Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting / Métodos não farmacológicos para reduzir a dor durante o trabalho de parto ativo em um cenário da vida real

Abstract Objective To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario. Methods This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods. Results A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2- maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334). Conclusion In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.

Resumo Objetivo Avaliar a associação da intensidade da dor na fase ativa da dilatação do parto em mulheres de acordo com a utilização ou não de métodos não farmacológicos para alívio da dor em cenário de vida real. Métodos Trata-se de um estudo observacional de corte transversal. As variáveis analisadas foram obtidas através de questionário com as puérperas (até 48 horas pós-parto) investigando a intensidade da dor no parto pela escala visual analógica (EVA). As medidas não farmacológicas de alívio da dor, utilizadas rotineiramente na prática obstétrica, foram avaliadas pela consulta aos prontuários. As pacientes foram separadas em dois grupos: Grupo I - pacientes que não utilizaram medidas não farmacológicas para alívio da dor e Grupo II - pacientes que utilizaram estas medidas. Resultados Foram incluídas 439 mulheres que tiveram parto vaginal, sendo que 386 (87,9%) utilizaram, pelo menos, uma medida não farmacológica e 53 (12,1%) não utilizaram. As mulheres que não utilizaram as medidas não farmacológicas apresentaram idade gestacional significativamente menor (37,2 versus 39,6 semanas, p < 0,001) e menor duração do trabalho de parto (24 versus 114 minutos, p < 0,001) quando comparadas às que utilizaram as medidas. Não houve diferença estatisticamente significativa na pontuação da escala da dor pela EVA de acordo com a categorização pelo uso ou não de métodos não farmacológicos (mediana 10 [mínimo 2-máximo 10] versus 10 (mínimo 6-máximo 10), p = 0,334]. Conclusão Em cenário de vida real, as pacientes submetidas aos métodos não farmacológicos não apresentaram diferença em relação à intensidade da dor quando comparadas às que não os utilizaram durante a fase ativa do trabalho de parto.

Effect of Family-Participated Delivery in a Labor Delivery Room on the Childbirth of Primiparas / 여성건강간호학회지

The purpose of the present study is to consider its effect on the childbirth of a woman. This is a quasi-experimental study with nonequivalent control group post-test design. The subjects of this study are 60 primiparas (30 in the control, and another 30 in the experimental group) who have had a regular prenatal care from February 5 to March 20, 2002, in an outpatient obstetrics and gynecology of S university medical center located in Seoul. The result is as follows: 1. The hours of labor pains in the entire delivery period: the average hours are 7 hr. 9 min. in the experimental group, and 10 hr. 39 min. in the control group. The hours of labor pains are shorter in the woman with a family delivery experience in LDR. The difference is statistically significant (t=-3.34, p=.001). 2. The degree of pains in the entire delivery period: the average degree is 7.38 in the experimental group, and 7.68 in the control group. The degree of labor pains are lower in the woman with a family delivery experience in LDR. But, the difference is statistically insignificant (t=-0.86, p=.396). 3. The perceptions of the delivery experience: the average score of the perception is 73.63 in the experimental group, and 63.57 in the control group. The women with a family delivery experience in LDR have more positive perception of the delivery procedure, and, the difference is statistically significant (t=4.65, p=.000). In summary of the above result, a family- participated delivery in LDR is proved to be an effective nursing intervention that shortens the hours spent in the delivery procedure and promotes positive perceptions of the delivery experience.