Department of Obstetrics, Gynaecology and Women's Health, University of Otago Wellington, Wellington, Aotearoa New Zealand.
Department of Primary Health Care and General Practice, University of Otago Wellington, Wellington, Aotearoa New Zealand.
N Z Med J. 2022 Jan 21;135(1548):54-64.
To explore health professionals' views on the impact of early miscarriage on mental health and accessibility of services and support available to women.
Semi-structured interviews were conducted with 10 health professionals from an urban tertiary hospital and a community setting, followed by semi-inductive thematic analysis.
Three overarching themes were identified: (1) extent and nature of psychological impact, (2) barriers to accessing mental health support and (3) facilitators of change or improvement. Early miscarriage was regarded as a "loss" that affected not only the women but their partners and other family/whānau members. Establishing how women felt about the pregnancy was regarded as important in directing both the scope of the consultation and subsequent guide to support services. Inequitable access to services and support was identified. Cost of counselling, geographic location and fragmented care were cited as barriers to accessing support. Improved clinical pathways and channels for inter-professional communication, as well as more accessible counselling, were regarded as key areas for service improvement.
This study highlights that, although health professionals appropriately recognise early miscarriage as a significant loss, access to support is inequitable and fragmented. Early miscarriage care is an area of unmet need and, given the high incidence of early miscarriage and its impact on mental health, urgent action around service provision is needed.
探讨健康专业人员对早期流产对心理健康的影响以及妇女获得服务和支持的途径的看法。
对一家城市三级医院和社区的 10 名健康专业人员进行了半结构化访谈，然后进行了半诱导式主题分析。
确定了三个总体主题：（1）心理影响的程度和性质，（2）获得心理健康支持的障碍，（3）改变或改善的促进因素。早期流产被视为一种“损失”，不仅影响妇女，还影响其伴侣和其他家庭/亲属。了解妇女对怀孕的感受被认为对指导咨询的范围和随后的支持服务指南很重要。服务和支持的获取存在不平等现象。咨询费用、地理位置和分散的护理被认为是获得支持的障碍。改善临床途径和专业间沟通渠道，以及更方便的咨询，被认为是服务改进的关键领域。
本研究表明，尽管健康专业人员适当认识到早期流产是一个重大的损失，但获得支持是不平等和分散的。早期流产护理是一个未满足的需求领域，鉴于早期流产的高发生率及其对心理健康的影响，需要在服务提供方面采取紧急行动。
