Department of Midwifery, College of Medicine and Health Science, BahirDar University, BahirDar, Ethiopia.
School of Public Health, College of Medicine and Health Science, BahirDar University, BahirDar, Ethiopia.
Reprod Health. 2020 Nov 23;17(1):183. doi: 10.1186/s12978-020-01043-1.
Healthcare providers have a responsibility to provide pain management support to women during labor. Labor pain management in low and middle income countries primarily relies on non-pharmacological methods, as there is little access to pharmacologic pain management. This study aimed to determine the utilization of non-pharmacological labor pain management (NPLPM) and associated factors among skilled birth attendants (SBAs) in Amhara Regional State health institutions, Ethiopia.
A cross-sectional study was conducted on 592 SBAs working in the Amhara Region, Ethiopia. A multistage sampling was used to collect data using a pretested interview-administered questionnaire. Descriptive analysis was done to characterize the study population. Logistic regression was used to model predictors of NPLPM utilization among SBAs, including age, qualifications, type of medical institution, knowledge, attitudes, and the presence of a protocol.
Nearly forty seven percent 277(46.8%) of SBAs in the study cohort utilized NPLPM. SBAs who had adequate knowledge of NPLPM had 2.8 times increased odds of using NPLPM than SBAs who had inadequate knowledge. (95%CI 1.89-4.014). SBAs who had a positive attitude had 4.12 times increased odds of using NPLPM than SBAs with a negative attitude (95%CI 2.36, 7.2). SBAs who had labor a pain management protocol in their facility had 3.98 times increased odds of using NPLPM than those who didn't have a labor pain management protocol (95%CI 1.83, 8.62).
The analysis pointed to a gap in the utilization of NPLPM in the Amhara Region facilities studied. Less than half of SBAs used NPLPM when caring for laboring women. Professional factors related to use of NPLPM included the age of SBAs, their attitudes, level of education, and knowledge concerning pain management. NPLPM was also significantly associated with the availability of labor pain management protocols.
医疗保健提供者有责任在分娩期间为女性提供疼痛管理支持。在中低收入国家，分娩疼痛管理主要依赖于非药物方法，因为很少有机会使用药物疼痛管理。本研究旨在确定在埃塞俄比亚阿姆哈拉地区卫生机构中，熟练助产士（SBAs）对非药物性分娩疼痛管理（NPLPM）的利用情况及其相关因素。
在埃塞俄比亚阿姆哈拉地区对 592 名 SBAs 进行了横断面研究。采用多阶段抽样方法，使用经过预测试的访谈式问卷收集数据。对研究人群进行描述性分析。采用逻辑回归对 SBAs 中 NPLPM 利用的预测因素进行建模，包括年龄、资格、医疗机构类型、知识、态度和协议的存在。
在研究队列中，近 47%（277 人）的 SBAs 使用了 NPLPM。与知识不足的 SBAs 相比，具备足够 NPLPM 知识的 SBAs 使用 NPLPM 的可能性增加了 2.8 倍。（95%CI 1.89-4.014）。具有积极态度的 SBAs 使用 NPLPM 的可能性是具有消极态度的 SBAs 的 4.12 倍。（95%CI 2.36，7.2）。在其设施中具有分娩疼痛管理方案的 SBAs 使用 NPLPM 的可能性是没有分娩疼痛管理方案的 SBAs 的 3.98 倍。（95%CI 1.83，8.62）。
分析表明，在所研究的阿姆哈拉地区设施中，NPLPM 的利用存在差距。在照顾分娩妇女时，不到一半的 SBAs 使用 NPLPM。与 NPLPM 使用相关的专业因素包括 SBAs 的年龄、态度、教育水平和疼痛管理知识。NPLPM 与分娩疼痛管理方案的可用性也有显著关联。
