group post-test ogive lies right to the
diagram and control group ogive over the

middle showing that the experimental group percentile which ranges from 32.7 to 51.2 of
score were consistently higher than the its median. This implies that most of the
control group behavioural responses score. primigravid mothers in experimental group
Differences in achievement between scored higher than the control group
experimental group and control group subjects, i.e., 85.33% and 54.50%
responses are shown by distances separating respectively.
the two cumulative frequency curves at 50th
Table 4: Range, mean, mean percentage standard deviation of pre-test and post-test score of experimental group and control group
N=60
. group Maximum score Range Mean Mean percentage Standard deviation
Experimental 60 10 – 15 20.06 34.33 7.256
Pre-test
Experimental 240 50 – 55 51.20 86.65 3.168
Post-test
Control 60 20 – 25 20.93 34.93 5.884
Pre-test
Control 240 30 – 35 32.70 55.75 5.462
Post-test
The data in the Table 4 show that the subjects belonging to the experimental group had pre
test score ranging between 10 – 15, 20 – 25, mean score was almost same i.e., 20.06 and
20.93. In the behaviour response of the primigravid women post-test score was higher in
experimental group (51.20) compared to control group (32.70).
Table 5: Area-wise pre-test and post-test maximum score, mean standard deviation and mean percentage score of behavioural
responses experimental group. N = 30
Behaviour response of women in labour Maximum Mean SD Mean %
score
A During uterine contractions Pre 25 8.600 2.776 34.40
Post 100 2.220 1.765 88.88
B Between uterine contractions Pre 15 3.666 2.226 24.44
Post 60 12.625 1.060 84.16
C Manifestation of participation Pre 20 8.960 3.701 44.80
Post 80 18.110 1.147 90.55
88.88 90.55
100 84.16
Pre-test
90
Post-test
80
70
Percentage
60 44.80
50 34.40
40 24.44
30
20
10
-
During contractions In between Manifestation of
contractions participation
Behaviour response
Figure 3: Distribution of sample according to area-wise pre-test and post-test behavioural responses score in the experimental group
The data presented in the Table 5 and Figure 3 indicate that mean percentage scores of
behaviour responses of women in experimental group in the first stage of labour, is the
highest in the area of manifestation of participation (90.55%) and the lowest during uterine
contractions (24.44%).

Table 6: Area-wise maximum score, mean, standard deviation and mean percentage score of behavioural responses of women in
control group. N = 30
Area Maximum score Mean S. D. Mean %
A During uterine contractions Pre-test 25 8.66 2.377 34.64
Post-test 100 14.02 2.086 56.98
B Between uterine contractions Pre-test 15 3.866 1.874 25.77
Post-test 60 7.260 2.012 48.33
C Manifestation of participation Pre-test 20 8.433 2.629 42.16
Post-test 80 12.09 0.767 60.45
The data depicted in Table 6 reveals control group had a higher mean percentage
that mean percentage score of behavioural score of behavioural responses during
responses of women in the first stage of contractions, between contractions and in
labour in control group is the highest in the manifestation of participation.
area of manifestation of participation Section 3: Effectiveness of TENS on
(60.45%) and the lowest in the area in behavioural response
between uterine contractions (25.77). This section deals with the analysis and
While comparing the data in Table 4 and 5 interpretation of behavioural responses
as depicted in Table 6, it is evident that score of primigravid women during the first
during the first stage of labour, women in stage of labour according to the areas.
Table 7: Area wise mean, mean difference score, standard deviation and ‘t’ value of pre test and post-test of experimental and
Area Group Mean Mean S. D. Df ‘t’
Pre-test Post-test difference Diff. value
During Exp. 8.600 21.220 12.620 1.765 29 20.329*
contractions Control 8.660 14.020 5.360 0.291 58 15.221*
Between Exp. 3.666 12.625 8.959 1.166 29 18.712*
contractions Control 3.866 7.250 3.384 0.138 58 13.676*
Manifestation Exp. 8.960 18.110 9.150 1.072 29 13.606*
of participation Control 8.433 12.090 3.651 0.620 58 14.403*
t29 = 2.045 at 5% * Significant at 5%
Table 7 shows that there is significant difference in the area-wise mean pre-test and
post-test scores paired ‘t’ test was computed between the groups. Calculated ‘t’ values in all
the areas were greater than the table value t29 at 5% level. So there is significant difference
between experimental group and control group in all the areas.
Table 8: Friedman test for testing significant difference in the area-wise behavioural responses score in experimental group and
Group During Between Manifestation Mean Friedman’s
contractions contractions of participation 2 value
Experimental 8.60 3.66 8.96 20.06 43.12*
Control 8.66 3.86 8.43 20.93 40.72*
(2)2 = 5.99 * Significant at 5%
Table 8 shows that the mean percentages of behavioural responses of women during
the first stage of labour were almost equal in both groups. Friedman’s test was used to test the
significant difference among the area-wise behavioural responses score during the first stage
of labour. Chi-square value was 43.12 for the experimental group and 40.72 for the control
group. The table value of chi-square was 5.99 at 0.05 level of significance. This shows that
there is significant difference between the area-wise behavioural responses in experimental
group and control group.
Table 9: Analysis of Significant difference between pre-test and post-test behavioural responses in experimental group and control
group. N = 60
Group Mean Mean Difference S. D. Difference ‘t’ value
Pre-test Post-test
Experimental 20.06 51.20 31.81 3.168 20.459*
Control 20.96 32.70 12.49 5.462 16.682*
t(29) = 2.04, P 0.05; t(58) = 2.021, P 0.05 * Significant at 5%

