Roberts J, Sealy D, Marshak H Hopp, Manda-Taylor L, Gleason P, Mataya R
School of Public Health, Loma Linda University, Loma Linda, California, USA.
University of Malawi, College of Medicine, Chichiri Blantyre 3, Malawi.
Malawi Med J. 2015 Dec;27(4):145-50.
Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization's recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake.
A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites.
Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed that, due to staff shortages, patients often do not receive the care they deserve.
The results of this study suggest that, in addition to other factors, healthcare provider attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.
大约90%的马拉维女性在孕期至少接受一次产前护理；然而，大多数母亲在怀孕五到六个月时才首次就诊，且未遵循世界卫生组织建议的四次就诊。本研究的目的是探讨医患关系在产前护理利用方面所起的作用。
2014年9月至12月进行了一项定性研究，包括对20名城市孕妇和8名医护人员的访谈。马拉维中部和南部地区的两家大型三级护理医院被选为研究地点。
几个因素影响产前护理就诊情况。报告的重大障碍包括医患关系、诊所候诊时间、家人和朋友的支持、从家到诊所的距离、交通、费用以及就诊次数。医患关系似乎对产前诊所的参与度有很大影响。母亲们表示，医护人员在就诊期间经常虐待或贬低她们。此外，医护人员透露，由于人员短缺，患者常常得不到应有的护理。
本研究结果表明，除其他因素外，医疗服务提供者的态度会影响产前诊所就诊情况。改善医患关系可能会增加产前诊所就诊人数，并减少孕期并发症。专业发展机会和质量改进计划将有助于改善患者护理和健康结果，同时解决该国持续存在的人员短缺问题。
