Vajinal doğum yapmış annelere uygulanan ayak masajının doğum sonu konfor ve ağrı düzeyine etkisi
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Doğumdan sonra 6 hafta süren, anne, bebek ve aile açısından uyumun sağlandığı karmaşık ve yeni döneme "doğum sonu dönem" denir. Bu dönemde, her ne kadar şikayetler az olsa da, anne genellikle ağrı hissetmektedir. Farklı nonfarmakolojik teknikler uygulayan ebelerin ağrı kontrolünde ve ağrının hafifletilmesinde önemli rolleri vardır. Bu tekniklerden birisi de ayak masajdır. Bu araştırmada; vajinal doğum yapmış annelere doğum sonu dönemde uygulanan ayak masajının, annenin doğum sonu konforu ve ağrı durumu değerlendirilip buna bağlı olarak analjezik ilaç alma gereksinimi üzerine etkisi değerlendirilmiştir. Veriler 01.07.2017 – 31.08.2017 tarihleri arasında toplanmış ve toplam 66 anne (Çalışma grubu:33 kişi, kontrol grubu:33 kişi) ile araştırma tamamlanmıştır. Gruplar arasındaki birey sayısını dengede tutabilmek için sabit olasılıklı randomizasyon yöntemlerinden "blok randomizasyon" yöntemi kullanılmıştır. Blok randomizasyon yönteminde grupların birbirinden etkilenmemesi için veriler araştırmaya dahil edilme kriterleri dikkate alınarak birer hafta aralıklarla toplanmıştır. Annelerin sosyodemografik ve obstetrik özelliklerine göre dağılımlarında her iki grup arasında istatistiksel olarak anlamlı fark bulunmamış, her iki grubun benzer olduğu saptanmıştır (p>0.05). Doğum Sonu Konfor Ölçeği (DSKÖ) puan ortalamaları incelendiğinde, çalışma grubu annelerinin ilk ayak masajı uygulaması öncesi ölçek puan ortalaması ile son ayak masajı uygulaması sonrası ölçek puan ortalaması arasında anlamlı bir artış olduğu (p< 0.001), kontrol grubu annelerin ilk DSKÖ puan ortalaması ile son DSKÖ puan ortalaması arasında anlamlı bir düşüş olduğu (p = 0.003) saptanmıştır. Ayrıca, çalışma ve kontrol grubu arasında ilk ölçek puan ortalamalarında anlamlı fark saptanmamışken (p=0.490), son ölçek puan ortalamalarında anlamlı fark saptanmıştır (p<0.001). Çalışma grubunda yer alan annelerin ayak masajı ilk uygulama öncesi ve sonrası ağrı şiddeti ile kontrol grubunda yer alan annelerin ağrı şiddeti karşılaştırıldığında, çalışma grubunda yer alan annelerin ayak masajı uygulaması öncesi (0. dakika), uygulamanın hemen (20. dakika) ve 30 dakika sonrasında (50. dakika) Görsel Analog Ölçeği (GAÖ) puan ortalamalarının anlamlı olarak azaldığı (p < 0.001), kontrol grubunda yer alan annelere ise aynı sürelerde uygulanan GAÖ puan ortalamaları arasında istatistiksel açıdan anlamlı fark olmadığı görülmüştür (p= 0.606). Çalışma grubunda yer alan annelerin ayak masajı ikinci uygulaması öncesi ve sonrası ağrı şiddeti ile kontrol grubunda yer alan annelerin ağrı şiddeti karşılaştırıldığında, ilk uygulama ile benzer sonuçların olduğu saptanmıştır. Ancak, kontrol grubunda yer alan annelerde aynı sürelerde uygulanan GAÖ puan ortalamaları arasında da istatistiksel açıdan anlamlı fark saptanmıştır (p=0.011). Çalışma grubu ile karşılaştırıldığında farkın yok denecek kadar az olduğu görünmektedir. Çalışma grubunda yer alan annelerin doğumdan sonra taburcu olana kadar aldığı analjezik ilaç sayısı ve kontrol grubunda yer alan annelerin aldığı analjezik ilaç sayısı değerlendirildiğinde, çalışma grubunda yer alan annelerin kontrol grubunda yer alan annelerden daha az sayıda analjezik ilaç aldıkları görünmektedir (p<0.001). Sonuç olarak; annelere uygulanan nonfarmakolojik yöntemlerin etkisinin daha uzun süre devam edebilmesi için devamlılığın sağlanmasının önemli olduğu ve doğum sonu dönemde uygulanan ayak masajının annelerin konfor ve ağrı düzeyleri üzerinde olumlu etkisinin olduğu, böylelikle gereksiz ilaç kullanımının ortadan kalkabileceği düşünülmektedir.
