[논문]Effects of a Postpartum Back Pain Relief Program for Korean Women

Oh, Hyun-Ei; Lee, Young-Sook; Shim, Mi-Jung; Kim, Jin-Sun

doi:10.4040/jkan.2007.37.2.163

[국내논문] Effects of a Postpartum Back Pain Relief Program for Korean Women 원문보기

대한간호학회지= Journal of Korean academy of nursing, v.37 no.2, 2007년, pp.163 - 170

Oh, Hyun-Ei (Department of Nursing, Chosun University) , Lee, Young-Sook (College of Nursing, Research Institute of Nursing Science, Chonnam National University) , Shim, Mi-Jung (Gwangju Health College) , Kim, Jin-Sun (Department of Nursing, Chosun University)

Abstract ▼ AI-Helper

Purpose. Despite the high prevalence of back pain and its subsequent effects in post-partum women, intervention programs are scarce. The purpose of this study was to test the effects of a back-pain-reducing program on post-partum women who experienced low-back pain during pregnancy. Methods. A non-equivalent control-group pretest-posttest design was used. Pregnant women who attended a hospital for prenatal check-ups and experienced back pain participated in an intervention program (n=27), and the results were compared with women in a control group from another hospital (n=25). Results. At 8 weeks post-partum, the pain intensity, functional limitations were lower in the intervention group than in the control group. However, differences in mean change of the pain intensity and functional limitations between 36 and 39 weeks of gestation and at 8 weeks post-partum were not statistically significant between the groups. Moreover, the flexibility, post-partum functional status, and post-partum depression did not differ significantly between the groups. Conclusions. A back-pain-relief program in this study was not effective to reduce the back-pain intensity in post-partum women and to decrease the associated functional limitations. The implications for nursing practice and directions for future research are discussed.

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문제 정의

Traditional post-partum care in Korea emphasizes rest as the means to post-partum recovery, with exercise considered a physical stressor (Kim-Godwin, 2003; Schneiderman, 1996). The purpose of this study was therefore to identify the effects of a back-pain-reducing program applied to post-partum Korean women who experienced low-back pain during pregnancy. The effects of the program on post-partum back-pain intensity, functional limitations, flexibility, post-partum functional status, and post-partum depression were examined.

가설 설정

The effects of the program on post-partum back-pain intensity, functional limitations, flexibility, post-partum functional status, and post-partum depression were examined. This study hypothesizes that participants in intervention group will have lower back pain, fewer functional limitations, higher flexibility higher postpartum functional status, and lower postpartum depression than those of control group at 8weeks after delivery.

제안 방법

The intervention program was implemented by the first author. A 40-minute class was given at 35 to 39 weeks of gestation, which included instruction on simple anatomy, posture physiology, lifting and working techniques, muscle training, and relaxation training. This class was h아d at the education room in the Ob-Gy hospital.
Women in the intervention group were encouraged to perform this exercise 3 sessions a day, and 3 to 5 days a week from the day attended education class to 8weeks after delivery. It took 30 minutes to finish all motions in a session.
The data were collected at three time points: between 36 and 39 weeks gestation (pretest 1), at 10 days postpartum (pretest 2), and at 8 weeks post-partum (posttest). Time points for data collection were decided based on the literature review and judgements of the panel of experts.
in Figure 1. Pretest 1 was conducted in education rooms at the Ob-Gy hospitals, and pretest 2 and the posttest were conducted either in these rooms or at the subject's home by the first author. Upon completion of the questionnaire, the participant received a gift (a waterproof bed-sheet cover) to compensate them for their assistance.
1. The 砂-test, Fishefs exact probability test, and t-test were used to compare homogeneity on general characteristics, obstetrical characteristics, and factors related to back pain between the intervention and control groups.
Lack of effect in this study may be influenced by the way in which instructions for the exercise were given to the subjects. The subjects performed the exercises at home, instructed by videotape, without personal guidance and supervision. Stuge, Holm, and Vollestad (2006) reported that personal instruction and guidance improve the quality of the performance and increase the motivation to exercise.
A back-pain-relief program designed for this study was not effective to reduce the back-pain intensity in postpartum women and decreased the associated functional limitations. However, considering substantial prevalence of post-partum back pain and their influence of postpartum recovery, there are several implications for nursing professionals.

