الفهرس 
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Abstract
Childbirth is always associated with intense pain caused by uterine contractions which dilate the lower uterine segment and the cervix. When the labor starts, the contractions are irregular and the pain experienced in mild to moderate. The contractions gradually occur more frequently, and the pain becomes severe or unbearable (Green, 2016).Nowadays, measures that contribute to maternal and fetal well-being are the primary concern of maternity hospitals committed to the humanization of childbirth,for women and for their families. In this respect, evidence based practices such as non-
pharmacological and non-invasive interventions that control pain and guarantee comfort and safety for both mothers and fetuses are increasingly utilized. One of the widely accepted non-pharmacological measures is abdominal effleurage (Tsay, et al., 2017).Massage help to reduce the intensity of pain by facilitating the release of endorphins at various points in the central nervous system. When endorphins produced,they bind to opioid receptor sites, providing pain relief and a sense of euphoria (Dubner,et al., 2015).Therefore, this study was carried out to examine the effect of abdominal
effleurage during the first stage of labor on pain experienced by women.
The study was conducted in delivery units at Menoufia University Hospital and Shebin El-Kom Teatching Hoapital. A convenient sample of 80 laboring women was selected from the previously mentioned setting where, a simple random sample was used to assign women in a control (G1) and study (G2) groups according to the following criteria:
- Full term (37 to 42) weeks of gestation.-Free from any medical or obstetric risk factors.- Having a single viable fetus in cephalic presentation.
- No administration of any pharmacological pain relief.-Women in the first stage of labor.-Normal delivery (no acceleration, induction or instrumental delivery).Throughout the course of the present study the researcher used three instruments:
Instrument I: A structured interviewing questionnaire.Instrument II: Visual analog scale (VAS).Instrument III: Partograph.The instruments were developed by the researcher and reviewed by a jury of qualified experts and then tested for validity and reliability.
Pilot study was carried out on 8 women who were excluded from the study. The
aim of the pilot study was to test the validity, clarity and the needed to complete the tool.The collected data was computerized, tabulated, analyzed and represented in descriptive and association form.The main findings of the current study were as follows:
- There was no statistically significant difference between study and control groups regarding socio-demographic characteristics.-There was a shorter duration of 3rd stage of labor among study group women with ahighly statistically significant difference between study and control groups (P< 0.001**) while, there was a shorter duration of 1st and 2nd stages of labor among study group women with a statistically significant difference between study and control groups (P< 0.05*).-The results indicated that, at latent and transitional phases, there was no a statistically significant difference between study and control groups regarding vital signs measurements (P>0.05). At active phase, there was a highly statistically significant difference between study and control groups regarding pulse measurement (P <0.001**) and as regarding systolic and diastolic blood
pressure there was a statistically significant difference between the study and control groups regarding measurements (P <0.05*) while there was no a statistically significant difference between study and control groups regarding temperature measurement (P>0.05).-There was no statistically significant difference between study and control groups before intervention. There was a reduction on labour pain scores during the 1st stage of labour (immediately after intervention, at latent active phases) with a statistically significant difference between study and control groups P <0.05*. On the other hand, there was no statistically significant difference between study and control groups after intervention at transitional phase.
Based on the findings of this study it was recommended that: •Nursing management protocol and abdominal effleurage should be advocated as
a non-pharmacological effective approach to the management of labor pain and
should be recommended in hospital protocols.Nursing attending labor should be encouraged to use non-pharmacological pain relieving methods during labor to make this experience a pleasant and memorable one for the rest of the woman’s life.•Nursing research focus on supportive care techniques such as effleurage massage, its provision and outcome of labor.