Development and Evaluation of Clinical Practice Guidelines for Labor Care with a Birth Companion on Pain Coping, Labor Duration, Delivery Mode, and Satisfaction with Intrapartum Nursing Care among Primiparous Women
Keywords:
Birth companion, nursing practice guidelines, pain coping, duration of labor, satisfaction with intrapartum nursing careAbstract
Childbirth induces labor pain and anxiety, which negatively impact labor progression and the overall childbirth experience. This research and development study aimed to develop and evaluate clinical nursing practice guidelines utilizing a labor support model, assessing its effects on labor pain coping, duration of labor, mode of delivery, and satisfaction with intrapartum care among primiparas. Conducted at the Labor and Delivery Room, Khon Kaen Hospital, from December 2025 to March 2026, the study was divided into two phases guided by the Iowa Model. Phase 1 involved guideline development through a systematic review of 15 studies, content validity verification by 5 experts, and quality appraisal using the AGREE II instrument by 14 registered nurses. Phase 2 was a quasi-experimental study among 46 primiparous women aged 20–34 years, selected via purposive sampling and assigned to a control group (standard care, n = 23) or an experimental group (labor companionship CPGs, n = 23). Intervention tools included the 4-component CPGs paired with an educational video. Outcome evaluations were performed at the end of the first stage of labor using a labor pain coping scale and a questionnaire on satisfaction with intrapartum nursing care. Quantitative data were systematically analyzed using Independent t-test, Mann-Whitney U test, Chi-square test, and Fisher’s exact test.
The results revealed that the experimental group had significantly higher scores in pain coping and satisfaction with intrapartum nursing care compared to the control group (p < .001 and p < .001, respectively). However, no statistically significant differences were observed between the two groups regarding labor pain intensity, duration of labor, and mode of delivery (p > .05). These findings indicate that the guidelines enhance pain coping ability and maternal satisfaction, suggesting their application to improve the quality of intrapartum nursing care and further evaluation in other contexts.
References
Dick-Read G. Childbirth without fear: the original approach to natural childbirth. 4th ed. New York: Harper & Row; 1984.
Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;2017(7):CD003766.
สำนักงานสถิติแห่งชาติ. สถิติการเกิดและการตายในประเทศไทย. กรุงเทพฯ: สำนักงานสถิติแห่งชาติ; 2565-2567.
Dick-Read G. Childbirth without fear: the principles and practice of natural childbirth. London: Heinemann Medical Books; 1944.
ขวัญใจ เพทายประกายเพชร, ศริณธร มังคะมณี, รุ่งทิพย์ ไชยโยยิ่งยงค์. อิทธิพลของความเจ็บปวดต่อระยะเวลาการคลอด. วารสารวิจัยเพื่อการส่งเสริมสุขภาพและคุณภาพชีวิต. 2568;5(1):143-56.
Hasriantirisna H, Nanda K, M StM. Effects of Stress During Pregnancy on Maternal and Fetal Health: A Systematic Review. Advances in Healthcare Research. 2024;2:103-15. https://advancesinresearch.id/index.php/AHR/article/download/339/160
World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018.
Uvnäs-Moberg K, Ekström-Bergström A, Buckley S, Massarotti C, Pajalic Z, Luegmair K, et al. Maternal plasma levels of oxytocin during physiological childbirth–a systematic review with implications for uterine contractions and central actions of oxytocin. BMC Pregnancy Childbirth. 2019;19(1):285.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013;2013(7):CD003766.
Klaus M, Kennell J, Klaus P. Bonding: building the foundations of secure attachment and independence. Reading (MA): Addison-Wesley; 1995.
Phumdoung S, Youngvanichsetha S. Women's experiences during labor and childbirth. Belitung Nurs J. 2019;5(5):176-81.
Senanayake H, Piccoli M, Valente EP, Businelli C, Ciantelli C. Implementation of the WHO manual for augmentation of labour in a Sri Lankan hospital. Ceylon Med J. 2017;62(4):222-8.
Suwannaroop N, Boriboonhirunsarn D, Sunsaneevithayakul P. Anxiety and fear of childbirth in nulliparous women during COVID-19 pandemic. Arch Gynecol Obstet. 2021;304(4):975-81. doi: 10.1007/s00404-021-06047-3.
Boekhorst MG, Potharst ES, Beerthuizen A, Hulsbosch LP, Nyklíček I, Pop VJ. The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression. Arch Womens Ment Health. 2021;24(6):1037-43.
Chivers BR, Garad RM, Boyle JA, Skouteris H, Teede HJ, Harrison CL. Perinatal distress during COVID-19: thematic analysis of an online parenting forum. J Med Internet Res. 2020;22(9):e22002.
Dubey C, Champagne N, Daneault S, Caty MÈ, Gagnon MP. Fear of childbirth and its associated factors among pregnant women: a systematic review. Int J Environ Res Public Health. 2023;20(4):3158. doi: 10.3390/ijerph20043158
Valladares-Neto J. Effect size: A statistical basis for clinical practice. Revista Odonto Ciência. 2018;33(1):84-90.
Bahari F, Saleh S. Content Validation Procedure: Development of Problem-solving Skills Test (PSST). Jurnal Pendidikan Sains & Matematik Malaysia. 2023;13(1):1–9. https://doi.org/10.37134/jpsmm.vol13.1.1.2023
Downloads
Published
How to Cite
Issue
Section
License
This article was published in the Journal of regional healh promotion centre 7 khonkaen. It is considered an academic work or research. The results of the analysis and recommendations are subjective opinions. It is not the opinion of the Journal of regional healh promotion centre 7 khonkaen or the editorial office in any way. Authors are responsible for their own articles.
