A Comparison of Massage Effects on Labor Pain Using the McGill Pain Questionnaire

使用麥克吉爾疼痛量表比較按摩在產痛的成效

張美月(Mei-Yueh Chang)；陳彰惠(Chung-Hey Chen)；黃國峰(Kuo-Feng Huang)

產痛 ； 簡易型McGill疼痛量表SF-MPQ ； 按摩 ； 分娩支持 ； labor pain ； Short-Form McGill Pain Questionnaire SF-MPQ ； massage ； labor support

The Journal of Nursing Research

14卷3期（2006 / 09 / 01）

190 - 197

英文

本研究目的為描述按摩對待產婦產痛強度及特性的影響。60位初產婦隨機分派到按摩組及控制組，兩組產婦於待產三個期：子宮頸口開3-4公分、5-7公分及8-10公分，各以簡易型McGill疼痛量表(Short-Form McGill Pain Questionnaire, SF-MPQ)自評其疼痛強度與疼痛特性。按摩組除接受一般常規護理外尚加入按摩介入方案，控制組則只接受一般常規護理。結果顯示：(1)兩組產婦疼痛感都隨著產程進展增加；(2)按摩組產婦比控制組產婦在待產第一、二期疼痛強度有顯著減輕，但在待產第三期，兩組疼痛強度無顯著差異；(3)在待產第一、二期，最常被用來描述感覺性的疼痛，其前五項為：酸痛、尖銳的痛、悶痛、顫抖及絞痛。恐懼害怕感及精疲力竭感則為最常被用來描述情感性的疼痛，兩組在疼痛描述選項上則相類似。雖然按摩並沒改變兩組產婦對疼痛性質的描述，但可有效的減輕待產第一、二期的產痛強度。護理人員及待產婦主要照顧者可提供按摩來協助產婦度過待產期間的不適。

The purpose of this study was to describe the characteristics of pain during labor with and without massage. Sixty primiparas in labor were randomly assigned to either a massage or control group and tested using the self-reported Short-Form McGill Pain Questionnaire (SF-MPQ) at 3 phases of cervical dilation: phase 1 dilation (3-4 cm), phase 2 dilation (5-7 cm), and phase 3 dilation (8-10 cm). The massage group received standard nursing care and massage intervention, whereas the control group received standard nursing care only. The results of this study showed: (1) In both groups, as cervical dilation increased, there were significant increases in pain intensity as measured by SF-MPQ; (2) massage lessened pain intensity at phase 1 and phase 2, but there were no significant differences between the groups at phase 3; (3) the most frequently selected five sensory words chosen by both groups were similar at phases 1 and 2-(a) sore, (b) sharp, (c) heavy, (d) throbbing, and (e) cramping, while of the 4 affective classes, ”fearful” and ”tiring-exhausting” were the most used by participants to describe the affective dimension. The results of this study indicate that, although massage cannot change the characteristics of pain experienced by women in labor, it can effectively decrease labor pain intensity at phase 1 and phase 2 of cervical dilation during labor. Nurses and caregivers could consider using massage to help laboring women through the labor pain.

1. Anderson, F. J. W.,Johnson, C. T.(2005).Complementary and alternative medicine in obstetrics.International Journal of Gynecology and Obstetrics,91(2),116-124.
2. Bonnel, A. M.,Boureau, F.(1985).Labor pain assessment: Validity of a behavioral index.Pain,22(1),81-90.
3. Brown, S. T.,Campbell, D.,Kurtz, A.(1989).Characteristics of labor pain at two stages of cervical dilation.Pain,38(3),289-295.
4. Chang, M. Y.,Wang, S. Y.,Chen, C. H.(2002).Effects of massage on pain and anxiety during labor: A randomized controlled trial in Taiwan.Journal of Advanced Nursing,38(1),68-73.
5. Chen, S. H.(1998).Taiwan, ROC.,Kaohsiung Medical University.
6. Gaston-Johansson, F.,Fridh, G.,Turner-Norvell, K.(1988).Progression of labor pain in primiparas and multiparas.Nursing Research,37(2),86-90.
7. Huntley, A. L.,Coon, J. T.,Ernst, E.(2004).Complementary and alternative medicine for labor pain: A systematic review.American Journal of Obstetrics and Gynecology,191(1),36-44.
8. King, T.(2002).Labor pain in the 21st century.Journal of Midwifery & Women's Health,47(2),67.
9. Lowe, N. K.(2002).The nature of labor pain.American Journal of Obstetrics and Gynecology,186(5),16-24.
10. Lowe, N. K.(1996).The pain and discomfort of labor and birth.Journal of Obstetric, Gynecologic, & Neonatal Nursing,25(1),82-92.
11. Ludington, E.,Dexter, F.(1998).Statistical analysis of total pain using the visual analog scale and application to studies of analgesic effectiveness during childbirth.Anesthesia & Analgesia,87(3),723-727.
12. McCaffery, M.(1990).Nursing approaches to nonpharmacological pain control.International Journal of Nursing Studies,27(1),1-5.
13. McCaffery, M.,Beebe, A.(1989).Pain: Clinical manual for nursing practice.Mosby:St. Louis, MO.
14. Melzack, R.(1987).The short-form McGill pain questionnaire.Pain,30(2),191-197.
15. Melzack, R.,Kinch, R.,Dobkin, P.,Lebrun, M.,Taenzer, P.(1984).Severity of labour pain: Influence of physical as well as psychologic variables.Canada Medical Association Journal,130(1),579-584.
16. Melzack, R.,Taenzer, P.,Feldman, P.,Kinch, R. A.(1981).Labour is still painful after prepared childbirth training.Canada Medical Association Journal,125(4),357-363.
17. Mobily, P. R.,Herr, K. A.,Nicholson, A. C.(1994).Validation of cutaneous stimulation interventions for pain management.International Journal of Nursing Studies,31(6),533-544.
18. Reading, A. E.,Cox, D. N.(1985).Psychosocial predictors of labor pain.Pain,22(3),309-315.
19. Rin, H.(1978).Psychiatry and society.Taipei:Modern Medicine.
20. Simkin, P.,Bolding, A.(2004).Update on nonpharmacologic approaches to relieve labor pain and prevent suffering.Journal of Midwifery & Women's Health,49(6),489-504.
21. Skala, C.,DeClercq, E. R.,Corry, M. P.(2002).Listening to mothers: The first national U.S. survey of women's childbearing experiences.Journal of Obstetric Gynecologic Neonatal Nursing,31(6),633-634.

1. Ilknur Munevver GÖNENÇ,Füsun TERZIOĞLU(2020).Effects of Massage and Acupressure on Relieving Labor Pain, Reducing Labor Time, and Increasing Delivery Satisfaction.The Journal of Nursing Research,28(1),1-9.
2. Tzeng, Ya-Ling,Su, Tsann-Juu(2008).Low Back Pain During Labor and Related Factors.The Journalof Nursing Research,16(3),231-241.