Tecnologias não invasivas de cuidado utilizadas por enfermeiras obstétricas: contribuições terapêuticas / Tecnologías de atención no invasiva utilizadas por las enfermeras obstétricas: contribuciones terapêuticas / Non-invasive care technologies used by obstetric nurses: therapeutics contributions

Resumo Objetivo descrever as contribuições terapêuticas da utilização de tecnologias não invasivas de cuidado, oferecidas por enfermeiras obstétricas, durante o trabalho de parto. Método estudo qualitativo e descritivo, com oito enfermeiras obstétricas da casa de parto do Rio de Janeiro. Os dados foram coletados de setembro a dezembro de 2018, através de entrevistas semiestruturadas, e submetidos à técnica de análise temática. Resultados para aliviar a dor e promover relaxamento, recorrem ao estímulo à participação do acompanhante e à respiração consciente, à aplicação da massagem, à promoção do ambiente acolhedor e ao uso da água morna e dos óleos essenciais. Para ativar o trabalho de parto, auxiliar na descida da apresentação e correção do posicionamento fetal, incentivam posicionamentos verticalizados e movimentos corporais, com alguns instrumentos. Conclusões e implicações para a prática tecnologias não invasivas de cuidado possuem contribuições terapêuticas e conformam um cuidado desmedicalizado, respeitoso e centrado na mulher, que promove a autonomia feminina.

Resumen Objetivo describir las contribuciones terapéuticas de la utilización de tecnologías de atención no invasivas que ofrecen las enfermeras obstétricas durante el trabajo de parto. Método estudio cualitativo y descriptivo, con ocho enfermeras obstétricas de una casa de partos de Río de Janeiro. Los datos fueron recolectados de septiembre a diciembre de 2018, a través de entrevistas semiestructuradas, y sometidos a la técnica de análisis temático. Resultados para aliviar el dolor y favorecer la relajación, se recurre a fomentar la participación del acompañante y la respiración consciente, la aplicación de masajes, la promoción de un ambiente acogedor y el uso de agua tibia y aceites esenciales. Para activar el trabajo de parto, facilitan en el descenso de la presentación y corrección del posicionamiento fetal, fomentan las posiciones verticales y los movimientos corporales, con algunos instrumentos. Conclusiones e implicaciones para la práctica las tecnologías de atención no invasiva tienen aportes terapéuticos y conforman un cuidado desmedicalizado, respetuoso y centrado en la mujer que promueve la autonomía femenina.

Abstract Objective to describe the therapeutics contributions of the use of non-invasive care technologies offered by obstetric nurses during labor. Method a qualitative and descriptive study, with eight obstetric nurses from a birthing center in Rio de Janeiro. Data were collected from September to December 2018, through semi-structured interviews, and subjected to thematic analysis technique. Results to relieve pain and promote relaxation, they resort to encouraging the companion's participation and conscious breathing, the application of massage, the promotion of a supportive environment and the use of warm water and essential oils. To activate labor, assist in descending the presentation and correction of fetal positioning, they encourage vertical positioning and body movements, with some instruments. Conclusions and implications for practice non-invasive care technologies have therapeutic contributions and form a not medicalized, respectful and women-centered care that promotes female autonomy.

Randomised controlled trial of a comprehensive protocol for preventing constipation following total hip arthroplasty.

AIMS AND OBJECTIVES: To evaluate the efficacy and safety of a comprehensive protocol for constipation prevention. BACKGROUND: Constipation is a common problem for patients undergoing total hip arthroplasty (THA), yet sparse evidence is available to guide constipation prevention after THA. DESIGN: Randomised controlled superiority clinical trial. METHODS: This randomised controlled study was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). A total of 80 THA patients were randomised to receive only preoperative education about lifestyle or the combination of education with postoperative abdominal massage and polyethylene glycol 4,000 (Forlax®). Efficacy outcomes included rates of postoperative constipation and enema rescue, as well as time to first postoperative defecation and readmission within 30 days. Safety outcomes were number and type of adverse events. RESULTS: Patients who received combination treatment showed a significantly lower rate of postoperative constipation during hospitalisation than patients who received only preoperative education (25% versus 55%), and they showed a significantly lower rate of enema rescue (12.5% versus 40%). Many more patients receiving combination treatment experienced their first defecation within two postoperative days than patients who received only preoperative education (62.5% versus 35.9%). In contrast, the two groups were similar in terms of constipation rate on postoperative days 15 and 30, rate of readmission within 30 days and rate of postoperative adverse events. CONCLUSIONS: These results suggest that our comprehensive protocol can relieve constipation after THA, reduce the need for enema rescue and shorten time to first defecation without sacrificing safety. More work is needed to optimise and develop this protocol further. RELEVANCE TO CLINICAL PRACTICE: Constipation is a distressing problem that frequently occurs after THA. This study confirmed that a comprehensive protocol including preoperative education, postoperative abdominal massage and polyethylene glycol 4,000 can effectively relieve constipation after THA without sacrificing safety.

