Refusal of Epidural Anesthesia for Labor Pain Management by African American Parturients: An Examination of Factors Epidural anesthesia for labor pain management is utilized by the majority of parturients, with excellent pain relief possible within minutes of administration. Additional benefits include decreased inflammatory and stress responses as well as decreased blood loss. The obstetrical intervention contributes to improved outcomes and patient satisfaction all with minimal effects on the fetus, newborn, and patient. An examination of the literature reveals a disparity of use that exists along ethnic and racial lines, with African Americans less likely to accept epidural anesthesia. No studies to date explore the reasons for this disparity. The purpose of this qualitative study was to identify those factors that influence African American parturients to decline epidural anesthesia for labor pain management. Andersen's Behavioral Model of Health Services Use (Andersen, 1995) served as the conceptual framework for the study. Twelve primiparous African American parturients were selected for participation through the use of purposive (homogenous) sampling. All participants presented for vaginal delivery and declined or initially declined epidural anesthesia to manage their labor pain. Semi-structured interviews consisting of closed- and open-ended questions were used for data collection. Data analysis involved open coding, core category identification, selective coding, and theme identification. The study revealed three themes that helped address the research question: fear, naturalism, and family influence. In nursing practice, a thorough understanding of those factors examined in this study may better enable health care providers to assist parturients in the decision-making process with the potential for increased patient satisfaction and improved quality of life.
|Commitee:||Luckett, Tomekia, Lundstrom, Alicia, Roberts, Jaylynn|
|School:||William Carey University|
|Department:||School of Nursing|
|School Location:||United States -- Mississippi|
|Source:||DAI-B 80/01(E), Dissertation Abstracts International|
|Keywords:||African American, Anesthesia, Disparity, Epidural, Labor, Refusal|
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