Thesis (MCur)--Stellenbosch University, 2003 / ENGLISH ABSTRACT: It appears that registered midwives prefer not to cut episiotomies which results in an
increase in perineal tears. This may be the case as a result of current controversies
regarding episiotomies, lack of suturing skills due to insufficient training and
evaluation, or the fact that the necessity of an episiotomy are not recognised
timeously. In light of this the incidence of perineal trauma during deliveries in public
healthcare institutions in the Western Cape was evaluated from a nursing
perspective. The midwife can playa significant role in the prevention of unnecessary
perineal trauma by applying particular precautions in practice.
Triangulation was used as the research method. Seven public healthcare institutions
in the Western Cape were included in this study. Nurses completed 45
questionnaires while 33 deliveries and 25 cases of suturing of perineal wounds were
evaluated according to a pre-compiled checklist. Semi-structured interviews were
conducted with registered midwives and medical practitioners involved in the training
of nursing students.
According to findings it appears that nurses do not recognise the risk factors to be
contributory causes of perineal tears. Furthermore, it appeared that 46% of
registered midwives did not feel competent enough to suture perineal wounds.
Disparities were identified pertaining to the training of student nurses as well as the
continuous training and evaluation of registered midwives regarding the suturing of
perineal wounds.
It is recommended that a uniform policy should be formulated concerning guidelines
for the cut and suturing of episiotomies and lacerations. Furthermore, a uniform
classification system regarding perineal trauma should be formulated as well as a
uniform system to evaluate the competency of midwives. / AFRIKAANSE OPSOMMING: Dit blyk dat geregistreerde vroedvroue nie graag 'n episiotomie knip nie, met 'n
gevolglike toename in perineale skeure. Dit is moontlik as gevolg van die huidige
kontroversie betreffende episiotomies, óf hegtingsvaardighede wat nie voldoende is nie
te wyte aan gebrekkige opleiding en evaluering, óf die noodsaaklikheid van 'n
episiotomie word nie betyds ingesien nie. In die lig hiervan is die voorkoms van
perineale trauma tydens verlossings in openbare gesondheidsinstellings in die Wes-
Kaap vanuit 'n verpleegkundige perspektief geëvalueer. Die vroedvrou kan 'n
beduidende rol speel in die voorkoming van onnodige perineale trauma deur die
toepassing van sekere maatreëls in haar praktykvoering.
Triangulasie is as navorsingsmetode gebruik. Sewe openbare gesondheidsinstellings in
die Wes-Kaap is in hierdie studie ingesluit. Vyf-en-veertig vraelyste is deur
verpleegkundiges voltooi terwyl 33 bevallings en 25 hegtings van perineale wonde
volgens 'n voorafopgestelde kontrolelys geëvalueer is. Semi-gestruktureerde
onderhoude is gevoer met geregistreerde vroedvroue en geneeshere wat by die
opleiding van verpleegstudente betrokke is.
Volgens die bevindings blyk dit dat verpleegkundiges nie die risikofaktore as
aanleidende oorsake van perineale skeure herken nie. Hulle verkies ook om nie
episiotomies te knip nie en sal eerder 'n perineale skeur heg. Dit het verder geblyk dat
46% van die geregistreerde vroedvroue nie bevoeg gevoel het om perineale wonde te
heg nie.
Leemtes is geïdentifiseer ten opsigte van die opleiding van studentverpleegkundiges
asook voortgesette opleiding en evaluering van geregistreerde vroedvroue ten opsigte
van hegtingstegnieke.
Aanbevelings sluit in dat 'n eenvormige beleid geformuleer moet word ten opsigte van
die riglyne vir die knip en hegtings van episiotomies en skeure, 'n eenvorminge
klassifikasiesisteem van perineale trauma asook 'n stelsel van evaluering van
geregistreerde vroedvroue se bevoegdheid.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/53518 |
| Date | 04 1900 |
| Creators | Smit, Ilze |
| Contributors | Bester, E., Stellenbosch University. Faculty of Medicine Health Sciences . Dept. of Interdisciplinary Health Sciences. Nursing Science. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 228 p. : ill. |
| Rights | Stellenbosch University |
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