بررسی میزان رضایت‌مندی مادران از تحریک الکتریکی اعصاب از طریق پوست در تسکین درد بعد از اپی‌زیاتومی: یک مطالعه کارآزمایی بالینی تصادفی شده یک‌سوکور

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

2 مربی گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

3 استادیار گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران.

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

چکیده

مقدمه: هدف از توسعه علم مامایی و مراقبت از مادر، ایجاد زایمان ایمن و افزایش رضایت­ مندی مادر از روند تولد است. مطالعه حاضر با هدف بررسی میزان رضایت­ مندی مادران از تحریک الکتریکی اعصاب از طریق پوست در تسکین درد بعد از اپی‌زیاتومی انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده در سال 1397 بر روی 80 مادر نخست­زا در بیمارستان بعثت سنندج انجام شد. افراد به‌صورت تصادفی در دو گروه مداخله (تنس روشن) و دارونما (تنس خاموش) قرار گرفتند. الکترودهای تنس در محل اعصاب ژنیتوفمورال و پودندال قرار داده شد. میزان رضایت­ مندی از تنس با استفاده از پرسشنامه محقق­ ساخته بررسی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم ­افزار آماری SPSS (نسخه 20) و آزمون­ های همبستگی پیرسون، تی مستقل، کروسکال والیس، آنالیز واریانس و من‌ویتنی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: هر دو گروه مداخله و دارونما از سطح رضایت­ مندی بالایی برخوردار بودند. با این وجود، میانگین رضایت­ مندی در گروه در گروه مداخله (96/1±35/17) به‌طور معنی ­داری بیشتر از گروه دارونما (02/2±45/13) بود (001/0>p). بین هیچ‌کدام از مشخصات دموگرافیک و میزان رضایت­ مندی مادران ارتباط معنی­ داری یافت نشد (05/0˃p).
نتیجه ­گیری: استفاده از تنس می­ تواند اثرات قابل توجهی بر افزایش رضایت­ مندی مادران داشته باشد، لذا پیشنهاد می‌شود جهت افزایش میزان رضایت مددجویان و ارتقای سطح بهداشت روانی مادران، استفاده از تنس جهت کاهش درد بعد از اپی ­زیاتومی در تمامی واحدهای زایمانی به مرحله اجرا گذاشته شود.

کلیدواژه‌ها

عنوان مقاله [English]

Mothers’ satisfaction with transcutaneous electrical nerve stimulation (TENS) in relieving post-episiotomy pain: A clinical trial study

نویسندگان [English]

  • Roonak Shahoei 1
  • Shahnaz Salavati Ghasemi 2
  • Neda Sheikh zakaryaee 3
  • Seyedeh Soma Zakariaee 4
1 Associate Professor, Department of Midwifery, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
2 Instructor, Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
3 Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
4 Instructor, Department of Midwifery, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
چکیده [English]

Introduction: The goal of developing midwifery and maternal care is to create a safe delivery and increase maternal satisfaction from birth process. The present study was conducted aimed to evaluate mothers’ satisfaction with transcutaneous electrical nerve stimulation (TENS) in relieving post-episiotomy pain.
Methods: This randomized clinical trial was performed on 80 primiparous women referred to Sanandaj Besat Hospital in 2018. Patients were randomly divided into two groups: intervention (TENS-On) and placebo (TENS-Off) groups. TENS electrodes were located in the genitofemoral and pudendal nerves. The satisfaction from TENS was assessed by a researcher-made questionnaire. Data were analyzed using SPSS (version 20.0) and Pearson correlation, Independent t-test, Kruskal-Wallis, variance analysis, and Mann-Whitney tests. P<0.05 was considered statistically significant.
Results: The intervention and placebo groups had a high level of satisfaction. However, the mean satisfaction in the intervention group (17.35±1.96) was significantly higher than the placebo group (13.45±2.02) (p<0.001). There was no significant relationship between demographic variable and satisfaction level (p˃0.05).
Conclusion: TENS can have a noticeable effect on the level of maternal satisfaction. Therefore, it is suggested to implement TENS to reduce post-episiotomy pain in all maternity units in order to increase the level of satisfaction of patients and improve the level of mental health of mothers.

کلیدواژه‌ها [English]

  • Episiotomy
  • Pain
  • Satisfaction
  • Transcutaneous Electrical Nerve Stimulation

