影响产妇分娩疼痛程度的相关因素分析及综合护理干预体会
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摘要
目的分析影响产妇分娩疼痛程度的相关因素及实施综合护理干预的临床效果。方法选取2015年4月至2017年6月于太和县人民医院分娩的正常单胎头位产妇82例。采取视觉模拟评分法对产妇潜伏期、活跃期疼痛程度进行评定,经单因素及多因素Logistic回归分析,分析影响产妇分娩疼痛程度的相关因素,并实施综合护理干预,比较干预前后产妇分娩疼痛缓解情况。结果潜伏期:轻度疼痛36例,中度疼痛46例,其中年龄、孕次、分娩认知、夫妻关系与产妇潜伏期分娩疼痛程度有关(P <0. 05);活跃期:中度疼痛37例,重度疼痛45例,其中紧张焦虑情绪、对自然分娩的信心与产妇活跃期分娩疼痛程度有关(P <0. 05)。经多因素Logistic回归分析,发现高龄、孕次、分娩认知、夫妻关系是产妇潜伏期分娩疼痛程度的独立危险因素,而紧张焦虑情绪、对自然分娩缺乏信心是活跃期独立危险因素。实施综合护理干预后,产妇潜伏期、活跃期分娩疼痛程度较干预前明显缓解(P <0. 05)。结论针对影响产妇分娩疼痛程度的因素,给予综合护理干预,有利于缓解分娩疼痛。
Objective To analyze the related factors influencing the pain of maternal childbirth and the clinical effect of comprehensive nursing intervention. Methods A total of 82 normal single fetal head maternal enrolled in Taihe People's Hospital from April 2015 to June 2017 were selected. The Visual Analogue Scale( VAS) was used to assess the degree of pain in latency and active period,and the single and multivariate Logistic regression analysis was used to analyze the related factors affecting the degree of delivery pain,and the comprehensive nursing intervention was carried out. The relief of delivery pain before and after intervention was compared. Results Latency period: 36 cases of mild pain and 46 cases of moderate pain,among which the age,gestational age,childbirth cognition,relationship between husband and wife were influential factors of delivery pain in latency period( P < 0. 05);Active period: 37 cases of moderate pain and 45 cases of severe pain,among which the anxiety,the confidence of natural childbirth were influential factors of labor pain( P < 0. 05); Multivariate logistic regression analysis showed that the age,childbirth cognition and marital relationship were independent risk factors of the labor pain in maternal lantency period,and the anxiety and confidence of spontaneous delivery were independent risk factors during active childbirth. After comprehensive nursing intervention,the labor pain of maternal in the latency and active period was significantly relieved before intervention( P < 0. 05). Conclusion For the factors that affect the degree of labor pain,give comprehensive nursing intervention helps ease the pain of childbirth.
Objective To analyze the related factors influencing the pain of maternal childbirth and the clinical effect of comprehensive nursing intervention. Methods A total of 82 normal single fetal head maternal enrolled in Taihe People's Hospital from April 2015 to June 2017 were selected. The Visual Analogue Scale( VAS) was used to assess the degree of pain in latency and active period,and the single and multivariate Logistic regression analysis was used to analyze the related factors affecting the degree of delivery pain,and the comprehensive nursing intervention was carried out. The relief of delivery pain before and after intervention was compared. Results Latency period: 36 cases of mild pain and 46 cases of moderate pain,among which the age,gestational age,childbirth cognition,relationship between husband and wife were influential factors of delivery pain in latency period( P < 0. 05);Active period: 37 cases of moderate pain and 45 cases of severe pain,among which the anxiety,the confidence of natural childbirth were influential factors of labor pain( P < 0. 05); Multivariate logistic regression analysis showed that the age,childbirth cognition and marital relationship were independent risk factors of the labor pain in maternal lantency period,and the anxiety and confidence of spontaneous delivery were independent risk factors during active childbirth. After comprehensive nursing intervention,the labor pain of maternal in the latency and active period was significantly relieved before intervention( P < 0. 05). Conclusion For the factors that affect the degree of labor pain,give comprehensive nursing intervention helps ease the pain of childbirth.
引文
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[13]晏春丽,朱姝娟,彭红婴,等.综合干预对初产妇分娩自我效能、分娩应对及剖宫产率的影响[J].中华现代护理杂志,2012,18(32):3885-3888.
[14]伯秋芳,张轶兰,李秀军.拉玛泽呼吸减痛分娩法对产妇分娩疼痛及妊娠结局的影响评价[J].河北医学,2016,22(3):380-383.