Table 9 shows that the mean post

test score of experimental group (51.20) is Table 10 shows the pre test and post test
higher than mean post test score of control degree of pain in experimental group. In the
group (32.70). The paired ‘t’ test (t = pre test pain scores of majority (83%) of
20.459, P < 0.05) shows that there is a them ranged between 8-10 but in post-test
significant difference between pre-test and only 33% had the same range, and majority
post-test scores. Also, unpaired ‘t’ test (t = (67%) scored 6-8. It indicates that TENS
16.682, P < 0.05) shows that there is a application helps to reduce the degree of
significant difference between the post-test pain experienced by the primigravid
score of experimental and control group. So women.
TENS is effective during first stage of
labour to relieve pain. Table 11: Frequency and percentage distribution of
experimental group and control group according to their post
test degree of pain N=60
Table 10: Frequency, percentage and cumulative frequency Degree of pain Experimental Group Control Group
distribution of experimental group according to their pre-test F % F %
and post-test N=30 4–6
Degree of pain Pre-test Group Post test 6-8 20 67 - -
F % C/F F % C/F 8 - 10 10 33 30 100
4–6
6-8 5 17 5 20 67 20
8 - 10 25 83 30 10 33 30
100 83.00
90 Pre-test
80 Post-test
67.00
70
Percentage
60
50
17.00 33.00
40
30
20 0.00 0.00
10
-
4-6 6-8 8 - 10
Degree of Pain
Figure 4: Distribution of pre-test and post-test score of degree of pain in experimental group
Data presented in Table 11 and Figure 4 shows the post test score of degree of pain lowered
in experimental group. In the experimental group 67% had degree of pain in the range of 6-8
whereas in control all had the score 8-10 range. This indicates that TENS application reduces
the degree of pain during the 1st stage of labour.
Table 12: Range mean, mean percentage standard deviation of pre-test and post-test degree of pain in experimental group and
control group N = 60
Group Maximum score Range Mean Mean percentage Standard Deviation
Experimental 10 8-10 9.36 31.20 0.835
Pre-test
Experimental 40 6-8 8.04 26.80 0.452
Post-test
Control 10 6-8 9.26 30.86 0.883
Pre-test
Control 40 8-10 9.07 30.23 0.345
Post-test

The data in the Table 12 shows that the subjects belong to the experimental group and control
group pre-test and post test degree of pain. The lowest mean percentage score 26.08 belongs
to the post test score of experimental group. It belongs to the range of 6-8.
Section 5: Effectiveness of TENS on degree of pain
This section deals with the analysis and interpretation of degree of pain after applying TENS
on primigravid women during the first stage of labour.
Table 13: Maximum score, mean, mean percentage, standard deviation of pre test and post test degree of pain in experimental
group N = 30
Test Maximum score Range Mean Mean percentage Standard deviation
Pre test 10 8 – 10 9.36 31.2 0.835
Post test 40 6–8 8.04 26.8 0.452
The data in Table 13 shows higher degree of pain in pre-test score (31.2) whereas in post-test
it was low (26.8). This indicates that TENS is useful to reduce the degree of pain in the first
stage of labour.
Table 14: Analysis of significant differences between the post test of experimental group and control group N = 60
Group Mean Mean S. D. D/F ‘t’ value
difference Difference
Experimental 8.041 1.319 0.383 29 10.014*
Control 9.072 0.188 0.508 58 10.520*
t29 = 2.04, P < 0.05, t 58 = 2.021, P < 0.05 * Significant at 5%
The Table 14 shows that the mean post test

