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土耳其产妇在分娩护理中经历产科暴力的流行情况及其相关因素:一项横断面研究。

The prevalence of obstetric violence experienced by women during childbirth care and its associated factors in Türkiye: A cross-sectional study.

机构信息

Zübeyde Hanım Faculty of Health Sciences, Division of Midwifery, Niğde Ömer Halisdemir University, Niğde, Turkey.

Faculty of Health Sciences, Division of Midwifery, Marmara University, Istanbul, Turkey.

出版信息

Midwifery. 2023 Sep;124:103766. doi: 10.1016/j.midw.2023.103766. Epub 2023 Jun 22.

Abstract

Objective This study determined the prevalence of obstetric violence experienced by women during childbirth and related factors in Türkiye. Design Cross-sectional study Setting This study was conducted in the mother-child health and gynecology outpatient clinics of the training and research hospital in Türkiye. Participants The study was completed with 513 women who gave birth in the last two years between January and May 2022. Methods Data were collected using a questionnaire prepared by the researchers. Bivariate and multivariate logistic regression analyzed the relationship between obstetric violence and socio-demographic and obstetric characteristics. Findings Obstetric violence was reported by 76.4% of the women: 44.4% physical abuse, 44.4% abandonment of care, 26.5% non-consented care, 25.1% non-dignified care, 3.3% non-confidential care, and 0.4% discrimination. Low income (OR=1.98), physician-attended birth (OR=2.91), vaginal birth (OR=6.04), and newborn admission to the neonatal care unit (OR=2.99) were associated with higher reporting of obstetric violence. Primiparous women (OR=0.51), whose pain was controlled by non-pharmacological methods (OR=0.34) and who received companion support (OR=0.24) were less likely to report experiencing obstetric violence (p < 0.05). Key conclusions Approximately three out of four Turkish women report that they have been exposed to obstetric violence during childbirth. In Türkiye, vaginal birth is the type of childbirth with the highest rate of obstetric violence reporting. Women who are low-income and multiparous, who are deprived of midwife, companion, and pain control support during childbirth, are more likely to experience obstetric violence. Implications for practice Supporting low-income women, protecting women from traumatic acts and unnecessary interventions in a vaginal birth, increasing births under the attendance of midwives, and providing pain control with non-pharmacological methods, and companion support during labor may be protective factors against obstetric violence.

摘要

目的 本研究旨在确定土耳其女性分娩时经历产科暴力的流行情况及其相关因素。

设计 横断面研究

地点 本研究在土耳其一家培训和研究医院的母婴保健和妇科门诊进行。

参与者 本研究纳入了 2022 年 1 月至 5 月期间在过去两年内分娩的 513 名女性。

方法 使用研究人员编制的问卷收集数据。采用二变量和多变量逻辑回归分析产科暴力与社会人口学和产科特征之间的关系。

结果 76.4%的女性报告遭受过产科暴力:44.4%遭受过身体虐待,44.4%被遗弃护理,26.5%未经同意护理,25.1%非尊严护理,3.3%非保密护理,0.4%受到歧视。低收入(OR=1.98)、医生接生(OR=2.91)、阴道分娩(OR=6.04)和新生儿入住新生儿监护病房(OR=2.99)与更高的产科暴力报告率相关。初产妇(OR=0.51)、疼痛采用非药物方法控制(OR=0.34)和获得陪伴支持(OR=0.24)的产妇较少报告遭受产科暴力(p<0.05)。

结论 大约四分之三的土耳其女性报告在分娩时遭受过产科暴力。在土耳其,阴道分娩是报告产科暴力发生率最高的分娩方式。分娩时得不到助产士、陪伴和疼痛控制支持的低收入和多产妇更有可能经历产科暴力。

实践意义 支持低收入女性,防止女性在阴道分娩时受到创伤和不必要的干预,增加助产士接生的分娩数量,以及采用非药物方法控制疼痛和在分娩时提供陪伴支持,可能是预防产科暴力的保护因素。

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