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"[ABSTRAKNyeri dan kecemasan merupakan hal yang normal ketika ibu menghadapipersalinan, namun jika mengalami nyeri dan kecemasan yang berlebihan akanmenimbulkan komplikasi selama proses persalinan. Penelitian ini bertujuan untukmengetahui pengaruh paket Touching, Massage, Acupressure (T.M.A) olehkeluarga terhadap nyeri persalinan dan proses persalinan. Penelitian inimerupakan operasional research. Sampel dalam penelitian ini 94 ibu hamil yangdibagi menjadi dua kelompok yaitu 47 orang sebagai kelompok intervensi dan 47kelompok kontrol yang diambil dengan teknik consecutive sampling.Pengumpulan data menggunakan kuesioner FPRS, FAS, lembar observasi prosespersalinan dan wawancara. Hasil wawancara keluarga mengatakan bahwapengetahuan keluarga bertambah dan adanya manfaat setelah penerapan paketT.M.A. Hasil uji statistik dengan menggunakan Chi Square menunjukan bahwaada perbedaan yang bermakna pada proses persalinan (power, p=0,028);passanger p=0,006; passageway p=0,048; position p=0,048; psikologis p=0,000)dan nyeri persalinan (p=0,003) antara kedua kelompok intervensi dan kontrol. Halini menunjukan bahwa pendampingan keluarga dengan menggunakan paketT.M.A berpengaruh terhadap proses persalinan dan nyeri persalinan. Paket T.M.Adiharapkan menjadi intervensi non farmakologis dalam keperawatan untukmenurunkan nyeri dan kecemasan pada ibu bersalin.

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ABSTRACTPain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal.;Pain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal., Pain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal.]"

"[ABSTRAKNyeri dan kecemasan merupakan hal yang normal ketika ibu menghadapipersalinan, namun jika mengalami nyeri dan kecemasan yang berlebihan akanmenimbulkan komplikasi selama proses persalinan. Penelitian ini bertujuan untukmengetahui pengaruh paket Touching, Massage, Acupressure (T.M.A) olehkeluarga terhadap nyeri persalinan dan proses persalinan. Penelitian inimerupakan operasional research. Sampel dalam penelitian ini 94 ibu hamil yangdibagi menjadi dua kelompok yaitu 47 orang sebagai kelompok intervensi dan 47kelompok kontrol yang diambil dengan teknik consecutive sampling.Pengumpulan data menggunakan kuesioner FPRS, FAS, lembar observasi prosespersalinan dan wawancara. Hasil wawancara keluarga mengatakan bahwapengetahuan keluarga bertambah dan adanya manfaat setelah penerapan paketT.M.A. Hasil uji statistik dengan menggunakan Chi Square menunjukan bahwaada perbedaan yang bermakna pada proses persalinan (power, p=0,028);passanger p=0,006; passageway p=0,048; position p=0,048; psikologis p=0,000)dan nyeri persalinan (p=0,003) antara kedua kelompok intervensi dan kontrol. Halini menunjukan bahwa pendampingan keluarga dengan menggunakan paketT.M.A berpengaruh terhadap proses persalinan dan nyeri persalinan. Paket T.M.Adiharapkan menjadi intervensi non farmakologis dalam keperawatan untukmenurunkan nyeri dan kecemasan pada ibu bersalin.

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ABSTRAKPain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal.;Pain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal.;Pain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal., Pain and anxiety is normal when a mother facing labor. Excessive pain andanxiety will cause complications during childbirth. This research aimed to knowthe effect of touching package, Massage, Acupressure (TMA) by the family to thepain of labor and delivery process. This research operasional research. Thesample were 94 pregnant women that divided into two groups: 47 as interventiongroup and 47 control group that taken with consecutive sampling technique.Collection data using questionnaires FPRS, FAS and observation sheet deliveryprocess. The results obtained in the interview, participant said that familyknowledge has increased and they feel the benefit of the TMA package. Thequantitatif result showed there was a significant difference in labor process(power, p=0,028); passenger p=0,006; passageway p=0,048; position p=0,048;psychological response p=0,000) and pain (p=0,003) between the intervention andcontrol groups. This shows that the family what used TMA package influence onlabor process and pain. Touching package, Massage, Acupressure (TMA) isexpected as an intervention non farmakologis in decreased pain and anxietymaternal.]"

