7/29/2019 3rd_INC

1/8

The Effectiveness Between Warm Compress And Effleurage Technique Against

Dysmenorrhoea

Nia Risa Dewi, SKp., MKep., SpMat 1, Nurna Ningsih, SKp., MKes 2, Riska Hediya

Putri SKep., Ns, 3

1,2 Lecturer. Departement of Maternity Nursing, Sriwijaya University, South Sumatera,

Indonesia

3 Clinical Nurse. Palembang, South Sumatera, Indonesia

Correspondence address: nia_risa@yahoo.co.id

ABSTRACT

Background

Dysmenorrhoea is a very painful menstruation, without any abnormality on pelvis. Several

theories suggest dysmenorrhoea can be overcome using the application of warm compress or

effleurage technique. The Objective of this research is to identify the effectiveness between

warm compress and effleurage technique in the reduction of dysmenorrhoea. Method Pre

experimental design was conducted to 15 female student of which received warm compress

and 15 female student of which received effleurage technique. Samples were recruited using

random sampling. Data were collected using questionnaire. A Paired Sample T-test and

Independent Sample T-test was used to examine the difference between the two groups.

Result findings There is no significant differences between warm compress and effleurage

technique in the reduction of dysmenorrhoea intensity (p = 0,310). Both intervention group

had significant to reduced dysmenorrhoea intensity (p = 0,00). Conclusion Warm compress

and effleurage technique can be equally used to reduced dysmenorrhoea intensity.

Keywords : Dysmenorrhoea, Pain Management, Pain Intensity

A. Background

Menstruation comonly may caused the emerge of pain or sickness in abdomen area. This

pain absolutelly disturb if it is not be cured. There are many ways to reduce the pain for

example : through pharmacologics; by using analgesic medicine or anti inflamation

7/29/2019 3rd_INC

2/8

nonsteroid medicine ( NSAID), or reducing the pain with the intervention or nursing care

without using pharmacologics medicine because nonpharmacologics treatment is safer

than consuming pharmacologics medicine. Pain management by using non

pharmacologics is safer because it is not arising the side effect and using physiological

process. For reducing the pain intensity, it is suggested to use non pharmacologics pain

management, such as : massage, ice therapy, warm compress, relaxation therapy and

hypnosis ( Bare and Smeltzer, 2002 )

Based on the experimental which is conducted, in Indonesia the rate of Dysmenorhea up

to 64.25% which consist of 54. 89% for primary dysmenorrhea and 9.36% secondary

dysmenorrhea ( Info sehat, 2008 ). Moreover, the research to 89 the students of Nurshing

Program of Sriwijaya University, it is found that 64% of the students get dysmenorrhea

and 36% not get dysmenorrhea. Most of the students do not try anything to reduce the

intensity of the pain and only little part of them who finding solution to reduce the pain of

dysmenorrhea by using cajuput oil, warm compress and analgesic medicine.

Unfortunatelly, the effectiveness of both treatments are not evaluated yet, and it is

necesarry to examine and compare which one is more effective to reduce or to prevent

dysmenorrhea.

B. Objective

The objective of this research is to identify the effectiveness between warm compress and

effleurage technique in reducing dysmenorrhea.

C. Hypothesis

There are differences between warm compress and effleurage technique through the

intensity of menstruation pain ( Dysmenorrhea ).

D. Method

7/29/2019 3rd_INC

3/8

Pre experimental design was conducted to 15 female students of which received warm

compress and 15 female students of which received effleurage technique. Samples were

recruited using random sampling with inclution criteria getting primary Dysmenorrhoea,

the average rate of less than 20 years old, and based on the criteria of those female

students do not smoking or having diet, event getting depressed.

Data were collected by using quetionaire through two group of samplings. Meanwhile, to

measure the intensity of dysmenorrhea pain is using Mankoski classification. The first

group is exemined by taking warm compress which lies under the stomach for ten

minutes at the first day of getting menstruation. Then, the second group is examine with

efflurage by giving soft touch to the stomache used circle movement ( one direction) and

giving soft pressure for ten minutes at the first day of getting menstruation.

A Paired Sample T- test and Independentsample T- test was used to examined the

difference between two groups.

