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埃塞俄比亚中部西谢瓦地区产科护理人员在分娩疼痛管理中使用产科镇痛及其相关因素

Obstetric analgesia utilization in labor pain management and associated factors among obstetric care providers in the West Shewa Zone, Central Ethiopia.

作者信息

Terfasa Eba Abera, Bulto Gizachew Abdissa, Irenso Dereje Yadesa

机构信息

Maternity and Reproductive Health Nursing, Oromia Regional Health Bureau, Addis Ababa, Ethiopia.

Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.

出版信息

SAGE Open Med. 2022 Mar 22;10:20503121221088705. doi: 10.1177/20503121221088705. eCollection 2022.

Abstract

OBJECTIVES

Labor pain is the worst pain that almost every woman experiences during childbirth. Labor pain management plays a crucial role in promoting maternal-wellbeing, contributing enormously to maternal satisfaction with the childbirth experience and the high quality of services. Although there have been previous studies, they have primarily been conducted at referral or general hospitals located in urban settings. Thus, this study aimed to assess the utilization of labor pain analgesia and associated factors among obstetric care providers at all levels of health facilities in central Ethiopia.

METHODS

A multicenter institution-based cross-sectional study design was employed from 1 July to 30 September 2020. Simple random sampling using the lottery method was employed to select 399 obstetric care providers. The data were entered into Epi-data version 4.2 and analyzed using SPSS version 26. Bivariate and multivariable logistic regression analysis were used to identify the associated factors. The adjusted odds ratio with its 95% confidence interval and p value ⩽ 0.05 were used to identify associated factors.

RESULTS

The overall utilization of obstetric analgesia was 46% (95% confidence interval: 41.2%-50.8%). Being a Midwife (adjusted odds ratio: 2.10, 95% confidence interval: 1.27-3.47), having heard of the World Health Organization pain ladder (adjusted odds ratio: 2.95, 95% confidence interval: 1.73-5.01), having favorable attitude (adjusted odds ratio: 1.89, 95% confidence interval: 1.17-3.05), the expectation of obstetric care providers about labor pain (adjusted odds ratio: 3.26, 95% confidence interval: 1.27-8.36), having training on labor pain management (adjusted odds ratio: 2.51, 95% confidence interval: 1.03-6.07), and presence of chance for preference of obstetric analgesia for mothers in the facility (adjusted odds ratio = 2.30, 95% confidence interval: 1.33-3.98) were identified as factors significantly associated with the practice of obstetric analgesia among obstetric care providers.

CONCLUSION

The overall use of labor pain management methods among obstetric care providers is low. Professional category, provider attitude, labor pain severity expectations, and having training were found to be factors associated with the use of obstetric analgesia. Therefore, working on adapting and disseminating the harmonized guideline and protocols on labor pain management and provision of training for obstetric care providers on labor pain management techniques were recommended.

摘要

目的

分娩疼痛是几乎每位女性在分娩过程中所经历的最剧烈的疼痛。分娩疼痛管理在促进产妇福祉方面发挥着关键作用,对产妇对分娩体验的满意度以及高质量服务有巨大贡献。尽管此前已有相关研究,但主要是在城市地区的转诊医院或综合医院进行的。因此,本研究旨在评估埃塞俄比亚中部各级卫生设施中产科护理人员对分娩疼痛镇痛的使用情况及相关因素。

方法

采用多中心基于机构的横断面研究设计,研究时间为2020年7月1日至9月30日。使用抽签法进行简单随机抽样,选取399名产科护理人员。数据录入Epi - data 4.2版本,并使用SPSS 26版本进行分析。采用双变量和多变量逻辑回归分析来确定相关因素。使用调整后的比值比及其95%置信区间和p值≤0.05来确定相关因素。

结果

产科镇痛的总体使用率为46%(95%置信区间:41.2% - 50.8%)。职业为助产士(调整后的比值比:2.10,95%置信区间:1.27 - 3.47)、听说过世界卫生组织疼痛阶梯(调整后的比值比:2.95,95%置信区间:1.73 - 5.01)、态度积极(调整后的比值比:1.89,95%置信区间:1.17 - 3.05)、产科护理人员对分娩疼痛的预期(调整后的比值比:3.26,95%置信区间:1.27 - 8.36)、接受过分娩疼痛管理培训(调整后的比值比:2.51,95%置信区间:1.03 - 6.07)以及所在机构存在为母亲选择产科镇痛的机会(调整后的比值比 = 2.30,95%置信区间:1.33 - 3.98)被确定为与产科护理人员产科镇痛实践显著相关的因素。

结论

产科护理人员对分娩疼痛管理方法的总体使用率较低。专业类别、护理人员态度、分娩疼痛严重程度预期以及接受培训被发现是与产科镇痛使用相关的因素。因此,建议致力于调整和传播关于分娩疼痛管理的统一指南和方案,并为产科护理人员提供分娩疼痛管理技术培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d9/8943529/e233f245cbbb/10.1177_20503121221088705-fig1.jpg

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