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      Evidências científicas sobre métodos não farmacológicos para alívio a dor do parto Translated title: Scientific evidence on non-pharmacological methods for relief of labor pain Translated title: Evidencias científicas sobre métodos no farmacológicos para aliviar el dolor de parto

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          Abstract

          Resumo Objetivo Identificar na literatura nacional e internacional, estudos sobre a eficácia de métodos não farmacológicos na redução da dor do parto. Métodos Revisão integrativa realizada nas bases de dados MEDLINE/PUBMED, SCOPUS, CINAHL, LILACS e BDENF, com recorte temporal entre os anos de 2013 a 2018, em português, inglês e espanhol. Utilizado a metodologia PICo para construir a pergunta de pesquisa e selecionar descritores controlados e não controlados, que foram combinados com os operadores booleanos “AND”, “OR” e “NOT”. Resultados Foram selecionados 19 artigos. Dentre os métodos não farmacológicos encontrados, destacam-se: a acupuntura e suas principais variações (acupressão e auriculoterapia) (29,17%), hidroterapia (25%), exercícios perineais com a bola suíça (16,67%), terapias térmicas (8,33%) e os demais métodos (20,83%). Conclusão A acupuntura e a acupressão agem tanto sobre aspectos fisiológicos da dor como sobre sua subjetividade. O banho quente de aspersão, a musicoterapia, a aromaterapia e as técnicas de respiração promovem o relaxamento e a diminuição dos níveis de ansiedade. As terapias térmicas contribuem para a analgesia local de regiões afetadas pela dor. Os exercícios na bola suíça são importantes para reduzir a dor e adotar a posição vertical, importante na progressão do trabalho de parto.

          Translated abstract

          Abstract Objective To identify studies on the efficacy of non-pharmacological methods in reducing labor pain in the national and international literature. Methods Integrative review in the MEDLINE/PUBMED, SCOPUS, CINAHL, LILACS, and BDENF databases, limiting to studies published between 2013 and 2018, in Portuguese, English, and Spanish. The PICo methodology was used to build the research question and select the controlled and uncontrolled descriptors, which were combined with the “AND”, “OR,” and “NOT” Boolean operators. Results A total of 19 articles were selected. The non-pharmacological methods found were: acupuncture and its core variations (acupressure and auriculotherapy) (29.17%), hydrotherapy (25%), perineal exercises with the Swiss ball (16.67%), thermal therapies (8.33%), and other methods (20.83%). Conclusion Acupuncture and acupressure worked on both physiological aspects of pain and the subjective nature of pain. The warm bath, music therapy, aromatherapy, and breathing techniques promoted relaxation and decreased the levels of anxiety. Thermal therapies contributed to local analgesia in regions affected by pain. Exercises with the Swiss ball were important for pain relief, and the vertical position was important for labor.

          Translated abstract

          Resumen Objetivo Identificar en la literatura nacional e internacional estudios sobre la eficacia de métodos no farmacológicos para reducir el dolor de parto. Métodos Revisión integradora realizada en las bases de datos MEDLINE/PUBMED, SCOPUS, CINAHL, LILACS y BDENF, con un recorte temporal entre los años 2013 y 2018, en portugués, inglés y español. Se utilizó la metodología PICO para elaborar la pregunta de investigación y seleccionar descriptores controlados y no controlados, que fueron combinados con los operadores booleanos “AND”, “OR” y “NOT”. Resultado Se seleccionaron 19 artículos. Entre los métodos no farmacológicos encontrados, se destacan: la acupuntura y sus principales variantes (acupresión y auriculoterapia) (29,17%), hidroterapia (25%), ejercicios perineales con pelota suiza (16,67%), terapias térmicas (8,33%) y demás métodos (20,83%). Conclusión La acupuntura y la acupresión actúan tanto sobre aspectos fisiológicos del dolor, como sobre su subjetividad. La ducha caliente, la musicoterapia, la aromaterapia y las técnicas de respiración promueven la relajación y la reducción de los niveles de ansiedad. Las terapias térmicas contribuyen como analgésico local en regiones afectadas por el dolor. Los ejercicios con pelota suiza son importantes para reducir el dolor y adoptar la posición vertical, importante en la progresión del trabajo de parto.

