KATA PENGANTAR

Assalamu’alaikum Warrahmatullahi Wabarakatuh. Segala puji bagi Allah

SWT. yang telah memberikan nikmat serta hidayah-Nya terutama nikmat
kesehatan dan kesempatan sehingga kami dapat menyelesaikan tugas makalah
mata kuliah “Asuhan Kebidanan” dengan tepat waktu. Shalawat beserta salam
kita sampaikan kepada nabi besar Muhammad SAW. yang telah memberikan
pedoman hidup yakni Al-Qur’an dan sunnah untuk keselamatan umat di dunia.

Makalah ini merupakan tugas pertama mata kuliah Asuhan Kebidanan di

program studi D3 Kebidanan. Selanjutnya kami mengucapkan terima kasih
yang sebesar-besarnya kepada dosen pembimbing mata kuliah Asuhan
Kebidanan Ibu Lutfianan yang telah memberikan bimbingan serta arahan
selama proses perkuliahan mata kuliah ini. Akhirnya kami menyadari bahwa
banyak terdapat kekurangan-kekurangan dalam penulisan makalah ini, maka
dari itu kami mengharapkan kritik dan saran demi perbaikan-perbaikan
selanjutnya. Akhir kata semoga makalah ini dapat memberikan manfaat bagi
kita sekalian.

Yogyakarta, 24 Februari 2021

Penyusun

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DAFTAR ISI

JUDUL ..............................................................................................................i

KATA PENGANTAR .........................................................................................ii

DAFTAR ISI.......................................................................................................iii

BAB I Pembahasan

A. Penahuluan .......................................................................................1
B. Rumusan Masalah ............................................................................2
C. Tujuan Penulisan ..............................................................................3

BAB II Pembahasan

BAB III Penutup

Kesimpulan`...................................................................................................... 13

DAFTAR PUSTAKA ..........................................................................................iv

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 BAB 1

PENDAHULUAN

A. Latar Belakang Masalah

Kehamilan adalah suatu keadaan dimana janin dikandung di dalam tubuh
wanita, yang sebelumnya diawali dengan pembuahan dan kemudian akan diakhiri
dengan proses persalinan. Dalam kehamilan akan terjadi perubahan fisik dan
psikologis pada ibu hamil (Cunningham, 2006).
Kehamilan merupakan proses alami yang dialami oleh wanita dan menjadi
suatu peristiwa yang penting dalam kehidupannya. Setiap wanita membayangkan
kehamilan dalam pikiran-pikirannya sendiri tentang seperti apa ibu hamil karena
mereka belum pernah mengalaminya. Pemikiran seperti ini mempengaruhi
bagaimana ia berespon terhadap kehamilan. Beberapa wanita berpikir kehamilan
sebagai penyakit, kejelekan, atau memalukan karena bentuk tubuh tidak menarik lagi
seperti sebelum hamil, bahkan mereka beranggapan bahwa kehamilan dapat
mengganggu hubungan seksual mereka dengan suami (Prawiroharjo, 2011)
Perubahan psikologis pada trimester I (pada periode penyesuaian). Ibu
merasa tidak sehat dan kadang merasa benci dengan kehamilannya. Kadang muncul
penolakan, kekecewaan, kecemasan, dan kesedihan. Pada trimester ini hasrat untuk
melakukan hubungan seksual berbeda-beda pada tiap wanita, tetapi kebanyakan
akan mengalami penurunan. Pada trimester ketiga rasa tidak nyaman timbul
kembali. Takut akan rasa sakit dan bahaya fisik yang timbul pada saat melahirkan,
khawatir akan keselamatannya dan bayinya. Libido cenderung menurun kembali dan
menambah kecemasan saat berhubungan karena ketidaknyamanan atas diri si ibu
hamil (Sulistyawati, 2009).
Perubahan fisik yang dialami ibu hamil trimester pertama ada prmbrsaran
payudara, sering buang air kecil, konstipasi, morning sickness, mual dan muntah,
merasa lelah atau ffatingue, sakit kepala, kram perut, prningkatan berat badan.
Untuk menguranginya dapat dilakukan salah satunya adalah terapi Komplementer
(Kurnia, 2009)
Terapi Komplementer adalah terapi tradisional yang diberikan sebagai
pendampingan pengobatan modern. Komplementer adalah penggunaan terapi
tradisional kedalam pengobatan modern, salah satuny adalah relaksasi. (Andrew et
al, 1999)

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 Relaksasi adalah suatu teknik yang dapat membuat pikiran dan tubuh menjadi
rileks melalui sebuah proses yang secara progresif akan melepaskan ketegangan otot
di setiap tubuh (Potter & Perry, 2010). Teknik relaksasi berguna dalam berbagai
situasi, misalnya nyeri, cemas, kurangnya kebutuhan tidur, stres, serta emosi yang
ditunjukkan. Relaksasi memelihara reaksi tubuh terhadap respon fight or flight,
penurunan respirasi, nadi, dan jumlah metabolik, tekanan darah dan energi yang
digunakan (Potter & Perry, 2010). Tehnik relaksasi bermacam-macam ada nafas
dalam, Relaksasi Otot Progresif, Biofeedback dan Relaksasi Benson Relaksasi
Benson.
Relaksasi Benson dikembangkan oleh Benson di Harvard’s Thorndike
Memorial Laboratory dan Benson’s Hospital. Relaksasi Benson dapat dilakukan
sendiri, bersama-sama, atau bimbingan mentor. Relaksasi Benson merupakan teknik
relaksasi yang digabungkan dengan keyakinan yang dianut oleh pasien. Formula
kata-kata atau kalimat tertentu yang dibaca berulangulang dengan melibatkan unsur
keimanan dan keyakinan akan menimbulkan respon relaksasi yang lebih kuat
dibandingkan dengan hanya relaksasi tanpa melibatkan unsur keyakinan. Keyakinan
pasien tersebut memiliki makna menenangkan (Benson & Proctor, 2000).

B. Rumusan Masalah
Berdasarkan latar belakang di atas maka didapatkan rumusan masalah
sebagai berikut :
1. Apa yang dimasud dengan Terapi Komplementer ?
2. Apa saja macam-macam terapi komplementer ?
3. Apa yang dimaksud dengan relaksasi ?
4. Apa saja macam-macam tehnik relaksasi ?
5. Apa yang dimaksud dengan tennik relaksasi benson ?
6. Prosedur teknik relaksasi benson ?
7. Apa manfaat relaksasi benson ?
C. Tujuan Penulisan
Materi pada bab ini menjadi landasan untuk memahami terapi komplementer
yang berbentuk relaksasi benson yang dapat dipraktikan dalam kehidupan sehari-
hari dengan orang lain maupun kerabat dan sudara.
1. Untuk mengetahu yang dimasud dengan Terapi Komplementer
2. Untuk mengetahui macam-macam terapi komplementer

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3. Untuk mengetahui yang dimaksud dengan relaksasi
4. Untuk mengetahui macam-macam tehnik relaksasi
5. Untuk mengetahui yang dimaksud dengan tennik relaksasi benson
6. Bagaimana prosedur teknik relaksasi benson
7. Untuk mengetaui manfaat relaksasi benson

