Faculty of Health Sciences, Australian Catholic University, Australia.
Midwifery. 2012 Apr;28(2):163-72. doi: 10.1016/j.midw.2011.03.002. Epub 2011 Jun 11.
to explore the extent to which a specialist clinic meets the needs of chemically dependent women.
a critical ethnography informed by theorists such as Habermas and feminists' interpretation of Foucault.
a specialist antenatal clinic for chemically dependent pregnant women at a major metropolitan women's hospital in Melbourne, Australia.
a purposive sample of twenty (20) chemically dependent pregnant women who attended the clinic. Data collection and analysis included three taped interviews (two preceding the birth and one post birth), observation of the interactions between the women and the clinic staff over a 25-month period and chart audits.
similar to other studies there were multiple factors influencing development and maintenance of chemical dependency in this group of women, including family instability, family history of drug and alcohol abuse, childhood sexual abuse, having a chemically dependent partner and having a dual diagnosis of both drug addiction and mental illness. Initially there was considerable variation between the women and the clinic staff's expectations with regard to attending for antenatal care and conforming to a set regime as the women struggled with the contradictions inherent in their lifestyle and that of the 'normal' expectant mother. Aspects of that struggle included their belief that their opinions and knowledge of their lives was largely ignored, leading to episodes of resistance. Several women alleged the clinics staff's relationship with them was influenced by a belief that the women were 'hopeless addicts in need of expert medical and midwifery care' and that the clinic staff exercised control in an authoritarian manner. However, as they explored possibilities for collaboration, they realised they could exercise power and work towards a more equal relationship with staff. The quality of relationships in most instances improved over time, and if not always strictly collaborative, was situated at various points along a continuum from minimal to full co-operation, with concomitant varying levels of success in terms of outcomes. It was often the attitude of individual staff members, particularly midwives, that was the key to the way in which the women responded to care.
comprehensive history-taking and engaging women as early as possible in pregnancy; providing continuity of care - particularly midwife care - to assist in developing a collaborative approach to care; provision of an extended period of postnatal support to at least six months for those women able to parent their children was a key recommendation.
探讨专门诊所满足依赖化学物质的女性需求的程度。
受哈贝马斯等理论家以及女权主义者对福柯的解读的启发，进行了批判性民族志研究。
澳大利亚墨尔本一家主要的大都市妇女医院的专门产前诊所，为依赖化学物质的孕妇提供服务。
参加该诊所的 20 名（20 名）有化学依赖的孕妇的有目的抽样。数据收集和分析包括三次录音访谈（两次在分娩前，一次在分娩后），观察妇女与诊所工作人员之间的互动在 25 个月的时间内，以及图表审计。
与其他研究类似，该组妇女的化学依赖的发展和维持有多种因素，包括家庭不稳定、家庭药物和酒精滥用史、儿童期性虐待、有化学依赖的伴侣以及同时患有药物成瘾和精神疾病的双重诊断。最初，妇女和诊所工作人员对产前保健的期望存在相当大的差异，并且妇女在遵守一套规定方面存在困难，因为她们在生活方式上与“正常”孕妇存在矛盾。那场斗争的一个方面包括他们认为自己的意见和生活知识在很大程度上被忽视了，导致了一些抵抗的事件。几名妇女声称，诊所工作人员与她们的关系受到这样一种信念的影响，即妇女是“需要专家医疗和助产护理的绝望瘾君子”，并且诊所工作人员以专横的方式行使控制。然而，当他们探索合作的可能性时，他们意识到他们可以行使权力，并努力与工作人员建立更平等的关系。大多数情况下，人际关系的质量随着时间的推移而提高，如果不是完全合作的话，也处于从最低到完全合作的连续体的不同点上，并且在结果方面取得不同程度的成功。通常情况下，关键是个别工作人员的态度，尤其是助产士的态度，这是妇女对护理做出反应的方式。
全面的病史采集，并尽早让孕妇参与妊娠；提供连续性护理 - 特别是助产士护理 - 以协助发展对护理的协作方法；为那些能够照顾孩子的妇女提供至少六个月的延长产后支持，这是一个关键建议。
