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Zhang EW, Jones LE, Whitburn LY. Tools for assessing labour pain: a comprehensive review of research literature. Pain 2023; 164:2642-2652. [PMID: 37556378 DOI: 10.1097/j.pain.0000000000003004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/31/2023] [Indexed: 08/11/2023]
Abstract
ABSTRACT The experience of pain associated with labour is complex and challenging to assess. A range of pain measurement tools are reported in the literature. This review aimed to identify current tools used in research to assess labour pain across the past decade and to evaluate their implementation and adequacy when used in the context of labour pain. A literature search was conducted in databases MEDLINE and Cumulative Index of Nursing and Allied Health Literature, using search terms relating to labour, pain, and measurement. A total of 363 articles were selected for inclusion. Most studies (89.9%) assessed pain as a unidimensional experience, with the most common tool being the Visual Analogue Scale, followed by the Numerical Rating Scale. Where studies assessed pain as a multidimensional experience, the most common measurement tool was the McGill Pain Questionnaire. Only 4 studies that used multidimensional tools selected a tool that was capable of capturing positive affective states. Numerous variations in the implementation of scales were noted. This included 35 variations found in the wording of the upper and lower anchors of the Visual Analogue Scale, some assessment tools not allowing an option for "no pain," and instances where only sections of validated tools were used. It is clear that development of a standardised pain assessment strategy, which evaluates the multidimensions of labour pain efficiently and effectively and allows for both positive and negative experiences of pain to be reported, is needed.
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Affiliation(s)
- Erina W Zhang
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
| | - Lester E Jones
- Health Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Laura Y Whitburn
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
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2
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Hoffmann L, Hilger N, Riolino E, Lenz A, Banse R. Partner support and relationship quality as potential resources for childbirth and the transition to parenthood. BMC Pregnancy Childbirth 2023; 23:435. [PMID: 37312055 DOI: 10.1186/s12884-023-05748-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The aim of the present paper was to explore the role of partners for the stressful life events of birth and the transition to parenthood. METHODS In a first prospective longitudinal study (N = 304 dyads) we tested whether relationship quality positively predicted fewer interventions during labor and birth, a more positive birth experience, and better well-being during the first six weeks after birth. In a second study we surveyed mothers (N = 980; retrospective quasi-experimental design) who had given birth during the first lockdown of the COVID-19 pandemic in spring 2020 - some in the absence of their partners - to test the assumption that regardless of relationship quality, the presence of the partner was positively related to low-intervention births and the birth experience. RESULTS The results of the longitudinal study (Study 1) could be integrated into a Single Indicator model. They revealed that a high relationship quality assessed between week 5 and week 25 of pregnancy had a positive effect on birth experience for the mother and on psychological well-being during the transition to parenthood for both mothers and fathers. Results of the retrospective quasi-experimental field study (Study 2) revealed that the continuous presence of the partner was associated with a higher probability of a low-intervention birth and a more positive birth experience. Presence of a partner for only part of the birth did not positively predict labor and birth, but did positively predict the birth experience. The effects were independent of relationship quality. CONCLUSION The results of both studies highlight the importance of partners for psychological well-being during labor and birth and the transition to parenthood.
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Affiliation(s)
- Lisa Hoffmann
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany.
| | - Norbert Hilger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany
| | - Elena Riolino
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany
| | - Annika Lenz
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany
| | - Rainer Banse
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany
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Lau-Zhu A, Williams F, Steel C. Attachment patterns and autobiographical episodic memory functioning: A systemic review of adult studies to advance clinical psychological science. Clin Psychol Rev 2023; 101:102254. [PMID: 36804184 DOI: 10.1016/j.cpr.2023.102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Patterns of insecure attachment are associated with psychopathology but the mechanisms involved remain poorly understood. Cognitive science proposes that attachment patterns are influenced by the autobiographical memory system and in turn influence its ongoing functioning. Disturbances in autobiographical memory represent cognitive risks for later emotional difficulties. We systemically reviewed 33 studies (in 28 articles) examining the association between attachment patterns and autobiographical episodic memory (AEM) in individuals from the age of 16 (i.e., from young to older adulthood). Attachment patterns were associated with key areas of AEM phenomenology, including intensity and arousal; detail, specificity, and vividness; coherence and fragmentation; and accuracy and latency. These associations appeared to be moderated by contextual and individual factors; mediated by emotional regulation and schema-based processing; linked to mental health outcomes. Attachment patterns may also influence the impact of certain AEM-based manipulations. We conclude by providing a critical discussion and a research agenda for bringing together attachment, memory, and emotion, with a view to promote mechanism-driven treatment innovation in clinical psychology.