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 BAB II
PEMBAHASAN
A. Terapi komplementer
Kehamilan merupakan salah satu tahapan terpenting dalam kehidupan
seorang wanita. Kesejahteraan dan kenyamanan mental dan psikologis wanita selama
kehamilan dapat menjamin kesehatan mereka sendiri serta pertumbuhan dan
perkembangan janin yang sehat. Kenyamanan secara positif dipengaruhi oleh tidur
dan istirahat yang cukup . Sebaliknya, kelelahan dan gangguan tidur memiliki efek
negatif pada kenyamanan dan hasil kehamilan. Prevalensi kelelahan selama
kehamilan setinggi 65% sampai 72%. Kelelahan lebih parah selama trimester
pertama dan ketiga kehamilan. Kelelahan pada trimester pertama terutama
disebabkan oleh perubahan metabolik, adaptif, dan hormonal, terutama pelepasan
hormon dari pla centa. Di sisi lain, kelelahan pada trimester ketiga disebabkan oleh
nokturia, penambahan berat badan, masalah gastrointestinal, dan gangguan tidur,
akibat gerakan janin, kontraksi uterus, dan kram kaki.
Kelelahan kehamilan dikaitkan dengan berbeda hasil negatif yang, seperti
iritabilitas, penurunan kemampuan untuk melakukan aktivitas hidup sehari-hari,
kehilangan minat, penurunan li bido, tidur yang buruk, penurunan kualitas hidup,
dan ketidakseimbangan emosional dan psikologis pasca kelahiran . Selain itu, dapat
berdampak negatif pada pola kontraksi uterus selama persalinan.
Kelelahan dikelola melalui terapi farmakologis dan non farmakologis. Terapi
pengobatan non-farmakologisatau komplemen dan alternatif telah menarik banyak
perhatian dalam beberapa tahun terakhir. Terapi mental lengkap lebih aman dan
memiliki komplikasi yang lebih sedikit dibandingkan terapi farmakologis. Terapi
pelengkap yang paling umum adalah istirahat, latihan fisik, rehabilitasi, terapi
energi, dan relaksasi. Sebuah penelitian menunjukkan bahwa pelatihan relaksasi
dapat membantu mengurangi kelelahan pada wanita hamil
Salah satu teknik relaksasi yang paling terkenal dikembangkan dan diperkenalkan
oleh Benson pada tahun 1970. Karena kesederhanaannya, respons relaksasi Benson
(BRR)
Terapi komplementer adalah suatu terapi mental yang lengkap dan lebih
aman serta memiliki komplikasi yang lebih sedikit dibandingkan terapi farmakologis.
Farmakoterapi juga memiliki efek samping dan jarang bisa begitu berhasil sehingga
menyebabkan ibu menghilangkan gejala, oleh karena itu terapi komplementer dapat

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 menjadi solusi dalam terapi ketidaknyamanan dari ibu hamil. Terapi komplementer
yang paling umum adalah istirahat, latihan fisik, rehabilitasi, terapi energi, dan
relaksasi.
B. Macam – Macam Terapi Komplementer
a. Intervensi tubuh dan pikiran (mind and body interventions) meliputi :
Hipnoterapi, mediasi, penyembuhan spiritual, doa dan yoga
b. Sistem pelayanan pengobatan alternatifmeliputi: akupuntur, akupresur,
naturopati,homeopati, aromaterapi, ayurveda
c. Cara penyembuhan manual meliputi:chiropractice,healing touch,
tuina,shiatsu,osteopati, pijat urut
d. Pengobatan farmakologi dan biologi meliputi: jamu, herbal, gurah
e. Diet dan nutrisi untuk pencegahan dan pengobatan meliputi: diet makro
nutrient, mikro nutrient
f. Cara lain dalam diagnosa dan pengobatan meliputi: terapi ozon, hiperbarik.
C. Relaksasi
Relaksasi adalah suatu teknik yang dapat membuat pikiran dan tubuh menjadi
rileks melalui sebuah proses yang secara progresif akan melepaskan ketegangan otot
di setiap tubuh (Potter & Perry, 2010). Teknik relaksasi berguna dalam berbagai
situasi, misalnya nyeri, cemas, kurangnya kebutuhan tidur, stres, serta emosi yang
ditunjukkan. Relaksasi memelihara reaksi tubuh terhadap respon fight or flight,
penurunan respirasi, nadi, dan jumlah metabolik, tekanan darah dan energi yang
digunakan (Potter & Perry, 2010).
Adapun efek relaksasi menurut Potter & Perry (2010), relaksasi memiliki
beberapa manfaat, yaitu: menurunkan nadi, tekanan darah, dan pernapasan;
penurunan konsumsi oksigen; penurunan ketegangan otot; penurunan kecepatan
metabolisme, peningkatan kesadaran; kurang perhatian terhadap stimulus
lingkungan; tidak ada perubahan posisi yang volunteer; perasaan damai dan
sejahtera; periode kewaspadaan yang santai, terjaga, dan dala
D. Macam – Macam Teknik Relaksasi
1. Napas Dalam
Latihan pernapasan terdiri atas latihan dan praktik pernapasan yang dirancang
dan dijalankan untuk mencapai ventilasi yang lebih terkontrol (Smeltzer & Bare,
2009).
2. Relaksasi Otot Progresif

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 Relaksasi otot progresif merupakan teknik relaksasi yang terdiri atas penegangan
dan pelepasan otot tubuh secara berurutan dan individu yang melakukan teknik
ini dapat merasakan perbedaanya. Relaksasi progresif sangat baik dilakukan bila
pasien dalam posisi berbaring pada bantalan yang lunak atau lantai dan di ruang
yang tenang (Smeltzer & Bare, 2009).
3. Biofeedback
Biofeedback merupakan terapi perilaku yang dilakukan dengan memberikan
individu informasi tentang respon fisiologis. Terapi ini untuk menghasilkan
relaksasi dalam dan sangat efektif untuk mengatasi ketegangan otot dan nyeri
kepala. Teknik ini
4. Relaksasi Benson
5. Relaksasi Benson merupakan teknik relaksasi yang digabungkan dengan
keyakinan yang dianut oleh pasien.
E. Relaksasi Benson
Relaksasi Benson dikembangkan oleh Benson di Harvard’s Thorndike Memorial
Laboratory dan Benson’s Hospital. Relaksasi Benson dapat dilakukan sendiri,
bersama-sama, atau bimbingan mentor. Relaksasi Benson merupakan teknik
relaksasi yang digabungkan dengan keyakinan yang dianut oleh pasien. Formula
kata-kata atau kalimat tertentu yang dibaca berulangulang dengan melibatkan unsur
keimanan dan keyakinan akan menimbulkan respon relaksasi yang lebih kuat
dibandingkan dengan hanya relaksasi tanpa melibatkan unsur keyakinan. Keyakinan
pasien tersebut memiliki makna menenangkan (Benson & Proctor, 2000). Benson &
Proctor (2000) menjelaskan relaksasi benson terdiri dari empat komponen dasar
yaitu:
1. Suasana tenang
Suasana yang tenang membantu efektivitas pengulangan kata atau kelompok
kata dan dengan demikian mempermudah menghilangkan pikiran-pikiran yang
mengganggu.
2. Perangkat mental
Untuk memindahkan pikiran-pikiran yang berorientasi pada hal-hal yang logis
dan yang berada di luar diri diperlukan suatu rangsangan yang konstan yaitu satu
kata atau frase singkat yang diulang-ulang dalam hati sesuai dengan keyakinan.
Kata atau frase yang singkat merupakan fokus dalam melakukan relaksasi
benson. Fokus terhadap kata atau rase singkat akan meningkatkan kekuatan

