الفهرس 
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Abstract
Although childbirth is a natural phenomenon, labor pain renders it a very unpleasant experience. As pharmacological approaches of relieving labor pain may have adverse effect on the maternal and fetal health, using non-pharmacological intervention is an alternative solution to reduce it and make child birth a pleasant experience because it is easy to administer, cost effective, harmless, and appealing to the mother. However, lower back massage with jasmine oil is the most popular non-pharmacological method that nurses can use during labor to reduce pain. It has no side effects for both the mother and the fetus as well as it lessens the need for intrusive pain relief techniques. Therefore, this study offers guidance for introducing back massage with jasmine oil in nursing practice by testing its efficacy on relieving labor pain.
This study aimed to determine the effect of jasmine oil back massage on pain intensity among primigravidae during the first stage of labor.
The study comprised a convenient sample of 100 laboring women, who were selected from labor and delivery unit of El-Shatby Maternity University Hospital in Alexandria Governorate. They were assigned equally to either study group (50 laboring women), who received back massage with jasmine oil or control group (50 laboring women), who received routine hospital care.
Three tools were utilized by the researcher to gather the required data: Tool one: basic and clinical data, which was established by the researcher and involved 3 parts, Socio- demographic data, profile of current pregnancy and clinical data. Tool two: Visual analog scale (VAS) and tool three: Present Behavioral Intensity (PBI) Scale, which were adapted by the researcher to measure intensity and present behavioral manifestations of labor pain.
A pilot study was conducted on 10 laboring women (excluded from the study subjects) to determine the feasibility of the study, the clarity and applicability of the tools as well as to estimate the time required to fill them. Following this pilot study, the tools were rechecked, rebuilt and prepared for use.
Data collection covered a 6 months period (starting from the beginning of January till the end of June 2021), 3 days/week; 1-2 laboring women /day. The average time needed to complete tool one ranged between 20-30 minutes, while the time needed for tool two & three was 2 hours.
Using the Statistical Package for Social Sciences (SPSS) version 23 program, the obtained data were classified, coded, computerized, tabulated and analyzed.
The main findings of the study were:
Socio - demographic data:
- The relationship between the two groups’ socio-demographic data was not statistically significant in terms of age (P=0.398), level of education (P=0.566), occupation (P=0.334) and current residence (P=0.190).
Profile of current pregnancy:
- No statistically significant differences were found between the two groups’ profile of current pregnancy in respect of number and place of antenatal visit (P=0.074 & P=0.059) respectively
Clinical data:
Vital signs:
- Before intervention, the relationship between the two groups was highly statistically significant (P=<0.0001), where the mean vital signs was higher among the study group than the control one.
- After intervention, the relationship between the two groups was also statistically significant in relation to temperature (P=0.032) and respiration (P=0.046), where their mean was lower among the study group (36.954 ± 0.279 º C& 19.92 ± 2.239 breaths/m respectively) than the control one (37.068 ± 0.243 º C& 20.78 ± 2.003 breaths/m respectively)
- By the end of the active phase, the relationship between the two groups was highly statistically significant (P=<0.0001), where the mean vital signs was lower in the study group than the control one.
Uterine contractions:
- Before intervention, no statistically significant difference was discovered between the two groups
- After intervention, the relationship between the two groups was highly statistically significant regarding the mean No/10 minutes and duration of uterine contractions (P=<0.0001), where the study group had higher mean No/10 minutes and shorter duration (4.60 ± 0.495 contractions & 44.00 ± 8.081 minutes respectively) than the control group (3.98 ± 0.428 contractions& 57.20 ± 7.010 minutes respectively)
- At the end of the active phase, the relationship between the two groups’ interval of uterine contractions was statistically significant (P=0.003), where the mean interval was lower among the study group (2.84 ± 0.370 minutes) than the control one (3.00 ± 0.000 minutes).
Cervical dilatation:
- The relationship between the two groups was highly statistically significant before intervention (P=<0.0001), as the mean cervical dilation was greater among the study group (3.54 ± 0.762 cm) than the control one (2.98 ± 0.428 cm)
- A statistically significant difference was also observed between them after intervention (P= 0.023), where the mean cervical dilation was larger among the study group (4.72 ± 0.970 cm) than the control one (4.30 ± 0.839 cm).
FHR:
- A highly statistically significant differences were observed between the two groups before and after intervention as well as at the end of the active phase of labor (P=<0.0001), where the mean FHR was lower among the study group than the control one.
Intensity of labor pains using VAS:
- Before intervention, a statistically significant difference was found between the two groups (P=0.022), as 36% of the study group had unbearable pains, compared to 20% of the control group.
- After intervention and at the end of the active phase, the relationship between the two groups was highly statistically significant (P=0.000), where unbearable pains decreased sharply from 36% to 0% among the study group, while it increased from 20% to 36% & from 36% to 50% respectively among the control group.
Intensity of labor pains using PBI Scale
- Before intervention, the relationship between the two groups was statistically significant. (P=0.037), where 46% of the study group had unbearable pain, compared to 26% of the control group.
- After intervention and at the end of the active phase, a highly statistically significant differences were found between the two groups (P=0.000), where unbearable pain dropped sharply from 46% to 4% & from 4% to 0% respectively among the study group, while it elevated markedly from 26% to 76% & from 76% to 82% respectively among the control group.
Recommendations:
Non-pharmacologic pain relief methods during labor, including jasmine oil back massage, should be added to nursing curricula and nursing care protocols
In-service training programs should be conducted for midwives in maternity hospitals and primary health care centers to help them implement jasmine oil back massage as a non-pharmacological labor pain relief method
The responsible authority should prepare a simplified guideline about the proper use and advantages of jasmine oil back massage for the relief of labor pain should be made available for midwives.
Health teaching classes for pregnant women should be conducted by maternity nurses to increase their awareness about the effect and benefits of jasmine oil back massage in decreasing labor pain.
Additional studies are required to:
- Repeat the current study with greater sample sizes and different settings for generalization of the findings.
- Perform an identical study on multiparous women, during the prenatal and postnatal periods
- Investigate other non-pharmacologic techniques’ effectiveness on reducing labor pain and other birth outcomes.