Doğum öncesi perine masajı ve kegel egzersizlerinin doğum sonrası perine bütünlüğüne etkisi
Küçük Resim Yok
Tarih
2014
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Vajinal doğum yapan kadınlarda doğum öncesi uygulanan perine masajı ve Kegel egzersizlerinin doğumda perineal travmaya doğumdan sonra da perine ağrısı ve iyileşmesine etkisini incelemek üzere randomize, kontrollü ve deneysel bir çalışma olarak yapılmıştır. Araştırma, 1 Ocak 2012- 1 Ocak 2013 tarihleri arasında; Ege Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Anabilim Dalı gebe polikliniğine başvuran riskli gebeliği olmayan ve kesinleşmiş sezaryen endikasyonu olmayan, 33.gestasyon haftasının üzerinde olan ve araştırmaya katılmayı kabul eden 30 masaj, 32 egzersiz ve 39 kontrol grubu toplam 101 gebe ile yapılmıştır. Veri toplama aracı olarak; Veri Toplama Formu, Kegel Egzersizi Eğitim Broşürü ve Uygulama İzlem Formu, Uygulayıcı İçin Doğum Öncesi Perine Masajı Öğrenim Rehberi kullanılmıştır. Veriler gerekli tüm izinler alındıktan sonra; masaj grubuna, masaj yapılmadan önce araştırmacı tarafından masajın önemi hakkında bilgi verilmiş ve perine bölgesine araştırmacı tarafından perine masajı yapılmıştır. Masaj haftada bir kez doğuma kadar araştırmacı tarafından yapılmıştır. Egzersiz grubundaki gebelere de pelvik taban kaslarını kullanmaları için Kegel egzersizleri, birebir olarak öğretilmiş ve evlerinde doğuma kadar her gün en az 5-10 kez yapmaları ve yaptıkları egzersizleri kayıt etmeleri istenmiştir. Egzersiz grubu her hafta kontrole geldiklerinde ve ayrıca telefonla aranarak egzersizi yapıp yapmadıkları incelenmiştir. Kontrol grubundaki gebelere perine masajı, Kegel egzersizi ya da herhangi bir uygulama yapılmamıştır. Doğumda, doğumdan 24 saat sonra hastanede birebir, doğumdan 15 gün sonra telefonla görüşülerek masaj ve egzersizin doğum sonu etkilerini belirlemek amacıyla üç grup değerlendirilmiştir. Verilerin analizinde; sayı, yüzde, ki-kare, Mann Whitney U testi ve Kruskal Wallis testi kullanılmıştır. Çalışma ve kontrol grubu arasında epizyotomi yapılma durumu, laserasyon oluşma durumu, laserasyon derecesi, doğumdan 24 saat ve 15 gün sonra perineal ağrı ve Reeda skalası puan ortalamaları arasında istatistiksel olarak anlamlı bir fark bulunmuştur. Araştırma sonuçlarına göre; doğum öncesi perine masajı ve Kegel egzersizinin epizyotomi kullanımını ve perineal travmayı azalttığı, doğum sonrası perineal ağrı ve iyileşmeyi anlamlı olarak etkilediği bulunmuştur. Bu bulgular doğrultusunda; doğum öncesi perine masajı ve Kegel egzersizinin doğum sonrası dönemde perineal yırtıkları ve epizyotomi oranını azaltmakta, dolayısıyla doğum sonrası dönemde iyileşmeyi hızlandırmaktadır. Dolayısıyla gebelik sırasında yapılan perine masajı ve Kegel egzersizi doğum sırasında sağlık personeli tarafından da desteklenirse hem doğumda hem de doğum sonu dönemde kadının yaşam kalitesini artırmada önemli bir yere sahip olacağı düşünülmektedir
This randomize controlled experimental study has been carried out to investigate the effects of perine massage and Kegel exercises applied prenatally to women who experienced vaginal delivery on the prenatal perineal trauma and postnatal perine pain and its improvement. Research was carried out between 1 January 2012 and 1 January 2013, with a total of 101 pregnant women (30 massage, 32 exercise and 39 control group) who referred to Pregnancy Polyclinic of Department of Gynecology and Delivery, Ege University Hospital, who had no risky pregnancy or any indication of predetermined cesarean section, whose gestation period was over 33 weeks and who accepted to participate in research. As a data collection tool, Data Collection Form, Kegel Exercise Training Brochure, Practice Observation Form and Prenatal Perine Massage Learning Guide for Implementer were used. After all necessary permissions obtained, researcher informed the message group related to the importance of massage and then performed perine massage over perine region. Researcher continued to perform this massage once a week until delivery. Kegel exercises were taught to pregnant women in exercise group one to one and they were asked to perform exercises at home at least 5 – 10 times daily and also to register them until delivery. When exercise group came to weekly controls or when they were contacted at home they