|
|
Experience of expecting mothers with spinal analgesia
VRHELOVÁ, Jitka
Obstetric analgesia has lately become a modern supplement during physiological birth as well as during births with increased risk. Spinal analgesia together with epidural analgesia represent important methods in obstetric analgesia and anesthesia during delivery. The objective and the core of my thesis is to make a survey of expecting mothers´ experience with spinal analgesia which is a less used method of obstetric analgesia than for example the epidural method. But because this method is entirely equivalent to the epidural method, it is advisable to get familiar with its adverse and positive aspects and especially with the expecting mothers´ response to this method. In the thesis I used combination of quantitative and qualitative research, with six objectives, six hypotheses and two research questions. Methods of collecting data were questionnaires and interviews. The research database consisted of women after vaginal as well as operative deliveries who had used spinal analgesia or anesthesia during delivery. Objective 1 {--} to find out the overall awareness of women about methods of obstetric analgesia was fulfilled and hypothesis 1 {--} women do not have enough information about methods of obstetric analgesia was confirmed. Objective 2 {--} to find out whether the spinal analgesia method brings expected comfort of painless birth to expecting mothers was fulfilled. Hypothesis 2 {--} spinal analgesia method brings expected comfort of painless birth to expecting mothers was confirmed as well. Objective 3 {--} to find out whether spinal analgesia has a positive effect on the course of delivery was fulfilled. Hypothesis 3 which stated that spinal analgesia method has a positive effect on course of delivery was confirmed as well. Objective 4 to find out how the spinal analgesia method influences condition of fetus during delivery was fulfilled. Hypothesis 4 {--} spinal analgesia method has a positive influence on condition of faetus during delivery was confirmed. Objective 5 was to find out side effects of spinal analgesia during delivery as well as in confinement. The objective was fulfilled and the hypothesis was confirmed as well. Objective 6 to compare postoperative condition of mothers after Caesarean section in spinal analgesia and total anesthesia was fulfilled. The hypothesis stated to objective 6 was also confirmed . Two hypotheses can be stated from the results of qualitative research which comprised two research questions. The first hypothesis claims that spinal analgesia has a positive effect on physical condition of expecting mothers during delivery. The second hypothesis claims that spinal analgesia has a positive effect on mental condition of expecting mothers. The findings from the field of obstetric analgesia and research results can be used in the nursing process not only in delivery rooms and obstetric wards but also in primary care where the pregnant woman gets into the very first contact with medical staff.
|
|
|
Women´s in childbed attitude towards cardiotocographical fetal monitoring during childbirth
PAPÍRNÍKOVÁ, Petra
Cardiotocography is a noninvasive method providing information on the condition of the fetus during pregnancy and childbirth. Fetal monitoring has become standard in obstetric care for pregnant women and mothers. The procedures recommended by the Czech Gynecological-Obstetrical Society determine indications of the use of cardiotocography and state rules of how to interpret the results of the method. During physiological childbirth the mother can be observed intermittently, i.e. at regular intervals according to the practice of the specific obstetric department. Pathological delivery, such as breech delivery, delivery of a hypotrofic fetus, fetus with a nonphysiological CTG record, should be monitored continuously. External fetal heart sounds scanning may bring mother some unpleasant restrictions in movement and positioning. When medical staff show preference in observing data obtained by monitoring, it may make the mother fear about the fetus´ condition or raise presumption that midwives do not adequately meet her own needs during the delivery. Nursing care of mothers during cardiotocographical scanning is very specific because a midwife provides care to two subjects - the mother and the child. According to scarce literature on this subject mothers{\crq} in bed attitudes toward cardiotocography vary from the positive view that monitoring protects the fetus and ensures its health to negative feelings of discomfort, limitations, pointless medialization of the natural process, medical personnel distraction and rejection of medical examination. Czech studies, however, have never been conducted and modern literature on this topic does not exist. The research was conducted by the prospective quantitative research using questionnaires. The questionnaires were anonymous and contained 26 questions, 23 of which were closed, 1 was semi-closed and 2 were open. The total number of questionnaires distributed was 101, the target respondents were women in confinement in the Gynecological-Obstetrical clinic of. 1. LF UK a VFN in Praque. The research database was composed of women who were 2 or 3 days after delivery, women with elective Caesarean section were not included into the research. The aim of the research was to learn women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth. Three hypotheses were stated: Hypothesis 1 assumes that mothers consider cardiotocographical fetal monitoring to be a source of information on the child condition, and this hypothesis was confirmed. Hypothesis 2 assumes that cardiotocographical fetal monitoring during childbirth restricts the mother{\crq}s movement and relief positioning, and this was confirmed by the research. Hypothesis 3 raises the presumption that there is a lack of valid information provided to mothers on cardiotocography, interpretation of CTG records and their relevance. This hypothesis was confirmed by the research. The women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth was evaluated and thus objectives of the thesis were met. Holistic approach in nursing care is supposed to ensure that all patients have access to the best possible comfort, comprehensive care and enough information. The conclusions of the research conducted in the Gynecological-Obstetrical clinic imply the need to improve communication and the flow of information from medical staff to women in childbed and technical possibility of CTG recorders.
|
|
|
Effect of antenatal preparation for childbirth first female nascent and cooperation with the midwife.
