Te Manaaki Kaiwhakawhanau i roto i ngā Take Whakararuraru Tarukino
Pendahuluan
He raruraru hauora uaua te waranga tarukino (te whakamahi kino i ngā matū) i roto i ngā wāhine o te tau whānautanga nā te mea he pānga tika ki te hauora tinana, hinengaro, pāpori, me te hauora whānau. I roto i te horopaki o te whānautanga, he āwangawanga nui te waranga tarukino nā te mea ka pā ki ngā kōtiro taiohi, ngā wahine e hiahia ana ki te whānau, ngā wāhine hapu, ngā wāhine e whānau ana, ngā wāhine whai muri i te whānautanga, me ngā whaea whāngai u. I roto i ēnei take, ehara i te mea ko ngā āhuatanga whānau anake te arotahi o te tiaki kaiwhakawhanau engari me whai huarahi whānui tae atu ki te kitenga wawe, te mātauranga, te tautoko hinengaro, ngā tuku, me te mahi tahi a ngā tohunga ngaio. Ka matapakihia e tēnei tuhinga ngā mātāpono, ngā mahi, me te whānuitanga o te tiaki kaiwhakawhanau i roto i ngā take waranga tarukino, me te aro nui ki te haumaru o te whaea me te pēpi me te whakaoranga mō te wā roa.
Te Ariā o te Waranga Tarukino me tōna Pānga ki te Whānau Whakawhanau
Ko te waranga ki ngā raau taero he āhuatanga o te whakamahinga tonu o ngā matū e arahi ana ki te whakawhirinakitanga tinana me te hinengaro, ā, he uaua ki te whakamutu ahakoa ngā hua kino. Ko ngā matū e whakamahia kinotia ana ko ngā opioids, ngā amphetamines, te mariuana, ngā benzodiazepines, te waipiro, me ngā rongoā kua tohua e te tākuta e whakamahia ana i te kore e tika. I roto i ngā wāhine, ka taea e te waranga te whakararu i ngā huringa paheketanga me te momonatanga, te whakanui ake i te mōrearea o ngā mate pāwera i runga i te moepuku nā te whanonga morearea, ā, ka arahi ki te korenga o ngā kai.
I te wā e hapu ana, ka taea e te whakamahinga ture kore, te whakamahi kino rānei i ngā raau taero kua tohua te whakanui ake i te mōrearea o te whakatahe, te aukati i te tipu o roto i te kōpū (IUGR), te whānautanga wawe, te pakaru o te whenua, te preeclampsia, me te mate perinatal. Kei te mōrearea hoki ngā pēpi ki te mate kore kai pēpi hou (NAS), e tohuhia ana e te nui o te manukanuka, te wiri, te raruraru moe, te ruaki, te korere, me te hopuhopu. Ko tētahi atu pānga nui ko te iti o te urunga atu ki te hauora nā te whakama, te wehi, ngā āhuatanga pāpori uaua rānei. Nō reira, he mahi rautaki tā ngā kaiwhakawhanau ki te hono i te āputa i waenga i ngā ratonga haumaru, kore whakahāwea, me te aro ki te whakaora.
Ngā Mātāpono Taketake o te Manaaki Kaiwhakawhanau i roto i ngā Take Waranga
I te rongoā i ngā tūroro e waranga ana ki ngā raau taero, me whai ngā kaiwhakawhanau i ngā mātāpono e whai ake nei:
1. Huarahi kore whakahāwea, me te aroha: Te karo i te whakama me te whakapae i ngā tūroro kia tuwhera ai ngā tūroro ki te whakapuaki i ō rātou hītori whakamahi matū.
2. Te noho muna me ngā tikanga matatika: Me pupuri ngā mōhiohio tūroro i runga anō i te tikanga matatika, ki te kore he tūponotanga haumaru e hiahiatia ana kia ripoatatia i runga anō i ngā ture ā-rohe.
