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Opinions And Practices Regarding With Perineal Trauma Of Primipar Women: A Qualitative Study

Yıl 2016, Cilt: 13 Sayı: 3, 89 - 94, 01.07.2016

Öz

Aim: Perineal trauma is any damage to the genitalia during childbirth that occurs spontaneously or intentionally by surgical incision episiotomy . It is a serious condition affecting morbidity, mortality and quality of life in negatively beholder. The aim of this study is to determine the opinion and application for perineal trauma of primipar women in the postpartum period.Material and Methods: It is a qualitative study. 15 women who were admitted to the gynecology clinic of a public hospital in the postpartum period formed the study group. The data obtained by questionnaires and semi-structured interview form was evaluated by content analysis.Results: In the postpartum period, there have been seen pain, discharge, redness, edema swelling in the female fairy, as well as sexual problems and having concerns about fulfilling their responsibilities. At the end of the research; it was determined that they used several methods such as povidone ıodine,antibacterial ointment, paracetamol, hot application, cold application, olive oil for compete with perineal trauma. However, it was determined that there was no attempt on “Sexual and psychosocial problems”.Conclusion: It was determined that some of the practices were insufficient and incorrect for perineal complaints related to women. It is recommended giving a training to women for the care of the perineum by health care personal before discharge in the postpartum period.

