自然產初產婦於第一產程之調適策略及其相關因素

Coping strategies and relative factors in primiparous women during the first stage of labour

陳映如(Yin-Ru Chen)

指導教授 ： 蘇燦煑

國立臺灣大學/醫學院/護理學研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.02411

摘要

懷孕生產是家庭的大事，對於準父母來說也是極大的挑戰。目前產前教育課程能教導待產相關的調適策略，但在臨床上卻常見產婦未積極運用調適策略而默默忍受產痛。本研究目的探討自然產初產婦在第一產程，面對待產不適的調適策略之知識、態度與實際運用狀況及其相關因素。採事後回溯法之研究設計，以調查法進行，研究情境為台北市某醫學中心之產後病房，該院年生產數約為2600名。研究對象為自然產初產婦，採立意選樣共53名。研究工具為自擬之結構式產時調適策略量表，包括知識、態度與實際使用三個次量表。資料收集於研究對象產後72小時內收集，以自填方式作答，共發出59份問卷，回收53份，有效問卷53份，回收率達89.8%。
研究結果顯示，婦女之產時調適策略的知識程度平均為3.59 (total=5) 屬中等程度，產時調適策略的態度平均為3.17 (total=5)，趨於微正向。使用與重複使用調適策略的頻率較多的前三種依序為呼吸技巧(29.3%)、姿勢改變(21.8%)及放鬆模式(21.3%)。年齡越大，對產時調適策略之知識程度越低；知覺陪產者參與程度越高，調適策略使用態度越正向；曾經停用的策略頻率最高的為姿勢改變，策略停用的原因比例最高者是自己覺得無法有效緩解不適。第ㄧ產程時間越長，待產婦對產時調適策略使用程度越高。結論：自然產初產婦於第一產程之產時調適策略的知識程度中等，使用之態度微正向，而實際使用最多之策略為呼吸技巧；年齡、知覺陪產者之參與及產程時間長短分別為知識、態度與實際使用程度之相關因素。建議臨床上，對待產婦給予適時的產時調適策略指導，並指導與協助陪產者共同參與產時調適策略的運用；此外，另類療法之使用，亦可提供產婦更多的選擇。

關鍵字

初產婦 ； 產前教育 ； 調適策略 ； 第一產程

並列摘要

Pregnancy is a family event; it is also an enormous challenge for prospective parents. At present, it is observed that part of the prenatal education courses can be provided in the classroom to wait for relevant coping strategies, but in clinical practice has failed to be used actively; mothers usually endure the pain silently.
The purpose of this study is aimed to analyze the coping strategies and relative factors in primiparous women in the first stage of labor. Retrospective survey and purposive sampling were used for this study. Following Ethics Committee approval and providing informed consent, 53 nulliparous women completed a questionnaire at 72 hours of the birth of their first child at a medical center in North Taiwan were subjects for the study. SPSS 12.0 software for Windows was used to analysis the data.
The research results indicate that nulliparous women’s knowledge of the use of copying strategies is in a middle level. The average score for this knowledge was 3.59 (total=5).
Knowledge and age are negatively inter-correlated. The average score for women’s attitude was 3.17(total=5). It was positive. Attitude and birth companion’s involvement in the use of copying strategies are positively inter-correlated. The most used continuous strategy throughout the first stage of labor was the breathing strategy, and for discontinuous strategy, postural change showed to be more used. The highest proportion of reasons for stopping use of postural change was no longer working. The degree of using of coping strategies and duration first stage of labor are positively inter-correlated. The correlation analysis showed that continuous using of massage was significantly related to duration first stage of labor and nurse’s involvement in the use of coping strategies; stopping relaxation was significantly related to birth companion’s involvement in the use of coping strategies.
Based on the results of this study, it is recommended to obstetric nurses: first ensure that the women have learned the knowledge and skills, second fit the current situation of the women to coping strategy, and third consider the importance and function of birth companion. In addition, aromatherapy and the use of music also could be useful. Aromatherapy and music is provided by the usage of reference for women at antenatal classes.

並列關鍵字

nulliparous women ； antenatal education ； coping strategies ； the first stage of labor

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