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一项关于女性分娩时会阴创伤经历的系统混合研究综述。

A systematic mixed studies review of women's experiences of perineal trauma sustained during childbirth.

作者信息

Crookall Rebecca, Fowler Gillian, Wood Caroline, Slade Pauline

机构信息

Research Associate, University of Liverpool.

Consultant Urogynaecologist, Liverpool Women's NHS Foundation Trust.

出版信息

J Adv Nurs. 2018 May 23. doi: 10.1111/jan.13724.

Abstract

AIM

To explore the quantitative/qualitative literature on women's experiences of perineal trauma sustained during childbirth and the impact it may have on psychological/emotional wellbeing BACKGROUND: Obstetric complications during childbirth can be a risk factor for postpartum psychological distress. Perineal trauma is one of the most frequent obstetric complications and it is important to understand any impact on psychological/emotional wellbeing.

DESIGN

A convergent qualitative design using a hybrid deductive-inductive thematic synthesis approach to data transformation was used.

DATA SOURCES

Web of knowledge, CINAHL, MEDLINE, AMED, PsyArticles, PsycInfo until May 2017.

REVIEW METHODS

Stage 1: transforming findings from the qualitative, quantitative and mixed methods studies into themes using thematic synthesis. Stage 2: integrating themes from the quantitative studies into those derived from the qualitative studies RESULTS: Records (N=2152) found of which 11 qualitative 22 quantitative and 1 mixed methods were included in this review. Five themes were derived from thematic synthesis of qualitative studies 'The mystery of perineal trauma', 'The misery of perineal suturing', 'The postnatal perineum', 'Normalisation and feeling dismissed' and 'Adjusting to a new normal - Coping and compromise' and five themes identified from the quantitative studies, experience of birth (N=4), Sexual functioning (N=12), Social functioning (N=2), Psychological health (N=8) and Quality of Life (N=5).

CONCLUSION

Perineal trauma can have a negative impact on psychological/emotional wellbeing, however the literature is conflicted and in need of clarification. Future research should clearly describe the perineal status of the women in the sample, use validated measures and consider the timing of such measures. This article is protected by copyright. All rights reserved.

摘要

目的

探讨关于女性分娩时会阴创伤经历及其对心理/情绪健康可能产生影响的定量/定性文献。背景:分娩时的产科并发症可能是产后心理困扰的一个风险因素。会阴创伤是最常见的产科并发症之一,了解其对心理/情绪健康的任何影响很重要。

设计

采用了一种收敛性定性设计,使用混合演绎 - 归纳主题综合方法进行数据转换。

数据来源

截至2017年5月的知识网络、护理学与健康领域数据库(CINAHL)、医学文献数据库(MEDLINE)、联合和补充医学数据库(AMED)、心理学全文数据库(PsyArticles)、心理学文摘数据库(PsycInfo)。

综述方法

第1阶段:使用主题综合将定性、定量和混合方法研究的结果转化为主题。第2阶段:将定量研究的主题整合到定性研究得出的主题中。结果:共找到2152条记录,其中11篇定性研究、22篇定量研究和1篇混合方法研究纳入本综述。定性研究的主题综合得出了五个主题:“会阴创伤之谜”、“会阴缝合之苦”、“产后会阴”、“正常化与被忽视感”以及“适应新常态——应对与妥协”;定量研究确定了五个主题:分娩经历(N = 4)、性功能(N = 12)、社会功能(N = 2)、心理健康(N = 8)和生活质量(N = 5)。

结论

会阴创伤可能对心理/情绪健康产生负面影响,然而文献存在矛盾之处,需要进一步阐明。未来的研究应清晰描述样本中女性的会阴状况,使用经过验证的测量方法并考虑这些测量的时间。本文受版权保护。保留所有权利。

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