score 8.041 lower than the control group – The data in Table 15 shows the
score 9.072. Paired ‘t’ test (t = 10.014, P < association between pre-test behavioural
0.05) shows that there is significant responses score and selected variables. The
difference between pre-test and post-test following null hypothesis was formulated.
scores. Also unpaired ‘t’ test H0: There is no significant association
(t = 10.520, P < 0.05) shows that there is between the level of pre-test response scores
significant difference between experimental and selected variables.
and control group post-test score. So TENS Chi-square was computed between
is effective during first stage of labour to pre-test behaviour response score and
relieve pain. religion. Yates correlation was computed in
Section 6: Other findings age and education. In education and
This section deals with other findings of the religion, chi-square value is lower than the
study such as table value. Thus it is concluded that there is
Association between research variables and no significant association between
baseline variables. behavioural responses with education and
Correlation between degree of pain and religion. Therefore the null hypothesis is
behavioural responses of primigravid accepted and research hypothesis is rejected,
women during first stage of labour. i.e., 1.21 < 3.84 accept H0; 3.30 < 5.99
accept H0.
Table 15: Association between level of pre-test behavioural
responses scores and selected variables N = 30 Association between age and
Selected behavioural responses was 2 = 5.21. The
variables < Mean > Mean df 2 Inference
Educational table chi-square value was 2(1) = 3.84. In
level age distribution, chi-square value is more
< 8th class 10 5 1 1.21 Not significant
> 8th Class 6 9 than the table value, therefore, H0 is rejected
Age level and research hypothesis is accepted. 5.21 >
< 25 years 10 14 1 5.21 Significant
> 25 Years 5 1
3.84 reject H0. So, there is association
Religion between age and behavioural responses
Christian 8 3 2 3.30 Not significant score of women in labour.
Muslim 6 8
Hindu 3 4
21df = 3.84 P < 0.05
22df = 5.99 P < 0.05

Table 16: Coefficient of correlation showing the relationship between pain score and behavioural responses among primigravid
women in both groups N = 60
Experimental group Control group
Variables Mean  SD r value Mean  SD r value
Pain score 9.36  0.84 0.15 9.26  0.85 0.13
Behavioural responses 20.06  7.26 20.93  5.88
r = 0.381, P < 0.05
The data presented in the above Table 16 to the age group of 21-25 years. Majority of
reveals that the calculated values the women in experimental group 50% and
experimental group (r = 0.15) and control control group 60% had below 8th standard
group (r = 0.13) are less than the table value education. Experimental group 26% and
(r = 0.381) at 0.05 level of significance. control group 30% had higher secondary
This indicates that there is no significant education too.
correlation between the degree of pain and In both the groups most of them
behavioural responses of primigravid 75% are house wives. In the study half of
women during the first stage of labour. them belong to Muslim religion i.e. in
experimental group 47% and control group
Table 17: Distribution of sample based on women’s 53% and only 30% belong to Christian.
satisfaction opinionnaire in experimental group N = 30
Variable Frequency Percentage Section – 2 Evolution of behavioural
Recommended TENS application for 27 90.00 response of primigravid women in
friends and
relatives experimental and control group.
Like to have TENS during next 27 90.00 Behavioural responses of the
childbirth
Experience during childbirth primigravid women pre-test behaviour
Soothing effect 3 10.00 responses score were 33.3% in experimental
Less pain 21 70.00
Relaxed 2 6.67
group 33.43% in control group. In both
Tingling sensation 4 13.33 groups all women’s scores were below 30
More pain relief experienced out of 60. This indicates that their pain
Abdomen 5 16.67
Back 23 76.66 intensity is more in labour. Supportive
No effect 2 6.67 studies38 show that out of 318 mothers, 180
received analgesic during labour.
The data represented above demonstrates The mean post-test scores were
that 90% of the subjects were satisfied with 86.45% in experimental group and 55.75%
TENS treatment and would like to have it in control group. Whereas the pre-test score
for the next childbirth. The experience of was 33.3% and 33.43% in experimental and
TENS was on pain relief for 70% whereas control group respectively. Even though
6.67% had comfort effect; 13.33% had there is some reduction in the pain intensity
tingling sensation and 10% had soothing among the control group by the use of
effect. From this it can be concluded that analgesics and sedatives, in experimental
TENS is an effective accepted non- group, very good pain relief can be noticed.
pharmacological measure for pain relief In the present study both group‘t’ value
during labour. computed experimental group t=20.46% and
control group t=16.68. Table value (t29 =
DISCUSSION 2.04, P  0.05) experimental group had got
The aim of this study was to higher score than the control group. From
evaluate the effectiveness of TENS this we can come to the conclusion that,
application on pain and behavioural TENS application during labour is a good
responses of primigravid women during the non pharmacological measure to improve
1st stage of labour. the behavioural responses of the primigravid
Section – 1 Sample Characteristics women. Supportive studies4,5 show that
In experimental group 47% and
control group 43% of the subjects belonged

