青少年怀孕与为人父母：医疗服务提供者的看法
Adolescent Pregnancy and Parenting: Perceptions of Healthcare Providers.
作者信息
Govender Desiree, Taylor Myra, Naidoo Saloshni
机构信息
KwaZulu-Natal Department of Health, South Africa Developing Research Innovation Localisation and Leadership (DRILL) Programme, University of KwaZulu-Natal, Durban, South Africa.
School of Nursing and Public Health, Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
出版信息
J Multidiscip Healthc. 2020 Nov 18;13:1607-1628. doi: 10.2147/JMDH.S258576. eCollection 2020.
BACKGROUND
Adverse maternal and child health outcomes due to adolescent pregnancy are central to public health research and practice. In addition, public health has emphasised that the care rendered by healthcare providers plays a pivotal role in the health and well-being of pregnant and parenting adolescents. Healthcare providers may differ in the ways they interpret adolescent pregnancy and parenting and consequently, this may have profound implications for healthcare decision making. The aim of this study was to explore the multiple perspectives of a diverse group of healthcare providers' delivering services and engaging with pregnant adolescents and adolescent mothers at a district hospital in Ugu, KwaZulu Natal, South Africa.
METHODS
This descriptive qualitative study used semi-structured interviews (n=33). Healthcare providers rendering care to pregnant and parenting adolescents were recruited from the maternity, antenatal, paediatrics, psychology, dietetics, physiotherapy and social work departments, as well as from the HIV/AIDS, STIs and TB (HAST) programme. The data were analysed using thematic analysis.
RESULTS
The healthcare providers acknowledged that adolescent pregnancy is a problematic issue in Ugu district. Furthermore, they felt that the postpartum sexual-related and reproductive health of adolescent mothers was not given priority. In the healthcare providers' view, the problems experienced by pregnant and parenting adolescents were school dropout, financial constraints, breakdown of relationships, abandonment, stigmatisation, parenting and child rearing difficulties, and both physical and mental health problems.
CONCLUSION
This study highlights that the issue of sexual- and reproductive-related outcomes of adolescent pregnancy and parenting is not given priority. In addition, the findings also highlighted the need for a multidisciplinary approach to the care of pregnant and parenting adolescents. Multidisciplinary communities of practices as interventions can be used to generate and share knowledge, capacitate healthcare providers and improve clinical practice. The training of healthcare providers, provision of non-judgemental counselling and tailored services for pregnant adolescents and adolescent mothers are essential. When appropriately disseminated, the findings will assist relevant healthcare providers, administrators in healthcare institutions, policymakers, and officials of the Department of Health and the Department of Education in South Africa to address the lack of appropriate care for pregnant and parenting adolescents.
背景
青少年怀孕导致的不良母婴健康结局是公共卫生研究和实践的核心问题。此外，公共卫生强调医疗服务提供者提供的护理对怀孕及育有子女的青少年的健康和福祉起着关键作用。医疗服务提供者对青少年怀孕和育儿的理解方式可能存在差异，因此，这可能对医疗决策产生深远影响。本研究的目的是探讨南非夸祖鲁-纳塔尔省乌古区一家区级医院中，不同类型的医疗服务提供者在为怀孕青少年和青少年母亲提供服务及互动过程中的多种观点。
方法
本描述性定性研究采用半结构式访谈（n = 33）。从产科、产前科、儿科、心理学、营养学、物理治疗和社会工作部门，以及艾滋病毒/艾滋病、性传播感染和结核病（HAST）项目中招募为怀孕及育有子女的青少年提供护理的医疗服务提供者。采用主题分析法对数据进行分析。
结果
医疗服务提供者承认青少年怀孕在乌古区是一个有问题的议题。此外，他们认为青少年母亲产后与性相关的生殖健康未得到优先关注。在医疗服务提供者看来，怀孕及育有子女的青少年所面临的问题包括辍学、经济困难、关系破裂、被遗弃、受污名化、育儿和抚养孩子困难，以及身心健康问题。
结论
本研究强调青少年怀孕和育儿中性与生殖相关结局的问题未得到优先关注。此外，研究结果还凸显了对怀孕及育有子女的青少年进行多学科护理的必要性。作为干预措施的多学科实践社区可用于生成和共享知识、提升医疗服务提供者的能力并改善临床实践。对医疗服务提供者进行培训、为怀孕青少年和青少年母亲提供无偏见的咨询和量身定制的服务至关重要。研究结果如能得到适当传播，将有助于南非相关医疗服务提供者、医疗机构管理人员、政策制定者以及卫生部门和教育部门的官员解决对怀孕及育有子女的青少年缺乏适当护理的问题。
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