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助产士见证创伤性医院分娩事件的体验:一项定性研究。

Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study.

机构信息

Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey.

出版信息

J Eval Clin Pract. 2021 Aug;27(4):847-857. doi: 10.1111/jep.13487. Epub 2020 Oct 1.

Abstract

AIMS AND OBJECTIVES

The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies.

METHODS

The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis.

FINDINGS

As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth.

CONCLUSION(S): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

摘要

目的和目标

本研究旨在详细调查产房助产士的创伤性分娩经历,以及他们的态度、反应和应对策略。

方法

研究设计为描述性,采用目的抽样法。这种方法非常适合对现象的本质进行初步探索。2018 年 10 月至 2019 年 1 月期间,采用目的抽样法对助产士进行了半结构式访谈。研究对象为 29 名在产房工作的助产士,他们被要求描述在分娩过程中经历的特定紧张情况、对该事件的情绪反应以及应对策略和支持系统。所有访谈均以数字形式记录、存储在数据库中,并转移到 MAX 定性数据分析 18.1.0 进行分析。

结果

通过内容分析,出现了三个主要主题:心理影响、防御性实践以及对医院支持的期望。结果表明,在创伤性分娩后,助产士经历了高度的情绪疲惫,表现为悲伤、闪回、内疚、恐惧和同理心,并且他们采取了越来越多的防御性实践。在访谈中,我们观察到 19 名助产士需要心理支持。此外,助产士明确表示,他们对创伤性事件没有足够的准备,而且他们工作场所中大多数创伤性分娩都被简单忽略了。最终确定,助产士在发生创伤性分娩时主要从同事那里获得支持。

结论

助产士在应对情绪压力时需要感到被重视并得到机构的支持。因此,由经验丰富或专业助产士进行临床检查可能成为减少防御性干预的支持框架。

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