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 。

优化产房管理降低剖宫产率促进自然分娩临床观察

转变产时服务模式，优化产房管理，避免不必要的医疗干预，降低剖官产促进自然分娩是广大医务工作者广泛关注的问题。分娩过程中，家属是否可以陪伴，是否限制产妇体位或活动早有争议。WHO于1996年在“正常分娩监护实用手册”中提出Doula分娩列为有用的、鼓励使用的措施，所以优化产房管理，转变分娩模式直接关系到母婴安全，据统计孕产妇死亡50％发生于分娩当天与产时保健质量直接相关。

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。

分娩镇痛的心理支持及人性化护理的运用与探讨

目的探讨积极心理干预Lamaze精神预防法-doula陪伴分娩-人性化综合护理方法在产科分娩镇痛工作中的临床应用效果,提升护理服务品质。方法对2011年11月～2012年2月收治的232例患者的临床资料进行回顾性总结分析。结果实施积极心理干预Lamaze精神预防法-doula陪伴分娩-人性化综合护理方法明显改善患者心理状态(P<0.05),减少产后出血的发生率(P<0.05),降低剖宫产率(P<0.05)及助产发生率(P<0.05),两组医疗质量评价比较差异有统计学意义(P<0.01)。结论通过积极心理干预Lamaze精神预防法-doula陪伴分娩-人性化综合护理,对改善产妇心理状况有着积极的影响,提高了产妇对医疗质量的评价,有利于的医疗服务质量的提高,帮助产妇顺利度过分娩期。

导乐式分娩与自然分娩过程几项生物指标相关性的研究

目的:探讨导乐式分娩的临床应用效果。方法:对184例围生期妇女进行分组对比研究,应用导乐式分娩(研究组)92例及自然分娩(对照组)92例对比。结果:研究组顺产率明显高于对照组(P<0.01);研究组第一产程显著短于对照组(P<0.01),第二产程、总产程也短于对照组(P<0.05);产后出血发生率、新生儿窒息率明显低于对照组。结论:导乐式分娩能使孕妇得到心理、生理的帮助和呵护,提高顺产率,降低手术产率,缩短分娩时间,有利母婴安全。

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。

“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。

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

剖宫产率及剖宫产指征12年变化分析

目的:总结观察剖宫产率及剖宫产指征的变化趋势。方法:对1993～2004年的剖宫产率及剖宫产指征变化进行回顾性分析。结果:剖宫产率在1993～2002年逐年上升,2003～2004年有所下降;在剖宫产指征中,难产因素始终位于第1位,社会因素自1998年逐年升高,近2年上升至第2位。结论:剖宫产率的升高是多方面因素造成的,其中社会因素是主要原因之一。Doula分娩可在一定程度上降低剖宫产率。

分娩镇痛

分娩镇痛是医学发展和社会发展的需要,该文通过对分娩疼痛产生的原因、分娩镇痛的方式进行综述与分析,得出了如下结论:最有效的分娩镇痛方式是建立在非药物性镇痛的基础上,采用药物镇痛,其中可行走镇痛方式最有发展前途。

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 。