مقایسه تأثیر فشار در نقاط مثانهای-GV20 و کیسه صفرا-GV20 بر توانایی مقابله با درد زایمان در زنان نخست‌زا: کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه مامایی، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه طب سوزنی، دانشکده طب سنتی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استاد گروه آمار زیستی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: درد زایمان به‌عنوان یک عامل استرس­زا، روش­های مقابله­ای ویژه خود را می­طلبد. یکی از این روش­ها که ممکن است در مقابله با درد زایمان مؤثر باشد، طب فشاری است. مطالعه حاضر با هدف مقایسه فشار در نقاط مثانه‌ای - GV20 و کیسه صفرا- GV20 بر توانایی مقابله با درد زایمان در زنان نخست­زا انجام گرفت.
روش‌کار: این مطالعه کارآزمایی بالینی یک­سور در سال 1396 بر روی 158 زن نخست­زای مراجعه­کننده به بیمارستان ام­البنین (س) مشهد انجام گرفت. افراد در سه گروه طب فشاری نقاط مثانه­ای (BL5، BL8، BL9) وGV20 (مداخله 1)، کیسه صفرا (GB8، GB16، GB17، GB18) و GV20 (مداخله 2) و کنترل قرار گرفتند. در فاز فعال مرحله اول زایمان در گروه مداخله 1، 5 سیکل فشار 4 دقیقه‌ای و در گروه مداخله 2، 4 سیکل فشار 5 دقیقه‌ای و در مرحله دوم زایمان نیز 1 سیکل فشار بر نقاط مذکور در هر دو گروه اعمال شد. گروه کنترل نیز مراقبت­های معمول را دریافت نمودند. توانایی مقابله با درد زایمان با استفاده از پرسشنامه مشاهده­ای رفتار مقابله­ای با درد زایمان قبل از مداخله و سپس هر 30 دقیقه تا اتمام مرحله دوم زایمان اندازه­گیری شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS(نسخه 25) و آزمون­های دقیق فیشر، آنالیز واریانس یک­طرفه، توکی و ناپارامتری کروسکال والیس، دان با تصحیح بونفرونی و فریدمن انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته­ها:میانگین نمره توانایی مقابله با درد در مرحله اول و دوم زایمان به‌ترتیب در گروه مداخله 1 (9/1±5/16، 0/2±4/17) و مداخله 2 (1/2±9/16، 2/2±8/16) نسبت به گروه کنترل (7/2±0/12، 4/2±4/10) اختلاف آماری معنی­داری داشت (05/0>p)، اما بین دو گروه مداخله اختلاف آماری وجود نداشت (05/0<p).
نتیجه­گیری: فشار بر نقاط مثانه­ای - GV20 و کیسه صفرا - GV20، توانایی مقابله با درد مرحله اول و دوم زایمان را افزایش می­دهد، لذا به‌عنوان یک روش ساده و غیرتهاجمی در کنار سایر روش­ها پیشنهاد می­گردد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the effect of pressure on bladder-GV20 and gallbladder-GV20 points on the ability to cope with labor pain among the primiparous women: A randomized clinical trial

نویسندگان [English]

  • Elaheh Mansouri 1
  • Masoumeh Kordi 2
  • Shapour Badiee Aval 3
  • Mohammad Taghi Shakeri 4
  • Masoumeh Mirteimouri 5
1 M.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant professor, Department of Acupuncture Medicine, Faculty of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Biostatistics ,Social Determinants of Health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: As a stressor, labor pain requires special coping strategies. Acupressure is one of these strategies that may be effective in coping with labor pain. This study aimed to compare the effect of pressure on bladder-GV20 and gallbladder-GV20 points on the ability to cope with labor pain among the nulliparous females.
Methods: This single-blind randomized clinical trial was conducted on 158 primiparous women referring to Um Al-Benin Specialized Women Hospital, Mashhad, Iran in 2017. The subjects were randomly assigned to three groups of acupressure regarding the bladder points, namely (BL5-BL8-BL9) and GV20 (intervention 1), gallbladder (GB8-GB16–GB17-GB18) and GV20 (intervention 2), and the control group. The first stage of labor included five (4 min) and four (5 min) pressure cycles on acupressure points in bladder and gallbladder in the first and second groups, respectively. In the second stage of labor, one pressure cycle on the same points were applied. The control group only received the routine cares. The ability to cope with the labor pain was measured using the observational coping behavioral questionnaire with labor pain before the intervention and then every 30 minutes until the completion of the second stage of labor. The data were analyzed in SPSS software (version 25.0) using Fisher's exact test, one-way ANOVA, Tukey and non-parametric Kruskal Wallis test based on Dunn's approach with the Bonferroni and Friedman's correction. The P-value less than 0.05 was statistically significant.
Results: The results showed that the average scores of coping ability in the first and second stages of delivery were 16.5±1.9, 17.4±2.9 and 16.9 ± 2.2, 16.8 ± 2.2 in intervention groups one and two, respectively. There was a significant difference regarding the scores of the intervention groups and those of the control group (10.4±2.4, 12.0±2.7) (P<0.05). However, no significant difference was observed within the two intervention groups in terms of the scores of coping ability (P> 0.05).
Conclusion: According to the findings of the study, pressure on bladder-GV20 and gallbladder-GV20 points can increase the levels of labor pain coping abilities in the first and second stages of labor. Therefore, this method can be recommended as a simple, non-invasive and complementary approach in labor.

کلیدواژه‌ها [English]

  • Delivery
  • Acupressure
  • Coping
  • Primiparous
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