مراجع

  1. Delaram M, Jafar-Zadeh L, Dadkhah N. Comparing the effects of indomethacin suppository and mefenamic acid capsule on post episiotomy pain. J Kermanshah Univ Med Sci 2013; 17(3):e77106.
  2. Delaram M, Dadkhah N. Comparing the effects of lidocaine cream and mefenamic acid on post episiotomy pain. Iran J Obstet Gynecol Infertil 2014; 17(96):6-11.
  3. Kariman N. Assessing comparison the effect of cooling gel pads and topical olive oil on the intensity of episiotomy pain in primiparous women. Complementary Medicine Journal 2015; 4(4):977-86.
  4. Khani S, Taringo F, Shabani B. Episiotomy is protective of laceration genital system. Journal of modares med 2000; 16(4):16-22.
  5. Islam A, Hanif A, Ehsan A, Arif S, Niazi SK, Niazi AK. Morbidity from episiotomy. J Pak Med Assoc 2013; 63(6):696-701.
  6. Khajavi Shojae K, Dawati A, Zayeri F. Frequency and side effect of episiotomy in primiparous women: a three-month longitudinal survey. Qom University of Medical Sciences Journal 2009; 3(2):47-50.
  7. Zakariaee SS, Shahoei R, Nosab LH, Moradi G, Farshbaf M. The Effects of Transcutaneous Electrical Nerve Stimulation on Post-Episiotomy Pain Severity in Primiparous Women: A Randomized, Controlled, Placebo Clinical Trial. Galen Medical Journal 2019; 8:e1404.
  8. Minassian VA, Jazayeri A, Prien SD, Timmons RL, Stumbo K. Randomized trial of lidocaine ointment versus placebo for the treatment of postpartum perineal pain. Obstetrics & Gynecology 2002; 100(6):1239-43.
  9. Shahrahmani H, Kariman N, Jannesari S, Ghalandari S, Asadi N. A systematic review on the type of treatment methods to reduce pain and improve wound healing in Iran. Iran J Obstet Gynecol Infertil 2016; 19(9):17-31.
  10. Taleb S, Ozgoli G, Mojab F, Nsiri M, Ahvazi M. Effect of Verbascum Thapsus cream on intensity of episiotomy pain in primiparous women. Iran J Obstet Gynecol Infertil 2016; 19(7):9-17.
  11. Coutaux A. Non-pharmacological treatments for pain relief: TENS and acupuncture. Joint Bone Spine 2017; 84(6):657-61.
  12. Ebrahimi Houshyar A, Hosein Rezaie H, Jahani Y, Kazemi M, Monfared S. Comparison of two methods of aromatherapy with lavender essence and Transcutaneous Electrical Nerve Stimulation (TENS) on cesarean postoperative pain. Iran J Obstet Gynecol Infertil 2015; 18(146):6-12.
  13. Mokhtari T, Ren Q, Li N, Wang F, Bi Y, Hu L. Transcutaneous electrical nerve stimulation in relieving neuropathic pain: basic mechanisms and clinical applications. Current pain and headache reports 2020; 24(4):1-4.
  14. Schofield P. Beyond pain. John Wiley & Sons; 2006.
  15. Pitangui AC, Araújo RC, Bezerra MJ, Ribeiro CO, Nakano A. Low and high-frequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial. Brazilian journal of physical therapy 2014; 18:72-8.
  16. Khedri P. Comparison of transcutaneous electrical nerve stimulation and lidocaine on episiotomy pain.[The Master Degree Thessis]. Ahvaz Jondishapur University of Medical Sciences; 2005.
  17. Rezaeyan M, Geranmayeh M, Direkvand-Moghadam A. Comparison of transcutaneous electrical nerve stimulation and lidocaine on episiotomy complication in primiparous women: A randomized clinical trial. Iranian journal of nursing and midwifery research 2017; 22(1):26.
  18. Lorenzana FD. A randomized controlled trial of the efficacy of transcutaneous electrical nerve stimulation (TENS) versus lidocaine in the relief of episiotomy pain. Philipp J Obstet Gynecol 1999; 23(4):135-42.
  19. Decosterd I, Hugli O, Tamchès E, Blanc C, Mouhsine E, Givel JC, et al. Oligoanalgesia in the emergency department: short-term beneficial effects of an education program on acute pain. Annals of emergency medicine 2007; 50(4):462-71.
  20. Shah S, Ho AC, Kuehler BM, Childs SR, Towlerton G, Goodall ID, et al. Different measures, different outcomes? Survey into the effectiveness of chronic pain clinics in a London tertiary referral center. Journal of Pain Research 2015; 8:477.
  21. Bhakta HC, Marco CA. Pain management: association with patient satisfaction among emergency department patients. The Journal of emergency medicine 2014; 46(4):456-64.
  22. Karaca A, Durna Z. Patient satisfaction with the quality of nursing care. Nursing open 2019; 6(2):535-45.
  23. Fang J, Liu L, Fang P. What is the most important factor affecting patient satisfaction–a study based on gamma coefficient. Patient preference and adherence 2019; 13:515-25.
  24. Wager KA, Lee FW, Glaser JP. Health Care Information Systems: A Practical Approach for Health Care Management. 4nd New York: John Wiley & Sons; 2017.
  25. Mortazavi Y, Rabiee O, Rohi Z, Ghomi S. Patient satisfaction from pre and postoperative nursing care in hospitals affiliated to Babol University of Medical Sciences. Preventive Care in Nursing & Midwifery Journal 2013; 3(1):38-45.
