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塞尔维亚公共医疗机构中女性的分娩经历:一项定性研究。

Women's Experiences of Childbirth in Serbian Public Healthcare Institutions: a Qualitative Study.

作者信息

Stankovic Biljana

机构信息

Faculty of Philosophy, University of Belgrade, Cika Ljubina 18-20, Belgrade, 11000, Serbia.

出版信息

Int J Behav Med. 2017 Dec;24(6):803-814. doi: 10.1007/s12529-017-9672-1.

Abstract

PURPOSE

The aim of the present study was to explore how women, users of public maternity healthcare services in Serbia, experience birth and what the most problematic relational aspects of institutional context associated with negative or even traumatic aspects of birth experiences are, as described by the women themselves.

METHOD

An exploratory qualitative study was undertaken using semi-structured interviews with 15 primiparous women aged 26 to 49 who have recently given birth in different public healthcare institutions in Belgrade. The basic framework for the analysis of interview transcripts was the interpretative phenomenological analysis (IPA).

RESULTS

Through the analysis, four relatively broad and partly interrelated themes emerged: (a) feelings of isolation and abandonment, (b) lack of communication, (c) lack of a caring relationship, and (d) lack of control and agency. The aspects of institutional environment that were considered particularly distressing in most of the childbirth experiences are related to distant and cold relationship with healthcare providers which adds to the feelings of isolation and abandonment, in addition to the lack of insight into and control over the process of birth that is managed in the hospital context without relying on women's subjective involvement in any relevant way.

CONCLUSION

The present study emphasized a supportive and caring relationship with medical practitioners, as well as allowing women to be more involved into their birthing process, as crucial for positive experience of birth, which might have profound and long-lasting psychosocial consequences. Recommendations for policy makers and future research are offered.

摘要

目的

本研究旨在探讨塞尔维亚公共孕产妇医疗服务的女性使用者如何体验分娩,以及女性自身描述的与分娩经历的负面甚至创伤性方面相关的机构环境中最具问题的关系层面是什么。

方法

采用探索性定性研究,对15名年龄在26至49岁之间、最近在贝尔格莱德不同公共医疗机构分娩的初产妇进行半结构化访谈。访谈记录分析的基本框架是解释现象学分析(IPA)。

结果

通过分析,出现了四个相对宽泛且部分相互关联的主题:(a)孤立和被遗弃感,(b)缺乏沟通,(c)缺乏关怀关系,(d)缺乏控制和自主权。在大多数分娩经历中,被认为特别令人痛苦的机构环境方面与与医疗服务提供者疏远冷漠的关系有关,这加剧了孤立和被遗弃感,此外,在医院环境中管理分娩过程时,缺乏对分娩过程的洞察和控制,且没有以任何相关方式依赖女性的主观参与。

结论

本研究强调与医护人员建立支持性和关怀性的关系,以及让女性更多地参与到分娩过程中,对分娩的积极体验至关重要,这可能会产生深远而持久的心理社会影响。为政策制定者和未来研究提供了建议。

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