Gonzalez Basilia, Gonzalez Santiago R, Rojo Martha, Mhyre Jill
Department of Family Medicine, Lifelong Medical Care, Richmond, CA, USA.
Division of Plastic & Reconstructive Surgery, University of California San Francisco, San Francisco, CA, USA.
Int J Womens Health. 2021 Jan 13;13:87-94. doi: 10.2147/IJWH.S270711. eCollection 2021.
The presence of racial/ethnic disparities in the use of neuraxial labor analgesia for childbirth has been previously described. The purpose of this study was to assess the childbirth pain management beliefs among a small sample of pregnant Hispanic women and to evaluate the Spanish translation accuracy of the Childbirth Pain Scale (CPBS).
To collect data, we interviewed 20 pregnant Spanish-speaking women using an interview guide, a demographic datasheet, and the CPBS a 15-item survey. Interviews were transcribed verbatim, translated, and uploaded to ethnograph v6. Descriptive statistics and thematic analysis were used to analyze the data.
Most of the participants were from Mexico (n=16) and Central America (n=4), mean age was 28.3, and all (n=20) spoke Spanish as their primary language. In this sample, 80% of nulliparous and 100% of multiparous women saw pain as having a positive role in delivery. Four major themes emerged from the data: Theme 1: Normalcy of childbirth pain (pain is good), Theme 2: Availability and role of pain medication, Theme 3: Naturalistic strategies to endure pain, and Theme 4: Fear of the unknown/childbirth process. In this sample, 18 of 20 women stated they did not want epidural analgesia unless medically indicated. During labor and delivery 100% of nulliparous and 25% of multiparas chose to receive epidural analgesia. No changes were requested by the participants regarding the translation of the CPBS.
Childbirth pain was seen as a valuable component of the birthing process. The majority of participants believed pain medication should be avoided unless medically necessary. These results suggest that racial/ethnic disparities in the use of epidural analgesia may partially reflect patient beliefs and preferences. It is crucial to be aware of these differences to optimize shared decision-making for women in this vulnerable patient population.
先前已有关于分娩时使用椎管内分娩镇痛存在种族/民族差异的描述。本研究的目的是评估一小部分西班牙裔孕妇对分娩疼痛管理的看法，并评估分娩疼痛量表（CPBS）西班牙语翻译的准确性。
为收集数据，我们使用访谈指南、人口数据表和CPBS（一项15项的调查）对20名讲西班牙语的孕妇进行了访谈。访谈逐字记录、翻译并上传至Ethnograph v6。使用描述性统计和主题分析来分析数据。
大多数参与者来自墨西哥（n = 16）和中美洲（n = 4），平均年龄为28.3岁，所有20人（n = 20）均以西班牙语为主要语言。在这个样本中，80%的初产妇和100%的经产妇认为疼痛在分娩中具有积极作用。数据中出现了四个主要主题：主题1：分娩疼痛的常态（疼痛是好的），主题2：止痛药的可用性和作用，主题3：忍受疼痛的自然主义策略，以及主题4：对未知/分娩过程的恐惧。在这个样本中，20名女性中有18人表示除非有医学指征，否则她们不想使用硬膜外镇痛。在分娩期间，100%的初产妇和25%的经产妇选择接受硬膜外镇痛。参与者对CPBS的翻译未提出任何修改意见。
分娩疼痛被视为分娩过程中的一个重要组成部分。大多数参与者认为除非有医学必要，应避免使用止痛药。这些结果表明，硬膜外镇痛使用中的种族/民族差异可能部分反映了患者的信念和偏好。了解这些差异对于优化这一脆弱患者群体中女性的共同决策至关重要。