HANZLÍKOVÁ, Hana
Effect of antenatal preparation for childbirth first female nascent and cooperation with the midwife. Birth has always been perceived as a difficult life situation, which requires necessary preparation, even if it was mere passing on the wisdom from one generation of women to another. An expectant mother has a possibility of attending antenatal courses alongside with her partner. There, the parents-to-be gather information on the course of pregnancy, good nutrition, and possible complications during pregnancy. They become familiar with a might-be management of the birth, the issues relating to postpartum period, and the basics of how to take care of newborns. Since 2002, the author has organized antenatal courses for expectant women and their partners in Strakonice. This drew author?s attention to the question whether antenatal preparation of mostly primiparas has an impact on the management of the birth and postpartum period, and the question of collaboration between a prepared woman and a midwife. The first objective of the thesis was to confirm whether antenatal education of mothers-primiparas has an impact on the management of the birth and postpartum period. The second objective of the thesis was to observe the impact of the antenatal preparation on the collaboration between a woman-primipara and a midwife during the delivery and postpartum period. The bachelor?s thesis is based on a qualitative research that introduced 2 objectives and 4 research questions. Data were collected by interview. For the purposes of the research, interviews were held with primiparas who had completed antenatal preparation, primiparas who had delivered their babies at the maternity hospital in Strakonice, and midwives currently working at the Department of Obstetrics and Gynecology of the Hospital Strakonice PLC. The results of the qualitative research were processed in the form of case reports and assessment tables. The established objectives were met. The research questions provided necessary data to accomplish the research. Based on the responses to the research questions, 4 hypotheses were established. The outcomes of the research point out the quality of care provided by midwives during the antenatal preparation. In practice, they might be utilized in negotiations with insurance companies that are welcome to contribute to women so as they do not have to pay the full price of the courses in question. The outcomes also raise questions whether they help prevent complications during the birth and postpartum period or not.
|
|
|
Nursing care of women in childbirth completed VEX (vakuum extraction)
KŘÍŽOVÁ, Michala
My thesis is focused on nursing care for a woman during the childbirth ended with VEX (vacuum extractor). The first part of my thesis is the theoretical part where the method of vacuum extraction in obstetrics, its indications and conditions and the procedure technique is introduced, as well as nursing care of a midwife for a woman in the childbirth ended with VEX in the delivery room and the confinement department. The aim of the thesis was to determine if midwives have experience with care for a woman in the childbirth ended with VEX. Whether they know the conditions and indications for using VEX during childbirth on the part of a mother and fetus and in what maternity hospitals in the South Bohemian region the VEX method is used. To meet the objectives, hypotheses were stated. The first hypothesis: Midwives have experience and know how to take care of a woman during the childbirth ended with a VEX. The second hypothesis: Midwives know the conditions for ending the childbirth with a VEX. Third hypothesis: Midwives known indication on the part of a mother and fetus for childbirth ended with a VEX. Research Question 1 In what hospitals in the South Bohemian region is the VEX method for childbirth ending used? The quantitative research method was used to find the answers. The data were collected by the interview method, the questionnaire technique. The questionnaire was anonymous, it was composed of pre-formulated questions, which served as identification data. The questionnaire contained 23 questions. The research respondents for the quantitative research were midwives working in the delivery room and confinement department in selected hospitals of the South Bohemian region. The questionnaires were distributed to seven selected hospitals in the South Bohemian region (České Budějovice, Český Krumlov, Jindřichův Hradec, Strakonice, Písek, Tábor, Prachatice). The total number of distributed questionnaires was 100, 20 of them were not returned, namely from the hospital in České Budějovice. Therefore, the total number of responses was 80 (100%). The results are processed into graphs. The goals of the thesis were met. The research survey has shown that midwives are experienced and able to take care of a woman in the childbirth ended with a VEX, the first hypothesis was confirmed. The second hypothesis was also confirmed because midwives know conditions for the childbirth ended with a VEX. The hypothesis on indications on the part of a mother and a fetus was also confirmed. The second and supplementary technique was an inquiry intended to determine in what hospital in the South Bohemian region the method of childbirth ending with a VEX is used. The inquiry was addressed to head nurses of gynecological and obstetrical departments in hospitals in the South Bohemian region (České Budějovice, Český Krumlov. Jindřichův Hradec, Strakonice, Písek, Tábor, Prachatice). The total number of distributed inquiry questionnaires was 7, 1 of which was not returned, it was from the hospital in České Budějovice. The inquiry contained seven questions. It was found out that the vacuum extraction method is used in hospitals in Strakonice, Český Krumlov and Prachatice. In other maternity hospitals this method is considered to be used in the future. In the final part of the thesis a standard for midwives concerning the care for women in the childbirth ended with a VEX was created supposing that the standard will be used in nursing care.
