“Improving postnatal maternity care following severe perineal trauma by evaluating end-user's experiences of a pilot trial exploring laxative management; A qualitative study”

Abstract

Background

Trauma to the anal sphincter following vaginal birth increases the risk of anal incontinence. Laxative management in the postnatal period is recommended to improve defecation and reduce the risk of wound breakdown. Research underpinning management guidelines is lacking and omits end-users (clinicians and birthing women) involvement in evaluating pilot studies. Incorporating end-users' enhances the relevance of the research to those being investigated, improves the design, and translation of findings into clinical practice. No studies have evaluated end-users' experiences in research which investigates laxative management following anal sphincter injury.

Aim

This study identifies the barriers and facilitators in a pilot study research design and suggests improvements to inform larger scale research to improve clinical practice.

Methods

A phenomenological qualitative study using semi-structured interviews was adopted. Purposeful sampling of health professionals (n = 85) involved in the direct care of women following OASIs and women (n = 64) sustaining OASIs during the recent pilot trial. Data analysis employing thematic analysis.

Findings

The consensus from interviews (n = 23) highlighted the research was feasible with suggested improvements to enhance future recruitment, information for linguistically diverse women and review of quality-of-life tools. The evaluation process enhanced future research engagement.

Conclusions

The reliability and validity of future research can be improved adopting a qualitative framework and end-users' to evaluate pilot studies. Findings from this pilot study identified issues including recruitment, CALD participant information and accuracy of QoL data collection tools that needed to be addressed enhancing future findings that are relevant to the needs of the study population and enhance translation into practice.