Jonkers Marina, Richters Annemiek, Zwart Joost, Öry Ferko, van Roosmalen Jos
Department of Obstetrics, Leiden University Medical Centre, Leiden, Netherlands.
Reprod Health Matters. 2011 May;19(37):144-53. doi: 10.1016/S0968-8080(11)37556-8.
This 2006 study investigated ethnicity-related factors contributing to sub-standard maternity care and the effects on severe maternal morbidity among immigrant women in the Netherlands. In-depth interviews were carried out with 40 immigrant and 10 native Dutch women. The immigrant women reported that health care providers often paid insufficient attention to their pregnancy-related complaints, especially in cases of pre-eclampsia. They also reported delays in receiving information about diagnosis and treatment. Obstetricians who reviewed 20 of these cases judged sub-standard care to have played a role in the development of complications in 16 of them. The women themselves had problems identifying medically significant complications, presenting their complaints to health care providers effectively, and taking an active role as patients. Even highly educated migrant women showed low health literacy skills in their interaction with doctors. Patients' perspectives are valuable as one of the tools to evaluate the quality of maternity care. Communication by maternal health professionals can be improved through more sensitivity to social factors that affect immigrant women's health problems. Women with limited health literacy should be empowered through education about danger signs in pregnancy and information about preferences and policies in obstetrics in the Netherlands. They should also be invited to participate in medical decision-making.
这项2006年的研究调查了导致荷兰移民妇女孕产妇护理不达标的种族相关因素及其对严重孕产妇发病情况的影响。对40名移民妇女和10名荷兰本土妇女进行了深入访谈。移民妇女报告称，医疗服务提供者往往对她们与怀孕相关的不适不够重视，尤其是在先兆子痫的情况下。她们还报告了在获取诊断和治疗信息方面存在延迟。审查其中20个病例的产科医生判断，在其中16个病例中，护理不达标准在并发症的发生中起到了作用。这些妇女自身在识别具有医学意义的并发症、有效地向医疗服务提供者表达她们的不适以及积极作为患者发挥作用方面存在问题。即使是受过高等教育的移民妇女在与医生互动时也表现出较低的健康素养技能。患者的观点作为评估孕产妇护理质量的工具之一很有价值。孕产妇保健专业人员的沟通可以通过对影响移民妇女健康问题的社会因素更敏感来加以改善。健康素养有限的妇女应通过接受关于孕期危险信号的教育以及荷兰产科方面的偏好和政策信息来增强能力。还应邀请她们参与医疗决策。
