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助产士照顾有学习障碍女性的经历——一项定性研究。

Midwives׳ experiences of caring for women with learning disabilities - A qualitative study.

作者信息

Castell Emma, Stenfert Kroese Biza

机构信息

University of Birmingham, Department of Clinical Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom.

University of Birmingham, Department of Clinical Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom.

出版信息

Midwifery. 2016 May;36:35-42. doi: 10.1016/j.midw.2016.02.001. Epub 2016 Feb 8.

Abstract

BACKGROUND AND OBJECTIVE

people with learning disabilities (LD) are increasingly likely to become parents and are entitled to have access to the right support to be able to be suitable parents. However, access to such support is affected by limited resources, attitudes towards people with LD becoming parents, and lack of training regarding caring for parents with learning disabilities for midwives. A learning disability (LD) is defined as a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), reduced skills to cope independently with everyday life, has an impact on most areas of a person's life and the difficulties started in early childhood. Little research has explored health professionals' experiences of their support of people with LD during their journey to become parents. Midwives are often the first professionals pregnant women come into contact with and therefore are key professionals in the support system for parents with LD. The principle objective of the current research is to develop an understanding of midwives' experiences of caring for women with a LD.

DESIGN

the study explored midwives׳ experiences of caring for women with LD using an Interpretative Phenomenological Approach (IPA).

PARTICIPANTS

nine qualified midwives employed by a single NHS trust participated in the study.

MEASUREMENTS AND FINDINGS

a semi-structured interview schedule was utilised during one-to-one interviews with the midwives. The interview transcripts were analysed using IPA stages. Four superordinate themes were identified.

KEY CONCLUSIONS

The midwives reported receiving a lack of LD training and faced significant time constraints, which left them feeling that they could not spend the necessary time with the women to meet their pregnancy needs. The midwives felt unsupported in their attempts to deliver adequate midwifery care, speaking about a lack of accessible support for pregnant women with LD. They were left feeling responsible to fill the gaps in service provision. The midwives were dedicated in delivering adequate care to help give women with LD a positive experience of childbearing. They felt a safeguarding process (child protection) was an inevitable part of women with LD's pregnancy experience yet were aware that the right support at the right time could improve parenting capacity.

IMPLICATIONS FOR PRACTICE

it is recommended that training on working with and providing services for people with LD is made available to qualified and student midwives as well as accessible resources, professional support and supervision.

摘要

背景与目的

有学习障碍(LD)的人群成为父母的可能性越来越大,他们有权获得适当的支持以成为称职的父母。然而,获得此类支持受到资源有限、对有学习障碍者成为父母的态度以及助产士缺乏照顾有学习障碍的父母的培训等因素的影响。学习障碍(LD)被定义为理解新的或复杂信息、学习新技能的能力显著下降(智力受损),独立应对日常生活的技能降低,对人的生活大部分领域产生影响,且这些困难始于幼儿期。很少有研究探讨卫生专业人员在有学习障碍者成为父母的过程中提供支持的经历。助产士通常是孕妇接触的首批专业人员,因此是为有学习障碍的父母提供支持系统中的关键专业人员。本研究的主要目的是了解助产士照顾有学习障碍女性的经历。

设计

本研究采用解释现象学方法(IPA)探讨助产士照顾有学习障碍女性的经历。

参与者

由单一国民保健服务信托机构雇佣的九名合格助产士参与了该研究。

测量与结果

在与助产士的一对一访谈中使用了半结构化访谈提纲。访谈记录采用IPA阶段进行分析。确定了四个上位主题。

主要结论

助产士报告称缺乏学习障碍培训且面临严重的时间限制,这使他们觉得无法花费必要的时间陪伴这些女性以满足她们的孕期需求。助产士在试图提供充分的助产护理时感到缺乏支持,提到为有学习障碍的孕妇提供的支持难以获得。他们觉得有责任填补服务提供方面的空白。助产士致力于提供充分的护理,以帮助有学习障碍的女性获得积极的生育体验。他们认为保障程序(儿童保护)是有学习障碍女性孕期经历中不可避免的一部分,但也意识到在正确的时间提供正确的支持可以提高育儿能力。

对实践的启示

建议为合格和实习助产士提供关于与有学习障碍者合作及为其提供服务的培训,以及可获取的资源、专业支持和监督。

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