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对澳大利亚分娩期间水浸政策和指南的批判性分析。

A critical analysis of Australian policies and guidelines for water immersion during labour and birth.

作者信息

Cooper Megan, McCutcheon Helen, Warland Jane

机构信息

School of Nursing and Midwifery, University of South Australia, City East Campus, Adelaide, South Australia, Australia.

Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia Campus, Brisbane, Queensland, Australia.

出版信息

Women Birth. 2017 Oct;30(5):431-441. doi: 10.1016/j.wombi.2017.04.001. Epub 2017 May 18.

Abstract

BACKGROUND

Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy.

AIM

The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth.

METHOD

Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis.

FINDINGS

Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners.

CONCLUSION

Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines'.

ETHICAL CONSIDERATIONS

The Human Research Ethics Committee of the University of South Australia approved the research.

摘要

背景

分娩时使用水疗的可行性通常取决于护理人员以及支撑实践的政策/指南。由于关于水疗安全性和实用性的高质量研究较少,尤其是分娩用水疗,指导实践的政策/指南可能缺乏确保从业者对该选择充满信心所需的证据,从而限制了其可行性以及女性的自主权。

目的

本研究的目的是确定水疗政策和/或指南是如何形成的,谁解读证据以形成政策/指南,以及政策/指南在多大程度上促进了分娩时选择水疗。

方法

一项三阶段混合方法研究的第一阶段,使用批判性话语分析对25项澳大利亚水疗政策/指南进行了批判性分析。

研究结果

与水疗实践相关的政策/指南反映了当前文献库中支持以风险为重点的产科和生物医学话语实践的主观意见和观点。政策和指南受霸权影响而制定,对女性和从业者的自主权都有影响。

结论

与水疗相关的政策和指南,尤其是分娩用水疗,反映了对当前文献库的意见和不同解读。注意到一定程度的霸权影响,因此对未来的产妇护理政策和指南提出了建议。

伦理考量

南澳大利亚大学人类研究伦理委员会批准了该研究。

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