Vajinal Doğum Sonrası Perineal Soğuk Uygulamanın Fiziksel Aktivitelere Etkisi

Amaç: Araştırma, vajinal doğumdan sonra perineal ağrıyı azaltılmak için yapılan soğuk jel ped uygulamasının fiziksel aktivitelere etkisini belirlemek amacıyla yapıldı.Yöntem: Çalışma, bir kadın hastalıkları ve doğum hastanesinin lohusa servisinde Eylül 2012-Şubat 2013 tarihleri arasında yürütüldü. Örneklem kapsamına deney grubu için normal doğum yapan 50 primipar ve 50 multipar, kontrol grubu için ise örneklem grubu ile aynı sayıda primipar ve multipar olmak üzere toplam 200 lohusa alındı. Deney grubuna 0-2. saatte ve ilk uygulamadan 4 saat sonra toplam 2. kez 20 dakika süre ile perineal soğuk jel ped uygulaması yapıldı. Verilerin toplanmasında literatür doğrultusunda araştırmacı tarafından hazırlanan tanılama formu,Görsel Kıyaslama Ölçeği (GKÖ) kullanıldı.Bulgular: Araştırmada soğuk jel ped uygulaması sonrası primipar ve multipar lohusaların doğum sonu fiziksel aktiviteler sırasında kontrol grubuna göre daha az ağrı yaşadığı saptandı. Doğum sonu günlük aktiviteleri ve bebek bakımını olumsuz etkileyen perineal ağrının soğuk uygulama ile azaldığı, özellikle 2. soğuk uygulama sonrası yatma, oturma, yürüme, emzirme, idrar yapma gibi aktiviteleri yaparken ağrı düzeyinde anlamlı düzeyde azalma olduğu görüldü. Soğuk jel ped uygulanan primipar lohusaların %78'inin, multiparların ise %84'ünün perineal soğuk uygulamadan memnun olduğu saptandı.Sonuç: Vajinal doğum sonrası perineye soğuk jel ped uygulamasının perineal ağrıyı azalttığı ve fiziksel aktiviteler sırasında lohusaların daha rahat olduğu belirlendi.

The Eff ects of Cold Pad Application to The Perineum on Pain Relief and Comfort Level After Vaginal Birth

Aim: The study was conducted to identify the eff ect physical activity of cold gel pad application on relieving the perineal pain experienced by puerpera following normal birth.Method: The puerpera who were hospitalized in and delivered at the an obstetrics and gynecology hospital puerperal department between September, 2012 and February, 2013. The study was conducted on 200 puerpera in total with 50 primipara and 50 multipara (2. and 3. deliveries) puerpera for the experiment group and the same number of primipara and multipara in the control group. The experimental group was treated with a cold gel pad for 20 minutes for two times firstly in the 0-2 hours postpartum periodand secondly four hours later in the first cold application To collect the data, the identifying information form prepared by the researcher in line with the literature and the Visual Analogue Scale (VAS).Results: It was identified in the study that the application of cold gel pad reduced the postpartum perineal pain in primiparous and multiparous puerpera. It was observed that perineal pain, which adversely aff ects postpartum activities and infant care, was reduced by cold pad application and that there were significant decreases in the pain level especially while performing activities such as lying down, sitting, walking, breastfeeding and urinating after 2 cold pad applications. It was identified that 78.0% of primiparous puerpera and 84.0% of multiparous puerpera who received cold gel pad application were satisfied.Conclusion: It was determined that the application of cold gel pad on the perineum following normal birth relieved perineal pain with physical activity.

