بررسی مقایسه تأثیر کیف آب گرم، ماساژ افلوراج و مراقبت معمول لیبر بر شدت درد فاز فعال لیبر در زنان باردار نخست‌زا- یک مطالعه کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

2 مربی گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

3 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی زنجان، زنجان، ایران.

4 استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی زنجان، زنجان، ایران.

چکیده

مقدمه: درد، پدیده شایع و جزء اجتناب‌ناپذیر فرآیند زایمان است و کنترل مؤثر این درد همانند دیگر دردهای حاد، موضوع مهم جامعه و بهداشت می­ باشد. بر اساس مطالعات، یکی از علل اصلی عدم انتخاب زایمان طبیعی توسط مادران، ترس از درد طبیعی لیبر و زایمان می ­باشد. مطالعه حاضر با هدف بررسی مقایسه‌ای تأثیر ماساژ افلوراج و کیف آب گرم در کاهش درد مرحله اول زایمان زنان نخست‌زا انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی با گروه کنترل در سال 95-1394 بر روی 90 زن باردار نخست‌زای بستری شده در بیمارستان زنان تهران انجام شد. نمونه­ ها به‌طور تصادفی در دو گروه مداخله و یک گروه کنترل قرار گرفتند. در گروه آزمون 1، 15 دقیقه ماساژ، گروه 2 به‌مدت 15 دقیقه کیف آب گرم در ناحیه پشت در سه نوبت در دیلاتاسیون 4، 6 و 8 سانتی‌متر و گروه کنترل، مراقبت ­های معمول اتاق زایمان را دریافت کردند. در هر سه گروه شدت درد با استفاده از مقیاس VAS تا پایان زایمان اندازه ­گیری شد. تجزیه و تحلیل داده ­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 24) و آزمون‌های تی، کای دو و تحلیل واریانس با داده ­های تکراری صورت گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: پس از مداخله، شدت درد در گروه­ های مداخله در شروع فاز فعال و انتقالی زایمان نسبت به گروه کنترل کاهش معنی‌داری داشت (001/0>p). با این وجود تفاوت معناداری در میزان کاهش درد بین دو گروه مداخله وجود نداشت (001/0<p).
نتیجه­ گیری: در این مطالعه هم استفاده از کیسه آب گرم و هم ماساژ درمانی در کاهش درد حین لیبر مؤثر بودند. بنابراین این مداخلات می­ توانند توسط ماماها در مراکز مراقبتی و درمانی جهت خوشایندسازی زایمان و ارتقاء کیفیت مراقبت‌های مادر و نوزاد انجام شود.

کلیدواژه‌ها

عنوان مقاله [English]

The effect of hot water bag, effleurage massage and routine care on the intensity of active labor pain in primiparous women- A randomized clinical trial study

نویسندگان [English]

  • Zahra Kohzad 1
  • Shahnaz Golian Tehrani 2
  • Azadeh Hosseinkhani 3
  • Fatemeh Bayat 4
  • Mahnaz Keshavarz Afshar 3
1 M.Sc. of Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
2 Instructor, Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
4 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
چکیده [English]

Introduction: Pain is a common phenomenon and an inevitable part of the childbirth process, and the effective control of this pain, like other acute pains, is an important issue for society and health. Many studies show that one of the main reasons for not choosing natural childbirth by mothers is the fear of natural labor and childbirth pain. The present study was performed with aim to compare the effect of effleurage massage and hot water bag in reducing the pain of the first stage of labor for primiparous women.
Methods: This randomized clinical trial study with a control group was performed in 2015-2016 on 90 primiparous pregnant women admitted to the gynecology hospital of Tehran. The samples were randomly assigned to two intervention groups and one control group. The intervention group 1 received 15 minutes of massage, and in the intervention group 2, a hot water bag was placed in the back area in three times at dilatation 4, 6 and 8 cm for 15 minutes and the control group received routine care in the delivery room. In all three groups, pain intensity was measured using the VAS scale until the end of labor. Data were analyzed using SPSS software (version 24) and T-test, Chi-square, Fisher and analysis of variance with repeated measures. P<0.05 was considered statistically significant.
Results: After the intervention, the pain intensity significantly reduced in the intervention groups at the beginning of the active and transition phase of childbirth compared to the control group (p<0.001). However, there was no significant difference between the two intervention groups in the amount of pain reduction (p>0.001).
Conclusion: In this study, both the use of hot water bag and massage therapy were effective in reducing pain during labor. Therefore, these interventions can be performed by midwives in care and treatment centers to make childbirth pleasant and improve the quality of mother and baby care.

کلیدواژه‌ها [English]

  • Active phase
  • Massage
  • Massage therapy
  • Labor pain
  • Randomized clinical trial

