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Clin Nurs Res. 1998 Feb;7(1):82-93.

Adolescents' perceptions of pain during labor.

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Saint Elizabeth Community Health Center, Lincoln, Nebraska, USA.


This descriptive study systematically described the quality and intensity of adolescents' pain during the progression of labor. The Gaston-Johansson Pain-o-Meter was administered to 33 adolescents during the three labor phases (2-4 cm, 5-7 cm, and 8-10 cm) following a contraction. The most frequently selected sensory words were cramping in Phase I and pressing in Phases II and III. Miserable and killing were the most commonly chosen affective words during the three labor phases. Using the Gaston-Johansson Pain-O-Meter and the Gaston-Johansson Pain-O-Meter Visual Analogue Scale, the total pain intensity scores were highest during phase III of labor and delivery. At-test of independent samples found that quality and intensity pain scores for primiparous and multiparous adolescent participants were not significantly different during the progression of labor. The findings of the study illustrate the value of using objective measures, such as the Gaston-Johansson Pain-O-Meter and the Gaston-Johansson Pain-O-Meter Visual Analogue Scale, to assess pain during labor. The study also demonstrated that nurses can use these tools with minimal training.


To enable nurses to provide optimal pain management to adolescents during labor, a descriptive study was conducted of the quality and intensity of such pain at different stages of labor. Enrolled was a convenience sample of 24 primiparous and 9 multiparous women 16-19 years old (mean, 17.78 years) who entered a Nebraska hospital in full labor. The interactive Gaston-Johansson Pain-O-Meter was used to measure the affective, sensory, and intensity components of pain. The sensory words selected most frequently during the three stages of labor were "cramping" (46%), "pressing" (39%), and "pressing" (42%), respectively, while the most common affective terms were "killing" (52%), "miserable" (36%), and "killing" (79%). The highest mean affective and sensory pain scores were reported during the second stage of labor. Primiparas experienced the lowest pain levels during phase I of labor and the highest during phase II, while multiparas' mean scores increased as labor progressed; however, there were no significant differences in mean pain scores by parity. The study was not able to take into account the impact of variables such as self-efficacy, anxiety, analgesics, childbirth education class attendance, and length of labor on pain perceptions. Knowledge of the intensity of pain, and whether it is primarily affective or sensory, can assist nurses to develop individualized interventions for adolescents experiencing labor pains.

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