Kaynakça

  • Sayıner FD, Demirci N, Prenatal Perineal Masajın Vaginal Doğumlarda Etkinliği. İÜFN Hemşirelik Dergisi 2007; 15:146-154.
  • Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I, Wo- men’s Sexual Health After Childbirth. BJOG: An Int J Obstet Gynecol
  • Albers L, Garcia J, Renfrew M, Mc Candlish R, Elbourne D, Distribution Of Genital Tract Trauma In Childbirth And Related Postnatal Pain. Birth 1999;26:11-7.
  • Albers L, Reducing Genital Tract Trauma At Birth Launching A Clinical Trial In Midwifery. Journal Of Midwifery And Women’s Health 2003; 48: 105-110.
  • Eason E, Labrecque M, Marcoux S, Mondor M et al.,Anal Incontinance After Childbirth. Canadian Medical Association Journal 2002; 166:326- 3.
  • Kettle C, Tohil S, Perineal Care. BJM Clin 2008; 24:1401.
  • Mc Candlish R, Bowler et al., A Randomised Controlled Trial Of Care Of Perineum During Second Stage Of Normal Labour. Br J Obstet Gynecol 1998; 105: 1262-72.
  • Sleep J, Grant et al., West Berkshire Perineal Management Trial. BJM 1984; 298:578-690.
  • House MJ, To do or not to do episiotomy. In: Kitzinger S, (eds). Episi- otomy: physicaland emotional aspects. 1st. ed.London: National Child- birth Trust, 1981:6-11.
  • Reading AE, Sledmere CM, Cox DN, Campbell S, How women view post-episiotomy pain. Br Med J 1982;284 :243.
  • Russell JK, Episiotomy [Editorial]. Br Med J 1982;284:220.
  • Karaçam Z, Epizyotominin Doğum Sonrası Dönemde Cinsel Fonksiyona Etkisi. Hemşirelikte Araştırma Geliştirme Dergisi 2008; 38-46.
  • American College of Obstetricians and Gynecologists. Erişim tarihi 08 Ekim 2015 Available from:http://www.acog.org/from_home/publicati- ons/press_releases/nr03- 31-06-2.cfm.American College of Obstetrici- ans and Gynecologists –ACOG (2006). Recommends Restricted Use of Episiotomies.
  • Viswanathan M, Hartmann K, Palmieri R, et al. The Use of Episiotomy in Obstetrical Care: A Systematic Review. Summary, Evidence Report/ Technology Assessment 2005; 112:1-8.
  • Buhling K. J, Schmidt S, Robinson J. N, Klapp C, Siebert G, Dudenha- usen J. W, Rate of dyspareunia after delivery in primiparae according to mode of delivery. Eur J Obstet Gynecol and Reprod Biol 2006; 124: 42-46.
  • Mayerhofer K, Bodner-Adler B, Bodner K et al., Traditional care of the perineum during birth. A prospective, randomized, multicenter study of 1076 women. J Reprod Med 2002;47: 477–82.
  • Labrecque M, Eason E, Marcoux S, Randomized controlled trial of pre- vention of perineal trauma by perineal massage during pregnancy. Am J Obstet Gynecol 1999;180: 593-600.
  • Johanson R, Perineal massage for prevention of perineal trauma in child- birth. Lancet 2000; 355: 250–251.
  • Türkiye Nüfus ve Sağlık Araştırması 2013.Erişim tarihi 08 Ekim 2015 Available from:http://www.hips.hacettepe.edu.tr/TNSA_2013_ana_ra- por.pdf.
  • Balkaya N, Postpartum Dönemde Annelerin Bakım Gereksinimleri ve Ebe - Hemşirenin Rolü. C. Ü. Hemşirelik Yüksek Okulu Dergisi 2002; 6:2.
  • Sayıner F.D, Özerdoğan N, Doğal Doğum. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi 2009; 3:143.
  • Kettle C, Julie F, “Perineal care.” Clin Evid 7 2002; 1284-95.
  • Mohamed H. A. E, El-Nagger N. S, Effect of self perineal care instructi- ons on episiotomy pain and wound healing of postpartum women. J Am Sci 2012; 8:640-50.
  • McCandlish R, Perıneal trauma: Prevention and treatment. Journal of mi- dwifery & Women’s Health 2001; 46: 6.
  • Glazener CM, Abdalla M, Stroud P et al., Postnatal maternal morbidity: extent, causes, prevention and treatment. Br J Obstet Gynecol 1995; 102: 282–287.
  • Stamp G, Kruzins G, Crowther C, Perineal massage in labour and pre- vention of perineal trauma: randomised controlled trial. BMJ 2001;322 : 1277–1280.
  • Demirel G, Golbasi Z.Effect of perineal massage on the rate of episiotomy and perineal tearing.Int J Gynaecol Obstet 2015. Erişim tarihi 08 Ekim 2015 Available from: http://www.sciencedirect.com/science/article/pii/ S0020729215004361.
  • Beckmann M. M, Stock O. M, Antenatal perineal massage for reducing perinealtrauma. Cochrane Database Syst Rev 2013; 4Erişim tarihi 08 Ekim 2015 Available from: http://www.bibliotecacochrane.com/pdf/ CD005123.pdf
