To William Wk
Department of Obstetrics and Gynaecology, United Christian Hospital, Kwun Tong, Hong Kong.
Hong Kong Med J. 2007 Jun;13(3):208-15.
To evaluate patient attitudes about epidural services in labour and correlate them with patient options and actual usage of epidural analgesia.
Questionnaire survey.
Eight Hospital Authority obstetrics units.
A cohort of new antenatal patients and a cohort of postnatal in-patients over 1 calendar month.
Antenatal patient awareness of epidural services and attitudes towards epidural analgesia during labour; the actual usage of such analgesia and the reported experience of postnatal patients.
A total of 2109 and 2851 patients completed the antenatal and postnatal survey, respectively. The former revealed that only 47% of patients had been exposed to the concept of epidural analgesia in labour, and only 13% opted for such analgesia. In the postnatal cohort, the overall epidural analgesia rate was 10%, although 19% had actually requested it. Patients who received epidural analgesia in labour were more likely to consider their experience as favourable (85%) compared to those who went through labour without such analgesia (26%) [P<0.001]. There was no significant improvement in knowledge about epidural analgesia among postnatal as compared to antenatal patients. The main reasons generally ascribed by patients for not being able to obtain an epidural service despite it being requested, were related to limited resources.
The results showed poor general awareness of pregnant women about the proper role of epidural analgesia in labour, leading to a low patient demand for such services. Despite the low prevailing request rate for epidural analgesia in labour, there appears to be a lack of adequate resources to meet the demand.
评估患者对分娩时硬膜外服务的态度,并将其与患者的选择以及硬膜外镇痛的实际使用情况相关联。
问卷调查。
八个医院管理局的产科单位。
一组新的产前患者和一组为期1个日历月的产后住院患者。
产前患者对硬膜外服务的知晓情况以及对分娩时硬膜外镇痛的态度;此类镇痛的实际使用情况以及产后患者报告的体验。
分别有2109名和2851名患者完成了产前和产后调查。前者显示,只有47%的患者接触过分娩时硬膜外镇痛的概念,只有13%的患者选择此类镇痛。在产后队列中,硬膜外镇痛的总体使用率为10%,尽管有19%的患者实际要求使用。与未接受此类镇痛而分娩的患者(26%)相比,分娩时接受硬膜外镇痛的患者更有可能认为自己的体验良好(85%)[P<0.001]。与产前患者相比,产后患者对硬膜外镇痛的知识没有显著改善。患者普遍认为尽管要求了但仍无法获得硬膜外服务的主要原因与资源有限有关。
结果显示孕妇对硬膜外镇痛在分娩中适当作用的总体知晓度较低,导致患者对此类服务的需求较低。尽管分娩时硬膜外镇痛的普遍需求率较低,但似乎缺乏足够的资源来满足需求。