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Affiliation(s)
- A Lau-Zhu
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom; Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom.
| | - F Williams
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - C Steel
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
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Røseth I, Lyberg AM, Sommerseth E, Sandvik BM, Dahl B. “Out of This World”: Norwegian Women’s Experiences of Medical Abortion Pain. J Multidiscip Healthc 2023; 16:889-898. [PMID: 37038454 PMCID: PMC10082597 DOI: 10.2147/jmdh.s399209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/21/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Medical abortion has rapidly become the dominant abortion method in western countries. Pain is a known adverse effect; however, few studies have explored women's subjective experience of medical abortion pain. Purpose To explore Norwegian women's experiences of pain when performing a medical abortion at home. Material and Methods We recruited 24 women through an advertisement on Facebook and conducted semi-structured, face-to-face interviews. The interviews were transcribed verbatim and the data were analyzed using a phenomenological hermeneutical method. Results Our findings consisted of two main themes: 1) Being in pain or becoming pain, and 2) Being caught off guard and struggling to cope. Participants described undergoing severe pain, comparable to giving birth, during the medical abortion. Unprepared for the type and intensity of the pain, they felt anxious and insecure. Pain is physical, but it also has important psychological, social, and existential dimensions. Our culture (in)forms our thoughts and feelings about our pain, affecting our ability to endure suffering. The participants' experiences of abortion pain prompt timely questions concerning gendered socio-cultural and existential meanings connected to pain, specifically in relation to female reproductive functions. Conclusion Women need realistic information about the type and intensity of abortion pain, as well as evidence-based pain medication. Psychological factors may affect the experience of abortion pain and should therefore be taken into account in abortion care.
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Affiliation(s)
- Idun Røseth
- Department of Child and Adolescent Mental Health, Telemark Hospital Trust, Skien, Norway
- Centre for Women’s, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, Borre, Norway
- Correspondence: Idun Røseth, Department of Child and Adolescent Psychiatry, Telemark Hospital Trust, P.O Box 2900 Kjørbekk, Skien, 3710, Norway, Tel +47 41200462, Email
| | - Anne Marit Lyberg
- Centre for Women’s, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, Borre, Norway
| | - Eva Sommerseth
- Centre for Women’s, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, Borre, Norway
| | - Berit Margethe Sandvik
- Centre for Women’s, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, Borre, Norway
| | - Bente Dahl
- Centre for Women’s, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, Borre, Norway
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Thorstensson S, Ekström-Bergström A, Bäckström C. Effects of the "Inspirational Lecture" in Combination With "Ordinary Antenatal Parental Classes" as Professional Support for Expectant Parents: A Pilot Study as a Randomized Controlled Trial. Front Public Health 2020; 8:285. [PMID: 32850567 PMCID: PMC7399156 DOI: 10.3389/fpubh.2020.00285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 06/01/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Both expectant mothers and their partners describe weaknesses in ordinary parental preparatory professional support provided internationally and nationally within Sweden. Therefore, it is necessary to develop the parental preparatory professional support provided by midwives for expectant parents within Sweden. This study will evaluate the effects on expectant parents of receiving a combination of an “inspirational lecture” and “ordinary antenatal parental classes” compared with only “ordinary antenatal parental classes.” Methods/Design: This block randomized controlled trial included an intervention as a pilot study, in which expectant parents were randomized for (1) the inspirational lecture and ordinary antenatal parental classes (intervention group [IG]) (n = 66) or (2) ordinary antenatal parental classes (control group [CG]) (n = 60). Data collection with repeated questionnaires was conducted in the first week and 6 months after birth. Statistical analyses were conducted for participant characteristics, differences between parents within IG and CG, effects of the intervention, intention to treat, and internal consistency of the included measurements. Results: The intervention showed a tendency to be gainful for one out of four outcomes related to birth experience, and parents' perceived quality of parental couple relationship consensus and sexuality and manageability. These results were more prominent for the partners. Parents within both the intervention and control groups reported decreased social support in the first 6 months after birth. Conclusion and Clinical Implications: Overall, the concept of the inspirational lecture in combination with ordinary antenatal parental classes as parental preparatory professional support seems to be a valuable care intervention. However, this study was a pilot study and the results should therefore be interpreted with caution. More research is needed since childbirth and transition to parenthood are complex processes in need of comprehension.
