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孕期、分娩期及产后女性脆弱性的概念分析

A concept analysis of women's vulnerability during pregnancy, birth and the postnatal period.

作者信息

Briscoe Lesley, Lavender Tina, McGowan Linda

机构信息

SL Midwifery Education, Edge Hill University, Lancashire, UK.

Centre for Global Women's Health, University of Manchester, UK.

出版信息

J Adv Nurs. 2016 Oct;72(10):2330-45. doi: 10.1111/jan.13017. Epub 2016 Jun 3.

DOI:10.1111/jan.13017
PMID:27255232
Abstract

AIM

To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period.

BACKGROUND

The concept of vulnerability during childbirth is complex and the term, 'to be vulnerable' frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women.

DESIGN

Concept analysis.

DATA SOURCES

Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 - June 2014. Data were collected over 12 months during 2014.

METHODS

This concept analysis drew on Morse's qualitative methods.

RESULTS

Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub-attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept.

CONCLUSION

This concept analysis has clarified how the term vulnerability is currently understood and used in relation to pregnancy, birth and the postnatal period. Vulnerability should be viewed as a complex phenomenon rather than a singular concept. A 'vulnerability journey plan' has the potential to identify how reparative interventions may develop the woman's capacity for resilience and influence the degree of vulnerability experienced. Methodology based around complex theory should be explored in future work about vulnerability.

摘要

目的

报告一项关于与妊娠、分娩及产后阶段相关的脆弱性概念的分析。

背景

分娩期间的脆弱性概念复杂,“脆弱”一词的应用常常模糊不清。需要对脆弱性进行分析以指导政策、实践、教育和研究。明确这一概念有可能改善女性的结局。

设计

概念分析。

数据来源

在护理学与健康领域数据库(CINAHL)、荷兰医学文摘数据库(EMBASE)、美国国立医学图书馆医学期刊数据库(PubMed)、心理学文摘数据库(Psychinfo)、医学期刊数据库(MEDLINE)、助产士信息与资源服务数据库(MIDIRS)和应用社会科学索引与摘要数据库(ASSIA)中进行检索,检索时间限定在2000年1月至2014年6月之间。数据于2014年的12个月期间收集。

方法

本概念分析采用了莫尔斯的定性方法。

结果

妊娠、分娩及产后阶段的脆弱性可由三个主要属性来定义:(a)威胁;(b)障碍;(c)修复。关键属性有可能影响女性的结局。诸如母婴依恋、女性的自由意志和选择等不可分割的子属性增加了该概念的复杂性。

结论

本概念分析阐明了目前在妊娠、分娩及产后阶段中对脆弱性这一术语的理解和应用方式。脆弱性应被视为一种复杂现象而非单一概念。“脆弱性历程计划”有可能确定修复性干预措施如何培养女性的复原能力并影响其所经历的脆弱程度。在未来关于脆弱性的研究中应探索基于复杂理论的方法。

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