  • Gomme C, Sheridan M, Bewley S, Antenatal perineal massage: part 1. British Journal of Midwifery 2003; 11: 707–711.
  • Mynaugh P. A, A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations. Birth 1991; 18: 153–159.
  • Simon LS, Nonsteroidal anti-inflammatory drugs and their risk: a story still in development. Arthritis Res Ther 2013; 15:1.
  • Behmanesh F, Aghamohammadi A, Zeinalzadeh M, Khafri S, Effects of olive oil sitz bath on improvement of perineal injury after delivery. Koo- mesh 2013; 14: 309-315.
  • Kaur S, Sheoran P, Chand S, Haobijam J, Comparison of Infra Red Light Therapy vs Sitz Bath on Episiotomy in Terms of Wound Healing and In- tensity of Pain among Postnatal Mothers. International Journal of Nursing Care 2014; 2: 37.
  • Mahishale A, Chougala A, Patted S, Effect of Therapeutic Ultrasound and Maternal Cooling Gel Pad for Perineal Pain Following Vaginal Delivery with Episiotomy. J Women’s Health Care 2013;2: 2167-0420.
  • Steen M, Cooper K, Marchant P, Griffiths-Jones M, Walker J, A randomi- sed controlled trial to compare the effectiveness of icepacks and Epifoam with cooling maternity gel pads at alleviating postnatal perineal trauma. Midwifery 2000; 16: 48-55.
  • Leventhal L. C, de Oliveira S. M. J. V, Nobre M. R. C, da Silva F. M. B, Perineal analgesia with an ice pack after spontaneous vaginal birth: a randomized controlled trial. Journal of Midwifery & Women’s Health
  • Cooklin A. R, Amir L. H, Jarman J, Cullinane M, Donath S. M, Maternal Physical Health Symptoms in the First 8 Weeks Postpartum Among Pri- miparous Australian Women. Birth 2015;42:254-260.
  • Işık T, Akçınar M, Kadıoğlu S, Mersin ilinde gebelik, doğum ve loğusa- lık dönemlerinde anneye ve yenidoğana yönelik geleneksel uygulamalar. Uluslararası İnsan Bilimleri Dergisi 2010; 7: 71-84.
  • Gölbaşı Z, Eğri G, Doğum sonu dönemde annenin bakımına yönelik yapı- lan geleneksel uygulamalar. Cumhuriyet Tıp Dergisi 2010; 32: 276-282.
  • Kadanalı A, Karagöz G, Puerperal İnfeksiyonlar. Ümraniye Tıp Dergisi 2012; 5: 22-28
  • Winn H. N, Hobbins J. C, (Eds.). Clinical maternal-fetal medicine.1st ed. Pearl River, CRC Press, 2000.
  • Hastane Enfeksiyonları Dergisi.Erişim tarihi 08.Ekim.2015.Available from: der/1999-03/html/1999-3-3-133-139.htm
  • Mead PB.Infections of the female pelvis. In: Mandell GL, Bennett JE, Do- lin R (eds). Principles and Practice of Infectious Disease. New York 4thed : Churchill Livingstone, 1995:1090-8.
  • Güvenli Annelik. Cinsel Sağlık/Üreme Sağlığı Katılımcı Kitabı.Erişim tarihi 09.10.2015 Available from:http://sbu.saglik.gov.tr/Ekutuphane/kitaplar/ G%C3%BCvenli%20Annelik%20kat%C4%B1l%C4%B1mc%C4%B1%20 kitab%C4%B11.pdf.
  • Brumfıeld S.G, Early Postpartum Discharge. Clinical Obstetrics & Gyne- cology. Ambulatory Obstetric Management 1998; 41: 611-625.
  • Gözüm S, Kiliç D, Health problems related to early discharge of Turkish women. Midwifery 2005; 21: 371-378.
  • Priddis H, Dahlen H. G, Schmied V, Sneddon A, Kettle C et al. Risk of recurrence, subsequent mode of birth and morbidity for women who experienced severe perineal trauma in a first birth in New South Wales between 2000–2008: a population based data linkage study.BMC preg- nancy and childbirth 2013; 13: 89.
  • Gölbaşı Z, Postpartum dönemde erken taburculuk, evde bakım hizmetleri ve hemşirelik. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi 2003; 7: 15-22.
  • Cheng CY, Li Q, Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth. Womens Health Issues 2008;18:267-80.
  • Forster D. A, McLachlan H. L, Rayner J, Yelland J, Gold L, Rayner S, The early postnatal period: exploring women’s views, expectations and expe- riences of care using focus groups in Victoria, Australia. BMC pregnancy and childbirth 2008; 8: 27.
  • Yıldırım A, Hacıhasanoğlu R, Karakurt P, Postpartum depresyon ile sos- yal destek arasındaki ilişki ve etkileyen faktörler. International Journal of Human Sciences 2011; 8:1.
  • Sword W, Watt S, Learning needs of postpartum women: Does socioe- conomic status matter?. Birth 2005;32:86-92.
  • Beydağ K. D, Doğum sonu dönemde anneliğe uyum ve hemşirenin rolü. TSK Koruyucu Hekimlik Bülteni 2007; 6: 479-484.

