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从UJAMBO中学习:对马萨诸塞州波士顿非洲移民和难民妇女妇科护理的见解。

Learning from UJAMBO: Perspectives on Gynecologic Care in African Immigrant and Refugee Women in Boston, Massachusetts.

作者信息

Mehta P K, Saia K, Mody D, Crosby S S, Raj A, Maru S, Piwowarczyk L

机构信息

Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA.

Department of Obstetrics & Gynecology, School of Medicine, Program in Health Policy and Systems Management, School of Public Health, Maternal & Womens Health Policy, LSU Consortium for Health Transformation, Louisiana State University Health Sciences Center, New Orleans, LA, USA.

出版信息

J Immigr Minor Health. 2018 Apr;20(2):380-387. doi: 10.1007/s10903-017-0659-4.

Abstract

African-born immigrant women, and particularly refugees and asylum seekers, are at risk for reproductive health disparities but inadequately use relevant gynecologic services. We sought to elucidate perspectives on gynecologic care in a population of Congolese and Somali immigrants. We conducted a secondary qualitative analysis of focus group data using a grounded theory approach and the Integrated Behavioral Model as our theoretical framework. Thirty one women participated in six focus groups. Participant beliefs included the states of pregnancy and/or pain as triggers for care, preferences included having female providers and those with familiarity with female genital cutting. Barriers included stigma, lack of partner support, and lack of resources to access care. Experiential attitudes, normative beliefs, and environmental constraints significantly mediated care preferences for/barriers to gynecologic health service utilization in this population. Centering of patient perspectives to adapt delivery of gynecologic care to immigrants and refugees may improve utilization and reduce disparities.

摘要

出生于非洲的移民妇女,尤其是难民和寻求庇护者,面临生殖健康差异的风险,但对相关妇科服务的利用不足。我们试图阐明刚果和索马里移民群体对妇科护理的看法。我们采用扎根理论方法和整合行为模型作为理论框架,对焦点小组数据进行了二次定性分析。31名女性参加了6个焦点小组。参与者的信念包括将怀孕和/或疼痛状态作为就医的触发因素,偏好包括有女性医护人员以及熟悉女性割礼的人员。障碍包括耻辱感、缺乏伴侣支持以及缺乏获得护理的资源。经验态度、规范信念和环境限制显著影响了该群体对妇科健康服务利用的护理偏好/障碍。以患者视角为中心,使妇科护理的提供适应移民和难民的需求,可能会提高利用率并减少差异。

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