The complicated and new turnover of the mother, baby, and family enjoys for 6 weeks after birth is called "postpartum period". In this period, although the complaints are few, the mother usually feels pain. Midwives who practice different non-pharmacological techniques have important roles in pain control and alleviation. One of these techniques is foot massage. In this study, the postnatal comfort and pain level of the mothers to whom foot massage applied after vaginal birth were investigated and the effect of the massage on the need of analgesic medication depending on the findings for the comfort and pain level assessed. The data were collected between 01.07.2017 - 31.08.2017 and the research was completed with a total of 66 mothers (study group=33 mothers, control group=33 mothers). In order to keep the number of individuals among the groups balanced, "block randomization" method is used in the randomization methods. For the groups not to be affected by each other in block randomization method, the data were collected at intervals of one week, taking into account the inclusion criteria for the survey. There was no statistically significant difference between the two groups according to their socio-demographic and obstetric characteristics, and it was determined that both groups were similar (p>0.05). When the Postpartum Comfort Scale (PCS) point averages were examined, it was found that there was a significant increase between the scale point average of the study group mothers before the first foot massage application and the scale point average after the last foot massage application (p <0.001) and there was a significant decrease (p = 0.003) between the first PCS point average and the final PCS point average of the control group. In addition, there was no significant difference between the study and control groups in the mean of the first scale scores (p = 0.490), but a significant difference was found in the final scale average scores (p <0.001). When the pain intensity of the mothers in the study group before and after the first foot massage application and the pain intensity of the mothers in the control group were compared, Visual Analogue Scale (VAS) mean scores of the mothers in the study group before (0 min), immediately after (20th min) and 30 min after (50th min) foot massage application decreased significantly (p <0.001) (p = 0.606), whereas there was no statistically significant difference (p = 0.606) between the mean scores of the VAS administered at the same time for the mothers in the control group. When the pain intensity of the mothers in the study group before and after the second application of foot massage were compared with the pain intensity of the mothers in the control group, it was determined that similar results were obtained with the first application. However, there was a statistically significant difference between the PCS point averages applied at the same time in the control group (p = 0.011). When compared to the study group, it seems that difference is not too much. When the number of analgesic drugs taken by the study group from after birth until discharge and the number of analgesic drugs taken by the mothers in the control group were evaluated, it appears that the mothers in the study group received fewer analgesic medications than the control mothers (p <0.001). As a result; it is important to ensure continuity so that the effect of nonpharmacological methods applied to mothers can be maintained for a longer period of time and that postpartum foot massage has a positive effect on the comfort and pain levels of the mothers so that unnecessary use of the medication can be avoided.
The complicated and new turnover of the mother, baby, and family enjoys for 6 weeks after birth is called "postpartum period". In this period, although the complaints are few, the mother usually feels pain. Midwives who practice different non-pharmacological techniques have important roles in pain control and alleviation. One of these techniques is foot massage. In this study, the postnatal comfort and pain level of the mothers to whom foot massage applied after vaginal birth were investigated and the effect of the massage on the need of analgesic medication depending on the findings for the comfort and pain level assessed. The data were collected between 01.07.2017 - 31.08.2017 and the research was completed with a total of 66 mothers (study group=33 mothers, control group=33 mothers). In order to keep the number of individuals among the groups balanced, "block randomization" method is used in the randomization methods. For the groups not to be affected by each other in block randomization method, the data were collected at intervals of one week, taking into account the inclusion criteria for the survey. There was no statistically significant difference between the two groups according to their socio-demographic and obstetric characteristics, and it was determined that both groups were similar (p>0.05). When the Postpartum Comfort Scale (PCS) point averages were examined, it was found that there was a significant increase between the scale point average of the study group mothers before the first foot massage application and the scale point average after the last foot massage application (p <0.001) and there was a significant decrease (p = 0.003) between the first PCS point average and the final PCS point average of the control group. In addition, there was no significant difference between the study and control groups in the mean of the first scale scores (p = 0.490), but a significant difference was found in the final scale average scores (p <0.001). When the pain intensity of the mothers in the study group before and after the first foot massage application and the pain intensity of the mothers in the control group were compared, Visual Analogue Scale (VAS) mean scores of the mothers in the study group before (0 min), immediately after (20th min) and 30 min after (50th min) foot massage application decreased significantly (p <0.001) (p = 0.606), whereas there was no statistically significant difference (p = 0.606) between the mean scores of the VAS administered at the same time for the mothers in the control group. When the pain intensity of the mothers in the study group before and after the second application of foot massage were compared with the pain intensity of the mothers in the control group, it was determined that similar results were obtained with the first application. However, there was a statistically significant difference between the PCS point averages applied at the same time in the control group (p = 0.011). When compared to the study group, it seems that difference is not too much. When the number of analgesic drugs taken by the study group from after birth until discharge and the number of analgesic drugs taken by the mothers in the control group were evaluated, it appears that the mothers in the study group received fewer analgesic medications than the control mothers (p <0.001). As a result; it is important to ensure continuity so that the effect of nonpharmacological methods applied to mothers can be maintained for a longer period of time and that postpartum foot massage has a positive effect on the comfort and pain levels of the mothers so that unnecessary use of the medication can be avoided.
Açıklama
Anahtar Kelimeler
Ağrı, Doğum Sonu Dönem, Ebelik, Konfor, Masaj, Pain, Postpartum Period, Midwifery, Comfort, Massage
