围产期护理中有效沟通的障碍和促进因素：对具有感官、智力和/或发育障碍的产妇的经验的定性研究。
Barriers to and facilitators of effective communication in perinatal care: a qualitative study of the experiences of birthing people with sensory, intellectual, and/or developmental disabilities.
机构信息
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, M1C 1A4, Canada.
出版信息
BMC Pregnancy Childbirth. 2022 Apr 26;22(1):364. doi: 10.1186/s12884-022-04691-2.
BACKGROUND
Effective provider-patient communication is a key element of quality health care, including perinatal care. What constitutes "effective communication" in perinatal care may vary according to the population seeking care, such as women with intellectual and developmental disabilities (IDD) and sensory disabilities. Research broadly indicates that communication issues are among the barriers to perinatal care experienced by women with disabilities. However, few studies have explicitly explored their communication experiences in this context. The purpose of this study was to understand the communication experiences of birthing people with IDD and/or sensory disabilities in perinatal care.
METHODS
We conducted semi-structured interviews with 17 people with IDD (e.g., autism, cognitive delay) and/or sensory disabilities (e.g., d/Deaf, blind) in Ontario, Canada, who had recently given birth, to explore barriers to and facilitators of effective communication in perinatal care. A combination of deductive and inductive thematic analysis guided data analysis.
RESULTS
We found that birthing people with IDD and/or sensory disabilities encountered multiple barriers to effective communication in perinatal care, namely, lack of policies and guidelines, lack of provider experience, lack of provider effort, as well as ableism and provider assumptions. Facilitators included knowledgeable, aware, and supportive providers; access to communication aids and services; tailoring information to patients' disability-related communication needs; empathic communication; and, communication among providers.
CONCLUSION
Unmet communication needs may contribute to negative health and social outcomes for birthing people with disabilities and their newborns. Accessibility policy implementation and practice change are needed to meet the communication needs of people with IDD and/or sensory disabilities in perinatal care to ensure positive experiences and outcomes.
背景
有效的医患沟通是优质医疗保健的关键要素，包括围产期护理。在围产期护理中，什么构成“有效沟通”可能因寻求护理的人群而异，例如智障和发育障碍（ID）以及感官障碍的妇女。研究广泛表明，沟通问题是残疾妇女在围产期护理中面临的障碍之一。然而，很少有研究明确探讨她们在这种情况下的沟通经历。本研究的目的是了解智障和/或感官障碍的产妇在围产期护理中的沟通体验。
方法
我们在加拿大安大略省对 17 名智障（例如自闭症、认知迟缓）和/或感官障碍（例如聋哑、失明）的产妇进行了半结构化访谈，以探讨围产期护理中有效沟通的障碍和促进因素。结合演绎和归纳主题分析指导数据分析。
结果
我们发现智障和/或感官障碍的产妇在围产期护理中遇到了多种有效沟通的障碍，即缺乏政策和指导方针、缺乏提供者经验、缺乏提供者的努力，以及能力主义和提供者的假设。促进因素包括知识渊博、意识强和支持性的提供者；获得沟通辅助工具和服务；根据患者的残疾相关沟通需求调整信息；富有同理心的沟通；以及提供者之间的沟通。
结论
未满足的沟通需求可能会对残疾产妇及其新生儿的健康和社会结果产生负面影响。需要实施无障碍政策和实践变革，以满足智障和/或感官障碍产妇在围产期护理中的沟通需求，确保积极的体验和结果。
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