Informirano soglasje žensk v obporodnem obdobju; od sprejema v porodnišnico do treh ur po porodu : diplomsko delo

Erjavec, Anita (author), Stanek Zidarič, Tita (mentor), Prelec, Anita (reviewer)

Uvod: Zdravstveni delavci so zakonsko in etično dolžni omogočiti informirano odločitev pacienta oziroma osebe, deležne zdravstvene intervencije, in pridobiti njegovo informirano soglasje. Informirano soglasje je soglasje osebe, ki bo deležna zdravstvene intervencije po tem, ko je bila informirana o poteku, učinkih in vplivih le-te. Namen: Namen diplomskega dela je opisati, kaj je informirano soglasje, določila kodeksa etike, ki se nanašajo na informirano soglasje ter pravice žensk oziroma pacientove pravice v slovenski zakonodaji. Želeli smo tudi ugotoviti, ali so ženske informirane o posegih, postopkih oziroma zdravilih v obporodnem obdobju ter ali imajo možnost privolitve oziroma odklonitve posega oziroma postopka. Metode dela: Uporabljena je bila deskriptivna metoda dela. Literatura je bila iskana s pomočjo naslednjih ključnih besed v slovenščini: informirano soglasje, obporodno obdobje, kodeks etike za babice, pacientove pravice in angleščini: informed consent, informed decision, intrapartum care. Iskanje literature je potekalo preko mrežnika EBSCOhost z iskanjem po tujih in domačih bibliografskih elektronskih bazah podatkov Medline, CINAHL in COBIB.SI in drugih. V empiričnem delu je bila izvedena kvantitativna raziskava, ki je temeljila na kavzalno-neeksperimentalni metodi dela. Kot raziskovalni instrument je bil uporabljen vprašalnik, ki je bil oblikovan za namen raziskave na osnovi pregleda literature. Za zbiranje in za statistično analizo obdelave podatkov je bila uporabljena odprtokodna aplikacija za spletno anketiranje 1KA. Rezultati: Rezultati raziskave so pokazali, da ženske niso v celoti informirane o vseh postopkih v obporodnem obdobju in nimajo možnosti soodločanja o izvedbi pri vseh intervencijah. Najmanj so bile informirane o postopkih, kot so pritisk na fundus, anogenitalna nega in aplikacija vitamina K pri novorojenčku. Povprečen odstotek žensk, ki so bile deležne postopkov v obporodnem obdobju in o njih niso bile informirane, je 29,0 %. Najmanjšo možnost soodločanja o izvedbi postopkov so imele pri izvedbi vaginalnega pregleda, epiziotomije in pritiska na fundus. Povprečen odstotek žensk, ki niso imele možnosti privolitve ali odklonitve postopkov, je 49,0 %. Razprava in zaključek: Informirano soglasje se v obporodnem obdobju uporablja premalo, kljub zakonskim določbam, ki narekujejo njegovo uporabo pri vseh postopkih, ki se izvajajo pri osebi. Ženske imajo zaradi tega slabšo porodno izkušnjo in manj zaupajo v zdravstveni sistem. Ženske si želijo popolno informiranost ter možnost aktivnega sodelovanja pri zdravstveni obravnavi, kar jim omogočajo predpisi v slovenski zakonodaji.

• Language: Slovenian
• Keywords: diplomska dela, babištvo, informirano soglasje, informirani pristanek, pravice žensk, kodeks etike
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Erjavec]
• Year: 2020
• Number of pages: 39 str., [4] str. pril.
• PID: 20.500.12556/RUL-116093
• UDC: 618.2/.7
• COBISS.SI-ID: 15220739
• Publication date in RUL: 14.05.2020

Secondary language

• Language: English
• Title: Women's informed consent in the intrapartum period; from admission to maternity hospital to three hours after childbirth : diploma work

Abstract

Introduction: Health care providers are legally and ethically required to enable informed patient decision-making. Informed consent is a permission obtained before conducting a health care intervention and after informing the person about the procedure, effects and consequences. Purpose: The purpuse of the thesis is to present informed consent, ethical principles, women's rights and patients' rights according to Slovenian legislation. The purpose of the thesis is also to find out whether women are well informed about the interventions, procedures, medicaments in the intrapartum period and whether they are given a possibility to accept or refuse the intervention or procedure. Methods: A descriptive method was used. Literary sources were found with the help of key words in Slovenian: informirano soglasje, obporodno obdobje, kodeks etike za babice, pacientove pravice and English: informed consent, informed decision, intrapartum care. EBSCOhost web portal was used to search foreign and home bibliographic databases Medline, CINAHL, COBIB.SI and others. In the empirical part a quantitative research based on the causal-empirical method was carrid out. A questionnaire was used as a research instrument, made for this particular research basing it on literary sources. To collect and process the data statistically an open source application for online surveys 1KA was used. Results: The research results show women are not completely informed about all the procedures and are not given a possibility to co-decide on all the interventions. The lowest number was achieved in case of manual fundal pressure, anogenital care and vitamin K application with the newborn. The average percentage of women going through procedures in the intrapartum period without being informed about them was 29,0. The possibility of co-decision was the lowest with vaginal examination, episiotomy and manual fundal pressure. The average percentage of women unable to accept or refuse the procedure was 49,0. Discussion and conclusion: Informed consent is not practised enough in the intrapartum period, in spite of being stated by legislation with all the procedures. Due to this negative feelings related to childbirth are intensified and there is a lower rate of trust in the health system. Women expect to be completely informed and actively involved in decision-making, as it is stated in the Slovenian legislation.

• Keywords: diploma theses, midwifery, informed consent, decision-making, women's rights, code of ethics