BACKGROUND Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). METHODS A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA. RESULTS The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: - 0.8 to - 6.0; P = 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P < 0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to - 6.0; P = - 2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P = 0.504), second stage of delivery (P = 0.928), total length of delivery (P = 0.520), Apgar score (P = 1.000) and frequency of oxytocin consumption (P = 0.622). CONCLUSION According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion. TRIAL REGISTRATION IRCT2017042910324N39; Name of registry: Iranian Registry of Clinical Trials; Registered 11 September 2017. URL of registry: https://fa.irct.ir/user/trial/10814/view. Date of enrolment of the first participant to the trial: September 2017.

中文翻译：

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分心技术对分娩过程中疼痛和压力的影响：一项随机对照临床试验。

背景技术疼痛控制以及与分娩和分娩有关的压力是卫生保健系统的最重要问题。据报道，在分娩过程中使用分心技术可减轻痛苦和分娩压力。但是，只有有限的出版物探讨了分心技术对分娩疼痛和压力的影响。因此，本研究的目的是确定分心技术对分娩疼痛和压力（主要结果），对分娩的恐惧，分娩期的长短，第一分钟的Apgar评分和催产素的消耗（次要结果）的影响。方法对68名孕妇进行了随机对照临床试验。通过封闭随机分组将参与者分为两组（干预组和对照组）。干预组的参与者在四节课中接受了分散注意力的技术。对干预措施的问卷调查（W-DEQ版本A）和PSS已在干预前完成，在W-DEQ的第36周以及在PSS的积极阶段，都通过访谈完成了问卷调查。每小时在活动阶段通过VAS评估疼痛。分阶段图表中记录了交货阶段的长度。通过独立的t检验和ANCOVA分析数据。结果干预组分娩期间感觉到的压力平均值明显低于对照组（AMD：-3.2； 95％CI：-0.8至-6.0； P = 0.01）。分娩时疼痛强度的平均值（SD）低于干预组和对照组，与对照组相比（6.2 vs 7.5； P <0.001）。两组在分娩恐惧评分方面无显着差异（AMD：5.3； 95％CI：13.0至-6.0； P =-2.3）。此外，两组在分娩活动阶段（P = 0.504），分娩第二阶段（P = 0.928），分娩总时间（P = 0.520），Apgar评分（P = 1.000）和催产素消耗的频率（P = 0.622）。结论根据研究结果，分心技术可以减轻分娩过程中的痛苦和压力，但需要进一步研究以使用分心技术来得出决定性的结论。试用注册IRCT2017042910324N39；注册名称：伊朗临床试验注册；2017年9月11日注册。注册表的URL：https://fa.irct.ir/user/trial/10814/view。