Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.
J Clin Nurs. 2021 Aug;30(15-16):2386-2398. doi: 10.1111/jocn.15778. Epub 2021 Apr 19.
Pregnant women and partners with psychological and/or social challenges are exposed to adverse health outcomes. It is therefore recommended that they receive targeted maternity care services. The relationship between parents and professionals is key to help parents engage with services and experience them as supportive. However, more knowledge is needed on parents' care experiences during encounters with professionals to further understand when and how these are experienced as supportive.
This study aimed at identifying the key elements of supportive care practices by exploring how parents in vulnerable positions experience their relationship and encounters with the professionals involved in their pregnancy and postnatal care.
Ethnographic fieldwork was conducted in a Danish municipality, including 50 semi-structured interviews with parents and 51 field visits during parent-professional encounters, including informal interviews and participant observation. Using a purposive recruitment strategy, 26 women and 13 men were recruited, who varied in age, socioeconomic background and vulnerability factors. COREQ reporting guidelines were used.
The analysis identified five themes: (a) Having a voice: Feeling listened to, (b) Being met with empathy: Feeling understood, (c) Worthy of attention: Feeling taken seriously, (d) On equal terms: Feeling like a normal family and (e) Moving in the right direction: Feeling reassured.
Positive care experiences facilitate engagement with services and professionals as this contribute to parents feeling included, respected and safe. Conversely, negative care experiences leave parents feeling excluded, judged and anxious, potentially reinforcing and adding to existing feelings of anxiety and stigma. This requires that professionals have good communication skills and are able to approach parents in an open and non-judgmental way.
Understanding the significance of supportive care practices is paramount for health visitors, midwives and other professionals involved in providing for parents in vulnerable positions during pregnancy and the postnatal period.
有心理和/或社会挑战的孕妇及其伴侣面临不良健康结局的风险。因此，建议为他们提供针对性的孕产保健服务。父母与专业人员之间的关系是帮助父母参与服务并将其视为支持的关键。然而，为了进一步了解这些服务何时以及如何被视为支持，我们需要更多关于父母在与专业人员接触时的护理体验的知识。
本研究旨在通过探讨弱势处境下的父母如何体验他们与参与其妊娠和产后护理的专业人员的关系和互动，来确定支持性护理实践的关键要素。
在丹麦的一个市进行了民族志实地工作，包括对父母进行的 50 次半结构化访谈和 51 次父母与专业人员相遇时的实地访问，包括非正式访谈和参与式观察。采用有目的的招募策略，招募了 26 名女性和 13 名男性，他们在年龄、社会经济背景和脆弱性因素方面存在差异。使用了 COREQ 报告指南。
分析确定了五个主题：(a) 有发言权：感到被倾听，(b) 感同身受：感到被理解，(c) 值得关注：感到被认真对待，(d) 平等相待：感到像正常家庭一样，(e) 朝着正确的方向前进：感到安心。
积极的护理体验促进了父母与服务和专业人员的互动，因为这有助于父母感到被包容、被尊重和感到安全。相反，消极的护理体验会让父母感到被排斥、被评判和焦虑，这可能会加剧和增加他们现有的焦虑和耻辱感。这要求专业人员具备良好的沟通技巧，并能够以开放和非评判的方式与父母接触。
了解支持性护理实践的意义对参与孕妇和弱势处境下的产后父母的保健员、助产士和其他专业人员至关重要。
