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分娩过程中使用补充性、非药物性止痛方法的情况:外国出生和瑞典出生女性的对比。

Use of complementary, non-pharmacological pain reduction methods during childbirth among foreign-born and Swedish-born women.

机构信息

Institute of Woman and Child Health, Karolinska Institutet, Retzius väg 16b, SE-171 77 Solna, Sweden.

出版信息

Midwifery. 2010 Aug;26(4):442-9. doi: 10.1016/j.midw.2008.10.005. Epub 2008 Dec 11.

Abstract

OBJECTIVE

to investigate the association between country of origin of women and their use of complementary pain reduction methods (i.e. non-pharmacological) during childbirth in Sweden.

DESIGN

cross-sectional design.

SETTING

a national register-based study.

PARTICIPANTS

215,497 singleton deliveries (including the first birth of each woman during the period) of women aged 18-47 years in Sweden between 1996 and 1998, divided into 12 subgroups of countries or regions.

MEASUREMENTS

the use of complementary pain reduction methods during childbirth was analysed by logistic regression, adjusting for parity, level of education, number of antenatal care visits, complications in pregnancy, complications during childbirth, use of any pharmacological methods and use of epidural/spinal analgesia during childbirth.

FINDINGS

all subgroups of foreign-born women, except those from Finland, had lower odds of complementary pain reduction methods during childbirth than Swedish-born women. Women from Bosnia, Arab countries, Sub-Saharan Africa, Turkey, Iran and Asia had about 40% lower odds for use of complementary pain reduction methods during childbirth than Swedish-born women. Women who used epidural analgesia had higher odds for use of complementary pain reduction methods during childbirth than women who did not use any pharmacological methods.

KEY CONCLUSION

most subgroups of foreign-born women showed lower odds for and a different pattern in the use of complementary pain reduction methods during childbirth than Swedish-born women. These findings raise questions of whether the Swedish health-care system and care providers have sufficient awareness of and insight into the socio-cultural context of giving birth.

摘要

目的

探讨女性原籍国与她们在瑞典分娩时使用补充性止痛方法(即非药物性方法)之间的关系。

设计

横断面设计。

设置

基于全国注册的研究。

参与者

1996 年至 1998 年间,瑞典年龄在 18-47 岁的 215497 名单胎分娩产妇(包括该期间每位女性的首次分娩),分为 12 个国家或地区亚组。

测量方法

采用逻辑回归分析分娩时使用补充性止痛方法的情况,并根据产次、教育程度、产前检查次数、妊娠并发症、分娩并发症、任何药物性方法的使用情况以及分娩时使用硬膜外/脊髓镇痛情况进行调整。

结果

除芬兰以外,所有外国出生女性亚组在分娩时使用补充性止痛方法的几率均低于瑞典出生女性。来自波斯尼亚、阿拉伯国家、撒哈拉以南非洲、土耳其、伊朗和亚洲的女性在分娩时使用补充性止痛方法的几率比瑞典出生女性低约 40%。使用硬膜外镇痛的女性在分娩时使用补充性止痛方法的几率高于未使用任何药物性方法的女性。

主要结论

大多数外国出生女性亚组在分娩时使用补充性止痛方法的几率和模式均低于瑞典出生女性。这些发现引发了一些问题,即瑞典的医疗保健系统和医护人员是否充分了解和理解分娩的社会文化背景。

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