妊娠晚期下腰及骨盆痛影响因素分析

目的了解妊娠晚期孕妇下腰及骨盆痛发生率及其影响因素。方法采用问卷调查对1 254例妊娠晚期孕妇进行下腰、骨盆痛及其相关因素调查、分析。1 254例妇女在孕36周常规产前检查时接受问卷调查,包括:年龄,身高,肥胖指数,受教育程度,是否失业,城市或农村人口,有无保姆,孕前有否腰痛,前次妊娠有否腰痛,疼痛部位、程度、性质、加重及缓解方法,孕妇活动能力(日常活动,家务劳动,户外活动)等。结果妊娠晚期孕妇下腰及骨盆痛发生率为48.96%。身高,受教育程度,是否失业及有无保姆与疼痛无明显关系。低龄、高龄孕妇较适龄孕妇更易腰痛。超重孕妇更易腰痛。孕前有腰痛及前次妊娠有腰痛者在本次妊娠中发生腰痛比例增大。城乡孕妇腰痛发生率有较大差异。久站最易加重腰痛,卧位可以明显减轻疼痛。下腰及骨盆痛对妊娠晚期孕妇的活动影响较大。结论妊娠晚期孕妇下腰及骨盆痛发生率高,对于某些影响因素有必要采取相应的有效干预措施以提高孕妇的生活质量。     

个体化健康教育对妊娠晚期下腰痛的影响

[目的]探讨个体化健康教育对孕妇妊娠晚期下腰痛的影响。[方法]实验组孕妇实施个体化健康教育,对照组孕妇实施普通健康宣教,应用一般资料调查表、下腰痛情况调查表进行研究。[结果]个体化健康教育使下腰痛的程度减轻,频率降低;提高孕妇关于下腰痛保健知识。[结论]对妊娠晚期孕妇实施个体化健康教育,可以改善孕妇的下腰痛状况,提高其生活质量。     

个体化健康教育对妊娠晚期下腰痛的影响

[目的]探讨个体化健康教育对孕妇妊娠晚期下腰痛的影响.[方法]实验组孕妇实施个体化健康教育.对照组孕妇实施普通健康宣教,应用一般资料调查表、下腰痛情况调查表进行研究.[结果]个体化健康教育使下腰痛的程度减轻,频率降低;提高孕妇关于下腰痛保健知识.[结论]对妊娠晚期孕妇实施个体化健康教育,可以改善孕妇的下腰痛状况,提高其生活质量.     

高危妊娠孕妇剖宫产术前心理状况及影响因素分析

目的 探讨高危妊娠孕妇术前心理状况及影响因素,为护理干预提供依据.方法 2008年1月-2010年3月住院的高危妊娠孕妇458例,于住院第1天采用焦虑自评量表、抑郁自评量表、社会支持评定量表、生活事件量表、应对方式问卷及艾森克人格问卷进行调查,分析高危妊娠孕妇术前心理状况及术前各指标对抑郁和焦虑水平的影响.结果 本组高危妊娠孕妇术前抑郁、焦虑症状发生率分别为31.9%和33.2%;多元逐步回归分析表明,家庭有关问题、N量表分是影响抑郁水平的危险因素,社会支持则是其保护因素;家庭有关问题是影响焦虑水平的危险因素,而解决问题和社会支持则是其保护因素.结论 高危妊娠孕妇术前心理状况不容乐观,应从多方面着手,提高家庭和社会支持,改善高危妊娠孕妇心理健康状况.     

剖宫产后再妊娠孕妇分娩方式相关知识知晓状况

目的调查剖宫产后再妊娠孕妇分娩知识知晓现状及相关影响因素。方法选取2015年1月至2018年8月该院接收的剖宫产后再次妊娠孕妇489例作为研究对象,采用问卷调查的方式了解产妇对分娩知识的掌握现状,比较不同特征孕妇对分娩相关知识得分并采用Logistic回归方程进行计算,分析影响剖宫产后再妊娠孕妇分娩知识知晓程度的相关因素。结果本组489例孕妇对分娩方式相关知识得分为(13.28±2.64)分,得分处于中等偏上水平,仍有待提高。本组489例孕妇对分娩方式相关知识的影响因素分别为文化程度、经济水平、是否产前检查、分娩方式建议等,经独立样本t检验或单因素方差分析显示P<0.05;将上述有差异资料带入Logistic回归方程计算,发现文化程度、经济水平、是否产前检查、分娩方式建议等均是影响孕妇对分娩方式相关知识知晓掌握程度的相关因素。结论剖宫产后再妊娠孕妇对分娩方式相关知识掌握程度仍有待提高,因此对于此类孕妇,尤其是文化程度与经济水平较低、未进行产前检查的孕妇应加强宣教,以降低剖宫产率。     

