Upoštevanje smernic Svetovne zdravstvene organizacije iz 2018 pri porodu v 14-ih slovenskih porodnišnicah : diplomsko delo

Koblar Tutič, Aja (author), Mivšek, Ana Polona (mentor), Jug Došler, Anita (comentor), Prelec, Anita (reviewer)

Uvod: Posodobljene smernice Svetovne zdravstvene organizacije iz leta 2018 združujejo nova in že prej obstoječa priporočila, ki skupaj zagotavljajo z dokazi podprto in kakovostno obporodno obravnavo, ne glede na okolje ali raven zdravstvene obravnave. Priporočila so predstavljena glede na kontekst obravnave, na katerega se nanašajo, in sicer na predporodno obravnavo in obravnavo med porodom, obravnavo v 1. porodni dobi, obravnavo v 2. porodni dobi, obravnavo v 3. porodni dobi ter neposredno obravnavo novorojenčka in ženske po porodu. Termin zdrava nosečnica je v smernicah opredeljen za noseče ženske in mladostnice brez pridruženih bolezni in brez potrjenih dejavnikov tveganja zase ali za plod. Namen: Namen diplomskega dela je ugotoviti skladnost obporodne prakse v Sloveniji glede na aktualne usmeritve Svetovne zdravstvene organizacije, in sicer v 1. porodni dobi, 2. porodni dobi in 3. porodni dobi. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela, na osnovi katere smo izvedli empirično raziskavo. Empirični del je bil zasnovan na delno strukturiranem intervjuju, ki je bil izveden v 14 slovenskih porodnišnicah. Vzorec je predstavljal 14 diplomiranih babic, zaposlenih v vseh 14 slovenskih porodnišnicah, ki so na vprašanja intervjuja odgovarjale glede na uveljavljeno prakso inštitucije. Intervjuji so bili snemani, kasneje pa se je izvedla transkripcija intervjujev, ki je bila analizirana na podlagi tematske in vsebinske analize s kategorizacijo. Rezultati: Rezultati so bili analizirani na osnovi delno strukturiranega intervjuja. Skupno smo v 1., 2. in 3. porodni dobi preučevali 24 spremenljivk. Ugotovili smo, da je bilo skupno gledano 7 spremenljivk od 24 skladnih s smernicami Svetovne zdravstvene organizacije, 11 spremenljivk od 24 delno skladnih in 6 spremenljivk od 24 neskladnih s smernicami. Razprava in zaključek: Zaključimo lahko, da je obporodna praksa slovenskih porodnišnic v 1. porodni dobi, 2. porodni dobi in 3. porodni dobi v najvišjem deležu (45,8 %) delno skladna s smernicami Svetovne zdravstvene organizacije. Medtem ko nekatere porodnišnice smernicam sledijo skoraj v celoti, smo pri nekaterih porodnišnicah zaznali še precej možnosti za izboljšavo.

• Language: Slovenian
• Keywords: diplomska dela, babištvo, porodne dobe, smernice Svetovne zdravstvene organizacije, na dokazih temelječa babiška obravnava
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Koblar Tutič]
• Year: 2024
• Number of pages: 68 str., [3] str. pril.
• PID: 20.500.12556/RUL-164016
• UDC: 618.2/.7
• COBISS.SI-ID: 211790595
• Publication date in RUL: 16.10.2024

Secondary language

• Language: English
• Title: Adherence to the 2018 World Health Organization guidelines for childbirth in 14 Slovenian maternity hospitals : diploma work

Abstract

Introduction: The updated World Health Organization guidelines from 2018 bring together new and pre-existing recommendations, which provide evidence-based and quality-assured perinatal care regardless of setting or level of care. The recommendations are presented according to the context of care to which they apply, namely antenatal care and care during labour, care in the 1st stage of labour, care in the 2nd stage of labour, care in the 3rd stage of labour, and direct care of the newborn and the woman after delivery. The term healthy pregnant woman is defined in the guidelines as pregnant women and adolescent girls free of associated diseases and without confirmed risk factors for themselves or the baby. Purpose: The aim of the thesis is to determine the compliance of perinatal practice in Slovenia with the current World Health Organization guidelines, namely in the 1st stage of labour, the 2nd stage of labour and the 3rd stage of labour. Methods: The empirical part was based on semi-structured interviews conducted in 14 Slovenian maternity hospitals. The sample consisted of 14 certified midwives employed in all 14 Slovenian maternity hospitals, who answered the interview questions according to the established practice of the institution. The interviews were recorded and later transcribed for thematic and content analysis with categorisation. Results: The results were analysed on the basis of a semi-structured interview. A total of 24 variables were studied in the 1st, 2nd and 3rd stage of labour. We found that when viewed together, 7 variables out of 24 were compliant with the World Health Organization guidelines, 11 variables out of 24 were partially compliant and 6 variables out of 24 were non-compliant with the guidelines. Discussion and conclusion: We can conclude that the delivery practices of Slovenian maternity hospitals in the 1st stage of labour, the 2nd stage of labour and the 3rd stage of labour in the highest proportion (45.8%) are partially compliant with the World Health Organization guidelines. While some maternity hospitals follow the guidelines almost completely, we still perceived a lot of room for improvement in some maternity hospitals.

• Keywords: diploma theses, midwifery, stages of labour, World Health Organization guidelines, evidence based midwifery practice