Publication: Doğum sonu hemşirelik bakımının değerlendirilmesinde ölçek geliştirilmesi ve uygulanan bakım yönteminin (Pathway) etkilerinin belirlenmesi
Abstract
Araştırma, doğum sonu ( DS ) bakım yöntemi ( pathway ) ile verilen hemşirelik bakımını değerlendirmek ve bu bakım yönteminin, DS 8 haftalık dönemde annelerin kendi ve bebek bakımıyla ilgili fonksiyonel durumlarına olan etkilerini belirlemek amacıyla deneysel olarak planlanmıştır. Araştırmanın örneklemini; SB Zeynep kamil Doğum ve çocuk Hastanesinin II. kat DS servisinde yatan, normal doğum yapmış toplam 100 primipar anne oluşturmuştur. Ekim- Kasım 1997 de kontrol grubu ( 50 ), Şubat- Mart 1998 tarihleri arasında deney grubunu ( 50 ) oluşturan vakalar alınmıştır. Çalışmamızda; deney grubundaki annelere, araştırmacı tarafından oluşturulan ve hemşirelerin uyguladığı DS bakım yöntemi ( pathway) ile bakım verilmiş, kontrol grubundaki annelere hastanedeki mevcut şartlar dışında birşey yapılmamıştır. İki gruba verilen bakımın değerlendirilmesinde; araştırmacı tarafından geliştirilen DS Hemşirelik Bakımını Değerlendirme Ölçeği ( DSHBDÖ ) kullanılmış ve annelere taburcu olmadan önce diğer formlarla birlikte uygulanmıştır. DS 8 haftalık döneme ait veriler telefon görüşmeleriyle anket formu doldurularak alınmıştır. Verilerin analizinde; yüzdelik, ki- kare, tek ve çift yönlü varyans analizi, t- testi, pearson korelasyon testi ve kruskal Wallis testi kullanılmıştır. Araştırmada, deney ve kontrol grubundaki annelerin demografik ve gebelikle ilgili değişkenleri arasında benzer özellikler saptanmıştır. DS hemşirelik bakımını, hizmeti alan anneler ve bakımı veren hemşireler açısından iki yönlü değerlendirebilmeyi sağlamak amacıyla geliştirilen DSHBDÖ nin geçerlilik, güvenilirlik çalışmasında; hemşirelerle ilgili cronbach alpha = . 96, annelerle ilgili cronbach alpha = . 88 olarak bulunmuştur. Deney ve kontrol grubundaki annelerin; DSHBDÖ toplam ve bakım, eğitim alt boyutları arasında, annelerin DS serviste aldıkları hemşirelik bakımı, eğitimi ve hemşirelerin davranışlarına yönelik düşüncelerinin tümünde ve DS aldıkları hemşirelik bakımına ve memnuniyetlerine verdikleri puanlarda gruplar arasında deney grubu lehine ileri düzeyde anlamlı fark olduğu belirlenmiştir ( p < 0.0001 ). DS 8 haftalık dönemde, annelerin kendi ve bebek bakımıyla ilgili hemşirelerden ya da broşürden aldıkları bilgileri kullanma, epizyotomi ile ilgili sorun yaşama, kontraseptif kullanma ve DS kontrole gitme gibi davranışlarda ve annelerin bebekleriyle ilgili olarak; bebek bakımında sorun yaşama, aşılar ve sağlam çocuk kontrollerine başlatma gibi konularda her iki grup arasında anlamlı farklılıklar saptanmıştır ( p < 0.01, p < 0.05 ). Elde edilen sonuçlar doğrultusunda; DS standart bir bakım planının ve özellikle DS eğitimin önemi vurgulanmış ve geliştirilen DSHBDÖ nin klinik alandaki DS bakımı değerlendirmede güvenilir bir araç olduğu önerilmiştir. hemşirelik bakımı, Doğum Sonu Hemşirelik Bakımını Değerlendirme Ölçeği( DSHBDÖ), DS bakım yöntemi (pathway ), DS 8 haftalık dönem. THE DEVELOPMENT OF THE TOOL İN THE EVALUATİON OF POSTPARTUM NURSİNG CARE AND DETERMİNATİON OF THE EFFECTS TO THE APPLİED CARE METHOD ( PATHWAY )
The research has been experimentaly planned to evaluate nursing care given with potpartum care method ( pathway ) and the effects of this method, during the postpartum 8 week period, on mother's functional status in respect to themselves and their babies care. The sampling of the research was 100 primiparas mother, who had normal births and were staying in the postpartum unit on the second floor at the Zeynep Kamil Maternity and children's State Hospital 50 mother in the control group studied during October and November 1997 and 50 mother in the experimental group studied during February and March 1998. İn the study, the experimental group of mothers were taken care of according to the norms of the postpartum care method, which was prepared by the researcher and which nurses were responsible for rendering. The control group, however received nothing more than the usual care. The Postpartum Nursing Care Evaluation Tool (PPNCET) developed by the researcher was used for the evaluation of the care received by the both groups, and together with other forms, were applied on mothers before being discharged. The data optained at the and of the postpartum 8 week period were based on a questionnaire filled out on the telephone. İn data analyses, percentage, q square, t- test, single and double direction variance analysis, pearson corelation test, kruskal walls test methods were used. İn the research, it was determined that there were common characteristics between mother's demographic and maternal variations in both groups. The Postpartum Nursing Care Evaluation Tool was designed to make a-two-side evaluation of the postpartum nursing care from the point of the mothers receiving the care and the nurses giving it. The validity and reliability of the tool revealed the fact that the cronbach alpha for nurses was . 