身体残疾女性的怀孕情况:未满足的需求及孕期应对建议
Pregnancy among women with physical disabilities: Unmet needs and recommendations on navigating pregnancy.
作者信息
Mitra Monika, Long-Bellil Linda M, Iezzoni Lisa I, Smeltzer Suzanne C, Smith Lauren D
机构信息
The Lurie Institute for Disability Policy, The Heller School of Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 01453, USA.
Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA 01545, USA.
出版信息
Disabil Health J. 2016 Jul;9(3):457-63. doi: 10.1016/j.dhjo.2015.12.007. Epub 2016 Jan 2.
BACKGROUND
Despite concerns raised in the literature on the adverse pregnancy outcomes of women with physical disabilities, there is little information about unmet needs of women with physical disabilities during pregnancy and childbirth.
OBJECTIVE
This article provides an in-depth examination of unmet health care needs during and around the time of pregnancy among a sample of women with physical disabilities. It also offers recommendations to other women with physical disabilities who are considering pregnancy.
METHODS
Twenty-five phone interviews were conducted with women with physical disabilities from across the United States who had a baby in the past ten years. Individual semi-structured qualitative interviews lasting about 2 h were conducted. Interviews were audio-recorded, transcribed, and analyzed using an iterative, interpretive process.
RESULTS
Women reported a wide range of disabling conditions. Analysis revealed three broad themes related to unmet needs during pregnancy among women with physical disabilities. They included (1) clinician knowledge and attitudes, (2) physical accessibility of health care facilities and equipment, (3) need for information related to pregnancy and postpartum supports. The women also provided recommendations to other women with disabilities who are currently pregnant or thinking of becoming pregnant. Recommendations related to finding a clinician one trusts, seeking peer support, self-advocating, and preparing oneself for the baby.
CONCLUSIONS
This study sheds light on the unmet needs and barriers to care of women with mobility disabilities during pregnancy and childbirth. The study findings highlight the need for policy and practice recommendations for perinatal care of women with mobility disabilities.
背景
尽管文献中对身体残疾女性不良妊娠结局有所关注,但关于身体残疾女性在妊娠和分娩期间未满足的需求的信息却很少。
目的
本文深入研究了身体残疾女性样本在妊娠期间及前后未满足的医疗保健需求。它还为其他考虑怀孕的身体残疾女性提供了建议。
方法
对过去十年内在美国生育过的身体残疾女性进行了25次电话访谈。进行了持续约2小时的个人半结构化定性访谈。访谈进行了录音、转录,并采用迭代解释过程进行分析。
结果
女性报告了广泛的致残状况。分析揭示了与身体残疾女性妊娠期间未满足需求相关的三个主要主题。它们包括(1)临床医生的知识和态度,(2)医疗保健设施和设备的物理可达性,(3)与妊娠和产后支持相关的信息需求。这些女性还为其他目前怀孕或正在考虑怀孕的残疾女性提供了建议。建议包括找到一位信任的临床医生、寻求同伴支持、自我倡导以及为宝宝做好准备。
结论
本研究揭示了身体残疾女性在妊娠和分娩期间未满足的需求以及护理障碍。研究结果强调了针对身体残疾女性围产期护理的政策和实践建议的必要性。