E. The Analysis

1. The intensity of Menstruation Pain before and after Giving Warm Compress

The sampling which is taken from 15 respondens, before treating by warm compress, it is

gained that the highest intensity of the pain is 7 and the lowest intensity of the pain is 3

and the rate of SD is 1.20. After giving treatment with warm compress, there is 5 for the

highest intensity of the pain and the lowest intensity of the pain is 1, while the rate of

intensity of the pain is 3.13 and the rate of SD is 1.30. The whole respondens having

decreassion after giving treatment with warm compress for ten minutes. The decreassion

of the higest intensity of the pain is 4 and the decreassion of the lowest intensity of the

pain is 1. And the rate for the decreassion of the intensity of the pain is 2.06 with the rate

of SD is 0.961

7/29/2019 3rd_INC

4/8

The painfull of menstruation of the subjects is caused by the overload prostaglandin

secretion in endometrial area when the subjects get their menstruation. The increassion of

prostagladin number may caused over contraction of uterus, the decreassion of blood

stream to uterus, vasospasme arteriolar, and ischemics of uterus muscle.

The previous research which is conducted by Akin et all ( 2001) which compared the

effectiveness of giving warm compress intensivelly and the effectiveness of ibuprofen in

reducing of primary dysmenorrhea, it is shown that warm compress therapy is reducing

the intensity of the pain if it is comparing with the member group of control who do not

get the treatment.

According to Bobak ( 2005 ), warm compress is functioned for reducing or preventing the

pain of which the heat from the compress is able to reduce the ischemics because it is

declining the contraction of uterus and defusing blood vessel, so, it may reduce the

suspense and the pain, increase blood steam, and reduce vasocongesti pelvics. The

therapy of heat i s used to cure the pain and it is influenced in four difference levels;may

use local warming to reduce the stimulus or nociceptor perifer respons around it. Local

warming influenced in changing blood vessel to be vasodilatation; reducing a dismissal

from bradikinin, prostaglandin, and another alogogenics substance ( Thomas, 2006 ).

2. The Intensity of the Pain before and after Effleurage Technique

Before giving treatment by using Effleurage technique, it is found that the highest

intensity of the pain is 7 and the lowest intensity of the pain is 2 with the rate of mean the

pain intensity is 4.8 and the total SD 1. 56. After receiving Effleurage technique, the

highest intensity of the pain is 6 and the lowest intensity of the pain is 1, with the rate of

the pain intensity is 3. 06 and the total SD 1. 48. The sampling from 14 respondens

having decreation of the pain intensity and only one responden who is not responsif after

receiving Effleurage technique for ten minutes. The decreation of the highest intensity of

the pain is 3 levels and the lowest decreation of the pain intensity is 0 level or we may say

7/29/2019 3rd_INC

5/8

that it is not decreased. The rate of mean decreassion of the pain intensity is 1. 73 with the

total SD is 0.798.

The result of this research is supported Ekowatis research, Ekowati et all ( 2010 ), it is

stated that massage effleurage technique to abdomen has an effect for the decreassion of

the intensity of the pain for dysmenorrhea. The decreassion of menstruation pain is

occured after giving massage effleurage technique. It stimulates the tactile fiber of the

skin, so, the signal of the pain can be blocked (Bobak, 2005). According to Meek (1993),

soft touch and massage are the integration of sensory technique which is influenced the

activity of otonomous nerve system. If we perceive a touch as stimulus for relaxing, so, it

will arise the respons of relaxation ( Perry and Potter 2005)

3. The Analysis of Influence of Warm Compress in the Reduction of

Dysmenorrhea

Table 1

The Influence of Warm Compress in the reduction of dysmenorrhea

Paired Differences

95% Confidence Intervalof the Difference

Mean Std. Std. Error Lower Upper t Df Sig. (2-

7/29/2019 3rd_INC

6/8

Deviation Mean tailed)

2.06667 .96115 .24817 1.53440 2.59893 8.328 14 .000

b. The Analysis of Influence ofEffleurage technique in the reduction of Dysmenorrhea

Tabel 2

The Influence ofEffleurage technique in the Reduction of Dysmenorrhea

Paired Differences

95% Confidence Intervalof the Difference

Mean Std.Deviation

Std. ErrorMean

Lower Upper t Df Sig. (2-tailed)

1.73333 .79881 .20625 1.29097 2.17570 8.404 14 .000

4. The analysis of Effectiveness between Warm Compress and Effleurage

Technique in the Reduction of Dysmenorrhea

Tabel 3

Perbedaaan Perubahan Tingkat Intensitas Nyeri Menstruasi Antara Kelompok

Kompres Hangat dan Kelompok TeknikEffleurage

t-test for Equality of Means

95% Confidence Intervalof the Difference

Mean Difference Std. ErrorDifference

Lower Upper t Df Sig. (2-tailed)

.33333 .32269 -.32766 .99433 1.033 28 .310

From the table 3, it is shown that the two treatments; warm compress and effleurage

technique may reduce the pain intensity in menstruation ( dysmenorrhea ). But if we see the

differences of the changing of the intensity the pain, there is no significant differences, p

value = 0. 310. It can be concluded that there is no differences effectiveness between the use

of warm compress and effleurage technique in the reduction dysmenorrhea.