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review.

PURPOSE: To identify nonpharmacological clinically effective interventions for constipation in adults. METHODS: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. RESULTS: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. CONCLUSIONS: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. CLINICAL RELEVANCE: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

Dor no recém-nascido: perspectivas da equipe multiprofissional na unidade de terapia intensiva neonatal / Pain in the newborn: perspectives of the multi-professional team in the neonatal intensive care unit

Objetivou-se analisar a dor no recém-nascido sob a perspectiva da equipe multiprofissional de uma Unidade de Terapia Intensiva Neonatal. Trata-se de um estudo descritivo e exploratório, com abordagem quantitativa, realizado com 27 profissionais. A coleta de dados deu-se durante o mês de junho de 2016 por meio de um questionário estruturado fechado elaborado com base no questionário utilizado por Chermont et al. (2003). O instrumento abordou dados sociodemográficos, os critérios de identificação da dor, a conduta assistencial adotada, os sinais clínicos que motivaram a escolha da conduta, a análise da efetividade das intervenções e os procedimentos assistenciais capazes de ocasionar a dor. Os dados foram submetidos à análise estatística descritiva e distribuição de frequências por meio do programa Statistical Package for Social Science (SPSS) versão 21.0. A equipe multiprofissional concordou que o recém-nascido sente dor (100%). O choro e a expressão facial foram as manifestações comportamentais mais observadas (88,9%). Os parâmetros fisiológicos utilizados para detectar a presença de dor identificaram a frequência cardíaca (81,5%), frequência respiratória (74,1%) e êmese, pressão arterial e hipertermia (11,1%). O enrolamento de conforto foi a conduta de intervenção não farmacológica mais citada (66,7%). Conclui-se que, a equipe multiprofissional identifica a dor no recém-nascido, contudo, suas assistências não se fundamentam em boas práticas por meio da aplicação de escalas e protocolos.

This study aims to analyze pain in the newborn from the perspective of the multi-professional team in a Neonatal Intensive Care Unit. This is a descriptive and exploratory study, using a quantitative approach, performed with 27 professionals. Data were collected during the month of June 2016 through a closed structured questionnaire based on the questionnaire used by Chermont et al. (2003). The instrument covered sociodemographic data, pain identification criteria, adopted care behavior, clinical signs that led to the choice of conduct, analysis of effectiveness of the interventions, and assistance procedures that could cause pain. Data were submitted to descriptive statistical analysis and frequency distribution using the Statistical Package for Social Science (SPSS) version 21.0. The multi-professional team agreed that newborns feel pain (100%). Crying and facial expression were the most frequent behavioral manifestations (88.9%). The physiological parameters used to detect the presence of pain identified were heart rate (81.5%), respiratory rate (74.1%) and emesis, blood pressure and hyperthermia (11.1%). Comfort pacing was the most frequently mentioned nonpharmacological intervention (66.7%). It can be concluded that the multi-professional team identifies pain in the newborn; however, their care practices are not based on good practices through the application of scales and protocols.

The effects of enteral feeding improvement massage on premature infants: A randomised controlled trial.

