“我认为尊重意味着及时提供必要的治疗”——对埃塞俄比亚西南部分娩期间不尊重和虐待医护人员看法的定性研究。
'I believe respect means providing necessary treatment on time' - a qualitative study of health care providers' perspectives on disrespect and abuse during childbirth in Southwest Ethiopia.
机构信息
School of Nursing, St. Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
Department of Interdisciplinary Health Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
出版信息
BMC Pregnancy Childbirth. 2023 Apr 17;23(1):257. doi: 10.1186/s12884-023-05567-9.
BACKGROUND
The majority of maternal deaths occur in low-income countries, and facility-based childbirth is recognised as a strategy to reduce maternal mortality. However, experiences of disrespect and abuse during childbirth are reported as deterrents to women's utilisation of health care facilities. Health care providers play a critical role in women's experiences during childbirth; yet, there is limited research on service providers' views of disrespect and abuse in Ethiopia. Therefore, this study aimed to explore providers' perspectives on disrespect and abuse during childbirth in a teaching hospital in Southwest Ethiopia.
METHOD
Qualitative study was conducted in a tertiary teaching hospital in Jimma Ethiopia. In-depth interviews were conducted with 32 purposefully selected health care providers, including midwives, obstetrics and genecology resident's, senior obstetricians and nurses. Interviews were audio-recorded, transcribed and thematically analysed using the qualitative data analysis software program MAXQDA.
RESULTS
Three major themes were identified from the health care providers' perspectives: (1) respectful and abuse-free care, (2) recognised disrespect and abuse; and (3) drivers of women's feelings of disrespect and abuse. The first theme indicates that most of the participants perceived that women were treated with respect and had not experienced abuse during childbirth. The second theme showed that a minority of the participants recognised that women experienced disrespect and abuse during childbirth. The third theme covered situations in which providers thought that drivers for women felt disrespected.
CONCLUSION
Most providers perceived women's experiences as respectful, and they normalized, and rationalized disrespect and abuse. The effect of teaching environment, the scarcity of resources has been reported as a driver for disrespect and abuse. To ensure respectful maternity care, a collaborative effort of administrators, teaching institutions, professional associations and researchers is needed. Such collaboration is essential to create a respectful teaching environment, ensure availability of resources, sustained in-service training for providers, and establishing an accountability mechanism for respectful maternity care.
背景
大多数产妇死亡发生在低收入国家，而医疗机构分娩被认为是降低产妇死亡率的一种策略。然而，在分娩过程中遭受不尊重和虐待的经历被报道为妇女利用医疗保健设施的障碍。医疗保健提供者在妇女分娩过程中扮演着至关重要的角色；然而，在埃塞俄比亚，关于服务提供者对不尊重和虐待看法的研究有限。因此，本研究旨在探讨在埃塞俄比亚西南部的一所教学医院中，提供者对分娩过程中不尊重和虐待的看法。
方法
在埃塞俄比亚吉玛的一所三级教学医院进行了定性研究。通过深入访谈，共采访了 32 名有目的选择的医疗保健提供者，包括助产士、妇产科住院医师、高级产科医生和护士。采访内容被录音、转录，并使用 MAXQDA 定性数据分析软件进行主题分析。
结果
从医疗保健提供者的角度来看，确定了三个主要主题：（1）尊重和无虐待的护理；（2）公认的不尊重和虐待；以及（3）妇女感到不尊重和虐待的驱动因素。第一个主题表明，大多数参与者认为妇女在分娩过程中受到尊重，没有遭受虐待。第二个主题表明，少数参与者认识到妇女在分娩过程中经历了不尊重和虐待。第三个主题涵盖了提供者认为妇女感到不尊重的情况。
结论
大多数提供者认为妇女的经历是尊重的，他们将不尊重和虐待正常化和合理化。教学环境的影响、资源的稀缺性被报道为不尊重和虐待的驱动因素。为了确保尊重产妇护理，行政人员、教学机构、专业协会和研究人员需要共同努力。这种合作对于创造尊重的教学环境、确保资源的可用性、为提供者提供持续的在职培训以及建立尊重产妇护理的问责机制是必要的。
Zotero 插件