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低收入围产期护理经历的少数族裔孕妇:一项范围综述。

Racial and Ethnic Minority Pregnant Patients with Low-Income Experiences of Perinatal Care: A Scoping Review.

作者信息

Wishart Danielle, Cruz Alvarez Cindy, Ward Carmenisha, Danner Sankirtana, O'Brian Catherine A, Simon Melissa

机构信息

Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Center for Health Equity Transformation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Health Equity. 2021 Sep 3;5(1):554-568. doi: 10.1089/heq.2021.0017. eCollection 2021.

Abstract

The maternal mortality ratio for the United States (US) has consistently risen over recent decades. This mortality is especially pronounced within minority populations who experience a maternal mortality and morbidity rate that are much higher than their non-Hispanic white counterparts. Qualitative data are critical in gaining true insight from minority pregnant and postpartum persons. Such data should serve as the basis for building interventions and programs that seek to eradicate perinatal inequities. This review examines the qualitative literature on racial and ethnic minority pregnant patients with low income and their experiences during perinatal care (PNC) to identify recurrent themes that can be addressed through targeted interventions. PubMed, CINAHL, and Web of Science databases were searched for qualitative studies on racial and ethnic minority pregnant patients with low income and their experiences during PNC. Twenty-two articles were included for analysis. Thematic synthesis was performed to identify categories and recurring themes in each article. Five major categories were identified as consistent experiences of pregnant patients with PNC clinicians: support, education, connection, communication, and trust. Of these, clinician support was the most consistently coded category. Eighteen of the 23 articles discussed tangible support patients had received from their clinicians, such as care coordination and referrals to support services. The second most coded category was education, which was represented in 16 articles. Education was mostly represented negatively as lack of adequate perinatal care education given during the perinatal period. Finally, the categories of connection, communication, and trust were represented by 18, 17, and 17 articles, respectively. These qualitative studies provided specific examples of what racial and ethnic minority pregnant patients with low income deemed positive and negative during the perinatal period and outline ways that these experiences can be improved. Future studies can take the experiences reported in this review to help inform interventions to improve patient experiences and health outcomes that minority persons face in the perinatal period.

摘要

近几十年来,美国的孕产妇死亡率持续上升。这种死亡率在少数族裔人群中尤为明显,他们的孕产妇死亡率和发病率远高于非西班牙裔白人。定性数据对于深入了解少数族裔孕妇和产后人群至关重要。这些数据应作为构建旨在消除围产期不平等现象的干预措施和项目的基础。本综述考察了关于低收入种族和族裔少数族裔孕妇及其围产期护理(PNC)经历的定性文献,以确定可通过针对性干预措施解决的反复出现的主题。在PubMed、CINAHL和科学网数据库中搜索了关于低收入种族和族裔少数族裔孕妇及其PNC经历的定性研究。纳入22篇文章进行分析。进行主题综合以确定每篇文章中的类别和反复出现的主题。确定了五个主要类别,作为孕妇与PNC临床医生的一致经历:支持、教育、联系、沟通和信任。其中,临床医生的支持是编码最一致的类别。23篇文章中有18篇讨论了患者从临床医生那里获得的实际支持,如护理协调和转介支持服务。编码第二多的类别是教育,有16篇文章涉及。教育大多以负面形式呈现,表现为围产期缺乏足够的围产期护理教育。最后,联系、沟通和信任类别分别有18篇、17篇和17篇文章涉及。这些定性研究提供了具体例子,说明低收入种族和族裔少数族裔孕妇在围产期认为哪些是积极的,哪些是消极的,并概述了改善这些经历的方法。未来的研究可以借鉴本综述中报告的经历,为改善少数族裔人群在围产期面临的患者体验和健康结果的干预措施提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91af/8665802/1e17702f77f5/heq.2021.0017_figure1.jpg

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