方法通过测定分娩满意度水平来进行分娩镇痛

A. Romanenko, Y. Kuchyn
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摘要

介绍。妇女对分娩的满意度与充足的分娩镇痛有关[1]。消极的分娩经历会增加母子关系不良、母乳喂养问题的风险[2],并降低选择性剖腹产的意愿[3]。有效的分娩疼痛管理和积极的分娩体验可提高产妇护理质量[4]。探讨“家”/医院环境中不同药物/非药物分娩镇痛方法与积极分娩体验的关系。方法与材料:对321例产妇进行分娩经历问卷调查。调查由4个部分组成:“自身能力”、“专业支持”、“感知安全”、“参与”。在产后,将妇女分为4组:患者-控制性硬膜外镇痛(PCEA) (n=217)、氧化亚氮(50:50)(n=18)、“家庭”环境替代分娩镇痛(n=46)和住院分娩不使用药物镇痛(n=40)。采用Logistic回归分析风险。结果。研究显示,与VAS评分为0.05的患者相比,重度疼痛患者在“感知安全”部分(p= 0.034, OR=2,03 (95% CІ 1,06 - 3,86))、“专业支持”部分(p=0,006, OR=2,58 (95% CІ 1,31 - 5,07))的分娩体验问卷评估不满意的风险增加(VAS评分为7分)。在“参与”部分(p=0,029, OR=0,48 (95% CІ 0,25 - 0,93)、“自身能力”部分(r =0,040)分娩满意度较高,在“专业支持”部分(p=0,029, OR=1,91 (95% CІ 1,07 - 3,41)分娩满意度较低。结论。提高分娩满意度的一个有效策略是与妇女进行积极的沟通,并告知使用药物/非药物分娩镇痛的风险
本文章由计算机程序翻译,如有差异,请以英文原文为准。
METHODS OF LABOR ANALGESIA BY DETERMING THE LEVEL OF CHILDBIRTH SATISFACTION
Introduction. Woman’s satisfaction with childbirth is associated with adequate labor analgesia [1]. Negative labor experience could increase the risk of poor mother-child connection, breastfeeding problems [2], and decreased desire for elective caesarian section [3]. Effective management of labor pain and positive childbirth experience improve the quality of maternity care [4]. Aim. Explore correlation between different pharmacological/non-pharmacological methods of labor analgesia at ‘’home’’/hospital environment with positive childbirth experience. Methods and materials: There are 321 women who completed questionnaire of childbirth experience. Survey consists of 4 parts: ‘’own capacity’’, ‘’professional support’’, ‘’perceived safety’’, ‘’participation’’. In postpartum period, women were divided into 4 groups with: patient-control epidural analgesia (PCEA) (n=217), nitrous oxide (50:50) (n=18), alternative methods of labor analgesia in ‘’home’’ environment (n=46) and hospital birth without pharmacological analgesia (n=40). Logistic regression was used to analyze the risks. Results. The study shown the risk of unsatisfactory assessment of Childbirth Experience Questionnaire in the sections “perceived safety” (p=0,034, OR=2,03 (95% CІ 1,06–3,86)), ‘’professional support’’ (p=0,006, (OR=2,58 (95% CІ 1,31–5,07)), increased for patients with severe pain (VAS 7 points), compared with patients for VAS <7 points. PCEA is considered to be standard of labor analgesia and is not associated with the risk of unsatisfactory assessment in sections “perceived safety” and ‘’own capacity’’ (p>0,05). Nitrous oxide and alternative methods of analgesia shown higher rates of childbirth satisfaction in the sections ’’participation’’ (p=0,029, OR=0,48 (95% CІ 0,25–0,93), ‘’own capacity’’(р=0,040), and low rates in ‘’professional support’’ (p=0,029, OR=1,91 (95% CІ 1,07–3,41). Conclusions. An effective strategy to increase level of childbirth satisfaction is to provide positive communication with women and to inform about risk of using pharmacological/ non-pharmacological labor analgesia
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