3. Te haumaru o te whaea me te pēpi hei kaupapa matua: Aroturukihia ngā tohu mōrearea o te whānautanga me te mōrearea o ngā raruraru e pā ana ki ngā matū.
4. Te haere tonu o te tiaki: Te aroturukitanga mai i mua i te haputanga, i mua i te whānautanga, i roto i te whānautanga, i muri i te whānautanga tae noa ki te whakamahere whānau.
5. Te mahi tahi a ngā umanga: Te whai wāhi mai o ngā tākuta whānau, ngā tākuta hinengaro, ngā tākuta hinengaro, ngā kaimahi hapori, ngā kaiwhakatakoto whakaaro mō te waranga, me ngā ratonga whakaora.
6. Te mātauranga hauora me te whakamana: Te āwhina i ngā tūroro ki te mārama ki ngā mōrearea, ngā kōwhiringa maimoatanga, me ngā rautaki ārai i te hokinga mai o te mate.
Aromatawai i te Manaaki Kaiwhakawhanau
Ko te aromatawai te taahiraa tuatahi ki te whakatau i te mahere tiaki. Ka taea e ngā kaiwhakawhanau:
1. Te Anamnesis i Whakahaerehia
– Hītori o te whakamahinga matū: momo, horopeta, tikanga whakamahinga, auau, roa, wā o te whakamahinga whakamutunga.
– Hītori hapūtanga: te roa o te hapūtanga, ngā amuamu, ngā haerenga ANC o mua.
– Hītori hauora: mate ate, HIV, hepatitis B/C, TB, anemia, mate hinengaro (pouri, manukanuka).
– Hītori pāpori: tautoko whānau, hoa rangatira, tūkino ā-whare, mahi, āhuatanga ōhanga.
– Hītori hinengaro: ngā ahotea, te whara, te hihiri ki te whakamutu, te hītori whakaora.
2. Te Whakamātautau Tinana me te Whakamātautau Whānau
– Ngā tohu ora, te āhua kai, ngā tohu o te haurangi, te whakamutu rānei i te inu.
– Whakamātautau whānau: te teitei o te hope, te DJJ, te nekehanga o te kōpū, ngā tohu o te preeclampsia, te toto.
– Ngā tohu o te mate: te wāhi i werohia ai, te whewhe, ngā tohu o te mate tuku iho (STI).
3. Te Tautoko i te Whakamātautau (Te Mahi Tahi)
Ka taea e ngā kaiwhakawhanau te whakatenatena, te tuku rānei i ngā whakamātautau taiwhanga ina hiahiatia: te whakamātautau hemoglobin, te tātaritanga mimi, te HIV, te hepatitis, me te syphilis, tae atu ki te tirotiro matū mēnā e wātea ana, ā, i runga anō i ngā tikanga whakaae. He mea nui ngā whakamātautau ultrasound hei aromatawai i te tipu me te oranga o te pēpi.
Te Tātaritanga Whakawhanau me te Tāutu Raru
I runga i ngā raraunga, ka whakatakoto te kaiwhakawhanau i tētahi tātaritanga mate, i tētahi raruraru whānau rānei, hei tauira:
– Te haputanga me ngā āhuatanga mōrearea nui nā te whakamahinga o ngā matū.
– Te mōrearea o te whānautanga o mua.
– Te mōrearea o ngā mate tipu o te kukune.
– Ngā mate kai e iti iho ana i ngā whakaritenga.
– Te tūponotanga o te tutu, ngā raruraru pāpori rānei.
– Te manukanuka me te mōrearea o te pouri muri i te whānautanga.
– Te mōrearea o te whakamutu i te rongoā i roto i ngā pēpi hou.
He mea tino nui te tautuhi i ngā āhuatanga e whakaoho ana i te hokinga mai ki te mahi kino, pērā i te taiao pāpori, ngā raruraru whānau, ngā mate hinengaro rānei, i roto i te whakamahere manaaki.