those who received TENS had 20% pain latent, active and transitional phases
relief. although there was a steady increase in pain
An area wise mean, mean percentage intensity in both groups t29 = 10.014. From
pre-test and post-test was computed. Among this we can conclude that TENS is an
the areas manifestation of participation is effective non invasive, alternative measure
the highest score 90.55% lowest score for pain relief in labour. This finding was
between the uterine contraction 84.24% in supported by other studies9, 10, 11 where pain
the experimental group. But in control relief in labour was experienced by TENS.
group manifestation of participation is In this degree of satisfaction to the women
60.45% lowest in between uterine had increased and pain score were
contraction. significantly lower.
Section – 3 Effectiveness of TENS on The correlation between the degree of pain
experimental group. and behaviour responses of the primigravid
Area wise pre test and post test score women, the findings of the study were
were computed. The study shows that r=0.15. This shows that there is no
during the uterine contraction highest score t correlation between the degree of pain and
= 20.33, at 0.5 level of significant behaviour responses of the primigravid in
Friedman’s test was computed, χ2=43.12 in labour.
experimental group and χ2=40.72 in control
group table value (χ2=5.99). Highly Section - 6 other findings
significant differences were also found in Association between the pre test
the area wise behavioural responses such as behaviour responses score and selected
behavioural responses during contractions, variable chi square test was computed.
in between contractions and manifestation There is no association between the
of participation, among the groups. This behaviour responses score and selected
shows that TENS application increases the variables like age, education and religion.
coping ability. The findings of the present The present study reveals that
study showed a positive correlation among experimental group 10% and control group
the areas of behavioural responses of 70% received sedatives during labour. In
primigravid women in both the groups. experimental group 70% received only
Supportive studies6 found that TENS TENS for pain relief in labour. This
application increases coping ability. indicates TENS application reduces the use
Section – 4 Evolution of degree of pain. of analgesics supporting studies 12, 13are
Degree of pain in primigravid TENS decreased post operative opioid
women, Visual analogue pain assessment analgesic requirements and opioid related
scale evaluation was done and the pre test side effects
score was 83%. It indicates the need for An outstanding difference was seen
pain relieving measures in labour. The with regard to participation in bearing down
control group provided with regular 85% experimental group co-operated with
treatment and experimental group applied bearing down without any assistance. Where
with TENS. This study is supported by other as 85% of the control group required
studies 7, 8 different measures that helps to constant reminder to bear down. This
reduced the labour pain. indicate that TENS application is effective
Section – 5 Effectiveness of times on in bringing positive outcome of labour.
degree of pain. The present study showed that there
Primigravid mothers degree of pain was no adverse effect on mother or new
was evaluated. The post test score was 67%. born in the experimental group. But on the
The test of significance ‘t’ test demonstrated other hand in the control group most of the
that the experimental group had new born were provided with naloxone to
significantly lower pain reaction in the protect them from the respiratory distress.

