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Uvod: Čas, ki ga otročnica in novorojenec po vaginalnem porodu preživita v porodnišnici, se je skrajšal. Zgodnji odpust postaja del ustaljene prakse tudi v Sloveniji, ključnega pomena za varnost zgodnjega odpusta pa je kakovostna poporodna obravnava na domu. Namen: Je raziskati poporodno obravnavo po zgodnjem odpustu iz porodnišnice. Raziskovali smo med izvajalci patronažne zdravstvene dejavnosti v Sloveniji. Glede na to, da je preživljanje zgodnjega poporodnega obdobja prestavljeno v domače okolje, želimo z raziskavo ugotoviti, kako je temu prilagojen trenutni sistem poporodne obravnave. Metode dela: V prvem delu diplomskega dela je bila uporabljena deskriptivna metoda dela s pregledom znanstvene literature. Zbiranje literature je potekalo v spletnih podatkovnih bazah: ScienceDirect, PubMed in Cochrane Library. Nabor člankov za natančno analizo je bil izbran po metodologiji PRISMA. V drugem delu raziskave smo uporabili deskriptivno kavzalno ne-eksperimentalno metodo empiričnega raziskovanja. Podatki so bili zbrani s pomočjo strukturiranega anketnega vprašalnika. Za izvedbo raziskave smo izbrali neslučajnostni namenski vzorec, v katerega so bili vključeni vsi izvajalci patronažnega varstva v Sloveniji. Rezultati: Rezultati raziskave so pokazali deljena mnenja patronažnih medicinskih sester glede časovne opredelitve zgodnjega odpusta iz porodnišnice po vaginalnem porodu. Menijo, da zgodnji odpust ni niti varen in niti nevaren za otročnico in novorojenca. Skoraj polovica anketiranih ni obveščenih o odpustu otročnice in novorojenca s strani porodnišnice in bi se jim v večini to zdelo pomembno. Po zgodnjem odpustu iz porodnišnice se najpogosteje srečujejo s težavami s pristavljanjem, najmanj pa z obravnavo poporodnih duševnih motenj. Večina anketiranih se popolnoma strinja, da je zgodnji odpust iz porodnišnice razlog, da novonastala družina potrebuje več podpore s strani patronažne medicinske sestre ter da bi morala biti poporodna obravnava po zgodnjem odpustu bolj individualno prilagojena posamezni družini. Razprava in zaključek: Patronažne medicinske sestre se po zgodnjem odpustu srečujejo s kompleksnejšo obravnavo, kjer je izpostavljena predvsem večja potreba po pomoči pri pristavljanju in dojenju. Duševnemu zdravju žensk v poporodnem obdobju se ne namenja dovolj pozornosti, Edinburški vprašalnik za odkrivanje poporodne depresije pogosto ni vključen v obravnavo. Po zgodnjem odpustu je potrebna kontinuirana in individualno prilagojena obravnava s strani patronažne medicinske sestre, ki pa je mogoča le z ustreznim in pravočasnim obveščanjem s strani porodnišnice. Introduction: The time that mother and her newborn child spent in a hospital after a vaginal labour has been reduced. Early discharge has become a rather common practice also in Slovenia, and the safety of an early discharge depends on the quality of the postnatal care at home. Purpose: The purpose of this thesis is to research the postnatal care after an early discharge from the hospital. A research amongst the postnatal care providers in Slovenia was carried out. The goal was to find out how the system of the postnatal care is adjusted to an early discharge from the hospital after the vaginal birth. Methods: A descriptive method of research was used in the first part of this thesis where the theoretical background was presented to the reader. The literature search was carried out via ScienceDirect, PubMed and Cochrane Library online resources and databases. Articles were selected with the PRISMA methodology for the purpose of the detailed analysis. In the second part of this thesis, a descriptive, casual non-experimental empirical research method was used. The results were collected by means of an online survey and all providers of the postnatal care in Slovenia were included in the research. Results: The results have pointed out divergent opinions about the time window of an early discharge from the hospital after a vaginal birth. Postnatal care providers believe that early discharge is neither safe nor unsafe for a healthy woman and her newborn. Almost half of the participants are not informed about the discharge of the woman and her newborn from the hospital, and they think communication with the hospital plays an important role. The most common issue they face after an early discharge is lactation and breastfeeding. The treatment of postnatal mental disorders has been selected for the least common by most participants. Moreover, many of them do not use the Edinburgh postnatal depression scale on a regular basis. The majority agrees that families after an early discharge from the hospital need more support from the postnatal care providers and would need of a more individual care. Discussion and conclusion: After an early discharge from the hospital postnatal care providers in Slovenia are facing the need for a more complex treatment, where they commonly point out breastfeeding. Postnatal mental health is also a very important part of the postnatal care for women, but frequently neglected. Many of them do not use the Edinburgh postnatal depression scale on a regular basis. After an early discharge, there is a need for a continuous and an individual postnatal care possible only with up-to-date informing about the discharge from the hospital. |
