Efeito da auriculoterapia sobre a ansiedade, qualidade de vida e medo da COVID-19 em gestantes na atenção primária: ensaio clínico randomizado

Abstract

Pregnancy-related anxiety is a prevalent situation associated with concerns about the outcomes of pregnancy, childbirth, postpartum and the baby's health. It is observed that during the COVID-19 pandemic there was an increase in anxiety among pregnant women, with a negative impact on their quality of life. This condition, most of the time, is managed in Primary Health Care, where the role of nurses in tracking and treating anxiety stands out. Among nursing interventions, the demand and supply of Integrative and Complementary Practices has increased, with an emphasis on auriculotherapy. However, there are gaps in knowledge about the safety and effectiveness of the technique for pregnant women. With this in mind, the present study aimed to evaluate the effect of auriculotherapy on anxiety, quality of life and fear of COVID-19 in pregnant women receiving primary health care. To this end, a methodological study was carried out to validate by experts, and clinically in pregnant women, auriculotherapy points for the treatment of anxiety in pregnant women followed by a multicenter, single-blind, randomized clinical trial with normal-risk pregnant women. In the trial, four weekly auriculotherapy sessions were carried out with radionic crystals in the experimental group and inert tapes in the placebo group at the ear points identified in the validated clinical protocol. The outcomes were measured before the 1st, after the last session and at the seven-day follow up, using the State Anxiety Inventory, World Health Organization Quality of Life-Bref, COVID-19 Fear Scale in the Perinatal Period, and instrument satisfaction and evaluation of the technique. The data were analyzed using the Longitudinal Model of Generalized Estimation Equations, at 5% significance. The study was registered with REBEC (RBR-7fsjmyc). The auriculotherapy protocol for anxiety in pregnant women, validated by eighteen experts, was composed of the points Anxiety (100%), Shen Men (100%), Heart (94.4%), Kidney (94.4%), and Nervous System Visceral (94.4%). In clinical validation, auriculotherapy with unilateral radionic crystals, with alternating pinna once a week, for four sessions, showed a significant improvement in anxiety (p=0.029). In the clinical trial, 53 pregnant women participated in the intervention group and 51 in the placebo group and both showed a reduction in anxiety. In quality of life, a significant improvement was observed in the experimental group in the physical (p<0.001) and environmental (p<0.005) domains. In the psychological domain, there was improvement in both groups and in the social domain there were no significant changes. Fear of Covid-19 decreased significantly in both groups. Therefore, auriculotherapy had an effect equal to the placebo group in reducing anxiety and fear of COVID-19, and a superior effect in the physical and environmental domains of quality of life.