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指压按摩对分娩疼痛和焦虑的影响:一项随机对照试验。

The Impact of Shiatsu Massage on Labour Pain and Anxiety: A Randomized Controlled Trial.

机构信息

Department of Midwifery, Institut Teknologi Kesehatan Dan Sains Wiyata Husada Samarinda, Indonesia.

Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi Mara, Malaysia.

出版信息

Int J Community Based Nurs Midwifery. 2024 Oct 1;12(4):243-253. doi: 10.30476/ijcbnm.2024.101509.2432. eCollection 2024 Oct.

Abstract

BACKGROUND

Labour pain experienced by women during childbirth can significantly affect the mother's psychological condition and birthing process. This study aimed to determine the effect of shiatsu massage on pain and anxiety during labour.

METHOD

This randomized controlled trial was conducted on 80 nulliparous pregnant women who gave birth in four low-risk maternity clinics in Samarinda, Indonesia, from February to May 2022. The women were randomized into intervention (N=40) and control (N=40) groups based on random allocation. Certified midwives performed shiatsu massages following standard protocols. Pain was assessed using the Numeric Rating Scale, and anxiety was assessed using the Hamilton Anxiety Rating Score at three times including before the intervention (T0), the latent phase (T1), and at transition phase (T2). The impact of the intervention was analyzed using repeated measures analysis of variance by SPSS 26. A p-value less than 0.05 was considered statistically significant.

RESULTS

The intervention group showed a significant reduction in labour pain scores from 6.85±1.00 (T0) to 6.13±0.88 (T1) and 4.78±0.83 (T2) (P<0.001), while the control group showed an increase from 6.85±1.00 (T0) to 8.05±0.64 (T1) and 8.85±0.48 (T2) (P<0.001). Anxiety scores in the intervention group decreased from 28.53±4.41 (T0) to 26.15±3.59 (T1) and 20.65±2.69 (T2) (P<0.001), whereas the control group experienced an increase from 25.55±3.16 (T0) to 27.05±3.36 (T1) and 31.73±3.27 (T2) (P<0.001). The between-subject effects in time levels for labour pain and anxiety in the two study groups had a significant impact (P<0.001).

CONCLUSION

Findings showed that shiatsu massage was effective and safe for relieving pain and reducing anxiety during childbirth of nulliparous women. This research suggests that shiatsu massage can be used as an effective alternative method to relieve pain and anxiety during labour in low risk pregnancies, particularly in settings with limited access to pharmaceutical analgesics. IRCT20220317054316N1.

摘要

背景

产妇分娩时经历的宫缩痛会显著影响母亲的心理状态和分娩过程。本研究旨在探讨指压按摩对分娩疼痛和焦虑的影响。

方法

这是一项在印度尼西亚三马林达四家低风险产科诊所进行的随机对照试验,招募了 80 名初产妇,于 2022 年 2 月至 5 月期间参与研究。产妇按照随机分配原则分为干预组(n=40)和对照组(n=40)。注册助产士按照标准方案进行指压按摩。采用数字评分量表评估疼痛,汉密尔顿焦虑量表评估焦虑,分别于干预前(T0)、潜伏期(T1)和活跃期(T2)进行 3 次评估。采用 SPSS 26 进行重复测量方差分析,评估干预的影响。P 值小于 0.05 被认为具有统计学意义。

结果

干预组的宫缩痛评分从 T0 时的 6.85±1.00 显著降低至 T1 时的 6.13±0.88 和 T2 时的 4.78±0.83(P<0.001),而对照组的评分从 T0 时的 6.85±1.00 升高至 T1 时的 8.05±0.64 和 T2 时的 8.85±0.48(P<0.001)。干预组的焦虑评分从 T0 时的 28.53±4.41 显著降低至 T1 时的 26.15±3.59 和 T2 时的 20.65±2.69(P<0.001),而对照组的评分从 T0 时的 25.55±3.16 升高至 T1 时的 27.05±3.36 和 T2 时的 31.73±3.27(P<0.001)。两组研究对象在疼痛和焦虑的时间水平上的组间效应均具有显著影响(P<0.001)。

结论

研究结果表明,指压按摩可有效缓解初产妇分娩疼痛,降低焦虑。本研究提示,在低风险妊娠中,指压按摩可作为缓解分娩疼痛和焦虑的有效替代方法,尤其是在缺乏药物性镇痛的环境中。IRCT20220317054316N1。

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