بررسی تأثیر وضعیت سجده بر شدت درد و پیشرفت زایمان در زنان نخست‌زا :یک کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی جیرفت، جیرفت، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جیرفت، جیرفت، ایران.

3 دکتری آمار، دانشکده پزشکی، دانشگاه علوم پزشکی جیرفت، جیرفت، ایران.

10.22038/ijogi.2022.20709

چکیده

مقدمه: زایمان برای عده­ای از زنان رضایت‌بخش نبوده و با درد، ترس و رنج همراه است. مطالعه حاضر با هدف بررسی تأثیر وضعیت سجده بر شدت درد و طول مدت زایمان در زنان نخست‌زا انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در سال 1399 بر روی 100 نفر از زنان نخست‌زای بستری در بخش زایمان در جنوب استان کرمان انجام شد. افراد به‌صورت تصادفی در دو گروه 50 نفره وضعیت معمول و سجده قرار گرفتند. برای زنان وضعیت سجده، در ابتدای فاز فعال (دیلاتاسیون 4 سانتی‌متر)، به‌طور متناوب (هر یک ساعت، به‌مدت 15 دقیقه) تا پایان دیلاتاسیون کامل دهانه رحم در وضعیت سجده قرار گرفتند. گردآوری داده‌ها با استفاده از پرسشنامه‌های اطلاعات فردی و مقیاس دیداری درد و فرم پیشرفت زایمان (پارتوگراف) انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزارآماری SPSS ( نسخه 26) و آزمون‌های تی مستقل، کای دو و آزمون دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته‌ها: بر اساس نتایج آزمون آماری، میانگین شدت درد در گروه مداخله در مقایسه با گروه کنترل به‌طور معنی­داری کمتر بود (001/0>p). پیشرفت زایمان در مادران گروه مداخله در مقایسه با گروه کنترل به‌طور معنی‌داری سریع‌تر بود که مدت زمان زایمان در گروه مداخله و کنترل به‌ترتیب 04/1±48/4 و 7/1±16/7 بود (001/0>p). میزان رضایت مادران از وضعیت قرار‌گیری در پروسه زایمان در گروه مداخله بیشتر از گروه کنترل بود (001/0>p).
نتیجه‌گیری: وضعیت سجده در زنان نخست‌زا در طول فاز فعال زایمان در کاهش شدت درد و تسریع پیشرفت زایمان سودمند است، لذا توصیه می­شود که از این وضعیت به‌عنوان یک مراقبت معمول غیردارویی در بخش‌های زایمانی استفاده شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of Knee- chest position on labor pain and Duration of labor in nulliparous women: a randomized clinical trial

نویسندگان [English]

  • Tayebeh Sedighi Darijani 1
  • Sareh Mehni 2
  • Neda Dastyar 2
  • Azam Amirian 2
  • Akbar MehrAlizadeh 3
1 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran .
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran.
3 PhD of Statistics, Faculty of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran.
چکیده [English]

Introduction: Childbirth is not satisfactory for some women and is associated with pain, fear and suffering. The present study was conducted aimed to investigate the effect of Knee- chest position on pain intensity and duration of labor in nulliparous women.
Methods: This randomized clinical trial study was performed in 2020 on 100 nulliparous women admitted to the maternity ward in the south of Kerman province. Individuals were randomly divided into two groups of normal posture and Knee-chest position (n=50 in each group). For women who were in the Knee-chest position group, at the beginning of the active phase (dilatation 4cm), they were in Knee-chest position intermittently (for 15 minutes every hour) until the complete cervical dilatation. Data were collected by personal information questionnaire and pain visual scale and delivery progress form (partograph). Data were analyzed by SPSS software (version 26) and Independent t-test, chi-square and Fisher's exact test. P<0.05 was considered statistically significant.
Results: according to independent t-test, chi-square and Fisher's exact tests, the mean pain intensity in the intervention group (Knee-chest position) was significantly lower than the control group (normal position) (p <0.001). Also, the progression of labor in the mothers of the intervention group was significantly faster compared to the control group; duration of delivery in the intervention and control groups was 4.48±1.04 and 7.16±1.7, respectively (p <0.001). The level of mothers' satisfaction with the position status during delivery process was higher in the intervention group than in the control group (p<0.001).
Conclusion: The Knee-chest position in nulliparous women during the active phase of labor is beneficial in reducing labor pain and accelerating labor progression. Therefore, it is recommended that this condition be used as a routine non-pharmacological care in maternity wards.

کلیدواژه‌ها [English]

  • duration of Labor
  • Knee-chest position
  • Labor pain
  • Nulliparous women
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