scholarly journals Labour: Can we make it a better experience? Enhancing knowledge, expectations and use of natural pain relief in labour.

Author(s):  
Sharmela Brijmohan ◽  
Dr.H Ramdeholl ◽  
Dr.L Pedro

While a large body of research has explored risk factors for poor birth outcomes and catastrophic birth events, less attention has been paid to positive birth experience and maternal satisfaction. Between 10-20% of all women have negative experience. The reported prevalence of posttraumatic stress disorder after childbirth ranges from 1.5% to 6% Given the lack of regular use of labour analgesia and poor availability of childbirth education classes in Guyana, it is important patient have positive expectations and adequate knowledge of the labour process and strategies of natural pain relief. These factors not only impact on the resulting experience, but on the quality of subsequent mothering, attitudes toward modes of future deliveries and on CS rates.

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
A. Bernardino ◽  
T. Morgado ◽  
L. Torres ◽  
A. Almeida ◽  
I. Rute

2020 ◽  
Vol 17 ◽  
Author(s):  
Solmaz Ghanbari-Homayi ◽  
Sonia Hasani ◽  
Hojjat Pourfathi ◽  
Mojgan Mirghafourvand

Background:: The use of pharmacological pain relief methods during labour is increasing, however there is no clear evidence that pharmacological interventions can also improve women’s satisfaction with birth experience. Objective:: To assess the effectiveness of pharmacological interventions on women's satisfaction with birth experience (primary outcome) and satisfaction with the received method (secondary outcome). Methods:: We searched databases in English (MEDLINE, Cochrane Library, Embase, ProQuest, Scopus and Web of Science) and Persian languages (SID and Magiran) from inception until April 30, 2018 for clinical trials that pharmacological pain relief methods were compared with standard or routine cares, or non-pharmacological methods. The evaluation of studies in term of risk of bias was conducted using the Cochrane Handbook. Meta-analysis results were reported as OR and 95% confidence interval. In meta-analysis, subgroup analysis was performed based on the type of intervention. Due to the heterogeneity of over 30%, random effect was reported instead of the fixed effect. The heterogeneity was evaluated using I2, T2 and Chi2. The evaluation of the quality of the studies was also examined using the Grading of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach. Results:: The results of 7 studies with low-quality in meta-analysis, showed that pharmacological methods significantly improved satisfaction with birth experience (OR = 2.99; 95% CI: 1.37 to 6.52; P = 0.006). However, meta-analysis of subgroups showed that only inhalation of Entonox gas (OR = 6.51; 95% CI: 3.47 to 12.22; P < 0.001), in contrast to epidural analgesia (OR = 1.19; 95% CI: 0.62 to 2.27; P = 0.60) and Hyoscine injection (OR = 2.58; 95% CI: 0.93 to 7.20; P = 0.07) significantly improved satisfaction with birth experience. Conclusion:: Pharmacological interventions such as epidural, although introduced as one of the effective methods for pain relief, may not provide women with satisfaction with birth. However, more studies with precise methodology, high sample size, and standard tools should be performed to more accurately investigate the effect of pharmacological interventions on birth experience.


2020 ◽  
Vol 29 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Colleen G. Mueller ◽  
Pamela J. Webb ◽  
Stephanie Morgan

Past evaluation of the effectiveness of childbirth education classes related to obstetric outcomes and satisfaction with the birth experience have not shown consistent results. This study explored the relationship between attendance of set curriculum childbirth education class and the labor and birth process, as well as maternal satisfaction with the birth experience. Participants were 197 low-risk, primiparous women, self-selected into two groups consisting of 82 women who attended a childbirth class and 115 women who did not. Data were collected from medical records and a postpartum satisfaction survey was completed by each participant. The authors designed the Likert-type satisfaction survey based on “control” as a key factor in satisfaction. Data analysis revealed that women who took a class were less likely to be induced and had lower use of analgesics during labor. A logistical regression model showed that an increase in the number of interventions increased the risk for cesarean surgery for all women. Labor interventions were used significantly less in women who took a childbirth class. No statistical difference was seen in the perception of control or overall satisfaction of the birth experience. Childbirth education may help women prepare for what to expect in birth and minimize the use of medical interventions.


2014 ◽  
Vol 155 (3) ◽  
pp. 93-99
Author(s):  
Péter Heigl

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.


Author(s):  
Eva Visser ◽  
Brenda Leontine Den Oudsten ◽  
Taco Gosens ◽  
Paul Lodder ◽  
Jolanda De Vries

Abstract Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.


2004 ◽  
Vol 20 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Kyriaki Pistevou-Gompaki ◽  
Vassilis E. Kouloulias ◽  
Charalambos Varveris ◽  
Kyriaki Mystakidou ◽  
Grigoris Georgakopoulos ◽  
...  

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.


Author(s):  
Ming-Wu Li ◽  
Xiao-feng Jiang ◽  
Chaoshi Niu

Abstract Background and Objective Trigeminal neuralgia is a common neurologic disease that seriously impacts a patient's quality of life. We retrospectively investigated the efficacy and safety of internal neurolysis (nerve combing) for trigeminal neuralgia without vascular compression. Patients and Methods This study was a retrospective review of all patients with trigeminal neuralgia who were admitted between January 2014 and February 2019. A subgroup of 36 patients had no vascular compression at surgery and underwent internal neurolysis. Chart review and postoperative follow-up were performed to assess the overall outcomes of internal neurolysis. Results Thirty-six patients were identified, with a mean age of 44.89 ± 7.90 (rang: 31–65) years and a disease duration of 5.19 ± 2.61 years. The immediate postoperative pain relief (Barrow Neurological Institute [BNI] pain score of I or II) rate was 100%. The medium- to long-term pain relief rate was 91.7%. Three patients experienced recurrence. Facial numbness was the primary postoperative complication. Four patients with a score of III on the BNI numbness scale immediately after surgery had marked improvement at 6 months. No serious complications occurred. Conclusion Internal neurolysis is a safe and effective treatment for trigeminal neuralgia without vascular compression or clear responsible vessels.


2006 ◽  
Vol 3 (2) ◽  
pp. 201-207 ◽  
Author(s):  
Taras I. Usichenko ◽  
Hardy Edinger ◽  
Vasyl V. Gizhko ◽  
Christian Lehmann ◽  
Michael Wendt ◽  
...  

Millimeter wave therapy (MWT), a non-invasive complementary therapeutic technique is claimed to possess analgesic properties. We reviewed the clinical studies describing the pain-relief effect of MWT. Medline-based search according to review criteria and evaluation of methodological quality of the retrieved studies was performed. Of 13 studies, 9 of them were randomized controlled trials (RCTs), only three studies yielded more than 3 points on the Oxford scale of methodological quality of RCTs. MWT was reported to be effective in the treatment of headache, arthritic, neuropathic and acute postoperative pain. The rapid onset of pain relief during MWT lasting hours to days after, remote to the site of exposure (acupuncture points), was the most characteristic feature in MWT application for pain relief. The most commonly used parameters of MWT were the MW frequencies between 30 and 70 GHz and power density up to 10 mW cm−2. The promising results from pilot case series studies and small-size RCTs for analgesic/hypoalgesic effects of MWT should be verified in large-scale RCTs on the effectiveness of this treatment method.


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