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欧洲围产医学学会(EAPM)、欧洲妇产科医师学会理事会和学院(EBCOG)、欧洲助产士协会(EMA)。联合立场声明:分娩中的不达标和不尊重的护理——因为言语很重要。

European Association of Perinatal Medicine (EAPM), European Board and College of Obstetricians and Gynaecologists (EBCOG), European Midwives Association (EMA). Joint position statement: Substandard and disrespectful care in labour - because words matter.

机构信息

Medical School, Santa Maria University Hospital, University of Lisbon, Portugal.

Department of Obstetrics and Gynecology and Obstetrics, Goethe University Frankfurt/Main and University Hospital, Germany.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2024 May;296:205-207. doi: 10.1016/j.ejogrb.2024.02.048. Epub 2024 Feb 29.

Abstract

Substandard or disrespectful care during labour should be of serious concern for healthcare professionals, as it can affect one of the most important events in a woman's life. Substandard care refers to the use of interventions that are not considered best-practice, to the inadequate execution of interventions, to situations where best-practice interventions are withheld from patients, or there is lack of adequate informed consent. Disrespectful care refers to forms of verbal and non-verbal communication that affect patients' dignity, individuality, privacy, intimacy, or personal beliefs. There are many possible underlying causes for substandard and disrespectful care in labour, including difficulties in modifying behaviours, judgmental or paternalistic attitudes, personal interests and individualism, and a human tendency to make less arduous, less difficult, or less stressful clinical decisions. The term "obstetric violence" is used in some parts of the world to describe various forms of substandard and disrespectful care in labour, but suggests that it is mainly carried out by obstetricians and is a serious form of aggression, carried out with the intent to cause harm. We believe that this term should not be used, as it does not help to identify the underlying problem, its causes, or its correction. In addition, it is generally seen by obstetricians and other healthcare professionals as an unjust and offensive term, generating a defensive and less collaborative mindset. We reach out to all individuals and institutions sharing the common goal of improving women's experience during labour, to work together to address the underlying causes of substandard and disrespectful care, and to develop common strategies to deal with this problem, based on mutual comprehension, trust and respect.

摘要

医护人员应该对分娩过程中存在的不达标或不尊重的护理予以高度重视,因为这可能会对女性生命中最重要的时刻产生影响。不达标护理是指使用的干预措施不符合最佳实践,或者干预措施执行不到位,或者对患者隐瞒了最佳实践干预措施,或者缺乏充分的知情同意。不尊重护理是指影响患者尊严、个性、隐私、亲密关系或个人信仰的言语和非言语交流形式。分娩过程中出现不达标和不尊重护理的原因有很多,包括难以改变行为、评判性或家长式态度、个人利益和个人主义,以及人类倾向于做出不那么费力、不那么困难或不那么有压力的临床决策。在世界上的某些地区,术语“产科暴力”用于描述分娩过程中的各种不达标和不尊重护理形式,但它表明这主要是由产科医生实施的,是一种严重的侵犯行为,意图造成伤害。我们认为,这个术语不应该使用,因为它无助于识别潜在问题、其原因或纠正措施。此外,这个术语通常被产科医生和其他医护人员视为不公正和冒犯性的术语,会导致他们产生防御性和缺乏合作性的思维。我们呼吁所有共同致力于改善女性分娩体验的个人和机构,共同努力解决不达标和不尊重护理的根本原因,并基于相互理解、信任和尊重制定共同策略来应对这一问题。

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