PDF(Pubmed)
Abstract：
BACKGROUND: During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred.
METHODS: In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis.
RESULTS: Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women\'s difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a \'key person\' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered.
CONCLUSIONS: Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.
METHODS: In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis.
RESULTS: Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women\'s difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a \'key person\' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered.
CONCLUSIONS: Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.
摘要：
背景：在产后第一年，约25%的瑞典女性患有严重会阴创伤（SPT），即，分娩时会阴三度或四度裂伤，对他们的医疗联系人不满意。Further,缺乏对长期有SPT相关健康问题的女性在医疗保健方面的长期经验的研究.这项研究探讨了自我报告的持续性SPT相关健康问题的女性在发生SPT时，如何在分娩后18个月至5年与医疗服务机构接触。
方法：在这项描述性定性研究中，从2020年11月至2022年2月,对12名自我报告的SPT后持续存在健康问题的女性进行了针对性访谈.使用归纳定性内容分析对数据进行分析。
结果：我们的结果显示，由于SPT而导致持续健康问题的女性的情况自相矛盾。他们在受创伤的身体上挣扎，但是医疗保健专业人员拒绝将他们的健康问题视为产后正常状况。这个悖论凸显了妇女在获得产后医疗保健方面的困难，康复,还有病假,这让他们忽视了医疗保健需求，情感幸福感下降，以及经济和社会地位的丧失。我们的结果表明，这些健康问题并没有随着时间的推移而减少。因此,这些妇女不得不无情地寻找医疗保健领域的“关键人物”，他们承认她们持续存在的问题是获得所需护理的合法途径，康复,还有病假,因此感到被赋予了力量。
结论：我们的研究表明，患有持续SPT相关健康问题的女性经历了复杂的健康挑战。此外,他们的医疗需求，康复,病假在很大程度上被忽视了。因此，这项研究强调了瑞典与SPT相关的医疗保健服务的不公平提供，包括获得护理的地区差异。因此，作者建议，瑞典国家SPT相关护理指南需要制定和实施，运用以女性为中心的方法，为了确保公平，有效,和可访问的医疗保健。
方法：在这项描述性定性研究中，从2020年11月至2022年2月,对12名自我报告的SPT后持续存在健康问题的女性进行了针对性访谈.使用归纳定性内容分析对数据进行分析。
结果：我们的结果显示，由于SPT而导致持续健康问题的女性的情况自相矛盾。他们在受创伤的身体上挣扎，但是医疗保健专业人员拒绝将他们的健康问题视为产后正常状况。这个悖论凸显了妇女在获得产后医疗保健方面的困难，康复,还有病假,这让他们忽视了医疗保健需求，情感幸福感下降，以及经济和社会地位的丧失。我们的结果表明，这些健康问题并没有随着时间的推移而减少。因此,这些妇女不得不无情地寻找医疗保健领域的“关键人物”，他们承认她们持续存在的问题是获得所需护理的合法途径，康复,还有病假,因此感到被赋予了力量。
结论：我们的研究表明，患有持续SPT相关健康问题的女性经历了复杂的健康挑战。此外,他们的医疗需求，康复,病假在很大程度上被忽视了。因此，这项研究强调了瑞典与SPT相关的医疗保健服务的不公平提供，包括获得护理的地区差异。因此，作者建议，瑞典国家SPT相关护理指南需要制定和实施，运用以女性为中心的方法，为了确保公平，有效,和可访问的医疗保健。
