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伊朗产后女性中感知到的不尊重产妇护理的患病率及预测因素:一项横断面研究

Prevalence and predictors of perceived disrespectful maternity care in postpartum Iranian women: a cross-sectional study.

作者信息

Hajizadeh Khadije, Vaezi Maryam, Meedya Shahla, Mohammad Alizadeh Charandabi Sakineh, Mirghafourvand Mojgan

机构信息

Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran.

Department of obstetrics and gynecology, Alzahra teaching hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

BMC Pregnancy Childbirth. 2020 Aug 14;20(1):463. doi: 10.1186/s12884-020-03124-2.

Abstract

BACKGROUND

Disrespectful maternity care is a key impediment to achieving a good quality care. Identifying predicting factors can be used in mitigating any potential risk in for disrespect and abuse in maternity care. The present study was conducted to determine prevalence and predictors of perceived disrespectful maternity care among Iranian women.

METHODS

A cross-sectional study was conducted in three public and three private hospitals in the city of Tabriz involving 334 postpartum women. Tools included socio-demographic, pregnancy, labour and birth characteristics questionnaires, and disrespect and abuse scales. Data were collected in 6 to 18 h after birth. Multivariate logistic regression was used to determine predictors of disrespectful maternity care.

RESULTS

A majority of the women (253; 75.7%) reported one or several types of perceived disrespectful maternity care. The most frequent types related to not allowing women to choose labour positions (142; 44.3%) and not allowing them to move during labour (148; 42.5%). Nighttime childbirth (aOR 3.07; 95% CI 1.61 to 5.88) increased the likelihood of perceived disrespectful maternity care. However, presence of spouses to accompany their wives in waiting rooms (aOR 0.32; 95% CI 0.11 to 0.88), the attendance of private physicians (aOR 0.05; 95% CI 0.02 to 0.12), and midwives (aOR 0.22; 95% CI 0.11 to 0.45) decreased the likelihood of perceived disrespectful maternity care.

CONCLUSION

The results showed high levels of perceived disrespectful maternity care in postpartum women. Therefore, appropriate interventions, such as encouraging spouses' presence, increasing the number of night shift staff, and training obstetric residents and midwives by holding ethics classes, with particular emphasis on empathy with patients.

摘要

背景

不尊重产妇的护理是实现高质量护理的关键障碍。识别预测因素可用于减轻产妇护理中不尊重和虐待行为的任何潜在风险。本研究旨在确定伊朗女性中感知到的不尊重产妇护理的患病率及预测因素。

方法

在大不里士市的三家公立医院和三家私立医院对334名产后妇女进行了一项横断面研究。工具包括社会人口统计学、妊娠、分娩和出生特征问卷,以及不尊重和虐待量表。在产后6至18小时收集数据。采用多因素逻辑回归确定不尊重产妇护理的预测因素。

结果

大多数女性(253名;75.7%)报告了一种或几种感知到的不尊重产妇护理类型。最常见的类型是不允许女性选择分娩姿势(142名;44.3%)和不允许她们在分娩期间移动(148名;42.5%)。夜间分娩(调整后比值比3.07;95%置信区间1.61至5.88)增加了感知到不尊重产妇护理的可能性。然而,配偶在候诊室陪伴妻子(调整后比值比0.32;95%置信区间0.11至0.88)、私人医生的参与(调整后比值比0.05;95%置信区间0.02至0.12)以及助产士的参与(调整后比值比0.22;95%置信区间0.11至0.45)降低了感知到不尊重产妇护理的可能性。

结论

结果显示产后女性中感知到的不尊重产妇护理程度较高。因此,应采取适当干预措施,如鼓励配偶陪伴、增加夜班工作人员数量,以及通过举办道德课程培训产科住院医师和助产士,尤其要强调对患者的同理心。

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