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Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira Pileggi V, Madeira S, Leathersich S, Tunçalp Ӧ, Oladapo OT, Souza JP, Gülmezoglu AM. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG 2017; 125:932-942. [PMID: 29117644 PMCID: PMC6033006 DOI: 10.1111/1471-0528.15015] [Citation(s) in RCA: 196] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
Background What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable. Objectives To develop a conceptualisation of RMC. Search strategy Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies. Selection criteria Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date. Data collection and analysis A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings. Main results Sixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes. Tweetable abstract Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies. Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies.
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Affiliation(s)
- E Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Namadian
- Social Determinants of Health Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M A Bohren
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A Rashidian
- Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - V Nogueira Pileggi
- GLIDE Technical Cooperation and Research, Ribeirão Preto, São Paulo, Brazil.,Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - S Madeira
- Social Department of Ribeirão Preto, Medical School, University of São Paulo, São Paulo, Brazil
| | - S Leathersich
- King Edward Memorial Hospital for Women, Subiaco, WA, Australia
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - O T Oladapo
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Souza
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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Fakhraei R, Terrion JL. Identifying and Exploring the Informational and Emotional Support Needs of Primipara Women: A Focus on Supportive Communication. J Perinat Educ 2017; 26:195-207. [PMID: 30804655 DOI: 10.1891/1058-1243.26.4.195] [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] [Indexed: 11/25/2022] Open
Abstract
Primipara women may require greater informational and emotional support than multipara women. Supportive communication, including informational and emotional support, can help to build a strong caregiver-patient relationship and can alleviate the difficulties associated with first-time birth. The objective of this study was to explore first-time mothers' experiences of labor and birth. Three hundred primipara women completed self-report questionnaires. Qualitative analysis of one open-ended question about the women's experience was conducted. Nine themes emerged from the data. Eight themes reflected informational and emotional support needs, whereas the final theme reflected instrumental support needs. The study concluded that informational and emotional supports are important factors of supportive communication and influence the birthing experience of primipara women.
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Pinar G, Avsar F, Aslantekin F. Evaluation of the Impact of Childbirth Education Classes in Turkey on Adaptation to Pregnancy Process, Concerns About Birth, Rate of Vaginal Birth, and Adaptation to Maternity: A Case-Control Study. Clin Nurs Res 2016; 27:315-342. [PMID: 28038495 DOI: 10.1177/1054773816682331] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to examine the impact of childbirth education in Turkey on the adaptation to pregnancy process, concerns about birth, rate of vaginal birth, and adaptation to maternity. This quasi-experimental study with control group was conducted from December 2013 to December 2014. The sample size was 132 primiparous pregnant women ( nexperimental = 66, ncontrol = 66). The average age of the pregnant women in the experimental and control groups was 24.41 ± 3.92 and 23.68 ± 4.19, respectively. The study showed that experimental group participants had lower concerns about birth, higher levels of knowledge, and faster adaptation to pregnancy and postpartum process; they could also give positive feedback about labor pain and action and could start breastfeeding at an earlier stage when compared with those in the control group ( p < .05). Childbirth education classes increase the knowledge of pregnant women and positively contribute in pregnancy, labor, and the postpartum process.
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Affiliation(s)
- Gul Pinar
- 1 Yildirim Beyazit University, Ankara, Turkey
| | - Filiz Avsar
- 1 Yildirim Beyazit University, Ankara, Turkey
| | - Filiz Aslantekin
- 2 Ministry of Health, Public Health Institution of Turkey, Ankara, Turkey
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Kızılırmak A, Başer M. The effect of education given to primigravida women on fear of childbirth. Appl Nurs Res 2016; 29:19-24. [DOI: 10.1016/j.apnr.2015.04.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/30/2015] [Accepted: 04/10/2015] [Indexed: 11/29/2022]
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Uludağ E, Mete S. Development and Testing of Women's Perception for the Scale of Supportive Care Given During Labor. Pain Manag Nurs 2015; 16:751-8. [DOI: 10.1016/j.pmn.2015.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 05/05/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
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Hollins Martin CJ, Martin CR. Development and psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R). Midwifery 2013; 30:610-9. [PMID: 24252712 DOI: 10.1016/j.midw.2013.10.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 10/03/2013] [Accepted: 10/09/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to assess factor structure, validity and reliability of the Birth Satisfaction Scale (BSS) and to develop a short-form version of the tool. DESIGN a quantitative design focused on evaluating psychometric properties of the BSS using factor structure, internal consistency, divergent reliability and known groups validity. SETTING Ayrshire Maternity Unit community midwife bases that serve the obstetric population of Ayrshire, Scotland (UK). PARTICIPANTS a convenience sample of healthy women (n=228) <10 days post partum who had delivered a term infant. Data was collected from October 2010 to January 2011. MEASUREMENT the BSS contains 30 self report items, rated on a 5-point Likert scale that measure women's perceptions of: (1) quality of care provision, (2) women's personal attributes, and (3) stress experienced during labour (8, 8 and 14 items per factor). FINDINGS post data analysis the BSS was reconfigured into the 10 item BSS-Revised (BSS-R) comprised of three sub-scales that measure distinct but correlated domains of: (1) quality of care provision, (2) women's personal attributes, and (3) stress experienced during labour. These domains now consist of relatively few items (4, 2 and 4 items per factor), but offer a good fit to the data. KEY CONCLUSIONS the BSS-R would appear to be a robust, valid and reliable multidimensional psychometric instrument for measuring postnatal women's birth satisfaction. Further research to confirm the veracity of the instruments measurement properties highlighted in the current study is desirable. The BSS-R is available for use at a national/international level from the first author.
