Tarasoff Lesley A
Dalla Lana School of Public Health, University of Toronto, 6th Floor - 155 College Street, Toronto, Ontario M5T 3M7, Canada.
Disabil Health J. 2017 Jul;10(3):426-433. doi: 10.1016/j.dhjo.2017.03.017. Epub 2017 Apr 5.
While more women with physical disabilities are becoming mothers, many encounter barriers to perinatal care and experience poor outcomes. Little is known about the perinatal care experiences and outcomes of women with physical disabilities in Canada.
This qualitative study sought to understand the perinatal care experiences and outcomes of women with physical disabilities in one Canadian province, with an emphasis on identifying barriers to care.
In-depth interviews were conducted with 13 women with physical disabilities who had given birth in the last 5 years. Follow-up interviews were conducted with 10 of the 13 participants. All interviews were audio-recorded and transcribed verbatim. Data analysis was informed by a constructivist grounded theory approach.
Based on analysis of participants' interviews, five themes regarding barriers to care were identified: (1) Inaccessible care settings, (2) Negative attitudes, (3) Lack of knowledge and experience, (4) Lack of communication and collaboration among providers, and (5) Misunderstandings of disability and disability-related needs.
Study findings reveal that the perinatal care system is not set up with women with physical disabilities in mind and that barriers to perinatal care may contribute to poor outcomes. More research and training are needed to address barriers to perinatal care for women with physical disabilities. Collaboration among perinatal and disability-related providers and meaningful inclusion of women with physical disabilities in educational initiatives and care plans are vital to improve care experiences and outcomes.
虽然越来越多的身体残疾女性成为母亲，但许多人在围产期护理方面遇到障碍，且结局不佳。对于加拿大身体残疾女性的围产期护理经历和结局知之甚少。
这项定性研究旨在了解加拿大一个省份身体残疾女性的围产期护理经历和结局，重点是确定护理障碍。
对13名在过去5年内分娩的身体残疾女性进行了深入访谈。对13名参与者中的10名进行了随访访谈。所有访谈均进行了录音并逐字转录。数据分析采用建构主义扎根理论方法。
基于对参与者访谈的分析，确定了关于护理障碍的五个主题：（1）难以进入的护理场所，（2）消极态度，（3）缺乏知识和经验，（4）提供者之间缺乏沟通与协作，以及（5）对残疾和与残疾相关需求的误解。
研究结果表明，围产期护理系统在设计时没有考虑到身体残疾女性，围产期护理障碍可能导致不良结局。需要更多的研究和培训来解决身体残疾女性围产期护理的障碍。围产期提供者与残疾相关提供者之间的合作以及让身体残疾女性有意义地参与教育倡议和护理计划对于改善护理经历和结局至关重要。
