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Cesarean section births have rapidly increased both in our country and worldwide in recent years. According to OECD data, one in four births worldwide and one in two births in our country is a cesarean section. The cesarean section has become one of the most frequently performed surgical interventions. The incision from a cesarean section causes pain, mobilization issues, and delays in mother-infant interaction. The choice of pharmacological methods used after a cesarean section is often limited by concerns about the baby and breastfeeding, leading to inadequate pain management and causing women to experience moderate to high levels of pain. Pain negatively affects individuals' comfort, leading to sleep disturbances, fatigue, and a decreased quality of life. It makes daily activities and responsibilities as individuals more challenging to manage. There is a need for nurses, in their primary caregiver role, to adopt a multidisciplinary approach to pain management and to develop their skills in using non-pharmacological methods. These methods should be clinically applied and proven effective. Acupressure and massage are long-standing, cost-effective, easy-to-apply, and effective methods used to reduce pain. This study aims to reduce pain and fatigue and improve sleep quality in women who have undergone a cesarean section by applying acupressure and massage in the postoperative period, thereby preventing the chronicization of these problems.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acupressure | Experimental |
| |
| Massage | Experimental |
| |
| Control | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Acupressure to points HT7, LI4, SP6 and ST36 | Other | This point specialized for pain management, fatigue and sleep |
|
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Scale for Pain | Pain intensity was assessed using the Visual Analog Scale for Pain (VAS), a 10-cm horizontal line ranging from 0 to 10, where:
| Periprocedural (immediately after the intervention or standard care) |
| Measure | Description | Time Frame |
|---|---|---|
| Postpartum Sleep Quality Scale | Sleep quality was measured using the Postpartum Sleep Quality Scale, a 14-item questionnaire scored on a 5-point Likert scale (0 = Never to 4 = Always). Total scores range from 0 to 56, with higher scores indicating poorer sleep quality (worse outcome). The scale has no cut-off value. Assessments were performed before and after the intervention. | 15 minutes after completion of the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| PERSONAL INFORMATION FORM | Baseline demographic and obstetric characteristics were collected using a Personal Information Form administered once prior to the intervention. | Baseline (prior to intervention) |
| Intervention Satisfaction Form |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University | Istanbul | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| D007319 | Sleep Initiation and Maintenance Disorders |
| D005221 | Fatigue |
| D010146 | Pain |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| C047909 | arginyl-threonyl-prolyl-prolyl-prolyl-seryl-glycine |
| D008405 | Massage |
| ID | Term |
|---|---|
| D064746 | Therapy, Soft Tissue |
| D026201 | Musculoskeletal Manipulations |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
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Two intervention, one control group
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| Massage | Other | back massage |
|
| Postnatal Accumulated Fatigue Scale | Fatigue was assessed using the Postnatal Accumulated Fatigue Scale, a 13-item questionnaire comprising three subdomains (physical fatigue, emotional fatigue, and cognitive fatigue). Each item is scored as 0 = Almost none, 1 = Sometimes, and 3 = Mostly/Often. Total scores range from 0 to 39, with higher scores indicating greater fatigue (worse outcome). The scale has no cut-off value. Assessments were performed before and after the intervention. | 15 minutes after completion of the intervention |
Satisfaction with the intervention was assessed using the Intervention Satisfaction Form, a Visual Analog Scale-based measure ranging from 0 to 10, where:
Higher scores indicate greater satisfaction (better outcome).
| 15 minutes post-intervention |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D001523 | Mental Disorders |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |