n Evaluering van die voorkoms van perineale trauma tydens verlossings in openbare gesondheidsinstellings in die Wes-Kaap : 'n verpleegkundige perspektief

[摘要] ENGLISH ABSTRACT:It appears that registered midwives prefer not to cut episiotomies which results in anincrease in perineal tears. This may be the case as a result of current controversiesregarding episiotomies, lack of suturing skills due to insufficient training andevaluation, or the fact that the necessity of an episiotomy are not recognisedtimeously. In light of this the incidence of perineal trauma during deliveries in publichealthcare institutions in the Western Cape was evaluated from a nursingperspective. The midwife can playa significant role in the prevention of unnecessaryperineal trauma by applying particular precautions in practice.Triangulation was used as the research method. Seven public healthcare institutionsin the Western Cape were included in this study. Nurses completed 45questionnaires while 33 deliveries and 25 cases of suturing of perineal wounds wereevaluated according to a pre-compiled checklist. Semi-structured interviews wereconducted with registered midwives and medical practitioners involved in the trainingof nursing students.According to findings it appears that nurses do not recognise the risk factors to becontributory causes of perineal tears. Furthermore, it appeared that 46% ofregistered midwives did not feel competent enough to suture perineal wounds.Disparities were identified pertaining to the training of student nurses as well as thecontinuous training and evaluation of registered midwives regarding the suturing ofperineal wounds.It is recommended that a uniform policy should be formulated concerning guidelinesfor the cut and suturing of episiotomies and lacerations. Furthermore, a uniformclassification system regarding perineal trauma should be formulated as well as auniform system to evaluate the competency of midwives.

[发布机构] Stellenbosch University