Evaluation of the Bonapace Method: a specific educational intervention to reduce pain during childbirth

Julie Bonapace,1 Nils Chaillet,2 Isabelle Gaumond,3,4 &Eacute;milie Paul-Savoie,5 Serge Marchand3,41D&eacute;partement des Sciences de l&#39;&Eacute;ducation, Universit&eacute; du Qu&eacute;bec en Abitibi-T&eacute;miscamingue, Rouyn-Noranda, Qu&eacute;bec, 2Centre de Recherche de l&#39;H&ocirc;pital Sainte-Justine, Universit&eacute; de Montr&eacute;al, Montr&eacute;al, Qu&eacute;bec, 3D&eacute;partement de chirurgie, Facult&eacute; de M&eacute;decine et des Sciences de la Sant&eacute;, Universit&eacute; de Sherbrooke, Sherbrooke, Qu&eacute;bec, 4D&eacute;partement des Sciences de la Sant&eacute;, Universit&eacute; du Qu&eacute;bec en Abitibi-T&eacute;miscamingue, Rouyn-Noranda, Qu&eacute;bec, 5&Eacute;cole des sciences infirmi&egrave;res, Facult&eacute; de m&eacute;decine et des sciences de la sant&eacute;, Universit&eacute; de Sherbrooke, Sherbrooke, Qu&eacute;bec, CanadaObjective: As pain during childbirth is very intense, several educational programs exist to help women prepare for the event. This study evaluates the efficacy of a specific pain management program, the Bonapace Method (BM), to reduce the perception of pain during childbirth. The BM involves the father, or a significant partner, in the use of several pain control techniques based on three neurophysiological pain modulation models: (1) controlling the central nervous system through breathing, relaxation, and cognitive structuring; (2) using non-painful stimuli as described in the Gate Control Theory; and (3) recruiting descending inhibition by hyperstimulation of acupressure trigger points.Methods: A multicenter case control study in Quebec on pain perception during labor and delivery compared traditional childbirth training programs (TCTPs) and the BM. Visual analog scales were used to measure pain perception during labor. In all, 25 women (TCTP: n = 12; BM: n = 13) successfully reported their perceptions of pain intensity and unpleasantness every 15 minutes.Results: A positive correlation between the progression of labor and pain was found (pain intensity: P < 0.01; pain unpleasantness: P < 0.01). When compared to TCTP, the BM showed an overall significant lower pain perception for both intensity (45%; P < 0.01) and unpleasantness (46%; P < 0.01).Conclusion: These significant differences in pain perception between TCTP and the BM suggest that the emphasis on pain modulation models and techniques during labor combined with the active participation of a partner in BM are important variables to be added to the traditional childbirth training programs for childbirth pain management.Keywords: labor pain, yoga, perinatal care, DNIC, gate control theory, cognitive structuring, massage, fathe

College student sleep quality and mental and physical health are associated with food insecurity in a multi-campus study

AbstractObjective:To assess the relationship between food insecurity, sleep quality, and days with mental and physical health issues among college students.Design:An online survey was administered. Food insecurity was assessed using the ten-item Adult Food Security Survey Module. Sleep was measured using the nineteen-item Pittsburgh Sleep Quality Index (PSQI). Mental health and physical health were measured using three items from the Healthy Days Core Module. Multivariate logistic regression was conducted to assess the relationship between food insecurity, sleep quality, and days with poor mental and physical health.Setting:Twenty-two higher education institutions.Participants:College students (n 17 686) enrolled at one of twenty-two participating universities.Results:Compared with food-secure students, those classified as food insecure (43·4 %) had higher PSQI scores indicating poorer sleep quality (P \u3c 0·0001) and reported more days with poor mental (P \u3c 0·0001) and physical (P \u3c 0·0001) health as well as days when mental and physical health prevented them from completing daily activities (P \u3c 0·0001). Food-insecure students had higher adjusted odds of having poor sleep quality (adjusted OR (AOR): 1·13; 95 % CI 1·12, 1·14), days with poor physical health (AOR: 1·01; 95 % CI 1·01, 1·02), days with poor mental health (AOR: 1·03; 95 % CI 1·02, 1·03) and days when poor mental or physical health prevented them from completing daily activities (AOR: 1·03; 95 % CI 1·02, 1·04).Conclusions:College students report high food insecurity which is associated with poor mental and physical health, and sleep quality. Multi-level policy changes and campus wellness programmes are needed to prevent food insecurity and improve student health-related outcomes