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Thermal biofeedback and deep breathi...

Hagedorn, David W.

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Thermal biofeedback and deep breathing for labor pain.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Thermal biofeedback and deep breathing for labor pain./
Author:	Hagedorn, David W.
Description:	154 p.
Notes:	Adviser: Gregory Murrey.
Contained By:	Dissertation Abstracts International68-08B.
Subject:	Health Sciences, Obstetrics and Gynecology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3279467
ISBN:	9780549203919

Thermal biofeedback and deep breathing for labor pain.
Hagedorn, David W.

Thermal biofeedback and deep breathing for labor pain. - 154 p.

Adviser: Gregory Murrey.

Thesis (Ph.D.)--Fielding Graduate University, 2007.

Objectives. The treatment efficacy of complementary labor pain management has been questioned in light of sparse controlled research studies in this area. Biofeedback is one such intervention for reducing labor pain and improving labor outcome, but contradictory results due to methodological and practical issues have resulted in its lack of credibility among the established medical community. This paper first reviews the literature on biofeedback as it applies to the management of acute labor pain; and, second, evaluates the efficacy of autonomic self-regulation for labor pain using inexpensive and minimally intrusive finger temperature biofeedback (TBF) with deep diaphragmatic breathing. Toward this end, the benefits of home training was reviewed and assessed as well as TBF treatment efficacy. Methods. Uncomplicated primiparous and multiparous labor patients (n=35) participating in prenatal care were randomly assigned to home-practice and no-home-practice groups. Dependent variables are three verbal and visual rating scales for pain intensity (PPI, VAS, NRS) and 5-minute Apgar scores. An additional no-treatment comparison group consisted of women (n=28) delivered by the same obstetrical group without having been exposed to the TBF device or provided information or instruction regarding the application of TBF and diaphragmatic breathing. The no-treatment comparison group was assessed against the two randomly controlled groups using the available NRS pain measure and Apgar scores. Results. Five-minute Apgar scores were not correlated with the potential covariates. PPI and VAS were significantly correlated with the covariates of dilation at the time of hospital admission and the dilation at the time of epidural administration. The NRS pain measure was significantly associated with dilation at admission, dilation at the time of epidural administration, and dilation at the time of Pitocin interventions. Multiple regression analysis of how well home practice of diaphragmatic breathing with thermal feedback predicted mean PPI for 1 to 10 centimeters of cervical dilation indicated that the treatment did not significantly decrease pain as measured by the mean PPI. Similarly, the mean VAS and NRS pain measures did not significantly demonstrate a reduction of pain perception. Rather, the significant predictor of PPI and VAS was dilation at the time of epidural administration. Only the dilation at the time of epidural administration was a significant predictor of pain as measured by mean NRS. Compared to the NHP group, the HP group was admitted with significantly more advanced cervical dilation. Conclusions. Based on the results of this small sample, diaphragmatic breathing with thermal biofeedback does not demonstrate to be an adequate means of labor pain management among women that are exposed to pain associated with Pitocin augmentation and the correlated use of epidural analgesia. The home practice group did significantly present to the hospital later in the labor process suggesting the intervention may have had a positive effect that was less detectable given methodological and experimentally uncontrollable associated variables. Suggestions for further research to better isolate the covariates associated with labor pain are discussed.

ISBN: 9780549203919Subjects--Topical Terms:

1020690
Health Sciences, Obstetrics and Gynecology.

Thermal biofeedback and deep breathing for labor pain.
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100 1 $a Hagedorn, David W. $3 1265919
245 1 0 $a Thermal biofeedback and deep breathing for labor pain.
300 $a 154 p.
500 $a Adviser: Gregory Murrey.
500 $a Source: Dissertation Abstracts International, Volume: 68-08, Section: B, page: 5573.
502 $a Thesis (Ph.D.)--Fielding Graduate University, 2007.
520 $a Objectives. The treatment efficacy of complementary labor pain management has been questioned in light of sparse controlled research studies in this area. Biofeedback is one such intervention for reducing labor pain and improving labor outcome, but contradictory results due to methodological and practical issues have resulted in its lack of credibility among the established medical community. This paper first reviews the literature on biofeedback as it applies to the management of acute labor pain; and, second, evaluates the efficacy of autonomic self-regulation for labor pain using inexpensive and minimally intrusive finger temperature biofeedback (TBF) with deep diaphragmatic breathing. Toward this end, the benefits of home training was reviewed and assessed as well as TBF treatment efficacy. Methods. Uncomplicated primiparous and multiparous labor patients (n=35) participating in prenatal care were randomly assigned to home-practice and no-home-practice groups. Dependent variables are three verbal and visual rating scales for pain intensity (PPI, VAS, NRS) and 5-minute Apgar scores. An additional no-treatment comparison group consisted of women (n=28) delivered by the same obstetrical group without having been exposed to the TBF device or provided information or instruction regarding the application of TBF and diaphragmatic breathing. The no-treatment comparison group was assessed against the two randomly controlled groups using the available NRS pain measure and Apgar scores. Results. Five-minute Apgar scores were not correlated with the potential covariates. PPI and VAS were significantly correlated with the covariates of dilation at the time of hospital admission and the dilation at the time of epidural administration. The NRS pain measure was significantly associated with dilation at admission, dilation at the time of epidural administration, and dilation at the time of Pitocin interventions. Multiple regression analysis of how well home practice of diaphragmatic breathing with thermal feedback predicted mean PPI for 1 to 10 centimeters of cervical dilation indicated that the treatment did not significantly decrease pain as measured by the mean PPI. Similarly, the mean VAS and NRS pain measures did not significantly demonstrate a reduction of pain perception. Rather, the significant predictor of PPI and VAS was dilation at the time of epidural administration. Only the dilation at the time of epidural administration was a significant predictor of pain as measured by mean NRS. Compared to the NHP group, the HP group was admitted with significantly more advanced cervical dilation. Conclusions. Based on the results of this small sample, diaphragmatic breathing with thermal biofeedback does not demonstrate to be an adequate means of labor pain management among women that are exposed to pain associated with Pitocin augmentation and the correlated use of epidural analgesia. The home practice group did significantly present to the hospital later in the labor process suggesting the intervention may have had a positive effect that was less detectable given methodological and experimentally uncontrollable associated variables. Suggestions for further research to better isolate the covariates associated with labor pain are discussed.
590 $a School code: 1503.
650 4 $a Health Sciences, Obstetrics and Gynecology. $3 1020690
650 4 $a Psychology, Clinical. $3 524864
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773 0 $t Dissertation Abstracts International $g 68-08B.
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791 $a Ph.D.
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856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3279467