Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Effect of Resistance Training,Aerobic Exercise Before Doula-Assisted Delivery on the Psychological Well-Being and Labor Duration of Parturients

Objective:To investigate the impact of resistance training and aerobic exercise before doula-assisted delivery on the psychological well-being and labor duration of parturients.Methods:105 cases of parturients who gave birth in our hospital from February 2021 to April 2023 were included in this study.The patients were divided into a control group of 52 cases and an observation group of 53 cases.The patients in the control group received no particular intervention before delivery and only received doula assistance.The patients in the observation group received resistance training,aerobic exercise,and doula assistance prior to giving birth.After delivery,the mothers were observed for 2 hours in the delivery room and then returned to the maternal and infant ward.The observation indicators of the two groups were compared.Results:In comparison to the control group,the observation group exhibited shorter durations in the first,second,and third stages of labor,as well as the total delivery time.Additionally,the amount of postpartum blood loss at 2 hours was smaller in the observation group.The rate of cesarean section was lower,and the rate of vaginal natural delivery was higher in the observation group.Following the intervention,both groups of postpartum women showed decreased SAS and SDS scores compared to before the intervention.Moreover,the observation group had lower scores than the control group.These differences were all statistically significant(P<0.05).Conclusion:Resistance training and aerobic exercise before doula-assisted delivery can effectively improve the psychological state of parturients,shorten labor duration,increase the rate of natural vaginal delivery,and reduce pain and postpartum hemorrhage.

163例Doula分娩的临床意义

目的 :通过对 16 3例 Doula分娩孕妇的临床观察 ,寻找降低剖宫产率 ,提高阴道顺产率的有效措施。方法 :正常足月孕妇 ,无头盆不称 ,均排除妊娠合并症或妊娠并发症 ,随机分为 Doula分娩组及正常足月分娩组各 16 3例。结果 :16 3例 Doula分娩孕妇的剖宫产率、产钳助产率、产后 2小时出血量及新生儿窒息发生率明显低于对照组 (P<0 .0 1) ;Doula组孕妇的第一产程、第二产程及总产程均短于对照组 (P<0 .0 1)。结论 :Doula分娩可以降低剖宫产率。减少产科干预率、缩短产程 ,减少产科病率和围产儿病率等 。

硬膜外阻滞麻醉分娩镇痛配合Doula式分娩及连续胎心监护的临床分析

目的:观察硬膜外腔阻滞麻醉分娩镇痛配合Doula式分娩及连续胎心监护的临床效果及对产科质量的影响。方法:将低浓度罗哌卡因和小剂量含芬太尼的混合液注入硬膜外腔。配合Doula式分娩及连续胎心监护,用于76例没有产科并发症及麻醉禁忌症进入活跃期的初产妇作为观察组,将单纯采用Doula式分娩的89例相同条件的初产妇作为对照组,比较两组的镇痛效果及其对产科质量的影响。结果:两组镇痛效果有极显著性差异(P<0.01),催产素使用有显著性差异(P<0.05),产程时间、分娩方式、产后出血量、胎儿窘迫、胎心监护异常发生率及新生儿窒息发生率无显著性差异(P>0.05)。结论:硬膜外腔阻滞麻醉用于分娩镇痛,效果可靠,对母婴无不良影响,配合Doula式分娩及连续胎心监护,安全有效。

“Doula”教育对分娩过程的影响

目的 探讨“Doula”教育对分娩过程的影响。方法 研究组 :妊娠 32周无绝对剖宫产指征的孕妇 ,在门诊孕妇学校的“Doula”学习班培训 3次 ,由孕妇自行选择“责任助产士” ,配合医生进行生理和心理的个性化跟踪服务 ,直到产程结束 ;对照组 :按常规的“Doula”分娩进行。结果 两组剖宫产率、剖宫产手术指征、阴道助产率、经阴道分娩难产率和难产原因、产程时间、产后出血率比较具有显著性差异 (P <0 0 5 ) ;两组新生儿窒息发生率比较无显著性差异 (P >0 0 5 )。结论 “Doula”教育可进一步降低剖宫产率、阴道助产率和产后出血率 ,是现代产科服务模式的重要组成部分。

