Journal of Traditional Medical Complementary Therapies

.: REVIEW
Doğum Ağrısının Yönetiminde Kullanılan Nonfarmakolojik Yöntemler: Gevşeme Teknikleri
Non-Pharmacological Methods Used in Management of Labor Pain: Relaxation Techniques
Başak DEMİRTAŞ HİÇYILMAZa, Merve KAHRAMANb
aAnkara Üniversitesi Hemşirelik Fakültesi, Ankara, TÜRKİYE
bAnkara Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik ABD, Ankara, TÜRKİYE
J Tradit Complem Med. 2020;3(3):379-88
doi: 10.5336/jtracom.2020-73649
Article Language: TR
Full Text
ÖZET
 Doğum ağrısının kontrol altına alınması, gebenin fiziksel ve ruhsal rahatının sağlanarak yaşam kalitesinin yükseltilmesi ve komplikasyonların olmadığı sağlıklı bir doğum süreci yaşaması açısından elzemdir. Doğum ağrısının yönetiminde, farmakolojik ve nonfarmakolojik olmak üzere 2 farklı yöntem kullanılmaktadır. Nonfarmakolojik yöntemler, hem farmakolojik yöntemlere ek olarak hem de tek başına kullanılabilmektedir. İnvaziv olmamaları, yan etki içermemeleri, kolay ve güvenli bir biçimde uygulanabilmeleri nedeni ile nonfarmakolojik yöntemlere duyulan ilgi giderek artmaktadır. Bu yöntemler, algılanan doğum ağrısını azaltarak gebenin anksiyete düzeyini düşürür, uterin kan akışını artırır, kas gerilimini azaltır, anne-bebek ilişkisinin kurulmasını destekler, eşler arasında yakınlığı pekiştirir. Bu nedenlerle doğum ağrısının yönetiminde, medikal yöntemlere oranla daha çok tercih edilmektedirler. Doğum sürecinde hemşire ve ebeler, bu yöntemleri etkin bir şekilde uygulayabilmek için yeterli bilgi ve donanıma sahip olmalıdır. Bu derlemede, doğum eyleminde ağrının yönetiminde kullanılan nonfarmakolojik yöntemlerden biri olan gevşeme teknikleri; biyolojik geri bildirim, akupunktur, akupresür, hipnozla doğum, aromaterapi, masaj ve müzik başlıkları altında incelenmiştir. Her birine ait uygulama yöntemi, etki mekanizması ve doğum/doğum sonrası süreçteki etkileri sunulmuştur. Yapılan çalışmalar, sözü edilen bu yöntemlerin doğum ağrısına yönelik uygulanan tıbbi girişimleri ve sezaryen oranını azalttığını göstermekle birlikte, klinik uygulama için önerilerde bulunabilmek amacıyla doğumhanelerde ve gebe eğitim sınıflarında, konu ile ilgili daha geniş popülasyonu ve süreyi kapsayan bilimsel çalışmalara gereksinim duyulduğunu vurgulamaktadır.

Anahtar Kelimeler: Doğum ağrısı; anne-çocuk hemşireliği
ABSTRACT
 Management of labor pain is essential for ensuring the physical and mental comfort of the pregnant woman, increasing the quality of life and living a healthy birth process without complications. Two different methods are used in the management of labor pain, pharmacological and non-pharmacological. Non-pharmacological methods can be used both in addition to pharmacological methods and alone. The interest in non-pharmacological methods is increasing, as they are not invasive, do not contain side effects, and can be administered easily and safely. These methods reduce the perceived birth pain, decrease the anxiety level of the pregnant woman, increase the uterine blood flow, decrease the muscle tension, support the establishment of the motherbaby relationship, reinforce the intimacy between the spouses. For these reasons, they are more preferred than medical methods in the management of birth pain. Nurses and midwives should have sufficient knowledge and equipment to effectively apply these methods during labor. In this review, relaxation techniques which is one of the non-pharmacological methods used in the management of pain in labor have been examined under the titles of biofeedback, acupuncture, acupressure, birth with hypnosis, aromatherapy, massage and music. The application method, mechanism of action and the effects in the labor/postpartum process of each technique are presented. Studies have shown that these methods reduce the medical interventions for birth pain and cesarean rate, but more research covering a larger population and duration in the maternity hospitals and antenatal classes is needed to make recommendations for clinical practice.

Keywords: Labor pain; maternal-child nursing
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