مقایسه تأثیر تحریک الکتریکی عصب از طریق پوست (TENS) با مداخله حمایتی روانی بر درد و پیامدهای مادری و نوزادی زایمان در زنان باردار مراجعه کننده به بلوک زایمان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، مرکز تحقیقات پرستاری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

2 مربی گروه مامایی، مرکز تحقیقات پرستاری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

3 کارشناس ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

4 استادیار گروه مامایی، مرکز تحقیقات پرستاری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

5 استادیار گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران.

6 استادیار گروه مشاوره در مامایی، مرکز تحقیقات پرستاری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

چکیده

مقدمه: عواملی که با حداقل مداخله منجر به کاهش درد و طول مدت زایمان شود، همواره مورد توجه محققین بوده است. مطالعه حاضر با هدف مقایسه تأثیر تحریک الکتریکی عصب از طریق پوست (TENS) با مشاوره حمایتی روانی بر درد زایمان و نتایج مادری و نوزادی آن در زنان باردار مراجعه‌کننده به بلوک زایمان انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1400 بر روی 90 زن باردار بستری جهت زایمان در بلوک زایمان بیمارستان پیامبر اعظم کرمان انجام شد. افراد به‌طور تصادفی به سه گروه 30 نفره تنس، مداخله حمایتی روانی و کنترل تقسیم شدند. در فاز فعال زایمان در گروه تنس از دستگاه تنس و در گروه مشاوره، مشاوره حمایتی روانی توسط مامای همراه انجام گرفت. نمره در دو طول مدت فاز فعال زایمان (دیلاتاسیون 4 و 10 سانتی‌متر) و پیامدهای مادری- نوزادی بین سه گروه با هم مقایسه شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون‌های آماری تحلیل واریانس و دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: نمره درد در دیلاتاسیون ۴ سانتی‌متر، پیامدهای مادری، آپگار دقیقه 1و 5 و نوع زایمان در میان سه گروه تفاوت معناداری نداشت (05/0<p)، ولی نمره درد در دیلاتاسیون ۱۰ سانتی‌متر در گروه مشاوره و تنس به‌طور مشابهی در مقایسه با گروه کنترل به‌طور معناداری کاهش پیدا کرده بود. طول مدت مرحله اول فاز فعال زایمان بین سه گروه تفاوت معناداری نداشت (05/0<p)، ولی تفاوت طول مدت مرحله دوم فاز فعال و کل طول مدت فاز فعال بین سه گروه معنادار بود (05/0<p).
نتیجه‌گیری: هر دو روش مشاوره حمایتی روانی و تحریک الکتریکی عصب از طریق پوست (TENS) در کاهش درد و طول مدت زایمان به یک میزان مؤثر هستند و با توجه به بی‌خطر بودن هر دو روش، توصیه می‌شود جهت تسهیل فرآیند زایمان از این دو روش استفاده گردد.

کلیدواژه‌ها

عنوان مقاله [English]

The efficacy of Trans-cutaneous Electrical Nerve Stimulation (TENS) with psychological supportive intervention on pain and maternal -neonatal outcomes of childbirth in pregnant women referring to Maternity ward

نویسندگان [English]

  • Fereshteh Moradi 1
  • Katayoun Alidousti 2
  • Alieh Zarbaf 3
  • Masoumeh Ghazanfarpour 4
  • Abolfazl Hosseinnataj 5
  • Atefeh Ahmadi 6
1 M.Sc. of Midwifery, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
2 Instructor, Department of Midwifery, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
3 M.Sc. of Midwifery, Student Research Committee, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
4 Assistant professor, Department of Midwifery, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
5 Assistant Professor, Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
6 Assistant Professor, Department of Counseling in Midwifery, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
چکیده [English]

Introduction: The factors which lead to a reduction in pain and length of labor with minimal intervention have always been of interest to researchers. The present study was performed aimed to compare the effect of TENS with psychological supportive intervention on labor pain and maternal and neonatal outcomes in pregnant women referring to the maternity ward.
Methods: This clinical trial study was performed in 2021 on 90 pregnant women admitted to the delivery block of Payambar Azam hospital of Kerman. The subjects were randomly divided into three groups of TENS (n=30), psychological supportive intervention (n=30) and control (n=30). In the active labor phase, TENS was applied for the TENS group, the psychological supportive intervention was performed in the counseling group, and routine care was performed for the control group. Scores of pain during the active phase of labor (4 cm and 10 cm dilatation) and maternal and neonatal outcomes were compared in the three groups. Data were analyzed by SPSS statistical software (version 21) and Fisher's exact and variance analysis tests. P< 0.05 was considered statistically significant.
Results: There was no significant difference between the three groups in the scores of labor pain in 4 cm dilatation, maternal complications, Apgar scores 1 and 5 minutes, and type of delivery (p> 0.05). However, the score of pain in 10 cm dilatation in the TENS group and counseling group similarly was significantly reduced compared to the control group. The duration of the first stage of active phase labor was not significantly different between the three groups (p> 0.05), but the difference between the duration of the second stage of the active phase and the total duration of the active phase was significant between the three groups (p >0.05).
Conclusion: Both methods of psychological supportive counseling and transcutaneous electrical nerve stimulation (TENS) are equally effective in reducing labor pain and length of labor; considering the safety of both methods, it is recommended to use these two methods to facilitate the birth process.

