تأثیر موسیقی بر درد فاز فعال مرحله اول زایمان زنان نخست زا

Background: Patients recovering from craniotomy in the Intensive Care Unit (ICU) are at risk of hemodynamic changes related to stress responses, neurological impairment, pain, and environmental stimuli. A combination of music therapy and hand massage may help maintain hemodynamic stability in these patients. Objective: To describe the application of combined music therapy and hand massage to support hemodynamic stability in post-craniotomy patients in the ICU. Methods: This evidence-based nursing intervention was implemented with three post-craniotomy patients admitted to the ICU of Abdul Wahab Sjahranie Regional General Hospital, Samarinda. The intervention consisted of 15 minutes of instrumental or classical music followed by 15 minutes of effleurage hand massage. Systolic and diastolic blood pressure, mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO₂) were measured before and after each intervention. The intervention was conducted over three days, with each patient’s clinical changes monitored. Results: The case study findings indicated greater stability in blood pressure, MAP, HR, RR, and SpO₂ following the intervention. Conclusion: Combined music therapy and hand massage may be a safe, non-pharmacological intervention to support nursing care and maintain hemodynamic stability in post-craniotomy patients. Further research is needed to assess its effects on other outcomes, including biochemical changes.

ABSTRACT Low Back Pain (LBP) is a disease caused by non-ergonomic working conditions during manual handling activities. LBP is a leading cause of activity limitations, disability, inability and absenteeism from work. The aim of this study was to analyze ergonomic risk factors for LBP complaints and their relationship to the two in charcoal briquette manufacturing industry workers at PT. Arkelindo Bara Sejahtera. This study was quantitative with a cross-sectional approach. The study was conducted from June to November 2025. The population and sample were 183 and 151 workers, respectively. Research data was obtained from questionnaires, interviews, diagnoses, and direct on-site observations. Data analysis was conducted using univariate, bivariate, and multivariate methods. The results showed that as many as 64.2% of participants experienced complaints of severe LBP. It was also found that awkward postures, static work positions, repetitive movements and excessive force use were at risk of 62.9%, 70.2%, 73.5% and 57.6%, respectively. There is a relationship between awkward postures (p = 0.023, OR = 2.843), static work positions (p =0.004, OR = 3.875), repetitive movements (p = 0.000, OR = 6.013) and excessive force use (p = 0.003, OR = 4.178) and NBP complaints. The dominant ergonomic risk factor for LBP complaints is repetitive movements with an OR value of 6.013. This study indicates that repeated exposure to sitting or standing for more than half the working day, combined with awkward postures such as bending and twisting, were the dominant contributing factors to LBP. It is hoped that companies can implement ergonomic work positions to ensure worker comfort. Keywords: Charcoal Briquette Industry, Ergonomic Risks, Back Pain, Occupational Health. ABSTRAK Nyeri punggung bawah (NPB) merupakan penyakit akibat kondisi kerja yang tidak ergonomis selama aktivitas manual handling. NPB merupakan salah satu penyebab utama keterbatasan aktivitas, kecacatan, ketidakmampuan dan ketidakhadiran dalam bekerja. Tujuan penelitian ini adalah untuk menganalisis faktor risiko ergonomi terhadap keluhan NPB dan hubungan keduanya pada pekerja industri pembuatan briket arang di PT. Arkelindo Bara Sejahtera.Jenis penelitian ini adalah kuantitatif dengan pendekatan cross-sectional. Penelitian dilaksanakan bulan Juni hingga November 2025. Populasi dan sampel berturut-turut adalah 183 dan 151 pekerja. Data penelitian diperoleh dari kuesioner, wawancara, diagnosa dan pengamatan langsung. Analisis data dilakukan secara univariat, bivariat dan multivariat. Hasil menunjukkan bahwa sebanyak 64,2% responden mengalami keluhan NPB berat. Itu ditemukan juga bahwa postur tubuh janggal, posisi kerja statis, gerakan berulang, dan penggunaan tenaga berlebihan masing-masing berisiko sebesar 62,9%, 70,2%, 73,5%, dan 57,6%. Terdapat hubungan antara postur tubuh yang tidak nyaman (p = 0,023, OR = 2,843), posisi kerja statis (p = 0,004, OR = 3,875), gerakan berulang (p = 0,000, OR = 6,013), dan penggunaan tenaga berlebihan (p = 0,003, OR = 4,178) dengan keluhan NPB. Faktor risiko ergonomi dominan terhadap keluhan NPB adalah pergerakan berulang dengan nilai OR 6,013. Penelitian ini menunjukkan bahwa paparan berulang terhadap posisi duduk atau berdiri selama lebih dari setengah hari kerja, dikombinasikan dengan postur tubuh janggal seperti membungkuk dan memutar badan, merupakan faktor utama penyebab NPB. Itu diharapkan bahwa perusahaan dapat menerapkan posisi kerja ergonomis agar pekerja nyaman saat bekerja. Kata Kunci: Industri Briket Arang, Risiko Ergonomi, Nyeri Punggung, Kesehatan Kerja.