대상 데이터

Subjects were recruited from two obstetric and gynecologic (Ob-Gy) hospitals in G city, Korea. To avoid cross-contamination of information from the intervention to the control group, the subjects in the two groups were recruited from different hospitals.
To avoid cross-contamination of information from the intervention to the control group, the subjects in the two groups were recruited from different hospitals. The subjects were pregnant women who regularly attended a local Ob-Gy hospital for prenatal check-ups, and were recruited according to the order in which they visited the Ob- Gy hospital. The subjects in this study participated by volunteering after they received information about this program from the staff of the local Ob-Gy hospital that they attended.
The subjects were pregnant women who regularly attended a local Ob-Gy hospital for prenatal check-ups, and were recruited according to the order in which they visited the Ob- Gy hospital. The subjects in this study participated by volunteering after they received information about this program from the staff of the local Ob-Gy hospital that they attended.
The back-pain-relief program was developed by the first author based on a literature review and consultation with a panel of experts consisting of two professors in maternity nursing and an orthopedic surgeon. The back- pain-relief program consisted of a standardized education protocol: pamphlet, lecture, audio-visual tape describing the exercise, daily exercise record, and telephone calls.
A 40-minute class was given at 35 to 39 weeks of gestation, which included instruction on simple anatomy, posture physiology, lifting and working techniques, muscle training, and relaxation training. This class was h아d at the education room in the Ob-Gy hospital. At this time, all participants in the intervention group received instruction on how to perform back-painreducing and muscle-strengthening exercises, and were asked to perform these exercises at home.
At this time, all participants in the intervention group received instruction on how to perform back-painreducing and muscle-strengthening exercises, and were asked to perform these exercises at home. One to three subjects participated in each education lecture, and a total of 19 repeat lectures from May 18, 2002 to July 6, 2002 were held by the first author to recruit all participants in the intervention group.
The three dimension subscales of the IFSAC are the responsibilities of infant care, household activities, and self-care. The inventory consists of 26 items rated on a 4-point Likert scale (from 1 to 4), with a higher score indicating a higher functional status after childbirth. An evaluation of the IFSAC showed that its content validity as determined by Popham's average congruency procedure, was 96.

데이터처리

2. t-tests were used to test hypotheses.

이론/모형

A non-equivalent control-group pretest-posttest design was used in this study. An overview of the study design and measurement is given below (see Figure 1).
The presence and distribution of pain were measured with the aid of a pain drawing (Sturesson et al., 1997) completed by the subjects. Subjects were asked to localize their pain within areas LI to L5, including the symphysis region, the groin, the greater trochanter, the region of the sacroiliac joints, and the lateral parts of the buttock.
Post-partum depression was measured to assess any possible psychological effects of back pain using the Post-partum Depression Scale developed by Bai (1997). This scale is a 46-item, 4-point s이f-reported scale (from 1 to 4) designed to measure post-partum depression based on physiological and psychological measures, social responses, and the relationship with the infant, where a higher score indicates higher post-partum depression.
(1997). This scale is a 46-item, 4-point s이f-reported scale (from 1 to 4) designed to measure post-partum depression based on physiological and psychological measures, social responses, and the relationship with the infant, where a higher score indicates higher post-partum depression. Bai (1997) reported satisfactorily content and construct validity, and an internal consistency of 0.

성능/효과

The purpose of this study was therefore to identify the effects of a back-pain-reducing program applied to post-partum Korean women who experienced low-back pain during pregnancy. The effects of the program on post-partum back-pain intensity, functional limitations, flexibility, post-partum functional status, and post-partum depression were examined. This study hypothesizes that participants in intervention group will have lower back pain, fewer functional limitations, higher flexibility higher postpartum functional status, and lower postpartum depression than those of control group at 8weeks after delivery.

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