Hunter Lauren P
San Diego State University, School of Nursing, 5500 Campanile Drive, San Diego, CA 92182, USA.
J Midwifery Womens Health. 2009 Mar-Apr;54(2):111-8. doi: 10.1016/j.jmwh.2008.10.006.
The objective of this study was to learn more about women's perceptions of the nurse-midwifery practice of "being with woman" during childbirth. The descriptive, correlational design used a convenience sample of 238 low-risk postpartum women in a hospital nurse-midwifery practice, with two childbirth settings: a standard labor and delivery unit and an in-hospital birth center. The main outcome measure was a 29-item seven-response Likert scale questionnaire, the Positive Presence Index (PPI), administered to women cared for during labor and birth by nurse-midwives to measure the concept of being with woman. Statistical analysis demonstrated women who gave birth in the in-hospital birth center or who began labor in the in-hospital birth center prior to an indicated transfer to the standard labor and delivery unit gave higher PPI scores than women who were admitted to and gave birth on the standard labor and delivery unit. Parity, ethnicity, number of midwives attending, presence of personal support persons, length of labor, and pain relief medications were unrelated to PPI scores. Two coping/comfort techniques, music therapy and breathing, were found to be correlated with reported higher PPI scores than those of women who did not use the techniques. These results can be used to encourage continued use of midwifery care and for low client to midwife caseloads during childbirth, and to modify hospital settings to include more in-hospital birth centers.
本研究的目的是更深入地了解女性对分娩期间助产士“陪伴产妇”做法的看法。这项描述性、相关性设计采用了便利抽样，选取了一家医院助产士诊所的238名低风险产后女性，设有两种分娩环境：标准的产房和医院内的分娩中心。主要结局指标是一份由29个项目、有7种回答选项的李克特量表问卷，即积极陪伴指数（PPI），用于测量助产士在分娩期间照顾的女性的陪伴概念。统计分析表明，在医院内分娩中心分娩的女性，或在被转至标准产房之前在医院内分娩中心开始分娩的女性，其PPI得分高于在标准产房入院并分娩的女性。产次、种族、助产士人数、是否有个人支持人员、产程时长和止痛药物与PPI得分无关。研究发现，两种应对/舒适技巧，即音乐疗法和呼吸法，与报告的PPI得分高于未使用这些技巧的女性相关。这些结果可用于鼓励在分娩期间持续采用助产护理以及保持较低的产妇与助产士比例，并对医院环境进行调整，以增加医院内分娩中心的数量。
