Van den Bussche Eva, Crombez Geert, Eccleston Christopher, Sullivan Michael J L
Faculty of Psychology and Educational Sciences, University of Leuven - Campus Kortrijk, Belgium.
Eur J Pain. 2007 Apr;11(3):275-82. doi: 10.1016/j.ejpain.2006.03.002. Epub 2006 Apr 18.
This study investigated the reasons that might lead women to choose or not choose epidural analgesia as a strategy for the management of pain in childbirth. In our sample 55% of 114 women chose EA. Logistic regression resulted in a statistical model with four unique and independent predictors: Parity status and the fear of the side effects of EA each reduced the odds of choosing EA by half, whereas the desire to have a pain-free childbirth and positive experiences with EA of family and friends each doubled the odds of choosing EA. Pain catastrophizing was not related to EA use. The lack of an interrelationship between pain catastrophizing and EA use is probably due to an ambivalent attitude towards EA in pain catastrophizers. Pain catastrophizing was positively associated with the fear of being overwhelmed by labour pain and tendencies to avoid the pain, but also positively with the fear of pain during the insertion of the EA needle. Pain catastrophizing was also strongly related to recommendations to use EA from others, in particular from the midwife and from the gynecologist. Results are discussed in terms of the social impact of pain catastrophizing.
本研究调查了可能导致女性选择或不选择硬膜外镇痛作为分娩疼痛管理策略的原因。在我们的样本中，114名女性中有55%选择了硬膜外镇痛。逻辑回归得出了一个具有四个独特且独立预测因素的统计模型：经产状况和对硬膜外镇痛副作用的恐惧各自将选择硬膜外镇痛的几率降低了一半，而无痛分娩的愿望以及家人和朋友对硬膜外镇痛的积极体验各自使选择硬膜外镇痛的几率增加了一倍。疼痛灾难化与硬膜外镇痛的使用无关。疼痛灾难化与硬膜外镇痛使用之间缺乏相互关系可能是由于疼痛灾难化者对硬膜外镇痛持矛盾态度。疼痛灾难化与被分娩疼痛压倒的恐惧以及避免疼痛的倾向呈正相关，但也与硬膜外镇痛针插入时的疼痛恐惧呈正相关。疼痛灾难化也与他人，特别是助产士和妇科医生使用硬膜外镇痛的建议密切相关。根据疼痛灾难化的社会影响对结果进行了讨论。