Primipar Kadınların Perineal Travmaya İlişkin Görüşleri ve Uygulamaları: Nitel Bir Çalışma

Yıl 2016, Cilt: 13 Sayı: 3, 89 - 94, 01.07.2016

Öz

Amaç: Perineal travma, doğum esnasında genital bölgede kendiliğinden veya epizyotomi nedeniyle ortaya çıkan morbidite ve mortalite ile seyreden ve yaşam kalitesini olumsuz yönde etkileyen önemli bir durumdur. Çalışmanın amacı, primipar kadınların doğumsonu dönemde perineal travmaya ilişkin görüş ve uygulamalarını belirlemektir.Gereç ve Yöntemler: Nitel bir araştırmadır. Bir kamu hastanesinin kadın doğum polikliniğine doğum sonu dönemde başvuran15 kadın çalışma grubunu oluşturmuştur. Veriler anket formu ve yarı yapılandırılmış görüşme formu ile elde edilip, içerik analizi ile değerlendirilmiştir.Bulgular: Doğum sonu dönemde kadınların perineal travmaya bağlı sıklıkla ağrı, akıntı, kızarıklık, ödem gibi bazı fiziksel sorunların yanısıra özbakımında eksiklik, cinsel sorunlar ve sorumluluklarını yerine getirememe kaygısı yaşadıkları belirlenmiştir. Perineal şikayetlerin çözümüne yönelik kadınların “povidon iyod, antibakteriyel pomad, parasetamol, sıcak uygulama, soğuk uygulama, kolonya, zeytinyağı” gibi ürünleri kullandıkları ancak “cinsel ve psikososyal sorunlara” ilişkin herhangi bir girişimde bulunmadıkları belirlenmiştir.Sonuç: Kadınların perineal travmaya ilişkin uygulamalarının yetersiz ve bazılarının yanlış olduğu belirlenmiştir. Sağlık personeli tarafından doğum sonu dönemde perineal bakıma ilişkin eğitimlerin taburculuk öncesinde verilmesi ve sürecin izlenmesi önerilmektedir.

