背景:分娩是一种持久的生理应激。作为主要的压力源之一,分娩疼痛贯穿于整个过程。分娩自我效能感就是自信,或者相信他们可以控制分娩时的疼痛。这种自我效能感决定了孕妇如何应对分娩疼痛,并使她们能够规范自己的行为,积极应对分娩。然而,单胎(初产妇)和多胎(多胎)之间疼痛敏感性的差异很少得到研究.
目的:本研究旨在调查自我效能感,对分娩的恐惧,初产妇和多段产妇的分娩疼痛,并探讨与孕妇感知分娩疼痛强度相关的因素。
方法:前瞻性横断面研究。
方法:在广州某大型学术专科医院分娩,中国。
方法:共有347名女性,(182例初产妇和165例经产妇)纳入数据分析。在宫颈扩张之前评估疼痛(第一次分娩宫颈扩张≤3cm,第二次分娩≤2cm)。
方法:通过问卷调查获得受试者的一般信息,并从电子病历系统(EMRS)中提取的电子病历中获得受试者的产科记录。分娩自我效能感,比较了初产妇和经产妇对分娩的恐惧(FOC)和分娩疼痛.配对t检验,卡方检验,曼-惠特尼测试,采用单因素和多因素回归分析对两组产痛进行分析,并探讨产痛感知强度相关因素。
结果:与分娩恐惧相关的总分,胎儿健康,自我控制,与初产妇相比,多段分娩疼痛损伤明显减轻(均P<0.05)。与初产妇组相比,经产妇组第一产程的感觉疼痛强度和持续时间降低。经产妇的分娩控制感优于初产妇。感觉劳动疼痛强度与高龄(年龄≥35岁)呈负相关,自我效能感得分,家庭支持,受教育程度(均P<0.05)。相比之下,感觉劳动疼痛强度与紧张呈正相关,对分娩的严重恐惧,焦虑(P<0.05)。自我效能感,妊娠,交付认知,和对分娩的恐惧是潜伏期感知分娩疼痛强度的独立危险因素(均P<0.05)。
结论:对分娩的恐惧是感知分娩疼痛强度的预测因素。分娩疼痛的程度(最小和最大)可以通过准妈妈的恐惧程度来预测。在分娩的潜伏期,自我效能感,初产妇和多产妇对分娩和分娩疼痛的恐惧是不同的。
BACKGROUND: Childbirth is a long-lasting physiological stress. As one of the main stressors, labor pain exists throughout the whole process. Childbirth self-efficacy is the confidence, or belief that they can manage pain during childbirth. This sense of self-efficacy determines how pregnant women deal with labor pain and enables them to regulate their behavior and actively deal with childbirth. However, the difference in pain sensitivity between single births (primiparas) and multiple births (multiparas) has rarely been investigated.
OBJECTIVE: This study is aimed at investigating self-efficacy, fear of childbirth, labor pain of primiparas and multiparas and exploring factors related to the perceived labor pain intensity of pregnant women.
METHODS: Prospective cross-sectional study.
METHODS: Labour and delivery in a large academic specialized hospital in Guangzhou, China.
METHODS: A total of 347 women, (182 primiparas and 165 multiparas) were enrolled in the data analysis. Pain was assessed before cervical dilatation (cervical dilatation ≤ 3 cm for the first delivery and ≤ 2 cm for the second delivery).
METHODS: The general information of participants was obtained by questionnaire and obstetrical records of the subjects were obtained from the electronic medical records extracted from the electronic medical record system (EMRS). Childbirth self-efficacy, fear of childbirth (FOC) and labor pain were compared between primiparas and multiparas. Paired t-test, chi-square test, Mann-Whitney test, univariate and multivariate regression analysis were used to analyze labor pain between the two groups and investigate factors related perceived labor pain intensity.
RESULTS: The total scores related to fear of childbirth, fetal health, self-control, and labor pain injury of multiparas were notably reduced compared with primiparas (all P < 0.05). The perceived labor pain intensity and duration of the first stage of labor was reduced in the multipara group compared with the
primipara group. The childbirth control sense of the multipara was better than that of the
primipara. The perceived labor pain intensity was negatively correlated with advanced age (age ≥ 35 years), self-efficacy score, family support, and education (all P < 0.05). In contrast, the perceived labor pain intensity was positively correlated with tension, severe fear of childbirth, and anxiety (P < 0.05). Self-efficacy, gravidity, delivery cognition, and fear of childbirth were independent risk factors for the perceived labor pain intensity in the latent period (all P < 0.05).
CONCLUSIONS: Fear of childbirth is a predictor of perceived labor pain intensity. The extent of labor pain (minimum and maximum) can be predicted by the level of fear the expectant mother has. During the latent phase of labor, self-efficacy, fear of childbirth and labor pain are different between primiparas and multiparas.