1
|
Parkies LE, Murray D, Okafor UB. Pharmacological labour pain interventions: South African midwives' perspective. BMC Nurs 2024; 23:176. [PMID: 38486184 PMCID: PMC10938825 DOI: 10.1186/s12912-024-01844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Women of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives' perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch's open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician's prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives' ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.
Collapse
Affiliation(s)
- L E Parkies
- Department of Nursing Science, University of Fort Hare, 50 Church Street, 5201, East London, South Africa
| | - D Murray
- Department of Public Health, University of Fort Hare, 5 Oxford Street, 5201, East London, South Africa
| | - U B Okafor
- Faculty of Health Sciences, University of Fort Hare, 5 Oxford Street, 5201, East London, South Africa.
| |
Collapse
|
2
|
Abdel-Fatah Ibrahim H, Alshahrani MS, Al-Qinnah AJ, Elgzar WT. Nonpharmacological pain relief for labour pain: knowledge, attitude, and barriers among obstetric care providers. PeerJ 2024; 12:e16862. [PMID: 38317843 PMCID: PMC10840495 DOI: 10.7717/peerj.16862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
Background Labor pain is considered the worst pain in a woman's life. Hence, pain control should be essential to labor management at any level. There is scarce information, and there are gaps regarding the knowledge, attitude, and barriers to the utilization of nonpharmacological approaches for pain relief in Saudi Arabia. Therefore, the current study aims to evaluate nonpharmacological pain relief (NPPR)-related knowledge, attitudes, and barriers among obstetric care providers in Najran, Saudi Arabia. Methods A cross-sectional analytical study was performed at maternity departments in Maternal and Children Hospital (MCH), Najran, Saudi Arabia, from April 1 to May 26 2023. The study involved 186 obstetric care providers (OPCs), physicians (19), nurses (144), and midwives (23). A structured self-reported questionnaire was used to collect data and involves five main sections: demographic data, work-related data, nonpharmacological pain relief-related attitude, perceived barriers, and knowledge quiz. The adjusted odds ratio (AOR) along with 95% CI was estimated to determine the factors associated with nonpharmacological pain relief-related knowledge and attitude using multivariate analysis in the binary logistic regression. Results Over three-quarters (79%) of obstetric care providers had adequate knowledge of nonpharmacological pain relief methods. The majority (85.5%) of the participants had a positive attitude toward NPPR in labour pain management, with the mean scores ranging from 3.55-4.23 for all sub-items. Obstetric care providers acknowledged that patient belief, lack of time, and workload were the strongest barriers to offering nonpharmacological pain relief methods for labour pain 67.6%, 64.5%, and 61.3%, respectively. In binary logistic regression analysis, the in-service training related to nonpharmacological pain relief (AOR = 5.871 (2.174-15.857), p = 0.000), (AOR = 3.942 (1.926-11.380), p = 0.013) and years of work experience (AOR = 1.678 (1.080-2.564), p = 0.019), (AOR = 1.740 (1.188-2.548), p = 0.003) were significantly associated with obstetric care providers' knowledge and attitudes regarding nonpharmacological pain relief (p ≤ 0.05). Conclusion Although most OPCs have adequate knowledge and a positive attitude regarding NPPR, they need motivational strategies to enhance their utilization. In addition, an effort should be made to decrease OPCs' workload to provide more time for NPPR application and patient education. Training courses and in-service training can play an important role in enhancing NPPR knowledge and attitude and, consequently, its application. Also, in each working unit, the policymakers should provide clear guidelines and policies that enhance and control the utilization of NPPR.
Collapse
Affiliation(s)
- Heba Abdel-Fatah Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia
| | - Majed Said Alshahrani
- Department of Obstetrics and Gynecology, College of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Wafaa Taha Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia
| |
Collapse
|
3
|
Elgzar WT, Alshahrani MS, Ibrahim HA. Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia. Reprod Health 2024; 21:11. [PMID: 38268021 PMCID: PMC10809473 DOI: 10.1186/s12978-023-01737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Traditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses. METHODS A cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization. RESULTS The results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05). CONCLUSIONS High non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.
Collapse
Affiliation(s)
- Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia
| | - Majed S Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia.
| |
Collapse
|
4
|
Nori W, Kassim MAK, Helmi ZR, Pantazi AC, Brezeanu D, Brezeanu AM, Penciu RC, Serbanescu L. Non-Pharmacological Pain Management in Labor: A Systematic Review. J Clin Med 2023; 12:7203. [PMID: 38068274 PMCID: PMC10707619 DOI: 10.3390/jcm12237203] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 04/22/2024] Open
Abstract
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.
