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全科医生感知到的妊娠脆弱性指标:一项定性访谈研究。

General practitioners' perceived indicators of vulnerability in pregnancy- A qualitative interview study.

机构信息

Research Unit of General Practice, Department of Public Health, University of Southern, Odense, Denmark.

DaCHE - Danish Centre for Health Economics, Department of Public Health, University of Southern, Odense, Denmark.

出版信息

BMC Fam Pract. 2021 Jun 26;22(1):135. doi: 10.1186/s12875-021-01439-3.

Abstract

OBJECTIVE

To explore general practitioners' (GPs') perceived indicators of vulnerability among pregnant women in primary care.

DESIGN

A qualitative study with semi-structured in-depth focus group interviews.

SETTING

General practices located in a mixture of urban, semi-urban and rural practices throughout the Region of Southern Denmark SUBJECTS: Twenty GPs.

MAIN OUTCOME MEASURES

Through qualitative analysis with systematic text condensation of the interview data, the following themes emerged: (1) obvious indicators of vulnerability-i.e. somatic or psychological illnesses, or complex social problems and 2) intangible indicators of vulnerability - i.e. identification depended on the GPs' gut-feeling. From the GPs' perspective, the concept of vulnerability in pregnancy were perceived as the net result of risk factors and available individual and social resources, with a psychosocial etiology as the dominant framework.

CONCLUSIONS

The GPs demonstrated a broad variety of perceived indicators of vulnerability in pregnancy; most importantly, the GPs were aware of a group of pregnant women with intangible vulnerability mainly representing low resilience. Despite not fitting into the GPs' perceived concept of vulnerability, the GPs had a strong gut feeling that these women might be vulnerable. Misjudging the resources of pregnant women due to their physical appearance could delay the GPs' identification of vulnerability. Future studies should explore the challenges GPs experiences when assessing vulnerability among pregnant women.

摘要

目的

探讨初级保健中医师对孕妇脆弱性的感知指标。

设计

半结构化深入焦点小组访谈的定性研究。

地点

丹麦南部地区的城市、半城市和农村混合地区的普通诊所。

受试者

20 名全科医生。

主要观察指标

通过对访谈数据进行系统文本浓缩的定性分析,出现了以下主题:(1)明显的脆弱性指标-即躯体或心理疾病,或复杂的社会问题和 2)无形的脆弱性指标-即识别取决于医生的直觉。从全科医生的角度来看,怀孕脆弱性的概念被认为是危险因素和可用的个人和社会资源的净结果,以心理社会病因学为主要框架。

结论

全科医生在妊娠中表现出各种各样的脆弱性感知指标;最重要的是,全科医生意识到了一群具有无形脆弱性的孕妇,主要代表着低适应能力。尽管这些妇女不符合全科医生感知的脆弱性概念,但全科医生有一种强烈的直觉,认为这些妇女可能很脆弱。由于外表而误判孕妇的资源可能会延迟医生识别脆弱性。未来的研究应探讨全科医生在评估孕妇脆弱性时所面临的挑战。

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