Mainey Lydia, O'mullan Catherine, Reid-Searl Kerry
College of Nursing and Midwifery, CQUniversity, Cairns, Australia.
College of Science and Sustainability, CQUniversity, Bundaberg, Australia.
J Adv Nurs. 2023 Apr;79(4):1329-1341. doi: 10.1111/jan.15226. Epub 2022 Mar 14.
The aim of this study was to explain the process through which Australian nurses and midwives provide abortion care to people affected by gender-based violence (GBV).
A constructivist grounded theory study.
This study took place between 2019 and 2021. The lead author conducted semi-structured interviews with 18 Australian nurses and midwives who provided abortion care. Participants were recruited through pro-abortion, nursing and midwifery networks using a snowballing technique. Data collection and analysis proceeded using purposive and theoretical sampling until we reached data saturation.
Participants revealed they underwent a process of working with or against the system contingent on the degree to which the system (the interconnected networks through which a pregnant person, victimized by trauma, travels) was woman centred. When participants encountered barriers to person-centred abortion care, they bent or broke the law, local policy and cultural norms to facilitate timely holistic care. Though many participants felt professionally compromised, their resolve to continue working against the system continued.
Conservative abortion law, policies and clinical mores did not prevent participants from providing abortion care. The professional obligation to provide person-centred care was a higher priority than following the official or unofficial rules of the organizations.
This study addresses the clinical care of people accessing abortions in the context of GBV. Nurses and midwives may act out against the law, organizational policies and norms if prevented from providing person-centred care. This research is relevant for any location that restricts abortion through stigma, pro-life influences or politics.
本研究旨在阐释澳大利亚护士和助产士为遭受性别暴力（GBV）的人群提供堕胎护理的过程。
一项建构主义扎根理论研究。
本研究于2019年至2021年开展。第一作者对18名提供堕胎护理的澳大利亚护士和助产士进行了半结构化访谈。通过支持堕胎的网络、护理和助产网络，采用滚雪球技术招募参与者。数据收集和分析采用目的抽样和理论抽样，直至达到数据饱和。
参与者透露，他们根据系统（遭受创伤的孕妇所经历的相互关联的网络）以女性为中心的程度，经历了与系统合作或对抗的过程。当参与者在以患者为中心的堕胎护理中遇到障碍时，他们会违反法律、当地政策和文化规范，以促进及时的整体护理。尽管许多参与者感到职业操守受到损害，但他们继续对抗系统的决心依然坚定。
保守的堕胎法律、政策和临床习俗并未阻止参与者提供堕胎护理。提供以患者为中心的护理的职业义务比遵循组织的官方或非官方规则更为重要。
本研究探讨了在性别暴力背景下接受堕胎者的临床护理。如果护士和助产士被阻止提供以患者为中心的护理，他们可能会违反法律、组织政策和规范。这项研究适用于任何因耻辱感、支持生命的影响或政治因素而限制堕胎的地区。
