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Abstract Sleep during the postpartum period may be hindered by a number of biological, psychological and social stressors associated with motherhood. These stressors include physical changes such as a DROP in postpartum hormones and social factors including support and infant care.The aim of the study was to assess the effect of introducing self -care to postpartum primiparous woman on seep quality and independent self -care .The quasi-experimenta design was used to fulfill the aim of the study. Data were collected from the obstetrics and gynecological department in Menoufiya University Hospital and Shebin El-Kom Teaching Hospital at Shebin-ElKom. The convenience sample of 100 postpartum women was selected.Data were collected through the following:1.A structured interviewing questionnaire: it was developed by the researcher for obtaining complete data concerning sleep quality and self-care of postpartum women. It included three parts: Part I: Sociodemographic data: It included age, educational level, occupation,telephone number and marital status.Part II: Previous medical & surgical history: It referred to any chronic diseases and surgery for the women.Part III: Data about current pregnancy: It included the course of present pregnancy and gestational age per weeks.2.The Pittsburgh Sleep Quality Index: This scale was developed by Buysee,Reynold, Monk & Kopfer, 1989). The PSQI consists of 19 self-rated questions which assess a wide variety of factors related to sleep quality, including estimates of sleep duration and latency. Also, the frequency and severity of specific sleep-related problems during the last month was measured.3.Orem`s Self-Care Guidelines Checklist: it was adapted from Orem (1991)and modified by the researcher to assess the basic self-care needs of the study participants.It contained questions about:Part I: self-care practice to meet postpartum woman’s universal requisites such as: nutrition, elimination, rest, and sleep.Part II: Self-care practice to meet postpartum woman’s developmental requisites Rubin’s (2006) model such as self-esteem, disturbed body image, and risk for infection.Part III: Self-care practice to meet postpartum woman’s health deviation requisites. This include all minor discomforts of postpartum period such as stress incontinence (urinary), changes in comfort-pain (perineum), and changes in comfort-pain (breast).Results:- The main findings of the study revealed the following: There were highly statistical significant differences regarding sleep quality pattern among the study participants who are applying Pittsburgh sleep quality sufficiency domain) before (pre), during the first two weeks (post-test) and six weeks after the intervention. There were highly statistical significant differences regarding sleep quality pattern among the study participants who are applying Pittsburgh sleep quality (time dysfunction domain) before (pre), during the first two weeks (post-test) and six weeks after the intervention (follow-up test). There were highly statistical significant differences regarding sleep quality pattern among the study participants who are applying Pittsburgh sleep quality(disturbance domains) before (pre), during the first two weeks (post-test) and six weeks after the intervention (follow-up test) (P<0.001). There were significant differences regarding the universal self-care requisites before, during the first two weeks and six weeks after the intervention(P<0.01). There were highly statistically significant differences regarding the developmental self –care requests before, during the first two weeks and after six weeks of the intervention (P<0.01). There were highly significant differences regarding the health deviation self-care before, during the first two weeks and after six weeks of the intervention(P<0.01). There were highly significant differences regarding Orem’s self-care guidelines before, during the first two weeks and after six weeks of the intervention (P<0.01). There was significant positive correlation between sleep quality and Orem’s self-care guidelines (P<0.05) before the intervention, but there were highly significant positive correlation during the first two weeks and after six weeks of the intervention (P<0.01). There was significant positive correlation between sleep quality and Orem’s self-care guidelines (P<0.05) before the intervention, but there were highly significant positive correlation during the first two weeks and after six weeks of the intervention (P<0.01).Conclusion The sleep quality will significantly improve after introducing self- care to primiparos postpartum woman. This proved the first study hypothesis.Also, the independent self-care of primiparous woman doing postpartum will significantly improve after introducing self -care. This proved the second study hypothesis.Thus, the data of this study proves that Orem’s self-care theory is an efficient care theory for the postpartum primiparous women. Recommendations Based on the results of the current study, it was recommended to:4- Counseling and health education must be provided to all postpartum primiparous women to enhance them to use Orem self-care to improve the sleep quality.5- Training sessions should be provided to the primiparous women regarding how to apply Orem self -care to improve their sleep quality and dependent care.6-Dissiminate a simple illustrative booklet and pamphlets in Arabic language about sleep quality, self-care and dependent care should be prepared and made available to the postpartum women in the hospitals and outpatients clinic.Suggestions for future studies:-Conducting a similar study at different maternity settings on a large sample for generalization of results.-Further researches are needed regarding the postpartum primiparous sleep quality, self-care and dependent care for their neonates.-Educational programs for the maternity nurses are mandatory for the purpose of raising and updating their knowledge regarding apply Orem self-care during the postpartum period. |