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Dencker A, Bergqvist L, Berg M, Greenbrook JTV, Nilsson C, Lundgren I. Measuring women's experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire. BMC Pregnancy Childbirth 2020; 20:199. [PMID: 32252679 PMCID: PMC7137445 DOI: 10.1186/s12884-020-02869-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/09/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Women's experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience. Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2. METHOD A total of 11 new items (Professional Support and Participation) and 14 original items from the first CEQ (Own capacity and Perceived safety), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit. RESULTS The hypothesised four-factor model showed good fit (CMIN = 2.79; RMR = 0.33; GFI = 0.94; CFI = 0.94; TLI = 0.93; RMSEA = 0.054 and PCLOSE = 0.12) Cronbach's alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91). CONCLUSIONS CEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.
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Affiliation(s)
- Anna Dencker
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.
| | - Liselotte Bergqvist
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Josephine T V Greenbrook
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Mason Institute of Medicine, Life Science and the Law, University of Edinburgh, Edinburgh, UK
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Ingela Lundgren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
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Reisz S, Brennan J, Jacobvitz D, George C. Adult attachment and birth experience: importance of a secure base and safe haven during childbirth. J Reprod Infant Psychol 2018; 37:26-43. [PMID: 30269511 PMCID: PMC6343367 DOI: 10.1080/02646838.2018.1509303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: Examine connections between mothers’ adult attachment and subjective birth experience in the context of parity and mode of delivery. Background: Research has established a clear connection between adult attachment and birth experience. This study extended previous research with an in-depth self-report attachment measure examining different dimensions of mothers’ attachment representations and their relation to subjective birth experience. Interactions between mode of delivery and parity were also considered. Method: Participants were 257 mothers who gave birth 4 days to 12 months prior to the study. Mothers’ mean age was 30.5 years, 61% primiparas, and 26% delivered by caesarean. Participants completed an online survey with the Birth Experience Questionnaire, the Reciprocal Attachment Questionnaire, and demographic information. Results: Hierarchical moderated regression analyses showed direct effects from adult attachment dimensions to mothers’ subjective birth experiences, specifically perceived availability, feared loss, separation protest, angry withdrawal, and compulsive careseeking. Interactions emerged for parity and/or mode of delivery for overall subjective birth experience, perceived control, perceived social support, and satisfaction. Conclusion: Adult attachment representations related to subjective birth experience, indicating that attachment figures serve as secure bases and safe havens for mothers during childbirth. These results have implications for practitioners and provide direction for future research.
