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Nori W, Kassim MAK, Helmi ZR, Pantazi AC, Brezeanu D, Brezeanu AM, Penciu RC, Serbanescu L. Non-Pharmacological Pain Management in Labor: A Systematic Review. J Clin Med 2023; 12:7203. [PMID: 38068274 PMCID: PMC10707619 DOI: 10.3390/jcm12237203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 04/22/2024] Open
Abstract
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.
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Affiliation(s)
- Wassan Nori
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Mustafa Ali Kassim Kassim
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Zeena Raad Helmi
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Alexandru Cosmin Pantazi
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Dragos Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Ana Maria Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Roxana Cleopatra Penciu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Lucian Serbanescu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
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Dastjerd F, Erfanian Arghavanian F, Sazegarnia A, Akhlaghi F, Esmaily H, Kordi M. Effect of infrared belt and hot water bag on labor pain intensity among primiparous: a randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:405. [PMID: 37264341 DOI: 10.1186/s12884-023-05689-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 05/08/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Labor pain is complex, paradoxical and varied in every parturient woman. Management of labor pain has been a crucial component in maternity care. Heat therapy is one of the proposed method for labor pain relief. Infrared is one of the methods of heat therapy but there is any study in this regard. This study aimed to compare the effect of the infrared belt and hot water bag on the severity of pain in the first stage of labor among primiparous women. METHODS In this clinical trial in the first stage of labor, 20-min cycles of heat therapy were conducted at the dilations of 4-5 and 6-7 cm in the intervention group 1 by an infrared belt and in the intervention group 2 by hot water bag, respectively. The control group received routine care. The severity of the pain was measured by the short-form McGill Pain Questionnaire. RESULTS In total, 136 women consented to participate in this clinical trial study. The mean score of pain intensity was significantly lower in the two intervention groups compared to the control group (P < 0.001). The mean pain intensity was significantly lower in the infrared belt group than in the hot water bag group (P < 0.001). CONCLUSIONS Based on these findings, heat therapy with an infrared belt reduced the severity of pain in the first stage of labor. The infrared belt could be used and recommended as a safe and effective pain relief in childbirth and maternity care. TRIAL REGISTRATION This study was registered in the Iran Clinical Trial Center with the code of IRCT20190805044446N1 .
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Affiliation(s)
- Fatemeh Dastjerd
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Erfanian Arghavanian
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ameneh Sazegarnia
- Department of Medical Physics, Medical Physics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farideh Akhlaghi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Kordi
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Goswami S, Jelly P, Sharma S, Negi R, Sharma R. The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis. Eur J Midwifery 2022; 6:66. [DOI: 10.18332/ejm/156487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
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Guzewicz P, Sierakowska M. The Role of Midwives in the Course of Natural Childbirth-Analysis of Sociodemographic and Psychosocial Factors-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15824. [PMID: 36497898 PMCID: PMC9739036 DOI: 10.3390/ijerph192315824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An important role in the course of natural childbirth is played by midwives, who should effectively work on relieving pain. This study aims to present the opinions of midwives on non-pharmacological methods of relieving labor pain; the frequency of their use and reasons for their abandonment; and the relationship between the use of non-pharmacological methods of relieving labor pain and perceived job satisfaction, burnout, and self-efficacy of the midwife. METHODS The study was conducted online, with the participation of 135 Polish midwives working in the delivery room. The author's survey questionnaire, the Generalized Self-Efficacy Scale (GSES), the LBQ Burnout Questionnaire, and the Scale of Job Satisfaction were used. RESULTS Among the surveyed midwives, 77% use vertical positions in work with a patient giving birth. Almost all respondents consider vertical positions as an example of a non-pharmacological method of relieving labor pain; those with master's degree felt more prepared for their use (p = 0.02). The most common reason for abandoning their use was disagreement on the part of co-workers (p = 0.005). An association was observed between the use of vertical positions and the level of burnout (p = 0.001) and a significant correlation between preparation for their use and self-efficacy assessment, burnout, and job satisfaction. CONCLUSION Our research shows that it would be important to conduct additional training on the use of non-pharmacological methods to relieve labor pain and to present their benefits. In contrast to other research results, our results showed that midwives feel well prepared to use these methods; however, similar to other research, we found that they often feel disagreement from colleagues and a lack of support from their leaders. The use of vertical positions is related to burnout.
