产科中的针灸:用于缓解焦虑和疼痛的产房综合医学

Acupuncture in obstetrics: delivery room integrative medicine for anxiety and pain.

作者信息

Ben-Arye Eran, Biron-Shental Tal, Rosa William E, Samuels Noah, Levy Oz, Keshet Yael, Armon Shunit, Gressel Orit, Kedar Reuven, Messinger Aviv, Lev Ari Revital, Lavie Anat, Atzil Neta, Ben Zohar Bosmat, Ferrer Sokolovski Cara, Solt Ido, Yaffe Hila, Shechter Maor Gil, Levy Moti, Maor-Sagie Esther, Katz Shtern Danit, Stoffman Gali, Ben Ze'ev Reut, Lahav Sher Maayan, Zidenberg Betty, Sagi Shlomi, Schiff Elad

机构信息

Integrative Oncology Program, Oncology Service, LIN Medical Center, Haifa, Haifa District, Israel

Meir Medical Center, Kefar Sava, Center District, Israel.

出版信息

BMJ Support Palliat Care. 2025 Jun 27;15(4):535-541. doi: 10.1136/spcare-2025-005512.

Abstract

OBJECTIVES

Supportive and palliative care include non-oncology settings where patients suffer from pain and quality of life-related concerns. Integrative medicine plays important roles in supportive care and symptom management, including Integrative Obstetric (IOb) programmes within peri-partum settings. Multidisciplinary approaches may help nurse-midwives and obstetricians improve patient care and associated outcomes. This study presents a national perspective on IOb programmes in Israel.

METHODS

A qualitative research methodology was codesigned by the Society for Complementary Medicine and Society of Maternal-Fetal Medicine, Israel Medical Association. A questionnaire with 17 open-ended questions was distributed throughout obstetrics and gynaecology departments across Israel. Respondent narratives were qualitatively analysed using ATLAS.Ti software for systematic coding.

RESULTS

22 senior obstetricians and IOb directors across 11 centres with IOb programmes completed the questionnaire. Core themes considered essential for the design and operation of IOb programmes included (1) determining major goals and indications for referral, primarily pain and anxiety; (2) targeting patients most likely to benefit; (3) identifying barriers and enablers to implementation and communication with the obstetric team; (4) designing the referral process and (5) documenting outcomes and safety of the IOb intervention in electronic medical files.

CONCLUSIONS

Designing and implementing IOb models of care that effectively support holistic symptom management within obstetric settings requires identifying barriers and enablers and establishing effective communication between obstetric and integrative medical teams. Further research should explore other multidisciplinary models of IOb care and structured referral development and testing while assessing risks and effectiveness.

摘要

目的

支持性护理和姑息治疗包括患者存在疼痛及生活质量相关问题的非肿瘤环境。整合医学在支持性护理和症状管理中发挥着重要作用,包括围产期环境中的整合产科(IOb)项目。多学科方法可能有助于助产士和产科医生改善患者护理及相关结果。本研究呈现了以色列IOb项目的全国视角。

方法

定性研究方法由以色列医学协会补充医学协会和母胎医学协会共同设计。一份包含17个开放式问题的问卷在以色列各地的妇产科科室发放。使用ATLAS.Ti软件对受访者的叙述进行定性分析以进行系统编码。

结果

来自11个设有IOb项目中心的22位资深产科医生和IOb主任完成了问卷。IOb项目设计和运作中被认为至关重要的核心主题包括:(1)确定主要目标和转诊指征,主要是疼痛和焦虑;(2)针对最可能受益的患者;(3)识别实施障碍及促进因素以及与产科团队的沟通;(4)设计转诊流程;(5)在电子病历中记录IOb干预的结果和安全性。

结论

设计和实施能有效支持产科环境中整体症状管理的IOb护理模式需要识别障碍和促进因素,并在产科和整合医学团队之间建立有效的沟通。进一步的研究应探索IOb护理的其他多学科模式以及结构化转诊的发展和测试,同时评估风险和有效性。

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