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Affiliation(s)
- Caroline J Hollins Martin
- School of Nursing, Midwifery and Social Care, University of Salford, Greater Manchester, England, UK
| | - Colin R Martin
- Faculty of Society and Health, Buckinghamshire New University, Uxbridge, England, UK.
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Abstract
Reference to the concept of comfort measures is growing in the nursing and medical literature; however, the concept of comfort measures is rarely defined. For the comfort work of nurses to be recognized, nurses must be able to identify and delineate the key attributes of comfort measures. A concept analysis using Rodgers' evolutionary method (2000) was undertaken with the goal of identifying the core attributes of comfort measures and thereby clarifying this concept. Health care literature was accessed from the CINAHL and PubMed databases. No restrictions were placed on publication dates. Four main themes of attributes for comfort measures were identified during the analysis. Comfort measures involve an active, strategic process including elements of "stepping in" and "stepping back," are both simple and complex, move from a physical to a holistic perspective and are a part of supportive care. The antecedents to comfort measures are comfort needs and the most common consequence of comfort measures is enhanced comfort. Although the concept of comfort measures is often associated with end-of-life care, this analysis suggests that comfort measures are appropriate for nursing care in all settings and should be increasingly considered in the clinical management of patients who are living with multiple, chronic comorbidities.
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Affiliation(s)
- Irene Oliveira
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
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CY Chan Z, Wong KS, Lam WM, Wong KY, Kwok YC. An exploration of postpartum women's perspective on desired obstetric nursing qualities. J Clin Nurs 2013; 23:103-12. [DOI: 10.1111/jocn.12093] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Zenobia CY Chan
- School of Nursing; The Hong Kong Polytechnic University; Kowloon Hong Kong
| | - Kwan Sau Wong
- School of Nursing; The Hong Kong Polytechnic University; Kowloon Hong Kong
| | - Wing Man Lam
- School of Nursing; The Hong Kong Polytechnic University; Kowloon Hong Kong
| | - Ka Yi Wong
- School of Nursing; The Hong Kong Polytechnic University; Kowloon Hong Kong
| | - Yiu Cheung Kwok
- School of Nursing; The Hong Kong Polytechnic University; Kowloon Hong Kong
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Abstract
PURPOSE The purpose of this paper is to develop a psychometric scale--the birth satisfaction scale (BSS)--for assessing women's birth perceptions. DESIGN/METHODOLOGY/APPROACH Literature review and transcribed research-based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire. FINDINGS Three overarching themes were identified: service provision (home assessment, birth environment, support, relationships with health care professionals); personal attributes (ability to cope during labour, feeling in control, childbirth preparation, relationship with baby); and stress experienced during labour (distress, obstetric injuries, receiving sufficient medical care, obstetric intervention, pain, long labour and baby's health). RESEARCH LIMITATIONS/IMPLICATIONS Women construct their birth experience differently. Views are directed by personal beliefs, reactions, emotions and reflections, which alter in relation to mood, humour, disposition, frame of mind and company kept. Nevertheless, healthcare professionals can use BSS to assess women's birth satisfaction and dissatisfaction. Scores measure their service quality experiences. SOCIAL IMPLICATIONS Scores provide a global measure of care that women perceived they received during labour. ORIGINALITY/VALUE Finding out more about what causes birth satisfaction and dissatisfaction helps maternity care professionals improve intra-natal care standards and allocate resources effectively. An attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidence-based measuring tool.