妊娠相关下腰痛风险预测模型的构建与验证

目的 构建并验证妊娠相关下腰痛风险预测模型,探讨其在妊娠相关下腰痛风险预测中的应用价值。方法 便利选取2019年7—10月郑州市某3所三级甲等医院产检的702例孕妇,根据是否发生妊娠相关下腰痛分为妊娠相关下腰痛组（n=441）和非妊娠相关下腰痛组（n=261）,比较2组孕妇一般资料及孕期情况。利用二元Logistic回归建立风险预测模型,采用ROC曲线下面积检验及 Hosmer-Lemeshow检验检测模型鉴别效度和校准度,并选取301例产检孕妇对模型进行验证。结果 最终进入模型的预测因子分别为孕期增重过多、妊娠相关下腰痛史、月经期下腰痛史及工作压力。Hosmer-Lemeshow拟合优度检验结果显示χ²=10.165,P=0.254,受试者操作特征曲线下面积为0.757,约登指数为0.399,灵敏度为71.2%,特异度为65.9%,阳性预测值为76.3%,阴性预测值为69.5%。模型验证：灵敏度75.5%,特异度为84.4%,阳性预测值为89.0%,阴性预测值为66.7%,预测正确率为78.8%。结论 本预测模型在孕期妊娠相关下腰痛发生风险中具有较好的效能,可为医护人员早期采取预防性管理措施提供科学依据。     

高龄二胎孕妇妊娠晚期压力水平及其影响因素研究

目的:了解高龄二胎孕妇妊娠晚期压力水平现状,并探讨其影响因素。方法:采用妊娠压力量表(PPS)、匹兹堡睡眠指数量表(PSQI)、简易应对方式问卷(SCSQ)及一般资料调查问卷,对274例孕周≥28周的高龄二胎孕妇进行问卷调查。结果:高龄二胎孕妇妊娠晚期压力水平总分为(65.25±10.45)分,妊娠压力与积极应对呈负相关,妊娠压力与消极应对、睡眠质量呈正相关(P<0.05),经济状况、职业、妊娠并发症、睡眠质量、积极应对可解释妊娠压力得分变异量的67.4%。结论:高龄二胎孕妇妊娠晚期压力处于偏高水平,护理人员应以妊娠压力各影响因素为切入点,开展针对性的健康宣教与健康管理干预,缓解高龄二胎孕妇妊娠晚期压力,促进其身心健康。     

孕妇自由体位分娩的认知现状及其影响因素

目的 探讨孕妇对自由体位分娩的认知现状,并分析其影响因素,为产科分娩体位护理开展提供理论依据。方法 2021年8月—2022年2月选择在衡阳市某三级甲等医院妇产科定期进行产前检查的175名孕妇作为研究对象。以孕妇一般资料调查问卷、孕妇自由体位分娩知信行简易问卷为研究工具,进行问卷调查。结果 孕妇自由体位分娩知信行总分为55.29±10.48分;单因素分析显示,工作情况、孕期产检次数及频率、文化程度、妊娠期接受宣教形式、孕周、居住地、家庭月收入、医疗支付形式、计划妊娠、分娩体位决策是孕妇自由体位分娩知识、信念及行为的影响因素（P<0.05）。多因素线性回归分析显示,文化程度、妊娠期接受宣教形式、居住地是影响孕妇自由体位分娩知识的因素（P<0.05）;文化程度、孕周、分娩体位决策是影响孕妇自由体位分娩的信念因素（P<0.05）;医疗支付方式、家庭月收入、计划妊娠是影响孕妇自由体位分娩的行为因素（P<0.05）;文化程度、医疗支付方式、计划妊娠、家庭月收入是影响孕妇自由体位分娩的知信行因素(P<0.05),其中文化程度高、有医保、计划妊娠、家庭月收入高的孕妇自由...     

