The Development and Validation of a Dynamic Model to Account for the Progress of Labor in the Assessment of Pain

Conell-Price, Jessamyn; Evans, Jennifer B; Hong, D H; Shafer, Steven L.; Flood, Pamela

doi:10.1213/ane.0b013e31816d14f3

Cited by 35 publications

(18 citation statements)

References 22 publications

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“…Despite methodological variations in relation to the sample and details that distinguish the study design, in one research, great variation in pain intensity was shown by scores 0 to 10 during the contractions throughout the evolution of labor (26) . …”

Section: Statisticalmentioning

confidence: 99%

Clinical validation of the nursing diagnosis labor pain

Mazoni¹,

Carvalho

Santos

2013

Rev. Latino-Am. Enfermagem

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Validación clínica del diagnóstico de enfermería dolor de partoObjetivos: El estudio propuso identificar la presencia de los indicadores clínicos de dolor de parto y correlacionar el relato verbal de intensidad del dolor con la ocurrencia de contracciones uterinas, como propuesta de validación clínica del diagnóstico de enfermería Dolor de Parto.Método: Estudio observacional de los 22 indicadores clínicos que representan las características definidoras para el diagnóstico. Resultados: Participaron 55 parturientes (18 en la fase activa inicial, 6 en la fase activa final y 31 en ambas fases), mayores de 18 años, gestación de feto único, contracciones efectivas y dilatación cervical ≥4cm. Fueron testadas 22 características definidoras, 6 presentes en la mayoría de las participantes en las dos fases: relato verbal o codificado, evidencia observada de contracción uterina, alteración del tono muscular, evidencia observada de dolor, comportamiento expresivo y expresión facial de dolor. Fueron encontradas diferencias entre las fases para diaforesis, expresión fácil de dolor, gestos protectores, posición antiálgica, comportamiento de distracción, foco en si mismo y relato de presión perineal.Conclusiones: Se observó correlación linear positiva entre escores de intensidad de dolor y amplitud de presión intrauterina en la fase inicial. El dolor de parto se evidenció un fenómeno compatible para diagnóstico de enfermería.

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Section: Statisticalmentioning

confidence: 99%

Clinical validation of the nursing diagnosis labor pain

Mazoni¹,

Carvalho

Santos

2013

Rev. Latino-Am. Enfermagem

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“…Based on the earlier studies, [1][2][3][4][5] we hypothesized significant heterogeneity among hospitals in the duration of labor analgesia for vaginal delivery.…”

Section: Large Heterogeneity In Mean Durations Of Labor Analgesia Amomentioning

confidence: 99%

“…5 Parturients who wish to have a more natural, less painful, labor experience may reject active management of labor. 4 Although the AQI currently lacks both patient factor data and relevant data on obstetric management, American Society of Anesthesiologists and American College of Obstetricians and Gynecologists have recently announced the Maternal Quality improvement Project to address this deficiency. l CONCLUSIONS Using data from the American Society of Anesthesiologists' AQI, we showed that the mean durations of labor analgesia for vaginal delivery have large heterogeneity among US hospitals.…”

Section: Limitationsmentioning

confidence: 99%

“…This is unlikely to reflect solely differences in the physiology of labor but also differences in local obstetrical practice among hospitals (e.g., when labor epidurals are requested and/or supplied) and/or heterogeneity of women's demographics among the hospitals (e.g., different incidences of Asian women or obese women). [1][2][3][4][5] An implication is that the number of labor epidurals alone is not a valid measure to be used as part of the quantification of the productivity of an anesthesia department. Equitable payment would not be based solely on the number of labor epidurals for vaginal delivery.…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Large Heterogeneity in Mean Durations of Labor Analgesia Among Hospitals Reporting to the American Society of Anesthesiologists’ Anesthesia Quality Institute

Flood

Dexter²,

Ledolter

et al. 2015

Anesthesia &Amp; Analgesia

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Our results show that the number of labor epidurals alone is not a valid measure to quantify obstetrical anesthesia productivity. In addition, payment to US anesthesia groups for labor analgesia based solely on the number of labor epidurals initiated is not equitable. Previous work showed lack of validity and equality of payment based on face-to-face time with the patient (i.e., like a surgical anesthetic). The use of base and time units, with one time unit per hour, is a suitable payment system.

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“…Recently this analytic technique was applied to build a sigmoidal mathematical model of labor pain. 18 A retrospective cohort study used data from 500 laboring women who ultimately delivered vaginally to derive a biexponential equation to describe cervical dilation over time, 19 and to show that patient weight, neuraxial analgesia, and Asian race each influence the progress of labor independently. Substantial individual variability was noted in both the labor pain and labor progress models.…”

Section: Communicationmentioning

confidence: 99%