96 and it was . 88 for mothers. The total PPNCET score, care and education subdimensional points scores, nursing care, education given by nurses and satisfaction regarding to these were significantly different between two groups in favour of the experimental group ( p < 0.0001 ). During the 8 week postpartum period other significant differences ( p < 0.01, p < 0.05). were determined between the two group concerning; · the way mothers made use of the instructions in the brochures or those given by the nurses on how to the care for themselves and their babies, · their problems about episiotomy and their use of contraseptives, adherence to their rutin postpartum control appointments, · the problems they face with regard to the care of their babies, · matters like vaccinations and commencement of health child-check. Considering all the facts overall, the importance of a standard postpartum care plan, and especially a education has been emphasized, and it is concluded that the tool developed during the process is an effective method of evaluating a postpartum care clinically. Key words: postpartum nursing care, Postpartum Nursing Care Evaluation Tool (PPNCET), postpartum care method ( pathway), postpartum 8 week period.
The research has been experimentaly planned to evaluate nursing care given with potpartum care method ( pathway ) and the effects of this method, during the postpartum 8 week period, on mother's functional status in respect to themselves and their babies care. The sampling of the research was 100 primiparas mother, who had normal births and were staying in the postpartum unit on the second floor at the Zeynep Kamil Maternity and children's State Hospital 50 mother in the control group studied during October and November 1997 and 50 mother in the experimental group studied during February and March 1998. İn the study, the experimental group of mothers were taken care of according to the norms of the postpartum care method, which was prepared by the researcher and which nurses were responsible for rendering. The control group, however received nothing more than the usual care. The Postpartum Nursing Care Evaluation Tool (PPNCET) developed by the researcher was used for the evaluation of the care received by the both groups, and together with other forms, were applied on mothers before being discharged. The data optained at the and of the postpartum 8 week period were based on a questionnaire filled out on the telephone. İn data analyses, percentage, q square, t- test, single and double direction variance analysis, pearson corelation test, kruskal walls test methods were used. İn the research, it was determined that there were common characteristics between mother's demographic and maternal variations in both groups. The Postpartum Nursing Care Evaluation Tool was designed to make a-two-side evaluation of the postpartum nursing care from the point of the mothers receiving the care and the nurses giving it. The validity and reliability of the tool revealed the fact that the cronbach alpha for nurses was . 96 and it was . 88 for mothers. The total PPNCET score, care and education subdimensional points scores, nursing care, education given by nurses and satisfaction regarding to these were significantly different between two groups in favour of the experimental group ( p < 0.0001 ). During the 8 week postpartum period other significant differences ( p < 0.01, p < 0.05). were determined between the two group concerning; · the way mothers made use of the instructions in the brochures or those given by the nurses on how to the care for themselves and their babies, · their problems about episiotomy and their use of contraseptives, adherence to their rutin postpartum control appointments, · the problems they face with regard to the care of their babies, · matters like vaccinations and commencement of health child-check. Considering all the facts overall, the importance of a standard postpartum care plan, and especially a education has been emphasized, and it is concluded that the tool developed during the process is an effective method of evaluating a postpartum care clinically. Key words: postpartum nursing care, Postpartum Nursing Care Evaluation Tool (PPNCET), postpartum care method ( pathway), postpartum 8 week period.