Hocaloski Shea, Elliott Stacy, Hodge Karen, McBride Kate, Hamilton Lynsey, McBride Christopher B, Basso Melanie
GF Strong Rehabilitation Centre, Vancouver, British Columbia.
The Blusson Spinal Cord Centre, Vancouver, British Columbia.
Top Spinal Cord Inj Rehabil. 2017 Fall;23(4):386-396. doi: 10.1310/sci16-00036.
In North America, there are currently no clearly defined standards of care for women with spinal cord injury (SCI) during the perinatal periods of preconception, pregnancy, labour/delivery, and postpartum. Women with SCI and their partners say resources specific to their needs are hard to find. Little evidence-informed research exists to guide clinicians in the care of women with SCI during pregnancy. To further explore these gaps in knowledge and practices for perinatal care for women with SCI, a 1-day workshop was held in Vancouver, British Columbia (BC), Canada in November 2013. Twenty-nine attendees included women with SCI, SCI-community service providers, researchers, and health care providers from maternal/fetal medicine, rehabilitation, anesthesiology, and psychiatry. A pre-meeting online survey of stakeholders elucidated 3 themes: lack of knowledge for both consumers and care providers, gaps in access to services and information, and a need for collaboration throughout the perinatal journey. The workshop addressed issues of care providers' lack of knowledge of nonmedical issues during the perinatal period, physical and attitudinal barriers to access to care for women with SCI, and the need for better collaboration and communication between care providers, the latter potentially initiated by providing information to care providers through the women with SCI themselves. Content experts attending the workshop collectively made recommendations for knowledge generation and research priorities, clinical application priorities, and the need for policy and guideline development in this field. Two information sources for women have since been developed and are available online.
在北美,目前对于脊髓损伤(SCI)女性在孕前、孕期、分娩期及产后围产期阶段,尚无明确界定的护理标准。患有脊髓损伤的女性及其伴侣表示,满足其特殊需求的资源很难找到。几乎没有基于证据的研究可指导临床医生对孕期脊髓损伤女性进行护理。为进一步探究脊髓损伤女性围产期护理在知识和实践方面的这些差距,2013年11月在加拿大不列颠哥伦比亚省(BC)温哥华举办了为期一天的研讨会。29名与会者包括脊髓损伤女性、脊髓损伤社区服务提供者、研究人员以及来自母胎医学、康复、麻醉学和精神病学领域的医疗保健提供者。会前对利益相关者进行的在线调查阐明了三个主题:消费者和护理提供者均缺乏知识、获取服务和信息存在差距,以及在整个围产期过程中需要开展协作。该研讨会讨论了护理提供者在围产期对非医疗问题缺乏了解、脊髓损伤女性获得护理存在身体和态度上的障碍,以及护理提供者之间需要更好地协作与沟通等问题,后者可能通过脊髓损伤女性自身向护理提供者提供信息来启动。参加研讨会的内容专家共同就知识生成和研究重点、临床应用重点以及该领域政策和指南制定的必要性提出了建议。此后已为女性开发了两个在线信息源。