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分娩中积极分娩体验的预测因素:一项横断面研究。

Predictors of a positive birth experience in childbirth: A cross-sectional study.

作者信息

Roqueta-Vall-Llosera M, Cámara-Liebana D, Serrat-Graboleda E, Salleras-Duran L, Buxó-Pujolràs M, Fuentes-Pumarola C, Ballester-Ferrando D

机构信息

Nursing Department, Health, Gender and Aging Research Group, University of Girona, Girona, Catalonia, Spain.

Nursing Department, Quality of Life Research Group, University of Girona, Girona, Catalonia, Spain.

出版信息

Heliyon. 2024 Sep 22;10(19):e38262. doi: 10.1016/j.heliyon.2024.e38262. eCollection 2024 Oct 15.

Abstract

BACKGROUND

Recognizing predictors of positive birth experience is viewed as essential for minimizing negative experiences during childbirth that are related to current obstetric care, especially when those could be attributed to intrapartum interventions. The CEQ-E is a suitable instrument for investigating maternal birth experience within the Spanish population, highlighting the necessity to identify predictors for all its domains. This study aimed to identify predictors of positive birth experience based on socio-demographic and clinical variables, and obstetric interventions.

METHODS

Cross-sectional study conducted with consecutive sampling (N = 301). Quantitative data were collected by the Childbirth Experience Questionnaire (CEQ-E) and an Ad hoc questionnaire. Clinical data was obtained from participants' medical records. Descriptive, bivariant and multivariant analysis were performed.

RESULTS

The CEQ overall mean score was 3.18(SD:0.42), showing the highest score for the professional support (3.79; SD: 0.43) and the lowest for the own capacity (2.8; SD:0.57). All domains and overall score showed negative correlations with the number of intrapartum interventions (p ≤ .001). Inductions of labour, instrumental deliveries, and caesarean sections were inversely related to; overall birth experience score (p ≤ .001), perceived safety (p ≤ .001), and own capacity (p ≤ .001). Epidural analgesia was linked to worse values of birth experience (p ≤ .001). Predictors of positive birth experience were identified as having a midwife as birth attendant (p ≤ .001) and neonatal higher Apgar scores at birth (p ≤ .001), whereas higher maternal education grade (p = .04), inductions of labour (p ≤ .001) and caesarean births (p ≤ .001) had worse values on birth experience.

CONCLUSION

Women reported a positive birth experience, and professional support was highly valued. Key predictors of lower scores in birth experience included higher maternal education, caesarean and instrumental deliveries, and neonatal intensive care unit (NICU) admission. Spontaneous labour onset predicted better capacity and safety. Epidural use decreased participation. Midwife-attended births reported better scores on birth experience, highlighting their importance in maternal care.

摘要

背景

识别积极分娩体验的预测因素被视为将分娩期间与当前产科护理相关的负面体验降至最低的关键,特别是当这些负面体验可归因于产时干预措施时。CEQ-E是一种适用于调查西班牙人群中孕产妇分娩体验的工具,这凸显了识别其所有领域预测因素的必要性。本研究旨在根据社会人口学和临床变量以及产科干预措施确定积极分娩体验的预测因素。

方法

采用连续抽样进行横断面研究(N = 301)。通过分娩体验问卷(CEQ-E)和一份特设问卷收集定量数据。临床数据从参与者的病历中获取。进行了描述性、双变量和多变量分析。

结果

CEQ的总体平均分为3.18(标准差:0.42),其中专业支持得分最高(3.79;标准差:0.43),自身能力得分最低(2.8;标准差:0.57)。所有领域和总分与产时干预措施的数量均呈负相关(p≤0.001)。引产、器械助产和剖宫产与总体分娩体验得分(p≤0.001)、感知安全性(p≤0.001)和自身能力(p≤0.001)呈负相关。硬膜外镇痛与更差的分娩体验值相关(p≤0.001)。积极分娩体验的预测因素被确定为有助产士作为接生人员(p≤0.001)以及新生儿出生时阿氏评分较高(p≤0.001),而母亲教育程度较高(p = 0.04)、引产(p≤0.001)和剖宫产(p≤0.001)在分娩体验方面的值较差。

结论

女性报告了积极的分娩体验,并且高度重视专业支持。分娩体验得分较低的关键预测因素包括母亲教育程度较高、剖宫产和器械助产以及新生儿重症监护病房(NICU)入院。自然发动分娩预示着更好的能力和安全性。使用硬膜外麻醉会降低参与度。由助产士接生的分娩在分娩体验方面得分更高,凸显了她们在孕产妇护理中的重要性。

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