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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: [email protected]
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
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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
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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
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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
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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-
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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
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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.
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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.