Effect of antenatal instruction of non-pharmacological techniques on pain during labor and satisfaction with the delivery experience

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Authors
Murray, Valoree L.
Advisor
Issue Date
2002
Keyword
Degree
Thesis (M.S.)
Department
School of Nursing
Other Identifiers
Abstract

Obstetrical patients often present in labor with little or no knowledge of how to manage the pain of labor before pharmacological means are available. This may lead to increased discomfort during labor and an overall decrease in the satisfaction of the birthing experience. A recommended intervention for improving pain outcomes and satisfaction in the birthing experience is antenatal patient education on nonpharmacological techniques to decrease pain and increase satisfaction during the birthing experience. The purpose of this study is to examine the effects of antenatal education of non-pharmacological techniques on patient pain during labor and satisfaction with the delivery experience.The Gate Control Theory of Pain will be used as the theoretical framework for this quasi-experimental study. According to Melzack & Wall (1982) the Gate-Control Theory predicts that massaging a particular area stimulates large diameter nerve fibres. These fibres have an inhibitory input onto T cells and the T cells are depressed. Nociceptive fibres have an excitatory input effect, which is, therefore, followed by pain relief. Nonpharmocologic pain relief measure such as effleurage, massage, cold/hot application etc. would then, in theory, work to decrease pain in the laboring patient. The sample will include 100 primaparas women randomly, alternately selected from an accessible population of physician offices of four Texas Health Resource (THR) hospitals located in North Texas. Inclusion in the study will consist of the ability of the participants to read and write English, primaparity, and planned spontaneous vaginal delivery. Patients will receive an invitation to participate in the study by the physician during an antenatal clinic visit. A cover letter explaining the study outlining the voluntary nature of the study will be given to all expectant patients by the physician. Informed consent will be signed. Responses collected will be confidential and the data will remain anonymous. No risks have been identified. Participants may withdraw from the study at any time. Women will then be divided into a control group, which will have no formal instruction on non-pharmacological techniques pain control techniques, and an experimental group, which will have formal instruction on non-pharmacological pain control techniques. The McGill Pain Questionnaire (MPQ), which measures perceptions of pain and Visual Analog Scales will be used to evaluate pain during the birthing process. The Coping with Childbirth Questionnaire and the Childbirth Satisfaction Questionnaire will be used to evaluate overall satisfaction with the delivery experience. The significance of this study will be to show that if primaparous women attend antenatal classes to learn to effectively use non-pharmacological pain relief measures, they may be able to benefit by having a decrease in labor pain and an increase in the satisfaction with the delivery experience.

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