Collapse
Affiliation(s)
- Wassan Nori
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Mustafa Ali Kassim Kassim
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Zeena Raad Helmi
- College of Medicine, Mustansiriyah University, Baghdad 10052, Iraq;
| | - Alexandru Cosmin Pantazi
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
| | - Dragos Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Ana Maria Brezeanu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Roxana Cleopatra Penciu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Lucian Serbanescu
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania; (D.B.); (A.M.B.); (R.C.P.); (L.S.)
- Obstetrics and Gynecology Department, Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| |
Collapse
|
5
|
Silva CBDO, Rodrigues KMD, Zoldan C, Nomura RMY, Araujo Júnior E, Peixoto AB. Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:3-10. [PMID: 36878247 PMCID: PMC10021005 DOI: 10.1055/s-0042-1759629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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.
Collapse
Affiliation(s)
| | | | - Camila Zoldan
- Gynecology and Obstetrics Service, Hospital Universitário Mario Palmério, Universidade de Uberaba, Uberaba, MG, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Alberto Borges Peixoto
- Gynecology and Obstetrics Service, Hospital Universitário Mario Palmério, Universidade de Uberaba, Uberaba, MG, Brazil.,Department of Obstetrics and Gynecology, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| |
Collapse
|
6
|
Abuijlan IAM, Muthu P, Avinash MN. Nurses Experience and Perceived Challenges of Using Nonpharmacological Pain Interventions for Musculoskeletal Pain: A Qualitative Study. SAGE Open Nurs 2023; 9:23779608231215600. [PMID: 38020316 PMCID: PMC10658770 DOI: 10.1177/23779608231215600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/20/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Current musculoskeletal pain management guidelines encourage utilizing nonpharmacological pain measures. Despite their positive effect in alleviating musculoskeletal pain, nurses reported negative attitudes toward utilizing nonpharmacological pain measures. Therefore, assessing nurses' perception of nonpharmacological pain measures is essential to promote patient comfort. Objective The aim of the study was to explore the nurses' experience and perceived challenges in using nonpharmacological pain measures in caring for patients with musculoskeletal pain. Materials & Methods A descriptive qualitative design was carried out. Face-to-face semistructured interviews were conducted among 11 nurses. Colaizzi's method was employed in analyzing the data. Results Four themes emerged, namely, constant monitoring and observation, selection of nonpharmacological pain measures, and various barriers related to patients and nurses. One of the ways to overcome these barriers or challenges, we should promote interprofessional teams in planning patient-centered pain management care. Also, defining the role of the pain management nurse would be pivotal to ensuring effective pain management measures. Conclusion The nursing workforce needs to initiate and utilize these measures as a common practice in managing musculoskeletal pain and in turn create a culture that strongly supports the utilization of nonpharmacological pain measures.
Collapse
Affiliation(s)
- Israa A. M. Abuijlan
- College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Priyalatha Muthu
- RAK College of Nursing, Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Manju Nair Avinash
- RAK College of Nursing, Medical and Health Sciences University, Ras Al Khaimah, UAE
| |
Collapse
|
7
|
Goswami S, Jelly P, Sharma S, Negi R, Sharma R. The effect of heat therapy on pain intensity, duration of labor during first stage among primiparous women and Apgar scores: A systematic review and meta-analysis. Eur J Midwifery 2022; 6:66. [DOI: 10.18332/ejm/156487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
|
8
|
Esan DT, Muhammad F, Tonye Ihueze A, Bukola Bello C, Ogunkorode A. [Cultural myths on the use of analgesia in labor: A cross-sectional study in Nigerian women]. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:326-333. [PMID: 36084998 DOI: 10.1016/j.enfcle.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Pain is termed as a subjective phenomenon, however almost all women acknowledge that labor pain is the most severe form of pain a woman experiences in her lifetime. Obstetric analgesia is underutilized in developing countries due to cultural myths and taboos. Hence, the present study aims to identify Nigerian women's knowledge of labor analgesia and to explore what myths and factors hinder with the use of analgesia in labor. METHOD A quantitative descriptive cross-sectional design was adopted in this study. The population of the study predominantly consisted of pregnant women from the «Yoruba ethnic group». An adapted semi-structured questionnaire was used to obtain data from participants from selected Health Care Centers in Ekiti state, Nigeria. The collected data was analyzed using a descriptive and inferential statistics and was represented in form of tables and charts with level of significance set at p ≤ 0.05. RESULTS A total of 236 respondents were included in the study (n = 236). Findings from this study revealed that, the participants showed very poor knowledge on labor pain management strategies, with only 26.3% being aware of pain management strategies used in relieving labor pain. An elevated number of the participants (56.8%) believed that labor pain should not be relieved with the use of drugs, strongly agreeing that analgesia was «a sign ofweakness» (57.2%). Also, more than half (51.7%) of participants had fears that pain relief administered during labor can cause harm to the unborn baby. Belief that experiencing labor pain completes one's motherhood (49.6%), Religion (50.4%) and Culture (54.5%), were reported as factors influencing the uptake/acceptance of labor analgesia among participants. Furthermore statistical significant association was found between educational level of participants and knowledge of labor analgesia among participants (p value = 0.000; p ≤ 0.05). CONCLUSIONS Cultural myths on the use of analgesia exist among participants. It is suggested that women-centered education should be targeted toward eliminating these myths and increasing awareness about labor analgesia.
