Exploring the presence of comfort within the context of childbirth.

Little is known about women's perception of comfort during childbirth or about what provides comfort during a time of known great travail. The purpose of this study was to explore the existence of comfort during childbirth, to quantify its existence and, analyze its relationship to childbirth pain. Secondary aims included identification of comforting interventions that positively impacted the women's level of comfort. A non-experimental descriptive design was used to characterize the phenomenon of comfort in a sample (n = 63) of healthy primagravid women experiencing normal labor and birth. Women using pain medication (including epidural analgesia) were included in the study because the thesis was that the experience of comfort is more than pain relief. A Childbirth Comfort Questionnaire (CCQ) adapted from the General Comfort Questionnaire (Kolcaba, 2003) was used to quantify comfort. A numerical rating scale (NRS) measured pain intensity. Measurement of pain and comfort during labor occurred at two time points during each woman's labor: (a) latent phase and (b) active phase. Data collectors asked women to rate their comfort using the CCQ and their pain using the NRS. Data about standard of care variables were also collected. The CCQ's Cronbach's alpha was 0.71. Bivariate analysis and analysis of variance (ANOVA) was used to analyze the data. Initial results indicated that pain and comfort were negatively correlated between latent (r = -.283, p = .03 [n = 60]) and active phases of labor (r = -.55, p ≤ .001 [n = 48]). However, further analysis using an ANOVA revealed that pain scores decreased in response to epidural analgesia (T1: F = 12.92, df = 2, 50, p ≤ .001; T2: F = 13.61, df = 2, 40, p ≤ .001), while the comfort scores remained almost unchanged during both phases (T1: F = .519, df = 2, 52, p = .60; T2 : F = 1.30, df 2, 43, p = .282). These results suggest that comfort exists during childbirth and that experiencing comfort requires more than relief of pain.PhDHealth and Environmental SciencesNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/123947/2/3106158.pd