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KADINLARIN NORMAL DOĞUM SÜRECİNDE VAJİNAL MUAYENEYE İLİŞKİN DENEYİMLERİ VE ETKİLEYEN FAKTÖRLER: NİTEL BİR ARAŞTIRMA

Yıl 2021, Cilt: 24 Sayı: 2, 220 - 230, 25.06.2021
https://doi.org/10.17049/ataunihem.856233

Öz

Amaç: Bu çalışma kadınların doğum sırasında vajinal muayeneye ilişkin deneyimlerini ve etkileyen faktörleri nitel olarak belirlemek amacıyla yapılmıştır.

Yöntem: Çalışma Türkiye'de bir ildeki iki devlet hastanesinde normal doğum yapan 20 kadın ile yapılmıştır. Veriler kişisel bilgi formu, yarı yapılandırılmış görüşme formu ve görüşmeci gözlem formu ile toplanmıştır. Veriler içerik analizi kullanılarak analiz edilmiştir.

Bulgular: Kadınların yaş ortalaması 34.60±6.40 olup, %75'i (n: 15) multipardı. Çalışmada vajinal muayene deneyimine ilişkin “vajinal muayene kavramı” ve “vajinal muayeneye ilişkin deneyim ve duygusal tepkiler” olarak iki tema belirlenmiştir. Vajinal muayene deneyimini etkileyen faktörlere ilişkin temalar ise “yaşantıyı etkileyenler” ve “vajinal muayene ile ilgili beklentiler” olarak belirlenmiştir. Katılımcılar sıklıkla muayenenin doğumun ilerleyişini değerlendirmek için yapıldığını ifade etmişlerdir. Kadınlar aynı zamanda muayene sürecinde sağlık çalışanlarından yeterli bilgi almadıklarını, sağlık profesyonellerinin mahremiyetlerine yeterince dikkat etmediklerini, gereksiz ve sık vajinal muayeneye maruz kaldıklarını söylemişlerdir. Çalışma sonucuna göre, kadınların vajinal muayene deneyimlerinin çoğunlukla olumsuz olduğu görülmüştür (özellikle utanma, ağrı ve yalnızlık hissi). Katılımcılar sağlık profesyonellerinden öncelikle güler yüzlü ve bilgilendirici olmalarını beklerken, muayene ortamının ise ergonomik açıdan uygun olmasını beklediklerini ifade etmişlerdir.

Sonuç: Kadınlar vajinal muayene sırasında fiziksel ve psiko-sosyal bakım gereksinimlerinin karşılanmasına önem verilmesini beklemektedir.