"Akupresur dapat merangsang pelepasan oksitosin untuk induksi persalinan dan juga dapat mengelola nyeri selama persalinan. Penelitian ini bertujuan untuk mengidentifikasi pengaruh akupresur terhadap tingkat nyeri dan lama persalinan ibu primipara. Penelitian ini merupakan penelitian kuantitatif dengan design cross sectional. Jumlah sampel 81 responden direkruit dari RSUD dr Slamet dan RSAD Guntur Garut. Hasil penelitian menunjukkan karakteristik responden pada ibu yang mendapat akupresur dan tidak mendapat akupresur adalah homogen (p > alpha, α: 0,05) dan Akupresur berpengaruh secara signifikan terhadap nyeri dan lama persalinan dengan P<0,05. Sehingga akupresur efektif digunakan untuk mengurangi tingkat nyeri dan lama persalinan kala I.

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Acupressure is able to stimulate the release of oxytocin for delivery induction and manage the pain during delivery term. The research is aimed to identify the influence of acupressure toward the delivery pain and its duration of Primiparaous mother. This research used quantitative with cross-sectional design method. Meanwhile, the eighty one- respondent sample of this research were collected from RSUD dr.Slamet and RSAD Guntur Garut.

The result showed that the respondent?s characteristic of mother who treated with and non-acupressure was homogeny (p>alpha, α: 0, 05) and acupressure influenced toward delivery pain and duration with p<0, 05 significantly. Hence, Acupressure is effectively used in reducing delivery pain level and its duration on the first stage."

"Tujuan dari penelitian ini adalah untuk mengetahui effektifitas pemberian paket pendamping persalinan terhadap lama persalinan dan tingkat kecemasan ibu bersalin. Metode penelitian yang digunakan adalah kuasi eksperimen dengan rancangan post test only design with control. Tehnik sampling penelitian ini dengan consecutive sampling. Sampel dipilih dengan kriteria inklusi sebanyak 120 orang yang dibagi menjadi dua kelompok yaitu 60 orang sebagai kelompok intervensi dan 60 orang sebagai kelompok non intervensi. Pengumpulan data menggunakan kuesioner T-MAS dan lembar observasi lama persalinan. Faktor yang paling berpengaruh terhadap lama persalinan adalah faktor paritas dengan pvalue 0,038 dengan OR 0,618. Faktor yang paling berpengaruh terhadap kecemasan adalah umur dengan p-value 0,022 dengan OR 2,713.

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The purpose of this study is to know effectiveness of delivery preparation package on the length of delivery process and level of anxiety. This study used quasi eksperiment with post test only design with control. The sampling technic used consecutive sampling. Of based on inclusion criteria, sample was recruited 120 mothers where 60 of them grouped as intervention an another 60 as control group. The instrumens in this study were T-MAS anxiety instrument and length of delivery process observation form. The most influence factor to the length of delivery process is paritas with p-value= 0,038 and OR 0,618. The most influence factor to the level of anxiety is age with p-value 0,022 and OR -2,713."

"Masalah utama pada periode intranatal yang terjadi pada ibu yang melahirkan ialah nyeri. Tingkat nyeri persalinan pada kala I yang tidak teratasi dapat berdampak pada psikologis ibu, salah satunya yaitu kecemasan. Selanjutnya, kecemasan sendiri menjadi faktor risiko terjadinya fetal distress dan dapat membahayakan janin. Karya tulis ilmiah ini bertujuan untuk menganalisis intervensi keperawatan back massage untuk mengontrol nyeri persalinan pada kala I, yaitu pada fase laten dan fase aktif. Back massage dapat meningkatkan aliran darah serta merangsang pengeluaran epinefrin sehingga dapat menurunkan nyeri. Karya tulis ilmiah ini menggunakan metode studi kasus. Hasil evaluasi intervensi back massage menunjukkan bahwa nyeri persalinan dapat terkontrol setelah diberikan intervensi keperawatan back massage. Oleh karena itu, karya tulis ini merekomendasikan intervensi back massage sebagai salah satu intervensi yang dapat diimplementasikan pada kala I persalinan guna menurunkan nyeri pada ibu yang melahirkan.

