影响女性在怀孕和分娩期间对选择和控制感知的因素：一项横断面研究。
Factors influencing women's perceptions of choice and control during pregnancy and birth: a cross-sectional study.
机构信息
School of Nursing and Midwifery, Brookfield Health Sciences Complex, College Road, Cork, T12 AK54, Ireland.
National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, T12 DC4A, Ireland.
出版信息
BMC Pregnancy Childbirth. 2021 Oct 1;21(1):667. doi: 10.1186/s12884-021-04106-8.
BACKGROUND
Women across the world value choice and control throughout their maternity care experiences. In response to this health policy and frameworks are adapting and developing. The concepts of choice and control are extrinsically complex and open to interpretation by healthcare professionals and service users, with the two not necessarily aligning. Depending on a number of factors, women's experiences of choice and control within the same maternity care system may be very different. This study aimed to investigate the factors influencing women's perceptions of choice and control during pregnancy and birth in Ireland.
METHODS
We conducted a cross-sectional study using an adapted version of the UK national maternity experience survey (National Perinatal Epidemiology Unit). During March - July 2017, a sample of 1277 women were recruited from the postnatal wards of three maternity units and a tertiary maternity hospital. Poisson regression was used to assess the association between twelve factors and a series of measures of the women's perception of choice and control.
RESULTS
Most women reported not having choice in the model or location of their maternity care but most reported being involved enough in decision-making, especially during birth. Women who availed of private maternity care reported higher levels of choice and control than those who availed of public maternity care. This factor was the most influential factor on almost all choice and control measures.
CONCLUSION
Most women experiencing maternity care in Ireland report not having choice in the model and location of care. These are core elements of the Irish maternity strategy and significant investment will be required if improved choice is to be provided. Availing of private maternity care has the strongest influence on a woman's perceived choice and control but many women cannot afford this type of care, nor may they want this model of care.
背景
世界各地的女性都重视在整个孕产过程中的选择权和掌控权。为了响应这一需求，医疗政策和框架正在进行调整和发展。选择和控制的概念非常复杂，容易受到医疗保健专业人员和服务使用者的解释，两者不一定一致。取决于许多因素，同一孕产体系中女性的选择和控制体验可能会有很大的不同。本研究旨在调查影响爱尔兰女性在怀孕和分娩期间对选择和控制感知的因素。
方法
我们采用英国国家孕产经历调查（国家围产流行病学单位）的改编版本进行了一项横断面研究。2017 年 3 月至 7 月期间，从三家产科病房和一家三级产科医院的产后病房招募了 1277 名女性。使用泊松回归评估 12 个因素与女性对选择和控制的感知的一系列措施之间的关联。
结果
大多数女性报告说，她们对自己的孕产护理模式和地点没有选择权，但大多数女性表示，她们在决策方面参与度很高，尤其是在分娩期间。选择私人孕产护理的女性报告的选择和控制水平高于选择公共孕产护理的女性。这一因素对几乎所有的选择和控制措施都有最深远的影响。
结论
大多数在爱尔兰接受孕产护理的女性报告说，她们对护理模式和地点没有选择权。这些都是爱尔兰孕产战略的核心要素，如果要提供更好的选择，就需要进行重大投资。选择私人孕产护理对女性感知的选择和控制有最强的影响，但许多女性负担不起这种类型的护理，也可能不希望选择这种护理模式。
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