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在瑞士分娩:一项使用焦点小组探索日内瓦和苏黎世移民妇女在怀孕期间和分娩期间经历的定性研究。

Giving birth in Switzerland: a qualitative study exploring migrant women's experiences during pregnancy and childbirth in Geneva and Zurich using focus groups.

机构信息

Faculty of Medicine, University of Geneva, Geneva, Switzerland.

Clinic of Obstetrics, University Hospital Zurich, Zurich, Switzerland.

出版信息

Reprod Health. 2019 Jul 22;16(1):112. doi: 10.1186/s12978-019-0771-0.

Abstract

BACKGROUND

Migrant mothers in high-income countries often encounter more complications during pregnancy, delivery, and the postpartum period. To enlighten health care providers concerning potential barriers, the objective of this study was to explore positive and negative experiences with maternal health services in the University Hospitals of Geneva and Zurich and to describe barriers to maternity services from a qualitative perspective.

METHODS

In this qualitative study, six focus groups (FGs) were conducted involving 33 women aged 21 to 40 years. All FG discussions were audio-recorded and later transcribed. Data were analysed using a thematic analysis approach assisted by the Atlas.ti qualitative data management software.

RESULTS

Positive experiences included not only the availability of maternity services, especially during emergency situations and the postpartum period, but also the availability of specific maternity services for undocumented migrants in Geneva. Negative experiences were classified into either personal or structural barriers. On the personal level, the main barriers were a lack of social support and a lack of health literacy, whereas the main themes on the structural level were language barriers and a lack of information.

CONCLUSION

Structural adaptation is necessary to meet the needs of the extremely diverse population. The needs include (1) the provision of specific information for migrant women in multiple languages, (2) the availability of trained interpreters who are easily accessible to health care providers, (3) specifically trained nurses or social assistance providers to guide migrants through the health system, and (4) a cultural competence-training programme for health care providers.

摘要

背景

高收入国家的移民母亲在妊娠、分娩和产后期间经常遇到更多的并发症。为了让医疗保健提供者了解潜在的障碍,本研究的目的是探索日内瓦大学附属医院和苏黎世大学附属医院产妇保健服务的积极和消极体验,并从定性的角度描述产妇服务的障碍。

方法

在这项定性研究中,进行了六次焦点小组(FG)讨论,涉及 33 名年龄在 21 至 40 岁的妇女。所有 FG 讨论都进行了录音,并随后进行了转录。使用主题分析方法,结合 Atlas.ti 定性数据管理软件对数据进行分析。

结果

积极的体验不仅包括产妇服务的可用性,特别是在紧急情况和产后期间,还包括日内瓦为无证移民提供的特定产妇服务。消极的体验分为个人或结构障碍。在个人层面上,主要障碍是缺乏社会支持和健康素养,而在结构层面上的主要主题是语言障碍和信息缺乏。

结论

需要进行结构性调整,以满足极其多样化的人口的需求。这些需求包括:(1) 以多种语言为移民妇女提供特定信息;(2) 提供易于医疗保健提供者获得的受过培训的口译员;(3) 专门培训护士或社会援助提供者,以指导移民通过卫生系统;(4) 为医疗保健提供者提供文化能力培训计划。

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