تأثیر حضور همراه ماما و همراه غیرماما بر میزان درد زایمان، طول مدت زایمان و میزان استفاده از اکسی‌توسین در زنان نخست‌زا: یک کارآزمایی بالینی

نوع مقاله : اصیل پژوهشی

نویسندگان

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

2 دانشکده بهداشت، دانشگاه علوم پزشکی قزوین، قزوین، ایران. دانشجوی دکترای اپیدمیولوژی، گروه اپیدمیولوژی و آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران

3 استادیار سلامت جامعه، گروه مامایی و بهداشت مادر و کودک، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی قزوین، قزوین، ایران.

4 مربی گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اراک، اراک، ایران.

چکیده

مقدمه: یکی از روش‌های کاهش درد زایمان، حمایت مداوم از مادر باردار در طول لیبر و زایمان است. رضایت زنان از تجربیات زایمان از نظر ارائه‌دهندگان مراقبت، سیاست‌گذاران سیستم بهداشتی- درمانی به‌‌عنوان یکی از شاخص‌های مهم کیفیت مراقبت از مادر تلقی می‌گردد. با توجه به نتایج متناقص مطالعات و کمبود شواهدی که تأثیر حضور همراه حرفه‌ای و غیر‌حرفه‌ای را بر زایمان مقایسه کند، مطالعه حاضر با هدف مقایسه تأثیر حضور همراه ماما و غیرماما بر میزان درد زایمان، طول مدت زایمان و میزان استفاده از اکسی‌توسین در زنان نخست‌زا انجام گرفت.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در سال 97-1396 بر روی 120 زن نخست‌زا شامل سه گروه همراه ماما، همراه غیرماما و گروه کنترل انجام گردید. پیامدهای مطالعه مقیاس عددی درد، طول مدت مراحل زایمان و میزان استفاده از اکسی‌توسین بود. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه20) و آزمون‌های کای اسکوئر، آنالیز واریانس یک‌طرفه و آنالیز واریانس اندازه‌های تکراری انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در ابتدای فاز فعال، نمره درد در گروه همراه ماما 83/1±56/2، در گروه همراه غیرماما 46/2±03/4 و در گروه کنترل 89/2±06/4 بود که از نظر آماری تفاوت معناداری را نشان داد (014/0=p). بر اساس نتایج، اثر زمان (001/0p<) معنی‌دار بود، ولی اثر گروه (386/0=p) و اثر متقابل زمان و گروه (538/0=p) از نظر آماری معنادار نبود. بر اساس نتایج آزمون آنالیز واریانس یک‌طرفه، کمترین طول مدت زایمان در هر دو مرحله مربوط به گروه همراه ماما بود (05/0>p). همچنین بر اساس نتایج، گروه همراه ماما در مقایسه با سایر گروه‌ها از اکسی‌توسین کمتری استفاده کرده بودند (004/0=p).
نتیجه‌گیری: وجود مامای همراه در کنار مادران زائو، یک مداخله غیر‌تهاجمی و تأثیرگذار در ایجاد آرامش جسمی و روانی در طول لیبر و زایمان است.

کلیدواژه‌ها

عنوان مقاله [English]

Effect of the presence of midwife and non-midwife companion on labor pain, duration of delivery, and amount of oxytocin drops in primiparous women: a clinical trial study

نویسندگان [English]

  • Masuomeh Darvishi 1
  • Mehdi Ranjbaran 2
  • Zinat Jourabchi 3
  • Hadi Jafarimanesh 4
1 M.Sc. student of Counseling in Midwifery, Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
2 School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran. PhD candidate in Epidemiology, Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3 Assistant professor, Department of Community Health, Department of Maternal and Child Health and Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
4 Instructor, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
چکیده [English]

Introduction: One of the methods of reducing labor pain is continuous support for pregnant women during labor and delivery. Women's satisfaction from labor experience in terms of care providers, policy-makers of health-care system is considered as one of the important indicators in the quality of mother care. According to controversial results of the studies and lack of evidence which compare the effect of professional and non-professional presence on labor, this study was performed with aim to compare the effect of presence of midwife and non-midwife companion on labor pain, duration of delivery and amount of oxytocin use in primiparous women.
Methods: This randomized clinical trial study was performed on 120 primiparous women including three groups of midwives, non-midwife and control group in 2017-2018. The outcome of the study included numerical scale of pain, duration of delivery stages and the amount of oxytocin drops. Data analysis was done using SPSS software (version 20) and Chi-square test, one-way ANOVA and repeated measures analysis of variance. PResults: At the beginning of active phase, pain score in midwife companions group was 2.56 ± 1.83, in non-midwife companions group was 4.03 ± 2.46 and in control group was 4.03 ± 2.46, which showed statistically significant difference (P = 0.014). The effect of time (P <0.001) was significant, but the effect of group (P = 0.386) and the interaction between time and group (P = 0.538) were not statistically significant. According to the results of one-way ANOVA, the least length of delivery in both stages was related to midwife group (P <0.05). Also, midwife companions group had used less oxytocin compared with other groups (P = 0.004).
 Conclusion: The presence of a midwife companion beside mothers is a non-invasive and effective intervention in creating physical and mental relaxation during labor and delivery.

کلیدواژه‌ها [English]

  • Labor pain
  • Labor support
  • Midwife companion
  • Non-midwife companion
  • Oxytocin

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مجله زنان، مامایی و نازایی ایران
دوره 22، شماره 4
تیر 1398
صفحه 63-72

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