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在农村背景下,了解为酷儿生育女性提供创伤知情护理的新认识。

Accessing new understandings of trauma-informed care with queer birthing women in a rural context.

作者信息

Searle Jennifer, Goldberg Lisa, Aston Megan, Burrow Sylvia

机构信息

Nova Scotia Health Authority, Halifax, NS, Canada.

Dalhousie University School of Nursing, Halifax, NS, Canada.

出版信息

J Clin Nurs. 2017 Nov;26(21-22):3576-3587. doi: 10.1111/jocn.13727. Epub 2017 Mar 22.

Abstract

AIMS AND OBJECTIVES

Participant narratives from a feminist and queer phenomenological study aim to broaden current understandings of trauma. Examining structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships.

BACKGROUND

Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences.

DESIGN

Analysis of the qualitative data was guided by feminist and queer phenomenology. This was well suited to understanding queer women's storied narratives of trauma, including disempowering processes of structural marginalisation.

METHODS

Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada.

RESULTS

Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that reconstructs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality.

CONCLUSIONS

Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces.

RELEVANCE TO CLINICAL PRACTICE

New trauma-informed assessment strategies reconstruct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re-experiencing the process of coming out as queer in opposition to the expectation of heterosexuality.

摘要

目的与目标

一项女性主义和酷儿现象学研究中的参与者叙述旨在拓宽当前对创伤的理解。审视围产期护理关系中的结构性边缘化,有助于深入了解主导护理模式对酷儿生育女性的影响。更具体地说,将酷儿经历确认为该研究的一项关键发现,能提供基于创伤知情的策略,用以重构以往使女性丧失权能的围产期关系。

背景

异性恋规范主导着分娩空间,给酷儿生育女性带来了巨大挑战,她们还可能因造成并维持社会建构差异的结构性边缘化过程而面临更高的创伤风险。

设计

定性数据分析以女性主义和酷儿现象学为指导。这非常适合理解酷儿女性关于创伤的故事性叙述,包括结构性边缘化的使女性丧失权能的过程。

方法

对13名自我认同为酷儿、在加拿大新斯科舍省农村有分娩经历的女性进行了有目的抽样的半结构化和对话式访谈。

结果

在新斯科舍省农村围产期护理的背景下,确认对酷儿女性具有重要意义。对传统评估模式提供新视角,为营造护理环境提供了策略,从而重构分娩空间,使有风险的女性不必违背异性恋期望出柜表明自己是酷儿。

结论

发现规范性做法会加剧结构性边缘化的影响,这表明围产期护理提供者,包括护士,可以挑战主导护理模式,重构酷儿女性与以往使女性丧失权能的异性恋规范期望之间的关系,而异性恋规范期望主导着分娩空间。

与临床实践的相关性

新的基于创伤知情的评估策略通过强化差异来重构历史上使女性丧失权能的围产期关系中的关联性,避免女性因再次经历违背异性恋期望出柜的过程而受到二次创伤。

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