Vpliv porodnih praks na porodno izkušnjo v institucionalni oskrbi

sekundarna analiza kvalitativnih podatkov

Ključne besede: medikalizacija, medicina, babištvo, ženske, družba

Povzetek

Uvod: Nosečnost in porod sta naravna dogodka, čeprav ju danes – ob upoštevanju dejstva, da živimo v »družbi tveganja« – opredeljujemo skozi prizmo patologije in potencialnih nevarnosti. Cilj raziskave je bil razumeti izkušnje in doživljanja žensk, povezana z rojevanjem v porodnišnicah skozi prevladujoče porodne prakse, ki so po prepričanju žensk pomembno krojile njihovo porodno izkušnjo.
Metode: Uporabljena je bila sekundarna analiza kvalitativnih podatkov. Primarni podatki so bili zbrani leta 2014 v okviru raziskave Medikalizacija nosečnosti in poroda kot družbena konstrukcija z narativno metodo. V vzorec sekundarne analize je bilo vključenih 18 transkriptov intervjujev z ženskami, ki so rodile v porodnišnici. Analiza kvalitativnih podatkov je bila izvedena s pomočjo računalniškega programa NVivo, verzija 12.
Rezultati: V analizi so bile identificirane tri teme: (1) pomembnost podpore zdravstvenega osebja in avtonomija odločanja; (2) sprememba fokusa v dojemanju carskega reza kot naravnega načina rojevanja; (3) rutinizacija in tehnifikacija porodnih praks.
Diskusija in zaključek: Rojevanje tako danes kot nekoč usmerjajo negativne in pozitivne porodne izkušnje. Poznati je treba oboje. Za ženske je prva porodna izkušnja poučna in obenem določujoča, saj na njeni podlagi presojajo prihodnje porodne izkušnje. Podpora zdravstvenega osebja ter avtonomija odločanja sta ključni za pozitivno porodno izkušnjo. K temu bi lahko v prihodnje pomembno prispevale tudi spremembe nekaterih utečenih porodnih praks, ki bi morale hitreje slediti praksi, utemeljeni z dokazi.

Prenosi

Podatki o prenosih še niso na voljo.

Biografija avtorja

Mirko Prosen, Univerza na Primorskem Fakulteta za vede o zdravju

doc. dr. Mirko Prosen, dipl. zdrav., univ. dipl. org.

Literatura

Aune, I., Dahlberg, M.U. & Ingebrigtsen, O., 2012. Parents' experiences of midwifery students providing continuity of care. Midwifery, 28(4), pp. 432−438. https://doi.org/10.1016/j.midw.2011.06.006 PMid:21764190

Behruzi, R., Hatem, M., Goulet, L., Fraser, W. & Misago, C., 2013. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework. BMC Pregnancy and Childbirth, 13, pp. 1–10. https://doi.org/10.1186/1471-2393-13-205 PMid:24215446; PMCid:PMC3835545

Bezenšek, J. & Barle, A., 2007. Poglavja iz sociologije medicine. Univerza v Mariboru, Medicinska fakulteta: Maribor. Bystrova, K., Ivanova, V., Edhborg, M.,Matthiesen, A.S., Ransjö-Arvidson, A.B., Mukhamedrakhimov, R., et al., 2010. Early contact versus separation: effects on mother-infant interaction 1 year later. Obstetric Anesthesia Digest, 30(2), pp. 116−117. https://doi.org/10.1097/01.aoa.0000370536.74543.e3

Christiaens, W. & Van Teijlingen, E., 2009. Four meanings of medicalization: childbirth as a case study. Salute e societa, 8(2), pp. 123–142.

Conrad, P., 1992. Medicalization and social control. Annual Review of Sociology, 18(1), pp. 209−232. https://doi.org/10.1146/annurev.so.18.080192.001233

Conrad, P., 2005. The shifting engines of medicalization. Journal of Health and Social Behavior, 46(1), pp. 3−14.

Conrad, P., 2007. The Medicalization of society: on the transformation of human conditions into treatable disorders. The Johns Hopkins University Press: Baltimore.

Conrad, P. & Barker, K.K., 2010. The Social construction of illness: key insights and policy implications. Journal of Health and Social Behavior, 51(Suppl 1), pp. S67−S79. https://doi.org/10.1177/0022146510383495 PMid:20943584

Correia, T., 2017. Revisiting medicalization: a critique of the assumptions of what counts as medical knowledge. Frontiers in Sociology, 2(14). Available at: https://www.frontiersin.org/article/10.3389/fsoc.2017.00014 [14. 11. 2018].