کلیدواژه‌ها [English]

  • Labor pain
  • Psychological supportive counseling
  • Transcutaneous Electrical Nerve Stimulation

مراجع

  1. Payandeh M, Nahidi F, Nasiri M, Fouladi A. Comparing the effects of transcutaneous electrical nerve stimulation and pharmaceutical hyoscine–promethazine compound on duration of second phase of labor. Iran J Obstet Gynecol Infertil 2019; 22(8):19-25.
  2. Dolatian M, Hasanpour A, Montazeri SH, Heshmat R, Majd HA. The effect of reflexology on pain intensity and duration of labor on primiparas. Iranian Red Crescent Medical Journal 2011; 13(7):475-9.
  3. BOlBOl-haGhiGhi N, Masoumi SZ, Kazemi F. Effect of continued support of midwifery students in labour on the childbirth and labour consequences: a randomized controlled clinical trial. Journal of clinical and diagnostic research: JCDR 2016; 10(9):QC14.
  4. Khodabakhshi Koolaee A, Heidari S, Khoshkonesh A, Heidari M. Relationship between spiritual intelligence and resilience to stress in preference of delivery method in pregnant women. Iran J Obstet Gynecol Infertil 2013; 16(58):8-15.
  5. Taheri Z, Mazaheri MA, Khorsandi M, Hassanzadeh A, Amiri M. Effect of educational intervention on self-efficacy for choosing delivery method among pregnant women in 2013. International journal of preventive medicine 2014; 5(10):1247.
  6. Mohiuddin AK. Non-drug pain management: opportunities to explore. LAP LAMBERT Academic Publishing; 2019.
  7. Emami Moghadam Z, Aemmi SZ, Dadgar S, Sardar Abadi F. Improving the performance of pregnant women in oral and dental health based on the Health Belief Model. Iran J Obstet Gynecol Infertil 2015; 18(176):11-16.
  8. Reynolds F. The effects of maternal labour analgesia on the fetus. Best practice & research Clinical obstetrics & gynaecology 2010; 24(3):289-302.
  9. Darvishi M, Ranjbaran M, Jourabchi Z, Jafarimanesh H. 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. Iran J Obstet Gynecol Infertil 2019; 22(4):63-72.
  10. Saghiri M, Satarzadeh N, Tabrizi N, Pezeshki Z. A comparative study on the severity of labor pain with or without Entonox and it's effects on the new-borns of primiparas. J Ardabil Univ Med Sci 2008; 8(1):62-7.
  11. Stamer UM, Stuber F, Wiese R, Wulf H, Meuser T. Contraindications to regional anaesthesia in obstetrics: a survey of German practice. International Journal of Obstetric Anesthesia 2007; 16(4):328-35.
  12. Deepak AK, Chopra S. Effect of acupressure on intensity of labor pains and duration of first stage of labor among primigravida mothers. Iran J Nurs Midwifery Res 2013; 9(4):178-86.
  13. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25nd New York: McGraw-Hill Education; 2018.
  14. Curley MA, Smith JB, Moloney-Harmon PA. Critical Care Nursing of Infants and Children. philadelphia: WB saunders; 1996.
  15. Bedwell C, Dowswell T, Neilson JP, Lavender T. The use of transcutaneous electrical nerve stimulation (TENS) for pain relief in labour: a review of the evidence. Midwifery 2011; 27(5):e141-8.
  16. Glavin K, Smith L, Sørum R, Ellefsen B. Supportive counselling by public health nurses for women with postpartum depression. Journal of advanced nursing 2010; 66(6):1317-27.
  17. Kordi M, Bakhshi M, Tara F. The effect of continuous support during labor on labor progress in primigravida women. Iran J Obstet, Gynecol Infertil 2014; 17(107):7-14.
  18. Jepson HA, Talashek ML, Tichy AM. The Apgar score: evolution, limitations, and scoring guidelines. Birth 1991; 18(2):83-92.
  19. Illingworth RS. The Development of the Infant and Young Child: Normal and Abnormal. 9nd Singapore: Churchill Livingstone; 1987.
  20. Yelikar K, Deshpande S, Deshpande R, Lone D. Safety and efficacy of oral mifepristone in pre-induction cervical ripening and induction of labour in prolonged pregnancy. The Journal of Obstetrics and Gynecology of India 2015; 65(4):221-5.
  21. Njogu A, Qin S, Chen Y, Hu L, Luo Y. The effects of transcutaneous electrical nerve stimulation during the first stage of labor: a randomized controlled trial. BMC Pregnancy and Childbirth 2021; 21(1):1-8.