导乐(Doula)式分娩117例临床观察

目的 探讨导乐式分娩对降低孕产妇和围产儿死亡率、减少产时并发症和难产率的意义。结果 导乐式分娩缩短产程时间 ,减少产程中镇静镇痛剂的使用 ,减少会阴切开、产后出血及新生儿窒息率。结论 99%产妇对导乐式分娩表示满意。导乐式分娩能提高产时质量 ,降低孕产妇和围产儿死亡率 ,有较好的社会效益。

耳穴疗法在Doula式分娩中的应用

目的 :探讨帮助产妇安全顺利分娩 ,减轻宫缩痛 ,减少产后出血量的方法。方法 :将 6 0例产妇随机分为治疗组与对照组各 30例 ,治疗组采用耳穴贴压法 ,在子宫、神门、下腹等耳穴上用电刺激后 ,再贴压王不留行籽 ,同时对产妇实行一对一护理 ,采用Doula式分娩照顾。对照组只采用Doula式分娩照顾。结果 :采用耳穴贴压方法止痛效果好 ,产程明显缩短 ,产后出血量少 (P <0 0 1)。结论

Doula法对产程的影响及其分娩镇痛作用

目的 了解Doula法对产程的影响及对分娩镇痛的作用。方法 选择 10 0例住院分娩患者 ,随机分为Doula组及对照组 ,研究Doula法对产妇的影响及在分娩镇痛中的作用。结果 Doula法可明显减轻分娩疼痛 ,缩短第一产程 ,降低剖宫产率 ,减少产后出血率。

笑气吸入性镇痛配合Doula式分娩在分娩镇痛中的疗效观察

目的 探讨药物镇痛与心理治疗相结合的理想的分娩镇痛方法。方法 将 2 0 0例初产妇随机分为观察组与对照组。观察组给予笑气吸入性镇痛配合Doula式分娩 ,对照组单纯采用Doula式分娩。观察比较两组的镇痛效果、不良反应及对产程、产后出血量、胎儿、新生儿的影响。结果 两组镇痛效果有极显著性差异 (P <0 0 1 ) ,产程时间亦有显著性差异 (P <0 0 5 )。结论 笑气吸入性镇痛配合Doula式分娩用于分娩镇痛产程时间短 ,对母儿均无不良影响 ,是一种药物镇痛与心理治疗相结合的理想的分娩镇痛方法 。

妊娠末期实施“Doula”教育模式的效果分析

在对 1 982名妊娠者的护理过程中 ,尝试在妊娠末期应用“Doula”教育模式的做法 ,并经过对实验结果的调查和分析 ,得出在产妇的分娩方式、剖宫产率。

硬膜外自控镇痛配合Doula陪伴在分娩镇痛中的应用

目的探讨分娩镇痛的效果及对产程、母儿情况的影响。方法采用硬膜外自控镇痛(PCEA)配合全程Doula陪伴200例(观察组);与未采用任何分娩镇痛方法而进入产程的产妇200例对照(对照组);分别观察两组镇痛效果、产程时间、分娩方式、产后出血及新生儿情况。结果观察组镇痛效果明显,第一产程缩短,两组剖宫产率比较差异有高度显著性(P<0.01)。两组胎儿窘迫,新生儿Apgar评分及产后出血率差异无显著性(P>0.05)。结论PCEA配合Doula用于分娩镇痛产妇活动自如,自控灵活,镇痛及时有效,减少了药物用量,加速产程,降低剖宫产率,对母儿均无不良反应。

Doula分娩的临床观察

为了解Doula分娩对产妇分娩方式和新生儿的影响 ,选择 2 0 0 2年 3月～ 7月住院的正常足月产妇 2 2 0例作为Doula组 ,并与 2 0 0 1年住院的正常足月产妇 2 2 0例进行比较观察。结果 ,2 2 0例Doula分娩产妇的剖宫产率、新生儿窒息发生率明显低于对照组 (P <0 0 5 )。认为Doula分娩可以降低剖宫产率 ,减少围产儿窒息率 ,使顺产率大大提高。