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研究生:黃資裡
研究生(外文):Tze-Li Huang
論文名稱:熱敷減緩第一產程生產不適的成效
論文名稱(外文):Effectiveness of hot packing attenuating discomfort in the first stage of labor
指導教授:郭素珍郭素珍引用關係
指導教授(外文):Su-Chen Kuo
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理助產研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:85
中文關鍵詞:非藥物性減痛熱敷產痛舒適
外文關鍵詞:non-pharmacological pains reliefhot compresslabor paincomfort
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本研究目的是以自製鵝卵石熱敷袋方式,測試對第一產程產婦疼痛、舒適、緊張及心跳、血壓之成效。
本研究為實驗性研究,於一家醫院與診所以隨機分派取樣,樣本數為128位個案,實驗組64位,對照組64位。實驗組是分別在潛伏期、活動期及轉變期各接受30分鐘熱敷,並在熱敷前、中間的15分鐘及結束時的30分鐘 ,以視覺類比量表(簡稱VAS)檢測研究對象對疼痛、舒適、緊張及以電子血壓計監測心跳、血壓的變化。以概似估計方程式(GEE model)進行迴歸分析。研究結果顯示:熱敷對於實驗組待產婦減緩產痛在第一產程潛伏期開始相對中期(p<.001)、活動期開始相對中期(p<.01)及轉變期(p<.001);潛伏期開始相對結束(p<.01)、活動期開始相對中期(p<.001)及轉變期(p<.05)實驗組優於對照組;在增進舒適方面實驗組待產婦在第一產程潛伏期開始相對中期(p<.05)、活動期開始相對中期(p<.001)及轉變期(p<.001);潛伏期開始相對結束(p<.05)、活動期開始相對中期(p<.001)實驗組優於對照組;但是對轉變期結束時熱敷的影響不顯著。然而,熱敷對於待產婦第一產程潛伏期、活動期及轉變期不足以降低緊張程度。結果也不影響婦女的心跳、血壓及新生兒的Apgar score。待產婦女熱敷袋使用是一個方便、簡單安全的減緩生產不適的好工具。本研究提供臨床介入措施的實驗資料。
The objective of this study was to evaluate how a home-made pebble bag for hot compress affected women’s pain, comfort, tension, heart beating and blood pressure during their first stage of labor and the Apgar score of newborn. An experimental design was used. A total of 128 laboring women who met the study criteria, were allocated by randomization to experimental (n = 64) and control (n = 64) groups. The women completed their basic personal information, when they were recruited. In the experimental group, 30 minutes of hot compress were applied in the latent phase, active phase and transition phase, respectively. In addition, before the hot compress, 15 minutes amid the treatment, and 30 minutes at the end the treatment, the VAS was used to measure pain, comfort, tension, heart beating and blood pressure. Generalized Estimating Equation model was used for regression analysis. The results showed that the treatment was significant relieving labor pain of the women in the latent phase before the hot compress vs. 15-minute (p < .001) and 30-minute (p < .01); in the active phase before the hot compress vs. 15-minute (p < .01) and 30-minute (p < .001); in the transition phase before the hot compress vs. 15-minute (p < .001) and 30-minute (p < .05). In addition, the treatment was significant increasing comfort of the women in the latent phase before the hot compress vs. 15-minute (p < .01) and 30-minute (p < .01); in the active phase before the hot compress vs. 15-minute (p < .001) and 30-minute (p < .001); in the transition phase before the hot compress vs. 15-minute (p < .001), but it was not significant at the 30-minute. And the hot compress could not ease tension of the women in the first stage of labor during the latent phase, active phase, and the transition phase. And the result would not affect women’s heart beating, blood pressure, and Apgar score of the new born. The hot compress is a convenient, simple, safe tool in relieving pain and discomfort. This study also provided empirical data that may contribute to clinical intervention by nurses and midwives.
誌 謝 1
中文摘要 II
英文摘要 III
第一章 緒 論 1
第一節 前 言 1
第二節 問題陳述 4
第三節 研究目的 5
第四節 研究假設 5
第五節 研究重要性 6
第二章 文獻查證 7
第一節 子宮收縮不適的意義與影響 7
第二節 非藥物緩解生產不適的方法 12
第三節 熱敷的運用及研究 17
第三章 研究方法 22
第一節 研究設計 22
第二節 研究對象與研究場域 23
第三節 熱敷措施 25
第四節 研究變項與定義 31
第五節 研究工具 33
第六節 資料收集 34
第七節 資料分析 36
第八節 研究倫理考量 37
第四章 結果 39
第一節 研究對象的基本屬性 39
第二節 以GEE MODEL分析第一產程熱敷對減緩不適的情形 44
第五章 討論 51
第一節 研究對象的特性 51
第二節 熱敷減緩第一產程不適的成效 53
第三節 待產時熱敷不足以減緩緊張 54
第四節 待產時熱敷不足以影響母親及嬰兒安全 55
第五節 待產期使用熱敷推廣的可行性 56
第六節 結論 58
參考資料 61
一、中文部分 61
二、英文部分 64
附錄 71
附件一 產痛源點、疼痛神經傳遞、陣痛位置圖 71
附件二 156個的分派表 79

附件三 基本資料表 80
附件四 熱敷護理評估單 81
附件五 待產資料 82
附件六 同意書 83
附件七 各種熱敷袋 84
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