School of Health Sciences, Western Sydney University, Sydney, Australia.
Physiotherapy Department, Westmead Hospital, Sydney, Australia.
BMC Pregnancy Childbirth. 2023 Sep 21;23(1):682. doi: 10.1186/s12884-023-06000-x.
Pregnancy-related pelvic girdle pain (PPGP) is a common condition worldwide. Women report being unprepared about PPGP, and state they receive little recognition and support from healthcare professionals. Situated within the Common-Sense Model and Convergent Care Theory, this study sought to gain a conceptual understanding of the perceptions, beliefs and experiences of healthcare professionals who provide routine care for women with PPGP in Australia.
A qualitative research design, using individual, semi-structured interviews with purposive sampling of healthcare professionals (N=27) consisting of doctors (N=9), midwives (N=9) and physiotherapists (N=9). Most participants were female (22/27) with a range of professional experience. An interview guide consisting of open-ended questions was used with a flexible and responsive approach. Thematic analysis was performed where interview data were transcribed, coded, grouped into meaningful categories and then constructed into broad themes.
Four themes were identified: 1. Identity and impact of PPGP; 2. What works well?; 3. What gets in the way?; and 4. Quality care: What is needed? Healthcare professionals recognised PPGP as a common and disabling condition, which created a large impact on a woman's life during pregnancy. Stepped-level care, including education and physiotherapy intervention, was seen to be helpful and led to a positive prognosis. Barriers at patient, clinician and organisation levels were identified and led to consequences for women with PPGP not receiving the care they need.
This study elucidates important implications for health care delivery. Acknowledging that PPGP is a common condition causing difficulty for many women, healthcare professionals identified strong teamwork and greater clinical experience as important factors in being able to deliver appropriate healthcare. Whilst healthcare professionals reported being committed to caring for women during pregnancy, busy workloads, attitudes towards curability, and a lack of formal education were identified as barriers to care. The findings suggest timely access, clear referral pathways and an integrated approach are required for best care practice for women with PPGP. A greater emphasis on the need for multidisciplinary models of care during pregnancy is evident.
妊娠相关骨盆带疼痛（PPGP）是一种全球范围内常见的病症。女性报告称，她们对 PPGP 毫无准备，并表示很少得到医疗保健专业人员的认可和支持。本研究基于常识模型和汇聚护理理论，旨在深入了解澳大利亚为 PPGP 女性提供常规护理的医疗保健专业人员的认知、信念和经验。
采用定性研究设计，对医疗保健专业人员（N=27）进行个体、半结构化访谈，采用目的抽样，其中包括医生（N=9）、助产士（N=9）和物理治疗师（N=9）。大多数参与者为女性（22/27），具有不同的专业经验。使用开放式问题的访谈指南，采用灵活和响应式的方法。对访谈数据进行转录、编码、分组为有意义的类别，然后构建为广泛的主题，进行主题分析。
确定了四个主题：1. PPGP 的身份和影响；2. 什么有效？；3. 什么有阻碍？；4. 优质护理：需要什么？医疗保健专业人员认识到 PPGP 是一种常见且使人丧失能力的病症，这对女性怀孕期间的生活产生了巨大影响。包括教育和物理治疗干预在内的分级护理被认为是有帮助的，并导致了积极的预后。在患者、临床医生和组织层面都确定了障碍，并导致 PPGP 女性无法获得所需的护理。
本研究阐明了对医疗保健服务提供的重要影响。医疗保健专业人员承认 PPGP 是一种常见病症，会给许多女性带来困难，他们认为团队合作和更多的临床经验是提供适当医疗保健的重要因素。虽然医疗保健专业人员表示致力于在怀孕期间照顾女性，但忙碌的工作量、对可治愈性的态度以及缺乏正规教育被认为是护理障碍。研究结果表明，为 PPGP 女性提供最佳护理实践需要及时获得、明确的转诊途径和综合方法。显然，需要更多关注妊娠期间多学科护理模式。