According to Perry and Potter ( 2005 ), warm compress and effleurage technique is

nonpharmacologics therapy; cutaneus stimulus, in which skin stimulus is used for reducing

7/29/2019 3rd_INC

7/8

the pain. The method of cutaneus stimulus is not really clear. One of theory stated that this

way will stimulate a dismissal of endorfin which is blocking the transmission of pain

stimulation. Gate Control Theory stated that cutaneus stimulus activated the fiber of

sensory nerve A Beta and make it bigger and faster. This proccess is reducing the

transmission of the pain through the fiber C and Delta- A with small diameter. It will caused

the gate sinaps closing the transmission of pain stimulus.

F. Conclussion

1. The intensity of the pain of the responden before receiving warm compress, for the

highest intensity of the pain is 7, and the lowest intensity of the pain is 3, with the rate

of mean is 5.2 and total SD is 1. 20

2. The intensity of the pain of the responden after receiving warm compress with the

highest intensity of the pain is 5, and the lowest intensity of the pain is 1, with the

mean rate is 3. 13 and total SD is 1.30.

3. The intensity of the pain of the respondens before effleurage technique with the

highest intensity of the pain 7 and the lowest intensity of the pain 2,and the rate mean

is 3. 06 and SD 1. 48.

4. The intensity of the pain of responden after receiving effleurage with the highest

intensity of the pain is 3. 06 and total SD 1. 48.

5. From 15 respondens who receive warm compress, it is getting the decreassion of the

mean rate 2.06 and 15 respondens who receive effleurage technique get decreassion

for 1.73. It is shown that warm compress and effleurage technique is effective in the

reduction of the pain intensity of menstruation. The result of the data to the

effectiveness between warm compress and effleurage technique through the intensity

of dysmenorrhea using independent sample T- test with = 0, 05 is gained the P value

= 0.310, it means that the hyipothesis is not valid or in another word there is no

significant differences between warm compress and effleurage technique againts

dysmenorrhea.

DAFTAR PUSTAKA

Akin, M.D.,et al. (2001). Continuous topical heat was as effective as ibuprofen for

dysmenorrhoea.Evid Based Nurs. 4:113 doi:10.1136.

7/29/2019 3rd_INC

8/8

Arikunto, S. (2006).Prosedur Penelitian; Suatu Pendekatan Praktik. Jakarta; PT. Rineka

Cipta.

Badziah, A. 2003.Endrokrinologi dan Ginekologi. Edisi 2. Jakarta: Media Aesculapius.

Bobak,et al., (2005). Buku Ajar Keperawatan Maternitas. Edisi 4 . Jakarta : EGC.Dawood, M.Y. (2006). Primary Dysmenorehea. Obstet Gynecol. 108: 42841.

Ekowati, R.,et al. (2010).Efek Teknik Masase Effleurage Pada Abdomen Terhadap

Penurunan

Intensitas Nyeri Pada Dismenore Primer Mahasiswi PSIK FKUB Malang.

French, L. (2005). Dysmenorrhea.American Family Physician. 71 (2): 285-91.

Kennedy, S. (1997). Primary dysmenorrhoea.Lancet. 349: 1116-1118.

Kozier, et al.(2009).Buku ajar praktik keperawatan klinis. Jakarta: EGC. Diunduh 20 Maret

2011.

Nugrahwaty, E.S., (2010).Perbedaan Antara Teknik Effleurage dan Kompres Hangat dalam

Menurunkan Skala Nyeri Menstruasi (Dismenore) Pada Siswa Perempuan di SMA

Negeri 1 Gresik.

Potter, P.A., and Perry, A.G. (2005). Buku Ajar Fundamental Keperawatan : Konsep, Proses,

Dan Praktik.Edisi 4.Volume 1.Alih Bahasa : Yasmin Asih, dkk. Jakarta : EGC.

Smeltzer, C.S., and Bare. G.B. (2001).Keperawatan medikal bedah . Ed 8. Jakarta: EGC.

Thomas, S. (2006).Modulation of Pain through Thermotherapy: An Appraisal of Current

Theories. Departmental Honors Thesis The University of Tennessee at Chattanooga.

Wiknjosastro, H., (2007).Ilmu Kandungan. Jakarta : Yayasan Bina Pustaka Sarwono

Prawirahardjo.