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一项关于女性对在产前预约时被问及心理健康问题的可接受性看法的定性研究。

A qualitative study of women's views on the acceptability of being asked about mental health problems at antenatal booking appointments.

作者信息

Yapp Emma, Howard Louise M, Kadicheeni Meeriam, Telesia Laurence A, Milgrom Jeanette, Trevillion Kylee

机构信息

King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.

King's College London, Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.

出版信息

Midwifery. 2019 Jul;74:126-133. doi: 10.1016/j.midw.2019.03.021. Epub 2019 Mar 29.

Abstract

OBJECTIVE

To explore women's views on the acceptability of being asked about mental health problems at antenatal booking.

DESIGN

Qualitative study.

SETTING

Brief semi-structured qualitative interviews were conducted with women in a private setting at a hospital, or at women's homes. Interview discussions centered around three key questions: "What was it like for you answering the questions about your mood?", "Were there any questions you found upsetting, distressing or confronting?" and "Did the midwife give you some feedback about your answers?"

MEASUREMENTS

Interviews were audio-recorded, transcribed verbatim, and analysed using thematic and framework approaches.

PARTICIPANTS

An ethnically diverse sample [32% white British/Irish, 68% non-white, non-British] of 52 women living in the study area.

FINDINGS

Most women found mental health enquiry acceptable. A smaller proportion reported difficulties and many of these women had a past or current mental health problem and/or a history of abuse. These women reported difficulty due to the emotional responses triggered by the questions and the way disclosures were handled. In general, women wanted to be asked clear questions about mental health problems, to have sufficient time to discuss issues, and to receive responses from midwives which were normalising and well-informed about mental health.

CONCLUSIONS

This study highlights that women want midwives to ask clearly-framed questions about mental health problems [addressing past and current mental health concerns], and value responses from midwives that are normalising, well-informed and allow for discussion.

IMPLICATIONS FOR PRACTICE

Training should be provided to midwives on how to appropriately respond to women's distress during mental health enquiry, and on referral to support services.

摘要

目的

探讨女性对于在产前预约时被询问心理健康问题的可接受性的看法。

设计

定性研究。

背景

在医院的私密场所或女性家中,对女性进行简短的半结构化定性访谈。访谈讨论围绕三个关键问题展开:“回答关于你情绪的问题对你来说是怎样的?”“有没有你觉得令人不安、苦恼或难以应对的问题?”以及“助产士有没有就你的回答给你一些反馈?”

测量

访谈进行录音,逐字转录,并采用主题和框架方法进行分析。

参与者

居住在研究区域的52名女性组成的种族多样化样本(32%为英国/爱尔兰白人,68%为非白人、非英国裔)。

结果

大多数女性认为心理健康询问是可接受的。较小比例的女性报告有困难,其中许多女性有过去或当前的心理健康问题和/或虐待史。这些女性报告说有困难是因为问题引发的情绪反应以及披露信息的处理方式。总体而言,女性希望被问到关于心理健康问题的明确问题,有足够的时间讨论问题,并从助产士那里得到使情况正常化且对心理健康有充分了解的回应。

结论

本研究强调女性希望助产士询问关于心理健康问题的明确框架问题(涉及过去和当前的心理健康问题),并重视助产士使情况正常化、信息充分且允许讨论的回应。

对实践的启示

应为助产士提供培训,内容包括如何在心理健康询问期间适当应对女性的困扰,以及如何转介至支持服务。

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