- 期刊
溫柔生產教育介入對產婦臨床指標及生產經驗態度改善之成效探討：前趨式研究
The effect of gentle childbirth education on clinical indicators and attitudes about childbirth experience for women in labor: A pilot study
摘要
背景：筆者所在醫院落實推動母嬰親善生產，近年由助產師團隊舉辦一系列溫柔生產教育課程，帶領懷孕婦女及陪產者建立因應待產生產的相關知識及舒適技巧。目的：探討溫柔生產教育介入對待產婦待產生產結果及生產經驗之成效。方法：本研究為類實驗研究，實驗組為懷孕24～32週之孕婦，接受助產師主導的溫柔生產教育課程，共3堂課12小時，課程結束後，助產師團隊仍持續與孕婦互動，不論個案選擇居家或醫院生產，全產程皆由助產師團隊繼續照護以執行連續性護理；控制組選取孕程超過37週並於筆者所在醫院接受陰道自然分娩之產婦，其懷孕過程接受常規照護。測量工具為待產生產結果及生產經驗。結果：共收案55位，實驗組25位，控制組30位，研究結果發現，相較於控制組，實驗組待產時較少使用催生藥物（p＜.001）與減痛分娩（p＝.02）、有較多樣的減痛技巧及分娩姿勢，且經共變數分析，實驗組待產疼痛分數顯著較低（p＝.01），生產經驗中如待產期間信心（p＝.002）及是否擔心寶寶安全（p＝.004）、生產期間信心（p=.04）、生產過程感受（p＝.01）及生產期間是否感害怕（p＝.001）及擔心寶寶安全（p＝.002）之題項皆有較正向表現。結論／實務應用：介入助產師主導的溫柔生產教育能讓產婦待產時運用多樣的減痛技巧使得待產疼痛較低，且讓分娩自行啟動，較少介入催生藥物與減痛分娩，對於待產期間較有信心及生產期間較少感到害怕，建議醫療院將溫柔生產教育課程列為常規衛教活動，以提升產婦正向生產經驗感受。
並列摘要
Background: Our hospital has vigorously promoted childbirth-friendly policies. Recently, a series of birth education programs have been conducted to comprehensively convey knowledge and practical skills for pregnant women and their husbands. Purpose: The aim of this study was to explore the effects of birth education to improve clinical indicators and attitudes about the childbirth experience among women in labor. Methods: This was a quasi-experimental study, and participants were allocated to the experimental group (EG) or to the control group (CG). The EG comprised pregnant women from 24-32 gestational weeks who received birth education for 4 hours per session, for a total of 3 sessions. Afterward, the midwife team continued to interact with the pregnant women. Regardless of whether the patient chose a home or hospital birth, the midwife team continued to oversee the whole process to provide continuous care. The CG comprised women who were pregnant for more than 37 weeks and received routine care during pregnancy and eventually during labor in our hospital. The measurements included the clinical indicators and attitudes about the childbirth experience among women who underwent labor. Results: Fifty-five women who underwent labor were recruited: 25 in the EG and 30 in the CG. The results of this study showed that women in labor in the EG had less use of birth-inducing drugs (p＜ .001) and epidural analgesia (p=.02), and used a variety of pain-reducing skills and childbirth postures. After the covariate analysis, the women in the EG had significantly lower pain scores during labor (p=.01). Regarding the attitudes about the delivery experience, such as confidence during labor (p=.002), whether she was worried about safety for her baby (p=.004), confidence in labor (p=.04), the delivery experience (p=.01), whether the woman was afraid (p=.001) and whether she was worried about her baby's safety during labor (p=.002) were more positive attitudes among women in the EG. Conclusions/Implications for Practice: Birth education led by midwives can enable mothers to use a variety of pain-reducing skills during delivery to make labor less painful and allow labor to begin on its own, with less use of birth-inducing drugs and epidural analgesia. On the other hand, the woman in labor felt more confident and less afraid during labor and delivery. It is recommended that other medical hospitals list childbirth education courses as routine health education activities to enhance the maternal experience of childbirth.