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 dasar respon relaksasi dengan memberi kesempatan faktor keyakinan untuk
memberi pengaruh terhadap penurunan aktivitas saraf simpatik. Mata biasanya
terpejam apabila tengah mengulang kata atau frase singkat. Relaksasi benson
dilakukan 1 atau 2 kali sehari selama antara 10 menit. Waktu yang baik untuk
mempraktikkan relaksasi benson adalah sebelum makan atau beberapa jam
sesudah makan, karena selama melakukan relaksasi, darah akan dialirkan ke
kulit, otot-otot ekstremitas, otak, dan menjauhi daerah perut, sehingga efeknya
akan bersaing dengan proses makan (Benson & Proctor, 2000).
3. Sikap pasif
Apabila pikiran-pikiran yang mengacaukan muncul, pikiran tersebut harus
diabaikan dan perhatian diarahkan lagi ke pengulangan kata atau frase singkat
sesuai dengan keyakinan. Tidak perlu cemas seberapa baik melakukannya karena
hal itu akan mencegah terjadinya respon relaksasi benson. Sikap pasif dengan
membiarkan hal itu terjadi merupakan elemen yang paling penting dalam
mempraktikkan relaksasi benson.
4. Posisi nyaman
Posisi tubuh yang nyaman adalah penting agar tidak menyebabkan ketegangan
otot-otot. Posisi tubuh yang digunakan, biasanya dengan duduk atau berbaring di
tempat tidur.
Relaksasi memerlukan pengendoran fisik secara sengaja, dalam relaksasi benson
akan digabungkan dengan sikap pasrah. Sikap pasrah ini merupakan respon relaksasi
yang tidak hanya terjadi pada tataran fisik saja tetapi juga psikis yang lebih
mendalam. Sikap pasrah ini merupakan sikap menyerahkan atau menggantungkan
diri secara totalitas, sehingga ketegangan yang ditimbulkan oleh permasalahan hidup
dapat ditolerir dengan sikap ini. Menyebutkan pengulangan kata atau frase secara
ritmis dapat membuat tubuh menjadi rileks. Pengulangan tersebut harus disertai
dengan sikap pasif terhadap rangsang baik dari luar maupun dari dalam. Sikap pasif
dalam konsep religius dapat diidentikkan dengan sikap pasrah kepada Tuhan
(Smeltzer & Bare, 2009).
Beberapa penelitian tentang ilmu kedokteran holistik yang dilakukan oleh
Herbert Benson, seorang ahli ilmu kedokteran dari Harvard. Setelah melakukan riset
selama bertahun-tahun bersama koleganya di Universitas Harvard dan Universitas
Boston, dia mendapati bahwa kekuatan mental seseorang punya peran yang sangat
besar dalam membantu kesembuhan seseorang dari berbagai macam penyakit.

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Dalam bukunya yang berjudul Relaxation Response (terjemahannya berjudul
Respons Relaksasi), Benson menunjukkan bahwa ternyata mantra-mantra yakni
formula tertentu yang dibaca berulang-ulang mempunyai efek menyembuhkan
berbagai penyakit, khususnya tekanan darah tinggi dan penyakit jantung (Sholeh,
2006).
Dalam Agama Islam, kalimat yang dapat dibaca berulangulang yaitu dzikir.
Kalimat dzikir tersebut antara lain adalah kalimat laa ilaha illallah, astaghfirullah,
dan subhanallah. AlQur’an memerintahkan kepada umat muslim beriman agar
melakukan dzikir sebanyak-banyaknya, sementara Rasulullah menyatakan bahwa
dzikir paling utama adalah ucapan laa ilaha illallah. Semakin intensif melakukan
dzikir sebagai bagian dari pemenuhan perintah Al-Qur’an, maka umat muslim
beriman juga berhak memperoleh penjagaan malaikat, memperoleh curahan rahmat,
memperoleh ketenangan, dan sekaligus menjadi umat kebanggaan Allah SWT
(Muhammad, 2014). Nyaris semua umat Islam mengenal dan memahami arti kalimat
tauhid laa ilaha illallah, karena kalimat itu terdapat dalam persaksian (syahadat)
yang diucapkan seseorang ketika menekadkan dirinya untuk memeluk agama Islam.
Setiap kali seorang muslim mendirikan salat, ia pun pasti membawa kalimat tauhid
yang biasa dibaca saat tasyahud. Banyak keutamaan yang terkandung dalam kalimat
tersebut, karena kalimat itu merupakan pondasi keberimanan seseorang kepada
Allah (Saleh, 2018). Proses zikir dengan mengucapkan kalimat yang mengandung
huruf jahr, seperti kalimat tauhid (laa ilaha illallah) akan meningkatkan
pembuangan CO2 dalam paru-paru. Kalimat laa ilaha illallah mengandung enam
huruf kategori jahr. Huruf-huruf jahr yang dilafalkan secara tepat dapat
mengeluarkan karbon
dioksida jauh lebih banyak dibandingkan jenis huruf lain dari sisi pelafalan. Diameter
pembuluh darah otak sesaat akan mengalami pengecilan ketika seseorang berzikir.
Suplai aliran darah (penurunan kadar oksigen dan glukosa) ke jaringan otak
mengalami penurunan. Keadaan ini segera direspon oleh otak dengan refleks
menguap, yang secara besar-besaran memasukkan oksigen melalui paru menuju otak
disertai pelebaran diameter pembuluh darah. Akibatnya, suplai oksigen dan glukosa
ke dalam jaringan otak meningkat pesat. Kondisi ini akan merevitalisasi semua unsur
seluler dan mikroseluler yang berdampak pada kekuatan dan daya hidup sel otak
(Saleh, 2018).

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 Berdasarkan pengamatan empiris yang dilakukan oleh Dr. Arman Yurisaldi
Saleh, Sp.S, beliau memberikan saran kepada para pasien untuk berzikir dan
memohon ampunan kepada Allah dengan kalimat yang mengandung banyak huruf
jahr, ternyata tampilan klinis atau kondisi kesehatan mereka semakin baik, bahkan
beberapa pasien merasa jauh lebih sehat. Keberserahan diri dapat mempengaruhi
kondisi jiwa seseorang, sehingga ia menjadi lebih rileks dan nyaman. Zikir yang
dilatunkan dengan pelafalan yang benar, juga disertai pemahaman terhadap
maknanya, memberikan efek yang sangat baik terhadap kondisi jiwa seseorang
(Saleh, 2018) Kalimat astaghfirullah juga dijelaskan oleh Syeikh Islam Ibnu
Taimiyah, beliau mengatakan bahwa istighfar adalah berharap ampunan. Kalimat
tersebut tergolong jenis doa, permohonan, dan seringkali berkaitan dengan taubat
(Haqqy, 2013). Sedangkan untuk kalimat subhanallah adalah sebuah ungkapan yang
sering diucapkan dalam kehidupan sehari-hari sebagai ungkapan rasa takjub (Mujieb
& Ismail, 2009). Dalam Agama Kristen, tidak ada bacaan khusus seperti dzikir dalam
agama Islam. Pada ajaran Kristiani, doa yang diucapkan biasanya spontan melalui
kata-kata sendiri dan merupakan ungkapan doa yang keluar dari hati. Ada tujuh
unsur dalam berdoa dalam ajaran Kristiani. Pertama memuliakan nama Tuhannya,
kedua mensyukuri nikmat, ketiga memaafkan orang lain, keempat mengakui
dosanya, kelima berdoa secara spesifik mengenai permintaanya, keenam
menyerahkan segalanya pada Tuhan, dan yang terakhir menutup doa dalam nama
Tuhan Yesus (Borst, 2006). Dalam Agama Katolik, doa yang paling sering diucapkan
adalah doa Bapa Kami, Salam Maria, dan Kemuliaan. Selain itu, dalam berdoa umat
Katolik biasanya disertai dengan membuat tanda salib. Tanda salib dibuat
menggunakan jari tangan kanan (boleh jari telunjuk, atau keempat jari dikuncupkan
jadi satu) mulai dari dahi, bahu depan sebelah kiri, bahu depan sebelah kanan, dan di
tengah-tengah dada bagian bawah (persis pada tulang dada). Sambil melakukan
tanda salib, umat Katolik akan menyebut “Dalam nama Bapa (tangan di dahi), Putra
(bahu kirikanan), dan Roh Kudus (dada bawah), Amin”. Tanda salib ini menjadi
permulaan dan akhir dari doa, ibadat, dan misa pada agama Katolik. Seringkali, umat
Katolik juga menggunakan tanda salib sebelum mulai ujian, pertandingan, dan
peristiwa yang membutuhkan doa lainnya (Supranto, 2013).
Dalam Agama Hindu, doa yang dibaca untuk meminta kebajikan dan juga doa
yang dipakai sebelum meditasi adalah “Om wiswàni dewa sawitar duri tàni parà
suwa yad bhadram tanna à suwa”, yang artinya “Ya Tuhan, Sawitar, usirlah jauh-

