Sociology of Development and Change Group, Wageningen University, P. O. Box 8130, Hollandsweg 1, 6700 EW, Wageningen, Netherlands.
Dodowa Health Research Centre, Research & Development Division, Ghana Health Service, P. O. Box DD 1, Dodowa-Accra, Ghana.
BMC Pregnancy Childbirth. 2018 Jul 3;18(1):274. doi: 10.1186/s12884-018-1916-9.
Pregnant women can misinform or withhold their reproductive and medical information from providers when they interact with them during care decision-making interactions, although, the information clients reveal or withhold while seeking care plays a critical role in the quality of care provided. This study explored 'how' and 'why' pregnant women in Ghana control their past obstetric and reproductive information as they interact with providers at their first antenatal visit, and how this influences providers' decision-making at the time and in subsequent care encounters.
This research was a case-study of two public hospitals in southern Ghana, using participant observation, conversations, interviews and focus group discussions with antenatal, delivery, and post-natal clients and providers over a 22-month period. The Ghana Health Service Ethical Review Committee gave ethical approval for the study (Ethical approval number: GHS-ERC: 03/01/12). Data analysis was conducted according to grounded theory.
Many of the women in this study selectively controlled the reproductive, obstetric and social history information they shared with their provider at their first visit. They believed that telling a complete history might cause providers to verbally abuse them and they would be regarded in a negative light. Examples of the information controlled included concealing the actual number of children or self-induced abortions. The women adopted this behaviour as a resistance strategy to mitigate providers' disrespectful treatment through verbal abuses and questioning women's practices that contradicted providers' biomedical ideologies. Secondly, they utilised this strategy to evade public humiliation because of inadequate privacy in the hospitals. The withheld information affected quality of care decision-making and care provision processes and outcomes, since misinformed providers were unaware of particular women's risk profile.
Many mothers in this study withhold or misinform providers about their obstetric, reproductive and social information as a way to avoid receiving disrespectful maternal care and protect their privacy. Improving provider client relationship skills, empowering clients and providing adequate infrastructure to ensure privacy and confidentiality in hospitals, are critical to the provision of respectful maternal care.
孕妇在与医护人员进行护理决策互动时，可能会向医护人员提供错误或隐瞒其生殖和医疗信息，尽管客户在寻求护理时透露或隐瞒的信息对所提供护理的质量起着至关重要的作用。本研究探讨了加纳的孕妇在与医护人员进行第一次产前就诊时，如何以及为何控制其过去的产科和生殖信息，以及这如何影响医护人员在当时和后续护理接触中的决策。
本研究是加纳南部两家公立医院的案例研究，使用参与观察、对话、访谈和焦点小组讨论，在 22 个月的时间里与产前、分娩和产后的客户和医护人员进行了交流。加纳卫生服务伦理审查委员会对该研究给予了伦理批准（伦理批准编号：GHS-ERC：03/01/12）。数据分析按照扎根理论进行。
本研究中的许多女性在第一次就诊时会选择性地控制她们与医护人员分享的生殖、产科和社会史信息。她们认为，透露完整的病史可能会导致医护人员辱骂她们，并对她们产生负面看法。被控制的信息包括隐瞒实际子女数量或自我诱导的堕胎。这些女性采取这种行为作为一种抵抗策略，以减轻医护人员的不尊重对待，避免因言语侮辱和质疑女性与医护人员的生物医学观念相悖的行为而遭受公开羞辱。其次，她们利用这种策略来避免因医院隐私不足而遭受公开羞辱。这些隐瞒的信息影响了护理决策的质量以及护理的提供过程和结果，因为信息错误的医护人员不了解特定女性的风险概况。
本研究中的许多母亲在与医护人员交流时会隐瞒或提供错误的产科、生殖和社会信息，以避免接受不尊重的产妇护理，并保护自己的隐私。改善医护人员与客户的关系技巧，赋予客户权力，并提供足够的基础设施以确保医院的隐私和保密性，对于提供尊重产妇护理至关重要。
