ABSTRACT
BACKGROUND AND OBJECTIVES:
Labor pain is caused by several physiological changes and may cause psychological damage to the parturient and her relatives and, therefore, must be relieved. The objective of this study was to evaluate the knowledge, attitude, and practice of obstetricians concerning pharmacological methods of labor analgesia.
METHODS:
Cross-sectional study (38 obstetricians working at public maternity hospitals). A structured questionnaire was applied about knowledge, attitude and practice concerning systemic and regional pharmacological methods. The agreement magnitude was assessed by kappa coefficient.
RESULTS:
We observed adequate knowledge about the indications of all methods (31 to 86%), the contraindications of opioids (92%) and the adverse effects of non-opioid analgesics /antispasmodics on the fetus (76%). Concerning attitude, they agree that non-opioid analgesics/antispasmodics do not minimize labor pain (98%) but should be available at the maternity wards (89%) and that epidural analgesia is effective (100%) and should be available (94%). In practice, the indication of non-opioid analgesics/antispasmodic and epidural analgesia prevailed. In most of the requirements in each dimension (knowledge: K=-0.092 to 0.158; p=0.057 to 1.0 and attitude: K=-0.005 to 0.472; p=0.004 to 1.0), there was minimal agreement with practice, except for the non-opioid analgesics/antispasmodics (K=0.421, p=0.009), and epidural analgesia (K=0.472, p=0.004), with a moderate agreement.
CONCLUSION:
Knowledge was heterogeneous. The attitude was unanimous concerning the effectiveness and the need of having epidural available, and the ineffectiveness of non-opioid analgesics/ antispasmodics, and the practice of prescribing them. There was a minimal agreement between knowledge and practice, and between attitude and practice on most of the other requirements in each dimension.
Keywords:
Analgesia; Attitude and practice in health; Childbirth pain; Knowledge; Medical education; Obstetric analgesia; Pharmacological treatment
