加拿大安大略省年轻母亲使用和体验精神卫生保健服务的情况：一项定性描述性研究。
Young mothers' use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study.
机构信息
School of Nursing, McMaster University, HSC 3H48B, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
出版信息
BMC Womens Health. 2022 Jun 7;22(1):214. doi: 10.1186/s12905-022-01804-z.
BACKGROUND
Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services.
METHODS
As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics.
RESULTS
Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services.
CONCLUSION
Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.
背景
尽管年轻母亲群体中心理健康问题的普遍程度较高，但她们对心理健康保健支持的后续需求与其对服务的获取和使用并不相关。本研究以生活在加拿大安大略省的年轻母亲为背景，旨在描述她们在围产期使用心理健康服务的体验，并确定影响她们使用心理健康服务的服务和专业人员的属性。
方法
作为一项顺序解释性混合方法研究的定性部分，定性描述原则为抽样、数据收集和分析决策提供了信息。通过目的性抽样，对 29 名年轻母亲（≤21 岁）进行了深入的半结构化访谈，这些年轻母亲符合至少一种精神障碍的诊断标准，且分娩后≥2 个月。访谈数据与生态图和定量研究部分调查中这一目的性样本的一部分人口统计学数据进行了三角剖分。使用常规内容分析和反思性主题分析对定性数据进行了分析；为了进行这些分析，从调查中提取了这 29 名参与者的部分调查数据，并使用描述性统计方法对其进行了分析。
结果
年轻母亲们表示，她们至少需要有一个可以与之谈论心理健康问题的人，这个人可以是非正式的社会支持，也可以是正式的服务提供者。在决定寻求专业心理健康支持的参与者中，他们对获取服务的犹豫态度源于过去的负面经历或对被评判、被药物治疗、不被视为护理决策的积极参与者或经历增加的儿童保护介入的恐惧。参与者确定了提供心理健康服务的组织和提供者的属性，他们认为这些属性影响了他们对服务的使用或参与。
结论
建议为年轻孕妇或育儿母亲提供心理健康服务的组织或卫生/社会保健专业人员实施创伤和暴力知情护理。这种方法优先考虑护理环境中个人的情感和身体安全。在服务提供中应用这种视角也符合年轻母亲的需求，包括她们被积极倾听、受到尊重，并作为护理和治疗决策的积极参与者而真正参与。
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