Olayemi O, Aimakhu C O, Akinyemi O A
Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria.
J Obstet Gynaecol. 2006 May;26(4):329-31. doi: 10.1080/01443610600595028.
Pain perception as perceived by the parturient is determined by physical and psychological factors. The interplay of these factors is important to the healthcare professional who will be managing these women in labour. We therefore set out to assess the influence of educational attainment as a proxy for westernisation on pain perception by parturients. This was a cross-sectional study conducted among 765 parturients using a questionnaire with the Box Numerical Scale to assess pain score within 48 h of delivery. We studied women in labour at the University College Hospital Ibadan Nigeria from August 2003 to July 2004. A total of 1,000 consecutive parturients were enrolled into the study but 765 were included in the analysis after excluding women requiring caesarean section. Multiple linear regression with robust estimation of the Standard Error of the Mean (SEM) was utilised. The main outcome studied was the pain score obtained within 48 h of delivery using the Box Numerical Scale (BNS). The pain scores were highest among ethnic groups other than the predominant ethnic group (Yoruba) 9.13 (95% CI 8.13 - 9.33), it was lowest among those with no formal education. Multivariate analysis revealed educational attainment as a significant predictor of BNS. An interaction between age and educational attainment; only women between the ages of 25 - 30 had lower mean pain scores when educated compared with those without formal education -3.56 (95% CI -4.28, -2.87). In conclusion, findings in this study support the hypothesis that westernisation through education tends to increase perception of pain by parturients in this environment.
产妇所感知的疼痛由生理和心理因素决定。这些因素的相互作用对于管理分娩期女性的医护人员来说很重要。因此，我们着手评估以教育程度作为西方化的一个指标对产妇疼痛感知的影响。这是一项横断面研究，对765名产妇进行问卷调查，采用数字量表在分娩后48小时内评估疼痛评分。我们于2003年8月至2004年7月在尼日利亚伊巴丹大学学院医院研究分娩期女性。共有1000名连续的产妇纳入研究，但在排除需要剖宫产的女性后，765名被纳入分析。采用对均值标准误（SEM）进行稳健估计的多元线性回归。研究的主要结果是使用数字量表（BNS）在分娩后48小时内获得的疼痛评分。在主要族群（约鲁巴族）以外的族群中疼痛评分最高，为9.13（95%置信区间8.13 - 9.33），在未接受过正规教育的人群中最低。多变量分析显示教育程度是BNS的一个重要预测因素。年龄与教育程度之间存在相互作用；只有年龄在25 - 30岁之间的女性，受过教育的与未接受过正规教育的相比，平均疼痛评分更低，为-3.56（95%置信区间-4.28，-2.87）。总之，本研究结果支持这样的假设，即在这种环境下，通过教育实现的西方化往往会增加产妇对疼痛的感知。
