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“高危”妊娠住院的临床关系和心理体验。

Clinical relationship and psychological experience of hospitalization in "high-risk" pregnancy.

机构信息

Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, Milan, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2010 Apr;149(2):136-42. doi: 10.1016/j.ejogrb.2009.12.009. Epub 2010 Jan 15.

Abstract

OBJECTIVE

To explore, in a systemic view, the reciprocal perceived relationship between hospitalized "high-risk" pregnant women with uncertain fetal prognosis and the multidisciplinary prenatal care team, by the use of specifically developed questionnaires.

STUDY DESIGN

A pilot study in a high-risk pregnancy department. We enrolled 52 pregnant hospitalized women and 17 clinical operators and we interviewed them by the use of open-ended and close-ended question questionnaires.

RESULTS

We described patients' perception of doctors and staff communication, patients' feelings and emotions relating to "high-risk" pregnancy and hospitalization, operators' emotions, perceived facilitating factors, difficulties and resources. In a "high-risk" pregnancy condition, some difficulties in the relationship between hospitalized women and health operators occur. For inpatients the emotional difficulties were mostly connected to the pathologic situation and the contingent loneliness. Although the majority of women said that they understood staff communication and that they established a basic trust towards the entire clinical staff, there was a request for greater outspokenness. For clinical operators the relational and communication difficulties specifically concerned the overall management of the relationship with the patients studied. In particular, they perceived themselves to be called to a greater clearness and clinical reliability.

CONCLUSIONS

Overcoming the dyadic model of the doctor-patient relationship (in a systemic view) by incorporating clinical operators' and inpatients' points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" conditions. Condensation Overcoming the dyadic vision of the doctor-patient relationship, by crossing clinical operator's and inpatient's points of view, seems a useful tool to highlight critical and facilitating factors about the relationship and communication in "high-risk" pregnancy conditions.

摘要

目的

通过使用专门设计的问卷,从系统的角度探讨具有不确定胎儿预后的住院“高危”孕妇与多学科产前护理团队之间相互感知的关系。

研究设计

高危妊娠科的试点研究。我们招募了 52 名住院孕妇和 17 名临床医生,并通过开放式和封闭式问题问卷对他们进行了访谈。

结果

我们描述了患者对医生和工作人员沟通的看法、患者对“高危”妊娠和住院的感受和情绪、工作人员的情绪、感知的促进因素、困难和资源。在“高危”妊娠情况下,住院妇女与卫生工作者之间的关系会出现一些困难。对于住院患者,情绪上的困难主要与病理情况和随之而来的孤独感有关。尽管大多数女性表示她们理解工作人员的沟通,并对整个临床工作人员建立了基本的信任,但她们希望得到更多的坦率。对于临床医生来说,关系和沟通方面的困难主要涉及到与所研究患者的关系的整体管理。特别是,他们认为自己需要更加清晰和临床可靠。

结论

通过纳入临床医生和住院患者的观点,超越医患关系的二元模式(从系统的角度来看),似乎是一个有用的工具,可以突出“高危”情况下关系和沟通的关键和促进因素。

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