Toledo Paloma, Pumarino Javiera, Grobman William A, Wong Cynthia A, Holl Jane L, Hasnain-Wynia Romana
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Birth. 2017 Dec;44(4):345-351. doi: 10.1111/birt.12292. Epub 2017 May 5.
The decision to use, or not use, neuraxial labor analgesia is complex, with both maternal and fetal considerations. Fears and concerns about neuraxial analgesia may influence analgesic decision-making. Little is known about patients' preferences for analgesic counseling. Therefore, the objectives of this qualitative study were to evaluate the sources of information used by patients, the timing and content of antepartum counseling about labor analgesia, and patients' preferences for such counseling.
A semi-structured interview guide was developed. Survey domains included the sources of information used by patients, the timing and content of antenatal counseling, patients' perceptions of intrapartum analgesic counseling, and their preferences for analgesic counseling. Interviews occured on postpartum day 1. Interview transcripts were analyzed using content analysis.
The interviews of 45 women were analyzed. The Internet was the most frequently mentioned source of information (44%). The majority of women (78%) discussed analgesic options with their obstetric providers before delivery. All women were counseled intrapartum by an anesthesiologist, but several women commented on the difficulty of concentrating while laboring. Seventy-three percent of women stated that they would want counseling on analgesic options from their obstetric provider during the second or third trimester.
Women prefer to be counseled about labor analgesia by their obstetric providers, as they have an established relationship. Patients would prefer the counseling to occur during pregnancy, before the onset of labor. However, given the frequent use of the Internet, the content and quality of online materials should also be evaluated.
决定是否使用椎管内分娩镇痛是一个复杂的问题，需要考虑母体和胎儿两方面的因素。对椎管内镇痛的恐惧和担忧可能会影响镇痛决策。关于患者对镇痛咨询的偏好知之甚少。因此，本定性研究的目的是评估患者使用的信息来源、产前分娩镇痛咨询的时间和内容，以及患者对这种咨询的偏好。
制定了一份半结构化访谈指南。调查领域包括患者使用的信息来源、产前咨询的时间和内容、患者对产时镇痛咨询的看法，以及他们对镇痛咨询的偏好。访谈在产后第1天进行。使用内容分析法对访谈记录进行分析。
对45名女性的访谈进行了分析。互联网是最常被提及的信息来源（44%）。大多数女性（78%）在分娩前与产科医生讨论了镇痛选择。所有女性在产时都接受了麻醉医生的咨询，但有几位女性提到在分娩时难以集中注意力。73%的女性表示，她们希望在孕中期或孕晚期从产科医生那里获得关于镇痛选择的咨询。
女性更希望由她们已建立关系的产科医生提供分娩镇痛咨询。患者希望在分娩开始前的孕期进行咨询。然而，鉴于互联网的频繁使用，也应该评估在线材料的内容和质量。
