Novick Gina, Sadler Lois S, Knafl Kathleen A, Groce Nora Ellen, Kennedy Holly Powell
Yale University School of Nursing, USA.
J Health Care Poor Underserved. 2012 May;23(2):589-603. doi: 10.1353/hpu.2012.0060.
Women from vulnerable populations encounter challenging circumstances that generate stress and may adversely affect their health. Group prenatal care (GPNC) incorporates features that address social stressors, and has been demonstrated to improve pregnancy outcomes and prenatal care experiences. In this qualitative study, we describe the complex circumstances in the lives of women receiving care in two urban clinics and how GPNC attenuated them. Stressors included problems with transportation and child care, demanding jobs, poverty, homelessness, difficult relationships with partners, limited family support, and frustrating health care experiences. Receiving prenatal care in groups allowed women to strengthen relationships with significant others, gain social support, and develop meaningful relationships with group leaders. By eliminating waits and providing the opportunity to participate in care, GPNC also offered sanctuary from frustrations encountered in receiving individual care. Reducing such stressors may help improve pregnancy outcomes; however, more evidence is needed on mechanisms underlying these effects.
弱势群体中的女性面临着具有挑战性的环境,这些环境会产生压力,并可能对她们的健康产生不利影响。小组产前护理(GPNC)包含应对社会压力源的特点,并且已被证明可以改善妊娠结局和产前护理体验。在这项定性研究中,我们描述了在两家城市诊所接受护理的女性生活中的复杂情况,以及小组产前护理如何缓解这些情况。压力源包括交通和 childcare 问题、要求苛刻的工作、贫困、无家可归、与伴侣的关系困难、家庭支持有限以及令人沮丧的医疗保健经历。在小组中接受产前护理使女性能够加强与重要他人的关系,获得社会支持,并与小组负责人建立有意义的关系。通过消除等待并提供参与护理的机会,小组产前护理还为在接受个体护理时遇到的挫折提供了庇护所。减少此类压力源可能有助于改善妊娠结局;然而,需要更多关于这些影响背后机制的证据。 (注:原文中“childcare”未翻译完整,可能是“儿童保育”之类的意思,需结合完整语境准确理解)