  22. Bodian CA, Freedman G, Hossain S, Eisenkraft JB, Beilin Y. The visual analog scale for pain: clinical significance in postoperative patients. The Journal of the American Society of Anesthesiologists 2001; 95(6):1356-61.
  23. Rezaie M, Parpouchi SF, Dakhesh S. Evaluation of the Relationship between the Attendance of a Companion Midwife and Maternal and Neonatal Consequences in 2013-2018. Scientific Journal of Nursing, Midwifery and Paramedical Faculty 2021; 6(3):88-96.
  24. Karlinah N, Irianti B. Effect of transcutaneous electrical nerve stimulation (TENS) on the Pain Intensity Phase I Stage of Labor Active In Bidan Praktik Mandiri Rahmadina Rosa 2019. Science Midwifery 2020; 8(2, April):39-43.
  25. Heydari A, Nasiri F, Kariman N. Effect of topical magnesium sulfate in latent phase on Bishop Score and latent phase duration in primiparous women. Iran J Obstet Gynecol Infertil 2020; 23(2):42-9.
  26. Saxena KN, Shokeen S, Taneja B. Comparative evaluation of efficacy of transcutaneous electrical nerve stimulation administered by dermatomal stimulation versus acupuncture points stimulation. Northern J ISA 2016; 1(1):29-34.
  27. CD L. Effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) Application on Pain and Behavioural Responses of Primigravid Women during the First Stage of Labour in a Selected Hospital at Mangalore. International Journal of Health Sciences and Research 2020; 10(2):78-88.
  28. Rezaei R, Beheshti Z, Sharif Nia H, Saatsaz S. Comparing the Effects of Standard Maternity Care and Continuous Support by Doula Midwife and Female Relatives during Labor. Journal of Mazandaran University of Medical Sciences 2020; 30(184):94-105.
  29. Darvishi M, Ranjbaran M, Jourabchi Z, Jafarimanesh H. 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. Iran J Obstet Gynecol Infertil 2019; 22(4):63-72.
  30. Thuvarakan K, Zimmermann H, Mikkelsen MK, Gazerani P. Transcutaneous electrical nerve stimulation as a pain-relieving approach in labor pain: a systematic review and meta-analysis of randomized controlled trials. Neuromodulation: Technology at the Neural Interface 2020; 23(6):732-46.
  31. Mucuk S, Baser M. Effects of noninvasive electroacupuncture on labour pain and duration. Journal of Clinical Nursing 2014; 23(11-12):1603-10.
  32. Chao AS, Chao A, Wang TH, Chang YC, Peng HH, Chang SD, et al. Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind placebo-controlled trial. Pain 2007; 127(3):214-20.
  33. Ahmadi Z. Evaluation of the effect of continuous midwifery support on pain intensity in labor and delivery. Journal of Rafsanjan University of Medical Sciences 2010; 9(4):293-304.
  34. Andaroon N, Kordi M, Kimiaee SA, Esmaily H. Effect of individual counseling program by a midwife on anxiety during pregnancy in nulliparous women. Iran J Obstet Gynecol Infertil 2018; 20(12):86-95.
  35. Nommsen-Rivers LA, Mastergeorge AM, Hansen RL, Cullum AS, Dewey KG. Doula care, early breastfeeding outcomes, and breastfeeding status at 6 weeks postpartum among low-income primiparae. Journal of Obstetric, Gynecologic & Neonatal Nursing 2009; 38(2):157-73.
  36. Khavandizadeh Aghdam S, Kazemzadeh R, Nikjoo R. The effect of the doula support during labor on delivery length in primigravida women. Iran J Obstet Gynecol Infertil 2015; 18(150):8-13.
  37. Lundgren I. Swedish women's experiences of doula support during childbirth. Midwifery 2010; 26(2):173-80.
  38. Gray C, Nukada H, Jackson DM, McMorran PD, Wu A, Ma F. Neuroprotective effects of nitrone radical scavenger S-PBN on reperfusion nerve injury in rats. Brain research 2003; 982(2):179-85.
  39. Samieizadeh Toosi T, Sereshti M, Dashipur AR, Mohammadinia N, Arzani A. The effect of supportive companionship on Length of labor and desire to breastfeed in primiparous Women. Journal of Urmia Nursing & Midwifery Faculty 2011; 9(4).
  40. Dadshahi S, Torkzahrani S, Janati-Ataie P, Nasiri M. Does continuous labor support by midwife make a difference in delivery outcomes?. Iran J Obstet Gynecol Infertil 2018; 20(12):67-76.
  41. Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci 2016; 4(3):125-9.
مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 6
شهریور 1401
صفحه 61-70

فایل ها

هم رسانی

ارجاع به این مقاله

آمار