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针对与产前咨询相关的高危孕妇的短期面对面及在线产前教育干预措施的评估。

Evaluation of a short in-person and online antenatal educational intervention for high-risk pregnant women linked to antenatal consultation.

作者信息

Heim Maria A, Makuch Maria Y

机构信息

Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil.

Campinas Reproductive Health Research Center, Sao Paulo, Brazil.

出版信息

Eur J Midwifery. 2024 Jan 18;8. doi: 10.18332/ejm/175927. eCollection 2024.

Abstract

INTRODUCTION

The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic.

METHODS

This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used.

RESULTS

When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033).

CONCLUSIONS

Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.

摘要

引言

本研究的目的是评估一项短期教育干预措施,该措施聚焦于严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新型冠状病毒肺炎)大流行之前及期间的分娩疼痛(通过视觉模拟评分法,VAS)、产后焦虑和分娩体验。

方法

这是一项准实验研究,于2019年11月至2021年5月在巴西对100名妊娠晚期高危孕妇进行,分为干预组(在新型冠状病毒肺炎大流行期间进行面对面或虚拟课程)和非干预组。产前干预包括呼吸和放松技巧、直立姿势以及分娩相关信息。评估时使用了一份产前问卷、状态-特质焦虑量表(STAI)和一份产后问卷。数据分析采用了学生t检验、卡方检验和费舍尔精确检验、方差分析、双变量和多变量回归分析。

结果

将干预组女性与非干预组女性进行比较时发现,后者在产前咨询时报告对分娩疼痛的恐惧更高(p<0.013);更多女性在宫口扩张0至4厘米时需要镇痛(17/40)(p<0.018);产程持续时间≥12小时(37/50)(p<0.037);而干预组报告有规律、良好或优秀的产程(36/50)(p=0.014)。分娩疼痛的多变量回归分析显示,分娩方式(剖宫产:RR;SE -21.43;5.32,p<0.001)与分娩疼痛以及对分娩的良好满意度之间存在显著关系(RR;SE -13.86;6.40,p=0.033)。

结论

与非干预组女性相比,干预组女性在分娩期间的满意度更高,疼痛更少。

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