Psychosocial factors in¯uencing personal control in pain relief Hally McCrea a, *, Marion E. Wright a , Maurice Stringer b a School of Health Sciences Ð Nursing, University of Ulster, Coleraine, Co. Londonderry BT52 1SA, UK b School of Psychology and Communication, University of Ulster, Coleraine, Co. Londonderry BT52 1SA, UK Received 11 November 1999; received in revised form 26 January 2000; accepted 7 February 2000 Abstract A questionnaire was administered to 100 women (50 primigravidae, 50 multigravidae) to investigate the in¯uence of psychosocial factors on personal control in pain relief. Personal control was measured using a 36-item scale based on the concept of `Rule'. The women were asked to rate each rule on a 7-point Likert scale. Measures of psychosocial factors included assessment of the women's expectations of labour pain, maternal con®dence, pain intensity, antenatal training and partner support. Demographic variables including parity were also recorded. The questionnaires were completed prior to and within 48 h following the women's delivery (whilst they were inpatients on the postnatal ward). Two variables, antenatal training and pain intensity, emerged as predictors of personal control in pain relief following stepwise multiple regression analysis. These ®ndings have implications for clinical practice particularly in the area of antenatal care and planning care during labour. 7 2000 Elsevier Science Ltd. All rights reserved. Keywords: Labour pain; Personal control; Antenatal training; Pain intensity 1. Introduction Personal control is an integral part of woman- centred care if the goal is to encourage women to be active in their care during childbirth. The `desire to be in control' (expectations) does not necessarily mean, however, that all women will `be in control' (experi- ence); evidence suggests that experience can be vastly dierent from expectations (Green et al., 1988, 1990). This is not surprising since childbirth and particularly labour pain (the focus of this study) is variable and subject to individual and environmental in¯uences. Considerable evidence is available to suggest that some factors exert their in¯uence by modulating the eects of labour pain. They include expectations of labour pain (Green et al., 1988; Fridth et al., 1988; Green et al., 1990), parity (Melzack et al., 1981; Niven and Gijs- bers, 1984), maternal con®dence (Doering et al., 1980; Lowe, 1991), antenatal training (Melzack et al., 1984; Geden et al., 1985; Whipple et al., 1990) and partner support (Hodnett and Osborn, 1989; Hofmeyr et al., 1991). The study reported here builds on this evidence to investigate the in¯uence of these factors on personal control in pain relief during labour. Childbirth represents the most painful event in most women's lifetime (Brownridge, 1991). The experience is never the same; it may dier between women, between International Journal of Nursing Studies 37 (2000) 493±503 0020-7489/00/$ - see front matter 7 2000 Elsevier Science Ltd. All rights reserved. PII: S0020-7489(00)00029-8 www.elsevier.com/locate/ijnurstu * Corresponding author. Tel.: +44-1265-324737; fax: +44- 1265-324951. E-mail address: bh.mccrea@ulst.ac.uk (H. McCrea).