Te Whakamahere me te Wawaotanga Tiaki Kaiwhakawhanau
Ka whakahaerehia ngā wawaotanga i runga i te wāhanga oranga whānau me te kaha o te waranga.
1. Te Tiaki i mua i te Whānautanga (ANC)
– Te tohutohu mō te whakarerekētanga whanonga: Te whakamahi i ngā huarahi whakawhitiwhiti kōrero whai hua (hei tauira, te whakatenatena) hei hanga i te rite ki te whakamutu, te whakatakoto i ngā whāinga tūturu, me ngā rautaki hei karo i ngā mea e whakaoho ana i te whanonga.
– Te ako mōrearea me te whakaiti i te kino: Mena kāore e taea e te tūroro te whakamutu katoa, ka ngana tonu te kaiwhakawhanau ki te whakaiti i te mōrearea, hei tauira te karo i te whakamahi i ngā ngira e whakamahia tahitia ana, te pupuri i te kai totika, me te ANC auau.
– Te aro turuki kaha: Whakaritea te ANC kia auau ake, aroturukihia te tipu o te kukune, kitea wawe te preeclampsia me te mate.
– Tautoko kai: Me tūtohu he kai taurite, he tāpiringa rino/folate, me te aromatawai i te anemia.
– Te tukunga whakaora: Mena he nui te whakawhirinakitanga, ka tukuna e ngā kaiwhakawhanau ngā tūroro ki ngā ratonga whakawhirinakitanga mō te rongoā hanganga. I ētahi wā o te whakamahinga opioid, ka tukuna te rongoā whakakapinga (hei tauira, methadone/buprenorphine) e te tākuta e ai ki ngā aratohu.
– Te tirotiro hauora hinengaro: Kitea te pouri me te manukanuka, me tuku atu ki te tari hauora hinengaro/hinengaro.
2. Te Tiaki i roto i te Whānautanga (Whānautanga)
– Te whakarite mō te whānautanga haumaru: Matapaetia ngā raruraru pēnei i te toto, te toto toto tiketike, te mamae rānei o te pēpi.
– Te whakahaere mamae mohio: Kōrerohia ngā kōwhiringa whakangāwari mamae me tō tākuta, me te whai whakaaro ki tō hītori o te whakawhirinakitanga ki te mamae kia kore ai e hoki anō ki te mamae.
– Te aro turuki tata ki te kukune: CTG mēnā e wātea ana, te aro turuki DJJ auau, te aromatawai i te ahunga whakamua o te whānautanga.
– Kei te tatari te tīma pēpi hou: Me tirotirohia ngā pēpi o ngā whaea he hītori whakamahi matū, mō ngā tohu o te NAS, te uaua o te manawa, ngā raruraru urutau rānei.
3. Te Tiaki i muri i te Whānautanga me te Whāngai U
– Te aroturuki i te toto me te mate urutā: Tērā pea ka nui ake te whakaraerae o te āhua whānui o te whaea nā te āhua kai me ngā mate tāpiri.
– Tautoko whāngai ū: Ko te tikanga, me whāngai ū te whaea mēnā kei te ora tonu ia, ā, kāore hoki e whakamahi ana i ngā matū ture kore, engari me whakatau takitahi te whakatau, ā, me whai i ngā aratohu me te kōrero ki te tākuta.
– Te tirotiro i te pouri i muri i te whānautanga: He nui ake te mōrearea o ngā whaea kua pāngia e te waranga, nō reira me aroturuki me te tuku atu mēnā he tohu mōrearea.
– Te ārai i te hokinga mai o te mate: Te whakawhanake i tētahi mahere mō te tautoko a te whānau, ngā rōpū tautoko, ngā kaiwhakatakoto whakaaro, me ngā tirotiro hauora kua whakaritea.