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The main problem in the intranatal period that occurs in mothers who give birth is pain. The level of labor pain at the first time that is not resolved can have an impact on the psychological mother, one of which is anxiety. Furthermore, anxiety itself is a risk factor for fetal distress and can endanger the fetus. This scientific paper aims to analyze nursing back massage interventions to control labor pain at the first time, namely in the latent phase and active phase. Back massage can increase blood flow and stimulate the release of epinephrine so that it can reduce pain. This scientific paper uses a case study method. The results of the back massage intervention evaluation showed that labor pain can be controlled after being given back massage nursing intervention. Therefore, this paper recommends back massage intervention as one of the interventions that can be implemented in the first stage of labor in order to reduce pain in mothers who give birth."

"Pasien kanker yang sedang menjalani pengobatan berupa kemoterapi sering sekali mengalami nyeri dan kecemasan. Penelitian ini bertujuan untuk mengidentifikasi pengaruh akupresur terhadap nyeri dan kecemasan akibat kemoterapi pada pasien kanker payudara di RSUD Jend. Ahmad Yani Kota Metro Lampung. Penelitian ini menggunakan desain Randomized Controlled Trial (RCT) dengan randomisasi alokasi yang menggunakan cara randomisasi blok. Sampel dalam penelitian ini berjumlah 48 responden yang dibagi menjadi 24 responden kelompok intervensi yang mendapatkan perlakuan akupresur pada titik LI4, LR3, PC6 dan ST 36. Selanjutnya 24 responden kelompok kontrol yang mendapatkan perlakuan akupresur pada titik placebo. Semua kelompok tetap mendapatkan terapi standar. Hasil penelitian menunjukkan penurunan rata-rata nyeri dan kecemasan setelah akupresur pada kelompok intervensi lebih tinggi secara bermakna dibandingkan kelompok kontrol (p value 0,001). Penelitian ini merekomendasikan bahwa akupresur merupakan salah satu terapi komplementer yang dapat diterapkan untuk membantu menangani permasalahan nyeri dan kecemasan.

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Cancer patients who are undergoing chemotherapy often experience pain and anxiety. This study aims to identify the effect of acupressure on pain and anxiety due to chemotherapy in breast cancer patients at RSUD Jend. Ahmad Yani, Metro City, Lampung. This study used a Randomized Controlled Trial (RCT) design with randomized allocation using block randomization. The sample in this study is 48 respondents who were divided into two groups, group one 24 respondents in the intervention who received acupressure treatment at the LI4, LR3, PC6 and ST 36 points, and another 24 respondents in the control group received acupressure treatment at the placebo point. All groups continued to receive standard therapy. The results showed that the average reduction in pain and anxiety after acupressure in the intervention group was significantly higher than the control group (p value 0.001). This study recommends that the complementary therapies: acupressure can be applied to decrease pain and anxiety level"

"Latar belakang dan tujuanNyeri biasanya dianggap sebagai suatu fenomena patologis. Tetapi nyeri yang berhubungan dengan persalinan mempunyai makna berbeda pada wanita dan sangat bergantung pada pengalaman nyeri serta konstribusi ibu pada pengendalian nyeri tersebut. Ketika seorang wanita merasa bahwa suatu persalinan, terdiri dari lsquo;nyeri dan kerja keras rsquo;, dan rasa nyeri yang lama dan tak tertahankan dapat mengganggu ibu serta bayi, maka saat itulah diperlukan intervensi pengendalian rasa nyeri pada persalinan. Telah banyak metode yang dipergunakan dalam penanggulangan nyeri pada persalinan salah satunya adalah akupunktur. Penelitian ini ditujukan untuk melihat efek terapi akupunktur terhadap pengurangan nyeri ibu bersalin normalMetodePenelitian ini memakai metode Randomized Clinical Trial With Control. Penelitian ini dilakukan terhadap 50 wanita bersalin normal. Terdiri dari 25 orang kelompok kasus dan 25 orang kelompok kontrol. Kedua kelompok mendapat perlakuan sama sesuai protokol kebidanan wanita akan melahirkan. Pada kelompok kasus diberikan terapi akupunktur pada saat kala 1 aktif atau dimana rasa nyeri mulai mengganggu, sedangkan pada kelompok kontrol tidak. Dilakukan penilaian terhadap NAS nyeri persalinan, dihitung jumlah dan lama his. Lama kala 2 dan membandingkan APGAR Score bayiHasilTerapi akupunktur mempunyai efek terhadap pengurangan nyeri persalinan dengan dilihat pada kelompok kasus secara bermakna.

