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    The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial
    (Wiley, 2020) Turkmen, Hulya; Turfan, Esin Ceber
    Aim This study aims to determine the effect of acupressure (SP6) on first stage of labor pain and duration. Methods A single blind, randomized controlled experimental trial was conducted with 60 pregnant women: 30 in the experimental group and 30 in the control group. At the active and transition stages of labor, acupressure was applied to the SP6 point of the experimental group, and the SP6 point of the control group was touched each contraction. the data were collected using the Pregnant Information Form. the Partograph Form was used to determine the duration of active stage and transition stage. the labor pain severity was measured using a numeric rating scale (NRS) immediately after each acupressure/touch SP6 in active and transition stages. A participant questionnaire on satisfaction was administered in the immediate postnatal period. the group difference was tested for statistical significance using the Chi-square test, Fisher's exact test, and the Mann-Whitney U test. Results As the primary outcome, labor pain was less and duration of labor was shorter for the experimental group. As the secondary outcome, satisfaction was increased that could be as a result of reduced pain in labor and/or shorter duration of labor. the perceived pain level in the active stage in the experimental group (n = 30) was less than the control group (n = 30) (labor pain: 7.17 + 0.89 vs. 7.66 + 0.71, p = .002). the mean duration of the first stage of labor in the experimental group was shorter than the control group (4.88 + 0.85 hr vs. 5.56 +/- 0.66, p = .001). It was also found that pregnant women in the experimental group would recommend this method to other pregnant women (Chi-square = 5.711, p = .017). Conclusions Application of acupressure on SP6 was found to have a positive effect on pregnant women's labor experience and reducing the labor pain and shortening the duration of first stage of labor compared to touch on SP6. the women receiving acupressure had higher levels of satisfaction in acupressure application than women receiving only touch on SP6, which could be as a result of reduced pain in labor and/or shorter duration of labor.
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    Massage and heat application on labor pain and comfort: A quasi-randomized controlled experimental study
    (Elsevier Science Inc, 2021) Turkmen, Hulya; Oran, Nazan Tuna
    Aim: The aim of this study was to determine the effects of sacral massage and heat application on the perceptions of labor pain and comfort level in pregnant women. Methods: This was a quasi-randomized controlled experimental study. The data were collected under three groups in 2016: the heat application group (HAG), the massage group (MG), and the control group (CG). Each group included 30 primiparous pregnant women (range of age: 17-35) whose cervix was dilated to 4-5 cm. At 4-5 cm, 6-7 cm, and 8-9 cm cervical dilation, sacral massage was applied to MG, and sacral heat application was applied to HAG. Each group received standard midwifery care during labor. The data were collected using the Childbirth Comfort Questionnaire (CCQ) and the Numerical Rating Scale (NRS). The data were analyzed by using the Chi-square test, the Friedman test, Paired sample t -test, ANOVA, the Kruskal-Wallis test, and Wilcoxon signed-ranks test Results: The mean pain score in HAG (4.56 +/- 0.67) during 4-5 cm of cervical dilation was significantly lower than those in MG (5.03 +/- 1.06) or CG (5.23 +/- 0.72) (p < 0.05). The mean pain scores in HAG (6.80 +/- 0.7) and MG (7.30 +/- 0.8) during 6-7 cm of cervical dilation were significantly lower than that in CG (7.70 +/- 0.5) (p < 0.001). Moreover, a statistically significant difference was found between the mean CCQ total scores (HAG: 31.06 +/- 3.46, CG: 27.66 +/- 3.85, p < 0.05), mean CCQ physical comfort scores (HAG: 13.16 +/- 1.89, CG: 11.03 +/- 1.80, p < 0.001), mean CCQ relief comfort level score (HAG: 11.23 +/- 1.43, CG: 10.00 +/- 2.01, p < 0.05) and mean CCQ transcendence comfort level scores (HAG: 19.83 +/- 2.37, CG: 17.66 +/- 2.15, p < 0.05) and both HAG and CG during 8-9 cm of cervical dilation. Conclusions: Heat application and massage can be used as a safe and effective midwifery intervention to reduce the perception of pain in pregnant women and provide comfort during labor. (c) 2020 Elsevier Inc. All rights reserved.
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    Postpartum Excessive Social Support Scale: A Scale Development and Psychometric Testing Study
    (Sage Publications Inc, 2024) Turkmen, Hulya; Oran, Nazan Tuna; Gurol, Serpil; Ince, Kuebra Aydin
    Introduction: In Turkey and other collectivist cultures, child-rearing is a communal effort provided by multiple family members, especially female relatives such as mothers-in-law, aunts, and sisters. Environments with excessively controlling social factors can adversely affect their maternal roles. This study was conducted to develop a measurement tool for determining postpartum excessive social support. Methods: This is a scale development and psychometric evaluation study. In the study, a draft of the Postpartum Excessive Social Support Scale (PESSS) was created, subsequently submitted to expert opinion, and administered to mothers in the postpartum period of 1 to 6 weeks online between March and December 2023 (n = 440). A factor analysis (including explanatory factor analysis [EFA] and confirmatory factor analysis) was conducted to determine the construct validity of the scale, while Cronbach's alpha was examined to establish its reliability. Response bias (Hotelling T-2) and additivity (Tukey's test of additivity) of the scale were also determined in the study. Results: For the content validity of the scale, 10 experts from the field of midwifery were consulted (content validity index [CVI] = 0.80). As a result of the EFA, Kaiser-Meyer-Olkin value was found as 0.916. Through factor analysis using the direct oblimin rotation technique, a four-factor structure was identified for the scale, explaining 64.197% of the total variance (social pressure, effect of environmental factors on paternal role, effect of environmental factors on maternal role, and barriers in mother-infant interaction). The internal reliability coefficient of the scale was highly reliable (Cronbach's alpha = 0.936). There was no response bias in the scale (Hotelling's T-2 = 433.558, p < .001) and it was additive (Tukey's Non-additivity = 0.000, p < .001). Discussion: The PESSS is a 20-item scale measuring excessive social support between 1 and 6 weeks postpartum. The PESSS serves as a guiding tool for health care professionals to identify excessive environmental pressure hindering mothers' maternal role and to provide care accordingly. In this context, health care professionals can readily utilize the PESSS in routine postpartum assessments for mothers.