PENGARUH STIMULASI KUTAN SLOW STROKE BACK MASSAGE TERHADAP PERUBAHAN KADAR ENDORPHIN DAN NYERI PERSALINAN PADA IBU INPARTU DI RSUD KOTA SEMARANG

Abstract

Latar Belakang : Nyeri persalinan merupakan salah satu penyebab terjadinya inersia uteri. Penanganan nyeri persalinan secara nonfarmakologi di RSUD Kota Semarang adalah dengan teknik pernafasan dan mengusap punggung, namun belum dilakukan stimulasi kutan slow stroke back massage (SSBM). Tujuan : Penelitian ini bertujuan untuk mengetahui adanya pengaruh SSBM terhadap kadar endorphin dan tingkat nyeri persalinan kala I. Metode : Metode dalam penelitian ini adalah quasi experiment dengan rancangan non equivalent control group. Sampel adalah ibu primigravida dalam masa inpartu kala I di RSUD Kota Semarang dengan consecutive sampling. Analisis bivariat menggunakan paired t-test dan multivariat menggunakan manova. Hasil : Ada perbedaan kadar endorphin sebelum dan setelah pemberian SSBM 5 menit (P = 0,031) dan 15 menit (P=0,024). Ada perbedaan nyeri sebelum dan sesudah pemberian SSBM 5 menit (P=0,002) dan 15 menit (P=0,002).Ada perbedaan antara kadar endorphin setelah diberikan SSBM 15 menit dan kontrol (P=0,028),ada perbedaan antara nyeri persalinan setelah diberikan SSBM 5 menit dan kontrol (P=0,007) serta SSBM 15 menit dan kontrol (P=0,004). Kesimpulan : SSBM menurunkan nyeri persalinan dengan meningkatkan produksi hormon endorphin dan mekanisme gate control. Lama waktu paling efektif dalam penelitian ini adalah 15 menit dengan peningkatan kadar endorphin 164,04 % dan penurunan nyeri sebesar 42,61 %. Saran : Perlunya pelaksanaan SSBM selama 15 menit untuk manajemen nyeri persalinan, perlunya pelayanan kesehatan untuk memberikan sosialisasi dan mengambil kebijakan untuk pelaksanaan SSBM sebagai manajemen nyeri. Kata Kunci : Stimulasi Kutan Slow Stroke Back Massage, SSBM, Kadar Endorphin, Nyeri Persalinan Background: One of the causes of uterine inertia is labour pain. Nonpharmacological techniques undertaken to reduce labour pain in RSUD Kota Semarang is breathing techniques and rubbed her back, but cutaneous stimulation of slow stroke back massage (SSBM) has not done. Goal : This research aims at examining the influence of SSBM on endorphin level and pain during labour process stage I Method : This research employs Quasi Experiment method with non equivalent control group designl. The subjects are primigravida during their level I of inpartu phase in RSUD Kota Semarang. It was chosen by consecutive sampling. Bivariat analysis uses paired t-test and multivariate uses manova. Result : There were differences of endorphin levels before and after given 5 minutes of SSBM (P = 0.031) and 15 minutes (P = 0.024). There were differences in pain before and after given 5 minutes of SSBM (P = 0.002) and 15 minutes (P = 0.002). There was a difference between the endorphins levels after given 15 minutes of SSBM and controls (P = 0.028), there was a difference between labor pain after given 5 min of SSBM and controls (P = 0.007) and than 15 minutes of SSBM and controls (P = 0.004). Conclusion : SSBM greatly reduces pain during labour process because it increases the production of endorphin hormones and gate control mecanism. The most effective duration according to this research is 15 minutes by the increase of endorphin level for 164,04 % and the reduction of pain during labour process for 42,61 % . Suggestion : Needed 15 minutes of SSBM implementation to reduce labor pain, health services should provide socialization and adopt policies for the implementation of the SSBM as pain management. Key Words : Cutaneous Simulation Slow Stroke Back Massage, SSBM, Endorphin Level, Pain in Labour Process