腹主动脉粥样硬化和下腰痛

尽管临床上下腰痛很常见,但目前仍有很多不明确的问题,文章从腰骶区血供及其变化、营养供给与椎间盘蜕变、动脉粥样硬化和下腰痛的相关性等方面进行了综述。指出动脉粥样硬化可能是一些下腰痛患者的病因,腰骶区的血供不足可能导致下腰痛。尽管下腰痛是多因素作用的结果,但作者建议临床要高度重视血管因素在下腰痛中的作用。     

韩氏穴位神经刺激仪对妊娠晚期下腰痛的影响

目的:评估韩氏穴位神经刺激仪(HANS)对妊娠晚期下腰痛的疗效及安全性.方法:95例妊娠晚期下腰痛孕妇随机分入HANS组(n=46)和对照组(n=49).HANS组给予每周一次的HANS治疗,持续6周;对照组未予治疗.采用视觉模拟评分(VAS)评估孕妇下腰痛程度.记录HANS治疗即时反应、孕妇早产率、新生儿情况和分娩方式.结果:对照组孕妇下腰痛有加重趋势.HANS组孕妇下腰痛程度比治疗前好转,较对照组也显著减轻(P＜0.05),未发现严重不良反应.两组孕妇早产率、新生儿情况、分娩方式差异无显著性意义(P＞0.05).结论:HANS可安全用于孕妇并减轻妊娠晚期下腰痛.     

Musculoskeletal pain and menopausal status

OBJECTIVES: The authors examined whether self-reported menopausal status is associated with musculoskeletal pain in a multiethnic population of community-dwelling middle-aged women after considering sociodemographics, medical factors, smoking, depression, and body mass index using a cross-sectional study design. METHODS: Participants were 2218 women from the Study of Women's Health Across the Nation assessed at the time of their third annual follow-up exam. Two dependent variables were derived from a factor analysis of survey questions about pain. These 2 outcomes were Aches and Pains, derived from 5 of 6 pain symptom questions and Consultation for Low Back Pain, derived from 1 question. RESULTS: Prevalence of aches and pains was high, with 1 in 6 women reporting daily symptoms. Compared with premenopausal women, those who were early perimenopausal (P=0.002), late perimenopausal (P=0.002), or postmenopausal (P<0.0001) reported significantly more aches and pains in age-adjusted analysis. With complete risk factor adjustment, postmenopausal women still reported significantly greater pain symptoms (P=0.03) than did premenopausal women. Menopausal status was marginally related to consulting a healthcare provider for back pain. DISCUSSION: This study demonstrates an association between pain and self-reported menopausal status, with postmenopausal women experiencing greater pain symptoms than premenopausal women.     

慢性下腰痛患者自我管理行为及影响因素分析

目的 调查慢性下腰痛患者自我管理行为现状,分析其影响因素。方法 应用便利抽样,于2019年1月-12月采用一般资料、慢性病自我管理行为量表、下腰痛疾病知识问卷、慢性病自我效能量表、社会支持评定量表对226例慢性下腰痛患者进行调查,采用多重线性回归分析探讨自我管理行为的影响因素。结果 慢性下腰痛患者自我管理行为总分(21.76±7.82)分；疾病知识、自我效能、社会支持、治疗方式、辅助工具使用史进入回归方程,解释慢性下腰痛患者自我管理行为总变异的51.3%。结论 慢性下腰痛患者自我管理水平较低,社会支持、疾病知识、自我效能、治疗方法、辅助工具应用史是其主要影响因素。建议在进行自我管理健康教育时,应考虑患者个体特点,采用针对性、适合的健康教育方式,提供多渠道健康信息获取方法,鼓励家庭参与,提高患者疾病知识和社会支持水平,增强自我效能,从而改善自我管理行为。     

内镜室医务人员腰背痛危险因素的调查研究

目的了解内镜室医务人员腰背痛的发生现状及其影响因素。方法采用一般资料调查表、腰背痛危险因素调查表、改良Oswestry腰背痛调查量表对广州市7家医院内镜窒115名医务人员进行调查。结果内镜室医务人员腰背痛发生率为45．2％。站立时间大于4h、职业伤害定期上报和精神高度紧张是腰背痛发生的主要因素。结论内镜室医务人员腰背痛发生率较高,应提高人文关怀,建立安全工作环境等以预防内镜室医务人员腰背痛的发生。     

Optimizing pain relief during pregnancy using manual therapy

Question Many of my pregnant patients have muscle and joint aches, and are reluctant to use analgesics. What is known about chiropractic care during pregnancy?Answer As pregnant women move into their second and third trimesters, their centres of mass shift anteriorly, causing an increase in lumbar lordosis, which causes low back and pelvic girdle pain. Increasing recent evidence attests to the effectiveness and safety of treating this pain using manual therapy. Massage therapy and chiropractic care, including spinal manipulation, are highly safe and effective evidence-based options for pregnant women suffering from mechanical low back and pelvic pain.     