Collapse
Affiliation(s)
- Deborah Tolulope Esan
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria.
| | - Fatimah Muhammad
- Afe Babalola University Multisystem Hospital, Ado-Ekiti, Nigeria
| | - Amarachi Tonye Ihueze
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Cecelia Bukola Bello
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Agatha Ogunkorode
- Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| |
Collapse
|
9
|
Ingram MA, Brady S, Peacock AS. The barriers to offering non-pharmacological pain management as an initial option for laboring women: A review of the literature. Eur J Midwifery 2022; 6:37. [PMID: 35794877 PMCID: PMC9186088 DOI: 10.18332/ejm/149244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives’ beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this. METHODS This review of the literature sought to understand midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists. RESULTS Thirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers. CONCLUSIONS The review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.
Collapse
Affiliation(s)
- Matilda A. Ingram
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Susannah Brady
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ann S. Peacock
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
| |
Collapse
|
10
|
Baradwan S, Khadawardi K, Badghish E, Alkhamis WH, Dahi AA, Abdallah KM, Kamel M, Sayd ZS, Mohamed MA, Ali HM, Elhalim AEMA, Mahmoud M, Mohamed AA, Mohamed DF, Shama AAA, Hagras AM, Ali HAA, Abdelhakim AM, Saleh M, Badawy MA, Bakry MS. The impact of virtual reality on pain management during normal labor: A systematic review and meta-analysis of randomized controlled trials. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 32:100720. [PMID: 35381438 DOI: 10.1016/j.srhc.2022.100720] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/28/2022] [Accepted: 03/18/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the impact of virtual reality on pain management during normal labor. METHODS A systematic search was performed in September 2021 through PubMed, Cochrane Library, Scopus, and ISI web of science. We selected randomized clinical trials (RCTs) that compared virtual reality in the intervention group versus placebo or no intervention in the control group among laboring women during their normal delivery. Revman software was used for performing our meta-analysis. Our primary outcome was the pain score evaluated during the labor process by the Visual Analog Scale (VAS). Our secondary outcomes were anxiety and satisfaction scores during childbirth in addition to the duration of the first and second stages of labor. RESULTS Eight RCTs met our inclusion criteria with a total number of 466 patients. We found virtual reality was linked to a significant reduction in the VAS pain score during labor compared to the control group (MD = -1.40, 95% CI [-1.83, -0.96], p < 0.001). The anxiety score during labor was significantly reduced among the virtual reality group (SMD = -1.15, 95% CI [-2.18, -0.12], p = 0.03). Moreover, virtual reality significantly improved the satisfaction score during labor (MD = 15.58, 95% CI [4.93, 26.22], p = 0.004). However, there were no significant differences between virtual reality and control groups regarding the duration of the first and second stages of labor. CONCLUSIONS Virtual reality is an effective technique for reducing anxiety, increasing satisfaction, and improving pain management during normal labor.