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jauh
segala kekuatan jahat. Berikanlah hamba yang terbaik”. Selain itu, doa yang dibac
untuk memohon perlindungan dan juga baik diucapkan ketika sakit adalah “Om
Trayambhakam yajàmahe sugandhim pusti wardhanam unwarukam iwa
bandhanàt mrtyor muksiya màmrtàt”, yang artinya “Ya Tuhan, hamba memuja
Hyang Trayambhaka/Rudra yang menyebarkan keharuman dan memperbanyak
makanan. Semoga Ia melepaskan hamba seperti buah mentimun dari batangnya,
melepaskan dari kematian dan bukan dari kekekalan” (Redaksi Pustaka Manikgeni,
2011).
Dalam Agama Buddha, umatnya menyatakan ketaatan dan kesetiaan mereka
kepada Buddha, Dhamma, dan Sangha dengan kata-kata dalam suatu rumusan kuno
yang sederhana, namun menyentuh hati, yang terkenal dengan nama Tisarana (Tiga
Perlindungan). Hal inilah yang menjadi panduan bagi umat Buddha dalam menjalani
kehidupan yang terarah dalam mengenal Tuhan sehingga rumusan itu berbunyi:
“Buddham saranam gacchâmi” (Aku berlindung kepada Buddha), “Dhammam
saranam gacchâmi” (Aku berlindung kepada Dhamma), dan “Sangham saranam
gacchâmi” (Aku berlindung kepada Sangha) (Toharuddin, 2016).
Relaksasi benson dilakukan dengan melakukan inspiras panjang yang nantinya
akan menstimulasi secara perlahan-lahan reseptor regang paru karena inflamasi
paru. Keadaan ini memberikan sinyal yang kemudian dikirim ke medulla oblongata
yang akan memberikan informasi tentang peningkatan aliran darah. Informasi ini
akan diteruskan ke batang otak, akibatnya saraf parasimpatis mengalami
peningkatan aktivitas dan saraf simpatis mengalami penurunan aktivitas pada
kemoreseptor, sehingga peningkatan tekanan darah dan inflamasi paru akan
menurunkan frekuensi denyut jantung dan terjadi vasodilatasi pada sejumlah
pembuluh darah (Rice, 2006). Saat seseorang mengalami ketegangan yang bekerja
adalah sistem saraf simpatis. Aktivasi sistem saraf simpatis akan mengakibatkan
terjadinya peningkatan frekuensi jantung, peningkatan nadi, dilatasi arteri koronaria,
dilatasi pupil, dilatasi bronkus dan meningkatkan aktivasi mental, sedangkan pada
waktu rileks yang bekerja adalah sistem saraf parasimpatis, dengan demikian
relaksasi dapat menekan rasa tegang, sehingga timbul perasaan rileks dan
penghilangan. Perasaan rileks akan diteruskan ke hipotalamus untuk menghasilkan
Corticotropin Releasing Hormone (CRH) dan Corticotropin Releasing Hormone
(CRH) mengaktifkan anterior pituitary untuk mensekresi encephalin dan endorphin

11
 yang berperan sebagai neurotransmitter yang mempengaruhi suasana hati sehingga
menjadi rileks dan senang. Di samping itu, pada anterior pituitary sekresi
Adrenocorticotropic Hormone (ACTH) menurun, kemudian Adrenocorticotropic
Hormone (ACTH) mengontrol adrenal cortex untuk mengendalikan sekresi kortisol.
Menurunnya kadar Adrenocorticotropic Hormone (ACTH) dan kortisol
menyebabkan stres dan ketegangan menurun (Sholeh, 2006).
F. Prosedur teknik relaksasi benson
Langkah-langkah relaksasi benson menurut Datak (2008) adalah sebagai berikut.
1. Ambil posisi yang dirasakan paling nyaman.
2. Pejamkan mata dengan pelan tidak perlu dipaksakan, sehingga tidak ada
ketegangan otot sekitar mata.
3. Kendurkan otot-otot serileks mungkin, mulai dari kaki, betis, paha, perut, dan
lanjutkan ke semua otot tubuh. Tangan dan lengan diulurkan kemudian
lemaskan dan biarkan terkulai wajar. Usahakan agar tetap rileks.
4. Mulai dengan bernapas yang lambat dan wajar, serta mengucapkan dalam hati
satu kata atau kalimat sesuai keyakinan pasien, kalimat yang digunakan berupa
kalimat pilihan pasien. Pada saat menarik napas disertai dengan mengucapkan
kalimat sesuai keyakinan dan pilihan pasien di dalam hati dan setelah
mengeluarkan napas, ucapkan kembali kalimat sesuai keyakinan dan pilihan
pasien di dalam hati. Sambil terus melakukan langkah nomor 5 ini, lemaskan
seluruh tubuh disertai dengan sikap pasrah.
5. Teruskan selama 10 menit, bila sudah selesai bukalah mata perlahan-lahan
G. Manfaat relaksasi benson
Relaksasi benson lebih mudah dilakukan bahkan dalam kondisi apapun serta tidak
memiliki efek samping apapun. Di samping itu, kelebihan dari teknik relaksasi lebih mudah
dilaksanakan oleh pasien, dapat menekan biaya pengobatan, dan dapat digunakan untuk
mencegah terjadinya stres (Yosep, 2007).
Menurut Miltenberger (2004), bahwa manfaat relaksasi benson yaitu mengurangi
nyeri, mengatasi gangguan tidur (insomnia), mengatasi kecemasan, dan sebagainya. Hal ini
juga senada dengan apa yang disampaikan Mander (2004) yang menyatakan bahwa
keuntungan pengajaran teknik relaksasi benson pada pasien bedah ortopedi yang tidak lagi
mendapat obat analgesia sistemik menunjukkan skor distres yang lebih rendah, skor nyeri
lebih rendah, dan menderita insomnia lebih sedikit.

12
 BAB III
PENUTUP

Kesimpulan

Kelelahan dikelola melalui terapi farmakologis dan non farmakologis. Terapi

pengobatan non-farmakologisatau komplemen dan alternatif telah menarik banyak
perhatian dalam beberapa tahun terakhir. Terapi mental lengkap lebih aman dan
memiliki komplikasi yang lebih sedikit dibandingkan terapi farmakologis. Terapi
pelengkap yang paling umum adalah istirahat, latihan fisik, rehabilitasi, terapi
energi, dan relaksasi.