  26. Adjei KK, Kikuchi K, Owusu-Agyei S, Enuameh Y, Shibanuma A, Ansah EK, et al. Women’s overall satisfaction with health facility delivery services in Ghana: a mixed-methods study. Tropical Medicine and Health 2019; 47(1):1-9.
  27. Adhikari M, Paudel NR, Mishra SR, Shrestha A, Upadhyaya DP. Patient satisfaction and its socio-demographic correlates in a tertiary public hospital in Nepal: a cross-sectional study. BMC health services research 2021; 21(1):1-0.
  28. Haseli A, Eghdampour F, Ghiasi A. Impact of Massage Therapy and Breathing Techniques on the Satisfaction of Primiparous Women with Childbirth. Iran J Obstet Gynecol Infertil 2018; 21(6):18-26.
  29. Jafari G. Khalifegari S. Danaii k, Dolatshahi P, Ramezani M, Roohparvar R, Sabaghiyan PA. Hospital accreditation standards in Iran Tehran: Sound Publication Center; 2010.
  30. Arbabi H, Amiri-Farahani L, Hasanpoor-Azghady SB. Regret and satisfaction in women with vaginal delivery and cesarean section: a literature review. Journal of Zabol Medical School 2020; 3(2):93-101.
  31. Pitangui AC, de Sousa L, Gomes FA, Ferreira CH, Nakano AM. High‐frequency TENS in post‐episiotomy pain relief in primiparous puerpere: A randomized, controlled trial. Journal of Obstetrics and Gynaecology Research 2012; 38(7):980-7.
  32. Eyvan Bagha R, Fardi Azar Z, Kamranpour SB, Ghoujazadeh M. The comparison of the effect of acetaminophen tablets, diclofenac suppositories and ice packs on the relief of perineal pain after episiotomy in patients admitted to al-zahra teaching hospital in Tabriz, Iran. J Sabzevar Univ of Med Sci 2006; 13(3):145-51.
  33. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse D, Spong CY, et al. Williams Obstetrics. 24nd New York: McGraw-Hill Education; 2014.
  34. Yar Mohammadi S, Kiani Asiabar A. The Role of Midwife in Providing Health Services . J Holist Nurs Midwifery 2003; 13(1 and 49):42-6.
  35. Khavandizadeh Aghdam S, Daryabakhsh A. Effect of acupressure at Hugo point (LI4) on the process and outcomes of labor in nulliparous women. Iran J Obstet Gynecol Infertil 2012; 15(27):14-20.
  36. Jafari E, Mohebbi P, Rastegari L, Mazloomzadeh S. The comparison of physiologic and routine method of delivery in mother’s satisfaction level in Ayatollah Mosavai Hospital, Zanjan, Iran, 2012. Iran J Obstet Gynecol Infertil 2013; 16(73):9-18.
  37. Fischer RL, Bianculli KW, Sehdev H, Hediger ML. Does light pressure effleurage reduce pain and anxiety associated with genetic amniocentesis? A randomized clinical trial. Journal of Maternal-Fetal Medicine 2000; 9(5):294-7.
  38. Chung UL, Hung LC, Kuo SC, Huang CL. Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. The journal of nursing research: JNR 2003; 11(4):251-60.
  39. Desta H, Berhe T, Hintsa S. Assessment of patients’ satisfaction and associated factors among outpatients received mental health services at public hospitals of Mekelle Town, northern Ethiopia. Int J Ment Health Syst 2018; 12(1):1-7.
  40. Erdogan M, Erdogan A, Erbil N, Karakaya HK, Demircan A. Prospective, randomized, placebo-controlled study of the effect of TENS on postthoracotomy pain and pulmonary function. World journal of surgery 2005; 29(12):1563-70.
  41. Clement HJ, Caruso L, Lopez F, Broisin F, Blanc‐Jouvan M, Derré‐Brunet E, et al. Epidural analgesia with 0.15% ropivacaine plus sufentanil 0.5 µg ml–1 versus 0.10% bupivacaine plus sufentanil 0.5 µg ml–1: a double‐blind comparison during labour. British journal of anaesthesia 2002; 88(6):809-13.
  42. Hodnett ED. Pain and women's satisfaction with the experience of childbirth: a systematic review. American journal of obstetrics and gynecology 2002; 186(5):S160-72.
  43. Hu L, Zhou BP, Liu S, Wang Z, Liu Y. Outpatient satisfaction with tertiary hospitals in china: the role of sociodemographic characteristics. International Journal of Environmental Research and Public Health 2019; 16(19):3518.
  44. Yazdi Moghadam H, Memarian R, Mohammadi I. The effect of pain management by nurses on the satisfaction rate of patients after abdominal surgery .2006:121-128.‏
  45. Tokunaga J, Imanaka Y, Nobutomo K. Effects of patient demands on satisfaction with Japanese hospital care. International Journal for Quality in Health Care 2000; 12(5):395-401.
  46. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse D, Spong CY, et al. Williams Obstetrics. 23nd New York: McGraw-Hill Education; 2011.
  47. Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. European Journal of Pain 2003; 7(2):181-8.
  48. Platon B, Andréll P, Raner C, Rudolph M, Dvoretsky A, Mannheimer C. High-frequency, high-intensity transcutaneous electrical nerve stimulation as treatment of pain after surgical abortion. Pain 2010; 148(1):114-9.
  49. Rosen MA. Nitrous oxide for relief of labor pain: a systematic review. American journal of obstetrics and gynecology 2002; 186(5):S110-26.
مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 9
آذر 1401
صفحه 11-21

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