生產球運動計畫對孕產期婦女生產疼痛及生產滿意度之成效

Effects of Birth Ball Exercises on Labor Pain and Childbirth Satisfaction

田淑惠(Shu‐Hui Tian) ； 高千惠(Chien‐Huei Kao) ； 林寬佳(Kuan‐Chia Lin) ； 張靜宜(Ching‐Yi Chang) ； 高美玲(Meei‐Ling Gau)

《護理暨健康照護研究》 9卷1期 (2013/03) Pp. 13-22

https://doi.org/10.6225/JNHR.09.1.13

摘要

背景：負向的生產經驗易導致婦女低自尊及影響母性角色。目的：探討生產球運動練習及介入措施對懷孕末期婦女生產滿意度及生產疼痛之成效，並評估生產疼痛對產球運動介入措施於生產滿意度的中介效應。方法：於一家區域醫院及一家醫學中心收案，採臨床隨機試驗，將167位符合收案條件的懷孕婦女隨機分派至實驗組（42人）及控制組（32人）。孕產期生產球運動計畫包含衛教手冊、運動DVD示範光碟、生產球及產球運動執行情形。實驗組婦女（n = 42）分別由兩位研究者教導與示教生產球運動姿勢，研究對象每週需至少練習3次、每次20分鐘，為期6 − 8週；待產時實驗組個案由產房護理人員提供生產球，並每小時鼓勵更換最舒服之姿勢或運動。除了介入措施有所不同外，實驗組及控制組個案均接受醫院孕期及待產期的常規性照護。研究的問卷包括：人口學及產科學資料、疼痛視覺類比量表及中文版生產滿意度量表。結果：實驗組具有顯著改善生產滿意度及緩解生產疼痛，且介入措施（生產球運動計畫）中48.97%的效應係經由緩解疼痛而提昇了生產滿意度。結論／實務應用：生產球運動能改善生產滿意度及緩解生產疼痛。醫療專業人員若在產前應教導婦女及其伴侶在產前熟悉生產球運動以因應生產疼痛，將有助於正向及滿意的生產經驗。

關鍵字

生產球運動 ； 疼痛處理 ； 生產滿意度

並列摘要

Background: Dissatisfaction with childbirth experience negatively affects self‐esteem and maternal role development in new mothers. Purpose: This study examines the effectiveness of a birth ball exercise program during childbirth. Childbirth satisfaction and childbirth pain were measured. The mediating effect of childbirth pain on the relationship between the birth ball exercise program and childbirth satisfaction was also examined. Methods: This study was conducted in birth units at one regional hospital and one medical center. In a randomised controlled trial, 167 expectant mothers were recruited and allocated by block randomization into the two arms of the study, with 42 intervention and 32 control group partipants completing the trial. The birth ball exercise program consisted of a booklet and a DVD, with periodic follow‐ups during prenatal checks. All members of the experimental group were asked to practice the exercises and positions at home for at least twenty minutes three times a week for a period of 6‐8 weeks. Each woman in the experimental group was given a birth ball for use during labour and encouraged every hour to choose the most comfortable positions, movements, and exercises. Both experimental and control groups received standard nursing care from hospital staff nurses in all aspects of pregnancy and childbirth. The questionnaire used collected data using a demographic and obstetrics information datasheet, the Visual Analog Pain Scale (VAPS), and Chinese version of the Mackey Childbirth Satisfaction Rating Scale. Results: Our study revealed that birth ball exercises provided statistically significant improvements in childbirth satisfaction and pain. Pain had a 48.97% mediating effect on relationships between birth ball exercises and childbirth satisfaction. Conclusions / Implications for Practice: Clinical implementation of the birth ball exercise program could be an effective adjunctive tool to improve childbirth satisfaction and reduce pain among women in labour. Health professionals can educate women and their partners prenatally about how to use birth ball exercise to cope with childbirth in order to facilitate more positive feelings about the childbirth experience.

並列關鍵字

birth ball exercises ； pain management ； childbirth satisfaction