Kaynakça

  • Sayıner FD, Demirci N, Prenatal Perineal Masajın Vaginal Doğumlarda Etkinliği. İÜFN Hemşirelik Dergisi 2007; 15:146-154.
  • Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I, Wo- men’s Sexual Health After Childbirth. BJOG: An Int J Obstet Gynecol
  • Albers L, Garcia J, Renfrew M, Mc Candlish R, Elbourne D, Distribution Of Genital Tract Trauma In Childbirth And Related Postnatal Pain. Birth 1999;26:11-7.
  • Albers L, Reducing Genital Tract Trauma At Birth Launching A Clinical Trial In Midwifery. Journal Of Midwifery And Women’s Health 2003; 48: 105-110.
  • Eason E, Labrecque M, Marcoux S, Mondor M et al.,Anal Incontinance After Childbirth. Canadian Medical Association Journal 2002; 166:326- 3.
  • Kettle C, Tohil S, Perineal Care. BJM Clin 2008; 24:1401.
  • Mc Candlish R, Bowler et al., A Randomised Controlled Trial Of Care Of Perineum During Second Stage Of Normal Labour. Br J Obstet Gynecol 1998; 105: 1262-72.
  • Sleep J, Grant et al., West Berkshire Perineal Management Trial. BJM 1984; 298:578-690.
  • House MJ, To do or not to do episiotomy. In: Kitzinger S, (eds). Episi- otomy: physicaland emotional aspects. 1st. ed.London: National Child- birth Trust, 1981:6-11.
  • Reading AE, Sledmere CM, Cox DN, Campbell S, How women view post-episiotomy pain. Br Med J 1982;284 :243.
  • Russell JK, Episiotomy [Editorial]. Br Med J 1982;284:220.
  • Karaçam Z, Epizyotominin Doğum Sonrası Dönemde Cinsel Fonksiyona Etkisi. Hemşirelikte Araştırma Geliştirme Dergisi 2008; 38-46.
  • American College of Obstetricians and Gynecologists. Erişim tarihi 08 Ekim 2015 Available from:http://www.acog.org/from_home/publicati- ons/press_releases/nr03- 31-06-2.cfm.American College of Obstetrici- ans and Gynecologists –ACOG (2006). Recommends Restricted Use of Episiotomies.
  • Viswanathan M, Hartmann K, Palmieri R, et al. The Use of Episiotomy in Obstetrical Care: A Systematic Review. Summary, Evidence Report/ Technology Assessment 2005; 112:1-8.
  • Buhling K. J, Schmidt S, Robinson J. N, Klapp C, Siebert G, Dudenha- usen J. W, Rate of dyspareunia after delivery in primiparae according to mode of delivery. Eur J Obstet Gynecol and Reprod Biol 2006; 124: 42-46.
  • Mayerhofer K, Bodner-Adler B, Bodner K et al., Traditional care of the perineum during birth. A prospective, randomized, multicenter study of 1076 women. J Reprod Med 2002;47: 477–82.
  • Labrecque M, Eason E, Marcoux S, Randomized controlled trial of pre- vention of perineal trauma by perineal massage during pregnancy. Am J Obstet Gynecol 1999;180: 593-600.
  • Johanson R, Perineal massage for prevention of perineal trauma in child- birth. Lancet 2000; 355: 250–251.
  • Türkiye Nüfus ve Sağlık Araştırması 2013.Erişim tarihi 08 Ekim 2015 Available from:http://www.hips.hacettepe.edu.tr/TNSA_2013_ana_ra- por.pdf.
  • Balkaya N, Postpartum Dönemde Annelerin Bakım Gereksinimleri ve Ebe - Hemşirenin Rolü. C. Ü. Hemşirelik Yüksek Okulu Dergisi 2002; 6:2.
  • Sayıner F.D, Özerdoğan N, Doğal Doğum. Maltepe Üniversitesi Hemşirelik Bilim ve Sanat Dergisi 2009; 3:143.
  • Kettle C, Julie F, “Perineal care.” Clin Evid 7 2002; 1284-95.
  • Mohamed H. A. E, El-Nagger N. S, Effect of self perineal care instructi- ons on episiotomy pain and wound healing of postpartum women. J Am Sci 2012; 8:640-50.
  • McCandlish R, Perıneal trauma: Prevention and treatment. Journal of mi- dwifery & Women’s Health 2001; 46: 6.
  • Glazener CM, Abdalla M, Stroud P et al., Postnatal maternal morbidity: extent, causes, prevention and treatment. Br J Obstet Gynecol 1995; 102: 282–287.
  • Stamp G, Kruzins G, Crowther C, Perineal massage in labour and pre- vention of perineal trauma: randomised controlled trial. BMJ 2001;322 : 1277–1280.
  • Demirel G, Golbasi Z.Effect of perineal massage on the rate of episiotomy and perineal tearing.Int J Gynaecol Obstet 2015. Erişim tarihi 08 Ekim 2015 Available from: http://www.sciencedirect.com/science/article/pii/ S0020729215004361.
  • Beckmann M. M, Stock O. M, Antenatal perineal massage for reducing perinealtrauma. Cochrane Database Syst Rev 2013; 4Erişim tarihi 08 Ekim 2015 Available from: http://www.bibliotecacochrane.com/pdf/ CD005123.pdf
  • Gomme C, Sheridan M, Bewley S, Antenatal perineal massage: part 1. British Journal of Midwifery 2003; 11: 707–711.
  • Mynaugh P. A, A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations. Birth 1991; 18: 153–159.