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Affiliation(s)
- Samantha Reisz
- a Department of Public Health and Primary Care , University of Cambridge , Cambridge , United Kingdom of Great Britain and Northern Ireland.,b Human Development and Family Sciences , University of Texas at Austin , Austin , TX , USA
| | - Jessica Brennan
- c Department of Psychological and Brain Sciences , University of Delaware , Newark , DE , USA.,d Family and Consumer Sciences , Modesto Junior College , Modesto , CA , USA
| | - Deborah Jacobvitz
- e Human Development & Family Sciences , University of Texas at Austin College of Natural Sciences , Austin , TX , USA
| | - Carol George
- f Psychology , Mills College , Oakland , CA , USA
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Whitburn LY, Jones LE, Davey MA, McDonald S. The nature of labour pain: An updated review of the literature. Women Birth 2018; 32:28-38. [PMID: 29685345 DOI: 10.1016/j.wombi.2018.03.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/07/2018] [Accepted: 03/15/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The pain experience associated with labour is complex. Literature indicates psychosocial and environmental determinants of labour pain, and yet methods to support women usually target physiological attributes via pharmacological interventions. AIM To provide an update of our understanding of labour pain based on modern pain science. The review aims to help explain why women can experience labour pain so differently - why some cope well, whilst others experience great suffering. This understanding is pertinent to providing optimal support to women in labour. METHOD A literature search was conducted in databases Medline, Cumulative Index to Nursing and Allied Health Literature and PsycINFO, using search terms labor/labour, childbirth, pain, experience and perception. Thirty-one papers were selected for inclusion. FINDINGS Labour pain is a highly individual experience. It is a challenging, emotional and meaningful pain and is very different from other types of pain. Key determinants and influences of labour pain were identified and grouped into cognitive, social and environmental factors. CONCLUSION If a woman can sustain the belief that her pain is purposeful (i.e. her body working to birth her baby), if she interprets her pain as productive (i.e. taking her through a process to a desired goal) and the birthing environment is safe and supportive, it would be expected she would experience the pain as a non-threatening, transformative life event. Changing the conceptualisation of labour pain to a purposeful and productive pain may be one step to improving women's experiences of it, and reducing their need for pain interventions.
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Affiliation(s)
- Laura Y Whitburn
- School of Life Sciences, La Trobe University, Bundoora, Victoria 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora, Victoria 3086, Australia.
| | - Lester E Jones
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Mary-Ann Davey
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria 3086, Australia; Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3186, Australia
| | - Susan McDonald
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria 3086, Australia; Mercy Hospital for Women, Mercy Health, Heidelberg, Victoria 3084, Australia
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Whitburn LY, Jones LE, Davey MA, Small R. The meaning of labour pain: how the social environment and other contextual factors shape women's experiences. BMC Pregnancy Childbirth 2017; 17:157. [PMID: 28558667 PMCID: PMC5450354 DOI: 10.1186/s12884-017-1343-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/24/2017] [Indexed: 01/30/2023] Open
Abstract
Background The majority of women experience pain during labour and childbirth, however not all women experience it in the same way. In order to develop a more complete understanding of labour pain, this study aimed to examine women’s experiences within the perspective of modern pain science. A more complete understanding of this phenomenon can then guide the development of interventions to enhance women’s experiences and potentially reduce their need for pharmacological intervention. Methods A qualitative study was conducted using phenomenology as the theoretical framework. Data were collected from 21 nulliparous women, birthing at one of two large maternity services, through face-to-face interviews and written questionnaires. Data were analysed using an Interpretative Phenomenological Analysis approach. Results The data from this study suggest that a determining factor of a woman’s experience of pain during labour is the meaning she ascribes to it. When women interpret the pain as productive and purposeful, it is associated with positive cognitions and emotions, and they are more likely to feel they can cope. Alternatively, when women interpret the pain as threatening, it is associated with negative cognitions and emotions and they tend to feel they need help from external methods of pain control. The social environment seems particularly important in shaping a woman’s pain experience by influencing her interpretation of the context of the pain, and in doing so can change its meaning. The context and social environment are dynamic and can also change throughout labour. Conclusion A determining factor in a woman’s experience of pain during labour is its perceived meaning which can then influence how the woman responds to the pain. The meaning of the pain is shaped by the social environment and other contextual factors within which it is experienced. Focussed promotion of labour pain as a productive and purposeful pain and efforts to empower women to utilise their inner capacity to cope, as well as careful attention to women’s cognitions and the social environment around them may improve women’s experiences of labour pain and decrease their need for pain interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1343-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Y Whitburn
- School of Life Sciences & Judith Lumley Centre, La Trobe University, Bundoora, Victoria, 3086, Australia.
