BMJ open · 2017
Perineal resuturing versus expectant management following vaginal delivery complicated by a dehisced wound (PREVIEW): a nested qualitative study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Dudley L, Kettle C, Waterfield J, Ismail Khaled M K
Аннотация
OBJECTIVE: To explore women's lived experiences of a dehisced perineal wound following childbirth and how they felt participating in a pilot and feasibility randomised controlled trial (RCT).
DESIGN: A nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology.
PARTICIPANTS AND SETTING: A purposive sample of six women at 6-9 months postnatal who participated in the RCT were interviewed in their own homes.
RESULTS: Following Giorgi's analytical framework the verbatim transcripts were analysed for key themes. Women's lived experiences revealed 4 emerging themes: (1) Physical impact, with sub-themes focusing upon avoiding infection, perineal pain and the impact of the wound dehiscence upon daily activities; (2) Psychosocial impact, with sub-themes of denial, sense of failure or self-blame, fear, isolation and altered body image; (3) Sexual impact; and (4) Satisfaction with wound healing. A fifth theme 'participating in the RCT' was 'a priori' with sub-themes centred upon understanding the randomisation process, completing the trial questionnaires, attending for hospital appointments and acceptability of the treatment options.
CONCLUSIONS: To the best of our knowledge, this is the first qualitative study to grant women the opportunity to voice their personal experiences of a dehisced perineal wound and their views on the management offered. The powerful testimonies presented disclose the extent of morbidity experienced while also revealing a strong preference for a treatment option.
TRIAL REGISTRATION NUMBER: ISRCTN05754020; results.
DESIGN: A nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology.
PARTICIPANTS AND SETTING: A purposive sample of six women at 6-9 months postnatal who participated in the RCT were interviewed in their own homes.
RESULTS: Following Giorgi's analytical framework the verbatim transcripts were analysed for key themes. Women's lived experiences revealed 4 emerging themes: (1) Physical impact, with sub-themes focusing upon avoiding infection, perineal pain and the impact of the wound dehiscence upon daily activities; (2) Psychosocial impact, with sub-themes of denial, sense of failure or self-blame, fear, isolation and altered body image; (3) Sexual impact; and (4) Satisfaction with wound healing. A fifth theme 'participating in the RCT' was 'a priori' with sub-themes centred upon understanding the randomisation process, completing the trial questionnaires, attending for hospital appointments and acceptability of the treatment options.
CONCLUSIONS: To the best of our knowledge, this is the first qualitative study to grant women the opportunity to voice their personal experiences of a dehisced perineal wound and their views on the management offered. The powerful testimonies presented disclose the extent of morbidity experienced while also revealing a strong preference for a treatment option.
TRIAL REGISTRATION NUMBER: ISRCTN05754020; results.
Предметные рубрики MeSH
Activities of Daily LivingAdultBody ImageDelivery, ObstetricFeasibility StudiesFemaleHumansLacerationsPostoperative PainPatient ParticipationPatient SatisfactionPerineumPilot ProjectsPregnancyQualitative ResearchRandomized Controlled Trials as TopicSocial IsolationSurgical Wound DehiscenceTreatment OutcomeUnited KingdomWound HealingYoung Adult