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转诊至产前专科门诊及就诊情况:对女性观点的定性研究

Referral and attendance at a specialist antenatal clinic: qualitative study of women's views.

作者信息

Jackson C J, Bosio P, Habiba M, Waugh J, Kamal P, Dixon-Woods M

机构信息

Department of Health Sciences, University of Leicester, Leicester, UK.

出版信息

BJOG. 2006 Aug;113(8):909-13. doi: 10.1111/j.1471-0528.2006.01016.x.

Abstract

OBJECTIVE

To explore women's views on being referred to and attending a specialist antenatal hypertension clinic.

DESIGN

Qualitative interview study.

SETTING

A pregnancy hypertension clinic in a large teaching hospital in the East Midlands.

POPULATION

Twenty-one women (aged 18 years and above) attending the pregnancy hypertension clinic for the first time during their current pregnancy.

METHODS

Women who had been referred to and attended a specialist antenatal clinic participated in semi-structured interviews. Data analysis was based on the constant comparative method.

MAIN OUTCOME MEASURES

Women's experiences and perceptions of being referred to and attending a specialist antenatal clinic.

RESULTS

Being referred to the clinic conferred an 'at risk' status on women. Some women welcomed the referral but others experienced it as unsettling. Many were unclear about why they had been identified as being at risk or had difficulties in accepting the legitimacy of the reason for referral. Women were often inadequately informed about why they were referred to the clinic, what they could expect and the benefits of attending the clinic over management in the community. Although attendance at the clinic was cited as a source of reassurance, the reassurance was often made necessary by concern raised by the initial referral.

CONCLUSIONS

Women's accounts suggest that the interface between community and secondary antenatal services needs improvement to minimise possible adverse effects from identifying women as being 'at risk' during pregnancy.

摘要

目的

探讨女性对于被转诊至并前往产前高血压专科门诊的看法。

设计

定性访谈研究。

地点

东米德兰兹郡一家大型教学医院的妊娠高血压门诊。

研究对象

21名年龄在18岁及以上、在本次孕期首次前往妊娠高血压门诊就诊的女性。

方法

被转诊至并前往专科产前门诊的女性参与半结构化访谈。数据分析采用持续比较法。

主要观察指标

女性被转诊至并前往专科产前门诊的经历与看法。

结果

被转诊至该门诊使女性处于“风险”状态。一些女性对转诊表示欢迎,但另一些女性则觉得不安。许多女性不清楚自己为何被认定有风险,或者难以接受转诊理由的合理性。女性往往未得到充分告知,不明白自己为何被转诊至该门诊、会有怎样的预期以及相较于在社区接受管理,前往该门诊就诊有哪些益处。尽管前往门诊就诊被视为一种安心的来源,但这种安心往往是由最初转诊引发的担忧所导致的。

结论

女性的叙述表明,社区与二级产前服务之间的衔接需要改进,以尽量减少孕期将女性认定为“有风险”可能产生的不利影响。

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