تأثیر آموزش تن‌آرامی بنسون بر شدت تهوع و استفراغ در زنان باردار

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مشاوره در مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

2 دکتری تخصصی بهداشت باروری، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

3 مربی گروه مامایی، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

4 استادیار گروه بهداشت مادر و کودک، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

چکیده

مقدمه: تهوع و استفراغ، از شکایات شایع زنان در دوران بارداری است. تن‌آرامی مجموعه‌ای از تمرین‌های عصبی و عضلانی است که می‌تواند به‌عنوان درمان غیردارویی تهوع و استفراغ در بارداری مورد استفاده قرار گیرد. مطالعه حاضر با هدف تعیین تأثیر تن‌آرامی بنسون بر شدت تهوع و استفراغ در زنان باردار مراجعه‌کننده به مراکز جامع سلامت شهر همدان انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی کنترل شده با طرح پیش‌آزمون- پس‌آزمون در سال 1398 بر روی 100 زن نخست باردار 10-6 هفته مراجعه‌کننده به مراکز جامع سلامت شهر همدان انجام شد. افراد به‌طور تصادفی به دو گروه 50 نفره کنترل و مداخله تقسیم شدند. قبل از مداخله پرسشنامه PUQE-24 برای هر دو گروه تکمیل شد. گروه مداخله علاوه بر دریافت مراقبت‌های معمول بارداری، تمرینات تن‌آرامی را به‌مدت 4 هفته دریافت کردند. پس از پایان 4 هفته مجدداً افراد دو گروه مداخله و کنترل پرسشنامه را تکمیل کردند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار stata (نسخه 13) و آزمون‌های آماری کای دو، تست دقیق فیشر، ویلکاکسون و من‌ویتنی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین نمره تهوع و استفراغ قبل از مداخله در دو گروه مداخله و کنترل تفاوت معناداری نداشت (05/0<p). میانگین نمرات شدت تهوع و استفراغ در گروه مداخله، قبل و بعد از مداخله از 60/1±30/8 به 65/2±30/5 کاهش یافت که این تفاوت از نظر آماری معنادار بود (001/0>p)، همچنین در گروه کنترل از 51/1±38/8 به 70/1±39/7 تغییر یافت و این اختلاف از نظر آماری معنادار بود (01/0=p). پس از مداخله، شدت تهوع و استفراغ در گروه مداخله به‌طور قابل توجهی کمتر از گروه کنترل بود و تفاوت از نظر آماری معنادار بود (001/0>p).
نتیجه‌گیری: با توجه به تأثیر تن‌آرامی بنسون در کاهش حالت تهوع و استفراغ در بارداری، آموزش آن برای تمام زنان باردار در سه ماهه اول بارداری توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of Benson relaxation training on the severity of nausea and vomiting in pregnant women

نویسندگان [English]

  • Zahra Jadidi 1
  • Farideh Kazemi 2
  • Arezoo Shayan 3
  • Soodabeh Aghababaei 4
1 M.Sc. student of Counseling in Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
2 PhD of Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
3 Instructor, Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
4 Assistant Professor, Department of Mother and Child Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
چکیده [English]

Introduction: Nausea and vomiting are common complaints of women during pregnancy.Relaxation is a set of neuromuscular exercises that can be used as a non-pharmacological treatment for nausea and vomiting in pregnancy.This study was performed with aim to determine the effect of Benson relaxation on the severity of nausea and vomiting in pregnant women referred to the comprehensive health centers in Hamadan.
Methods: This controlled clinical trial with pre-test-post-test design was performed in 2019 on 100 primigravida women with 6-10 weeks of gestational age referred to the comprehensive health centers in Hamadan. The subjects were randomly divided into two groups of intervention and control (n=50 in each group). PUQE-24 questionnaire was completed for both groups before the intervention. The intervention group, in addition to routine pregnancy care, received relaxation techniques for 4 weeks. At the end of 4 weeks, the subjects in the intervention and control groups completed the questionnaire again. Data analysis was performed using stata (software 13) and Chi-square, Fisher's exact, Wilcoxon and Mann-Whitney. P<0.05 was considered statistically significant.
Results: The mean score of nausea and vomiting before the intervention was not significantly different between the intervention and control groups (P>0.05). The mean scores of nausea and vomiting in the intervention group before and after the intervention decreased from (8.30±1.60) to (5.30±2.65) which was statistically significant (P<0.001), also changed from (8.38±1.51) to (7.39±1.70) in the control group and this difference was statistically significant (P=0.01). After the intervention, the severity of nausea and vomiting in the intervention group was significantly lower than the control group and the difference was statistically significant (P<0.001).
Conclusion: Considering the effect of Benson's relaxation on reducing nausea and vomiting in pregnancy, its training is recommended for all pregnant women in the first trimester of pregnancy.

کلیدواژه‌ها [English]