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          Most cited references28

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          Participatory action research (PAR) with children and youth: An integrative review of methodology and PAR outcomes for participants, organizations, and communities

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            Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan.

            To examine the effectiveness of a birth ball exercise programme during childbirth by measuring childbirth self-efficacy and childbirth pain. In addition, it tested the mediating effects of childbirth self-efficacy on the relationship between the birth ball exercise programme and childbirth pain. Randomised controlled trial. The study was conducted from December 2008 to November 2009, at two birth units, one at a regional hospital and one at a medical centre, with 600 and 1022 annual births, respectively. One hundred and eighty-eight expectant mothers were recruited (recruitment rate: 47%) and were allocated by block randomisation into the two arms of the study, but only 48 intervention and 39 control group participants completing the trial. The birth ball exercise programme consisted of a 26-page booklet and a 19-minute videotape, with periodic follow-ups during prenatal checks. All members of the experimental group were asked to practise the exercises and positions at home for at least 20 minutes three times a week for a period of 6-8 weeks. Each woman in the experimental group was given a birth ball for use during labour and encouraged every hour to choose the most comfortable positions, movements, and exercises. Both the experimental and control groups received standard nursing and midwifery care from hospital staff nurses in all aspects of pregnancy and childbirth. When cervical dilations were four centimetres and eight centimetres, the women completed demographic and obstetrics information, the Childbirth Self-efficacy Inventory (CBSEI), and the short form of the McGill Pain Questionnaire (SF-MPQ). Our study revealed that birth ball exercises provided statistically significant improvements in childbirth self-efficacy and pain. Specifically, self-efficacy had a 30-40% mediating effect on relationships between birth ball exercises and childbirth pain. Mothers in the experimental group had shorter first-stage labour duration, less epidural analgesia, and fewer caesarean deliveries than the control group. Clinical implementation of the birth ball exercise programme could be an effective adjunctive tool to improve childbirth self-efficacy and reduce pain among women in labour. On the basis of our mediating model, the results further suggest that confidence is greater after prenatal preparation powerfully related to decreased pain perception and decreased medication/analgesia use during labour. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Modelos de assistência ao parto e taxa de cesárea em diferentes países

              Revisão bibliográfica que descreve as taxas de cesárea em diferentes países e os modelos de atenção ao parto de acordo com o uso de tecnologias assistenciais. Foram analisados 60 estudos publicados entre 1999 e 2010, obtidos nas bases de dados da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e ProQuest. O modelo de assistência obstétrica praticado no país baseia-se na relação médico-paciente, ao grau de utilização de tecnologias e à realização do parto cesáreo.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ape
                Acta Paulista de Enfermagem
                Acta paul. enferm.
                Escola Paulista de Enfermagem, Universidade Federal de São Paulo (São Paulo, SP, Brazil )
                0103-2100
                1982-0194
                June 2019
                : 32
                : 3
                : 350-357
                Affiliations
                [1] Teresina PI orgnameUniversidade Federal do Piau Brasil
                [2] Saskatoon Saskatchewan orgnameUniversity of Saskatchewan Canada
                Article
                S0103-21002019000300350
                10.1590/1982-0194201900048
                700594c3-c574-4501-8ffa-d22096b804e0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 January 2019
                : 14 March 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 8
                Product

                SciELO Brazil

                Categories
                Revisão Integrativa

                Terapias complementarias,Enfermería obstétrica,Dor do parto,Trabalho de parto,Gestantes,Terapias complementares,Enfermagem obstétrica,Labor pain,Labor, obstetric,Pregnant women,Complementary therapies,Obstetric nursing,Dolor de parto,Trabajo de parto,Mujeres embarazadas

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