PDF(Pubmed)
Abstract：
BACKGROUND: The majority of women experience pain during childbirth. Offering and supporting women to use different methods for coping with pain is an essential competency for maternity care providers globally. Research suggests a gap between what women desire for pain management and what is available and provided in many low-and middle-income settings. The study aimed to understand how pain management is perceived by those involved: women experiencing childbirth and maternity care providers.
METHODS: Individual semi-structured interviews with women (n = 23), maternity care providers (n = 17) and focus group discussions (n = 4) with both providers and women were conducted in two hospitals in Southern Tanzania in 2021. Transcribed interviews were analysed using reflexive thematic analysis. Coding and analysis were supported by the software MAXQDA.
RESULTS: Three main themes were generated from the data. The first, \'pain management is multifaceted\', describes how some providers and women perceived pain management as entailing various methods to manage pain. Providers perceived themselves as having a role in utilization of pain management to varying degree. The second theme \'pain management is primarily a woman\'s task\' highlights a perception of pain management as unnecessary, which appeared to link with some providers\' perceptions of pain as natural and necessary for successful childbirth. Few women explicitly shared this perception. The third theme \'practice of pain management can be improved\' illustrates how women and maternity care providers perceived current practices of pain management as suboptimal. According to providers, this is primarily due to contextual factors such as shortage of staff and poor ward infrastructure.
CONCLUSIONS: Women\'s and maternity care providers\' perceptions ranged from perceiving pain management as involving a combination of physiological, psychological and social aspects to perceive it as related with limited to no pain relief and/or support. While some women and providers had similar perceptions about pain management, other women also reported a dissonance between what they experienced and what they would have preferred. Efforts should be made to increase women\'s access to respectful pain management in Tanzania.
METHODS: Individual semi-structured interviews with women (n = 23), maternity care providers (n = 17) and focus group discussions (n = 4) with both providers and women were conducted in two hospitals in Southern Tanzania in 2021. Transcribed interviews were analysed using reflexive thematic analysis. Coding and analysis were supported by the software MAXQDA.
RESULTS: Three main themes were generated from the data. The first, \'pain management is multifaceted\', describes how some providers and women perceived pain management as entailing various methods to manage pain. Providers perceived themselves as having a role in utilization of pain management to varying degree. The second theme \'pain management is primarily a woman\'s task\' highlights a perception of pain management as unnecessary, which appeared to link with some providers\' perceptions of pain as natural and necessary for successful childbirth. Few women explicitly shared this perception. The third theme \'practice of pain management can be improved\' illustrates how women and maternity care providers perceived current practices of pain management as suboptimal. According to providers, this is primarily due to contextual factors such as shortage of staff and poor ward infrastructure.
CONCLUSIONS: Women\'s and maternity care providers\' perceptions ranged from perceiving pain management as involving a combination of physiological, psychological and social aspects to perceive it as related with limited to no pain relief and/or support. While some women and providers had similar perceptions about pain management, other women also reported a dissonance between what they experienced and what they would have preferred. Efforts should be made to increase women\'s access to respectful pain management in Tanzania.
摘要：
背景：大多数妇女在分娩时经历疼痛。提供和支持妇女使用不同的方法来应对疼痛是全球产妇护理提供者的一项基本能力。研究表明，女性对疼痛管理的渴望与许多中低收入环境中可用和提供的疼痛之间存在差距。该研究旨在了解相关人员如何看待疼痛管理：经历分娩和产妇护理提供者的妇女。
方法：对女性进行个人半结构化访谈（n=23），2021年在坦桑尼亚南部的两家医院进行了产妇护理提供者(n=17)和焦点小组讨论(n=4).转录访谈使用反身性主题分析进行了分析。软件MAXQDA支持编码和分析。
结果：从数据中产生了三个主要主题。第一,“疼痛管理是多方面的”，描述了一些提供者和女性如何认为疼痛管理需要各种方法来管理疼痛。提供者认为自己在不同程度上在疼痛管理的利用中发挥作用。第二个主题“疼痛管理主要是女性的任务”强调疼痛管理是不必要的，这似乎与一些提供者认为疼痛是自然的和成功分娩所必需的。很少有女性明确认同这种看法。第三个主题“可以改善疼痛管理的实践”说明了妇女和产妇护理提供者如何将当前的疼痛管理实践视为次优。根据供应商的说法，这主要是由于背景因素，如人员短缺和病房基础设施差。
结论：妇女和产妇护理提供者的观念范围从感知疼痛管理到涉及生理，心理和社会方面，认为它与有限的疼痛缓解和/或支持有关。虽然一些女性和提供者对疼痛管理有类似的看法，其他女性也报告说，她们所经历的和她们所希望的不一致。在坦桑尼亚，应该努力增加妇女获得尊重疼痛管理的机会。
方法：对女性进行个人半结构化访谈（n=23），2021年在坦桑尼亚南部的两家医院进行了产妇护理提供者(n=17)和焦点小组讨论(n=4).转录访谈使用反身性主题分析进行了分析。软件MAXQDA支持编码和分析。
结果：从数据中产生了三个主要主题。第一,“疼痛管理是多方面的”，描述了一些提供者和女性如何认为疼痛管理需要各种方法来管理疼痛。提供者认为自己在不同程度上在疼痛管理的利用中发挥作用。第二个主题“疼痛管理主要是女性的任务”强调疼痛管理是不必要的，这似乎与一些提供者认为疼痛是自然的和成功分娩所必需的。很少有女性明确认同这种看法。第三个主题“可以改善疼痛管理的实践”说明了妇女和产妇护理提供者如何将当前的疼痛管理实践视为次优。根据供应商的说法，这主要是由于背景因素，如人员短缺和病房基础设施差。
结论：妇女和产妇护理提供者的观念范围从感知疼痛管理到涉及生理，心理和社会方面，认为它与有限的疼痛缓解和/或支持有关。虽然一些女性和提供者对疼痛管理有类似的看法，其他女性也报告说，她们所经历的和她们所希望的不一致。在坦桑尼亚，应该努力增加妇女获得尊重疼痛管理的机会。
