Vol.
02 No.
02 Page.
75-82 ISSN 2987-2804 Prefix DOI: 10.
52221/nuri Implementation of Lavender Aromatherapy Inhalation to Reduce Pain Intensity in Post Sectio Caesarea Patients Herni Oktriani1.
Ayu Endang Purwati1.
Sri Wulan Ratna Dewi1 1STIKes Muhammadiyah Ciamis.
Ciamis.
Indonesia Correspondence Author: Herni Oktriani Email: hernioktriani11@gmail.
Address: Jl.
H Ahmad Dahlan No.
Ciamis.
West Java.
Indonesia, 6281931461073 Submitted: August 2024 Revised: September 2024 Published: 30 September 2024 Nurul Ilmi Journal is licensed under a Creative Commons Attribution 4.
0 International License ABSTRACT Introduction: The standard operating for sectio caesarea according to WHO increases by around 5-15% per 1000 births in the world.
One of the effects experienced by post-sectio caesarea mothers is pain.
The form of pain experienced by postoperative patients is acute Objective: This study was conducted to present implementation of lavender aromatherapy inhalation to reduce pain intensity in post sectio caesarea patients.
Method:
The method used in this case study is descriptive analytic with a nursing care approach by collecting data starting from assessment, formulating diagnosis, planning, implementing actions and conducting comprehensive evaluations.
Subjects in this study amounted to a person, namely post sectio caesarea clients who experienced pain problems.
The client was treated in Teratai 2 Room.
BLUD Banjar Hospital.
The type of intervention given was lavender aromatherapy inhalation for three days starting from May 31-June 2 2023 and the intensity of pain felt by the client was measured by Numeric Rating Scales.
Result: After carrying out nursing assesment through a phisical examination, the result showed that the client looked grimacing, there was a section caesarea incision in the abdomen with a size of 11 centimeter.
This raises a nursing problem namely acute pain associated with phisical injury agents and the interventions carried out is pain management with inhalation of lavender aromatherapy.
After the intervention for three days with a duration of 30 minutes there was a decrease in the percevied pain scale from eight to three .
Conclusion:
Lavender aromatherapy inhalation intervention is effective in reducing pain intensity in post sectio caesarea patients as evidenced by the decrease in pain scale from eight to three .
Beside that, researcher did not find discrepancies between facts and theories so that this research is not contradictory to research that has been done by previous researchers.
Keywords: lavender aromatherapy, pain intensity, sectio caesarea Introduction Sectio caesarea delivery is an delivery of the fetus where it is born through an incision in the wall of the abdominal and uterine with the uterine nerves intact and weighing over 500 grams (Aprina & Puri, 2.
The indications for sectio caesarea are premature rupture membranes, cephalopelvic disproportion, fetal distress, hypertention, breech location, seizures, bleeding and many others (Rezeki & Sari, 2.
The standard operating for sectio caesarea according to WHO increases by around 515% per 1000 births in the world.
(Hapsari & Hendraningsih, 2.
WHO data in the Global Survey on Maternal and Perinatal Health in 2011 showed 46.
1% of all births were through sectio caesarea (Marlina, 2.
Based on RISKESDAS data for 2018, the number of deliveries using the sectio caesarea (SC) method in Indonesia was 17.
6% (Putra.
Wandia, & Harkitasari.
Indications for delivery by sectio caesarea (SC) are caused by several complications with a percentage of 23.
2% including premature rupture of membranes .
6%), prolonged labor .
3%), transverse/ breech fetal position .
1%), amniotic fluid premature rupture of transverse/ breech fetus .
1%), cord entanglement center .
9%), hypertension .
7%),
4%), retained placenta .
8%), seizures .
2%), placenta previa .
7%), and others .
6%) (Hayati.
Pujiati, & Sumanti, 2.
One of the effects experienced by post-sectio caesarea mothers is pain.
The form of pain experienced by postoperative patients is acute pain (WAHYU, 2.
Pain is a problem that must be addressed, because it can cause discomfort.
