Waldenström U, Bergman V, Vasell G
Graduate Clinical School of Midwifery, Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
J Psychosom Obstet Gynaecol. 1996 Dec;17(4):215-28. doi: 10.3109/01674829609025686.
All women giving birth over a period of 2 weeks in a major city of Sweden, except non-Swedish speaking women and those with elective Caesarean sections, were asked about their experience of pain 2 days after the birth. The sensory (pain intensity) and effective (negative or positive experience) dimensions of pain, as well as need for pain relief during labor were explored. The 278 women who returned completed questionnaires (91%) reported high levels of pain, 41% worst imaginable pain, in spite of wide use of pharmacological pain relief. Only 9% had no analgesia. Pain was not an entirely negative experience, 28% assessing it as more positive than negative, suggesting that coping with pain is a rewarding experience for some women. More than 30 different explanatory variables were included in regression analysis to explain the variation in pain intensity and pain attitude scores, but only five contributed to the respective model. Most of the variables explaining pain intensity, namely anxiety during labor, expected pain, expected birth experience, midwife support and duration of labor, differed from the variables explaining attitude to pain. These were pain intensity, anxiety, expected birth experience physical well-being during pregnancy and emergency Caesarean section. The explanatory values were relatively low, especially for the model explaining pain intensity (R2 = 15%). The findings are discussed in the light of the different character and meaning of childbirth pain compared with pain related to disease.
在瑞典一个主要城市，对所有在两周内分娩的女性进行了调查，非瑞典语女性和择期剖宫产女性除外。在产后两天询问她们的疼痛经历，探究疼痛的感觉维度（疼痛强度）和情感维度（负面或正面体验），以及分娩期间的止痛需求。278名返回并完成问卷的女性（91%）报告疼痛程度较高，41%表示疼痛程度达到了所能想象的最严重程度，尽管广泛使用了药物止痛措施。只有9%的女性未使用任何止痛药物。疼痛并非完全是负面体验，28%的女性认为疼痛的积极方面多于消极方面，这表明应对疼痛对一些女性而言是一种有益的体验。回归分析纳入了30多个不同的解释变量，以解释疼痛强度和疼痛态度得分的差异，但只有五个变量对各自的模型有贡献。大多数解释疼痛强度的变量，即分娩期间的焦虑、预期疼痛、预期分娩经历、助产士支持和分娩时长，与解释疼痛态度的变量不同。解释疼痛态度的变量有疼痛强度、焦虑、预期分娩经历、孕期身体健康状况和急诊剖宫产。解释值相对较低，尤其是解释疼痛强度的模型（R2 = 15%）。结合分娩疼痛与疾病相关疼痛的不同特征和意义对研究结果进行了讨论。
