Eri Tine S, Bondas Terese, Gross Mechthild M, Janssen Patricia, Green Josephine M
Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
University of Nordland, Faculty of Professional Studies, 8049 Bodö, Norway.
Midwifery. 2015 Mar;31(3):e58-67. doi: 10.1016/j.midw.2014.11.007. Epub 2014 Nov 18.
to integrate findings of individual studies in order to broaden the understanding of first-time mothers' experiences of early labour.
the methodology was metasynthesis which is based on the interpretive meta-ethnography described by Noblit and Hare (1988). Metasynthesis is research on research which synthesises the findings of previous qualitative studies, and the focus is on interpretation and the creation of new knowledge.
all included studies originated from high resource countries (USA 2, UK 4, and Scandinavia 5) and all were carried out in a context of hospital based maternity care.
a total of 231 women participated in the studies.
11 articles were included. The main results are presented with the metaphor a balancing act in an unknown territory. The 'unknown territory' has a double meaning: as the personal experience of going into labour for the first time and as encountering the maternity care system. On both levels women have to make significant decisions: whether labour really has started and subsequently when to go to the hospital. A key challenge is to balance the arrival on the labour ward at the 'right' time, not too early and not too late. Arriving at the 'right' time leads to a positive path, while arriving 'too soon' might lead to a cascade of negative experiences. The results are further presented with five central themes: 'Finding out if labour has started is absorbing'; 'Dealing with labour at home'; 'Trying to arrive at the labour ward at the right time'; 'There is always a risk of being sent home'; 'Encountering health professionals arouses strong emotions'.
the metasynthesis broadens the understanding of first-time mothers' experiences of early labour, and suggests that women's needs when planning a hospital birth are not being adequately met at this stage in the labour process. Three areas of future research are suggested: how to support and strengthen women during pregnancy in order to cope with early labour; women's experiences of early labour when planning a birth in contexts other than hospital; and to continue to investigate new ways of giving care during early labour.
整合各项研究结果，以加深对初产妇早期分娩经历的理解。
采用的方法是元综合法，该方法基于诺布利特和黑尔（1988年）所描述的解释性元民族志。元综合法是对研究的研究，它综合了先前定性研究的结果，重点在于解释和新知识的创造。
所有纳入研究均来自资源丰富的国家（美国2项、英国4项、斯堪的纳维亚5项），且均在以医院为基础的产科护理环境中进行。
共有231名女性参与了这些研究。
纳入了11篇文章。主要结果用“在未知领域的平衡行为”这一隐喻来呈现。“未知领域”有双重含义：一是首次分娩的个人经历，二是遭遇产科护理系统。在这两个层面上，女性都必须做出重大决定：分娩是否真的开始，以及随后何时去医院。一个关键挑战是在“正确”的时间到达产房，既不能太早也不能太晚。在“正确”的时间到达会带来积极的结果，而“太早”到达可能会引发一系列负面经历。结果还通过五个核心主题进一步呈现：“弄清楚分娩是否开始引人入神”；“在家应对分娩”；“试图在正确的时间到达产房”；“总是有被送回家的风险”；“与医护人员接触会引发强烈情绪”。
元综合法拓宽了对初产妇早期分娩经历的理解，并表明在分娩过程的这个阶段，女性在计划医院分娩时的需求未得到充分满足。提出了未来研究的三个领域：如何在孕期支持和增强女性应对早期分娩的能力；女性在非医院环境中计划分娩时的早期分娩经历；以及继续研究早期分娩期间提供护理的新方法。