Kaynakça

  • 1. Shepherd A, Cheyne H. The Frequency and Reasons for Vaginal Examinations in Labour. Women Birth 2013;26(1):49-54.
  • 2. Bekmezci H, Özkan H. Ebelik Uygulamalarında Mahremiyetin Önemi. Sağlık Bilimleri ve Meslekleri Dergisi 2015;2(1):113-24.
  • 3. Downe S, Gyte GML, Dahlen HG, Singata M. Routine Vaginal Examinations for Assessing Progress of Labour to Improve Outcomes for Women and Babies at Term. The Cochrane Database of Systematic Reviews 2013;15(7):010088.
  • 4. Muliira RS, Seshan V, Ramasubramaniam S. Improving Vaginal Examinations Performed by Midwives. Sultan Qaboos University Medical Journal 2013;13(3):442-9.
  • 5. World Health Organization [Internet]. Geneva; Switzerland. 2014. WHO Recommendations for Augmentation of Labour. [cited 2020 Feb 11]; Available from: https://apps.who.int/iris/bitstream/handle/10665/112825/9789241507363_eng.pdf;jsessionid=79878068B39536309BD54E225F1EB340?sequence=1
  • 6. Hassan SJ, Sundby J, Husseini A, Bjertness E. The Paradox of Vaginal Examination Practice During Normal Childbirth: Palestinian Women’s Feelings, Opinions Knowledge and Experiences. Reproductive Health 2012;9(16):1-9.
  • 7. Teskereci G, Yangın H, Akpınar A. Experiences of Women Regarding Vaginal Examination During Labor: A Qualitative Study. Health Care Women International 2020;41(1):75-88.
  • 8. Lewin D, Fearon B, Hemmings V, Johnson G. Women’s Experiences of Vaginal Examinations in Labor. Midwifery 2005;21(3):267-77.
  • 9. Bonilla-Escobar FJ, Ortega-Lenis D, Rojas-Mirquez JC, Ortega-Loubon C. Panamanian Women's Experience of Vaginal Examination in Labour: A Questionnaire Validation. Midwifery 2016;36(2016):8-13.
  • 10. Yanıkkerem E, Özdemir M, Bingöl H, Tatar A, Karadeniz G. Women’s Attitudes and Expectations Regarding Gynaecological Examination. Midwifery 2009;25(5):500-8.
  • 11. Szymoniak K, Cwiek D, Berezowska E. Women's Opinions Regarding Gynaecological Examination in a Hospital. Ginekologia Polska 2009;80(7):498-502.
  • 12. de Klerk H, Boere E, van Lunsen R, Bakker J. Women’s Experiences with Vaginal Examinations During Labor in the Netherlands. Journal of Psychosomatic Obstetrics and Gynecology 2018;39(2):90-5.
  • 13. Ying Lai C, Levy V. Hong Kong Chinese Women’s Experiences of Vaginal Examinations in Labour. Midwifery 2002;18(4):296-303.
  • 14. Güneş G, Karaçam Z. Doğum Sonu Dönemdeki Kadınların Vajinal Muayene Deneyimleri: Nitel Bir Araştırma. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi 2018;11(2):87-95.
  • 15. Chen CH, Wang SY, Chang MY. Women’s Perceptions of Helpful and Unhelpful Nursing Behaviors During Labor: A Study in Taiwan. Birth 2001;28(3):180-5.
  • 16. Lathlean J. Qualitative analysis. In Gerrish K, Lathlean J, eds. The Research Process in Nursing. 7th ed. London: Wiley-Blackwell Publishing; 2015. p. 471-88.
  • 17. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in Qualitative Research: Exploring Its Conceptualization and Operationalization. Quality & Quantity 2018;52(4):1893-907.
  • 18. Polit DF, Beck CT. Nursing research, principles and methods. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 2013.
  • 19. Sarpkaya D, Vural G. Hemşirelikte Dört Bilme Yolunun Jinekolojik Muayenede Kullanımı. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi 2014;7(2):124-7.
  • 20. Hartigan L, Cussen L, Meaney S, O’Donoghue K. Patients’ Perception of Privacy and Confidentiality in the Emergency Department of a Busy Obstetric Unit. BMC Health Services Research 2018;18(1):1-6.
  • 21. Arslan ET, Demir H. Attitudes of Health Workers Related to Patient Confidentiality: A Qualitative Research. Bolu Abant İzzet Baysal University Journal of Graduate School of Social Sciences 2017;17(4):191-220.
  • 22. Şen Y. İslâm Hukukuna Göre Sağlık Hizmetlerinde Mahremiyet Hakkı Ekev Akademi Dergisi 2015;19(61):425-50.
  • 23. Bostan S, Unal C. Awareness and Attitude of Patients about Patient Privacy. Turkiye Klinikleri Journal of Medical Ethics-Law and History 2019;27(3):239-49.
  • 24. Kilpi HL, Valimaki M, Dassen T, Gasull M, Lemonidou C, Scott A. et al. Privacy: a Review of the Literature. International Journal of Nursing Studies 2001;38(6):663-71.
  • 25. Kim K, Han Y, Kim JS. Nurses’ and Patients’ Perceptions of Privacy Protection Behaviours and Information Provision. Nursing Ethics 2017;24(5):598-611.
  • 26. Erbil N, Şenkul A, Sağlam Y, Ergül N. Determination of Attitudes with Gynecologic Examination and Anxiety of Turkish Women Before Gynecologic Examination. Journal of Human Sciences 2008;5(1):1-5.
  • 27. Nilsson C, Hessmen E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, Measurements and Prevalence of Fear of Childbirth: A Systematic Review. BMC Pregnancy and Childbirth 2018;18(28):2-15.
  • 28. Turgut N, Gölbaşı Z. Aspects of Emotional and Physical Discomfort in Gynecologic Examination: A Study of Turkish Women. The Journal of Obstetrics and Gynaecology Research 2014;40(6):1777-84.
  • 29. Demir S, Oskay UY. Jinekolojik Muayene Olan Kadınların Yaşadığı Deneyimler ve Sağlık Profesyonelinden Beklentileri. Kadın Sağlığı Hemşireliği Dergisi 2014;1(1):68-79.
  • 30. Bilgin NÇ. Ergonomics in delivery rooms and its importance. In Çamlı AA, Ak B, Arabacı R, Efe R, eds. Recent advances in health sciences. Sofia: St. Kliment Ohridski University Press; 2016. p. 174-82.
  • 31. Larkin P, Begley CM, Devane D. Women’ Experiences of Labour and Birth: An Evolutionary Concept Analysis. Midwifery 2009;25(2):49-59.
  • 32. Çıtak Bilgin N, Böyük M. Doğum Ünitelerinde Ergonomi: Riskler, Etkiler ve Öneriler. Yaşam Boyu Hemşirelik Dergisi 2020;1(1):25-45.
  • 33. Setola N, Iannuzzi L, Santini M, Cocina GG, Naldi E, Branchini L, et al. Optimal Settings for Childbirth. Minerva Ginecologica 2018;70(6):687-99.
  • 34. Jenkinson B, Josey N, Kruske S. Birth Space: An Evidence-Based Guide to Birth Environment Design. Brisbane QLD, Australia: Queensland Centre for Mothers & Babies, The University of Queensland 2014.
  • 35. Gedey S. Labor-Delivery-Recovery Room Design That Facilitates Non-Pharmacological Reduction of Labor Pain: A Model Labor Room Plan and Recommended Best Practices. Perkins+Will Research Journal 2014;1:127-39.
  • 36. Duncan J. The Effect of Colour and Design in Labour and Delivery: A Scientific Approach. Optics & Laser Technology 2011;43(2):420-4.
  • 37. Kocabaş P, Khorshid L. Comparison of the Effects of a Special Gynecological Garment and Music in Reducing the Anxiety Related to Gynecological Examination. Journal of Clinical Nursing 2012;21(5-6):791-7.