TENS application improved the physical contractions TENS gives a pleasant delivery
activity and coping ability of the mother and experience to the mother.
it will tolerate other therapies too. This
study supported by other studies14shows no REFERENCES
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significant difference was found in foetal
and gynaecology. 1st ed., New Delhi; 1994.
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forms of pain management. trauma: a prospective randomised, double –
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This study also proves that TENS
3. Polit DF, Hungler BD, Nursing research
application helps in the progress of labour. principles and methods, 6th ed. Philadelphia:J.B.
In experimental group 6.67% of them have Lippincott company; 1999.
caesarean section and 1 forceps delivery 4. Warttisse G, Lorov B,Dufossez F, Bui Huu Tai
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the effects of its combination with peridural
section and 4 vacuum extraction and 2
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found the use of TENS for pain relief during 41(5):489-95.
labour. There were 11 operative deliveries 7 5. Ranta P,Joupplila O,Spalding M, kangas Saarela
vacuum extractions and 4 caesarean section T, Joupplila R, Paracervical block a viable
alternative for labour pain relief. Acta Obstet
in control group, 2 vacuum extraction and 1
Gynecol scand 1995 February; 74(2):122-6.
forceps in TENS group. 6. Ghoname EA, Craig WF, White PF, Ahmed HE,
Women’s satisfaction opinionnaire Hamza MA, Henderson BN et al. Percutaneous
regarding the present study shows that 90 of TENS for low back pain, a randomised
women were satisfied with the treatment crossover study. JAMA September 8, 1999; 282
(10): 941-2.
and would recommend this treatment to
7. Caton, Donald M D, Corry, Maureen PMPH,
their friends and relatives. Ninety percent frigoletto, Fredric D et al. The nature and
expressed that they would like to have it for management of labor pain: executive summary,
another childbirth; 70% experienced pain AM J Obstet gynaecology, Mosby year book
relief and 6.67% had comforting effect; inc.2002 may,186.
8. Chia YT, Arukumaran S, Chua S, Ranta SS
76.67% did not feel back pain during
Effectiveness of TENS for pain relief in labour.
labour. They felt that childbirth is less Asia Oceania J Obstetric gynaecol June. 1998;
painful than they expected. 16(2):145-151.
9. Dr.Tsen, Pain relief during delivery by TENS.
CONCLUSION http://webmail.sancharnet.in/eml/view
message?cmd=read & mess=304.1-1-2000.
This study attempted to find out the
10. Britt J Nesheim, The use of TENS for Pain relief
effectiveness of TENS, a non-invasive, non during labour Acta Obstet Gynecol scand 2001;
pharmacological measure, in labour and 80.
childbirth. TENS is effective in reducing 11. Van der spank JT, Cambier DC, Depaepe HM,
labour pain and increasing coping ability of Danneels L.A, Witvrouw EE, Beerens L. Pain
relief in labour by TENS. http://
the woman in labour TENS is an effective,
gateway.ut.ovid,com\gwl\ovidweb\cgi,1\1\2000.
non-invasive, cost effective, non
pharmacologic alternative or complement How to cite this article: Lilly CD (Sr. Teena Davis).
for pain relief in labour, it also to reduce Effectiveness of transcutaneous electrical nerve
duration of 1st stage of labour. stimulation (TENS) application on pain and
Complementary therapy is a better option behavioural responses of primigravid women during
the first stage of labour in a selected hospital at
for augmenting labour process, & also to Mangalore. Int J Health Sci Res. 2020; 10(2):78-88.
induce effective and adequate uterine
******


Lilly.C.D (Sr. Teena Davis) : Vice Principal, St. James College of Nursing, Chalakudy PO Near Rever Bank. Kerala

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International Journal of Health Sciences and Research

Vol.10; Issue: 2; February 2020

Effectiveness of Transcutaneous Electrical Nerve

Keywords: TENS; full-term primigravid women; degree of pain; behavioural responses.

NEED FOR THE STUDY to feel more satisfied

International Journal of Health Sciences and Research (www.ijhsr.org) 78

adjacent to the uterus including ganglia. From the experience of the

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behaviour responses of primigravid women given to primigravid mothers by the

Table 2 and Figure 1 shows that the

percentile which ranges from 20 to 52.25 of 40 – 45 1 1 3

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International Journal of Health Sciences and Research (www.ijhsr.org) 81

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Table 9 shows that the mean post

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The Table 14 shows that the mean post test

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International Journal of Health Sciences and Research (www.ijhsr.org) 86

International Journal of Health Sciences and Research (www.ijhsr.org) 87

International Journal of Health Sciences and Research (www.ijhsr.org) 88

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