|
|
|
Communication in the Birth Suite.
MELÍŠKOVÁ, Jana
Given the importance of pregnancy and childbirth to a woman, communication is a key feature contributing to the successful development of and control over that anxious period. An appropriate and correct communication prevents confusion and misunderstanding between clients and healthcare professionals. Everyone needs to communicate, especially if they are at a healthcare facility and expect healthcare professionals to come up with words of explanation, encouragement and support. The theoretical section of the work deals with communication between a birth assistant and a birthing woman. The general section summarizes communication in the birth suite and lists factors affecting communication, such as pain and childbirth training. The main objectives of the work were to determine the effect of childbirth training on communication between the expectant mother and healthcare professionals during childbirth, to see whether birth assistants were able to appropriately react to conditions accompanying childbirth and to find out whether successful communication with women in labor depended on birth assistants{\crq} expertise. The objectives have been met thanks to the research conducted. Qualitative survey by means of interviews was employed in the research section of the bachelor thesis. Eight birth assistants were interviewed: four out of them had worked in the birth suite for more than ten years and the others for one year. In addition, eight mothers were interviewed the day after they had given birth. Four of them gave birth for the first time and four of them for the fourth time. The interviews were prepared so that I could answer the following research questions: 1. What do birth assistants think about the effect of childbirth training on communication with mothers during childbirth? Most of the birth assistants answered that question in the affirmative. Expectant mothers who have been trained before childbirth communicate better and have more information and skills. 2. What do expectant mothers think about communication in the birth suite? Expectant mothers think that communication in the birth suite is positive from the very first contact and especially emphasize healthcare professionals{\crq} readiness, patience, attentiveness, professionalism and human touch. 3. Do birth assistants have sufficient knowledge and experience of communicating in the birth suite? Birth assistants with ten and more years{\crq} work experience have enough knowledge and experience, whereas birth assistants with a year{\crq}s experience of the birth suite lack the expertise. This work has attempted to shed light on communication by birth assistants. It can serve secondary school and college students and birth assistants and doctors who can use it as a resource and make an assessment of their communication skills and abilities and it can be a source of information to help improve communication by birth assistants.
|
|
|
Problems in nurse care of delf birth women
KOTTOVÁ, Jiřina
Problems in nursing care of deaf women giving birth Thanks to opening the frontiers and migration of population, the structure of clients of Czech maternity hospitals has changed during the past fifteen years, and the hospitals have responded to this circumstance accordingly. We are able to create suitable conditions for women of various cultures and religious backgrounds. We should create unlimiting and friendly environment also for deaf women giving birth. I work in the Institute for Mother and Child Care, which became a center for deaf women giving birth in 2004. The main aim of this undergraduate thesis is to find out what are the major difficulties the nursing staff faces in care for deaf women giving birth. The theoretical part describes specific features of care for deaf women giving birth. Further chapters outline the anatomy of the auditory system, hearing impairments and their diagnostics and also deal with communication of deaf people and their identity. The objective of the thesis is to find out whether the nursing staff is able to communicate with deaf women, whether maternity hospitals can procure an interpreter and what are the problems deaf women and nursing staff face. As a hypothesis it was assumed that nursing staff does not have basic information on communication with deaf women giving birth, they are not acquainted with means of communication, that maternity hospitals can procure an interpreter for deaf women and that in health care the main problem for the nursing staff and the deaf women is communication. In order to achieve the research objective, quantitative survey was chosen in the form of a questionnaire for nursing staff in the Institute for Mother and Child Care, together with qualitative research, represented by four interviews with deaf women giving birth in the same place. Data were collected in February and March 2010. From the results of the survey it follows that nursing staff lacks basic information about communication with the deaf and is not acquainted with even the basics of the communication and the biggest problem in the nursing care for deaf women giving birth according to midwives, children{\crq}s nurses and the deaf women is communication. A conclusion was drawn from the results of the survey that the problem of communication with deaf women giving birth has to be addressed. One of the main recommendations is to improve informing the nursing staff about the world of the deaf, improving the attitude to the deaf and respecting their personalities. We do not have to know the sign language in order to communicate with the deaf, it is sufficient to be sensitive, kind and willing to understand.