The impact of pain in post SC patients will result in limited mobilization of the mother, impaired daily activity needs or Activity of Daily Living (ADL), bonding attachment and early initiation of breastfeeding (IMD) not being met (Siti Safaah.
Iwan Purnawan, 2.
Therefore pain management during post SC especially on the first day is very necessary.
The purpose of postoperative pain management is to relieve the patient's pain and discomfort with the minimal side effects (Dwienda Ristica & Irianti, 2.
The are two treatment, pharmacological and non-pharmacological that can be used to reduce post-sectio caesarea pain (Anwar.
Astuti, & Bangsawan, 2.
Pharmacological treatment that is commonly used to reduce pain is by giving the analgesic ketorolac injection and suppositories (Antari.
Nafisah, & Sulistyaningsih, 2.
Meanwhile, non-pharmacological treatment that can be used is inhalation aromatherapy (Maryani & Himalaya, 2.
One of the inhalation aromatherapy that can be used is lavender aromatherapy (Tirtawati.
Purwandari, & Yusuf, 2.
Lavender aromatherapy inhalation is a pain relief therapy using lavender essential oil which is put into a diffuser and turns into a fragrant vapor that spreads in the air (Widiani & Karmiani, 2.
The active substance contained in lavender aromatherapy will stimulate the hypothalamus to produce and release endorphins, this process occurs when the aromatherapy is inhaled (Widayani, 2.
Endorphins are substances that cause a feeling of calm, relaxed, and happy, endorphins are known as hormones of happiness and have an analgesic effect (Taqiyah.
Alam.
Leisubun, & Jama, 2.
Based on the phenomena from the background above, the researchers felt interested in intervening lavender aromatherapy to reduce pain intensity in post-sectio caesarea patients in Teratai 2 Room.
BLUD Banjar Hospital.
Objective This study was conducted to present lavender aromatherapy inhalation implementation to reduce pain intensity in post- sectio caesarea patients.
Method The method used in this case study is descriptive analytic with a nursing care approach by collecting data starting from assessment, formulating diagnoses, planning, implementing actions and conducting comprehensive evaluations.
Subjects in this study amounted to 1 person, namely post sectio caesarea clients who experienced pain problems.
The client was treated in the Teratai 2 room at BLUD Banjar City Hospital in a conscious state and was willing to be a respondent.
The type of intervention given was lavender aromatherapy inhalation for 3 days starting from May 31-June 2 2023 and the intensity of pain felt by the client was measured by Numeric Rating Scales.
Data collection techniques used were observation, physical examination, interviews, as well as documentation.
Results are written in the form of field notes, then copied in the form of transcripts or structured notes.
Presentation of data is done with tables, pictures, charts and narrative text.
Result Nursing Assesment The client is Mrs.
R with female sex, 29 years old, having address in Sukasari Hamlet.
Sukajadi Village.
RT 14 RW 04.
Pamarican District.
Ciamis Regency.
During the assessment in the Teratai 2 Room on May 31, 2023 at 09.
28 WIB, the client said pain in the first day postsectio caesarea postoperative wound in the lower abdomen.
The pain is felt like irises, the pain increases when the client moves a lot and decreases slightly when resting, the pain scale is 8 from the range 0-10 and the pain that is felt comes and goes.
The results of measuring vital signs showed blood pressure 130/90 mmHg, respiration 25 beats/minute, pulse 98 beats/minute and temperature 37.
the results of the physical examination obtained the quality of the Glasgow Coma Scale (GCS) compos mentis client with the quantity of Eye 4.
Motor 6, and Verbal 5.
The physical examination focused on the reproductive system and integumentary system.
In the reproductive system, normal vaginal bleeding results were obtained with red-black lochia rubra.
On the integumentary system, the results showed that there was an incision wound in the lower abdomen.
TFU 3 fingers below the center and there was tenderness in the incision.
Nursing Diagnosis Table 1.
Data Analysis Symptom Etiology Subjective Data:
Sectio caesarea The client complains of pain in the lower abdomen after a post sectio Section caesarea wound caesarea scar.
Pain that feels like being sliced.