Introduction The Tibetan Buddhist tradition distinguishes between two broad categories of meditation: Sutra and Tantra, which differ in the methods and mental faculties they employ. The main neurophysiological studies of Tibetan Buddhist meditation have been conducted mostly on Sutra practices; while Tantric meditation remains less studied. Methods This publication presents a dual comparative study, using both between-groups and within-subjects design, of the neurophysiological (EEG) correlates characterizing Sutra and Tantra meditative practices, examining both the meditative states and the meditative traits. The study was carried out within the natural environment of Tibetan Buddhist monasteries in India, maintaining the socio-cultural context. Two groups of long-term practitioners (Buddhist monks of Gelug lineage), one experienced in the Tantra tradition (T-group, n = 21) and the other in the Sutra tradition (S-group, n = 20) participated in the study. Results A between-group cluster permutation test revealed that the groups differed in EEG alpha power during meditation, as well as in baseline resting conditions before and after meditation. Specifically, T-group demonstrated consistently lower alpha power compared to the S-group, regardless of the conditions. Thus, the observed differences are stable characteristics of the groups. The within-subjects analysis demonstrated that the conditions (meditation, and baseline resting states before and after meditation) differed only in the T-group: during meditation, an increase in individual alpha peak frequency (iAPF) was observed in the occipital leads, followed by a decrease in iAPF after meditation. Discussion We suggest that reported between-group differences represent enduring meditative traits developed through years of training in meditative techniques in the Sutra and Tantra traditions. Nevertheless, we cannot entirely exclude the possibility that these variations may also stem from certain cohort-specific characteristics unrelated to meditation. An examination of individual power spectra revealed that the absence of significant differences in EEG spectral power between conditions can be primarily attributed to the inter-individual variability in both groups. This variability, in turn, may stem from extensive expertise of highly experienced practitioners, who over years of training, develop individualized cognitive strategies for maintaining the meditative state. Our future research will focus on a more detailed quantitative analysis of inter-individual variability during meditations and on identifying additional between-group differences among practitioners in different traditions.

BackgroundSleep disruption is common during postoperative hospitalisation and may be influenced by pain, overnight clinical care, and environmental factors.This quality improvement project assessed sleep quality among postoperative paediatric inpatients and identified potentially modifiable contributors to sleep disturbance. MethodologyA clinical audit was conducted on a paediatric inpatient ward between April and June 2026.Children aged 0-18 years admitted following elective or emergency orthopaedic surgery and requiring at least one overnight postoperative stay were eligible.Parents or carers completed a questionnaire after the child's first postoperative night assessing sleep quality, nighttime awakenings, causes of sleep disturbance, ward noise and lighting, clustering of overnight care, assessment of sleep needs, and parent/carer sleep.Responses were analysed descriptively using frequencies and percentages. ResultsIn total, 19 questionnaires were included: 14 from children accommodated in multi-bed bays and five from children in individual cubicles.In bays, eight of 14 (57.1%)children were reported to have fair sleep and six (42.9%) woke more than five times overnight.In cubicles, two of five (40.0%) children were reported to have good sleep and one (20.0%)woke more than five times.Nursing observations were reported as a contributor to sleep disturbance in 10 of 14 (71.4%)children in bays and four of five (80.0%) in cubicles.Pain contributed to sleep disturbance in 10 of 19 (52.6%) children overall.Most respondents reported that the ward was quiet overnight and that lights were kept low.However, only seven of 19 (36.8%) families reported being asked about their child's sleep needs.Parent/carer sleep was also frequently disrupted. ConclusionsPostoperative sleep disruption was common, with nursing observations and pain among the most frequently reported contributors.Despite generally favourable perceptions of overnight noise and lighting, opportunities for improvement were identified in assessment of individual sleep needs, coordination of overnight care where clinically appropriate, and optimisation of pain management.A subsequent audit cycle following implementation of these measures will assess their impact on sleep-related outcomes.

