Zeleke Agerie Mengistie, Gonete Yosef Aragaw, Tassew Worku Chekol, Ferede Yeshiwas Ayale
Department of Midwifery, Debark University College of Health Science, Debark, Ethiopia.
Department of Nursing, Tedda Health Science College, Gondar, Ethiopia.
BMC Pregnancy Childbirth. 2025 Mar 18;25(1):309. doi: 10.1186/s12884-025-07417-2.
Health outcomes are a global priority, and the use of nonpharmacological methods for labor pain relief is recommended to improve these outcomes. However, there is a lack of a review regarding on the utilization of nonpharmacological labor pain management.
this study aimed to assess the pooled utilization of nonpharmacological labor pain management and the associated factors among healthcare providers in Ethiopia.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. A total of 2837 articles were retrieved from international databases, including Scopus, PubMed, Web of Science, Science Direct, and National Digital Library repositories. The search for articles was conducted from February 1, 2024, to February 30, 2024. To assess the methodological quality Newcastle Ottawa Scale was utilized. Data extraction was performed using Excel, and the analysis was conducted with Stata 11 software.The effect size measurement utilization of nonpharmacological labor pain management was estimated using the Random Effect Mode. The Cochran's Q test and I statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias.
Fourteen studies met the eligibility criteria with a total sample size of 4,821. The overall pooled utilization of nonpharmacological labor pain management among healthcare provider was 45.48% (95% CI: 35.74-55.22). Healthcare providers aged 20-29 years (AOR: 4.10; 95% CI: 1.79-9.39), those having with knowledge about nonpharmacological pain management (AOR: 3.11; 95% CI: 1.88-5.16), and those who allowed companions to support laboring mothers (AOR: 3.37; 95% CI: 1.56-7.24) were determinants of outcome variables.
Over half of Ethiopian healthcare providers did not use nonpharmacological pain management during childbirth. Key factors healthcare providers aged 20-29, those with adequate knowledge, and healthcare providers' ability who allowed companions to enter labor ward to support laboring mothers. Providing updated in-service training programs for older healthcare providers are recommended to utilize nonpharmacological pain management techniques. Policymakers should also create clear understand about obstetric guidelines to promote pain management during childbirth.
健康结果是全球关注的重点，建议使用非药物方法缓解分娩疼痛以改善这些结果。然而，目前缺乏关于非药物分娩疼痛管理利用情况的综述。
本研究旨在评估埃塞俄比亚医疗服务提供者中非药物分娩疼痛管理的综合利用情况及相关因素。
本综述遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。从国际数据库中检索到2837篇文章，包括Scopus、PubMed、科学网、科学Direct和国家数字图书馆存储库。文章检索时间为2024年2月1日至2024年2月30日。使用纽卡斯尔渥太华量表评估方法学质量。使用Excel进行数据提取，并使用Stata 11软件进行分析。使用随机效应模型估计非药物分娩疼痛管理的效应量利用率。使用Cochran's Q检验和I统计量评估研究的异质性。使用漏斗图的对称性和Egger检验检查发表偏倚。
14项研究符合纳入标准，总样本量为4821。医疗服务提供者中非药物分娩疼痛管理的总体综合利用率为45.48%（95%置信区间： 35.74 - 55.22）。年龄在20 - 29岁的医疗服务提供者（比值比：4.10；95%置信区间：1.79 - 9.39）、了解非药物疼痛管理的人（比值比：3.11；95%置信区间：1.88 - 5.16）以及允许陪伴人员支持分娩母亲的人（比值比：3.37；95%置信区间：1.56 - 7.24）是结果变量的决定因素。
超过一半的埃塞俄比亚医疗服务提供者在分娩期间未使用非药物疼痛管理。关键因素包括年龄在20 - 29岁的医疗服务提供者、知识充足的人以及允许陪伴人员进入产房支持分娩母亲的医疗服务提供者的能力。建议为年长的医疗服务提供者提供更新的在职培训项目，以利用非药物疼痛管理技术。政策制定者还应明确产科指南，以促进分娩期间的疼痛管理。
