Abstract | Ciljevi: Primarni cilj ovog istraživanja bio je ispitati stav relevantnih pojedinaca: zdravstvenih djelatnika u KBC-u Split Klinici za ženske bolesti i porode - rodilišta, majki koje su rodile u KBC-u Split u rodilištu te volonterki, koje su educirane za savjetovanje o dojenju, kako zdravstvenih tako i nezdravstvenih djelatnika o uvođenju volonterskog rada u rad rodilišta. Specifični cilj bio je ispitati sadašnje stanje u splitskom rodilištu glede potpore dojenju rodiljama, kroz viđenje primalja/sestara u rodilištu i majki koje su rodile u KBC-u Split u rodilištu. Svjesni činjenice kako se može pojaviti otpor uvođenju promjena u radu u splitskom rodilištu dodatni cilj bio je istražiti moguće prepreke i načine rješavanja istih.
Postupci i ispitanici: Ovo kvalitativno istraživanje, provedeno je u Domu zdravlja Splitsko -dalmatinske županije u Patronažnoj djelatnosti u razdoblju od 24. studenoga 2014. do 31. ožujka 2015. godine. Ispitanice za istraživanje su se sastojale od tri fokus grupe: 1) primalje/medicinske sestre koje rade u splitskom rodilištu; 2) rodilje koje su rodile u splitskom rodilištu; 3) potencijalne volonterke/savjetnice za dojenje (zdravstveni i nezdravstveni djelatnici). Svaka fokus grupa je imala šest sudionica, osim grupe majke, pet, jedna majka je otkazala dolazak. Istraživači su unaprijed definirali ključna pitanja za razgovor te poticali sugovornike na raspravu o temi „volontersko savjetovanje o dojenju u rodilištu“. Sa svakom fokus grupom se pojedinačno proveo detaljan intervju u trajanju od 51 do 68 minuta. Razgovor se snimao (uz raniji pisani informirani pristanak), snimljeni materijal se zapisao te unosio, i analizirao pomoću NVivo programa za kvalitativna istraživanja.
Rezultati: Dobiveni stavovi sve tri fokus grupe sortirani su u četiri glavne teme: Volontiranje, Savjetovanje primalja o dojenju, Organizacija savjetovanja dojenja u rodilištu i Edukacija o dojenju. Za prvu temu stav sve tri fokus grupe o uvođenju volonterki u rad rodilišta je pozitivan, majkama je svejedno jesu li volonterke zdravstveni ili nezdravstveni djelatnici, primalje ističu da su im povoljniji zdravstveni djelatnici. Kao prepreku uvođenju volonterki u rad rodilišta primalje su navele rukovodioce bolnice i rodilišta. Vrijeme kada je potrebna pomoć volonterki kod savjetovanja, za primalje i majke je cijeli dan. Kroz temu Savjetovanje primalja o dojenju majke su iznosile svoja iskustva koja su negativna i nezadovoljavajuća glede pomoći s dojenjem. Primalje također nisu zadovoljne svojim savjetovanjem majki o dojenju zbog nedostatka vremena. O temi Edukacija o dojenju sve tri grupe su imale isti stav, da je edukacija o dojenju važna tijekom trudnoće, no nakon poroda primalje su imale stav da je tada kasno za edukaciju, a majke i volonterke su mišljenja da je tada vrlo važno, ako ne i najvažnije.
Zaključak: Za uvođenje volonterki savjetnica za dojenje u rad rodilišta potrebna je suglasnost rukovoditelja bolnice i rodilišta te dobra volja osoblja. Majke i primalje imaju pozitivan stav o volonterkama u rodilištu. Dosadašnje savjetovanje o dojenju u rodilištu je nedostatno što zbog nedostatka vremena i manjka osoblja. Za kvalitetan i dugoročan rad volonterki potrebno je imati dovoljan broj volontera. |
Abstract (english) | Objectives: The primary objective of this study was to examine the attitudes of relevant individuals: health care workers at the University Hospital of Split maternity ward, mothers who gave birth on the maternity ward, and volunteers, who are trained in breastfeeding counseling on the introduction of voluntary breastfeeding counselling at the maternity ward. The specific objective was to assess the present situation on the Split hospital maternity ward, related to the support of breastfeeding mothers, through the eyes of midwives / nurses and mothers who recently gave birth. Aware of the usuall resistance to changes, an additional aim was to investigate possible barriers to introducing volunteer breastfeeding counselling and ways of addressing them.
Methods and Participants: This qualitative research was carried out at the Health Department of the Split-Dalmatia County during the period from 24 November, 2014 to 31 March, 2015. The subjects for the study consisted of three focus groups: 1) midwives / nurses working at the Split University Hospital maternity ward; 2) women who recently gave birth at the maternity ward of the Split University Hospital; and 3) potential volunteer breastfeeding counsellors (health and non-health professionals). Each focus group had six participants, except for the group of mothers, with five, as one mother canceled participation. The researchers had pre-defined key issues for discussion and encouraged participants to discuss the topic of "voluntary counseling on breastfeeding in the hospital." The focus groups, lasting 51-68 minutes each. Conversations were recorded (with prior signed, informed consent), written down verbatim, entered and then analyzed using NVivo program for qualitative data research.
Results: The attitudes of all three focus groups were sorted into four main topics: Volunteering, midwife breastfeeding support, organization of volunteer breastfeeding counseling, and breastfeeding education. For the first topic, all three focus groups had a positive attitude toward the introduction of volunteer breastfeeding support on maternity wards. Mothers do not care whether they are volunteer health or non-health workers, but midwives pointed out that they prefer health care workers. As an obstacle to the introduction of volunteers to the maternity ward, midwifes mentioned hospital decision makers. For the topic midwife breastfeeding support, breastfeeding mothers expressed negative feelings and were unsatisfactory with the care received. Midwives were also not satisfied with their counseling of new mothers about breastfeeding due to lack of time. On the subject of the Organization of counseling in the hospital the time of day when help by counsellors is needed is all day according midwives and mothers. On the topic of breastfeeding education, all three groups had the same attitude that education about breastfeeding is important during pregnancy, but midwives had a view that after birth it is too late for education, whereas mothers, as well as volunteers, believed that the time after birth is very important, if not the most important for education.
Conclusion: For the introduction of volunteer breastfeeding counselling in the maternity ward the consent of the manager of the hospital and of the maternity ward are needed as well as good will among staff. Mothers and midwives have a positive attitude about potential volunteer breastfeeding counsellors. Opinions of both mothers and midwives are that current counseling on breastfeeding in the hospital is insufficient, due to lack of time and lack of staff. For a volunteer breastfeeding support service to be sustainable, it is crucial to have sufficient numbers of volunteers. |