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Analysis of the Prognostic Impact of Staged Nursing Interventions on the Treatment of Patients with COPD Combined with Type II Respiratory Failure. Appl Bionics Biomech 2022; 2022:4498161. [PMID: 35911607 PMCID: PMC9325648 DOI: 10.1155/2022/4498161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/27/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To analyze the prognostic impact of staged nursing interventions on the treatment of patients with chronic obstructive pulmonary diseases (COPD) combined with type II respiratory failure. Methods 120 patients with COPD combined with type II respiratory failure admitted to our hospital between January 2021 and January 2022 were divided into a control group and a study group, with 60 patients in each group. The control group received conventional strategy interventions, and the study group received staged nursing interventions. Pulmonary function, blood gases, health impairment, knowledge, mood, hope level, and quality of survival were evaluated before and after patient care, and satisfaction and the impact on patient prognosis were assessed. Results The improvement of pulmonary function and blood gas in the study group was better than that in the control group aftercare, and the difference was statistically significant (P < 0.05). Health impairment and mood scores were lower in the study group compared to the control group aftercare, and the difference was statistically significant (P < 0.05). Knowledge awareness, hope, and quality of survival scores were higher in the study group compared to the control group aftercare, with statistically significant differences (P < 0.05). The rate of excellent prognosis and satisfaction was higher in the study group compared with the control group, and the difference was statistically significant (P < 0.05). Conclusion The implementation of staged nursing interventions during the treatment of patients with COPD combined with type II respiratory failure can significantly improve patient prognosis and has a high application value.
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Navvabi-Rigi SD, Didevar M, Dadkhah S. The effectiveness of heat therapy and cold therapy in labor pain intensity in primiparous women: A randomized controlled trial. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_87_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Martínez-Burnes J, Muns R, Barrios-García H, Villanueva-García D, Domínguez-Oliva A, Mota-Rojas D. Parturition in Mammals: Animal Models, Pain and Distress. Animals (Basel) 2021; 11:2960. [PMID: 34679979 PMCID: PMC8532935 DOI: 10.3390/ani11102960] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/11/2022] Open
Abstract
Parturition is a complex physiological process and involves many hormonal, morphological, physiological, and behavioural changes. Labour is a crucial moment for numerous species and is usually the most painful experience in females. Contrary to the extensive research in humans, there are limited pain studies associated with the birth process in domestic animals. Nonetheless, awareness of parturition has increased among the public, owners, and the scientific community during recent years. Dystocia is a significant factor that increases the level of parturition pain. It is considered less common in polytocous species because newborns' number and small size might lead to the belief that the parturition process is less painful than in monotocous animal species and humans. This review aims to provide elements of the current knowledge about human labour pain (monotocous species), the relevant contribution of the rat model to human labour pain, and the current clinical and experimental knowledge of parturition pain mechanisms in domestic animals that support the fact that domestic polytocous species also experience pain. Moreover, both for women and domestic animal species, parturition's pain represents a potential welfare concern, and information on pain indicators and the appropriate analgesic therapy are discussed.
