Wagg Ann R, Kendall Sally, Bunn Frances
1Senior Practice Nurse,Stanmore Medical Group,Stevenage,UK.
2Professor of Community Nursing and Public Health, Centre for Health Service Studies, School of Social Policy,Sociology and Social Research,George Allen Wing,University of Kent,CT2 7NF.
Prim Health Care Res Dev. 2017 Sep;18(5):448-462. doi: 10.1017/S1463423617000366.
Aim This study aimed to explore, describe and enhance understanding of women's experiences, beliefs and knowledge of urinary symptoms in the postpartum period and also sought to understand the perceptions of health professionals of these issues.
Women often take no action with regard to urinary symptoms particularly in the postnatal period, which can lead to the adoption of coping mechanisms or normalisation of symptoms. The true prevalence is difficult to assess due to differing age groups and time spans in studies. There is only a small body of work available to try to understand the lack of action on the part of the women, and even less around the attitudes of health professionals.
Grounded theory was selected for a qualitative inductive approach, to attempt to understand the social processes involved and generate new knowledge by examining the different interactions. Recruitment was by theoretical sampling. In total, 15 women were interviewed and two focus groups of health professionals were undertaken. In addition, an antenatal clinic and a postnatal mothers group were observed. All information was analysed manually using constant comparison. Findings The findings revealed that at times poor communication, lack of clear education and the power of relative's stories of the past were barriers to help seeking, and were disempowering women, creating a climate for normalisation. Women were willing to talk but preferred the health professional to initiate discussion. In addition, health professionals were concerned about a lack of time and knowledge and were uncertain of the effect of pelvic floor muscle exercises due to some research indicating improvement may not be maintained over time. The core category was; 'overcoming barriers to facilitate empowerment', indicating that improving communication and education could reduce barriers and enable them to seek help.
目的 本研究旨在探索、描述并增进对产后女性泌尿症状经历、信念和知识的理解，同时试图了解医护人员对这些问题的看法。
女性对于泌尿症状往往不采取任何行动，尤其是在产后阶段，这可能导致她们采取应对机制或使症状常态化。由于研究中年龄组和时间跨度不同，真实患病率难以评估。仅有少量研究试图理解女性不采取行动的原因，而关于医护人员态度的研究更少。
选择扎根理论进行定性归纳研究，试图通过审视不同的互动来理解其中涉及的社会过程并产生新知识。采用理论抽样进行招募。总共对15名女性进行了访谈，并开展了两个医护人员焦点小组讨论。此外，观察了一个产前诊所和一个产后母亲小组。所有信息均采用持续比较法进行人工分析。结果 结果显示，沟通不畅、缺乏清晰的教育以及亲属过去经历的影响有时会成为寻求帮助的障碍，使女性失去力量，营造了症状常态化的氛围。女性愿意交谈，但更希望医护人员发起讨论。此外，医护人员担心时间和知识不足，并且由于一些研究表明盆底肌肉锻炼的效果可能无法长期维持而对其效果不确定。核心类别是：“克服障碍以促进赋权”，这表明改善沟通和教育可以减少障碍并使她们能够寻求帮助。
