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产房产科不尊重和虐待护理行为的影响,以及改善中低收入国家护理质量的潜在干预措施:叙事性综述。

Impacts of disrespectful care and abusive care practices in maternity units and potential interventions to improve the quality of care in low- and middle-income countries: A narrative review.

机构信息

Department of Psychology, Faculty of Health Sciences, KIU, Battaramulla, Sri Lanka.

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

出版信息

Int J Gynaecol Obstet. 2023 Sep;162(3):847-859. doi: 10.1002/ijgo.14811. Epub 2023 Apr 28.

Abstract

This review article explored the impacts of disrespectful care and abusive care practices and the potential interventions to eliminate those practices. Respectful maternity care is a fundamental right for all women. It ensures that women are able to exercise their rights in maternity care. However, research studies have shown the recent prevalence of poor-quality care for women in maternity units in low- and middle-income countries. The literature on this topic was searched on PubMed, Medline, Google Scholar, Cochrane, Science Direct/ Elsevier, and SCOPUS. A total of 24 qualitative and quantitative research articles were included. Thematic analysis was conducted by using the six steps. Impacts are coded on topics including psychological impacts due to disrespectful and abusive care practices, impact on the care process, normalization of the absence of care, suppression of knowledge regarding the labor process, and poor obstetric outcomes. Interventions are coded on topics including programs for health professionals to improve care, education and empowerment programs targeting the women and community, enacting policies and guidelines regarding disrespectful and abusive care practices and improving the facilities in the healthcare system. The majority of the evidenced-based interventions were multi-component and tailored to the needs of a particular setting. More research evidence is needed to inform the healthcare authorities and policymakers to transform these potential interventions into practice. Future research should clearly document the effectiveness of various combinations of interventions, feasibility, cost-effectiveness, and outcomes.

摘要

这篇综述文章探讨了不尊重和虐待护理行为的影响,以及消除这些行为的潜在干预措施。尊重产妇护理是所有妇女的一项基本权利。它确保妇女能够在产妇护理中行使自己的权利。然而,研究表明,最近在中低收入国家的产科病房中,妇女得到的护理质量较差。在 PubMed、Medline、Google Scholar、Cochrane、Science Direct/Elsevier 和 SCOPUS 上搜索了关于这个主题的文献。共纳入了 24 篇定性和定量研究文章。使用六个步骤进行了主题分析。影响的编码主题包括不尊重和虐待护理行为导致的心理影响、对护理过程的影响、护理缺失的正常化、对分娩过程知识的压制以及不良的产科结局。干预的编码主题包括改善护理的卫生专业人员方案、针对妇女和社区的教育和赋权方案、制定关于不尊重和虐待护理行为的政策和准则以及改善医疗保健系统中的设施。大多数基于证据的干预措施是多组分的,并且针对特定环境的需求进行了定制。需要更多的研究证据来告知卫生当局和政策制定者,将这些潜在的干预措施转化为实践。未来的研究应该清楚地记录各种干预措施组合的有效性、可行性、成本效益和结果。

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