WOMEN'S EXPERIENCES OF VAGINAL EXAMINATION DURING NORMAL CHILDBIRTH AND AFFECTING FACTORS: A QUALITATIVE STUDY

Yıl 2021, Cilt: 24 Sayı: 2, 220 - 230, 25.06.2021
https://doi.org/10.17049/ataunihem.856233

Öz

Aim: This study aims to determine qualitatively experiences and affecting factors of the women related to vaginal examination during labor.

Methods: The study was conducted with 20 normal birth giving women at two state hospitals in a province in Turkey. The data were collected by personal information form, semi-structured interview form and interviewer observation form. The data were analyzed by the content analysis.

Results: The average age of women was 34.60 ± 6.40, and 75% (n: 15) of them were multiparous. Two themes were identified as “vaginal examination concept” and “experience and emotional reactions related to the vaginal examination.” The themes affecting the vaginal examination experience were also determined as “affecting life” and “expectations on vaginal examination.” The participants often declared that the examination was performed to assess the progression of childbirth. They also stated that they did not get enough information from the healthcare professionals during the examination process. They declared that the professionals did not pay enough attention to their privacy, and they were exposed to unnecessary and frequent vaginal examinations. According to the results, most of their experiences were negative (especially feelings of shame, pain and loneliness). The healthcare professionals were expected to be friendly and informative. The examination environment was expected to be appropriate in terms of ergonomics.

Conclusion: Women expect special attention for their physical and psycho-social care needs during vaginal examination.

