探討穴位指壓對初產婦於分娩過程中產痛、焦慮和產程之成效

本研究的目的在探討三陰交穴位指壓對分娩婦女之疼痛感受、焦慮程度與產程的成效，研究對象為南部某醫學中心自然生產的初產婦，以實驗性研究隨機分派50位分娩婦女至實驗組與對照組，實驗組接受30分鐘穴位指壓措施，對照組則無接受穴位指壓措施，於待產期間比較兩組分娩婦女在接受實驗措施的前測、介入立即後測及潛伏期、活動期及過渡期的疼痛感受、焦慮程度與產程時數之差異。研究工具為疼痛與焦慮視覺類比量表，並以目前行為強度作為疼痛客觀指標。資料以卡方檢定、獨立樣本t檢定、重複量數雙因子變異數分析等方法進行統計分析。研究結果顯示，三陰交穴位指壓能顯著降低實驗組分娩婦女在介入立即後測、潛伏期、活動期及過渡期的疼痛感受及焦慮程度；實驗組在三陰交穴位指壓後立即後測、潛伏期之指溫較對照組有顯著升高；實驗組在第一產程的時數顯著低於對照組。而實驗組分娩婦女100%認為穴位指壓能提供中度以上有效的幫助，是一種很好的減痛、促進產程進展及增進舒適的照護方式。根據研究發現，建議產房護理人員可在待產婦的待產過程中，提供穴位指壓的另類護理措施，以協助待產婦面對疼痛與焦慮的適應能力，是件可行且符合成本效益的護理措施，進而可提升照護品質。

關鍵字

三陰交；穴位指壓；分娩婦女；疼痛；焦慮；產程進展

並列摘要

The purpose of this study was to evaluate the effects of SP-6 (Sanyinjiao) acupressure on women’s pain perception, anxiety and labor progress. An experimental study with a pretest-and-posttest-control-group design was utilized. The subjects were primiparas who had a normal spontaneous delivery at a Medical Center in Southern Taiwan. They were randomly assigned to either the experimental or the control group. The experimental group received 30-minute SP-6 acupressure intervention and the control group did not. The intensity of pain perception and anxiety between the two groups were compared in five check points : before intervention, immediately after the intervention, the latent phase, active phase and transitional phase. Length of delivery time was calculated from 2cm cervical dilation to full cervical dilatation. The data were analyzed by using the descriptive statistics, chi-square test, t-test, repeated measures two-way ANOVA. The effectiveness of the SP-6 acupressure were as follows: First, the experimental group had significantly lower pain perception at immediately after acupressure, the latent phase, active phase and transitional phase than the control group. Second, the anxiety level between the two groups only in immediately after acupressure, the latent phase and active phase, transitional phase achieved significant difference. Third, skin temperature of the index’s finger was significantly elevated at immediately after acupressure, the latent phase in the experimental group compared to the control group. Forth, length of delivery time was significantly shorter in the SP6 acupressure intervention group than in the control group. And finally, one hundred percent of the experimental group women reported that the SP-6 acupressure was helpful and provided a great mental support during labor. It is concluded that SP-6 acupressur is a safe, noninvasive, cost-effective method to help the laboring women to decrease pain perception, anxiety and improve labor progress.