13
Daftar pustaka
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%20KOMPLEMENTER%20PADA%20BIDAN%20PRAKTEK%20MANDIRI%20DI
%20KABUPATEN%20KLATEN

http://www.ejgm.co.uk

Mod Care J. 2017 July; 14(3):e66965. *Corresponding author: Fateme

Published online 2017 July 28.
Biabani, Msc Nursing, East Nursing
doi: 10.5812/modernc.66965.
Research Article and Midwifery Research Center,
Instructor, Faculty of Nursing and
Midwifery College, Birjand University
The Effects of Benson’s of
Medical Sciences, Birjand, IR Iran. E-
Relaxation Response mail: arashniya2012@yahoo.com

on Fatigue During Received 2017 June 02; Accepted

2017 July 07.
Pregnancy: A Two- Abstract
Background and Aim: Pregnancy is
Group Randomized associated with different problems and

Controlled Field Trial changes in the body. Fatigue is one of

the pregnancyrelated problems. It
Gholamhossein Mahmoudirad,1 Mahdi
negatively effects quality of life and
Hosseini,2 Manizhe Nasirizade,2 and
fetal growth and development. This
Fateme Biabani2,*
study aimed at investigating the effects
1Associate Professor, Department of
of Benson’s relaxation response on
Nursing, Birjand University of Medical
fatigue during pregnancy.
Sciences, Birjand, IR Iran
Methods: This two-group randomized
2Msc Nursing, East Nursing and
controlled field trial was done on 54
Midwifery Research Center, Instructor,
pregnant females, who referred to the
Faculty of Nursing and Midwifery
only urban healthcare center in
College, Birjand University of Medical
Nehbandan, Iran, during year 2015.
Sciences, Birjand, IR Iran

14
Females were purposively recruited response is effective in reducing fatigue
and randomly allocated to control and in the first trimester of pregnancy.
intervention groups. Benson’s Keywords: Muscular Relaxation,
relaxation response was taught to the Fatigue, Pregnancy
participants individually in the 1. Background
intervention group in 3 sessions and Pregnancy is among the most
then, they were asked to perform important stages in a
relaxation exercises for 15 to 20 women’s life. Women’s mental and
minutes twice daily for one month. psychological wellbeing and comfort
Females in the control group during pregnancy can guarantee their
received no relaxation training. Fatigue own health and their fetuses’ healthy
assessment was performed for both growth and development. Comfort is
groups before and immediately after positively affected by adequate sleep
the intervention. and rest (1). In contrary, fatigue and
The SPSS software (v. 21.0) was used sleep disorders have
for data analysis employing the paired- negative effects on comfort and
sample t, the independent-sample t, pregnancy outcomes (2-5).
and the Chi-square The prevalence of fatigue during
tests as well as the one-way analysis of pregnancy is as high as
variance. The level of significance in all 65% to 72% (6, 7). Fatigue is more
statistical tests was set at below 0.05. severe during the first
Results: During the study, fatigue and the third trimesters of pregnancy.
significantly increased in the control Fatigue in the first
group (P = 0.013) and significantly trimester is mainly due to metabolic,
decreased in the intervention group (P adaptive, and hormonal changes,
= 0.035). Before the intervention, there particularly hormone release from the
was no significant difference between placenta. On the other hand, fatigue in
the groups regarding the mean score the third trimester is
of fatigue (P = 0.46), while after the secondary to nocturia, weight gain,
intervention, the mean score of fatigue gastrointestinal problems, and sleep
in the intervention group was disorders, due to fetal movements,
significantly lower than uterine
the control group (P = 0.001). contractions, and leg cramps (8).
Conclusions: Benson’s relaxation Pregnancy fatigue is associated with

15
different negative outcomes, such as Journal. This is an open-access article
irritability, decreased ability to distributed under the terms of the
perform daily living activities, loss of Creative Commons Attribution-
interest, decreased libido, poor sleep, NonCommercial 4.0 International
reduced quality of life, and postnatal License
emotional and psychological imbalance (http://creativecommons.org/licenses/
(9, 10). Moreover, by-nc/4.0/) which permits copy and
it can negatively affect the pattern of redistribute the material just in
uterine contractions noncommercial usages, provided the
during labor (11). original work is
Fatigue is managed via both properly cited.
pharmacological and Mahmoudirad G et al.
nonpharmacological therapies. Non- is more popular than other relaxation
pharmacological or complementary techniques (14). It
and alternative medicine therapies has positive effects on a wide range of
have attracted considerable interest in physical and mental problems, such as
the recent years. Complementary pain, depression, anxiety, stress,
therapies are safer and have fewer mood disorders, and self-confidence
complications (15, 16). Previous
than pharmacological therapies. The studies reported that relaxation could
most common complementary significantly reduce
therapies are rest, physical exercise, blood pressure during pregnancy (17),
rehabilitation, energy therapy, and depression, anxiety,
relaxation (12). A study showed and stress among primigravida females
that relaxation training could help (18), and fatigue
reduce fatigue among among patients on hemodialysis (19).
pregnant females (13). Theauthor’sliteraturereviewretrievedn
One of the most well recognized ostudyonthe
relaxation techniques effects of BRR on pregnant women’s
was developed and introduced by fatigue. Therefore, the
Benson in 1970. Because of its present study was designed and
simplicity, Benson’s relaxation conducted to investigate
response (BRR) the effects of BRR on fatigue during
Copyright © 2017, Modern Care pregnancy.

16
2. Methods an X1 of 2.88, anS1of 1.64, anS2of 1.41,
This was a 2-group randomized a confidence level of
controlled field trial. 0.99, and a power of 0.90, sample size
The study population comprised of all for each group was
pregnant females, estimated as 22. Considering an
who referred to the only urban attrition rate of 20%, sample size was
healthcare center in Nehbandan, Iran, increased to 27 for each group, i.e. 54
during year 2015. Sampling was done cases in
purposively based on the following total.
eligibility criteria: a gestational age of 4 Data collection tools were a
to 16 weeks, full consciousness, no demographic questionnaire, a clinical
known characteristics questionnaire, the
mental disorders, such as anxiety and fatigue
depression, (based severity scale (FSS), and a relaxation
on medical records), no known exercise performance
muscular disorders, and checklist. The items of the
agreement to participate in the study. demographic questionnaire
Exclusion criteria were on participants’ age, gender,
were voluntary withdrawal from the marital status, educational status, and
study, absence from employment status, while the items of
BRR training sessions, failure to the clinical characteristics
perform relaxation exercises for 5 questionnaire were related to
sessions, hospitalization, travel, and their history of hypertension and
death. Recruited females were diabetes mellitus, number of children,
allocated to control and intervention and number of previous abortions. The
groups through block randomization FSS included 9 items scored on a
with a 4-person Likert-type scale from 1
block size. (“thelowestpossiblefatigue”)to7(“thehig
Sample size was calculated based on hestpossiblefatigue”). Therefore, the
the results of a total score of FSS was 9 to 63 (13). The
pilotstudy(on10females)andviathesam reliability of FSS was confirmed by
plesizecalculation previous studies with a
formulaforthecomparisonof 2means. Cronbach’s alpha value of 0.94, 0.91,
WithanX1of 4.66, and 0.81 (19-21). Moreover, the scale