AIMS AND OBJECTIVES: To prove the effects of an enteral feeding improvement massage for premature infants with regard to their feeding, growing and superior mesentery artery blood flow aspect by a randomised controlled trial. BACKGROUND: Premature infants have feeding-related problems related to eating and absorbing nutrition due to their immature gastrointestinal function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare. DESIGN: The study group was composed of 55 patients. Of the 55 patients, 26 were randomised into an experimental group and 29 were randomised into a control group. METHODS: They were all born <34 weeks of gestational age between 1 July 2011 and 30 March 2012. Premature infants in the experimental group received enteral feeding improvement massage twice a day for 14 days, and infants in the control group received a sham exercise. The collected data were analysed by spss 19.0, through t test, chi-square test (Fisher's exact) and ANCOVA. RESULTS: (i) The experimental group had reached the day of full enteral feeding significantly faster. (ii) The experimental group had a higher superior mesentery artery peak velocity (Vmax ) and lower RI (resistant index). (iii) The experimental group of the feeding-intolerant subgroup had a higher superior mesentery artery Vmax and Vmin . (iv) The experimental group had a heavier weight and larger head circumference after 14 days. CONCLUSIONS: This study demonstrates that enteral feeding improvement massage can be helpful for achieving earlier full enteral feeding, more increased superior mesentery artery, and faster growing. In particular, it can be a therapeutic, independent and evidence-based nursing intervention for feeding-intolerant premature infants. RELEVANCE TO CLINICAL PRACTICE: Neonatal nurses in neonatal intensive care unit can apply enteral feeding improvement massage massage for feeding-intolerant infants.

Construção e validação de um vídeo educativo sobre a reflexologia podal / Construction and validation of an educational video on foot reflexology

Este estudo teve como objetivo construir e validar um vídeo educativo sobre a reflexologia podal. Estudo metodológico, desenvolvido em uma Instituição de Ensino Superior do sudeste brasileiro, em que foram percorridas as fases de pré-produção, produção e pós-produção do vídeo, seguidas da avaliação da compreensão e da abrangência do conteúdo abordado. A versão final do vídeo educativo apresenta duração de 12 minutos e sete segundos. Os peritos o avaliaram como um recurso educativo que apresenta a temática de forma clara e objetiva. Os alunos consideraram o material educativo adequado e apontaram boa aceitação do mesmo. As etapas adotadas permitiram construir e validar o vídeo proposto, um material educativo claro, objetivo e adequado. Espera-se, em estudo posterior, avaliar o impacto do vídeo educativo na construção do conhecimento da reflexologia podal.

The aim of this study was to construct and validate an educational video about foot reflexology. A methodological study was conducted at a higher education institution in southeastern Brazil, where the video pre-production, production and post-production stages were performed, followed by an evaluation of content understanding and comprehensiveness. The duration of the final version of the educational video is 12'7" (12 minutes and 7 seconds). The experts considered it an educational resource that presents the theme in a clear and objective way. The students considered it a proper educational material and showed good acceptance. The stages adopted for video construction and validation produced a clear, objective and proper educational material. Further studies should evaluate the impact of an educational video on the construction of foot reflexology knowledge.

Aplicación de la digitopuntura en pacientes con cefalea migrañosa. Policlínico Contreras, Matanzas, 2014 / Digitopuncture application in patients with migrainous cephalalgia. Contreras Policlinic, Matanzas, 2014

Introducción: la cefalea es toda sensación dolorosa que tiene lugar en la parte superior de la cabeza, desde el reborde orbitario hasta la nuca. Constituye la primera causa de acudir al neurólogo y uno de los motivos más frecuentes en consultas de Medicina Interna. La cefalea tipo tensión es frecuente en la práctica diaria y la más invalidante desde los puntos de vistas físico, social, económico y psicológico. Objetivo: mostrar la actuación de Enfermería en el alivio de la migraña y describir la efectividad de la digitopuntura en pacientes con cefalea migrañosa, del Policlínico Contreras, primer trimestre de 2014. Materiales y métodos: estudio observacional, descriptivo y transversal. El grupo de estudio, 120 pacientes que acudieron a la consulta de Medicina Natural y Tradicional. Resultados: la edad de mayor incidencia 25-34 años, con 47.4 %. Prevaleció el sexo femenino, en un 70 %; la duración del dolor mostró un 43.3 % de afectación. Transcurrió entre las 4 y 8 horas, y siempre tuvo relación con el estrés, en 44.2 %; en un 69.2 % existió relación del dolor con la ingestión de alimentos. Se alivió con el sueño el 61.7 %, y el 52,5 % alcanzaron estado evolutivo excelente. Conclusiones: la aplicación de la digitopuntura a pacientes con cefalea migrañosa contribuyó a que los casos estudiados evolucionaran satisfactoriamente, expresando alivio del dolor. El tratamiento demostró efectividad y contribuyó a la disminución de drogas utilizadas en esta entidad, disminución de gastos económicos que implica el consumo de las mismas; lograr reincorporar a la vida laboral y social en un menor tiempo al paciente (AU).

