مقایسۀ تأثیر آموزش خودمراقبتی ماساژ افلوریج، آب‌درمانی و بالا نگه ‌داشتن پاها بر ادم فیزیولوژیک پا در زنان باردار: مطالعۀ کارآزمایی بالینی شاهددار تصادفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، کمیتۀ تحقیقات و فن‌آوری دانشجویی، دانشکدۀ پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استاد گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکدۀ پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه مامایی و بهداشت باروری، دانشکدۀ پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استادیار گروه علوم پایه، دانشکدۀ پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: ادم پا منجر به بروز ناراحتی‌‌هایی از قبیل احساس درد، گرفتگی‌ عضلانی و خستگی پاها موقع راه‌رفتن و در نتیجه کم‌تحرکی و افزایش احتمال بروز ترومبوآمبولی در زنان باردار می‌شود. روش‌‌‌های غیردارویی متعددی برای بهبود ادم فیزیولوژیک پا در بارداری استفاده شده که هیچ‌کدام از آنان تاکنون به‌صورت خودمراقبتی مورد بررسی قرار نگرفته‌اند. مطالعۀ حاضر با هدف تعیین و مقایسۀ تأثیر آموزش خودمراقبتی با ماساژ افلوریج، آب‌درمانی و بالا نگه‌ داشتن پا بر ادم فیزیولوژیک پا در بارداری انجام گرفت.
روش‌کار: این مطالعۀ کارآزمایی بالینی شاهددار تصادفی در سال 1401 بر روی 129 زن نخست باردار مراجعه‌کننده به مرکز درمانی مهدیۀ تهران انجام گرفت. واحدهای پژوهش ‌به‌صورت تصادفی در چهار گروه آب‌درمانی، ماساژ درمانی، بالا نگه ‌داشتن پا و کنترل قرار گرفتند. ابزار جمع‌آوری داده‌ها شامل: پرسشنامه‌های اطلاعات دموگرافیک- مامایی و بررسی عوارض و رضایت‌مندی از مداخله، چک‌لیست مشاهده و معاینۀ قبل و بعد از مداخله و متر غیرقابل ‌ارتجاع بود. پس از جمع‌آوری اطلاعات، تجزیه و تحلیل داده‌ها با نرم‌افزار آماری SPSS (نسخۀ 24) و آزمون‌های آماری پارامتریک و نان پارامتریک انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: در مقایسۀ درون‌گروهی، ادم پاها بعد از مداخله نسبت به قبل از مداخله کاهش معنی‌داری یافتند (001/0>p). نتایج آنالیز کوواریانس نشان‌دهندۀ معنی‌دار بودن تفاوت گروه‌‌ها از نظر میانگین اندازۀ محیط‌های پا بعد از مداخله بود (001/0>p). در مقایسۀ دوبه‌دوی گروه‌ها بعد از مداخله، بالا نگه ‌داشتن پا، بیشترین تأثیر را در میان دیگر مداخلات داشت (001/0>p).
نتیجه­ گیری: خودمراقبتی با ماساژ افلوریج، آب‌درمانی و بالا نگه‌ داشتن پا، بر بهبود ادم پا در بارداری مؤثر است و بالا نگه‌ داشتن پاها بر کاهش ادم پا مؤثر‌تر از سایر روش‌های خودمراقبتی است و ماساژ افلوریج کمترین تأثیر را بر بهبود ادم پا دارد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effects of self-care education with effleurage massage of feet, hydrotherapy, and leg elevation on physiologic edema of feet in pregnant women: a randomized controlled clinical trial

نویسندگان [English]

  • Fatemeh Asadi 1
  • Masoumeh Simbar 2
  • Shahnaz Tork Zahrani 3
  • Maliheh Nasiri 4
1 MSc. of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Department of Midwifery and Reproductive Health, Research Center for Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Assistant Professor, Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Physiologic edema in the feet can cause discomfort such as pain, muscle cramps and fatigue in the feet when walking and as a result lack of movement and increased probability of thromboembolism in pregnant women. Many non-pharmaceutical methods have been used to improve physiologic edema in pregnancy. None of these methods have been studied in a self-care context. Therefore, the present study was performed with aim to determine and compare the effects of self-care education with effleurage massage, hydrotherapy, and leg elevation on physiologic edema in pregnancy.
Methods: The randomized controlled clinical trial study was conducted in 2022 on 129 primigravid women who visited the Mahdieh Tehran Health Center. The samples were randomly divided to four groups: hydrotherapy, massage therapy, leg elevation, and control. The data collection tools included a demographic and obstetric questionnaire, investigation of complications and satisfaction from the intervention, observation checklist and examination before and after the intervention, and a non-elastic meter. After collecting information, data analysis was done using SPSS statistical software (version 24) and parametric and non-parametric statistical tests. P<0.05 was considered statistically significant.
Results: In the intragroup comparison, leg edema decreased significantly after the intervention compared to before the intervention (p<0.001). The results of the analysis of covariance indicated a significant difference in the mean size of foot circumferences after the intervention among the groups (p<0.001). In a side-by-side comparison of the groups after the intervention, leg elevation had the greatest effect among other interventions (p<0.001).
Conclusions: Self-care with effleurage massage, hydrotherapy, and leg elevation were effective in improving physiologic edema in the legs during pregnancy. Furthermore, leg elevation was found to be more effective in reducing degree of leg edema compared to other self-care interventions, and effleurage massage had the least effect in improving physiologic edema.

کلیدواژه‌ها [English]

  • Effleurage Massage
  • Foot Physiologic Edema
  • Hydrotherapy
  • Leg Elevation
  • Self-care

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 3
خرداد 1403
صفحه 50-63

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