Disconnected tissues The pain she feel increases when you move.
Tissue trauma The pain she feel goes away.
Perceived pain scale 8 .
Release of the histamin and Clients also complain of difficulty sleeping because the pain is very Stimulate sensory area Acute pain Problem Acute pain Objective Data:
Blood pressure: 130/90 mmHg Pulse: 98x/ minute Respiration: 25x/ minute Temperature: 37,6 ACelcius The client looks grimacing when There was a post sectio caesarea wound on the abdomen with a size of 11 cm.
The result of the assesment, it can be concluded that the nursing problems is acute pain associated with physical injury agents with diagnosis number (D.
page 172 in the Indonesian Nursing Diagnostics Standard book DPP PPNI Issue 1 2018.
Nursing Intervention Table 2.
Nursing Intervention Nursing Diagnosis Intervention (Objective.
Yield Criteri.
Acute pain related to physical injurious 1.
Identify the location, characteristics, frequency, intensity of pain.
Objective:
Identify the pain scale.
After nursing actions, the problem of 3.
Identify non-verbal pain responses.
acute pain is resolved with Identify factors that exacerbate and relieve pain Yield Criteria:
Provide non-pharmacological techniques to reduce Complaints of pain decreased .
pain with lavender aromatherapy.
The grimace descends .
Environmental control that exacerbate pain Decreased sleep difficulty .
emperature, lighting, nois.
Anxiety decreases .
Facilitate rest and sleep.
Suggest self-monitoring of pain.
Nursing Implementation Implementation of nursing given in accordance with nursing interventions that have been designed according to client needs.
The implementation includes identifying the location, characteristics, frequency, intensity of pain, identifying pain scales, identifying nonverbal pain responses, identifying factors that aggravate and relieve pain, provide nonpharmacological techniques to reduce pain with lavender aromatherapy, control environments that aggravate pain .
emperature , lighting, nois.
, facilitate rest and sleep and encourage self-monitoring of pain.
Nursing Evaluation Table 3.
Nursing Evaluation Nursing Evaluation Nursing Diagnosis 31 Mei 2023 01 June 2023 Acute pain related to S:
The client says he 1.
The client says it still feels pain in still hurts.
Subjective Data:
the surgical scar.
Pain scale 7 The Pain scale 8 complains of pain 02 June 2023 The client says Pain scale 5 in abdomen after a caesarea scar.
Pain that feels like being sliced.
The pain you feel you move.
The pain you feel goes away.
Perceived scale 8 .
Clients difficulty sleeping because the pain is very disturbing.
The pain increases when he move a The client looks There is a post wound in the BP: 130/90 mmHg P: 98x/ minute R: 25x/ minute T: 37,6AC The pain increases when you move a The client still looks grimacing.
There is a post wound in the BP: 130/80 mmHg P: 90x/ minute R: 23x/ minute T:36,8AC The client does not appear to wince.
There is a post wound in the BP: 120/80 mmHg P:92x/ minute R :21x/ minute T:36,7AC A: Acute pain has not A: Acute pain partially P: Continue Continue Objective Data:
Blood pressure:
130/90 mmHg Pulse: 98x/ minute 1.
Identify the Respiration: 25x/ Temperature:
37,6 ACelcius intensity of pain.
The client looks Result: The client grimacing when complains of pain There was a post wound in the wound on the abdomen with a like being sliced size of 11 cm.
and the pain the client moves a Identify the Identify the intensity of pain.
Result: The client complains of pain intensity of pain.
Result: The client complains of pain wound in the like being sliced wound in the and the pain like being sliced the client moves a and the pain the client moves a 2.
Identify the pain Result: skala nyeri Identify the pain 2.
Identify the pain Result: pain scale 7 Result: pain scale 5 5.
Provide non.
Identify non- 3.
Identify nonreduce pain with Result: The client Result: the client Result: The client seems to have seemed relaxed P: Continue A: Acute pain partially Identify that exacerbate and relieve pain.
Result: the client 5.
