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在坦桑尼亚东部的两家选定地区医院中,助产士在管理分娩疼痛时使用非药物方法的经验。

Use of non-pharmacological methods in managing labour pain: experiences of nurse-midwives in two selected district hospitals in eastern Tanzania.

机构信息

Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania.

Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania.

出版信息

BMC Pregnancy Childbirth. 2022 Apr 30;22(1):376. doi: 10.1186/s12884-022-04707-x.

Abstract

BACKGROUND

Labour pain usually brings with it many concerns for a parturient and her family. The majority of the women in labour pain may require some sort of pain relief method during this period, be it pharmacological or non-pharmacological. In Tanzania, the use of non-pharmacological methods to relief labour pain remains low among nurse-midwives. We analysed the experiences of nurse-midwives in the use of non-pharmacological methods to manage labour pain, in two selected districts of Pwani and Dar es Salaam regions in eastern Tanzania. This paper describes Non-pharmacological Methods (NPMs) currently used by nurse-midwives, the facilitators, myths and fears related to the use of NPMs.

MATERIALS AND METHODS

An exploratory qualitative study using in-depth interviews was conducted with 18 purposively recruited nurse-midwives working in labour wards in two selected district hospitals in Pwani and Dar es Salaam regions in eastern Tanzania. Qualitative conventional content analysis was used to generate categories describing the experience of using non-pharmacological methods in managing labour pain.

RESULTS

This study revealed that nurse-midwives encouraged women to tolerate labour pain and instructed them to change positions and to do deep breathing exercises as a means to relief labour pain. Nurse-midwives' inner motives facilitated the use of non-pharmacological strategies for labour pain relief despite the fear of using them and myths that labour pain is necessary for childbirth.

CONCLUSION

This study generates information about the use of non-pharmacological strategies to relief labour pain. Although nurse-midwives are motivated to apply various non-pharmacological strategies to relief labour pain, fear and misconceptions about the necessity of labour pain during childbirth prohibit the effective use of these strategies. Therefore, together with capacity building the nurse-midwives in the use of non-pharmacological strategies to relief labour pain, efforts should be made to address the misconceptions that may partly be of socio-cultural origin.

摘要

背景

分娩疼痛通常会给产妇及其家人带来诸多担忧。大多数产妇在分娩过程中可能需要某种止痛方法,无论是药物性的还是非药物性的。在坦桑尼亚,助产士在分娩过程中使用非药物性止痛方法的比例仍然较低。我们分析了坦桑尼亚东部滨海省和达累斯萨拉姆地区两个选定地区的助产士在使用非药物性方法缓解分娩疼痛方面的经验。本文描述了助产士目前使用的非药物性方法(NPM)、与使用 NPM 相关的促进因素、误区和恐惧。

材料和方法

采用探索性定性研究方法,对坦桑尼亚东部滨海省和达累斯萨拉姆地区两个选定地区医院产房工作的 18 名助产士进行了深入访谈。采用定性常规内容分析方法,生成描述使用非药物性方法缓解分娩疼痛的经验类别。

结果

本研究表明,助产士鼓励产妇忍受分娩疼痛,并指导她们改变姿势,进行深呼吸运动,以此缓解分娩疼痛。尽管助产士害怕使用非药物性策略缓解分娩疼痛,并存在分娩疼痛是分娩所必需的误解,但助产士的内在动机促进了这些策略的使用。

结论

本研究提供了有关使用非药物性策略缓解分娩疼痛的信息。尽管助产士有动机应用各种非药物性策略来缓解分娩疼痛,但对分娩疼痛必要性的恐惧和误解限制了这些策略的有效使用。因此,除了助产士在使用非药物性策略缓解分娩疼痛方面的能力建设外,还应努力解决可能部分源于社会文化的误解。

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