  • Benson's relaxation
  • Nausea and vomiting
  • Pregnancy
  1. Roberts RM, Muller T, Sweeney A, Bratkovic D, Gannoni A. Promoting psychological well-being in women with phenylketonuria: pregnancy-related stresses, coping strategies and supports. Molecular genetics and metabolism reports 2014; 1:148-57.
  2. Skouteris H. Pregnancy: Physical and body image changes. Encyclopedia of body image and human appearance 2012: 664-8.
  3. Munch S, Korst LM, Hernandez GD, Romero R, Goodwin TM. Health-related quality of life in women with nausea and vomiting of pregnancy: the importance of psychosocial context. Journal of Perinatology 2011; 31(1):10-20.
  4. Yazdani S, Sadat Z. Evaluating complications of pregnancy in patients with hyperemesis gravidarum. KAUMS Journal (FEYZ) 2011; 14(4):426-30.
  5. Dooley L. Psychoanalysis of Charlotte Brontë, as a Type of the Woman of Genius. The American Journal of Psychology 1920: 221-72.
  6. Abdolhosseini S, Mokaberinejad R, Aliasl J, Aliasl F. Medicinal plants proposed for nausea and vomiting of pregnancy: a review study based on Iranian traditional medicine. Iran J Obstet Gynecol Infertil 2017; 20:1-8.
  7. Aghababaei S, Soltanian AR, Sharifi S, Torkzaban E, Refaei M. Investigating the factors related to severity of nausea and vomiting during Pregnancy and how it is controlled by pregnant Women in Hamadan, 2014. Iran J Obstet Gynecol Infertil 2019; 21(11):23-31.
  8. Pakniat H, Memarzadeh MR, Azh N, Mafi M, Ranjkesh F. Comparison of the effect of chamomile, Ginger and vitamin B6 on treatment of nausea and vomiting in pregnancy: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(8):47-54.
  9. Sharifzadeh F, Kashanian M, Koohpayehzadeh J, Rezaian F, Sheikhansari N, Eshraghi N. A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP). The Journal of Maternal-Fetal & Neonatal Medicine 2018; 31(19):2509-14.
  10. Matthews A, Haas DM, O'Mathúna DP, Dowswell T. Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews 2015(9).
  11. Nikibakhsh A, Keshavarz M, Hoseini F. Incidence and severity of nausea and vomiting during pregnancy and its association with anxiety and depression in pregnant women. Iran Journal of Nursing 2016; 29(101):1-11.
  12. Yazdani J, Setareh J. Effect of benson relaxation response on stress among in hemodialysis patients. Journal of Mazandaran University of Medical Sciences 2012; 22(91):61-8.
  13. Benson H, Kotch JB, Crassweller KD. The relaxation response: a bridge between psychiatry and medicine. Medical Clinics of North America 1977; 61(4):929-38.
  14. Rafiee B, Akbarzade M, Asadi N, Zare N. Comparison of Attachment and Relaxation Training Effects on Anxiety in Third Trimester and Postpartum Depression among Primipara Women. Hayat 2013; 19(1):76-88.
  15. Saeedi M, Ashktorab T, Saatchi K, Zayeri F, Amir Ali Akbari S. The effect of progressive muscle relaxation on sleep quality of patients undergoing hemodialysis. Iranian Journal of Critical Care Nursing 2012; 5(1):23-8.
  16. Hazrati M, Hoseini M, Dezh Bakhsh T, Taghavi A, Rajaeifard A. The effect of Benson relaxation therapy on anxiety level and severity of symptoms in patients with irritable bowel syndrome. Arak Medical University Journal 2007; 9(4(37)):9-17.
  17. Torabi M, Ghahri Sarabi AR, Salavati M, Pourismail Z, Akbarzade Baghban AR. Survey the effect of comparison Acupressure and Benson relaxation interventions on pre-operating anxiety of patients undergoing of kidney transplantation. scientific journal of ilam university of medical sciences 2013; 21(6):189-96.
  18. Alder J, Urech C, Fink N, Bitzer J, Hoesli I. Response to induced relaxation during pregnancy: comparison of women with high versus low levels of anxiety. Journal of clinical psychology in medical settings 2011; 18(1):13-21.
  19. Consonni EB, Calderon IM, Consonni M, De Conti MH, Prevedel TT, Rudge MV. A multidisciplinary program of preparation for childbirth and motherhood: maternal anxiety and perinatal outcomes. Reproductive health 2010; 7(1):1-6.
  20. Biabani F, Moradi Koosha F, Moeini V, NikNezhad Jalali A, Nasirizadeh M, Moradi The effect of Benson's muscle relaxation technique on severity of pregnancy nausea. Electronic Journal of General Medicine 2019; 16(2): ):em125.
  21. Shourgashti Z, Mirzaei K, Chamanzari H, Asghari Nekah M, Dadgar S, Emami Moghaddam Z. The effect of progressive muscle relaxation on nausea and vomiting in pregnant women. Iran J Obstet Gynecol Infertil 2019; 22(2):52-62.
  22. Yoo HJ, Ahn SH, Kim SB, Kim WK, Han OS. Efficacy of progressive muscle relaxation training and guided imagery in reducing chemotherapy side effects in patients with breast cancer and in improving their quality of life. Supportive Care in Cancer 2005; 13(10):826-33.
  23. Koken G, Yilmazer M, Cosar EN, Sahi˙ n FG, Cevri˙ oglu S, Geci˙ ci˙ O. Nausea and vomiting in early pregnancy: relationship with anxiety and depression. Journal of Psychosomatic Obstetrics & Gynecology 2008; 29(2):91-5.
  24. Ozgoli G, Gharayagh Zandi M, Nazem Ekbatani N, Allavi H, Moattar F. Cardamom powder effect on nausea and vomiting during pregnancy. Complement Med J 2015; 14:1056-76.
  25. Kia PY. The Effect Of Lemon Inhalation On Nusea And Vomiting Of Pregnancy: A Double-Blinded, Randomized. Controlled Clinical Trial. Iran Red Crescent Med J 2014; 10.
  26. Shakiba M, Parsi H, Shikhi ZP, Navidian A. The effect of psycho-education intervention based on relaxation methods and guided imagery on nausea and vomiting of pregnant women. Journal of family & reproductive health 2019; 13(1):47.
  27. Charalambous A, Giannakopoulou M, Bozas E, Paikousis L. A randomized controlled trial for the effectiveness of progressive muscle relaxation and guided imagery as anxiety reducing interventions in breast and prostate cancer patients undergoing chemotherapy. Evidence-Based Complementary and Alternative Medicine 2015; 2015.