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南澳大利亚原住民和托雷斯海峡岛民妇女获得标准医院分娩护理的经历——一项现象学研究。

Aboriginal and Torres Strait Islander women's experiences accessing standard hospital care for birth in South Australia - A phenomenological study.

作者信息

Brown Angela E, Fereday Jennifer A, Middleton Philippa F, Pincombe Jan I

机构信息

School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia.

School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia.

出版信息

Women Birth. 2016 Aug;29(4):350-8. doi: 10.1016/j.wombi.2016.01.004. Epub 2016 Feb 3.

Abstract

BACKGROUND

Aboriginal and Torres Strait Islander women, hereafter called Indigenous women, can experience a lack of understanding of their cultural needs when accessing maternity care in the standard hospital care system.

AIM

To explore the lived experiences described by Indigenous women accessing labour and birth care in the standard hospital care system at a tertiary public hospital in South Australia.

METHODS

An interpretive Heideggerian phenomenological approach was used. Indigenous women who accessed standard care voluntarily agreed to participate in semi-structured interviews with Indigenous interviewers. The interviews were transcribed and analysed informed by van Manen's approach.

FINDINGS

Thematic analysis revealed six main themes: "knowing what is best and wanting the best for my baby", "communicating my way", "how they made me feel", "all of my physical needs were met", "we have resilience and strength despite our hardships" and "recognising my culture".

CONCLUSION

Indigenous women in this study expressed and shared some of their cultural needs, identifying culturally unsafe practices. Recommendations to address these include the extension of current care planners to include cultural needs; Aboriginal Maternal Infant Care (AMIC) workers for women from rural and remote areas; AMIC workers on call to assist the women and midwives; increased education, employment and retention of Indigenous midwives; increased review into the women's experiences; removal of signs on the door restricting visitors in the birth suite; flexibility in the application of hospital rules and regulations; and changes to birthing services in rural and remote areas so women may not have to relocate for birth.

摘要

背景

原住民及托雷斯海峡岛民女性(以下简称原住民女性)在标准医院护理体系中接受孕产护理时,其文化需求可能得不到理解。

目的

探究南澳大利亚一家三级公立医院中,原住民女性在标准医院护理体系下接受分娩护理时的生活经历。

方法

采用诠释性海德格尔现象学方法。自愿接受标准护理的原住民女性同意与原住民访谈者进行半结构式访谈。访谈内容经转录后,依据范曼的方法进行分析。

结果

主题分析揭示了六个主要主题:“知晓何为最佳并希望为宝宝提供最好的”“以我的方式沟通”“她们给我的感受”“我的所有身体需求都得到了满足”“尽管历经艰辛,我们仍有复原力和力量”以及“认可我的文化”。

结论

本研究中的原住民女性表达并分享了她们的一些文化需求,指出了文化上不安全的做法。针对这些问题的建议包括:扩展现有护理计划,纳入文化需求;为农村和偏远地区的女性配备原住民母婴护理(AMIC)工作人员;安排随叫随到的AMIC工作人员协助产妇和助产士;增加原住民助产士的教育、就业机会并提高其留用率;加强对女性经历的审查;拆除产房门上限制访客的标识;灵活执行医院规章制度;改变农村和偏远地区的分娩服务,使女性无需为分娩而搬迁。

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