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Affiliation(s)
- Julio Martínez-Burnes
- Animal Health Group, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Tamaulipas, Mexico;
| | - Ramon Muns
- Agri-Food and Biosciences Institute, Hillsborough, Co Down BT26 6DR, Northern Ireland, UK;
| | - Hugo Barrios-García
- Animal Health Group, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City 87000, Tamaulipas, Mexico;
| | - Dina Villanueva-García
- Division of Neonatology, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico;
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico;
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico;
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Akın B, Balçık Çolak M, Öztürk Can H, Küni F. Practices of midwives working in delivery rooms for protection of perineum during intrapartum period and their feedback on these applications. J Matern Fetal Neonatal Med 2020; 35:24-29. [PMID: 32878505 DOI: 10.1080/14767058.2020.1812573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Perineal traumas occurring during labor are undesirable for both the midwives and the woman. Midwives and obstetricians could use different techniques to protect the perineum. PURPOSE The aim of this study was to determine the practices of midwives working in the delivery room to protect the perineum during the second stage of labor. METHODS This is a prospective observational study regarding practices of midwifes for protection of perineum during intrapartum period. The study was conducted with a total of 20 midwives in a maternity unit of an training and research hospital. The data were collected through the forms prepared by the researchers. FINDINGS The average age of the midwives was 34 ± 8.77. The majority of midwives (n: 17, 85%) believed that the need for practices to protect the perineum during labor; 40% of them used perineal protection (hands on) technique to protect perineum and they preferred to perform routine episiotomy in all primiparas. RESULTS AND CONCLUSIONS As a result of the study, it was observed that evidence-based practices was not applied sufficiently enough by the midwives although they were knowledgeable and believed that they are beneficial. Studies are needed for the obstacles to these practices to be identified and removed.
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Affiliation(s)
- Bihter Akın
- Faculty of Health Sciences, Midwifery Department, Selcuk University, Konya, Turkey
| | - Melek Balçık Çolak
- Faculty of Health Science, Midwifery Department, Ege University, Izmir, Turkey
| | - Hafize Öztürk Can
- Faculty of Health Science, Midwifery Department, Ege University, Izmir, Turkey
| | - Filiz Küni
- Maternity Unit, Sakarya Training and Research Hospital, Sakarya, Turkey
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Massage and heat application on labor pain and comfort: A quasi-randomized controlled experimental study. Explore (NY) 2020; 17:438-445. [PMID: 32828687 DOI: 10.1016/j.explore.2020.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 11/20/2022]
Abstract
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.
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Kaur J, Sheoran P, Kaur S, Sarin J. Effectiveness of Warm Compression on Lumbo-Sacral Region in Terms of Labour Pain Intensity and Labour Outcomes among Nulliparous: an Interventional Study. J Caring Sci 2020; 9:9-12. [PMID: 32296653 PMCID: PMC7146727 DOI: 10.34172/jcs.2020.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/25/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction: Childbirth is a distinctive and joyous moment in every mother’s life. Giving birth is one of the powerful and vital event. This study aimed to assess and evaluate the effectiveness of warm compression (moist heat) on lumbo-sacral region in terms of labor pain intensity and labor outcomes Methods: An experimental research design was carried out on 88 nulliparous mothers with normal singleton term pregnancy (44 participants in each group) who were admitted in the labor room. Mothers who had high-risk pregnancy were excluded. Warm compression was given to nulliparous mothers of the experimental group with hydrochollator pack at 70◦C temperature for 20 minutes for 3 times with one-hour interval on lumbo sacral region starting from 4-5 cm of cervical dilatation. Labor pain intensity score, fetal heart rate, frequency and duration of uterine contractions were assessed before and immediately of warm compression and again after 30 minutes only labor pain was assessed. Results: Study results revealed that immediately after first, second and third time of warm compression labor pain intensity score in experimental group was lower than control group respectively ( t= 3.20; P< 0.001; t =4.45; P< 0.001; t= 6.18; P< 0.001). But no significant difference found in fetal heart rate and labor outcomes in terms of duration of labor, type of delivery, baby born alive/ not and cried immediately after birth. Conclusion: Warm compression was useful method to decrease the labour pain among nulliparous mothers in the first stage of labour and mothers reported satisfaction with intervention.
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Affiliation(s)
- Jasvir Kaur
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Poonam Sheoran
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Simarjeet Kaur
- Department Obstetrics and Gynaecological Nursing, Maharishi Markandeshwar College of Nursing, Maharishi Markandeshwar Deemed to be University, Mullana, India
| | - Jyoti Sarin
- Nursing Faculty, Maharishi Markandeshwar Deemed to be University, Mullana, India
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