زمینه و هدف: اختلال خواب در دوران بستری پس از عمل جراحی شایع است و ممکن است تحت تأثیر درد، مراقبت‌های بالینی شبانه و عوامل محیطی قرار گیرد. این پروژه بهبود کیفیت، کیفیت خواب بیماران بستری کودکان پس از عمل جراحی را ارزیابی کرده و عوامل قابل اصلاح مؤثر بر اختلال خواب را شناسایی نمود. روش: یک ممیزی بالینی در بخش بستری کودکان بین آوریل تا ژوئن ۲۰۲۶ انجام شد. کودکان ۰ تا ۱۸ سال که پس از جراحی ارتوپدی انتخابی یا اورژانسی بستری شده و حداقل یک شب پس از عمل در بیمارستان مانده بودند، واجد شرایط بودند. والدین یا مراقبان پس از اولین شب پس از عمل کودک، پرسشنامه‌ای را در خصوص کیفیت خواب، بیدار شدن‌های شبانه، علل اختلال خواب، سر و صدای بخش و نورپردازی، تجمع مراقبت‌های شبانه، ارزیابی نیازهای خواب و خواب والدین/مراقبان تکمیل کردند. پاسخ‌ها به صورت توصیفی با استفاده از فراوانی و درصدها تحلیل شد. نتایج: در مجموع ۱۹ پرسشنامه وارد مطالعه شد: ۱۴ مورد مربوط به کودکانی که در بخش‌های چندتخته بستری بودند و پنج مورد مربوط به کودکانی که در اتاق‌های انفرادی قرار داشتند. در بخش‌های چندتخته، خواب هشت نفر از ۱۴ کودک (۵۷/۱٪) متوسط گزارش شد و شش نفر (۴۲/۹٪) بیش از پنج بار در طول شب بیدار شدند. در اتاق‌های انفرادی، خواب دو نفر از پنج کودک (۴۰/۰٪) خوب گزارش شد و یک نفر (۲۰/۰٪) بیش از پنج بار بیدار شد. مشاهدات پرستاری به عنوان یکی از عوامل اختلال خواب در ۱۰ نفر از ۱۴ کودک (۷۱/۴٪) در بخش‌های چندتخته و چهار نفر از پنج کودک (۸۰/۰٪) در اتاق‌های انفرادی گزارش شد. درد در مجموع در ۱۰ نفر از ۱۹ کودک (۵۲/۶٪) به عنوان عامل اختلال خواب نقش داشت. اکثر پاسخ‌دهندگان گزارش کردند که بخش در طول شب آرام بوده و نور کم نگه داشته شده است. با این حال، تنها هفت خانواده از ۱۹ خانواده (۳۶/۸٪) گزارش کردند که در مورد نیازهای خواب کودکشان از آن‌ها سؤال شده است. خواب والدین/مراقبان نیز اغلب مختل شده بود. نتیجه‌گیری: اختلال خواب پس از عمل شایع بود و مشاهدات پرستاری و درد از جمله عوامل گزارش‌شده مهم بودند. علی‌رغم برداشت کلی مثبت از سر و صدای شبانه و نورپردازی، فرصت‌هایی برای بهبود در ارزیابی نیازهای فردی خواب، هماهنگی مراقبت‌های شبانه در صورت امکان بالینی و بهینه‌سازی مدیریت درد شناسایی شد. یک چرخه ممیزی بعدی پس از اجرای این اقدامات، تأثیر آن‌ها را بر پیامدهای مرتبط با خواب ارزیابی خواهد کرد.

