بررسی تأثیر طب فشاری نقاطSP6 ،LI4 ، H7 و NEIMA بر اضطراب حین زایمان زنان نخست‌زا: کارآزمایی بالینی تصادفی شده

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی قزوین، قزوین، ایران.

2 کارشناس ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی قزوین، قزوین، ایران.

3 کارشناس ارشد آمار زیستی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی قزوین، قزوین، ایران.

4 پزشک عمومی، انجمن طب سوزنی ایران، تهران، ایران.

چکیده

مقدمه: زایمان یک رویداد فیزیولوژیک اما استرس­زا در زندگی زنان است. اضطراب حین زایمان می‌تواند پیامدهای بارداری را تحت تأثیر قرار دهد و منجر به افزایش درد و ترس از زایمان شود، لذا کاهش اضطراب حین زایمان در مطالعات مختلف موکداً پیشنهاد شده است. طب فشاری برخلاف روش‌های دارویی، روشی ساده و مقرون به‌صرفه است که در حیطه زایمان به‌طور محدود مورد بررسی قرار گرفته است. مطالعه حاضر با هدف تعیین تأثیر طب فشاری نقاطSP6 ، LI4 ، H7 و  NEIMAبر میزان اضطراب حین زایمان زنان نخست­زا انجام شد.
روش­کار: این مطالعه کارآزمایی بالینی- تصادفی شده در سال 1397 بر روی 130 مادر بستری در بخش زایمان بیمارستان رازی قزوین انجام شد. نمونه‌ها با تخصیص تصادفی در دو گروه مداخله و شاهد قرار گرفتند. در گروه مداخله، تحریک نقاط SP6 و NEIMA در دیلاتاسیون 4 سانتی‌متری شروع و به‌مدت 5/0 ساعت ادامه داشت و سپس در دیلاتاسیون 8 سانتی‌متری، تحریک نقاطH7  و LI4 تا انتهای زایمان توسط دستگاه TENS انجام شد. گروه کنترل مراقبت‌های معمول مامایی را دریافت کردند. پرسشنامه اضطراب اسپیل برگر در بدو ورود به اتاق زایمان و یک­ ساعت بعد از زایمان در دو گروه تکمیل شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 24) و آزمون‌های کای دو، تی مستقل و تی زوجی انجام گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: طب فشاری تأثیر معناداری بر میانگین نمره اضطراب آشکار گروه مداخله (5/9±7/33) نسبت به گروه کنترل (9/9±1/40) داشت (001/0=p). تفاوت میانگین نمره اضطراب پنهان، در گروه مداخله (2/8±5/35) نسبت به گروه کنترل (7/7±08/39) نیز از نظر آماری معنادار بود (048/0=p).
نتیجه‌گیری: تحریک نقاط فشاریSP6 ، LI4، H7 و NEIMA در کاهش اضطراب پنهان و آشکار زنان نخست­زا مؤثر است و به‌عنوان یکی از روش‌های درمان اضطراب در بارداری و زایمان پیشنهاد می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

Effects of acupressure at LI4, He7, SP6 and Neima points on labor anxiety in nulliparous women: randomized clinical trial

نویسندگان [English]

  • Fatemeh Ranjkesh 1
  • Zahra Mehri 2
  • Maryam Mafi 3
  • Mohammad Habibi 4
  • Farnoosh Moafi 1
1 M.Sc. in Midwifery, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
2 M.Sc. in Midwifery, Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
3 M.Sc. in Biostatistics, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
4 General Practitioner, Iran Scientific Association of Acupuncture, Tehran, Iran.
چکیده [English]

Introduction: Childbirth is a physiologic but stressful event in women's life. Anxiety during labor can affect pregnancy outcomes and causes pain and fear of childbirth. So, reduction of anxiety during labor was strictly recommended in various studies. Acupressure, against pharmacological methods, is a simple and cost-effective method which is limitedly investigated in childbirth. This study was performed with aim to investigate the effects of acupressure at LI4, He7, SP6 and Neima points on anxiety during labor in nulliparous women.
Methods: This randomized clinical trial was conducted on 130 mothers who were hospitalized in delivery wards of Qazvin Razi hospital in 2018. They were randomly assigned to intervention and control groups. In the intervention group, stimulation of SP6 and Neima points was started in cervical dilatation of 4 cm and continued for 30 minutes, then in cervical dilatation of 8 cm, stimulation of LI4 and H7 continued by TENS until the end of delivery. Control group received routine obstetrics cares. Spielberger’s State-Trait Anxiety Inventory (STAI) was completed at the time of admission to delivery room and one hour after delivery. Data was analyzed by SPSS software (version 24) and Chi-square, independent t-test, Paired t-test. PResults: Acupressure had a significant influence on mean score of state anxiety in experimental (33.7 ± 9.5) compared to control group (40.1 ± 9.9) (P = 0.001). Difference in mean score of trait anxiety in experimental (35.5 ± 8.2) compared to control group (39.08 ± 7.7) was statically significant (p=0.04).
Conclusion: Stimulation of LI4, H7, SP6 and Neima points is effective in decreasing state and trait anxiety in nulliparous women and is recommended as one of the methods for treatment of anxiety in pregnancy and childbirth.

کلیدواژه‌ها [English]

  • Acupressure
  • Anxiety
  • Childbirth
  • Nulliparous
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