PDF

___

Bick, D. E. ve ark. (2010). Perineal assessment and repair longitudinal study (PEARLS): Protocol for matched pair cluster trial. BMCPregnancy and Childbirth, 10(1): 1-10.
Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., Herrlich, A. (2014). Major survey findings of listening to motherssm III: New mothers speak out. Perinat Educ, 23(1): 17-24.
Declercq, E., Cunningham, D. K., Johnson, C., Sakala, C. (2008). Mothers' reports of postpartum pain associated with vaginal and cesarean deliveries: Results of national survey. Birth, 35(1): 16-24.
East, C. E., Begg, L., Henshall, N. E., Marchant, P., Wallace, K. (2007). Local cooling for relieving pain from perineal trauma sustained during childbirth (review). Cochrane Database quystematic Reviews, 2012(5): l-l46.
East, C. E., Sherburn, M., Nagle, C., Said, ., Forster, D. (2012). Perineal pain following childbirth: Prevalence, effects on postnatal recovery and analgesia usage. Midwifery, 28(1): 93-97.
Eshkevari, L., Trout, K. K., Damore, ]. (2013). Management of postpartum pain. Midwifery Women Health, 58(6): 622-631.
Francisco, A. A., Vasconcellos, 0. S. M. ., Barbosa, S. F. M., Bick, D., Riesco, M. L. G. (2011). Women's experiences of perineal pain during the immediate postnatal period: cross-sectional study in Brazil. Midwifery, 26(7): 254-257.
Francisco, A. A., Vasconcellos, 0. S. M. ., Leventhal, L. C., Busco, C. S. (2013). Cryotherapy after childbirth: The length of application and changes in perineal temperature. Rev Esc Enferm USP, 47(3): 555-561.
Huskisson, E. C. (1974). Measurement of pain. Lancet, 304(7889): 1127-1131.
Jahdi, F., Sheikhan, F., Merghati, K. E., Haghani, H. (2010). The effect of cooling gel pad on the intensity of perineal pain following episiotomy. Arak Medical University Journal (AMUJ), 13(3): 76-83.
Kazan, E. E. (2011). Soğuk uygulamalar ve hemşirelik bakımı. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi, 18(1): 73-82.
Leventhal, L. C., Vasconcellos, 0. S. M. J., Nobre, M. R. C., Barbosa da Silva, F.M. (2011). Perineal analgesia with an ice pack after spontaneous vaginal birth: randomized controlled trial. Midwifery Women 's Health, 56(2): 141-146.
Macarthur, A. J., Macaıthur, C. (2004). Incidence, severity, and determinants of perineal pain after vaginal delivery: prospective cohort study. American Journal of Obstetrics and Gynecology, 191(4): 119--204.
Navvabi- Rigi, S. H., Abedian, Z., Steen, G. M. (2009). Effectiveness of cooling gel pads and ice packs on perineal pain. BJM, 17(11): 724--729.
Navvabi- Rigi, S. H., Kerman-Saravi F., Saroneh- Rigi, M., Abedian, Z. (2011). Cold and reduced episiotomy pain interfere with mood and daily activity. Shiraz Medical Journal, 12(2): 87-92.
Paiva, S. B. ve ark. (2015). Length of perineal pain relief after ice pack application: quasi-experimental study. Women Birth, 29(2): 117-122.
Rogers, R. G., Borders, N., Leeman, L. M., Albers, L. L. (2009). Does spontaneous genital tract trauma impact postpartum sexual lîınction? Midwifery and Women 's Health, 54(2): 98-103.
Sheikhan, F. ve ark. (2011). Episiotomy discomforts relief using cold gel pads in primiparaus Iranian Women (a comparative study). Research Journal ofMedical Sciences, 5(3): 150-154.
Steen, M. (2010). Care and consequences of perineal trauma. BJM, 18(11): 710-715.
Steen, M. P. (2005). 'I can't sit down': Easing genital tract trauma. BJM 13(5): 311-314.
Steen, M., Briggs, M., King, D. (2006). Alleviating postnatal perineal trauma: To cool or not to cool? BJM, 14(5): 304-308.
Steen, M., Marchant, P. (2007). Ice packs and cooling gel pads versus no localised treatment for relief of perineal pain: randomised controlled trial. Evidence Based Midwifery, 5(1): 16-22.
Swain, J., Dahlen, H. G. (2013). Putting evidence into practice: quality activity of proactive pain relief for postpartum perineal pain. Women andBirth, 26(1): 65-70.
Thompson, J. F., Roberts, C. L., Currie, M., Ellwood, D. A. (2002). Prevalence and persistence of health problems after child-- birth: Associations with parity and method of birth. Birth, 29(2): 83-94.
Vasconcellos, 0. S. M. J., Silva, F. M. B., Riesco, M. L. G., Do Latorre, M. R., Nobre, M. R. C. (2012). Comparison of application times for ice packs used to relieve perineal pain after normal birth: Arandomised clinical trial. Journal of Clinical Nursing, 21(23-24): 3382-3391.
Way, S. (2012). qualitative study exploring women's personal experiences of their perineum after childbirth: Expectations, reality and returning to normality. Midwifery, 28(5): 712-719.