Introduction: cephalalgia is any painful sensation occurring in the superior part of the head, from the orbital ridge to the nape. It is the first cause of visiting a neurologist and one of the most frequent causes of Internal Medicine consultations. The tension-kind cephalalgia is frequent in daily practice and the most invaliding one from the physical, social, economic and psychological point of view. Aim: to show Nursery behavior in migraine alleviation and to describe the digitopuncture effectiveness in patients with migrainous cephalalgia from Contreras Policlinic in the first trimester of 2014. Materials and methods: observational, descriptive, cross-sectional study. The studied group was 120 patients assisting the consultation of Natural and Traditional Medicine. Outcomes: the 25-34 age group was the one that showed higher incidence, with 47.4 %. The female sex prevailed with 70 %; pain lasting had 44.3 % of affectation. It lasted between 4 and 8 hours, always related to stress in 44.2 %. There it was a relation between pain and food intake in 69.2 %. 61.7 % of the cases were lessened with sleep, and 52.5 % achieved an excellent evolving status. Conclusions: Acupuncture application to patients with migrainous cephalalgia contributed to the satisfactory evolution of the studied cases: The patients expressed pain relieve. The treatment showed effectiveness and facilitated the decrease of drug usage in this entity, also diminishing the economic expenses its use implies; the patients reincorporated to social and working life in a shorter time period (AU).

Bebés saludables con estímulos y afecto / Healthy babies with stimuli and affection

El masaje infantil es un arte milenario que además de fortalecer el vínculo entre el bebé y los padres, aporta múltiples beneficios para su desarrollo fisiológico, psicológico y emocional. El masaje al ser algo natural y no precisar de un talento especial hace que sea una opción muy sencilla para lograr el bienestar del recién nacido. La enfermera y la matrona como profesionales sanitarios son capaces con una adecuada formación de enseñar esta técnica a los padres que deseen practicarla. Se realizó un estudio dentro de un enfoque cuantitativo, no experimental de tipo exploratorio, transeccional. La población participante en el estudio, estuvo conformada por enfermeros/as que laboran en las consultas de pediatría de Atención Primaria de Ávila. La variable descriptiva está conformada por los conocimientos, experiencias y opiniones de los enfermeros/as de pediatría en Atención Primaria. Según las profesionales, las mayores ventajas es el fortalecimiento de vínculos entre el bebé y quien le facilita el masaje. De las entrevistadas, 26 opinaron que el masaje facilita la relajación; 10 concluyeron que el mayor aporte es en cuanto al manejo del estrés y 14 afirman que contribuye a aliviar el estreñimiento. Dentro de las conclusiones a las que se llegaron, decir que, el Masaje Infantil es una práctica cada vez más valorada en nuestra sociedad, y por lo tanto, una práctica que las madres demandan, además, a través del masaje el bebe conecta con la persona que lo realiza y así se comunica. Esto tiene su importancia porque los profundos vínculos emocionales creados en la infancia son una base perfecta para toda una vida de confianza, seguridad y amor.

The infant massage is an ancient art that, in addition to strengthening the bond between the baby and the parents, brings multiple benefits for their physiological, psychological and emotional development. The massage being natural and not needing a special talent makes it a very simple option to achieve the well-being of the newborn. The nurse and midwife as health professionals are capable with an adequate training to teach this technique to parents who wish to practice it A study was conducted within a quantitative, non-experimental, exploratory, transectional approach. The population participating in the study was made up of nurses who work in the pediatric consultations of Primary Care in Ávila. The descriptive variable is formed by the knowledge, experiences and opinions of the nurses of pediatrics in Primary Care. According to professionals, the greatest advantages is the strengthening of bonds between the baby and the one who facilitates the massage. Of the interviewees, 26 thought that massage facilitates relaxation; 10 concluded that the greatest contribution is in terms of stress management and 14 say that it contributes to relieve constipation. Within the conclusions reached, say that, Infant Massage is a practice increasingly valued in our society, and therefore, a practice that mothers demand, in addition, through massage the baby connects with the Person who performs it and thus communicates. This is important because the deep emotional bonds created in childhood are a perfect foundation for a lifetime of trust, security and love.