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Bergstrom L, Richards L, Morse JM, Roberts J. How caregivers manage pain and distress in second-stage labor. J Midwifery Womens Health 2010; 55:38-45. [PMID: 20129228 DOI: 10.1016/j.jmwh.2009.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Revised: 01/19/2009] [Accepted: 05/04/2009] [Indexed: 11/25/2022]
Abstract
Innovative care interactions are needed when helping a woman who exhibits severe pain or distress during the second stage of labor. We describe how caregivers and laboring women interacted during second-stage labor, with particular attention to how caregivers managed pain and distress. We used observational methods to perform a microanalysis of behaviors from video-recorded data. Pain occurred during labor contractions, and distress (an emotional response to pain) manifested primarily between contractions. Four patterns of women's behavior were identified: 1) no pain or distress, 2) low-level pain and/or distress, 3) focused working, and 4) severe pain and/or distress. Successful care was identified as enabling the woman to maintain herself in any state other than severe pain and/or distress. Particular modes of speech used by the caregiver enabled the attainment of successful care when the woman was not in severe pain or distress. When severe pain or distress existed, innovative caregiving transitioned the woman to another state. Successful intervention strategies included 1) giving innovative directions and 2) "talking down." Ordinary modes of "birth talk" can be used when severe pain or distress is not manifested and when the primary care problem is to assist women with bearing down. Innovative care interactions are needed when faced with severe pain or distress. Managing labor pain is an ongoing focus of clinicians who provide care to women in labor. In addition to pain, women might also experience distress, an emotional response to the labor experience. Whether from choice or necessity, caregivers for laboring women need nonpharmacologic interventions and interpersonal skills that can help women endure labor and give birth. Labor is hard work, and even in precipitous labors most women require assistance. Care given to a laboring woman consists of employing comforting strategies that help her cope with the pain of uterine contractions. The purpose of these comfort strategies is to help the woman find needed resilience during labor. Most cultures have mechanisms for providing this kind of support. In this article, we identify patterns of behavior used by laboring women and describe successful and unsuccessful strategies used by caregivers to help these women deal with pain and distress during the second stage of labor.
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Affiliation(s)
- Linda Bergstrom
- College of Nursing, University of Utah, Salt Lake City, UT 84114, USA.
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Brown JB, Beckhoff C, Bickford J, Stewart M, Freeman TR, Kasperski MJ. Women and their partners' perceptions of the key roles of the labor and delivery nurse. Clin Nurs Res 2009; 18:323-35. [PMID: 19679701 DOI: 10.1177/1054773809341711] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This descriptive qualitative study examined the perspectives of women and their partners regarding the key roles of the labor and delivery nurse during labor and birth.Ten couples were interviewed separately.The data analysis, conducted through independent and team analysis, was both iterative and interpretive. Participants identified four key roles of the labor and delivery nurse: support person, educator, patient advocate, and provider of continuity. Nurses provided both physical and emotional support.As an educator, they normalized the birth experience and served as a coach for the couple. Nurses advocated on behalf of the woman in labor, particularly when there was an adverse event. The continuity of care provided by the nurses wove the above roles into a cohesive whole. Findings provide important information for nursing educators, supervisors, and hospital administrators to reinforce the meaningful roles nurses serve in the labor and birth experiences of women and their partners.
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12
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Bianchi AL, Adams ED. Labor support during second stage labor for women with epidurals: birth in this era is technology driven. Many women giving birth in hospital settings have epidurals for pain management. Yet laboring women need more than technology--they have basic needs that can't be addressed by technology alone. Nurs Womens Health 2009; 13:38-47. [PMID: 19207503 DOI: 10.1111/j.1751-486x.2009.01372.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Price S, Noseworthy J, Thornton J. Women's experience with social presence during childbirth. MCN Am J Matern Child Nurs 2007; 32:184-91. [PMID: 17479056 DOI: 10.1097/01.nmc.0000269569.94561.7c] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To explore the meaning and significance women attach to family and friend presence during childbirth within a tertiary care birth unit. DESIGN AND METHODS Qualitative descriptive study using interviews conducted with 16 women in the immediate postpartum period after vaginal birth. Interviews were analyzed using thematic analysis. RESULTS Overall, women revealed that they greatly value companionship and social support in labor. The women's choice of who would be present was often related to who "knew them best." They chose to have individuals present not for the purpose of visiting but to provide support and share in the birth experience. The women believed that decisions regarding visitation in labor were theirs to make and as a result often didn't discuss their choices with healthcare professionals beforehand. CLINICAL IMPLICATIONS The findings have implications for family-centered maternity care and visitation policy development. Nurses who work in the childbearing area should be aware of women's desires for supportive friends and relatives during the birthing process and work toward helping women achieve their goals for a supportive birth experience.
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Affiliation(s)
- Sheri Price
- University of Toronto, IWK Health Centre, Halifax, Nova Scotia, Canada.
