| Abstract [eng] |
Aim of the study. To evaluate the level of knowledge and attitudes of Lithuanian citizens regarding labor pain management methods, to identify factors influencing women’s decision-making when choosing a method of labor pain relief, and to analyze the characteristics and clinical application of labor pain management methods described in the scientific literature. Objectives. 1. To compare knowledge and attitude indicators of Lithuanian citizens according to sociodemographic and obstetric variables. 2. To identify factors influencing women’s decisions regarding pain relief and the choice of method during labor. 3. To compare knowledge and attitudes of Lithuanian citizens toward non-pharmacological and pharmacological pain relief methods. 4. To conduct a comprehensive literature review on contemporary labor pain management methods, evaluating both pharmacological and non-pharmacological approaches, their effectiveness, safety, and applicability. Methods. The study was approved by the Vilnius University Faculty of Medicine Research Ethics Committee (No. (1.7 E) 150000-KT-597). A cross-sectional observational quantitative study was conducted, involving a total of 491 respondents. An original anonymous questionnaire consisting of four parts was used. Statistical data analysis was performed using the SPSS software package. In addition, a narrative review of the scientific literature was carried out in order to analyze methods of labor pain management as well as the factors influencing women’s decisions when choosing pain relief methods during labor. Results. The study included 491 respondents, the majority of whom were women (96.7%). Among women who had given birth (n = 343), nearly half had received pharmacological pain relief methods, most commonly epidural analgesia (approximately 40%). No statistically significant association was found between maternal age and the use of regional anesthesia (p = 0.874). Subjectively, respondents reported having the most knowledge about epidural analgesia (58.2%) and the least knowledge about paracervical nerve block. Regarding non-pharmacological methods, respondents were most familiar with emotional support (67.2%), whereas only 8.4% were familiar with transcutaneous electrical nerve stimulation. Objectively assessed knowledge showed that 60.9% of respondents correctly defined epidural analgesia, 42.0% correctly identified the use of spinal analgesia, and 35.4% correctly identified opioid-related fetal complications. Knowledge levels differed according to age, education, and childbirth experience: younger respondents, those with higher education, and respondents without childbirth experience answered some questions more accurately. Respondents younger than 35 years used the internet more frequently as a source of information compared to respondents aged ≥35 years (67.6% vs. 50.8%, respectively; p = 0.004). Younger respondents also placed greater importance on the risk of adverse effects for the newborn and the mother, as well as on the effectiveness, and more frequently relied on recommendations from physicians or midwives. Most respondents disagreed with the statement that labor pain should not be relieved (62.8%). In addition, 76.8% of respondents would choose a stepwise pain management strategy, preferring non-pharmacological methods first and pharmacological methods if needed. Conclusions. 1. Sociodemographic and obstetric factors were associated with differences in the population’s level of knowledge and attitudes toward labor pain relief methods. 2. Women’s decisions regarding labor pain relief were influenced by a combination of factors, with safety-related aspects being the most important. 3. The population’s knowledge about pharmacological labor pain relief methods was better than about non-pharmacological methods; however, the overall attitude demonstrated a tendency to choose a combination of these approaches. |
