Van der Gucht Natalie, Lewis Kiara
Bradford Teaching Hospital, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
University of Huddersfield, Institute for Research in Citizenship and Applied Human Sciences, Queensgate Campus, Huddersfield HD1 3DH, UK.
Midwifery. 2015 Mar;31(3):349-58. doi: 10.1016/j.midw.2014.12.005. Epub 2014 Dec 31.
to identify and analyse qualitative literature exploring women's experiences of coping with pain during childbirth.
critical review of qualitative research.
ten studies were included, conducted in Australia, England, Finland, Iceland, Indonesia, Iran and Sweden. Eight of the studies employed a phenomenological perspective with the remaining two without a specific qualitative methodological perspective. Thematic analysis was used as the approach for synthesising the data in this review. Two main themes emerged as the most significant influences upon a woman's ability to cope with pain: (i) the importance of individualised, continuous support and (ii) an acceptance of pain during childbirth. This review found that women felt vulnerable during childbirth and valued the relationships they had with health professionals. Many of the women perceived childbirth pain as challenging, however, they described the inherent paradox for the need for pain to birth their child. This allowed them to embrace the pain subsequently enhancing their coping ability.
women's experience of coping with pain during childbirth is complex and multifaceted. Many women felt the need for effective support throughout childbirth and described the potential implications where this support failed to be provided. Feeling safe through the concept of continuous support was a key element of care to enhance the coping ability and avoid feelings of loneliness and fear. A positive outlook and acceptance of pain was acknowledged by many of the women, demonstrating the beneficial implications for coping ability. These findings were consistent despite the socio-economic, cultural and contextual differences observed within the studies suggesting that experiences of coping with pain during childbirth are universal.
the findings suggest there is a dissonance between what women want in order to enhance their ability to cope with pain and the reality of clinical practice. This review found women would like health professionals to maintain a continuous presence throughout childbirth and support a social model of care that promotes continuity of care and an increasing acceptance of pain as part of normal childbirth. It is suggested future research regarding the role of antenatal provision for instilling such a viewpoint in preparation of birth be undertaken to inform policy makers. The need for a shift in societal norms is also suggested to disseminate expectations and positive or negative views of what the role of pain during childbirth should be to empower women to cope with childbirth and embrace this transition to motherhood as part of a normal process.
识别并分析探索女性分娩时应对疼痛经历的定性文献。
对定性研究的批判性综述。
纳入了10项研究，这些研究在澳大利亚、英国、芬兰、冰岛、印度尼西亚、伊朗和瑞典开展。其中8项研究采用现象学视角，其余两项未采用特定的定性方法论视角。本综述采用主题分析法来综合数据。出现了两个对女性应对疼痛能力影响最大的主要主题：（i）个性化、持续支持的重要性，以及（ii）对分娩疼痛的接受。本综述发现，女性在分娩时感到脆弱，重视她们与医护人员的关系。许多女性认为分娩疼痛具有挑战性，然而，她们描述了分娩时疼痛与生下孩子之间内在的矛盾。这使她们能够接受疼痛，从而增强了应对能力。
女性分娩时应对疼痛的经历复杂且多面。许多女性感到在整个分娩过程中都需要有效的支持，并描述了未能提供这种支持可能产生的影响。通过持续支持的理念感到安全是增强应对能力、避免孤独和恐惧情绪的关键护理要素。许多女性认可积极的态度和对疼痛的接受，这表明其对应对能力有有益影响。尽管在这些研究中观察到社会经济、文化和背景存在差异，但这些发现是一致的，这表明分娩时应对疼痛的经历具有普遍性。
研究结果表明，女性为增强应对疼痛能力的需求与临床实践的现实之间存在脱节。本综述发现，女性希望医护人员在整个分娩过程中持续陪伴，并支持一种促进护理连续性以及越来越接受疼痛是正常分娩一部分的社会护理模式。建议未来开展关于产前准备在灌输这种分娩准备观点方面作用的研究，为政策制定者提供信息。还建议转变社会规范，以传播对分娩时疼痛作用的期望以及积极或消极观点，使女性有能力应对分娩并将这种向母亲身份的转变视为正常过程的一部分。