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Back Ground and PurposePain is usually regarded as a pathological phenomenon. But the pain associated with childbirth have different meanings in women and relies heavily on the experience of pain as well as the mother 39 s contribution is on controlling the pain. When a woman feels that a labor, consists of 39 pain and hard work 39 , and the prolonged pain and unbearable can interfere with the mother and the baby, that 39 s when the necessary interventions for controlling pain in childbirth. Many methods have been used in pain relief in childbirth one is acupuncture. This study aimed to look at the effect of acupuncture therapy against a reduction of the normal maternity mother pain researchMethodThis method of wear of Randomized Clinical Trial With Control. Research. This research was conducted against 50 women maternity normally. Consists of 25 people groups of case and control groups of 25 people. Both groups received the same treatment protocol accordingly obstetrics women will give birth. In the case group was given acupuncture therapy at the time of the fase 1 active or where the pain starts to interrupt, whereas in the control group did not. Conducted assessment of the NAS calculated the amount of labor pain, and long and intensity of the uterus contraction . Long fase 2 and compare the APGAR Score baby.Results of acupuncture Therapy has an effect against the reduction of labor pain with views on this group of cases significantly p 0.05 Acupuncture Therapy Conclusion have the effect of a reduction of labor pain. Strengthen uterus contraction, speed up fase 2 and has no side effects on the mother and baby. "

"Latar belakang: Nyeri perineum adalah keluhan umum di kalangan wanita setelah persalinan pervaginam yang dapat menyebabkan morbiditas jangka panjang. Berbagai faktor determinan persalinan telah diidentifikasi berpengaruh terhadap peningkatan nyeri perineum setelah persalinan pervaginam. Studi sebelumnya telah berfokus pada nyeri persalinan dan manajemen nyeri pasca operasi caesar tetapi tidak pada faktor yang dapat memperberat derajat nyeri.Tujuan: Menganalisis dan menilai hubungan faktor determinan persalinan pervaginam dan derajat nyeri perineum postpartum dalam 24 jam setelah persalinan pervaginam.Metode: Ini adalah studi kasus-kontrol dengan subyek pasien yang menjalani persalinan pervaginam baik secara spontan atau dengan bantuan alat dengan indikasi apa pun di Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta, selama tahun 2020. Nyeri perineum dinilai dengan Visual Analog Scale (VAS) dalam waktu 24 jam pasca persalinan setelah pemberian Asam Mefenamat 500mg dosis tunggal secara oral. Perbandingan dilakukan dengan Chi-square atau uji eksak Fisher dilanjutkan dengan analisis multivariat dengan regresi logistik.Hasil: Sebanyak 205 subjek dilibatkan dalam penelitian ini. Peningkatan nyeri perineum (VAS 4-10) ditemukan pada 41 kasus (20%). Peningkatan nyeri perineum banyak ditemukan pada subyek berusia di bawah 30 tahun (p=0,04). Ditemukan hubungan bermakna antara berat badan lahir bayi baru lahir > 3.000 gram dengan nyeri perineum (p<0.001) dengan aOR 8.38 CI 95% (2,8–24,97). Terdapat juga hubungan bermakna antara derajat robekan perineum dengan nyeri perineum postpartum (p 0,006) dengan aOR 41,25. Prosedur episiotomi juga menunjukkan hubungan yang signifikan dengan peningkatan nyeri perineum postpartum (p < 0,001) dengan aOR 45,2Kesimpulan: Berat lahir bayi, derajat robekan perineum, dan episiotomi telah terbukti menjadi faktor yang dapat meningkatkan nyeri perineum setelah persalinan pervaginam. Faktor-faktor ini harus dipertimbangkan dalam mengelola nyeri perineum postpartum untuk mencegah morbiditas jangka panjang dari persalinan pervaginam. Studi tambahan dengan sampel yang lebih besar diperlukan untuk kesimpulan yang tepat.

