Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards.

BACKGROUND: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. METHODS: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. RESULTS AND CONCLUSION: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way.

Midwifery students' conceptions of worst imaginable pain.

BACKGROUND: The Visual Analogue Scale (VAS) is one of the most widely used pain assessment scales in clinical practice and research. However, the VAS is used less frequently in midwifery than in other clinical contexts. The issue of how people interpret the meaning of the VAS endpoints (i.e. no pain and worst imaginable pain) has been discussed. The aim of this study was to explore midwifery students' conceptions of 'worst imaginable pain'. METHODS: A sample of 230 midwifery students at seven universities in Sweden responded to an open-ended question: 'What is the worst imaginable pain for you?' This open-ended question is a part of a larger study. Their responses underwent manifest content analysis. RESULTS: Analysis of the midwifery students' responses to the open-ended question revealed five categories with 24 sub-categories. The categories were Overwhelming pain, Condition-related pain, Accidents, Inflicted pain and Psychological suffering. CONCLUSIONS: The midwifery students' conceptions of 'worst imaginable pain' are complex, elusive and diverse.

The recovery process after day surgery within the symptom management theory.

PURPOSE: The aim was to illustrate two cases in a postoperative situation following day surgery within the framework of the symptom management theory. METHOD: Template analysis using the symptom management theory. RESULT: Neither the woman nor the man was able to return to their normal activities, health status or functional status, within a week. CONCLUSION: The results illustrate how a postoperative situation may involve personal suffering up to 3 months. PRACTICAL IMPLICATION: To obtain an outcome following day surgery, as optimal as possible, improving clinical practices and routines, such as discharge criteria, guidelines, and care pathways, is necessary.

Midwifery students attribute different quantitative meanings to hurt, ache and pain: a cross-sectional survey.

BACKGROUND: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. RESULTS: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. CONCLUSIONS: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain.

Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment.

OBJECTIVE: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment. DESIGN: randomised controlled trial. SETTING: labour ward with approximately 2500 childbirths per year in western Sweden. PARTICIPANTS: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180 minutes after treatment. MEASUREMENTS AND FINDINGS: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements. CONCLUSIONS: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain. IMPLICATIONS FOR PRACTICE: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.