Phumdoung Sasitorn, Good Marion
Obstetric Gynecological Nursing and Midwifery Department, Prince of Songkla University, Faculty of Nursing, Hatyai, Songhkla 90112, Thailand.
Pain Manag Nurs. 2003 Jun;4(2):54-61. doi: 10.1016/s1524-9042(02)54202-8.
Labor pain is often severe, and analgesic medication may not be indicated. In this randomized controlled trial we examined the effects of music on sensation and distress of pain in Thai primiparous women during the active phase of labor. The gate control theory of pain was the theoretical framework for this study. Randomization with a computerized minimization program was used to assign women to a music group (n = 55) or a control group (n = 55). Women in the intervention group listened to soft music without lyrics for 3 hours starting early in the active phase of labor. Dual visual analog scales were used to measure sensation and distress of pain before starting the study and at three hourly posttests. While controlling for pretest scores, one-way repeated measures analysis of covariance indicated that those in the music group had significantly less sensation and distress of pain than did the control group (F (1, 107) = 18.69, p <.001, effect size =.15, and F (1, 107) = 14.87, p <.001, effect size =.12), respectively. Sensation and distress significantly increased across the 3 hours in both groups (p <.001), except for distress in the music group during the first hour. Distress was significantly lower than sensation in both groups (p <.05). In this controlled study, music--a mild to moderate strength intervention--consistently provided significant relief of severe pain across 3 hours of labor and delayed the increase of affective pain for 1 hour. Nurses can provide soft music to laboring women for greater pain relief during the active phase when contractions are strong and women suffer.
分娩疼痛通常很剧烈，可能不需要使用止痛药物。在这项随机对照试验中，我们研究了音乐对泰国初产妇分娩活跃期疼痛感觉和痛苦程度的影响。疼痛的闸门控制理论是本研究的理论框架。使用计算机化最小化程序进行随机分组，将女性分为音乐组（n = 55）或对照组（n = 55）。干预组的女性在分娩活跃期早期开始听3小时无歌词的轻柔音乐。在研究开始前以及每三小时进行一次的后续测试中，使用双视觉模拟量表来测量疼痛的感觉和痛苦程度。在控制预测试分数的同时，单因素重复测量协方差分析表明，音乐组的疼痛感觉和痛苦程度明显低于对照组（F(1, 107) = 18.69，p <.001，效应大小 =.15；F(1, 107) = 14.87，p <.001，效应大小 =.12）。两组在3小时内疼痛感觉和痛苦程度均显著增加（p <.001），但音乐组在第一个小时的痛苦程度除外。两组的痛苦程度均明显低于疼痛感觉（p <.05）。在这项对照研究中，音乐——一种轻度至中度强度的干预措施——在3小时的分娩过程中持续显著缓解了剧烈疼痛，并将情感性疼痛的增加延迟了1小时。当宫缩强烈且产妇痛苦时，护士可以为分娩中的女性提供轻柔的音乐，以更好地缓解疼痛。
