İsbir Gözde Gökçe, Serçekuş Pinar
1PhD, RN, Assistant Professor, Niğde Zübeyde Hanim School of Health, Niğde University, Turkey 2PhD, RN, Assistant Professor, Denizli School of Health, Pamukkale University, Turkey.
J Nurs Res. 2017 Apr;25(2):112-119. doi: 10.1097/JNR.0000000000000129.
Supportive care during labor, the primary role of intrapartum nurses and midwives, provides comfort to prepartum women and helps facilitate a positive labor experience. It has been argued that supportive care during labor reduces fear and anxiety as well as the resultant side effects. However, evidence supporting this argument is insufficient.
The aim of this study was to assess the effects of intrapartum supportive care on fear of delivery and on the key parameters of the labor process.
This study used a single-blind randomized controlled trial approach. Randomized block assignment was used to assign 72 participants to either the intervention group (n = 36) or the control group (n = 36). Three women in the intervention group and six in the control group were later excluded from the study because they received emergency cesarean delivery. The intervention group received continuous supportive care, and the control group received routine hospital care.
No significant differences were identified between the two groups at baseline. The intervention group reported less fear of delivery during the active and transient phases of labor, higher perceived support and control during delivery, lower pain scores during the transient phase of labor, and a shorter delivery period than the control group (p < .05). However, no significant difference in the use of oxytocin during delivery between the two groups was reported.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this evidence-based study suggest that continuous support during labor has clinically meaningful benefits for women and that all women should receive this support throughout their labor and delivery process.
分娩期间的支持性护理是产时护士和助产士的主要职责,可为产前女性提供舒适感,并有助于促成积极的分娩体验。有人认为,分娩期间的支持性护理可减少恐惧和焦虑以及由此产生的副作用。然而,支持这一观点的证据并不充分。
本研究旨在评估产时支持性护理对分娩恐惧及分娩过程关键参数的影响。
本研究采用单盲随机对照试验方法。使用随机区组设计将72名参与者分为干预组(n = 36)或对照组(n = 36)。干预组有3名女性和对照组有6名女性后来被排除在研究之外,因为她们接受了急诊剖宫产。干预组接受持续的支持性护理,对照组接受常规医院护理。
两组在基线时未发现显著差异。与对照组相比,干预组在活跃期和过渡期分娩时报告的分娩恐惧较少,分娩时的支持感和控制感较高,过渡期分娩时疼痛评分较低,分娩时间较短(p < 0.05)。然而,两组在分娩期间缩宫素的使用上未报告有显著差异。
结论/对实践的启示:这项基于证据的研究结果表明,分娩期间的持续支持对女性具有临床意义上的益处,所有女性在分娩和接生过程中都应获得这种支持。