were asked if they have performed daily exercise or not. The pregnant women in control group did not receive perine massage, Kegel exercise or any other application. To determine postnatal effects of massage and exercise, one to one interview was performed during delivery and postnatal 24 hours at the hospital and a telephone interview was performed 15 days postnatal, so three groups were evaluated. During analysis of data, number, percentage, chi-square, Mann Whitney U test and Kruskal Wallis test were used. A statistically significant different was found between study and control groups in terms of episiotomy application status, occurrence of laceration, degree of laceration, postnatal 24 hours and 15 days perineal pain and the mean scores of Reeda scale. According to the results of research, it was found that prenatal perine massage and Kegel exercises have caused reduction in the use of episiotomy and in perineal trauma and also affected perinatal pain and its improvement significantly. In line with these findings, the prenatal perine massage and Kegel exercise reduce prenatal perineal laceration and episiotomy rates; thus accelerate improvement during postnatal period. Therefore, it is thought that when the perine massage and Kegel exercise being performed during pregnancy is supported by health personnel, it will play a significant role in increasing women's quality of life both during delivery and postnatal period.
This randomize controlled experimental study has been carried out to investigate the effects of perine massage and Kegel exercises applied prenatally to women who experienced vaginal delivery on the prenatal perineal trauma and postnatal perine pain and its improvement. Research was carried out between 1 January 2012 and 1 January 2013, with a total of 101 pregnant women (30 massage, 32 exercise and 39 control group) who referred to Pregnancy Polyclinic of Department of Gynecology and Delivery, Ege University Hospital, who had no risky pregnancy or any indication of predetermined cesarean section, whose gestation period was over 33 weeks and who accepted to participate in research. As a data collection tool, Data Collection Form, Kegel Exercise Training Brochure, Practice Observation Form and Prenatal Perine Massage Learning Guide for Implementer were used. After all necessary permissions obtained, researcher informed the message group related to the importance of massage and then performed perine massage over perine region. Researcher continued to perform this massage once a week until delivery. Kegel exercises were taught to pregnant women in exercise group one to one and they were asked to perform exercises at home at least 5 – 10 times daily and also to register them until delivery. When exercise group came to weekly controls or when they were contacted at home they were asked if they have performed daily exercise or not. The pregnant women in control group did not receive perine massage, Kegel exercise or any other application. To determine postnatal effects of massage and exercise, one to one interview was performed during delivery and postnatal 24 hours at the hospital and a telephone interview was performed 15 days postnatal, so three groups were evaluated. During analysis of data, number, percentage, chi-square, Mann Whitney U test and Kruskal Wallis test were used. A statistically significant different was found between study and control groups in terms of episiotomy application status, occurrence of laceration, degree of laceration, postnatal 24 hours and 15 days perineal pain and the mean scores of Reeda scale. According to the results of research, it was found that prenatal perine massage and Kegel exercises have caused reduction in the use of episiotomy and in perineal trauma and also affected perinatal pain and its improvement significantly. In line with these findings, the prenatal perine massage and Kegel exercise reduce prenatal perineal laceration and episiotomy rates; thus accelerate improvement during postnatal period. Therefore, it is thought that when the perine massage and Kegel exercise being performed during pregnancy is supported by health personnel, it will play a significant role in increasing women's quality of life both during delivery and postnatal period.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