Collapse
Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ehab Badghish
- Department of Obstetrics and Gynecology, Maternity and Children Hospital, Makkah, Saudi Arabia
| | - Waleed H Alkhamis
- Department of Obstetrics and Gynecology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Abdelmoezz Dahi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Khaled M Abdallah
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Medhat Kamel
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Zainab Shehata Sayd
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | | | - Hamdi Mohamed Ali
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | | | - Mohamed Mahmoud
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Asmaa Abdelaal Mohamed
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Doaa Fathy Mohamed
- Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | | | - Ayman M Hagras
- Department of Urology, Faculty of Medicine, Tanta University Hospitals, Tanta, Egypt
| | - Hazem Abd Allah Ali
- Department of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Mohamed Saleh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mahmoud A Badawy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mohamed Sobhy Bakry
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| |
Collapse
|
11
|
O’Brien D, Coughlan B, Thompson S, Carroll L, Sheehy L, Brosnan M, Cronin M, McCreery T, Doherty J. Exploring midwives’ experiences of implementing the Labour Hopscotch Framework: A midwifery innovation. Eur J Midwifery 2022; 6:18. [PMID: 35515090 PMCID: PMC8988070 DOI: 10.18332/ejm/146081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/17/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
Collapse
Affiliation(s)
- Denise O’Brien
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Barbara Coughlan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | - Lorraine Carroll
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | | | | | | | | |
Collapse
|
12
|
Sulu R, Akbas M, Cetiner S. Effects of transcutaneous electrical nerve stimulation applied at different frequencies during labor on hormone levels, labor pain perception, and anxiety: a randomized placebo-controlled single-blind clinical trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Cultural myths on the use of analgesia in labor: A cross-sectional study in Nigerian women. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
14
|
Baljon K, Romli MH, Ismail AH, Khuan L, Chew BH. Effectiveness of Breathing Exercises, Foot Reflexology and Massage (BRM) on Maternal and Newborn Outcomes Among Primigravidae in Saudi Arabia: A Randomized Controlled Trial. Int J Womens Health 2022; 14:279-295. [PMID: 35241937 PMCID: PMC8887672 DOI: 10.2147/ijwh.s347971] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/08/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Labor pain and anxiety are important concerns during labor, especially among the primigravidae. It may increase the duration of labor, increase stress hormones, and affect maternal and new-born related outcomes. This study examined the effectiveness of combined breathing exercises, foot reflexology, and massage (BRM) interventions on labor pain, anxiety, labor duration, stress hormone levels, maternal satisfaction, maternal vital signs, and the new-born's APGAR scores. PARTICIPANTS AND METHODS This single-blind-parallel randomized controlled trial (RCT) was conducted at the Maternity and Children Hospital (MCH), Makkah, Saudi Arabia, by recruiting primigravidae aged 20 to 35 years, without any medical complications, and who were block-randomized at six-centimeter cervical dilation and stratified by intramuscular pethidine. The intervention is BRM compared to standard care. The labor pain was measured via present behavioral intensity (PBI) and visual analogue scale (VAS), and the anxiety was measured via Anxiety Assessment Scale for Pregnant Women in Labor (AASPWL). The secondary outcomes were duration of labor, maternal stress hormone levels, maternal vital signs, maternal satisfaction, fetal heart rate, and APGAR scores. All outcomes were measured at multiple time-points during and after contraction at baseline, during BRM intervention, at 60, 120, and 180 minutes post-intervention. Generalized linear mixed models were used to estimate the intervention effects over time. RESULTS A total of 225 participants were randomized for the control (n = 112) and intervention group (113). BRM lowered the labor pain intensity at 60 minutes after intervention during (1.3 vs 3.5, F = 102.5, p < 0.001) and after contraction (0.4 vs 2.4, F = 63.6, p < 0.001) and also lowered anxiety (2.9 vs 4.2, F = 80.4, p < 0.001). BRM correspondingly lowered adrenocorticotropic (ACTH) (133 vs 209 pg/mL, p < 0.001), cortisol (1231 vs 1360 nmol/mL, p = 0.003), and oxytocin (159 vs 121 pg/mL, p < 0.001). It also shortened the labor duration (165 vs 333 minutes, p < 0.001), improved vital signs, which resulted in higher APGAR scores, and increased maternal satisfaction. CONCLUSION The labor unit management could consider adopting BRM as one of the non-pharmacological analgesia for healthy women in labor. TRIAL REGISTRATION ISRCTN87414969, registered 3 May 2019.
Collapse
Affiliation(s)
- Kamilya Baljon
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
- Department of Nursing, Nursing College, Umm, Al-Qura University, Makkah, Saudi Arabia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Adibah Hanim Ismail
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
| | - Lee Khuan
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, 43400, Malaysia
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Serdang, 43400, Selangor, Malaysia
- Correspondence: Boon-How Chew, Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, 43400, Selangor, Malaysia, Tel +60 3-89472520, Fax +60 3-89472328, Email ;
| |
Collapse
|
15
|
Abstract
Pain and its management hold a central place in health care. The pain associated with pregnancy and giving birth is unique in that it is a normal, physiologic phenomenon that is affected by cultural mores, personal experience, and internalized sensations. There are numerous nonpharmacologic tools available to treat discomfort during pregnancy and childbirth. Some methods of nonpharmacologic relief are underutilized, due to the lack of knowledge of the evidence. Childbirth educators, doulas, nurses, and midwives are a prime source of knowledge for birthing families to learn a variety of comfort techniques during pregnancy and labor. The purpose of this article is to discuss the use of transcutaneous electrical nerve stimulation (TENS) as a nonpharmacologic comfort technique.