[Effects of a Facial Muscle Exercise Program including Facial Massage for Patients with Facial Palsy].

PURPOSE: The purpose of this study was to examine the effects of a facial muscle exercise program including facial massage on the facial muscle function, subjective symptoms related to paralysis and depression in patients with facial palsy. METHODS: This study was a quasi-experimental research with a non-equivalent control group non-synchronized design. Participants were 70 patients with facial palsy (experimental group 35, control group 35). For the experimental group, the facial muscular exercise program including facial massage was performed 20 minutes a day, 3 times a week for two weeks. Data were analyzed using descriptive statistics, χ²-test, Fisher's exact test and independent sample t-test with the SPSS 18.0 program. RESULTS: Facial muscular function of the experimental group improved significantly compared to the control group. There was no significant difference in symptoms related to paralysis between the experimental group and control group. The level of depression in the experimental group was significantly lower than the control group. CONCLUSION: Results suggest that a facial muscle exercise program including facial massage is an effective nursing intervention to improve facial muscle function and decrease depression in patients with facial palsy.

Comfort over Pain in Pregnancy.

Pregnancy is often a time when chronic pain is exacerbated, or when acute pain appears. Frequently the easiest intervention within reach, for both chronic and acute pain, is a prescription. However, medication cannot correct the cause of the pain; instead it alters the person's experiential perception of the pain. In addition, medication exposes both mother and fetus to risks. To provide simple, evidence-based, holistic/alternative remedies for women who experienced nonemergent pain during pregnancy. Holistic/alternative techniques for increasing comfort were taught to the participants and individualized during three sessions. Levels of pain and comfort were measured before and after the treatment, using the validated General Comfort Questionnaire and Pain Outcomes Profile. Pain scores decreased from an average of 5.8/10 to 3.5/10 (p = .00). Comfort scores increased from an average of 17.5 to 30 (p = .00).

Many Benefits, Little Risk: The Use of Massage in Nursing Practice.

Since ancient times, massage therapy has been used to promote healing by people of all backgrounds and cultures. Massage therapy was once taught as a core nursing skill, but it gradually lost ground in the United States during the second half of the 20th century with the increased use of technology and documentation in nursing. In recent years, however, there has been a resurgence in the use of massage therapy. Research has provided insight into the mechanisms by which massage supports the healing process, and this has sparked support for including massage therapy in routine hospital care. In this article, the authors touch on the history of massage in nursing care and discuss its emotional and physiologic benefits for both patient and nurse. They describe specific massage techniques and discuss precautions to consider before using massage with certain patients.

Foot massage: effectiveness on postoperative pain in breast surgery patients.

The aim of this study was to determine the effect of foot massage on pain after breast surgery, and provide guidance for nurses in nonpharmacologic interventions for pain relief. This was a quasiexperimental study with a total of 70 patients who had undergone breast surgery (35 in the experimental group and 35 in the control group). Patients in the control group received only analgesic treatment, whereas those in the experimental group received foot massage in addition to analgesic treatment. Patients received the first dose of analgesics during surgery. As soon as patients came from the operating room, they were evaluated for pain severity. Patients whose pain severity scored ≥4 according to the Short-Form McGill Pain Questionnaire were accepted into the study. In the experimental group, pain and vital signs (arterial blood pressure, pulse, and respiration) were evaluated before foot massage at the time patients complained about pain (time 0) and then 5, 30, 60, 90, and 120 minutes after foot massage. In the control group, pain and vital signs were also evaluated when the patients complained about pain (time 0) and again at 5, 30, 60, 90, and 120 minutes, in sync with the times when foot massage was completed in the experimental group. A patient information form was used to collect descriptive characteristics data of the patients, and the Short-Form McGill Pain Questionnaire was used to determine pain severity. Data were analyzed for frequencies, mean, standard deviation, chi-square, Student t, Pillai trace, and Bonferroni test. The results of the statistical analyses showed that patients in the experimental group experienced significantly less pain (p ≤ .001). Especially notable, patients in the experimental group showed a decrease in all vital signs 5 minutes after foot massage, but patients in the control group showed increases in vital signs except for heart rate at 5 minutes. The data obtained showed that foot massage in breast surgery patients was effective in postoperative pain management.

