"Persalinan merupakan hal penting bagi ibu dan juga tenaga kesehatan dalam konteks kesehatan maternal. Keperawatan sangat memperhatikan keluhan nyeri selama persalinan dengan mengembangkan berbagai metode mengurangi nyeri tetapi belum banyak diterapkan di Indonesia. Studi ini bertujuan mengidentifikasi konsep penerapan manajemen nyeri persalinan di Indonesia, khususnya di daerah perkotaan melalui rancangan constructivist grounded theory. Sebanyak 36 orang yaitu 17 ibu dan 19 tenaga kesehatan (dokter dan bidan) yang dipilih melalui theoretical sampling dari Rumah Sakit dan Klinik di Jakarta, Depok, Bekasi, dan Tangerang berpartisipasi. Data yang diperoleh dari wawancara mendalam, observasi dan studi dokumen dianalisis dengan pengodean awal, pengodean berfokus, pengodean berporos, dan pengodean teoretis.
Studi ini mengungkapkan bahwa manajemen nyeri persalinan merupakan suatu proses dan terjadi divergensi dalam penerapannya, yaitu pendekatan partisipatif, pendekatan medis dan pendekatan koersif. Kondisi ini terjadi karena pengaruh individu (ibu bersalin dan tenaga kesehatan), institusi profesi, sistem sosio-struktural, sistem kultural, perlindungan pasien dan kontingensi. Pendekatan koersif merupakan pendekatan yang mayoritas diterapkan di Indonesia. Model ini dapat dibandingkan dengan teori manajemen nyeri akut dan teori bureaucratic caring. Hasil ini merekomendasikan pentingnya peran perawat dalam persalinan, karena perawat mampu memberikan pelayanan yang komprehensif berdasarkan filosofi caring. Sistem institusi pelayanan juga perlu mendukung tenaga kesehatan dalam memenuhi kebutuhan perempuan dan keluarganya dalam persalinan.
Childbirth is an important moment for the mother as well as care providers in the context of maternal health. Nursing is very concerned about pain during labor through the development of various methods of alleviating the pain that has not been widely applied in Indonesia. This study aimed to identify the concept of labor pain management practices in Indonesia, particularly in urban areas through constructivist grounded theory. A total number of 36 people consisting of 17 mothers and 19 care providers participated in this study. They were selected through theoretical sampling from Hospitals and Clinics in Jakarta, Depok, Bekasi and Tangerang Data was obtained through in-depth interviews, observation and document analysis. The data was analyzed with initial coding, focused coding, axial coding, and theoretical coding.
This study revealed that pain management during labor is a process and a divergence occurs in its application, namely participatory approach, medical approach and coercive approach. This condition can occur because of the influence of maternal individual, care provider individual, professional institutions, socio-structural system, cultural system, the protection of patients, and contingency. Coercive approach is the majority approach applied in Indonesia. This model could be compared to the theory of acute pain management, bureaucratic caring theory, and organization culture theory.These results recommend the importance of the involvement of the nurse?s role in the labor care, because the nurse is able to provide comprehensive care based on the philosophy of caring. The health care institution system also needs to support care provider in meeting the needs of women and families in childbirth."