  • Simon LS, Nonsteroidal anti-inflammatory drugs and their risk: a story still in development. Arthritis Res Ther 2013; 15:1.
  • Behmanesh F, Aghamohammadi A, Zeinalzadeh M, Khafri S, Effects of olive oil sitz bath on improvement of perineal injury after delivery. Koo- mesh 2013; 14: 309-315.
  • Kaur S, Sheoran P, Chand S, Haobijam J, Comparison of Infra Red Light Therapy vs Sitz Bath on Episiotomy in Terms of Wound Healing and In- tensity of Pain among Postnatal Mothers. International Journal of Nursing Care 2014; 2: 37.
  • Mahishale A, Chougala A, Patted S, Effect of Therapeutic Ultrasound and Maternal Cooling Gel Pad for Perineal Pain Following Vaginal Delivery with Episiotomy. J Women’s Health Care 2013;2: 2167-0420.
  • Steen M, Cooper K, Marchant P, Griffiths-Jones M, Walker J, A randomi- sed controlled trial to compare the effectiveness of icepacks and Epifoam with cooling maternity gel pads at alleviating postnatal perineal trauma. Midwifery 2000; 16: 48-55.
  • Leventhal L. C, de Oliveira S. M. J. V, Nobre M. R. C, da Silva F. M. B, Perineal analgesia with an ice pack after spontaneous vaginal birth: a randomized controlled trial. Journal of Midwifery & Women’s Health
  • Cooklin A. R, Amir L. H, Jarman J, Cullinane M, Donath S. M, Maternal Physical Health Symptoms in the First 8 Weeks Postpartum Among Pri- miparous Australian Women. Birth 2015;42:254-260.
  • Işık T, Akçınar M, Kadıoğlu S, Mersin ilinde gebelik, doğum ve loğusa- lık dönemlerinde anneye ve yenidoğana yönelik geleneksel uygulamalar. Uluslararası İnsan Bilimleri Dergisi 2010; 7: 71-84.
  • Gölbaşı Z, Eğri G, Doğum sonu dönemde annenin bakımına yönelik yapı- lan geleneksel uygulamalar. Cumhuriyet Tıp Dergisi 2010; 32: 276-282.
  • Kadanalı A, Karagöz G, Puerperal İnfeksiyonlar. Ümraniye Tıp Dergisi 2012; 5: 22-28
  • Winn H. N, Hobbins J. C, (Eds.). Clinical maternal-fetal medicine.1st ed. Pearl River, CRC Press, 2000.
  • Hastane Enfeksiyonları Dergisi.Erişim tarihi 08.Ekim.2015.Available from: der/1999-03/html/1999-3-3-133-139.htm
  • Mead PB.Infections of the female pelvis. In: Mandell GL, Bennett JE, Do- lin R (eds). Principles and Practice of Infectious Disease. New York 4thed : Churchill Livingstone, 1995:1090-8.
  • Güvenli Annelik. Cinsel Sağlık/Üreme Sağlığı Katılımcı Kitabı.Erişim tarihi 09.10.2015 Available from:http://sbu.saglik.gov.tr/Ekutuphane/kitaplar/ G%C3%BCvenli%20Annelik%20kat%C4%B1l%C4%B1mc%C4%B1%20 kitab%C4%B11.pdf.
  • Brumfıeld S.G, Early Postpartum Discharge. Clinical Obstetrics & Gyne- cology. Ambulatory Obstetric Management 1998; 41: 611-625.
  • Gözüm S, Kiliç D, Health problems related to early discharge of Turkish women. Midwifery 2005; 21: 371-378.
  • Priddis H, Dahlen H. G, Schmied V, Sneddon A, Kettle C et al. Risk of recurrence, subsequent mode of birth and morbidity for women who experienced severe perineal trauma in a first birth in New South Wales between 2000–2008: a population based data linkage study.BMC preg- nancy and childbirth 2013; 13: 89.
  • Gölbaşı Z, Postpartum dönemde erken taburculuk, evde bakım hizmetleri ve hemşirelik. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi 2003; 7: 15-22.
  • Cheng CY, Li Q, Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth. Womens Health Issues 2008;18:267-80.
  • Forster D. A, McLachlan H. L, Rayner J, Yelland J, Gold L, Rayner S, The early postnatal period: exploring women’s views, expectations and expe- riences of care using focus groups in Victoria, Australia. BMC pregnancy and childbirth 2008; 8: 27.
  • Yıldırım A, Hacıhasanoğlu R, Karakurt P, Postpartum depresyon ile sos- yal destek arasındaki ilişki ve etkileyen faktörler. International Journal of Human Sciences 2011; 8:1.
  • Sword W, Watt S, Learning needs of postpartum women: Does socioe- conomic status matter?. Birth 2005;32:86-92.
  • Beydağ K. D, Doğum sonu dönemde anneliğe uyum ve hemşirenin rolü. TSK Koruyucu Hekimlik Bülteni 2007; 6: 479-484.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Hülya Erbaba Bu kişi benim

Gül Pınar Bu kişi benim

Yayımlanma Tarihi 1 Temmuz 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 13 Sayı: 3

Kaynak Göster

Vancouver Erbaba H, Pınar G. Primipar Kadınların Perineal Travmaya İlişkin Görüşleri ve Uygulamaları: Nitel Bir Çalışma. JGON. 2016;13(3):89-94.