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
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