Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
Health Service and Population Research Department, King's College London, De Crespingy Park, London, SE5 8AF, UK.
Int Urogynecol J. 2021 Jul;32(7):1807-1816. doi: 10.1007/s00192-020-04653-2. Epub 2021 Jan 21.
Obstetric anal sphincter injury (OASI) is a severe form of perineal trauma that can occur during vaginal birth. Long-term morbidities include anal incontinence and psychosocial disorders. To reduce these injuries within England, Scotland and Wales, the OASI Care Bundle was introduced to 16 maternity units (January 2017-March 2018). The OASI Care Bundle comprises four elements: (1) antenatal information, (2) manual perineal protection, (3) medio-lateral episiotomy (when indicated) and 4) recognition and diagnosis of tears. As part of the project evaluation, a qualitative study was conducted to explore women's experiences of the OASI Care Bundle.
Semi-structured interviews were conducted with women (n = 19) who received the OASI Care Bundle as part of their maternity care. This was to explore their experience of each element. A thematic analysis of the interview data was performed.
Three themes were identified: (1) memories of touch, whereby women reported that a 'hands-on' approach to perineal protection was a positive experience; (2) midwife as a supportive guide, where women reported that good communication facilitated a calm birth and post-birth diagnosis; (3) education: women need more information about perineal trauma.
This study contributes to the literature through its exploration of women's experiences of perineal protection techniques and diagnosis of perineal trauma. Interviewed women indicated that they did not experience any of the care bundle elements as an intrusion of their physical integrity. Additionally, an urgent need was identified for more information about perineal trauma in terms of risk, prevention and recovery.
产科肛门括约肌损伤（OASI）是一种严重的会阴创伤，可能发生在阴道分娩过程中。长期的病态包括肛门失禁和心理社会障碍。为了减少英格兰、苏格兰和威尔士的这些损伤，OASI 护理包被引入 16 个产科病房（2017 年 1 月至 2018 年 3 月）。OASI 护理包包括四个要素：（1）产前信息，（2）手动会阴保护，（3）会阴正中切开术（如有指征）和 4）识别和诊断撕裂。作为项目评估的一部分，进行了一项定性研究，以探讨女性对 OASI 护理包的体验。
对接受 OASI 护理包作为其产科护理一部分的 19 名女性进行了半结构化访谈。这是为了探讨她们对每个元素的体验。对访谈数据进行了主题分析。
确定了三个主题：（1）触摸的记忆，即妇女报告说，会阴保护的“动手”方法是一种积极的体验；（2）助产士作为支持性的指导者，妇女报告说，良好的沟通促进了平静的分娩和产后诊断；（3）教育：妇女需要更多关于会阴创伤的信息。
本研究通过探索女性对会阴保护技术和会阴创伤诊断的体验，为文献做出了贡献。接受采访的女性表示，她们没有将护理包的任何一个元素视为对其身体完整性的侵犯。此外，人们迫切需要更多关于会阴创伤的风险、预防和恢复方面的信息。