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Background: Perineal pain is a common complaint among women after vaginal delivery that may lead to long term morbidity. Various determinant factors in labour have been identified have influence on increasing perineal pain after vaginal delivery. Previous studies have focused on labor pain and post-cesarean delivery pain management but not on the determinant factors.

Objective: Analyze and assess the association of determinant factors in vaginal delivery and the postpartum perineal pain within 24 hours after vaginal delivery.

Methods: This was case-control study including patient underwent vaginal delivery either spontaneously or with assisted vaginal delivery at any indication at Dr. Cipto Mangunkusumo Hospital, Jakarta, during 2020. Perineal pain was assessed with Visual Analog Scale (VAS) within 24 hours post delivery after administration of Mefenamic Acid 500mg single dose orally. Comparisons were made with Chi-square or Fisher’s exact test continued with multivariate analysis with logistic regression.

Results: A total of 205 subjects were included in the study. Increased perineal pain (VAS 4-10) was found in 41 cases (20%). Increase perineal pain was commonly found in subjects under 30 years old (p = 0.04). Found significant association between newborn birthweight > 3.000 gram with perineal pain (p<0.001) with aOR 8.38 CI 95% (2,8–24,97). There was also significant association between degree of perineal tears with postpartum perineal pain (p 0.006) with aOR 41.25. Episiotomy procedure also shows significant association with increase postpartum perineal pain (p < 0.001) with aOR 45.2.

Conclusions: Neonatal birthweight, degree of perineal tear, and episiotomy have been shown to be determinant factors increasing perineal pain after vaginal delivery. These factors should be taken into consideration in managing postpartum perineal pain in order to prevent long-term morbidity from vaginal delivery. Additional studies with larger samples are needed for exact conclusion."

"ABSTRAKTujuan: Penelitian ini bertujuan untuk mengetahui pengaruh pendampingan terhadap tingkat nyeri persalinan.Metode: Menggunakan desain uji klinis acak tidak tersamar dengan concealment dengan cara mengobservasi dan mengukur tingkat nyeri selama persalinan pada dua kelompok pasien, yaitu kelompok pasien dengan pendampingan dan kelompok pasien tanpa pendampingan; dengan jumlah pasien 36 orang tiap kelompok. Nyeri persalinan diukur dengan menggunakan metode Faces Pain Rating Scale. Analisa dilakukan dengan uji Mann-Whitney.Hasil: Tingkat nyeri pada ibu yang tidak didampingi lebih tinggi daripada ibu yang didampingi, dimana yang merasakan sangat nyeri pada ibu yang tidak didampingi sebesar 50%, dengan rata-rata VAS 7.38±2.12, sedangkan pada ibu yang didampingi merasakan nyeri 44,4%, dengan rata-rata VAS 6.11±1.90.Kesimpulan: Terdapat perbedaan bermakna antara pendampingan dan tanpa pendampingan (p < 0,05 ).

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ABSTRACTObjective: This study aimed to assess assistence influence on labor pain level.Methods: This study was a randomized clinical unmasked trial with concealment by measuring labor pain level in two patients group: with and without assistance during labor; each group consisted of 36 subjects. Pain intensity were measured using Faces Pain Rating Scale. Mann-Whitney analysis was done to assess significance of pain level between two groups.Results:Majority of patient who were in non-assisted group had very painful score (50%) with mean of VAS 7.38±2.12, meanwhile most of assisted group complained painful score (44.44%), with mean of VAS 6.11±1.90.Conclusion:There was significance of painful score between non-assisted and assisted subjects (p < 0.05)."