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药理学分娩镇痛的利用:对埃塞俄比亚东部产科医护人员的调查。

Utilization of pharmacological labour analgesia: a survey of obstetric care providers in eastern Ethiopia.

机构信息

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

Int Health. 2023 May 2;15(3):335-341. doi: 10.1093/inthealth/ihac061.

Abstract

BACKGROUND

Despite a crucial role played by obstetric care providers (OCPs) in providing pain relief methods during labour, the evidence suggests that there is a large number of women in Ethiopia who did not have access to pain relief methods. Moreover, to the best of the investigators' knowledge, evidence is scarce regarding the utilization of pharmacological labour pain management methods in the study area. Thus this study was carried out to determine the practice of pharmacological labour pain management methods among OCPs in Harari regional state health facilities in Ethiopia.

METHODS

A facility-based cross-sectional study was conducted from 20 May to 10 June 2021 in Harari regional state health facilities. All (n=464) OCPs in Harari regional state health facilities were included in the study. Data were collected using a structured questionnaire adapted from previous studies. The data were entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out using SPSS for Windows version 22. Bivariate and multivariate logistic regression analyses were employed to determine the association between independent variables and the outcome variable. A p-value <0.05 was used to establish statistical significance.

RESULTS

In this study, 464 OCPs participated. The overall utilization of pharmacological labour pain relief methods was 50.9% (95% confidence interval [CI] 45.8 to 55.8). The main barriers to labouring mothers receiving pain relief include high patient flow (54.4%), the limited number of staff (51.9%) and a lack of knowledge and skill (32.9%). Being female (adjusted odds ratio [AOR] 2.07 [95% CI 1.31 to 3.26]), not having training (AOR 1.60 [95% CI 1.02 to 2.53]) and having an unfavourable attitude (AOR 9.1 [95% CI 5.34 to 15.35]) were the predictors of utilization of pharmacological labour pain management methods.

CONCLUSIONS

The study revealed that half of the OCPs utilized the pharmacological labour pain management method. In general, this study identified that variables like sex, training and the attitude of OCPs were factors associated with the utilization of pharmacological labour pain management methods. The health facilities should provide training to enhance the skill of OCPs and equip themselves with sufficient analgesic drugs.

摘要

背景

尽管产科医护人员在分娩时提供缓解疼痛的方法方面发挥了关键作用,但有证据表明,埃塞俄比亚仍有大量产妇无法获得缓解疼痛的方法。此外,据调查人员所知,在研究区域,关于利用药理学方法管理分娩疼痛的证据很少。因此,本研究旨在确定在埃塞俄比亚哈拉里地区州卫生机构中,产科医护人员实施药理学方法管理分娩疼痛的实践情况。

方法

本项 2021 年 5 月 20 日至 6 月 10 日在哈拉里地区州卫生机构进行的基于机构的横断面研究,纳入了哈拉里地区州卫生机构的所有(n=464)产科医护人员。使用改编自先前研究的结构化问卷收集数据。将数据录入 Epi-data 版本 3.1 统计软件中。使用 Windows 版 SPSS 22 进行统计分析。采用二变量和多变量逻辑回归分析来确定自变量与因变量之间的关联。采用 p 值<0.05 来确定统计学意义。

结果

本研究中,共有 464 名产科医护人员参与。总体上,50.9%(95%置信区间 [CI] 45.8%至 55.8%)的产妇使用了药理学方法缓解分娩疼痛。导致产妇无法获得疼痛缓解的主要障碍包括患者流量大(54.4%)、工作人员数量有限(51.9%)以及缺乏知识和技能(32.9%)。女性(调整后的优势比 [AOR] 2.07 [95%CI 1.31 至 3.26])、未接受培训(AOR 1.60 [95%CI 1.02 至 2.53])和持有不利态度(AOR 9.1 [95%CI 5.34 至 15.35])是利用药理学方法管理分娩疼痛的预测因素。

结论

本研究表明,半数产科医护人员使用了药理学方法管理分娩疼痛。总的来说,本研究发现,产科医护人员的性别、培训和态度等变量是与利用药理学方法管理分娩疼痛相关的因素。卫生机构应提供培训以提高产科医护人员的技能,并为其配备足够的镇痛药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caef/10153555/5a3030979cbf/ihac061fig1.jpg

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