探討產婦會陰切開術後會陰疼痛程度與困擾問題之相關性

根據研究顯示台灣婦女陰道分娩時執行會陰切開術的比例高達佔92.9％（郭，高，高，鄭，林，吳，2006），會陰切開術造成會陰部位的疼痛是產後婦女最常見的問題，不但造成婦女活動困難，影響婦女照顧新生兒的意願，進而可能導致生理的恢復延遲。本研究旨在探討產婦在會陰切開術後會陰疼痛與產後的困擾問題之相關性。採描述與相關性研究，以方便取樣方式於中部某區域教學醫院，針對執行會陰切開術後的陰道生產產婦進行收案，共取得有效樣本193份。本研究結果顯示產婦的會陰疼痛程度為中等；82.3％感到走路與移動有困難；76.1％解便時感到會陰部疼痛；結果發現會陰縫線種類(t=11.452,p＜0.000)、溫水坐浴(t=12.412,p＜0.001)、生產方式(t=8.361,p＜0.004)在產婦的疼痛程度上達顯著差異，且移動困難(r=0.461,p＜0.000)、解便疼痛(r=0.454,p＜0.000)、睡眠品質(r=0.537,p＜0.000)、新生兒照顧(r=0.451,p＜0.000)與會陰疼痛程度有顯著相關；多變項分析結果發現會陰縫線種類(β=0.623,p＜0.030)、溫水坐浴(β=0.748,p＜0.027)、解便疼痛(β=0.413,p＜0.032)、睡眠品質(β=0.460,p＜0.002)等與會陰疼痛達顯著相關，可解釋之變異量(R Square)為45.3％。研究結果強調一個完整的身體疼痛評估的重要性，並期望提供醫護人員對產婦疼痛問題的了解。

關鍵字

會陰切開術；困擾問題；會陰疼痛

並列摘要

Episiotomy rate was 92.9% in Taiwan. Perineum pain is the most common problem of postpartum women. The purpose of this paper is to explore perineum pain after episiotomy induced distress problems and relative factors. This is a descriptive, cross-sectional correlation design. A total of 193 valid questionnaires were collected. Results of this study found : degree of perineum pain was medium; 82.3% showed walking and moving difficulty ; 76.1% had defecated pain. One-way ANOVA and Pearson's correlation shows significant correlation among type of suture(t=11.452,p＜0.000), sitz bath(t=12.412,p＜0.001), way of delivery(t=8.361,p＜0.004), sleep quality(r=0.537,p＜0.000), moving difficulty (r=0.461,p＜0.000), newborn care (r=0.451,p＜0.000) and perineum pain. Multiple linear regression shows significant differences between sitz bath (B=0.748,p＜0.027), type of suture (B=0.623,p＜0.030), walking and moving difficulty, defecated pain(B=0.413,p＜0.032), sleep quality (B=0.460,p＜0.002) and perineum pain, explaining 45.3% of the variance. This study provides understanding of perineum pain for nurses, and suggests a well assessment of pain is important.