Kaynakça

  • 1. Shepherd A, Cheyne H. The Frequency and Reasons for Vaginal Examinations in Labour. Women Birth 2013;26(1):49-54.
  • 2. Bekmezci H, Özkan H. Ebelik Uygulamalarında Mahremiyetin Önemi. Sağlık Bilimleri ve Meslekleri Dergisi 2015;2(1):113-24.
  • 3. Downe S, Gyte GML, Dahlen HG, Singata M. Routine Vaginal Examinations for Assessing Progress of Labour to Improve Outcomes for Women and Babies at Term. The Cochrane Database of Systematic Reviews 2013;15(7):010088.
  • 4. Muliira RS, Seshan V, Ramasubramaniam S. Improving Vaginal Examinations Performed by Midwives. Sultan Qaboos University Medical Journal 2013;13(3):442-9.
  • 5. World Health Organization [Internet]. Geneva; Switzerland. 2014. WHO Recommendations for Augmentation of Labour. [cited 2020 Feb 11]; Available from: https://apps.who.int/iris/bitstream/handle/10665/112825/9789241507363_eng.pdf;jsessionid=79878068B39536309BD54E225F1EB340?sequence=1
  • 6. Hassan SJ, Sundby J, Husseini A, Bjertness E. The Paradox of Vaginal Examination Practice During Normal Childbirth: Palestinian Women’s Feelings, Opinions Knowledge and Experiences. Reproductive Health 2012;9(16):1-9.
  • 7. Teskereci G, Yangın H, Akpınar A. Experiences of Women Regarding Vaginal Examination During Labor: A Qualitative Study. Health Care Women International 2020;41(1):75-88.
  • 8. Lewin D, Fearon B, Hemmings V, Johnson G. Women’s Experiences of Vaginal Examinations in Labor. Midwifery 2005;21(3):267-77.
  • 9. Bonilla-Escobar FJ, Ortega-Lenis D, Rojas-Mirquez JC, Ortega-Loubon C. Panamanian Women's Experience of Vaginal Examination in Labour: A Questionnaire Validation. Midwifery 2016;36(2016):8-13.
  • 10. Yanıkkerem E, Özdemir M, Bingöl H, Tatar A, Karadeniz G. Women’s Attitudes and Expectations Regarding Gynaecological Examination. Midwifery 2009;25(5):500-8.
  • 11. Szymoniak K, Cwiek D, Berezowska E. Women's Opinions Regarding Gynaecological Examination in a Hospital. Ginekologia Polska 2009;80(7):498-502.
  • 12. de Klerk H, Boere E, van Lunsen R, Bakker J. Women’s Experiences with Vaginal Examinations During Labor in the Netherlands. Journal of Psychosomatic Obstetrics and Gynecology 2018;39(2):90-5.
  • 13. Ying Lai C, Levy V. Hong Kong Chinese Women’s Experiences of Vaginal Examinations in Labour. Midwifery 2002;18(4):296-303.
  • 14. Güneş G, Karaçam Z. Doğum Sonu Dönemdeki Kadınların Vajinal Muayene Deneyimleri: Nitel Bir Araştırma. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi 2018;11(2):87-95.
  • 15. Chen CH, Wang SY, Chang MY. Women’s Perceptions of Helpful and Unhelpful Nursing Behaviors During Labor: A Study in Taiwan. Birth 2001;28(3):180-5.
  • 16. Lathlean J. Qualitative analysis. In Gerrish K, Lathlean J, eds. The Research Process in Nursing. 7th ed. London: Wiley-Blackwell Publishing; 2015. p. 471-88.
  • 17. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in Qualitative Research: Exploring Its Conceptualization and Operationalization. Quality & Quantity 2018;52(4):1893-907.
  • 18. Polit DF, Beck CT. Nursing research, principles and methods. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 2013.
  • 19. Sarpkaya D, Vural G. Hemşirelikte Dört Bilme Yolunun Jinekolojik Muayenede Kullanımı. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi 2014;7(2):124-7.
  • 20. Hartigan L, Cussen L, Meaney S, O’Donoghue K. Patients’ Perception of Privacy and Confidentiality in the Emergency Department of a Busy Obstetric Unit. BMC Health Services Research 2018;18(1):1-6.
  • 21. Arslan ET, Demir H. Attitudes of Health Workers Related to Patient Confidentiality: A Qualitative Research. Bolu Abant İzzet Baysal University Journal of Graduate School of Social Sciences 2017;17(4):191-220.
