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Uvod: Motnja v duševnem razvoju se kaže kot bistven primanjkljaj v intelektualnih funkcijah, kot tudi v zmanjšani možnosti prilagajanja, ki na dnevni ravni vključuje socialne in praktične sposobnosti. Spolnost oseb z motnjo v duševnem razvoju je od nekdaj predstavljala tabu. Njihove pravice v zvezi s seksualnostjo so bile kršene. Tuje raziskave so pokazale zaskrbljenost babic zaradi pomanjkljivega znanja na področju poučevanja in obsežnega prilagajanja informacij, ki jih podajajo tem ljudem glede varnih spolnih odnosov in drugih podatkov povezanih z nosečnostjo, porodom in poporodnim obdobjem. Namen: Namen diplomskega dela je raziskati in preučiti, kako poteka nosečnost, kakšni so perinatalni izidi ter preživljanje poporodnega obdobja pri ženskah z motnjo v duševnem razvoju. Želimo pridobiti mnenja babic o lastni usposobljenosti za delo z ženskami z motnjo v duševnem razvoju ter pridobiti podatke, s katerimi izzivi se srečujejo tekom izvajanje babiške obravnave. Metode dela: V prvem delu diplomskega dela je uporabljena deskriptivna metoda dela. Uporabljeno literaturo smo pridobili preko podatkovnih baz COBISS, Medline, PubMed, ScienceDirect in Wiley Online Library. V drugem delu diplomskega dela je bila uporabljena kvalitativna metodologija polstrukturiranih intervjujev s petimi slovenskimi babicami, ki so zaposlene v Univerzitetnem kliničnem centru Maribor. Dovoljenje za izvajanje študije smo pridobili s strani Strokovne službe zdravstvene nege Univerzitetnega kliničnega centra Maribor. Izbrali smo pet babic, ki imajo vsaj tri leta delovnih izkušenj v porodnišnici. Posnetkom intervjujev je sledila transkripcija, ki je bila osnova za pridobitev kategorij in kod. Rezultati: Babice svojo vlogo vidijo kot podporo ženski med porodom, sebe vidijo kot pristojne za vodstvo in usmerjanje ženske z motnjo v duševnem razvoju skozi proces poroda. V obravnavo take ženske vključujejo patronažno službo, Center za socialno delo, psihologa, psihiatra in svojce. Največji izziv pri obravnavi take ženske jim predstavlja komunikacija. Način komunikacije babice prilagodijo glede na stopnjo motnje v duševnem razvoju. Babice si želijo pridobiti več znanja na tem področju. Večina se jih ne počuti dovolj kompetentno za izvajanje ustrezne oskrbe ženske z motnjo v duševnem razvoju. Glede ustvarjanja družine med temi osebami so mnenja, da je ta odločitev odvisna od stopnje motnje v duševnem razvoju matere in podpore partnerja. Razprava in zaključek: V Sloveniji praktično ni raziskav, ki bi opisovale to problematiko. Raziskovanje tega področja bo doprineslo h kvalitetnejši oskrbi žensk z motnjo v duševnem razvoju. Introduction: Intellectual disability is chategorized by a significant deficit in intellectual functions and adaptive ability, which affects also many everyday social and practical skills. The sexsuality of the intellectualy disabled has always been a taboo and intelectually disabled persons’ sexsual rights have often been violated in the past. Recent research has brought to attention the concerns of many midwives about the lack of their pedagogical knowledge in working with intelectually disabled mothers and the need for an extensive adaptation of information they have at their disposal, to pass on to intellectually disabled women about safe sex, pregnancy, childbirth and pospartum period. Purpose: The purpose of this thesis is to research and study the course of pregnancy, prenatal outcomes and postpartum period of women with intellectual disability. We then also wish to collect the opinions of midwives about their own ability to work with intellectually disabled women and about the challenges they face during the implementation of midwifery care in the same case. Methods: The first part of the research was theoretical where we reviewed the literature on the topic of the pregnacy, labour and postpartum period of intelectually disabled women. The literature used for the purpose of this research was obtaind through the databases COBISS, Medline, PubMed, ScienceDirect and Wiley Online Library. The second part was conducted in a form of a qualitative study, where semi-structured interviews were used as a method of research. Participants were five Slovenian midwives employed in University Clinical Centre Maribor. Results: Results of our study have shown that midwives in Slovenia view their role as supporting intelectually disabled women in childbirth, being responsible for leading and guiding them through the whole birthing process. They aslo feel that the whole treatment process of intelectually disabled mothers should include the patronage service, social workers (Social work centres), a psychologist, a psychiatrist and relatives of the mother. The biggest challenge midwives perceive having in dealing with intelectually disabled women is communication. They try to adjust their communication according to the degree of intellectual disability of the mother. Slovenian midwives also report the wish to gain more education and training in the aria of woriking with intellectually disabled women, since most of them feel they lack experience and specific knowledge. Lastly, midwives then also feel that family planing of persons with intelectuall disability should be done according to the degree of their intellectual impairment. Discussion and Conclusion: Research on the topic of midwives’ support of intellectually disabled mothers in Slovenia is sparse, so further study in this area should help to develop better methods and procedures of how to efficiently teach intelectually disabled mothers about pregancy and family care. This would also support Slovenian midwives in their efforts of offering t quality midwifery care for women with intellectual disabilities. |
