Sezaryen ile Doğum Yapan Kadınlara Uygulanan Progresif Gevşeme Egzersizleri ve Transkütan Elektriksel Sinir Stimülasyonunun Akut Ağrı, Emzirme Davranışı ve Konfor Düzeyine Etkisi; Randomize Kontrollü Çalışma

Abstract

Öztürk, D., The Effect of Progressive Relaxation Exercises and Transcutaneous Electrical Nerve Stimulation on Acute Pain, Breastfeeding Behavior and Comfort Level in Women Delivered by Cesarean Section; Randomized Controlled Study, Hacettepe University Graduate School of Health Sciences, Obstetrics and Gynecologial Nursing Programme Doctor of Philosophy Thesis, Ankara, 2019. Cesarean section rate is increasing in the world and in our country, and it might bring other problems with it. Pain, breastfeeding problems and decrease in comfort problems have high chance to happen after cesarean section. The insufficiency of pharmacological methods in reducing the problems experienced after cesarean section and having many side effects increase the using percentage tendency to non-pharmacological methods. This study was conducted as randomized controlled study to evaluate the effect of progressive relaxation exercises and Transcutaneous Electrical Nerve Stimulation on acute pain, breastfeeding behavior and comfort level in women who delivered by cesarean section. The number of samples was calculated by PASS 11 program and the women who were sampled were assigned to the groups according to the randomization plan. The sample of total 120 women consisted of 30 women in the TENS group, 30 women in the progressive relaxation exercises group, 30 women in the TENS and progressive relaxation exercises group and 30 women in the control group. The research was ran between August 20, 2018 and April 15, 2019 at Health Sciences University Ankara Training and Research Hospital. The data were collected by with using Data Collection Form, Visual Analog Scale, LATCH Breastfeeding Diagnostic Tool, Breastfeeding Self-Efficacy Short Form Scale (Postnatal Form), Postpartum Comfort Scale and Maternal Follow-up Form. Number, percentage and chi-square tests were used to evaluate the data. For continuous variables, the median, “Wilcoxon Sign Test” and “Kruskall-Wallis H Test” were applied. According to the findings of the study, it was determined that pain was decreased significantly after caesarean section and breastfeeding self-efficacy and comfort were increased in all three intervention groups (group of TENS, progressive relaxation exercises group and, TENS and progressive relaxation exercises group together) (p <0.05). Although there was no statistically significant change in breastfeeding behavior in the TENS group regarding breastfeeding behavior, it was found that breastfeeding behavior was significantly better in the progressive relaxation exercises group and in the TENS and progressive relaxation exercises group (p <0.05). As a conclusion, TENS and progressive relaxation exercises are the most effective methods to improve comfort by eliminating pain, breastfeeding problems after cesarean section. TENS is effective on pain, breastfeeding self-efficacy and comfort and progressive relaxation exercises are effective on pain, breastfeeding behavior, breastfeeding self-efficacy and comfort. According to the results of the study, the application of TENS and progressive relaxation exercises together or separately after cesarean section should be used as safe nonpharmacological methods in pain management, elimination of breastfeeding problems and increasing comfort as a suggestion.