بررسی تأثیر آرام‌سازی پیشرونده عضلانی بر تهوع و استفراغ در زنان باردار

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناس ارشد پرستاری سلامت جامعه، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

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

3 دانشجوی دکتری مدیریت آموزش عالی، دانشگاه خوارزمی تهران، تهران، ایران.

4 استادیار گروه روانشناسی مشاوره و تربیتی، دانشکده روانشناسی، دانشگاه فردوسی مشهد، مشهد، ایران.

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

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

چکیده

مقدمه: تهوع و استفراغ، یکی از شایع‌ترین مشکلات دوران بارداری است. از آنجا که بسیاری از محققین نقش اضطراب و یا افسردگی را در بروز تهوع و استفراغ بارداری مؤثر دانسته‌اند، آرام‌سازی با افزایش میزان آرامش احتمالاً می‌تواند سبب کاهش تهوع و استفراغ در زنان باردار شود، لذا مطالعه حاضر با هدف تعیین تأثیر آرام‌سازی عضلانی بر تهوع و استفراغ زنان باردار انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی در سال 1397 بر روی 66 زن باردار 12-6 هفته با تهوع و استفراغ بارداری، مراجعه‌کننده به دو مرکز انتخابی بهداشتی درمانی شهر مشهد انجام شد. افراد در دو گروه مداخله و کنترل قرار گرفتند. پس از برگزاری 2 جلسه آموزش آرام‌سازی پیشرونده عضلانی طی یک هفته برای گروه مداخله، واحدهای پژوهش تمرینات را به مدت 4 هفته در منزل انجام دادند. در گروه کنترل از طرف پژوهشگر آموزشی داده نمی‌شد. ابزار مورد استفاده در این مطالعه شامل: شاخص تهوع و استفراغ رودز و پرسش‌نامه افسردگی، اضطراب و استرس بود. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) و آزمون‌های من‌ویتنی، تی مستقل، آنالیز واریانس با اندازه‌های تکراری و فریدمن انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین نمره تهوع، استفراغ و عق زدن و نمره کل تهوع، استفراغ و عق زدن در گروه مداخله قبل از مطالعه به‌ترتیب 3/2±6/4، 3/2±2/3، 7/1±7/2 و 0/5±6/10 و بعد از مطالعه 4/1±8/2، 3/1±8/1، 9/0±6/1 و 8/2±6 بود، در‌حالی‌که میانگین نمره تهوع، استفراغ و عق زدن و نمره کل تهوع، استفراغ و عق زدن در گروه کنترل قبل از مطالعه به‌ترتیب 1/2±4/4، 4/2±3/2، 8/1±8/2 و 7/1±5/9 و بعد از مطالعه به‌ترتیب 6/1±8/3، 9/1±3/2، 2±7/2 و 8/4±8/8 بود که بر اساس نتایج آزمون‌های آماری، در گروه مداخله در طی تمام مراحل اندازه‌گیری، میانگین نمره تهوع، استفراغ و عق زدن و نمره کل تهوع، استفراغ، عق زدن زنان باردار کاهش معنی‌داری داشت (001/0>p)؛ در‌ حالی‌که در گروه کنترل، در برخی مراحل اندازه‌گیری، کاهش معنی‌دار نداشت (05/0<p).
نتیجه‌گیری: آرام‌سازی پیشرونده عضلانی با کاهش اضطراب، استرس و افسردگی می‌تواند منجر به کاهش شدت تهوع، استفراغ و عق زدن در زنان باردار شود، لذا با توجه به بی‌عارضه بودن و راحتی انجام آن، این روش به‌عنوان راهکاری برای کاهش تهوع و استفراغ بارداری توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of progressive muscle relaxation on nausea and vomiting in pregnant women

نویسندگان [English]

  • Zahra Shourgashti 1
  • Khadigeh Mirzaii najmabadi 2
  • Hamid Chamanzari 3
  • Mohsen Asghari Nekah 4
  • Salmeh Dadgar 5
  • Zahra Emami Moghadam 6
1 M.Sc. Student in Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Associate Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Ph.D. student of Higher Education Management, Kharazmi University of Tehran, Tehran, Iran.
4 Assistant Professor, Department of Education and Counseling Psychology, School of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.
5 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
6 Assistant Professor, Department of Nursing and Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Nausea and vomiting is one of the most common problems in pregnancy. Since many researchers have considered the effective role of anxiety or depression in the incidence of nausea and vomiting in pregnancy, relaxation probably can decrease nausea and vomiting in pregnant women through increasing the calmness. Therefore, this study was performed with aim to determine the effect of muscle relaxation on nausea and vomiting in pregnant women.
Methods: This randomized clinical trial was conducted on 66 pregnant women at gestational age of 6-12 weeks with nausea and vomiting of pregnancy who referred to two selected health centers in Mashhad in 2018. The subjects were randomly assigned to intervention and control groups. After holding two sessions of progressive muscle relaxation training within one week for the intervention group, the units performed the exercises for 4 weeks at home. The researcher did not give any training to the control group. The tools used in this study included Rhodes Nausea and Vomiting Index, and Depression, Anxiety and Stress Questionnaire (Dass-21). Data analysis was done using SPSS software (version 25) using Mann-Whitney, independent t-test, repeated measures analysis, and Friedman tests. PResults: The mean score of nausea, vomiting and gagging and the total score of nausea, vomiting and gagging in the intervention group before the study were 4.6 ± 2.3, 3.2 ± 2.3, 2.7 ± 1.7, and 10.6±5.0, and after the study were 2.8 ± 1.4, 1.8 ± 1.3, 1.6 ± 0.9, and 6 ± 2.8, respectively. In the control group, the mean score of nausea, vomiting and gagging and the total score of nausea, vomiting and gagging before the study were 4.4 ± 2.1, 2.3 ± 2.4, 2.8 ± 1.8, 9.5 ± 1.7, respectively, and after the study were 3.8 ± 1.6, 2.3 ± 1.9, 2.7 ± 2, and 8.8±4.8, respectively. The results of statistical tests showed that the mean score of nausea, vomiting, gagging and total score of nausea, vomiting, and gagging of pregnant women significantly decreased in the intervention group during all stages of measurement (p <0.001); while in the control group, there was no significant decrease in some stages of measurement (p >0.05).
Conclusion: Progressive muscle relaxation can reduce the severity of nausea, vomiting and gagging in pregnant women by reducing anxiety, stress and depression. Therefore, since it has no complications and is convenient to do it, this method is recommended as a way to reduce the incidence of nausea and vomiting in pregnancy.

کلیدواژه‌ها [English]

  • Muscle relaxation
  • Nausea
  • Pregnant women
  • Vomiting
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