| ABSTRACT
Introduction: International institutions have emphasised the
role of midwives in ensuring women health, which guarantees
family health and its physical, psychological, social, and
spiritual aspects. The integration of midwifery knowledge with
psychology is a good opportunity for the patients and healthcare
providers. Distraction technique is a psychological approach,
which has interested the field of medicine.
Aim: To review the effectiveness of Distraction techniques in
Obstetrics and Gynaecology.
Materials and Methods: This systematic review study was
conducted on articles indexed in Cochrane Library, Web of
Sciences, PubMed, Scopus, Google Scholar, CINHAL and
Persian databases including SID, Magiran, and Barakat
Knowledge Network System in October 2018 without time
restriction. Search was conducted according to MeSH-based
keywords, including distraction or distraction technique
Distraction OR Distraction techniques and use + or AND with
keywords Midwife, Birth Attendants, Traditional Midwives,
Traditional Birth Attendant, Genital Diseases, Female,
Gynaecologic Surgical Procedures, Reproductive Medicine,
Obstetrics, Pregnancy Complications, Obstetric Surgical
Procedures, Gynaecology and Gynaecological diseases. To
ensure, inclusion of relevant articles the search process was
conducted once again by using keywords of dysmenorrhea,
vomiting, nausea, pregnancy, delivery and cesarean section. The
inclusion criteria, based on PICOS were: Clients of obstetricsgynaecology centres; receiving a distraction technique; clinical
trials with a parallel design; psychosomatic outcomes; fulltext articles in Persian and English. Evaluation of the quality
of articles was done using Cochrane Handbook for Systematic
Reviews of Interventions version 5.2.0.
Results: Five out of 595 articles were included in this systematic
review. Outcomes of these studies were intensity of pain, and
stress and anxiety in patients visiting obstetrics-gynaecology
centres. Results showed that the distraction techniques could
reduce the intensity of pain in patients under obstetricsgynaecology procedures, and also the stress of prepubescent
girls caused by genital examination. Moreover, the meta-analysis
results showed that the mean score of anxiety in pregnant women
and women at labour, who received distraction interventions,
was significantly lower than the control (mean difference: -7.0;
95% Confidence Interval: -13.7 to -0.4; p=0.04).
Conclusion: According to the results, distraction is a simple,
low-cost, and accessible technique for reducing pain, anxiety,
and stress in the field of obstetrics and gynaecology. Moreover,
given that there are scant studies into this field and their high
risk of bias, it is recommended to use distraction techniques in
different areas of clinical trials with higher quality. |