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识别美国分娩叙事中的产科虐待经历:国际知情虐待类型学的应用。

Identifying Obstetric Mistreatment Experiences in U.S. Birth Narratives: Application of Internationally Informed Mistreatment Typologies.

出版信息

MCN Am J Matern Child Nurs. 2022;47(3):138-146. doi: 10.1097/NMC.0000000000000811.

Abstract

BACKGROUND

Traumatic births are those resulting in feelings of distress that persist after the birth experience. Health care providers may play a role in these experiences through various forms of mistreatment. Analyses of global birth experiences have generated several domains of mistreatment. This study applies these evidence-based domains of mistreatment as an a priori coding scheme for analysis of 96 oral narratives of U.S.-based births to describe the nature of perceived mistreatment using participants' own descriptions of experiences.

METHOD

Ninety-six transcripts of oral birth stories from 61 participants were coded using the domains of mistreatment experiences described by the Bohren et al.'s (2015) systematic review of obstetric mistreatment.

RESULTS

N = 131 individual experiences of perceived obstetric mistreatment were identified in 41 out of 96 narratives (42.7%). The most frequent types of experiences were Poor Rapport (90 incidences) and Failure to Meet Professional Standards of Care (29).

CLINICAL IMPLICATIONS

Although most women in our study did not perceive any instances of obstetric mistreatment during their childbirth, over 40% of participants noted at least one event that fit one of the typologies we used as a framework for analysis. Visibility and review of the types of perceived mistreatment experiences that occur during birth enables health system leaders to implement prevention and accountability strategies. Most instances of perceived mistreatment during birth may be prevented through intentional implementation of individualized, respectful, supportive care during labor and birth.

摘要

背景

创伤性分娩是指分娩后仍感到痛苦的分娩。医疗保健提供者可能通过各种形式的虐待在这些经历中发挥作用。对全球分娩经历的分析产生了虐待的几个领域。本研究将这些基于证据的虐待领域作为一个先验的编码方案,用于分析 96 名美国出生的口头叙述,以使用参与者自己对经历的描述来描述感知虐待的性质。

方法

使用 Bohren 等人(2015 年)对产科虐待的系统评价中描述的虐待经历领域,对 61 名参与者的 96 份口头分娩故事的记录进行了编码。

结果

在 96 个叙述中有 41 个(42.7%)确定了 131 个感知到的产科虐待的个体经历。最常见的类型是不良关系(90 例)和未能达到专业护理标准(29 例)。

临床意义

尽管我们研究中的大多数女性在分娩过程中没有感觉到任何产科虐待的情况,但超过 40%的参与者注意到至少有一种符合我们用作分析框架的类型学的事件。对分娩期间发生的感知虐待经历的类型进行可见性和审查,使卫生系统领导者能够实施预防和问责策略。通过在分娩和分娩期间有意实施个性化、尊重和支持性护理,大多数分娩期间的感知虐待事件可能会得到预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7052/9048623/ce76130b83dc/ajmcn-47-138-g001.jpg

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