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英格兰残疾妇女在孕期、分娩期及产后期获得的孕产妇保健服务及其质量:一项全国性调查的数据

Access and quality of maternity care for disabled women during pregnancy, birth and the postnatal period in England: data from a national survey.

作者信息

Malouf Reem, Henderson Jane, Redshaw Maggie

机构信息

Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.

出版信息

BMJ Open. 2017 Jul 20;7(7):e016757. doi: 10.1136/bmjopen-2017-016757.

Abstract

OBJECTIVES

More disabled women are becoming mothers, and yet, their care is rarely the focus of quantitative research. This study aimed to investigate access and quality of maternity care for women with differing disabilities.

DESIGN

Secondary analysis was conducted on data from a 2015 national survey of women's experience of maternity care. Descriptive and adjusted analyses were undertaken for five disability groups: physical disability, sensory impairment, mental health disability, learning disability and multiple disability, and comparisons were made with the responses of non-disabled women.

SETTING

Survey data were collected on women's experience of primary and secondary care in all trusts providing maternity care in England.

PARTICIPANTS

Women who had given birth 3 months previously, among whom were groups self-identifying with different types of disability. Exclusions were limited to women whose baby had died and those who were younger than 16 years at the time of the recent birth.

RESULTS

Overall, 20 094 women completed and returned the survey; 1958 women (9.5%) self-identified as having a disability. The findings indicate some gaps in maternity care provision for these women relating to interpersonal aspects of care: communication, feeling listened to and supported, involvement in decision making, having a trusted and respected relationship with clinical staff. Women from all disability groups wanted more postnatal contacts and help with infant feeding.

CONCLUSION

While access to care was generally satisfactory for disabled women, women's emotional well-being and support during pregnancy and beyond is an area that is in need of improvement. Specific areas identified included disseminating information effectively, ensuring appropriate communication and understanding, and supporting women's sense of control to build trusting relationships with healthcare providers.

摘要

目的

越来越多的残疾女性成为母亲,然而,她们的护理很少成为定量研究的重点。本研究旨在调查不同残疾类型女性获得产科护理的情况及护理质量。

设计

对2015年全国女性产科护理体验调查的数据进行二次分析。对身体残疾、感官障碍、心理健康障碍、学习障碍和多重残疾这五个残疾群体进行描述性和校正分析,并与非残疾女性的回答进行比较。

背景

收集了英格兰所有提供产科护理的信托机构中女性接受初级和二级护理体验的调查数据。

参与者

3个月前分娩的女性,其中包括自我认定为不同残疾类型的群体。排除仅限于婴儿死亡的女性和最近分娩时年龄小于16岁的女性。

结果

总体而言,20094名女性完成并返回了调查问卷;1958名女性(9.5%)自我认定为残疾。研究结果表明,在为这些女性提供产科护理方面,在护理的人际方面存在一些差距:沟通、感觉被倾听和支持、参与决策、与临床工作人员建立信任和受尊重的关系。所有残疾群体的女性都希望有更多的产后联系以及在婴儿喂养方面得到帮助。

结论

虽然残疾女性获得护理的情况总体上令人满意,但女性在孕期及之后的情绪健康和支持是一个需要改进的领域。确定的具体领域包括有效传播信息、确保适当的沟通和理解,以及支持女性的控制感,以与医疗服务提供者建立信任关系。

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