"Not just a theory": the relationship between Jin Shin Jyutsu® self-care training for nurses and stress, physical health, emotional health, and caring efficacy.

PURPOSE: The purpose of this study was to evaluate the effect of training nurses in Jin Shin Jyutsu® self-care methods and to correlate the training with measurement of the nurses' personal and organizational stress and their perceptions of their caring efficacy for patients. DESIGN: A quasi-experimental, pretest, posttest, and 30- to 40-day posttest design was used. METHOD: In all, 20 participants received three 2-hour Jin Shin Jyutsu self-care training sessions from a certified Jin Shin Jyutsu self-care trainer (who was also a registered nurse). The training took place over a 1-month period, and participants agreed to practice the self-care daily. Two study instruments, one measuring organizational and personal stress and the second measuring caring efficacy, were completed before the first training, after the last training, and 1 month after the trainings had been completed. FINDINGS: Analysis of data from the Personal and Organizational Quality Assessment-Revised by paired t tests showed significant increases in positive outlook, gratitude, motivation, calmness, and communication effectiveness and significant decreases in anger, resentfulness, depression, stress symptoms, time pressure, and morale issues. Nurses reported less muscle aches, sleeplessness, and headaches. Analysis of the Coates Caring Efficacy Scale measures showed statistically significant increases in nurses' caring efficacy in areas of serenity in giving care, tuning in to patients, relating to patients, providing culturally congruent care, individualization of patient care, ability to decrease stressful situations, planning for multiple needs, and creativity in care. CONCLUSIONS: This small study suggests that Jin Shin Jyutsu self-care may be a valuable tool for nurses, to decrease stress, both emotional and physical, and increase caring efficacy. Administrators may wish to invest in such a program, which may improve quality of care delivered. The Watson caring model, which reminds us that nurses who care for themselves and feel good about their work can better care for others, proved an accurate framework for this study.

Effect of foot and hand massage in post-cesarean section pain control: a randomized control trial.

One of the problems for mothers in the post-cesarean section period is pain, which disturbs the early relationship between mothers and newborns; timely pain management prevents the side effects of pain, facilitates the recovery of patient, reduces the costs of treatment by minimizing or eliminating the mother's distress, and increases mother-infant interactions. The aim of this study was to determine the effect of hand and foot massage on post-cesarean section pain. This study is a randomized and controlled trial which was performed in Mustafa Khomeini Hospital, Elam, Iran, April 1 to July 30, 2011; it was carried out on 80 pregnant women who had an elective cesarean section and met inclusion criteria for study. The visual analog scale was used to determine the pain intensity before, immediately, and 90 minutes after conducting 5 minutes of foot and hand massage. Vital signs were measured and recorded. The pain intensity was found to be reduced after intervention compared with the intensity before the intervention (p < .001). Also, there was a significant difference between groups in terms of the pain intensity and requests for analgesic (p < .001). According to these findings, the foot and hand massage can be considered as a complementary method to reduce the pain of cesarean section effectively and to decrease the amount of medications and their side effects.

The effectiveness of massage in therapy for obturator nerve dysfunction as complication of hip joint alloplasty-case report.

UNLABELLED: The purpose of our case presentation was to reveal effectiveness of medical massage in the therapy for obturator nerve dysfunction as a complication of hip joint alloplasty. DESIGN: Medical massage was carried out in a 58-year-old man after hip joint alloplasty. The aim was to normalize tension of muscle-ligament-fascia apparatus within pelvic girdle and reconstruct correct structural conditions in the course of obturator nerve. METHODS: The methodology included correct positioning and medical massage with individually designed procedures. FINDINGS: Full normalization of muscular tone and subsidence of pain complaints were obtained. CONCLUSIONS: Massage has a positive influence on subsidence of pain complaints; however, effectiveness of the procedure depends on an appropriate methodology. CLINICAL RELEVANCE: The presented massage procedure is an effective therapy in obturator nerve dysfunction as complication after alloplasty and it can be one of elements of complex improvement after surgical joint procedures within the scope of nursing rehabilitation.