مراجع

  1. Moradi Z, Jalili Z, Shojaei Zadeh D. The effect of educational intervention based on the theory of planned behavior on the choice of the type of delivery in primipara women referred to health centers in Tehran in 2016-2017. Iranian Journal of Health Education and Health Promotion 2019; 7(1):55-65.
  2. Eskandari F, Mousavi P, Valiani M, Ghanbari S, Iravani M. A comparison of the effect of Swedish massage with and without chamomile oil on labor outcomes and maternal satisfaction of the childbirth process: a randomized controlled trial. European Journal of Medical Research 2022; 27(1):266.
  3. Maghalian M, Mirghafourvand M, Ghaderi F, Abbasalizadeh S, Pak S, Kamalifard M. Comparison the effect of Swedish massage and interferential electrical stimulation on labor pain and childbirth experience in primiparous women: a randomized controlled clinical trial. Archives of Gynecology and Obstetrics 2022 ; 306(1):37-47.
  4. Wang E. Requests for cesarean deliveries: the politics of labor pain and pain relief in Shanghai, China. Social Science & Medicine 2017; 173:1-8.
  5. Moradi M, Niazi A, Mazloumi E. Prevalence and Causes Related to Fear of Vaginal Delivery in Iran: A Systematic Review. Iranian Journal of Nursing Research (IJNR) Original Article 2022; 17(1):. 43-53.
  6. Sharifi N, Bahri N. The effect of foot reflexology on the severity of labor pain: a systematic review study. Iran J Obstet Gynecol Infertil 2019; 22(9):85-93.
  7. Rafiei M, Ghare MS, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. International journal of reproductive biomedicine 2018; 16(4):221.
  8. Czech I, Fuchs P, Fuchs A, Lorek M, Tobolska-Lorek D, Drosdzol-Cop A, et al. Pharmacological and non-pharmacological methods of labour pain relief—establishment of effectiveness and comparison. International journal of environmental research and public health 2018; 15(12):2792.
  9. Vosoughian M, DAHI M, DABIR S, Moshari M, Tabashi S, Madadi F, et al. Pain management of painless labor in a university affiliated hospital: An observational study; 2021.
  10. Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZA, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. Journal of Reproductive and Infant Psychology 2022: 1-17.
  11. Behboodi Moghadam Z, Keshavarz Afshar M, Pourrahimi A, Taghizadeh Z, Mokhtari Zanjani P, Montazeri A. Evaluation of postpartum sleep quality and the influential factors in the women in Zanjan city, Iran (2014). Iran J Obstet Gynecol Infertil 2018; 21(1):6-14.
  12. Valiani M, Kianpour M, Shiran E. The effect of foot reflexology on duration of labor and neonatal apgar score in nulliparous women: A randomized clinical trial. Iran J Obstet Gynecol Infertil 2022; 25(1):46-55.
  13. Sohrabi H, Karimeh R, Ghaderkhani G, Shahoei R. The Effect of Oral Consumption of Honey-Saffron syrup with Date syrup on Labor Pain in Nulliparous Women. Iran J Obstet Gynecol Infertil 2022; 25(2):67-78.
  14. Melesse AS, Bayable SD, Ashebir YG, Ayenew NT, Fetene MB. Survey on knowledge, attitude and practice of labor analgesia among health care providers at Debre Markos Comprehensive Specialized Hospital, Ethiopia 2021. A cross-sectional study. Annals of Medicine and Surgery 2022; 74:103306.
  15. Afshar MK, Moghadam ZB, Taghizadeh Z, Bekhradi R, Montazeri A, Mokhtari P. Lavender fragrance essential oil and the quality of sleep in postpartum women. Iranian Red Crescent Medical Journal 2015; 17(4): e25880.
  16. Majidnia M, Nooreddini A, Jouybari L, Yazarlou P, Talebi Z. Comparison of the effect of three methods of massage, hot compress and normal perineal care on perceived stress and the severity of labor pain in first-born mothers. Journal of Health and Care 2020; 22(1):44-52.
  17. Brosseau L, Wells GA, Poitras S, Tugwell P, Casimiro L, Novikov M, et al. Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. Journal of bodywork and movement therapies 2012; 16(4):424-55.
  18. Tanvisut R, Traisrisilp K, Tongsong T. Efficacy of aromatherapy for reducing pain during labor: a randomized controlled trial. Archives of gynecology and obstetrics 2018; 297:1145-50.
  19. Ernst E. The safety of massage therapy. Rheumatology 2003; 42(9):1101-6.
  20. Nourimonfared B, Parang S, Mansoori K, Farhadifar F, Zaheri F. The effect of the two methods of massage and aromatherapy with salvia essence on labor pain severity in nulliparous women. Iran J Obstet Gynecol Infertil 2022; 25(1):83-92.
  21. Hanjani SM, Tourzani ZM, Shoghi MA, Ahmadi GO. Effect of foot reflexology on pain intensity and duration of labor on primiparous. Koomesh 2013; 14(2).
  22. Shahbazzadegan S, Nikjou R. The most appropriate cervical dilatation for massage to reduce labor pain and anxiety: a randomized clinical trial. BMC Women's Health 2022; 22(1):282.
  23. Smith CA, Levett KM, Collins CT, Dahlen HG, Ee CC, Suganuma M. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database of Systematic Reviews; 2018(3).
  24. Gallo RB, Santana LS, Ferreira CH, Marcolin AC, PoliNeto OB, Duarte G, Quintana SM. Massage reduced severity of pain during labour: a randomised trial. Journal of physiotherapy 2013; 59(2):109-16.
  25. Türkmen H, Oran NT. Massage and heat application on labor pain and comfort: A quasi-randomized controlled experimental study. Explore 2021; 17(5):438-45.
  26. Abasi Z, Abedian Z, Fadaie A, Esmaeili HA. The effects of back massage on pain intensity during the first stage of labor in primiparous women. Iran J Obstet Gynecol Infertil 2008; 11(4):39-47.
  27. Golmakani N. Comparison and correlation between visual analogue scale and different dimensions of the short form of McGill pain questionnaire in post cesarean pain evaluation. Nursing And Midwifery Journal 2018; 16(9):622-30.
مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 7
مهر 1402
صفحه 44-53

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