Collapse
|
16
|
Kia Z, Allahbakhshian M, Ilkhani M, Nasiri M, Allahbakhshian A. Nurses' use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study. Complement Ther Med 2021; 58:102705. [PMID: 33677019 DOI: 10.1016/j.ctim.2021.102705] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Pain is a common and unpleasant feeling among patients in intensive care units. Therefore, the use of proper pain management methods, such as non-pharmacological interventions, is a priority in intensive care units. OBJECTIVE This study aimed to ascertain the extent of the use of non-pharmacological pain management methods by intensive care unit nurses in Iran and to identify the obstacles that hindered the use of these methods. MATERIAL AND METHODS This study used a descriptive cross-sectional design which involved a convenience sample of 224 nurses who worked in 16 intensive care units across northern Iran. Data were collected using the non-pharmacological pain management questionnaire and a researcher-developed checklist of the obstacles that hindered the use of non-pharmacological pain management methods. RESULTS A moderate number of ICU nurses used non-pharmacological pain management methods (55.8 %). The most common method used by nurses was repositioning (M = 2.72), while methods such as acupuncture and reflexology were used less frequently. Furthermore, the most common obstacles to the use of non-pharmacological pain management methods were nurses' fatigue (M = 2.92) and multiple responsibilities (M = 2.91). Demographic variables such as age, gender, educational level, and work experience were not significantly associated with the use of non-pharmacological pain management methods. CONCLUSIONS Due to factors such as fatigue, multiple responsibilities, a heavy workload, and an insufficient number of nurses per shift, the rate of utilization of non-pharmacological pain management methods among intensive care unit nurses in Iran was low. Furthermore, most of the participants in this study had not attended courses on non-pharmacological pain management.
Collapse
Affiliation(s)
- Zeinab Kia
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Allahbakhshian
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mahnaz Ilkhani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Malihe Nasiri
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | |
Collapse
|
17
|
Pawale MP, Salunkhe JA. Effectiveness of back massage on pain relief during first stage of labor in primi mothers admitted at a Tertiary care center. J Family Med Prim Care 2020; 9:5933-5938. [PMID: 33681022 PMCID: PMC7928123 DOI: 10.4103/jfmpc.jfmpc_1189_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/08/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Labor pain is one of the most severe pains a woman experiences in her life, causing an increase in the anxiety and stress levels. Massage therapy has proven beneficial for relaxation purposes. Aim: To evaluate the effectiveness of back massage in relieving pain during the first stage of labor in primi mothers. Methodology: The study included 40 primipara mothers belonging to the age group 22–25 years, equally divided into 2 groups: Experimental (massage therapy) and control (routine care). The socio-demographic data, labor assessment parameters (cervical dilation, status of fetal membranes, frequency and duration of uterine contractions during the latent and active phase of labor, and the total duration of the first stage of labor), and the level of labor pain (numerical rating pain scale) were recorded. Data analysis was performed by one-way ANOVA and two independent samples t-test (P ≤ 0.05 as significant). Results: During the latent and active phase of labor, majority of the mothers experienced 4–5 contractions in a span of 10 min. During the latent phase of labor, uterine contractions for 20–40 s were exhibited by 90% and 75% mothers in the experimental and control group, respectively; and during active phase, contractions of >40 s were exhibited by 85% mothers in both groups. A significant difference in the post-test pain scores was noted between the 2 groups (P < 0.0001). Conclusion: Our study proved that back massage was effective in reducing pain during the first stage of labor in primipara mothers in comparison to those who were subjected to routine care.
Collapse
Affiliation(s)
- Manasi P Pawale
- Department of Obstetrics and Gynecological Nursing, Krishna Institute of Nursing Sciences, Deemed to be University, Karad, Satara District, Maharashtra, India
| | - Jyoti A Salunkhe
- Department of Obstetrics and Gynecological Nursing, Krishna Institute of Nursing Sciences, Deemed to be University, Karad, Satara District, Maharashtra, India
| |
Collapse
|