Davis, J., 2006. How medicalization lost its way. Society, 43(6), pp. 51−56. https://doi.org/10.1007/BF02698486

Davis, J.E., 2010. Medicalization, social control, and the relief of suffering. In: W.C. Cockerham, ed. The New Blackwell Companion to Medical Sociology. Malden: Wiley-Blackwell, pp. 211−241. PMid:20679093; PMCid:PMC3002238

Dove, S. & Muir-Cochrane, E., 2014. Being safe practitioners and safe mothers: a critical ethnography of continuity of care midwifery in Australia. Midwifery, 30(10), pp. 1063−1072. https://doi.org/10.1016/j.midw.2013.12.016 PMid:24462189

Hammer, R.P. & Burton-Jeangros, C., 2013. Tensions around risks in pregnancy: a typology of women's experiences of surveillance medicine. Social Science Medicine, 93, pp. 55–63. https://doi.org/10.1016/j.socscimed.2013.05.033 PMid:23906121

Healy, S., Humphreys, E. & Kennedy, C., 2017. A qualitative exploration of how midwives' and obstetricians' perception of risk affects care practices for low-risk women and normal birth. Women and Birth, 30(5), pp. 367−375. https://doi.org/10.1016/j.wombi.2017.02.005 PMid:28279637

Hislop, J. & Arber, S., 2003. Understanding women's sleep management: beyond medicalization-healthicization. Sociology of Health & Illness, 25(7), pp. 815−837. https://doi.org/10.1046/j.1467-9566.2003.00371.x PMid:19774748

Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije, 2014. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.

Long-Sutehall, T., Sque, M. & Addington-Hall, J., 2010. Secondary analysis of qualitative data: a valuable method for exploring sensitive issues with an elusive population. Journal of Research in Nursing, 16(4), pp. 335−344. https://doi.org/10.1177/1744987110381553

Lupton, D., 2003. Medicine as culture: illness, disease and the body in western societies. Sage: London.

Maharaj, D., 2009. Eating and drinking in labor: should it be allowed. European Journal of Obstetrics & Gynecology and Reproductive Biology, 146(1), pp. 3–7. https://doi.org/10.1016/j.ejogrb.2009.04.019 PMid:19428169

Malacrida, C. & Boulton, T., 2012. Women's Perceptions of Childbirth "Choices": competing discourses of motherhood, sexuality, and selflessness. Gender & Society, 26(5), pp. 748–772. https://doi.org/10.1177/0891243212452630

Malacrida, C. & Boulton, T., 2014. The best laid plans: women's choices, expectations and experiences in childbirth. Health, 18(1), pp. 41–59. https://doi.org/10.1177/1363459313476964 PMid:23426792

Maturo, A., 2012. Medicalization: current concept and future directions in a Bionic Society. Mens Sana Monographs, 10(1),pp. 122−133. https://doi.org/10.4103/0973-1229.91587 PMid:22654387; PMCid:PMC3353591

Njenjić, G. & Skela-Savič, B., 2011. Koncept kontinuirane babiške skrbi: percepcija in vedenje nosečnic. Obzornik zdravstvene nege, 45(2), pp. 83−91. Available at: https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2815 [5. 1. 2019].

Polit, D.F., & Tatano Beck, C., 2014. Essentials of nursing research: appraising evidence for nursing practice. 8th ed. Philadelphia: Wolters Kluwer Health.

Prosen, M., 2014. Vpetost zdravja žensk v kolesje medikalizacije. In: T. Štemberger Kolnik, D. Ravnik, K. Babnik & M. Bulič, eds. Zdravstvena nega v javnem zdravstvu: zbornik prispevkov z recenzijo. Druga znanstvena konferenca z mednarodno udeležbo, Izola, 31.1.2014. Koper: Založba Univerze na Primorskem, pp. 93−100. https://doi.org/10.1016/j.wombi.2018.06.018

Prosen, M., 2016. Medikalizacija nosečnosti in poroda kot družbena konstrukcija: doktorska disertacija. Maribor: Univerza v Mariboru, Filozofska fakulteta.

