Factors Influencing Postpartum Fatigue in Vaginal-Birth Women: Testing a Path Model

Ching-Hsing HSIEH; Chien-Lan CHEN; Tan-Ju HAN; Pei-Ju LIN; Hui-Chun CHIU

doi:10.1097/jnr.0000000000000249

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医药卫生 > 预防保健与卫生学
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Factors Influencing Postpartum Fatigue in Vaginal-Birth Women: Testing a Path Model

Ching-Hsing HSIEH ； Chien-Lan CHEN ； Tan-Ju HAN ； Pei-Ju LIN ； Hui-Chun CHIU

The Journal of Nursing Research ； 26 卷 5 期 (2018 / 10 / 01) ， P332 - 339

英文 DOI： 10.1097/jnr.0000000000000249

vaginal birth ； perineal pain ； the second stage of labor ； postpartum fatigue

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摘要 │ 参考文献 (34) │ 国际计量

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Background: Postpartum fatigue is a very common complaint among postpartum women. Although current evidence indicates that several factors (e.g., parity, epidural analgesia, perineal trauma, perineal pain, and longer second stage of labor) are associated with postpartum, not enough is known about the relationships among these physical factors simultaneously and how they contribute to the development of postpartum fatigue. Increased awareness of the complex relationships among these factors will help nurses assess, prevent, and alleviate postpartum fatigue. Purpose: The aims of this study were to test a model of factors that influence postpartum fatigue and to estimate the direct and indirect effects of these factors on postpartum fatigue in vaginal-birth women. Methods: The hypothesized model of the factors that influence postpartum fatigue after vaginal birth was developed based on previous studies. This study used a cross-sectional correlational design and convenience sampling. The Visual Analog Scale for Pain was used to measure postpartum perineal pain, and the Postpartum Fatigue Scale was used to assess postpartum fatigue via a structured, self-report questionnaire. Data analysis included descriptive statistics, Pearson's correlation coefficients, and path analysis. Results: This study evaluated 326 healthy postpartum women within the first day after vaginal birth. Participants ranged from 20 to 43 years old, and 50.9%were primiparous. The model of the factors influencing postpartum fatigue after vaginal birth showed a good fit with the empirical data. Parity and the use of epidural analgesia predicted the duration of the second stage of labor, and the degree of perineal trauma predicted perineal pain. Participants who had experienced longer durations of the second stage of labor and more perineal pain reported higher levels of early postpartum fatigue. Conclusions/Implications for Practice: It is suggested that maternal nurses should better understand postpartum fatigue, take precautions to decrease perineal pain, and pay more attention to the longer duration of the second stage of labor to minimize postpartum fatigue, increase patient comfort, and improve the quality of perinatal care.

参考文献 ( 34 ) 〈TOP〉

Lai, M. L.,Lin, K. C.,Li, H. Y.,Shey, K. S.,Gau, M. L.(2009).Effects of delayed pushing during the second stage of labor on postpartum fatigue and birth outcomes in nulliparous women.The Journal of Nursing Research,17(1),62-72.
连结：
Tzeng, Y. L.,Yang, Y. L.,Kuo, P. C.,Lin, Y. C.,Chen, S. L.(2017).Pain, anxiety, and fatigue during labor: A prospective, repeated measures study.The Journal of Nursing Research,25(1),59-67.
连结：
Borders, N.,Wendland, C.,Haozous, E.,Leeman, L.,Rogers, R.(2013).Midwives' verbal support of nulliparous women in second-stage labor.Journal of Obstetric, Gynecologic, & Neonatal Nursing,42(3),311-320.
Cappell, J.,Pukall, C. F.(2017).Clinical profile of persistent genito-pelvic postpartum pain.Midwifery,50,125-132.
Chang, S. C.,Chou, M. M.,Lin, K. C.,Lin, L. C.,Lin, Y. L.,Kuo, S. C.(2011).Effects of a pushing intervention on pain, fatigue and birthing experiences among Taiwanese women during the second stage of labour.Midwifery,27(6),825-831.

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