THE ROLE AND RESPONSIBILITIES OF MIDWIVES IN ENDOMETRIOSIS

Öz

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity. It is an estrogen-dependent, benign and inflammatory disease that affects women during the premenarche, reproductive and postmenopausal hormonal phases. Endometriosis is seen in approximately 10% of women of reproductive age. It is thought that approximately 2.4 million women in our country have endometriosis. Lesions are typically found in the pelvis, but can occur in many areas, including the bowel, diaphragm, and pleural cavity. Although endometriosis is a common and non-malignant process, ectopic endometrial tissue and consequent inflammation can cause menorrhagia, dyspareunia, infertility, and chronic pelvic pain. These symptoms related to the disease negatively affect women's daily life activities and quality of life. In order to increase the quality of life in women with endometriosis and to reduce the symptoms of endometriosis, a multidisciplinary team approach should be applied to individuals. Midwives, who are interested in women's health in every aspect, have important roles and responsibilities at this point. Midwifery activities include identification and management of signs and symptoms associated with endometriosis, referral to other healthcare professionals or services, direct patient care, administration of treatment, coordination of care, pain management, health education, administration of treatment, evaluation of treatment outcomes, and patient advocacy. In order for midwives to take an active role in the diagnosis and management of endometriosis, they should be able to recognize the signs, symptoms and risk factors of the disease and provide services in the light of evidence-based information on care and treatment. In this review, it is aimed to explain the roles and responsibilities of midwives in endometriosis.

Anahtar Kelimeler

• Endometriosis
• women
• quality of life
• midwifery
• health education

ENDOMETRİOZİSTE EBELERİN ROL VE SORUMLULUKLARI

Öz

Endometriozis, uterin kavite dışında endometriyal gland ve stromanın varlığı olarak tanımlanır. Kadınları menarş öncesi, üreme ve menopoz sonrası hormonal evrelerde etkileyen östrojene bağımlı, iyi huylu ve inflamatuar bir hastalıktır. Endometriozis üreme çağındaki kadınların yaklaşık %10'unda görülmektedir. Ülkemizde yaklaşık 2,4 milyon kadında endometriozis olduğu düşünülmektedir. Lezyonlar tipik olarak pelviste bulunur, ancak bağırsak, diyafram ve plevral boşluk dahil olmak üzere birçok bölgede ortaya çıkabilir. Endometriozis yaygın ve malign olmayan bir süreç olmakla birlikte, ektopik endometriyal doku ve bunun sonucunda oluşan inflamasyon, menoraji, disparoni, infertilite ve kronik pelvik ağrıya neden olabilir. Hastalığa ilişkin bu semptomlar, kadınların günlük yaşam aktivitelerini ve yaşam kalitelerini olumsuz yönde etkilemektedir. Endometriozisli kadınlarda yaşam kalitesinin artırılması ve endometriozis semptomlarının azaltılması amacıyla bireylere multidisipliner bir ekip yaklaşımı uygulanmalıdır. Kadın sağlığıyla her yönden ilgilenen ebelere bu noktada önemli rol ve sorumluluklar düşmektedir. Ebelik faaliyetleri, endometriozis ile ilişkili belirti ve semptomların tanımlanmasını ve yönetimini, diğer sağlık profesyonellerine veya servislerine sevk edilmesini, doğrudan hasta bakımını, tedavinin uygulanmasını, bakımın koordinasyonunu, ağrı yönetimini, sağlık eğitimini, tedavi uygulanmasını, tedavi sonuçlarının değerlendirilmesini ve hasta savunuculuğunu içerir. Endometriozis tanısında ve yönetiminde ebelerin aktif rol alabilmesi için hastalığın belirti, bulgularını, risk faktörlerini tanıyabilmesi ve bakım-tedavi konularında kanıta dayalı bilgiler ışığında hizmet sunması gerekmektedir. Bu derlemede, endometrioziste ebelerin rol ve sorumluluklarının açıklanması amaçlanmıştır.

Anahtar Kelimeler

• Endometriozis
• kadın sağlığı
• yaşam kalitesi
• ebelik
• sağlık eğitimi

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