自贡市4116例孕妇妊娠相关焦虑变化及其影响因素分析

[目的]探讨自贡市4116例孕妇妊娠相关焦虑变化及其影响因素.[方法]选取在本院产科建卡并定期检查的孕妇4116例,根据孕妇的焦虑评分将孕妇分为焦虑组和非焦虑组,比较两组孕妇的一般资料和临床资料,分析妊娠妇女焦虑的影响因素,多因素分析妊娠妇女焦虑的独立影响因素.[结果]4116例孕妇中共有603例合并焦虑,焦虑的发生率为14.7％(603/4116).单因素分析显示年龄分布、家庭收入、有吸烟史、有饮酒史、婚姻状况、流产史、计划内怀孕、胎儿性别期盼、确定分娩方式、合并遗产性疾病、主观担心胎儿健康均为孕妇妊娠期间产生焦虑的影响因素;多因素分析显示有吸烟史、有饮酒史、婚姻状况、流产史、计划内怀孕、胎儿性别期盼、主观担心胎儿健康均为孕妇妊娠期间产生焦虑的独立影响因素.[结论]有吸烟史、有饮酒史、未婚妇女妊娠、合并流产史、计划外怀孕、胎儿性别期盼、主观担心胎儿健康均为孕妇妊娠期间产生焦虑的危险因素,在妊娠期间对不同状况的孕妇给予对症心理干预,可有效的降低孕妇妊娠期间焦虑发生率.     

Thermography evaluation of low back pain in pregnant women: Cross-sectional study

BackgroundLow back pain during pregnancy is very common and thermography seems to be a promising method of evaluation for pregnant women, because it is painless and safe. The aim of the present study was to evaluate low back pain, during pregnancy, using thermography together with artificial intelligence.MethodsA cross-sectional study was carried out with pregnant women recruited from a university hospital. The following data were collected: (a) clinical data; (b) physical assessment with mobility and low back pain provocation tests; and (c) thermograms acquisitions, in a controlled environment. Artificial intelligence and the statistical tests were used to compare the groups’ mean: with low back pain (LBP) and without low back pain (WLBP).ResultsThirty pregnant women took part, with fifteen in each group. The mean ± Standard Deviation temperature of the lumbar region in both groups were 32.7 ± 1.05 °C and 32.6 ± 1.01 °C for LBP and WLBP, respectively. There was not any difference in temperature between the groups; however, the artificial intelligence software found thermogram differences between groups; furthermore, the correlation between pain intensity and functionality was found.ConclusionThermography associated with artificial intelligence analyses demonstrated to be a promising method as an adjunct to clinical evaluation.     

Bone mineral density and perceived menopausal symptoms: factors influencing low back pain in postmenopausal women

Title.  Bone mineral density and perceived menopausal symptoms: factors influencing low back pain in postmenopausal women.
Aim.  This paper is a report of a study of the relationships between the factors influencing low back pain in postmenopausal women (i.e. menopausal symptoms, bone mineral density, duration of menopause, hormonal therapy, obesity, inactivity during leisure time, parity, osteoarthritis and drinking coffee).
Background.  Previous studies have shown that low back pain in postmenopausal women is associated with bone mineral density, menopausal symptoms and lifestyle factors, yet the factors influencing low back pain are not clear and vary with ethnicity.
Method.  A survey was conducted with postmenopausal women ( n  =   134) in Korea in 2006. Bone mineral density in the lumbar spine, back pain status, menopausal symptoms and health habits were assessed.
Results.  Participants' mean age was 59 years. About 70% experienced back pain on more than 1 day during the week prior to the survey and 35% suffered back pain daily. Women with back pain reported more severe menopausal symptoms than those without back pain. Based on bone mineral density scores, 26·9% of the women were considered to be at risk of osteoporosis. However, there was no association between back pain status and fracture risk status. Based on a multiple logistic regression model, menopausal symptoms, drinking coffee and inactivity during leisure time were statistically significant influencing factors for low back pain in this sample.
Conclusion.  The prevalence of low back pain in postmenopausal women should be recognized in association with menopausal symptoms and health habits. Further research is needed to develop interventions for the management of low back pain in postmenopausal women.