17
was reported to have satisfactory face and slowly exhale through the mouth.
and During exhalation,
content validity (20, 21). say the word “one”. Breathe normally
Participants were primarily asked to and comfortably.
complete the - Repeat this exercise 15 to 20 minutes
demographic questionnaire, the while keeping all
clinical characteristics muscles relaxed. Finally, open your
questionnaire, and FSS. Next, the eyes softly and remain
fourth author personally in the same position for several
trained each woman in the minutes.
intervention group with BRR, - Do not feel worried about whether
in 3 training sessions using a training you have reached
video clip. The number of training deep relaxation or not. Just, let
sessions could be increased to achieve relaxation happen at its
participants’ complete learning of BRR. own pace. In case of disturbing
After the training sessions, the fourth thoughts, attempt to overlook them
author asked the intended participant and to be indifferent towards them
to (22).
perform BRR in order to ensure of her In order to remind participants of
ability to performing the BRR
independentlyandaccuratelyperformB regularly, both telephone and face-to-
RR.Thereafter, face contacts were
eachparticipantwasaskedtolistentoaBR made with them, and their family
Rinstructionsoundfileand members were asked
perform BRR for 15 to 20 minutes to remind them, and asked them to
twice daily for 1 month. complete the relaxation exercise
The instructions were as follows: performance checklist. Females in the
- Assume a comfortable position. control group did not receive any
- Close your eyes softly. relaxation-related training.
- Gradually relax all body muscles from The level of participants’ fatigue in
the toes to the both groups was reassessed
head. Attempt to keep muscles relaxed. immediately after the 30-day
- Inhale through the nose, be aware of intervention.
your breathing, The SPSS software (v. 21.0) was used

18
for data analysis ±
through the paired-sample t, the 0.57, respectively. Most females in the
independent-sample t, control and the intervention groups
and the Chi-square test as well as the were housewives (66.7% vs. 70.4%)
one-way analysis of and
variance. The level of significance in all the rest were employed. The results of
statistical tests was the independentsample t and the Chi-
set at below 0.05. square tests illustrated no significant
This study was approved by the Ethics differences between the groups
Committee of regarding demographic
Gonabad University of Medical and clinical characteristics (P > 0.05;
Sciences, Gonabad, Iran Tables 1 and 2).
(with the approval code of The independent-sample’s t test also
GMUFEC1393.10). Necessary showed that the
permissions for the study were control and the intervention groups did
obtained from Gonabad and not significantly
Birjand Universities of Medical differ from each other regarding the
Sciences, Gonabad and Birjand, Iran, baseline mean scores
as well as healthcare authorities of of fatigue (P = 0.46). However, this
Nehbandan, difference was statistically significant
Iran. Written informed consent was after the intervention (P = 0.001).
obtained from all participants. Betweengroup differences regarding
2 Mod Care J. 2017; 14(3):e66965. the pretest-posttest mean difference of
Mahmoudirad G et al. fatigue was also statistically significant
3. Results (P =
The means of female’s age in the 0.002). The results of the paired-
control and the intervention groups sample t test indicated a
were 28.87 ± 6.07 and 28.70 ± 6.32 significant increase in the mean score
years, of fatigue in the control group (P =
while the means of their gestational 0.013) and a significant decrease in the
age were 10.33 ± 2.71 mean
and 9.19 ± 2.85 weeks, respectively. score of fatigue in the intervention
The number of previous abortions in group (P = 0.035; Table
these groups was 0.41 ± 0.69 and 0.41 3).

19
Statistical analyses revealed that patients receiving hemodialysis (13)
female’s fatigue had and patients with multiple sclerosis
no significant relationship with their (21, 24). The literature search of this
age (P = 0.331), educational status (P = study showed
0.57), employment status (P = 0.10), that none of the previous studies had
history of diabetes mellitus (P = 0.24), assessed BRR effects
and history of hypertension (P = 0.31). on pregnancy fatigue.
4. Discussion Relaxation improves the balance
This study aimed at investigating the between anterior
effects of BRR on and posterior hypothalamus, reduces
fatigue during the first trimester of sympathetic activity and catecholamine
pregnancy. Findings release, relieves muscular tension,
revealed a significant increase in the decreases blood pressure and heart
mean score of fatigue rate, and regulates
in the control group during the study. breathing. Through BRR, individuals
Pregnancy fatigue can relax all their
is the result of energy imbalance in the muscles one by one and therefore,
body and energy alleviate their anxiety
demand-supply mismatch. In other and stress. Relaxation also stops stress
words, a pregnant female needs greater response, which
levels of energy in order to cope with has been found to significantly
pregnancy. Therefore, if she cannot contribute to pregnancyrelated
fulfill her need for problems, such as fatigue (25).
energy, she will experience fatigue, The current study findings also
particularly between revealed that fatigue
the fourth and the sixteenth week of had no significant relationship with
her pregnancy (23). age, educational status, and
On the other hand, study findings employment status. Two earlier studies
indicated a significant also reported that pregnancy fatigue
decrease in the mean score of fatigue in was not significantly related
the intervention to female’s employment status (26, 27).
group. Previous studies also showed However, a study
the effectiveness of relaxation revealed that employed females had
techniques in reducing fatigue among higher levels of fatigue in the first

20
trimester of pregnancy (23). Similarly, Acknowledgments
another study showed that two-thirds This article was retrieved from a
of employed pregnant females had research project approved by the
moderate to severe fatigue (12). These student research center of Gonabad
contradictions may be due to different University of Medical Sciences,
factors, such as Gonabad, Iran (with the approval
differences in fetal gender and code of 93.20). The authors would like
pregnant female’s perceived stress, job to thank the institutional review board
specifications, demographic of the University, all pregnant females,
characteristics, sleep patterns, who participated in this study, and the
nutritional status, physical activity, staff of the urban
hemoglobin level, and type of gravidity. healthcare center of Nehbandan, Iran.
Therefore, future References
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Mod Care J. 2017; 14(3):e66965. 5

Electron J Gen Med 2019;16(2):em125

ISSN:2516-3507
OPEN ACCESS Original Article
https://doi.org/10.29333/ejgm/93480
1 Msc. Nursing, East Nursing and Midwifery Research Center,

25
Instructor, Faculty of
Biabani Fateme1, Moradi Koosha
Nursing and Midwifery college, Birjand University of Medical
Sciences, Birjand, Iran Fatemeh2, Moeini Vahid3, NikNezhad
2 Msc. School of Nursing and Midwifery, Gonabad University of
Medical Sciences, Jalali Arezou4, Nasirizadeh Manizhe1,
Gonabad, Iran
3 Msc. Department of Operating Room, Neyshabur University of
Moradi Zahra6
Medical Sciences, ABSTRACT
Neyshabur, Iran
4 Msc. Nursing department, Sabzevar branch, Islamic Azad Introduction: Nausea and vomiting
University, Sabzevar, Iran
5 Msc. Nursing. Department of Nursing, Neyshabur University of
caused by pregnancy significantly
Medical Sciences,
affect the quality of life of pregnant
Neyshabur, Iran
Received: 26 Feb 2018, Accepted: 13 Apr 2018 women and cause problems in them.
Correspondence: Moradi Zahra
Department of Nursing, Neyshabur University of Medical The
Sciences, Neyshabur, Iran
E-mail: moradiz1@nums.ac.ir
aim of this study was to evaluate the
© 2019 by the authors; licensee Modestum effect of muscle relaxation technique
Ltd., UK. This article is an open access article
on nausea during pregnancy.
distributed under the terms and conditions
of the Creative Commons Attribution License
Materials and Methods: This study
(http://creativecommons.org/licenses/by/4.0/). was a controlled clinical trial. 44
Electronic Journal of General Medicine
pregnant women referred to the health
center were randomly divided into two
groups: control and test. Benson’s
muscle relaxation was taught to the
test group during three sessions. They
were then asked to do relaxation for 15-
20 minutes for one month twice a day.
No training was provided for the
control group. The severity of nausea
was compared using visual analogue
The effect of vomiting (VAS) in two groups and the

