Jurczuk Magdalena, Phillips Lizzie, Bidwell Posy, Martinez Dorian, Silverton Louise, Sevdalis Nick, van der Meulen Jan, Gurol-Urganci Ipek, Thakar Ranee
Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, London, UK.
Maternity Services, University Hospital Plymouth NHS Trust, Plymouth, Devon, UK.
BJOG. 2025 Apr;132(5):588-595. doi: 10.1111/1471-0528.18029. Epub 2024 Dec 11.
To study experiences of women who gave birth in maternity units that have implemented a 'care bundle' quality improvement initiative to reduce obstetric anal sphincter injury (OASI) and associated morbidity.
Postnatal electronic questionnaire.
Twenty-nine maternity units across England, Scotland and Wales.
Women with live vaginal births.
Descriptive statistics for quantitative results. Analysis of free-text responses informed by framework method.
Experience with components of the care bundle: information provision, manual perineal protection (MPP) and post-birth rectal examination.
In this study, 1208 women completed the survey: 684 (56.6%) said they received antenatal information about perineal health, 377 (31.2%) recalled MPP, and 664 (55.0%) recalled rectal examination. Of the 684 women who said they received antenatal information, 595 (87.0%) agreed that the information was easy to understand, and 423 (61.8%) agreed that it helped them to make their own choices to reduce their OASI risk. One hundred and fifty-four (22.5%) agreed that the information made them fearful about giving birth vaginally. Of the 377 women who recalled MPP, 203 (53.9%) felt it provided them with support, and another 97 (25.7%) did not mind the sensation. Of the 664 women who recalled rectal examination, 281 (42.3%) did not mind the exam, and another 335 (50.5%) felt it was uncomfortable but understood its importance. Free-text responses aligned with quantitative results.
Many women did not recall MPP or rectal examination. The reported experiences for those who recalled these components do not support concerns that the OASI care bundle has negative effects on women's experiences.
研究在实施了“护理包”质量改进举措以降低产科肛门括约肌损伤（OASI）及相关发病率的产科病房分娩的女性的经历。
产后电子问卷。
英格兰、苏格兰和威尔士的29个产科病房。
经阴道顺产的女性。
对定量结果进行描述性统计。采用框架法对自由文本回复进行分析。
护理包各组成部分的体验：信息提供、手动会阴保护（MPP）和产后直肠检查。
在本研究中，1208名女性完成了调查：684名（56.6%）表示她们收到了有关会阴健康的产前信息，377名（31.2%）回忆起进行了MPP，664名（55.0%）回忆起进行了直肠检查。在684名表示收到产前信息的女性中，595名（87.0%）认为信息易于理解，423名（61.8%）认为这有助于她们做出自己的选择以降低OASI风险。154名（22.5%）认为该信息使她们对阴道分娩感到恐惧。在377名回忆起进行了MPP的女性中，203名（53.9%）觉得这为她们提供了支持，另外97名（25.7%）不介意这种感觉。在664名回忆起进行了直肠检查的女性中，281名（42.3%）不介意检查，另外335名（50.5%）觉得不舒服但理解其重要性。自由文本回复与定量结果一致。
许多女性没有回忆起MPP或直肠检查。对于那些回忆起这些组成部分的女性所报告的经历并不支持关于OASI护理包会对女性经历产生负面影响的担忧。
