Recovery after caesarean birth a qualitative study of womens accounts in Victoria, Australia 英文参考文献.docVIP

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Recovery after caesarean birth a qualitative study of womens accounts in Victoria, Australia 英文参考文献.doc

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Recovery after caesarean birth a qualitative study of womens accounts in Victoria, Australia 英文参考文献

Kealyetal.BMCPregnancyandChildbirth2010,10:47 /1471-2393/10/47 RESEARCH ARTICLE OpenAccess Recoveryaftercaesareanbirth:aqualitativestudy ofwomen’saccountsinVictoria,Australia MichelleAKealy1*,RhondaESmall1,PraneeLiamputtong2 Abstract Background:Thecaesareansectionrateisincreasingglobally,especiallyinhighincomecountries.Thereasonsfor thiscontinuetocreatewidedebate.Thereisgoodepidemiologicalevidenceonthematernalmorbidityassociated withcaesareansection.Fewstudieshaveusedwomen’spersonalaccountsoftheirexperiencesofrecoveryafter caesarean.Theaimofthispaperistodescribewomen’saccountsofrecoveryaftercaesareanbirth,fromshortly afterhospitaldischargetobetweenfivemonthsandsevenyearsaftersurgery. Method:WomenwhohadatleastonecaesareanbirthinatertiaryhospitalinVictoria,Australia,participatedinan interviewstudy.Womenwereselectedtoensurediversityinexperiences(typeofcaesarean,recency),caesarean andvaginalbirth,andmaternalrequestcaesareansection.Interviewswereaudiotapedandtranscribedverbatim.A theoreticalframeworkwasdeveloped(threeZonesofclinicalpractice)andthematicanalysisinformedthefindings. Results:Thirty-twowomenwereinterviewedwhobetweenthemhad68births;sevenwomenhadexperienced bothcaesareanandvaginalbirths.Threezonesofclinicalpracticewereidentifiedinwomen’sdescriptionsofthe reasonsfortheirfirstcaesareans.Twelvewomendescribedhow,atthetimeoftheirfirstcaesareansection,the operationwasperformedforpotentiallylife-savingreasons(CentralZone),11describedsituationsofclinical uncertainty(GreyZone),andninestatedtheyactivelysoughtsurgicalintervention(PeripheralZone). Thirtyofthe32womendescribeddifficultiesfollowingthepostoperativeadvicetheyreceivedpriortohospitaldis- chargeandtheirphysicalrecoveryaftercaesareanwashinderedbyarangeofhealthissues,includingpainand reducedmobility,abdominalwoundproblems,infection,vaginalbleedingandurinaryincontinence.Thesepro- blemswereexperiencedacrossthethreezonesofclinicalpractice,regardlessofthereasonswomengavefortheir caesarean. Conclusion:Thewomeninthisst