选择会阴切开术 - 事实还是幻想：一项关于女性对同意过程的体验的定性研究。
Choice in episiotomy - fact or fantasy: a qualitative study of women's experiences of the consent process.
机构信息
UCL Medical School, Medical School Building, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
Department of Reproductive Health, Faculty of Population Health Sciences, Medical School Building, EGA Institute for Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
出版信息
BMC Pregnancy Childbirth. 2022 Feb 21;22(1):139. doi: 10.1186/s12884-022-04475-8.
BACKGROUND
Consent to episiotomy is subject to the same legal and professional requirements as consent to other interventions, yet is often neglected. This study explores how women experience and perceive the consent process.
METHODS
Qualitative research in a large urban teaching hospital in London. Fifteen women who had recently undergone episiotomy were interviewed using a semi-structured interview guide and data was analysed using thematic analysis.
RESULTS
Three themes captured women's experiences of the episiotomy consent process: 1) Missing information - "We knew what it was, so they didn't give us details," 2) Lived experience of contemporaneous, competing events - "There's no time to think about it," and 3) Compromised volitional consent - "You have no other option." Minimal information on episiotomy was shared with participants, particularly concerning risks and alternatives. Practical realities such as time pressure, women's physical exhaustion and their focus on the baby's safe delivery, constrained consent discussions. Participants consequently inferred that there was no choice but episiotomy; whilst some women were still happy to agree, others perceived the choice to be illusory and disempowering, and subsequently experienced episiotomy as a distressing event.
CONCLUSIONS
Consent to episiotomy is not consistently informed and voluntary and more often takes the form of compliance. Information must be provided to women in a more timely fashion in order to fulfil legal requirements, and to facilitate a sense of genuine choice.
背景
会阴切开术的同意书须符合与其他干预措施相同的法律和专业要求，但往往被忽视。本研究探讨了女性对同意过程的体验和看法。
方法
在伦敦一家大型城市教学医院进行定性研究。对最近接受过会阴切开术的 15 名女性进行了半结构化访谈，并使用主题分析方法对数据进行分析。
结果
三个主题描述了女性对会阴切开术同意书过程的体验：1）信息缺失——“我们知道它是什么，所以他们没有提供详细信息”，2）同时发生的、竞争的事件的真实体验——“没有时间思考”，以及 3）意志同意受损——“你别无选择”。很少向参与者提供有关会阴切开术的信息，特别是关于风险和替代方案。实际情况如时间压力、女性身体疲惫以及她们对婴儿安全分娩的关注，限制了同意讨论。因此，参与者推断别无选择只能行会阴切开术；虽然有些女性仍然愿意同意，但其他女性认为选择是虚幻的和无力的，随后将会阴切开术视为令人痛苦的事件。
结论
会阴切开术的同意书并不总是知情和自愿的，更多的是形式上的遵从。为了满足法律要求，并促进真正选择的感觉，必须及时向女性提供信息。
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