| Massage is an old practice that has been broadly used during childbirth, yet, relatively few and small study has been conducted exploring the effects of massage on pain during child birth and the knowledge and awareness of its use among prenatal mothers.Objective:(1)Perform a systematic review and meta-analysis of all randomized studies investigating the effectiveness of massage therapy on labour pain.(2) To conduct a descriptive cross-sectional study in order identify knowledge, willingness and attitude of prenatal women regarding the use massage in labour for pain reliefMethods/Design:(1) This is a systematic review and meta-analysis of randomized control trials. We searched EBSCO (Cumulative Index to Nursing and Allied Health, CINAHL), PubMed, Embase, Cochrane Library, Web of Science, Science Direct and Theses, and conference reports. Two reviewers independently selected eligible trials, conducted critical appraisal of the methodological quality by using the quality appraisal criteria for randomized controlled studies recommended by Cochrane Handbook. A standardized data form was used to extract information. Meta-analysis was performed and data were presented in evidence tables and in meta-analytic forest plots.(2) The descriptive study enrolled 1022 prenatal mother attending clinic at Nanjing Maternal and child Health hospital. The collected data were coded and entered in the computer then was analyzed using SPSS statistical computer software version 19. Descriptive statistical analysis, cross tabulation and logistic regression were the major procedures used in the analysis.Results:(1)The meta-analysis(pool of 137 participants) showed that in the first phase of labour, massage had a moderate, significant effect in reducing labour pain [SMD=-0.76,95% CI (-1.33,-0.18), p< 0.01], and in third phase massage had large effect SMD-0.82,95%CI [-1.17,-0.47], P<0.00001. Another pooled analysis (106 participants) had shown a large significant effect in first stage of labour with (SMD-0.91,95%CI [-1.31,-1.51], and p=0.00001. Another trial on anxiety we found that there was only significant difference in phase one with moderate effect SMD-0.76, 95%CI [-1.28,-0.23], p=0.005, thus anxiety was reduced. On satisfaction, one trial noted a sense of satisfaction from massage with p=0.019 and p=0.001 for partners support level and effectiveness of assistance respectively and another one noted the median of satisfaction score was higher in massage group with (p= 0.000).(2) In the descriptive study, prenatal mothers had no knowledge about the use of massage during labour because only 4.9% had knowledge about massage. Regarding the attitude of the mothers towards the use of massage during labour,74.4% were found to have positive attitude. Willingness to use massage for reducing in their future labour pain in this study 55.7% were ready to consider its use in future. The factors associated with willingness to use massage include previous use of massage, awareness about massage use during labour, knowledge and attitude.Conclusion:Generally massage may have a moderate to large beneficial effect on reducing intensity of labour pain and anxiety. It is cost effective, and safe.These findings suggest that massage could be an alternative or complementary approach for helping women to cope with labour pain and improve their sense of satisfaction. Also a significant number of prenatal mothers had limited knowledge regarding the use of massage during labour to relieve labor pain but significant number mothers had positive attitude towards the use of massage therapy. Though most of the respondent were willing to use massage during their future labour more information is required to the mothers so that they can have a well informed choice on the use of massage therapy to reduce labour pain. |
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