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首次产前检查:一项关于被诊断患有精神疾病的女性经历的探索性研究。

The first antenatal appointment: An exploratory study of the experiences of women with a diagnosis of mental illness.

作者信息

Phillips Louise, Thomas Dona

机构信息

School of Health Sciences, Nursing Division, Myddelton Building, City University, Northampton Square, London EC1V OHB, UK.

Homerton University Hospital NHS Foundation Trust, Specialist Midwifery Office 5 1st Floor, 46 - 48 Clifden Road, Homerton Row, London E5 0LJ, UK.

出版信息

Midwifery. 2015 Aug;31(8):756-64. doi: 10.1016/j.midw.2015.04.004. Epub 2015 Apr 16.

Abstract

OBJECTIVE

to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals.

DESIGN

a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes.

SETTING

the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners.

PARTICIPANTS

twelve participants were selected from one antenatal clinic and one perinatal mental health service.

FINDINGS

the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services.

摘要

目的

探讨并深入了解已确诊患有精神疾病的女性对其首次预约产检的期望和经历;为医疗保健专业人员之间的实践发展和合作伙伴关系提出建议。

设计

采用半结构化访谈和数据主题分析的定性设计。使用QSR NVivo 10软件将数据整理成主题。

背景

访谈在女性家中或经女性及相关从业者同意后在产前服务机构内进行。

参与者

从一家产前诊所和一项围产期心理健康服务中选取了12名参与者。

结果

数据中确定的主题包括在首次预约助产士产检之前缺乏信息;在首次预约产检时感觉信息过多,且女性此时对自己的心理健康需求并不明确;对披露精神疾病诊断普遍持积极态度;对助产士总体看法积极,尽管有些助产士似乎对双相情感障碍了解较少,以及认为产前和围产期心理健康服务之间缺乏协同合作。

关键结论及对实践的启示

建议全科医生接受充分培训,使其具备讨论围产期精神疾病相关敏感问题以及对妊娠和分娩影响所需的技能。女性需要更多关于预约产检的信息,在每次后续产前检查时评估其情感和身体健康需求将有益处。需要促使助产士了解产前和产后精神疾病及治疗的最新知识,以及转诊至围产期心理健康服务的流程。

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