为何女性不寻求孕前健康信息？一项定性研究。
Why women do not ask for information on preconception health? A qualitative study.
作者信息
Bortolus Renata, Oprandi Nadia C, Rech Morassutti Francesca, Marchetto Luca, Filippini Francesca, Agricola Eleonora, Tozzi Alberto E, Castellani Carlo, Lalatta Faustina, Rusticali Bruno, Mastroiacovo Pierpaolo
机构信息
Office for Research Promotion, Department of the Hospital Management, Verona University Hospital, Verona, Italy.
Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
出版信息
BMC Pregnancy Childbirth. 2017 Jan 5;17(1):5. doi: 10.1186/s12884-016-1198-z.
BACKGROUND
Preconception care involves health promotion to reduce risk factors that might affect women and couples of childbearing age. The risk factors of adverse reproductive outcomes include recognized genetic diseases in the family or the individual, previous congenital diseases, miscarriage, prematurity, fetal growth restriction, infertility, chronic maternal diseases, lifestyle, and occupational or environmental factors. Effective preconception care involves a range of preventive, therapeutic and behavioural interventions. Although in Italy there are national preconception care recommendations concerning the general population, they are usually encouraged informally and only for single risk factors. At present there is increasing interest in offering a global intervention in this field. The aim of this study was to investigate attitudes and behaviours of Italian women of childbearing age and healthcare professionals regarding preconception health.
METHODS
We conducted a qualitative study among women of childbearing age and healthcare professionals between February 2014 and February 2015. Five focus groups were held: 2 with non-pregnant women aged 22 to 44 years and 3 with healthcare professionals. Discussion topics included women's questions about preconception health, worries and barriers regarding preconception care interventions, attitudes and behaviours of women and healthcare professionals towards preconception health, women's information sources. In the analysis of the focus groups priority was given to what was said by the women, supplemented by information from the healthcare professionals' focus groups.
RESULTS
Fourteen women of childbearing age (8 nulliparae and 6 multiparae) and 12 healthcare professionals (3 nurses, 4 midwives, 5 doctors) participated in the focus groups. The results indicate the presence of many barriers and a lack of awareness of preconception health relating to women, healthcare professionals and policies. Women's knowledge and attitudes towards primary preconception care information are described. The main reference source of information in this field for Italian women seems to be their obstetric-gynaecologist.
CONCLUSIONS
The study indicates that several barriers influence preconception care in Italy. Moreover, a lack of awareness of preconception health and care among Italian women of childbearing age and healthcare professionals emerges. The findings might contribute to strategies for the implementation of preconception care guidelines.
背景
孕前保健包括促进健康，以减少可能影响育龄妇女及其伴侣的风险因素。不良生殖结局的风险因素包括家族或个人已知的遗传疾病、既往先天性疾病、流产、早产、胎儿生长受限、不孕、慢性母体疾病、生活方式以及职业或环境因素。有效的孕前保健涉及一系列预防、治疗和行为干预措施。尽管在意大利有针对普通人群的国家孕前保健建议，但通常只是非正式鼓励，且仅针对单一风险因素。目前，人们越来越关注在这一领域提供全面干预。本研究的目的是调查意大利育龄妇女和医疗保健专业人员对孕前健康的态度和行为。
方法
2014年2月至2015年2月期间，我们对育龄妇女和医疗保健专业人员进行了一项定性研究。共举行了5次焦点小组讨论：2次针对年龄在22至44岁的未孕妇女，3次针对医疗保健专业人员。讨论主题包括妇女关于孕前健康的问题、对孕前保健干预措施的担忧和障碍、妇女及医疗保健专业人员对孕前健康的态度和行为、妇女的信息来源。在焦点小组讨论的分析中，优先考虑妇女所说的内容，并辅以医疗保健专业人员焦点小组提供的信息。
结果
14名育龄妇女（8名未产妇和6名经产妇）和12名医疗保健专业人员（3名护士、4名助产士、5名医生）参与了焦点小组讨论。结果表明，在妇女、医疗保健专业人员和政策方面，存在许多障碍且对孕前健康缺乏认识。描述了妇女对孕前初级保健信息的知识和态度。意大利妇女在这一领域的主要信息参考来源似乎是她们的妇产科医生。
结论
该研究表明，在意大利，有几个障碍影响着孕前保健。此外，意大利育龄妇女和医疗保健专业人员对孕前健康和保健缺乏认识。这些发现可能有助于制定实施孕前保健指南的策略。
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