  • 22. Şen Y. İslâm Hukukuna Göre Sağlık Hizmetlerinde Mahremiyet Hakkı Ekev Akademi Dergisi 2015;19(61):425-50.
  • 23. Bostan S, Unal C. Awareness and Attitude of Patients about Patient Privacy. Turkiye Klinikleri Journal of Medical Ethics-Law and History 2019;27(3):239-49.
  • 24. Kilpi HL, Valimaki M, Dassen T, Gasull M, Lemonidou C, Scott A. et al. Privacy: a Review of the Literature. International Journal of Nursing Studies 2001;38(6):663-71.
  • 25. Kim K, Han Y, Kim JS. Nurses’ and Patients’ Perceptions of Privacy Protection Behaviours and Information Provision. Nursing Ethics 2017;24(5):598-611.
  • 26. Erbil N, Şenkul A, Sağlam Y, Ergül N. Determination of Attitudes with Gynecologic Examination and Anxiety of Turkish Women Before Gynecologic Examination. Journal of Human Sciences 2008;5(1):1-5.
  • 27. Nilsson C, Hessmen E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, Measurements and Prevalence of Fear of Childbirth: A Systematic Review. BMC Pregnancy and Childbirth 2018;18(28):2-15.
  • 28. Turgut N, Gölbaşı Z. Aspects of Emotional and Physical Discomfort in Gynecologic Examination: A Study of Turkish Women. The Journal of Obstetrics and Gynaecology Research 2014;40(6):1777-84.
  • 29. Demir S, Oskay UY. Jinekolojik Muayene Olan Kadınların Yaşadığı Deneyimler ve Sağlık Profesyonelinden Beklentileri. Kadın Sağlığı Hemşireliği Dergisi 2014;1(1):68-79.
  • 30. Bilgin NÇ. Ergonomics in delivery rooms and its importance. In Çamlı AA, Ak B, Arabacı R, Efe R, eds. Recent advances in health sciences. Sofia: St. Kliment Ohridski University Press; 2016. p. 174-82.
  • 31. Larkin P, Begley CM, Devane D. Women’ Experiences of Labour and Birth: An Evolutionary Concept Analysis. Midwifery 2009;25(2):49-59.
  • 32. Çıtak Bilgin N, Böyük M. Doğum Ünitelerinde Ergonomi: Riskler, Etkiler ve Öneriler. Yaşam Boyu Hemşirelik Dergisi 2020;1(1):25-45.
  • 33. Setola N, Iannuzzi L, Santini M, Cocina GG, Naldi E, Branchini L, et al. Optimal Settings for Childbirth. Minerva Ginecologica 2018;70(6):687-99.
  • 34. Jenkinson B, Josey N, Kruske S. Birth Space: An Evidence-Based Guide to Birth Environment Design. Brisbane QLD, Australia: Queensland Centre for Mothers & Babies, The University of Queensland 2014.
  • 35. Gedey S. Labor-Delivery-Recovery Room Design That Facilitates Non-Pharmacological Reduction of Labor Pain: A Model Labor Room Plan and Recommended Best Practices. Perkins+Will Research Journal 2014;1:127-39.
  • 36. Duncan J. The Effect of Colour and Design in Labour and Delivery: A Scientific Approach. Optics & Laser Technology 2011;43(2):420-4.
  • 37. Kocabaş P, Khorshid L. Comparison of the Effects of a Special Gynecological Garment and Music in Reducing the Anxiety Related to Gynecological Examination. Journal of Clinical Nursing 2012;21(5-6):791-7.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Gülnur Yıldırım Bu kişi benim 0000-0001-5022-8319

Nevin Çıtak Bilgin 0000-0003-4367-215X

Yayımlanma Tarihi 25 Haziran 2021
Gönderilme Tarihi 8 Ocak 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 24 Sayı: 2

Kaynak Göster

Vancouver Yıldırım G, Çıtak Bilgin N. WOMEN’S EXPERIENCES OF VAGINAL EXAMINATION DURING NORMAL CHILDBIRTH AND AFFECTING FACTORS: A QUALITATIVE STUDY. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2021;24(2):220-3.

Dergimiz 2019 dan itibaren EBSCO CINAHL Database'de listelenmektedir.

Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC 4.0) ile lisanslanmıştır.

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