INTRODUCTION: Outpatient hysteroscopy is an essential gynaecological procedure used to evaluate and treat any intrauterine pathologies. However, the most common reason for procedure failure is pain. This study aimed to evaluate the efficacy of virtual reality (VR) and music for pain management during outpatient hysteroscopy. METHODS: This was a non-blinded randomised controlled trial conducted at a single tertiary hospital in Hong Kong. Eligible patients were randomised at a 1:1:1 ratio into three groups: VR, music, and control. Patients' pain scores were assessed using the Numerical Pain Rating Scale from 0 to 10 at various timepoints during hysteroscopy. The primary outcome was the maximum pain score during hysteroscopy. Secondary outcomes included pain scores at specific timepoints during hysteroscopy, other symptoms, patient satisfaction scores, and acceptance of undergoing future hysteroscopy in the same setting if needed. RESULTS: A total of 210 patients were analysed in the study. Overall, 65.7% of patients underwent diagnostic hysteroscopy, and 34.3% underwent additional procedures. The mean maximum pain scores did not significantly differ among the three groups (P=0.131). However, acceptance of future hysteroscopy was significantly higher in both the music group (mean ± standard deviation: 8.8 ± 2.1; P=0.002) and the VR group (8.6 ± 1.6; P=0.009) than in the control group (7.5 ± 2.7; overall P=0.001). CONCLUSION: The use of VR and music during outpatient hysteroscopy did not result in a statistically significant reduction in pain. However, patient acceptance of future hysteroscopy was significantly improved in both intervention groups.

مقدمه: هیستروسکوپی سرپایی یک روش ضروری در زنان‌ و زایمان است که برای ارزیابی و درمان آسیب‌شناسی‌های داخل‌رحمی به کار می‌رود. با این حال، شایع‌ترین علت شکست این روش، درد است. هدف این مطالعه، ارزیابی اثربخشی واقعیت مجازی (VR) و موسیقی در مدیریت درد حین هیستروسکوپی سرپایی بود. روش‌ها: این پژوهش یک کارآزمایی بالینی تصادفی‌سازی‌شده و غیرکور بود که در یک بیمارستان تخصصی در هنگ‌کنگ انجام شد. بیماران واجد شرایط به نسبت ۱:۱:۱ به سه گروه واقعیت مجازی، موسیقی و کنترل تقسیم شدند. نمرات درد بیماران با استفاده از مقیاس عددی ارزیابی درد از ۰ تا ۱۰ در زمان‌های مختلف حین هیستروسکوپی سنجیده شد. پیامد اصلی، بیشینه نمره درد در طول هیستروسکوپی بود. پیامدهای ثانویه شامل نمرات درد در زمان‌های خاص حین هیستروسکوپی، سایر علائم، نمرات رضایت بیماران و پذیرش انجام هیستروسکوپی مجدد در آینده در همان شرایط در صورت نیاز بود. نتایج: در مجموع ۲۱۰ بیمار در مطالعه مورد تحلیل قرار گرفتند. به طور کلی، ۶۵.۷٪ بیماران هیستروسکوپی تشخیصی و ۳۴.۳٪ بیماران اقدامات اضافی دریافت کردند. میانگین بیشینه نمرات درد بین سه گروه تفاوت معناداری نداشت (P=0.131). با این حال، پذیرش هیستروسکوپی آینده در گروه موسیقی (میانگین ± انحراف معیار: ۸.۸ ± ۲.۱؛ P=0.002) و گروه واقعیت مجازی (۸.۶ ± ۱.۶؛ P=0.009) به طور معناداری بیشتر از گروه کنترل (۷.۵ ± ۲.۷؛ P کلی=۰.۰۰۱) بود. نتیجه‌گیری: استفاده از واقعیت مجازی و موسیقی در طول هیستروسکوپی سرپایی منجر به کاهش معنادار آماری در درد نشد. با این حال، پذیرش بیماران برای انجام هیستروسکوپی آینده در هر دو گروه مداخله به طور معناداری بهبود یافت.