解决产前护理中的种族差异：对助产士参与 MAMAACT 干预经验的定性评估。
Addressing ethnic disparity in antenatal care: a qualitative evaluation of midwives' experiences with the MAMAACT intervention.
机构信息
Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200, Copenhagen N, Denmark.
Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postboks 2099, 1014, Copenhagen K, Denmark.
出版信息
BMC Pregnancy Childbirth. 2020 Feb 19;20(1):118. doi: 10.1186/s12884-020-2807-4.
BACKGROUND
In Denmark, 13% of all children are born by non-Western immigrant women. The public antenatal care has not adapted to this increased diversity of women. Compared to women coming from Western countries, non-Western immigrant women have an increased prevalence of severe maternal morbidity and higher risks of maternal death, stillbirth and infant death. Suboptimal care is a contributing factor to these ethnic disparities, and thus the provision of appropriate antenatal care services is pivotal to reducing these disparities and challenges to public health. Yet, little is known about the targeted interventions which have been developed to reduce these inequities in reproductive health. The MAMAACT intervention, which included a training course for midwives, a leaflet and a mobile application, as well as additional visit time, was developed and tested at a maternity ward to increase responses to pregnancy warning signs among midwives and non-Western immigrant women.
AIM
To explore the feasibility and acceptability of the MAMAACT intervention among midwives and identify factors affecting midwives' delivery of the intervention.
METHODS
Eight mini-group interviews with midwives (n = 18) were undertaken. Systematic text condensation was used to analyse data.
RESULTS
Three main categories were identified, which were 'Challenges of working with non-Western immigrant women', 'Attitudes towards and use of the leaflet and mobile application', and 'Organisational factors affecting the use of the MAMAACT intervention'.
CONCLUSIONS
The MAMAACT intervention was found to be feasible as well as acceptable among midwives. Women turning to relatives for pregnancy-related advice, time constraints during midwifery visits, incomplete clinical records and lack of professional interpreter assistance impacted midwives' delivery of the MAMAACT intervention. Midwives displayed a readiness for the MAMAACT intervention; however, there is a need to further examine how contextual factors may impact the use of the intervention in antenatal care.
TRIAL REGISTRATION
ClinicalTrials.gov, Retrospective Registration (07/2/2020), registration number NCT04261400.
背景
在丹麦，13%的儿童是由非西方移民妇女所生。公共产前护理尚未适应这种女性多样性的增加。与来自西方国家的妇女相比，非西方移民妇女患有严重产妇发病率的比例更高，且母婴死亡、死产和婴儿死亡的风险更高。护理不足是造成这些种族差异的一个因素，因此提供适当的产前护理服务对于减少这些差异和公共卫生挑战至关重要。然而，对于为减少生殖健康方面的这些不平等而制定的有针对性的干预措施，人们知之甚少。MAMAACT 干预措施包括为助产士提供培训课程、宣传册和移动应用程序，以及额外的就诊时间，该干预措施是在一家妇产科病房开发和测试的，旨在增加助产士对妊娠警告信号的反应以及非西方移民妇女的反应。
目的
探讨 MAMAACT 干预措施在助产士中的可行性和可接受性，并确定影响助产士实施干预措施的因素。
方法
对 18 名助产士进行了 8 次小型小组访谈。使用系统文本浓缩方法对数据进行分析。
结果
确定了三个主要类别，分别是“与非西方移民妇女合作的挑战”、“对宣传册和移动应用程序的态度和使用”以及“影响 MAMAACT 干预措施使用的组织因素”。
结论
MAMAACT 干预措施在助产士中被认为是可行且可接受的。妇女向亲属寻求与怀孕相关的建议、助产士就诊期间的时间限制、不完整的临床记录以及缺乏专业口译员的帮助，这些都影响了助产士实施 MAMAACT 干预措施。助产士对 MAMAACT 干预措施表现出积极性；但是，需要进一步研究环境因素如何影响该干预措施在产前护理中的使用。
试验注册
ClinicalTrials.gov，回顾性注册（2020 年 7 月 2 日），注册号 NCT04261400。
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