|
|
|
Mode of delivery in women with a history of caesarean section
PISKORZOVÁ, Martina
The thesis is focused on childbirth management in women with a history of Caesarean section. Two objectives were stated. The first one was to found out the childbirth management in women with previous Caesarean section. The second one was focused on the women{\crq}s demand for sterilization during Caesarean section. The objectives were accomplished. To meet the objectives, hypotheses were stated. It was presumed that in women with a history of Caesarean section another pregnancy would be terminated by another Caesarean section. This hypothesis was confirmed. The second hypothesis assumed the women{\crq}s demand for sterilization during Caesarean section. This hypothesis was not confirmed. The research was conducted by the quantitative method using retrospective analysis of data obtained in the perinatological centre in hospital in České Budějovice, a.s. in the period between January 1, 2004 and December 31, 2008.
|
|
|
Nursing of puerpa apter discharced form hospital form family midwifeis perspective
FIEDLEROVÁ, Jiřina
Confinement period {--} puerperium {--} is a difficult period for a woman after childbirth in terms of somatic and psychological aspects. The thesis deals with the issue of confinement, care for the mother after discharge form hospital and the role of an outpatient midwife. Following objectives were stated to find out: if women after delivery will need the assistance outpatient midwives may provide them with; if mothers are interested in such assistance; if women need professional help in the treatment of episiotomy, breastfeeding, right lifestyle and child care after being discharged from hospital; if women have enough information where to seek professional help in the event of complications.
|
|
|
Epidural anesthesia during labour nowadays
LAŠTOVKOVÁ, Aneta
Current Obstetric Epidural Analgesia Labour pain belongs to every physiological childbirth. Enormous pain, however, was proved to affect a woman in labour and a child negatively so satisfactory pain relief should be provided. Current obstetric analgesia aims at/seeks for/strives after observing a physiological childbirth process. Epidural analgesia is the safest and most effective method of labour pain relief available today. Epidural analgesia is used in case of pain in labour and delivery, on request of the woman in labour and in prolonged delivery. Epidural analgesia could be also provided in preeclampsy, breech delivery, multiple pregnancy, premature delivery and cardiotocographic abnormalities. Although epidural analgesia is very popular and safe, no complication should be omitted. Good hospital care provided by obstetricians, anesthesiologists and nurse midwives could prevent most complications. Obviously, professional care in labour with epidural analgesia can only be provided by well-educated and experienced obstetric staff. The theoretical part of the thesis deals with information concerning delivery pain and pain relief methods. Together with epidural method, its indication, contraindication and complications, also spinal anatomy is mentioned in this part. All professional and communicative steps of midwife care about the woman in labour with epidural analgesia are described here. To fulfil the aim of the thesis, qualitative and quantitative research strategies were used. The women in labour with and without epidural analgesia were observed for collecting data in qualitative method. The same clients were consequently asked about their information and attitudes to epidural analgesia. Altogether eight casualties were formed. To collect data for quantitative method, the questionnaire of thirteen questions was prepared and send out to maternity hospitals. Eighty-six questionnaires were sent out and twenty- eight (25, 7 %) were sent back. The main aim of the thesis was to find out how available the epidural analgesia in labour is in our maternity hospitals. The next aim was to monitor the women in labour with and without epidural analgesia. The aims were accomplished through the research questions: How available is epidural analgesia used in labour in Czech maternity hospitals? What diffferences are there in labour with and without epidural analgesia? This work can be applied as a source of information for midwife students and nurses.
|
|
|
Course of antepartum preparation
KASTENMAJEROVÁ, Lucie
This bachelor{\crq}s work is divided into practical and theoretical section. The theoretical part describes history of antenatal preparation and its current conception. Next it deals with courses of antenatal preparation, mission of midwife in their leading and with preparation of persons who accompany the mother to the childbirth. The objectives was managed to fulfill. First hypothesis - pregnant women don{\crq}t have enough information about antenatal preparation courses - wasn{\crq}t confirmed. Second hypothesis {--} courses of antenatal preparation are financially accessible for pregnant women {--} was confirmed. Third hypothesis {--} courses of antenatal preparation are accessible for the women in their area of living {--} was confirmed.
|
guest ::