4. Te Tiaki i te Pēpi Hou
– Te tirotiro mō te mate whakatārewatanga: Aroturukihia mēnā he āwangawanga, he wiri, he mate kai, he ruaki, he korere, he nui rawa te nekehanga o te tinana, he haurangi rānei.
– Manaaki tautoko: Mā ngā tikanga pēnei i te takai pēpi, te noho i roto i te rūma marino, te kiri-ki-kiri, me te whāngai ū (inā haumaru) ka āwhina i te whakaiti i ngā tohu.
– Te mahi tahi a te rongoā: Mena he kino rawa ngā tohu, ka taea e te tākuta te whakarato i te rongoā rongoā e ai ki te tikanga o te hōhipera.
5. Te Whakamahere Whānau me te Whakamahere Hapūtanga
He mea nui ngā ratonga whakamahere whānau hei ārai i ngā hāputanga kore i whakamaheretia i te wā o te tukanga whakaora. Ka taea e ngā kaiwhakawhanau te:
– Whakamāramahia ngā kōwhiringa ārai hapūtanga whai hua (hei tauira, te IUD, te tāpiringa, te werohanga, te pire) i whakaritea mō ngā āhuatanga hauora me ngā manakohanga.
– Whakauruhia te tohutohu i mua i te haputanga mō ngā tūroro e hiahia ana kia hapu i muri i te whakaūnga, tae atu ki te tango i ngā matū, te whakapai ake i te kai, me te whakahaere i ngā mate tāpiringa.
Ngā tuhinga, ngā tohutoro, me te mahi tahi
Me whakaoti ngā tuhinga tiaki: ngā hua aromatawai, ngā mahere, ngā mahi, ngā aromatawai, me ngā whakawhitiwhitinga tuku. Me mōhio ngā kaiwhakawhanau ki te whatunga ratonga: ngā pokapū hauora hapori, ngā hōhipera tuku, ngā ratonga hauora hinengaro, te whakaora i te waranga, me te tautoko pāpori. Kei roto hoki i te mahi tahi te āwhina whakahaere mēnā he uaua ki te taha pūtea, ki te taha tuakiri, ki te taha urunga rānei o te tūroro.
Ngā Wero me ngā Rautaki Ratonga
Ko ngā wero nui ko te whakama, te wehi o ngā tūroro ki te pono, te iti o ngā wāhi tirotiro, me te kore o tētahi pūnaha tuku kōrero māmā. Ko ngā rautaki ko te whakapai ake i te pūkenga o ngā kaiwhakawhanau, te whakangungu i roto i te whakawhitiwhiti kōrero aroha, te whakauru i ngā ratonga waranga ki ngā ratonga hauora whaea me te tamaiti, me te whakarato i ngā wāhi tohutohu haumaru. He mea nui te tautoko a te hapori me te whānau hei pupuri i te whakaoranga pumau.
Whakamutunga
Ko te tiaki i te waranga tarukino e hiahiatia ana he huarahi whānui e whakakotahi ana i te haumaru o te whānautanga, te tautoko hinengaro-pāpori, te aukati i ngā raruraru, me te mahi tahi a ngā tohunga ngaio. He mahi nui tā ngā kaiwhakawhanau ki te kimi wawe, te mātauranga, te aroturuki i te whaea me te tamaiti, te āwhina whānau, te tiaki i muri i te whānautanga, te aroturuki i ngā pēpi hou, me te tohutohu whakamahere whānau. Mā te atawhai aroha me te tiaki tonu, ka piki ake te tūponotanga o te whaea ki te ora, ā, ka whakaitihia te tūponotanga o ngā hua kino mō te pēpi.
Ki te hiahia koe, ka taea e au te whakarerekē i tēnei tuhinga ki tētahi whakatakotoranga mahi (kupu whakataki–arotake tuhinga–kōrero–whakamutunga), tāpirihia he rārangi pukapuka, arotahi rānei ki tētahi take motuhake pērā i te opioids, te methamphetamine, te whakamahi kino rānei i ngā raau taero.