[15]郝晖,金庆英.产妇心理健康及分娩自我效能感与分娩疼痛的相关性分析[J].中国妇幼保健,2013,28(27):4461-4463.
[16]贾艳妮,朱秀,郑修霞,等.自我效能干预护理对初产妇疼痛及分娩的影响[J].中国医药导报,2013,10(34):132-135.
[17]王玲.围产期综合护理干预措施对孕产妇分娩情况的影响[J].实用医学杂志,2012,28(20):3468-3470.
[18]Drzymalski DM,Tsen LC,Palanisamy A,et al.A randomized controlled trial of music use during epidural catheter placement on laboring parturient anxiety,pain,and satisfaction[J].Anesth Analg,2017,124(2):542-547.
[19]Sadacharam K,Ahmad M.Epidural anesthesia for labor pain and cesarean section in a parturient with arthrogryposis multiplex congenital[J].J Anaesthesiol Clin Pharmacol,2016,32(3):410-4111.
[20]徐亚平.产期综合护理干预在产妇分娩中的应用效果[J].实用临床医药杂志,2014,18(8):113-115.
[2]王娴,沈洁,冯善武,等.阴道分娩后会阴部疼痛的前瞻性观察研究[J].中国疼痛医学杂志,2014,20(7):490-493.
[3]Emelonye AU,Pitkaaho T,Aregbesola A,et al.Spouses'perspective of their participation and role in childbirth pain relief[J].Ann Med Health Sci Res,2016,6(6):367-374.
[4]王苏梅,祝玉琴,陈玉芬,等.非药物减痛分娩法对产妇血浆皮质醇及分娩疼痛的影响[J].中国妇幼保健,2010,25(25):3570-3572.
[5]熊莉华,窦娜,李珍,等.预产期前音乐干预缓解产妇分娩疼痛[J].护理学杂志,2010,25(14):57-59.
[6]郑振娇,陈丽霞.初产妇对分娩疼痛预期值与实际值的对比分析[J].广东医学,2012,33(14):2093-2094.
[7]成金焕,温穗文,林洁容,等.全产程分阶段应用拉玛泽分娩法对产妇疼痛及分娩结局的影响[J].现代临床护理,2011,10(7):42-44.
[8]翟敬芳,沙静.产妇分娩疼痛的影响因素及其对分娩结局的影响分析[J].中国妇幼保健,2016,31(21):4390-4391.
[9]刘丽春,杨彩荣.剖宫产和阴道自然分娩后产妇急性疼痛情况及影响因素分析[J].河北医药,2016,38(24):3826-3828.
[10]叶慧君,江延姣,阮芝芳.分娩疼痛程度及其相关因素与分娩结局[J].中华妇产科杂志,2011,46(10):753-757.
[11]贾艳妮,朱秀,郑修霞,等.自我效能干预护理对初产妇疼痛及分娩的影响[J].中国医药导报,2013,10(34):132-135.
[12]韦秀芬,汪莉,何恋云,等.耳穴压贴联合呼吸减痛法对产妇分娩疼痛的影响[J].护理研究,2014,28(9):1079-1080.
[13]晏春丽,朱姝娟,彭红婴,等.综合干预对初产妇分娩自我效能、分娩应对及剖宫产率的影响[J].中华现代护理杂志,2012,18(32):3885-3888.
[14]伯秋芳,张轶兰,李秀军.拉玛泽呼吸减痛分娩法对产妇分娩疼痛及妊娠结局的影响评价[J].河北医学,2016,22(3):380-383.
[15]郝晖,金庆英.产妇心理健康及分娩自我效能感与分娩疼痛的相关性分析[J].中国妇幼保健,2013,28(27):4461-4463.
[16]贾艳妮,朱秀,郑修霞,等.自我效能干预护理对初产妇疼痛及分娩的影响[J].中国医药导报,2013,10(34):132-135.
[17]王玲.围产期综合护理干预措施对孕产妇分娩情况的影响[J].实用医学杂志,2012,28(20):3468-3470.
[18]Drzymalski DM,Tsen LC,Palanisamy A,et al.A randomized controlled trial of music use during epidural catheter placement on laboring parturient anxiety,pain,and satisfaction[J].Anesth Analg,2017,124(2):542-547.
[19]Sadacharam K,Ahmad M.Epidural anesthesia for labor pain and cesarean section in a parturient with arthrogryposis multiplex congenital[J].J Anaesthesiol Clin Pharmacol,2016,32(3):410-4111.
[20]徐亚平.产期综合护理干预在产妇分娩中的应用效果[J].实用临床医药杂志,2014,18(8):113-115.