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在 COVID-19 大流行期间,因流产和医疗原因终止妊娠后出现妊娠丢失:对爱尔兰岛妇女医疗保健体验的主题分析。

Pregnancy loss following miscarriage and termination of pregnancy for medical reasons during the COVID-19 pandemic: a thematic analysis of women's experiences of healthcare on the island of Ireland.

机构信息

School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

出版信息

BMC Pregnancy Childbirth. 2023 Jul 21;23(1):529. doi: 10.1186/s12884-023-05839-4.

Abstract

BACKGROUND

Losing a baby during pregnancy can be a devastating experience for expectant parents. Many report dedicated, compassionate healthcare provision as a facilitator of positive mental health outcomes, however, healthcare services have been severely impacted during the COVID-19 pandemic.

AIM

To explore women's experiences of healthcare service provision for miscarriage and termination of pregnancy for medical reasons (TFMR) on the island of Ireland during the COVID-19 pandemic.

METHODS

Findings combine data from elements of two separate studies. Study 1 used a mixed methods approach with women who experienced miscarriage and attended a hospital in Northern Ireland. Study 2 was qualitative and examined experiences of TFMR in Northern Ireland and Ireland. Data analysed for this paper includes open-ended responses from 145 women to one survey question from Study 1, and semi-structured interview data with 12 women from Study 2. Data were analysed separately using Thematic Analysis and combined for presentation in this paper.

RESULTS

Combined analysis of results indicated three themes, (1) Lonely and anxiety-provoking experiences; (2) Waiting for inadequate healthcare; and (3) The comfort of compassionate healthcare professionals.

CONCLUSIONS

Women's experiences of healthcare provision were negatively impacted by COVID-19, with the exclusion of their partner in hospital, and delayed services highlighted as particularly distressing. Limited in-person interactions with health professionals appeared to compound difficulties. The lived experience of service users will be helpful in developing policies, guidelines, and training that balance both the need to minimise the risk of infection spread, with the emotional, psychological, and physical needs and wishes of parents. Further research is needed to explore the long-term impact of pregnancy loss during a pandemic on both parents and health professionals delivering care.

摘要

背景

怀孕期间失去婴儿对准父母来说可能是毁灭性的经历。许多人报告说,专业、富有同情心的医疗保健服务是促进心理健康的重要因素,但在 COVID-19 大流行期间,医疗保健服务受到了严重影响。

目的

探讨爱尔兰岛女性在 COVID-19 大流行期间对流产和因医疗原因终止妊娠(简称 TFMR)的医疗保健服务提供的体验。

方法

研究结果结合了两项单独研究的部分数据。研究 1 使用混合方法,对在北爱尔兰一家医院接受流产治疗的女性进行了研究。研究 2 是定性研究,检查了北爱尔兰和爱尔兰的 TFMR 经历。本文分析的数据包括研究 1 中 145 名女性对一个调查问题的开放式回答,以及研究 2 中 12 名女性的半结构化访谈数据。这些数据分别使用主题分析进行分析,并在本文中结合呈现。

结果

对结果的综合分析表明了三个主题,(1)孤独和焦虑的体验;(2)等待不充分的医疗保健服务;(3)富有同情心的医疗保健专业人员的安慰。

结论

COVID-19 对女性的医疗保健服务体验产生了负面影响,包括在医院排除伴侣以及延迟服务的情况,这些情况尤其令人痛苦。与卫生专业人员的有限面对面互动似乎加剧了困难。服务使用者的亲身体验将有助于制定政策、准则和培训计划,平衡减少感染传播风险的需要,以及父母的情感、心理和身体需求和愿望。需要进一步研究探索大流行期间怀孕损失对父母和提供护理的卫生专业人员的长期影响。

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