تبیین درک و تجربه متخصصین زنان و ماماها از معاینه بکارت و پیامدهای آن: یک مطالعه کیفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی لارستان، فارس، ایران

3 استاد گروه ، مرکز تحقیقات اندوکرینولوژی تولید مثل، پژوهشکده علوم غدد درون ریز و متابولیسم، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: معاینه بکارت در برخی کشورها از جمله ایران به صورت سنتی و عرفی شناخته شده است. اهداف اصلی برای انجام این معاینه در فرهنگ های گوناگون شامل ارزیابی خویشتن داری، تأخیر در ایجاد رابطه جنسی تا زمان ازدواج، پیشگیری از ایدز و سایر بیماری های مقاربتی و حفظ شرافت خانوادگی با دفاع از بکارت دختران می باشد. به علت وجود دیدگاه‌های متفاوت در رابطه با معاینه بکارت و اقدام به عمل جراحی برای ترمیم آن از جانب گروه پزشکی و ارائه‎دهندگان خدمات بهداشت باروری، بازنگری در نقش و وظایف آنان ضروری به نظر می رسد. مطالعه کیفی حاضر با هدف تبیین درک و تجربه متخصصین زنان و ماماها از معاینه بکارت و پیامدهای آن انجام شد.
روش کار: این مطالعه کیفی با روش تحلیل محتوا انجام شد. مشارکت‌کنندگان در این مطالعه 15 نفر، شامل 7 متخصص زنان و 8 مامای واجد شرایط پژوهش بودند که در ابتدا با روش هدفمند و سپس با روش گلوله برفی انتخاب و مورد مصاحبه عمیق فردی قرار گرفتند. جهت جمع آوری داده ها از راهنمای سؤال اولیه استفاده شد. تمام مصاحبه‌ها ضبط و تایپ شد و با روش تحلیل محتوای قراردادی آنالیز شدند.
یافته ها: تحلیل داده‌های کیفی منجر به ظهور سه طبقه "ماهیت معاینه"، "الزامات معاینه" و "پیشگیری از پیامدهای منفی معاینه" بود که در طبقه "ماهیت معاینه" سه زیر طبقه: "علل معاینه بکارت"، "ارزش تشخیصی معاینه" و "پیامد معاینه"، در طبقه "الزامات معاینه" زیر طبقات: "لزوم برنامه‌ریزی برای نظارت بر انجام معاینه و پیامدهای حاصل از نتایج منفی"، "آموزش، حمایت و امنیت سیستم پزشکی و مامایی" و "اخلاق و حقوق بهداشت باروری" بود و در طبقه سوم یعنی "پیشگیری از پیامدهای منفی معاینه" دو زیر طبقه: "راهکارهای توانمندسازی جامعه" و "راهکارهای پیشگیری از پیامدهای ناشی از اعلام نتیجه" جای گرفتند.
نتیجه‌گیری: معاینه بکارت مرتبط با مداخلات پزشکی مانند پیشگیری، درمان و بازتوانی نیست. این معاینه نمی تواند عدم وجود رابطه جنسی را اثبات کرده و دارای پیامدهای نامطلوب است، چنین ارتقاء سیستم بهداشتی در رابطه با کیفیت انجام این معاینه و توانمندسازی جامعه مبتنی بر آموزش، دو رویکرد اساسی برای حفظ حقوق بهداشت باروری می باشند.

کلیدواژه‌ها

عنوان مقاله [English]

Explaining the experiences and perceptions of gynecologists and midwives about virginity examination and it’s outcomes: A qualitative Study

نویسندگان [English]

  • Masoumeh Simbar 1
  • Fatemeh Rahmanian 2
  • Fahimeh Ramezani Tehrani 3
1 Associate professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Larestan Azad Islamic University, Fars, Iran.
3 Professor, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences and Metabolism, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Introduction: Virginity examination is known as a custom and norm in some countries including Iran. The main aims for virginity examination in different cultures are including assessment of abstinence, delay for sexual relationship until marriage, prevention of AIDS and other sexually transmitted diseases, and keeping honor of family by defending of girls’ virginity. Because of different views in relation to virginity examination and surgery procedures to repair it by medical team and reproductive health service providers, reviewing their role and tasks seems to be necessary. This qualitative study was performed with aim to explain the gynecologists’ and midwives’ perceptions and experiences towards virginity examination and its outcomes.
Methods: This qualitative study was performed using content analysis approach. Fifteen participants including 7 gynecologists and 8 midwives were qualified for the study that were selected at first by purposeful sampling method and then by snowball sampling method. They were interviewed by in-depth individual interview. Primary question guide was used to collect data. All interviews were recorded and typed and were analyzed by content analysis approach.
Results: The analysis of qualitative data led to the presentation of 3 categories "examination’s identity", "examination’s requirements", and "prevention of negative outcomes of examination". The category of “examination identity” had three sub-categories including “the reasons for virginity examination”, “prognostic value of the examination”, and “the outcomes of examination”. The category of “examination’s requirement” had the sub-categories of “the necessity for planning and monitoring of the examination process and the consequences of negative results”, “training, support and safety of medical and midwifery system”, and “reproductive health rights and ethics”. In third category of “prevention of negative outcomes of examination”, there were two subgroups of “the strategies for community empowerment” and “the strategies for prevention from the outcomes of the negative results”.
Conclusion: The virginity examination is not related to medical intervention such as prevention, treatment or rehabilitation. It cannot prove the lack of sexual activity and has undesired consequences. Health system promotion in relation to the quality of this examination and education-based community empowerment are two basic approaches to maintain the reproductive health rights.

کلیدواژه‌ها [English]

  • Gynecologists and midwives
  • Reproductive health
  • Virginity

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مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 173 - شماره پیاپی 173
هفته سوم آذر ماه 1394
آذر 1394
صفحه 1-22

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