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Brathwaite AC, Williams CC. Childbirth Experiences of Professional Chinese Canadian Women. J Obstet Gynecol Neonatal Nurs 2004; 33:748-55. [PMID: 15561663 DOI: 10.1177/0884217504270671] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To explore the connections between culture and expectations surrounding the childbirth experience for professional Chinese Canadian women. DESIGN Descriptive and qualitative, using ethnographic interview. SETTING Women were recruited from a community health care center in metropolitan Toronto. PARTICIPANTS Six professional Chinese Canadian women who had experienced at least one childbirth. RESULTS The respondents described adherence to many traditional values, beliefs, and practices throughout the pregnancy and childbirth experience. However, some practices were modified to address functioning in a context that could not support full expression of cultural traditions. Recent immigration to Canada was associated with less adherence to traditional Chinese rituals and beliefs. CONCLUSION Nurses cannot make assumptions about who will use traditional cultural practices or about the circumstances in which they are relevant. Nurses need to be aware of cultural expectations so they can provide culturally competent care, but they should also be aware of how to engage in discussions to clarify individual patient priorities.
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Blix-Lindström S, Christensson K, Johansson E. Women's satisfaction with decision-making related to augmentation of labour. Midwifery 2004; 20:104-12. [PMID: 15020032 DOI: 10.1016/j.midw.2003.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2002] [Revised: 01/22/2003] [Accepted: 07/08/2003] [Indexed: 11/23/2022]
Abstract
OBJECTIVE to describe women's experiences of participating in decision-making related to augmentation of labour. DESIGN a qualitative approach using modified grounded theory technique. Open-ended interviews were conducted 1-3 days after childbirth. SETTING the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. PARTICIPANTS 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. FINDINGS AND KEY CONCLUSIONS: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-making-and did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.
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Affiliation(s)
- Sabine Blix-Lindström
- Division of Reproductive and Perinatal Health Care, Department of Woman and Child Health, Karolinska Institutet, Stockholm SE-171 76, Sweden.
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Bowers BB. Mothers' experiences of labor support: exploration of qualitative research. J Obstet Gynecol Neonatal Nurs 2002; 31:742-52. [PMID: 12465871 DOI: 10.1177/0884217502239218] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To review and synthesize qualitative research studies of women's perceptions of professional labor support. DATA SOURCES Journal articles dated from 1990 to 2001. Search terms included labor support, labor and delivery, childbirth, birth, and caring during labor. Qualitative studies and combined quantitative/qualitative studies with open-ended questions were included. STUDY SELECTION The focus of the 17 studies was laboring women's rather than nurses' perceptions of labor support or care during labor. DATA EXTRACTION Data describing methods, samples, and findings were extracted from study reports. DATA SYNTHESIS Similarities reported in the study findings were synthesized using a model of labor support. Synthesis of the study findings was reported using exemplary statements in the words of women who experienced labor support. Categories included expectations of labor support, physical comfort, caring and emotional support, interpersonal communication style, communication of information and instructions, advocacy, and competence of the professional. CONCLUSIONS There were a limited number of qualitative studies of labor support. Professional labor support was influenced by the interpersonal communication style of the caregiver. Cultural differences existed in caregiver actions considered supportive.
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Affiliation(s)
- Beverly B Bowers
- The University of Oklahoma, College of Nursing, Oklahoma City 73117-1200, USA.
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Chang MY, Wang SY, Chen CH. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs 2002; 38:68-73. [PMID: 11895532 DOI: 10.1046/j.1365-2648.2002.02147.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To investigate the effects of massage on pain reaction and anxiety during labour. BACKGROUND Labour pain is a challenging issue for nurses designing intervention protocols. Massage is an ancient technique that has been widely employed during labour, however, relatively little study has been undertaken examining the effects of massage on women in labour. METHODS A randomized controlled study was conducted between September 1999 and January 2000. Sixty primiparous women expected to have a normal childbirth at a regional hospital in southern Taiwan were randomly assigned to either the experimental (n=30) or the control (n=30) group. The experimental group received massage intervention whereas the control group did not. The nurse-rated present behavioural intensity (PBI) was used as a measure of labour pain. Anxiety was measured with the visual analogue scale for anxiety (VASA). The intensity of pain and anxiety between the two groups was compared in the latent phase (cervix dilated 3-4 cm), active phase (5-7 cm) and transitional phase (8-10 cm). RESULTS In both groups, there was a relatively steady increase in pain intensity and anxiety level as labour progressed. A t-test demonstrated that the experimental group had significantly lower pain reactions in the latent, active and transitional phases. Anxiety levels were only significantly different between the two groups in the latent phase. Twenty-six of the 30 (87%) experimental group subjects reported that massage was helpful, providing pain relief and psychological support during labour. CONCLUSIONS Findings suggest that massage is a cost-effective nursing intervention that can decrease pain and anxiety during labour, and partners' participation in massage can positively influence the quality of women's birth experiences.
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