Center for Nursing Research, Villanova University College of Nursing, 800 Lancaster Avenue, Villanova, PA 190895, USA.
The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 15 South Street, Waltham, MA 02453, USA.
Disabil Health J. 2018 Jan;11(1):8-13. doi: 10.1016/j.dhjo.2017.07.004. Epub 2017 Aug 1.
Women with physical disabilities (WPD) experience major barriers to care during pregnancy. Lack of education about disability in health professionals' education is a pervasive barrier to quality care. In an effort to explore this issue, this study examined the issue from the perspective of obstetric clinicians who provide care to WPD.
This qualitative descriptive study explored perspectives of obstetric clinicians who provide perinatal care for WPD to inform the educational preparation of clinicians to care for women with disabilities.
We contacted 33 obstetric clinicians who care for pregnant WPD. Thirteen obstetricians and one nurse midwife participated in semi-structured telephone interviews. Interview transcriptions were content analyzed to identify initial themes. Investigators discussed and revised the themes as additional transcripts were reviewed and new themes were identified.
Themes identified from transcript analyses included: lack of education at any level including during postgraduate residency and fellowship on care of pregnant WPD, unplanned career pathway, educating other clinicians, and positive and negative experiences providing obstetrical care to women with physical disability. Several clinicians provided this care because of requests from other clinicians and did not begin their careers with the goal of providing obstetric care to women with physical disabilities. None had received formal education or training including during their residencies or fellowships. The clinicians described very rewarding experiences caring for WPD.
The experiences reported by this study's participants suggest the need to include disability in undergraduate and postgraduate education and training to improve obstetric care to WPD.
身体残疾的女性（WPD）在怀孕期间会遇到严重的护理障碍。卫生专业人员教育中缺乏残疾教育是阻碍优质护理的普遍障碍。为了探讨这个问题，本研究从为 WPD 提供护理的产科临床医生的角度探讨了这个问题。
这项定性描述性研究探讨了为 WPD 提供围产期护理的产科临床医生的观点，以为残疾妇女护理的临床医生的教育准备提供信息。
我们联系了 33 名为 WPD 孕妇提供护理的产科临床医生。13 名妇产科医生和 1 名护士助产士参加了半结构化电话访谈。对访谈记录进行内容分析，以确定初始主题。随着更多转录本的审查和新主题的确定，调查人员讨论并修改了主题。
从转录本分析中确定的主题包括：各级教育缺乏，包括在研究生住院医师和研究员期间对怀孕的 WPD 的护理，非计划的职业道路，教育其他临床医生，以及为身体残疾的女性提供产科护理的积极和消极经验。一些临床医生因为其他临床医生的要求而提供这种护理，他们的职业并不是为身体残疾的女性提供产科护理。他们都没有接受过正式的教育或培训，包括在住院医师和研究员期间。这些临床医生描述了非常有意义的照顾 WPD 的经验。
本研究参与者报告的经验表明，需要将残疾纳入本科和研究生教育和培训中，以改善对 WPD 的产科护理。