| | - Lester E Jones
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - Mary-Ann Davey
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, 3800, Australia
| | - Rhonda Small
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, 3086, Australia
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Fairchild E, Roberts L, Zelman K, Michelli S, Hastings-Tolsma M. Implementation of Robert's Coping with Labor Algorithm © in a large tertiary care facility. Midwifery 2017; 50:208-218. [PMID: 28477459 DOI: 10.1016/j.midw.2017.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 02/12/2017] [Accepted: 03/14/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE to implement use of Roberts' Coping with Labor Algorithm© (CWLA) with laboring women in a large tertiary care facility. DESIGN this was a quality improvement project to implement an alternate approach to pain assessment during labor. It included system assessment for change readiness, implementation of the algorithm across a 6-week period, evaluation of usefulness by nursing staff, and determination of sustained change at one month. Stakeholder Theory (Friedman and Miles, 2002) and Deming's (1982) Plan-Do-Check-Act Cycle, as adapted by Roberts et al (2010), provided the framework for project implementation. SETTING the project was undertaken on a labor and delivery (L&D) unit of a large tertiary care facility in a southwestern state in the USA. The unit had 19 suites with close to 6000 laboring patients each year. PARTICIPANTS full, part-time, and per diem Registered Nurse (RN) staff (N=80), including a subset (n=18) who served as the pilot group and champions for implementing the change. FINDINGS a majority of RNs held a positive attitude toward use of the CWLA to assess laboring women's coping with the pain of labor as compared to a Numeric Rating Scale (NRS). RNs reported usefulness in using the CWLA with patients from a wide variety of ethnicities. A pre-existing well-developed team which advocated for evidence-based practice on the unit proved to be a significant strength which promoted rapid change in practice. IMPLICATIONS FOR PRACTICE this work provides important knowledge supporting use of the CWLA in a large tertiary care facility and an approach for effectively implementing that change. Strengths identified in this project contributed to rapid implementation and could be emulated in other facilities. Participant reports support usefulness of the CWLA with patients of varied ethnicity. Assessment of change sustainability at 1 and 6 months demonstrated widespread use of the algorithm though long-term determination is yet needed.
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Affiliation(s)
- Esther Fairchild
- Baylor University, Louise Herrington School of Nursing, 3700 Worth St, Dallas, TX 75246, United States.
| | - Leissa Roberts
- University of Utah, School of Nursing,10 South 2000 East, Salt Lake City, Utah 84112, United States
| | - Karen Zelman
- Baylor University, Louise Herrington School of Nursing, 3700 Worth St, Dallas, TX 75246, United States
| | - Shelley Michelli
- Baylor Scott & White, Fort Worth's Andrews Women's Hospital,1400 8th Avenue Fort Worth, TX 76104, United States
| | - Marie Hastings-Tolsma
- Baylor University, Louise Herrington School of Nursing, 3700 Worth St, Dallas, TX 75246, United States
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Wilson CL, Simpson JA. Childbirth Pain, Attachment Orientations, and Romantic Partner Support During Labor and Delivery. PERSONAL RELATIONSHIPS 2016; 23:622-644. [PMID: 28529444 PMCID: PMC5436727 DOI: 10.1111/pere.12157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/29/2016] [Indexed: 06/07/2023]
Abstract
Attachment anxiety is associated with greater perceived physical pain, whereas social support is associated with lower pain perceptions. Few studies, however, have examined the joint effects of attachment and support on acute physical pain in a dyadic context. In this study, first-time expectant mothers (N=140) and their male partners completed romantic attachment measures (prenatally) and postnatal assessments of women's pain and men's emotional support during labor and delivery. More securely attached women benefited from emotional support in terms of reduced pain, more avoidantly attached women reported greater pain when given more support, and more anxiously attached women reported greater pain, regardless of their partner's support. These results advance our understanding of which women are most vulnerable to painful childbirth.
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Affiliation(s)
- Carol L Wilson
- School of Humanities & Social Sciences, Penn State Erie, The Behrend College
| | - Jeffry A Simpson
- Department of Psychology, University of Minnesota - Twin Cities Campus
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Greenfield M, Jomeen J, Glover L. What is traumatic birth? A concept analysis and literature review. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjom.2016.24.4.254] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mari Greenfield
- PhD student, Faculty of Health and Social Care, University of Hull
| | - Julie Jomeen
- Dean of Health and Social Care, University of Hull
| | - Lesley Glover
- Senior lecturer, Faculty of Health and Social Care, University of Hull
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