Benson’s muscle obtained results were analyzed using

Wilcoxon, Kruskal-Wallis and Mann-
relaxation Whitney tests at a significant level of
≤0.05.
technique on Results: Based on obtained results,

severity of 39.1% of mothers were aged between

30-35 years old. The mean and
pregnancy nausea standard deviation of severity of

26
nausea in usually begins at 4th week and is
the intervention (test) group before maximized at 10 to 15th week and
Benson relaxation was 6.9 ± 2.9 and symptoms disappear in the 20th week
after relaxation was 6.64 ± 1.99. of pregnancy.
Analysis (Mann-Whitney test) of In 50 to 55% of pregnant women,
severity of symptoms continue after 20th week of
nausea before and after intervention in pregnancy and sometimes even to the
the test group showed a significant end.
difference. Symptoms in most cases are nausea,
Conclusion: Considering the positive retching, vomiting and avoid the smell
effect of Benson’s relaxation on the of food (4). Various studies have
reduction of nausea and vomiting in indicated
pregnancy, its education is several factors for nausea and vomiting
recommended for all pregnant women in pregnancy. Psychological and social
in the first trimester of pregnancy in factors are also important and
health and counseling centers. vomiting
Keywords: muscle relaxation, may be more in people with unwanted
nausea, pregnancy pregnancy, although these factors are
INTRODUCTION not the primary cause but they are
Nausea and vomiting occur in 70% of effective
pregnancies, and almost 50% of in severity (5). For the first time, Dolly
pregnant women experience vomiting posed the relatedness of psychological
alone problems with nausea and vomiting of
(1 and 2). Although this is not a life- pregnancy. In his view, the fear of not
threatening problem, it can be stressful accepting the role of mother and
both for pregnant women and for their unwanted pregnancy shows itself as
families (3). Nausea and vomiting physical
during pregnancy can have a profound symptoms such as nausea and
effect on the life and performance of vomiting (6). Fairweath said that more
pregnant than 80 percent of severe cases of
women, including a significant nausea and
reduction in the quality of life, vomiting have a psychological source
individual and social performance of (7). The uncertainty about the main
them. This problem cause of nausea and vomiting in

27
pregnancy various stress-relieving methods, he
Fateme et al. / The effect of Benson’s concluded that the four essential
muscle relaxation technique on elements increase détente, including: a
severity of pregnancy nausea relaxed environment, a comfortable
2 / 6 http://www.ejgm.co.uk state, a
has led to a problem in finding specific mental device such as the word to focus
treatment. Most of the therapies are on and the passive attitude. This
supportive. Pharmacotherapy also has technique should be done in a relaxed
side environment, in a comfortable state, in
effects and rarely can be so successful mental concentration, and in a positive
that it causes the mother to get rid of attitude to make a real impact (11).
symptoms. Therefore, the use of Benson
complementary therapies can be a relaxation does not have muscle
solution to this problem (8). One of contraction because muscle
these complementary therapies is contraction increases the number of
relaxation. pulses, respiration and
Relaxation has several methods, but blood pressure, and increases the
the method introduced by Herbert burden of the heart (12). Behavioral
Benson in 1970 is more desirable for interventions such as relaxation are
others methods that
because of its easy learning and patients can independently carry out as
training (9). Benson’s relaxation is one self-care strategies. This method is
of the methods of focusing on the completely non-invasive and may
senses that reduce the
affect a wide range of physical and need for patients to use anti-vomiting
psychological symptoms such as drugs. This method has less side effects
anxiety, pain, depression, mood and and it saves the cost of hospitalization
self-confidence (13). Since muscle relaxation can
and reduces stress (10). As a result of reduce heart rate, decrease blood
his research, Benson points out the pressure and increase vasovagal blood
value of détente (relaxing of tension). flow and
He reduce the activity of the sympathetic
believed that détente is a key element system (14), it is expected to reduce
for the effects of care. In his study on nausea. However, since the main

28
causes of Nehbandan city in the year 2015. After
vomiting caused by chemotherapy are obtaining a
the stimulation of centers susceptible permit for the implementation of the
to chemicals in the brain and the project at Birjand University of
automated Medical Sciences with the ethics code
nervous system and psychosocial GMUFEC1393.10 from Gonabad
factors (15), is different with nausea University of Medical Sciences and
due to pregnancy that for other than obtaining informed consent from the
reasons. patients, the
Also, the mean depression in pregnant samples were selected according to
women in Iran has been reported since inclusion and exclusion criteria and
1996 to 2011 in a review article 27.6 randomly groups of test and control
(16). using
In the meantime, this technique blocking method with four blocks. The
reduces the stress of hemodialysis number of control and test groups was
patients. Considering all of above equally selected. The inclusion criteria
mentioned and of
that one of the important reasons for the study included: having 4-12 weeks
pregnancy nausea and vomiting is of pregnancy, having complete
psychological, and given so far, there vigilance, listening and speaking ability
has been to learn
no study on the effect of relaxation on relaxation, having a desire to
nausea and vomiting of pregnancy, we participate in research, lack of a known
decided to study the present study mental illness such as severe anxiety
entitled and depression,
“the effect of muscle relaxation on lack of medication anti-nausea and
nausea and vomiting of pregnancy”. vomiting (antiemetic), lack of history
METHODS of known muscular ailments, and lack
This study was a rondemized clinical of nausea
trial study with control group and the for reasons other than pregnancy, such
study population consisted of all as nausea due to certain medications,
pregnant food poisoning and digestive problems.
women in the first trimester of Exclusion criteria included reluctance
pregnancy in the health center of to continue cooperation, any

29
conditions that are created for the
patient during
intervention that makes it impossible
for the intervention to be continued,
such as death, travel
hospitalization, nonattendance at the
educational sessions, and failure to do
relaxation techniques for 5 sessions.
The sample size was calculated using
the formula for comparing the means
after the pilot study, taking into
account
the confidence coefficient of 0.95 and
test power of 80% was calculated 20
subjects in each group and for the
probable
loss of sample for each group, 22
subjects were included.
The tools used in this study were
demographic information
questionnaire in two parts of personal
information
age, marital status, level of education,
occupation), and information about
disease and treatment (history of
hypertension
and diabetes, cesarean section, and
stillbirths ...) and visual form of nausea
(visual analogue vomiting) (VAS) and a
relaxation
The tool for measuring the severity of
nausea (VAS), which validity and
reliability has been confirmed
various
studies, is a scale of 100 mm long
an vertical lines, numbered from 0 to 100.
On the one hand, the phrase without
nausea
and and the other side is the phrase nausea.
To measure the severity of nausea with
this tool, while showing it to the
patient,
he/she is asked to indicate the severity
of the nausea at that moment by
marking the mark on this line, then the
severity
of nausea by calculating the distance
from the mark location from zero point
(without nausea) is determined.
Electron J Gen Med 2019;16(2):em125
http://www.ejgm.co.uk 3 / 6
Content validity was used for validity
of the tool, and the reliability of this
criterion was obtained in one of the
studies
(sex, carried out abroad with a correlation
coefficient of 0.83 that was obtained
from the comparison of the two-fold
measurement of the severity of nausea
within 10-15 minutes intervals (17),
subsequently, a nausea visual
questionnaire
was used to measure the severity of
form. nausea in both groups to complete it
and deliver it to the researcher.
The method was done so that patients
in were first asked to complete the
demographic questionnaire and the
30
severity In order to achieve this goal, calls and
of nausea form. Then, Benson’s even frequent reminders to the patient
relaxation technique was individually for the technique, as well as on-site
trained to the subjects in the two visits and assistance from other
sessions. members of their family to indirectly
Afterwards, patients performed supervise the
relaxation techniques for one month patient in performing the technique, as
twice daily for 20-15 minutes each day. well as complete the checklist made by
The the researcher were used. There was no
procedure was as follows: 1. The intervention for the control group.
patient is slowly placed in a After six weeks, nausea was again
comfortable position, 2. Close the eyes compared between the control and
slowly, 3. Relax intervention
slowly all muscles of the body from the groups and the obtained results using
lower legs, gradually relaxing towards Fisher’s exact, Wilcoxon, Kruskal-
the face and keep calm down, 4. Wallis and Mann-Whitney tests by use
Breathe of software
through nose and be aware of his/her SPSS version 21 were analyzed.
own breath and slowly remove the RESULTS
breath from the mouth, and when Based on the results, the mean age of
breath the subjects was 29.01 ± 5.29 and the
comes out, repeat the number 1 under majority of the samples were between
the lips and breathe out comfortably the ages of 30 and 35 years old. The
and normally, 5. Do this 20-15 minutes majority level of education was a
and secondary school, and the job of
try to relax the muscles, then slowly majority of
open your eyes and do not go up for a subjects was housekeeper. The mean
few minutes. Doesn’t worry if he/she gestational age was 10.2 ± 32.2 weeks.
has 68.2% of the samples had no history of
reached a deep level of calm or not, diabetes and 63.6% of them have no
letting relaxation is occurred with its history of hypertension and the
song. When the disturbing thoughts abortion history was 29.5%. 84.1% of
come, try the samples
to ignore it and be indifferent to it (18). had no history of stillbirth. The mean