Prosen, M. & Tavčar Kranjc, M., 2013. Sociological conceptualization of the medicalization of pregnancy and childbirth: the implications in Slovenia. Revija za sociologiju, 43(3), pp. 251–272. https://doi.org/10.1016/j.wombi.2018.06.018

Prosen, M. & Tavčar Kranjc, M., 2018. Perspectives and experiences of healthcare professionals regarding the medicalisation of pregnancy and childbirth. Women and Birth, 32(2), pp. e173-e181. https://doi.org/10.1016/j.wombi.2018.06.018

Riegel, B. & Dickson, V.V., 2016. A qualitative secondary data analysis of intentional and unintentional medication nonadherence in adults with chronic heart failure. Heart & Lung, 45(6), pp. 468−474. https://doi.org/10.1016/j.hrtlng.2016.08.003 PMid:27595910

Riessman, C.K., 1983. Women and medicalization: a new perspective. Social Policy, 14(1), pp. 3–18. PMid:10264493

Ruggiano, N. & Perry, T.E., 2017. Conducting secondary analysis of qualitative data: should we, can we, and how. Qualitative Social Work. Available at: https://journals.sagepub.com/doi/abs/10.1177/1473325017700701 [12. 11. 2018].

Shepherd, A. & Cheyne, H., 2013. The frequency and reasons for vaginal examinations in labour. Women and Birth, 26(1), pp. 49−54. https://doi.org/10.1016/j.wombi.2012.02.001 PMid:22397830

Skubic, M., Petročnik, P., Mivšek, A.P., Jug Došler, A., Stanek Zidarič, T. & Škodič Zakšek, T., 2014. Kontinuirana babiška obravnava: prihodnost za zdravje žensk in njihovih družin. In: T. Štemberger Kolnik, D. Ravnik, K. Babnik & M. Bulič, eds. Zdravstvena nega v javnem zdravstvu: zbornik prispevkov z recenzijo. Druga znanstvena konferenca z mednarodno udeležbo, Izola, 31.1.2014. Koper: Založba Univerze na Primorskem, pp. 107−111.

Stanek Zidarič, T., Mivšek, A.P., Skubic, M. & Zakšek, T., 2011. Kontinuirana babiška skrb: predstavitev projekta Oddelka za babištvo Zdravstvene fakultete Ljubljana in Mestne občine Ljubljana. Obzornik zdravstvene nege, 45(5), pp. 141−145. Available at: https://obzornik.zbornica-zveza.si/index.php/ObzorZdravNeg/article/view/2826 [5. 7. 2018].

Strmec, B. & Hajtnik, K., 2015. Hranjenje in pitje med porodom: pregled priporočil in stanja v Sloveniji. In: S. Majcen Dvoršak, T. Štemberger Kolnik & D. Klemenc, eds. Z optimalnimi viri do učinkovite zdravstvene in babiške nege: zbornik prispevkov z recenzijo, 10. kongres zdravstvene in babiške nege Slovenije, Brdo pri Kranju, 11. in 12. maj 2015. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, Ljubljana, pp. 446–456.

Tate, J.A. & Happ, M.B., 2018. Qualitative secondary analysis: a case exemplar. Journal of Pediatric Health Care, 32(3), pp. 308−312. https://doi.org/10.1016/j.pedhc.2017.09.007 PMid:29254902

Vodušek Fabjan, V. & Kavšek, G., 2013. Delivery. In: I. Verdenik, Ž. Antolič Novak & J. Zupan, eds. Perinatologia Slovenica II: pregled slovenskih perinatalnih rezultatov za obdobje 2002-11. Ljubljana: Združenje za perinatalno medicino SZD, Klinični oddelek za perinatologijo, pp. 59–71. White, K., 2009. An introduction to the sociology of health and illness. Sage: London.

Williams, S.J., Gabe, J. & Davis, P., 2008. The sociology of pharmaceuticals: progress and prospects. Sociology of Health & Illness, 30(6), pp. 813−824. https://doi.org/10.1111/j.1467-9566.2008.01123.x PMid:18761505

World Medical Association, 2013. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), pp. 2191–2194. Available at: http://www.wma.net/en/20activities/10ethics/10helsinki/DoH-Oct2013-JAMA.pdf [1. 9. 2016].

Wray, S. & Deery, R., 2008. The Medicalization of Body size and women's healthcare. Health Care for Women International, 29(3), pp. 227−243. https://doi.org/10.1080/07399330701738291 PMid:18350426

Yin, R.K., 2011. Qualitative research from start to finish. The Guilford Press: New York.

Zanardo, V., Canella, A., Maone, R. & Straface, G., 2013. Bonding and breastfeeding after a cesarean delivery. Early Human Development, 89(Suppl 4), pp. S56−S57. https://doi.org/10.1016/S0378-3782(13)70100-2

Objavljeno
2019-12-16
Kako citirati
Prosen, M. (2019) Vpliv porodnih praks na porodno izkušnjo v institucionalni oskrbi, Obzornik zdravstvene nege, 53(4), str. 288-299. doi: 10.14528/snr.2019.53.4.2956.
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