Pain cognitions as predictors of the request for pain relief during the first stage of labor: a prospective study.

摘要

BACKGROUND: It is thought that pain cognitions determine coping behavior and success in adapting to labor. The aim of this study was to examine whether pain cognitions assessed by the labor pain coping and cognition list (LPCCL) predict the request for pain relief during the first stage of labor and which pain cognition is the strongest predictor of a request for pain relief over and above, and independent of, other pain cognitions. METHODS: Participants in this prospective study were 177 low-risk nulliparous pregnant women. Data were collected on two different occasions. The numerical pain intensity scale (NPS)-anticipated and the LPCCL were administered at 34-36 weeks' gestation followed by the NPS-during labor. RESULTS: Catastrophizing and external pain control predicted the request for pain relief during labor after adjustment for relevant demographic and clinical characteristics, respectively (adjusted odds ratio [OR] 2.61 [95% CI 1.45-4.68] and adjusted OR 1.90 [95% CI 1.16-3.10]). Catastrophizing was found to be the strongest and independent predictor among the pain cognitions while controlling for significant background variables (adjusted OR 2.61 p-value < 0.001). CONCLUSION: Catastrophizing seems to have a substantial impact on the request for pain relief in low-risk pregnant women.