'Soothing the ring of fire': Australian women's and midwives' experiences of using perineal warm packs in the second stage of labour
'Soothing the ring of fire': Australian women's and midwives' experiences of using perineal warm packs in the second stage of labour
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DOI：
10.1016/j.midw.2007.08.002
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发表时间：
2009-04-01
期刊：
影响因子：
2.7
通讯作者：
Brodrick, Belinda S.
中科院分区：
文献类型：
--
作者：
Dahlen, Hannah G.;Homer, Caroline S. E.;Brodrick, Belinda S.
目的：确定妇女和助产士在第二产程中使用会阴暖包的经验。设计：作为随机对照试验的一部分（暖包试验），妇女和助产士被要求完成关于暖包对疼痛、会阴创伤、舒适度、控制感、满意度和未来分娩期间使用意图的影响的问卷调查。设置：澳大利亚悉尼的两家医院。参与者：进行随机对照试验。在第二产程后期，将分娩的未经产妇女（n = 717）随机分配到会阴部使用暖包（n = 360）或标准护理（n = 357）。标准护理被定义为助产士进行的任何第二阶段实践，不包括在会阴处使用暖包。302名未经产妇女随机接受暖包（84%）接受了治疗。266（88%）妇女谁收到了温暖的包，270（89%）助产士谁适用于这些women.Intervention温暖，潮湿的包被施加到会阴在第二阶段的劳动后期。调查结果：温暖的包是高度接受的妇女和助产士作为一种手段，缓解疼痛在第二阶段的劳动后期。几乎相同数量的妇女（79.7%）和助产士（80.4%）认为温暖的包减少了分娩期间的会阴疼痛。助产士和妇女都对未来使用暖包持积极态度。大多数女性（85.7%）表示，她们希望在下次分娩时再次使用会阴暖包，并会向朋友推荐（86.1%）。同样，91%的助产士对使用暖包持积极态度，92.6%的助产士考虑在未来将其作为第二产程常规护理的一部分。关键结论：对问卷的回答，引出参与暖包试验的妇女和助产士的经验，证明了在第二产程后期应用会阴暖包的做法是高度可接受的，在帮助缓解会阴疼痛方面是有效的，增加舒适度。对实践的启示：会阴温暖包应纳入第二阶段疼痛缓解选择提供给妇女在分娩期间。(C)2007爱思唯尔有限公司保留所有权利。
Objective: to determine women's and midwives' experiences of using perineal warm packs in the second stage of labour.Design: as part of a randomised controlled trial (Warm Pack Trial), women and midwives were asked to complete questionnaires about the effects of the warm packs on pain, perineal trauma, comfort, feelings of control, satisfaction and intentions for use during future births.Setting: two hospitals in Sydney, Australia.Participants: a randomised controlled trial was undertaken. In the late second stage of labour, nulliparous women (n = 717) giving birth were randomly allocated to having warms packs (n = 360) applied to their perineum or standard care (n = 357). Standard care was defined as any second stage practice carried out by midwives that did not include the application of warm packs to the perineum. Three hundred and two nulliparous women randomised to receive warm packs (84%) received the treatment. Questionnaires were completed by 266 (88%) women who received warm packs, and 270 (89%) midwives who applied warm packs to these women.Intervention: warm, moist packs were applied to the perineum in the late second stage of labour.Findings: warm packs were highly acceptable to both women and midwives as a means of relieving pain during the late second stage of labour. Almost the same number of women (79.7%) and midwives (80.4%) felt that warm packs reduced perineal pain during the birth. Both midwives and women were positive about using warm packs in the future. The majority of women (85.7%) said that they would like to use perineal warm packs again for their next birth and would recommend them to friends (86.1%). Likewise, 91% of midwives were positive about using the warm packs, with 92.6% considering using them in the future as part of routine care in the second stage of labour.Key conclusions: responses to questionnaires, eliciting experiences of women and midwives involved in the Warm Pack Trial, demonstrated that the practice of applying perineal warm packs in the late second stage of labour was highly acceptable and effective in helping to relieve perineal pain and increase comfort.Implications for practice: perineal warm packs should be incorporated into second stage pain relief options available to women during childbirth. (C) 2007 Elsevier Ltd. All rights reserved.