EFEKTIVITAS PIJAT EFFLEURAGE DAN COUNTERPRESSURE TERHADAP PENURUNAN NYERI PERSALINAN DAN KEMAJUAN DILATASI SERVIKS PADA KALA I FASE AKTIF DI BIDAN PRAKTIK MANDIRI SURABAYA

RETTY NIRMALA S, dr. Detty S. Nurdiati, MPH, Ph.D, Sp.OG (K).; Wiwin Lismidiati, S.Kep.Ns.,M.Kep.,Sp.Kep.Mat.

2017 | Tesis | S2 Keperawatan

Latar belakang: Nyeri persalinan merupakan keadaan fisiologis yang dialami ibu selama proses persalinan. Dampak nyeri persalinan adalah pembengkakan rahim dan distosia persalinan yang membahayakan kondisi ibu dan janin. Pijat effleurage dan counterpressure merupakan tindakan komplementer untuk menciptakan kenyamanan. Tujuan: untuk mengetahui efektivitas pijat effleurage dan counterpressure terhadap penurunan nyeri persalinan dan kemajuan dilatasi serviks pada kala I fase aktif di BPM surabaya. Metode: desain penelitian yang digunakan adalah quasi experiment dengan prepost test non equivalent control group. Populasi penelitian adalah ibu bersalin kala I fase aktif. Sampel penelitian 68 orang yang dibagi menjadi dua kelompok. Teknik sampling menggunakan consecutive sampling. Variabel independen yaitu pijat effleurage dan counterpressure, variabel dependen terdiri dari penurunan nyeri persalinan dan kemajuan dilatasi serviks. Instrumen yang digunakan penelitian ini untuk mengukur nyeri persalinan menggunakan Numeric Rating Scale (NRS) dan kemajuan dilatasi serviks menggunakan pemeriksaan dalam. Data dianalisa menggunakan Wilcoxon dan Mann Whitney. Hasil: nyeri persalinan sebelum dan sesudah intervensi kelompok pijat effleurage 9,26+-1,05 vs 6,88+-1,22 dengan nilai p 0,00 dan kelompok counterpressure 9,00+-0,98 vs 6,59+-1,28 nilai p 0,00. Kemajuan dilatasi serviks sebelum dan sesudah intervensi pijat effleurage 4,74+-0,83 vs 7,47+-1,21 nilai p 0,00 dan kelompok counterpressuure 4,59+-0,66 vs 8,03+-0,96 nilai p 0,00. Rata-rata penurunan nyeri persalinan pada kelompok effleurage dan kelompok counterpressure 2,38 vs 2,41 dengan nilai p 0,74. Rata-rata peningkatan dilatasi serviks pada kelompok effleurage dan counterpressure 2,73 vs 3,44; nilai p 0,00. Kesimpulan: tidak ada perbedaan yang signifikan antara effleurage dan counterpressure dalam penurunan nyeri persalinan. Counterpressure mempunyai efek lebih besar dalam kemajuan dilatasi dibandingkan pijat effleurage.

Introduction: Labor pain is an emotional experience and involves both physiological and psychological mechanisms during labor. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counterpressure massage are a complementary treatment to relieve pain. Aim: This study was to analyze effectiveness of effleurage and counter-pressure massages for reducing labor pain and improving cervical dilatation in stage 1 of active labor phase in BPM Surabaya. Method: The study used quasi experiment design with pre-post test non- equivalent control group. Research subjects were 68 mothers in stage 1 of active labor phase, which were divided evenly to two groups. Sampling collection technique used consecutive sampling. Independent variables were effleurage and counter-pressure, while dependent variables were decline of labor pain and cervical dilatation improvement. Instrument to assess labor pain was Numeric Rating Scale (NRS), while cervical dilatation was assessed by Vagina Toucher (VT). Data were analyzed using Wilcoxon and Mann Whitney. Result: Labor pain before and after intervention in effleurage group were 9.26+-1.05 and 6.88+-1.22, respectively (p=0.00). Meanwhile, the respective numbers in counter-pressure groups were 9.00+-0.98 and 6.59+-1.28 (p=0.00). Cervical dilatation before and after intervention in effleurage group were 4.74+-0.83 and 7.47+-1.21, respectively (p=0.00). Meanwhile, the respective numbers in counter-pressure groups were 4.59+-0.66 and 8.03+-0.96 (p=0.00). Average labor pain decline in effleurage and counter-pressure groups were 2.38 and 2.41, respectively (p=0.74). Average cervical dilatation improvement in effleurage and counter-pressure groups were 2.73 and 3.44, respectively (p=0.00). Conclusion: There was no significant difference between effleurage and counterpressure in reducing labor pain. However, counter-pressure had more significant effect in improving cervical dilatation than effleurage.

Kata Kunci : nyeri persalinan, dilatasi serviks, pijat effleurage, counterpressure, labor pain, cervical dilatation, effleurage, counter-pressure