31
number of live births in each of the two groups (p = 0.44). The mean score
research subjects was 1.70 ± 1.21, and of severity of nausea after the
the intervention
majority of the subjects (29.5%) had in the control group was higher than
two live births (Table 1). According to the intervention group and the
Chi-square test, two groups of test and Whitney test showed a significant
control were not significantly different difference
from the demographic variables of age, between the two groups (p = 0.04). In
maternal age, gestational age, examining the mean difference
education between the severity of nausea before
and occupation, history of stillbirth, and after
history of gestational diabetes, a intervention in the two groups it was
history of hypertension and were found that the mean of nausea severity
homogenous. decreased in the intervention group
Also, in relation to disease information, and
most of the subjects did not have a decreased in the control group and the
history of hypertension and had a Mann-Whitney test revealed that this
history of technique significantly reduced the
gestational diabetes. The gestational severity
age was between 4 and 16 weeks. The of nausea (p = 0.001) (Table 2).
Chi-square test did not show Fateme et al. / The effect of Benson’s
significant muscle relaxation technique on
difference in terms of the variables severity of pregnancy nausea
mentioned in the two groups and in 4 / 6 http://www.ejgm.co.uk
this regard, the groups were DISCUSSION
homogeneous. The results of this study showed that
Regarding the severity of nausea in the there was no significant difference in
pre-interventional stage, according to the severity of nausea between the
the table, mean score of the severity control
of nausea in the intervention group and test groups (p = 0.44) before the
was higher than that of the control intervention. However, the results
group, and the Mann-Whitney test did showed that the severity of nausea in
not show the
a significant difference between the intervention group was significantly

32
lower than the control group (0.04). a lesser extent (20).
Also, according to the results of the Other findings of this study showed
MannWhitney test, the mean that there is no significant relationship
difference of nausea before and after between maternal age, gestational age,
the intervention was significant number of pregnancies, history of
(P=0.001). This means that abortion, cesarean section, education
this technique has been effective in level, occupation, history of
reducing the nausea rate in pregnant hypertension,
women. No studies, either inside or history of gestational diabetes and
outside severity of nausea.
the country, have been performed on In this regard, the result of the study
the effect of relaxation therapy on conducted by Noorani did not show a
nausea during pregnancy. But the significant relationship between
results of a maternal
study titled “Investigating the effect of age, gestational age, education level
telephone support on the severity of and nausea score (p≥0.05), which is
nausea and vomiting in the first half of consistent with the findings of this
pregnancy in firstly pregnant women” study.
by Abedian et al. showed that
telephone support reduced the severity Electron J Gen Med 2019;16(2):em125
of nausea http://www.ejgm.co.uk 5 / 6
and vomiting in pregnancy (19). The results of Soltani et al. study about
A study by Bakhshi and colleagues was the frequency of pregnancy nausea and
conducted about the effect of vomiting and its related factors in
progressive muscle relaxation on the pregnant women showed a significant
use of relationship between the gestational
anti-nausea and vomiting drugs age and the severity of nausea and
(antiemetic) in cancer patients treated vomiting,
with chemotherapy drugs. The results so that women aged 20 years or less
of this had more severe nausea. In the present
study showed that the experimental study, as the results show, the majority
group experienced less nausea and of
vomiting than the control group that research units were between 30 and 35
Metoclopramide drug has been used to years old. Also, the results of Soltani et

33
al. study showed that there is no women is higher (25). The results of
significant Yazdani et al study showed that the
relationship between education level incidence
and nausea in pregnancy (22), but and severity of pregnancy nausea was
weigel et al (2000) concluded in their higher in women who had gestational
study that diabetes (26), which this difference in
there is a significant relationship outcome may be due to the low sample
between low education and pregnancy size and the present nature of the
nausea and vomiting, which can be the study.
cause Considering the fact that for the
of the possible difference between the treatment of nausea and vomiting
two studies (23). The reason for the during pregnancy there is an enormous
lack of correlation between the level of cost every
education and severity of nausea in the year, including financial resources,
present study may be explained by an time wasting, the cost of visiting
increase in the proportion of people physicians and midwifery and nursing
with care, and the
high education (60%) than those with treatment of this problem increases the
low education (40%). Zhou et al. hospital occupancy rate and its
(1999) also reported that there is no negative consequences, on the other
significant hand,
relationship between the number of pharmaceutical and chemical
pregnancies with nausea and vomiting treatments have adverse effects on
in pregnancy, which is consistent with both the mother and the baby,
the therefore, Benson’s
findings of this study (24). The results muscle relaxation technique is widely
of Tabatabai Chehr’s study on the recommended in all midwives and
comparison of the incidence of severity doctors’ retraining classes as well as in
of pregnancy counseling classes and in
nausea and vomiting between the same vein, other research is
employee pregnant women and recommended.
housewives ones also showed that the CONCLUSION
severity of nausea Considering the positive effects of this
and vomiting in employee pregnant technique in this study, without cost

34
and ease of use and permanent intensity, and patterns of change. Am J
availability Obstet Gynecol. 2000;182(4):931-937.
of this technique and most https://doi.org/10.1016/S0002-
importantly, being non- 9378(00)70349-8
pharmacological, the teaching of this 3. Wills G, Forster D. Nausea and
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ACKNOWLEDGEMENT https://doi.org/10.1016/j.midw.2007.
This article was the result of approved 05.002 PMid:17850938
student research project of Gonabad 4. Clark SM, Constantine MM, Hankins
University of Medical Sciences with a GD. Review of NVP and HG and Early
code of 93.20. Hereby the Research Pharmacotherapeutic Intervention,
Council of Gonabad University of Obstet Gynecol Int. 2012;2012:252676.
Medical Sciences is appreciated. Also, Epub 2011 Nov 24.
the sincere 5. Eisenberg DM, Davis RB, Ettner SL,
cooperation of pregnant women Appel S, Wilkey S, Van RM, et al.
referring to the health center of Trends in alternative medicine use in
Nehbandan city and the staff of this the
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