Provide nonsays the pain she moves a lot reduce pain with slightly when she Result: The client seemed relaxed Provide reduce pain with Encourage selfResult: The client monitoring of pain seemed relaxed Result: the client understands what is explained.
E: Acute pain Encourage monitoring of pain partially resolved.
Result: the client understands what R:
Continue is explained.
intervention 1, 2, 5, 8 Acute Pain not resolved.
R: Continue intervention 1, 2, 3, 5, 8 Encourage selfmonitoring of pain at home.
Result: the client understands what is explained.
E: Problem partially Continue Discussion Nursing Care of Mrs.
R in the Teratai 2 Room at BLUD Banjar City Hospital has been accomplished by researchers in a comprehensive manner based on theories found from many kinds of sources.
The procedures of nursing care accomplished starting from the stage of assessment, formulation of diagnoses, planning, implementation and evaluation.
The results of the assessment showed that the client experienced acute pain problems.
This is supported by the subjective data of the client complaining of pain in the lower abdomen, post sectio caesarea scars, pain that is felt like being sliced, pain that is felt increases when moving, feels intermittent and a pain scale that is felt is 8 .
measured by Numerical Rating Scales (NRS).
In addition, there is also objective data, namely the client looks grimacing, there is a post sectio caesarea incision in the abdomen with a size of 11 cm.
The client's acknowledgment of his condition and the objective data found are one of the considerations in determining a nursing diagnosis.
Accordingly, the diagnosis founded is acute pain related to physical injury agents with the number of diagnosis (D.
page 172 in the Indonesian Nursing Diagnostics Standard book DPP PPNI Edition 1 2018.
For addressing these nursing problems the researchers intervened and implemented according to the book Indonesian Nursing Intervention Standards DPP PPNI Edition 1 2018 number I.
08066 page 201 including identifying locations, characteristics, frequency, pain intensity, identifying scales of the pain, identifying non-verbal pain responses, identifying factors that aggravating and alleviating pain, providing non-pharmacological techniques to reduce pain with lavender aromatherapy, controlling the environment that aggravates pain .
emperature, lighting, nois.
, facilitating rest and sleep and recommending independent pain monitoring.
Based on the implementation carried out for 3 days, there was significant progress.
On day 1, the pain scale felt by 8 .
clients looked grimacing, restless and reluctant to move at all because of the pain they were experiencing, but after being given lavender aromatherapy intervention the client looked a little more relaxed, grimaced a little less and the pain scale was reduced to 7 .
On the 2nd day the changes were very visible to the client, the scale of pain was reduced from 7 to 5 .
The client no longer feels anxious, looks relaxed and is no longer afraid to move.
In addition, the client also said that the pain he felt was not too disturbing to the client's sleep so that the client's sleep time increased as usual.
On the 3rd day the client's pain gradually decreased to scale 3 and the client seemed relaxed, did not appear to grimace and the client was able to move freely.
The results of the nursing evaluation show a significant change in the scale of pain that the client feels, this is according of research done by Ana Mariza.
Desfia Haryati HS that there is a significant effect of giving lavender aromatherapy to reducing pain in post section caesarea mothers.
The research was conducted on 30 respondents with the Wilcoxon test results showing a p value of 0.
<0.
so that lavender aromatherapy was declared significant for reducing pain in post section caesarea mothers (Mariza & Haryati HS, 2.
Conclusion Lavender aromatherapy inhalation intervention is effective in reducing pain intensity in post sectio caesarea patients as proved by the decrease in pain scale from 8 to 3 .
Beside that, researcher did not find discrepancies between facts and theories so that this research is not contradictory to research that has been done by previous researchers.
Acknowledgement Researchers would like to thank the supervisor of Maternity Nursing D3 Nursing STIKes Muhammadiyah Ciamis and Clinical Instructor (CI) BLUD Banjar City Hospital for facilitating and giving directions to researchers to conduct research.
Thanks also go to clients and their families who have facilitated carrying out a case study entitled "Implementation of Inhalation Lavender Aromatherapy to Reduce Pain Intensity in Post Sectio Caesarea Patients".
References