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农村澳大利亚妇女获得围产期保健服务的障碍和促进因素:农村卫生保健提供者观点的定性探讨。

Barriers and enablers to accessing perinatal health services for rural Australian women: A qualitative exploration of rural health care providers perspectives.

机构信息

Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.

出版信息

Aust J Rural Health. 2024 Aug;32(4):774-788. doi: 10.1111/ajr.13147. Epub 2024 Jun 4.

Abstract

OBJECTIVE

To identify perceived barriers and enablers for rural women in accessing perinatal care within their own community from the perspective of perinatal health care providers.

DESIGN

A qualitative descriptive study design utilising reflexive thematic analysis, using the socioecological framework to organise and articulate findings.

SETTING

Victoria, Australia.

PARTICIPANTS

Semi-structured interviews were conducted with nine perinatal health care providers who provide care to pregnant women or new mothers in rural communities. Participants were recruited across Victoria in 2023.

RESULTS

Providers reported multi-level barriers and enablers that exist for rural women in accessing perinatal care within their communities. Barriers included women's personal circumstances, challenging professional relationships, inequitable service provision, ineffective collaboration between services and clinicians and government funding models and policies. Enablers included strength and resilience of rural women, social capital within rural communities, flexible care delivery and innovative practice, rural culture and continuity of care models.

CONCLUSION

Rural perinatal health care providers perceived that rural women face multiple barriers that are created or sustained by complex interpersonal, organisational, community and policy factors that are intrinsic to rural health care delivery. Several addressable factors were identified that create unnecessary barriers for rural women in engaging with perinatal care. These included education regarding health systems, rights and expectations, equitable distribution of perinatal services, improved interprofessional relationships and collaborative approaches to care and equity-based funding models for perinatal services regardless of geographical location.

摘要

目的

从围产期保健提供者的角度确定农村妇女在其所在社区获得围产期保健的感知障碍和促进因素。

设计

使用反思性主题分析的定性描述性研究设计,利用社会生态框架来组织和表达研究结果。

地点

澳大利亚维多利亚州。

参与者

2023 年在维多利亚州各地招募了 9 名为农村社区的孕妇或新妈妈提供护理的围产期保健提供者。

结果

提供者报告了农村妇女在其社区获得围产期保健时存在的多层次障碍和促进因素。障碍包括妇女的个人情况、有挑战性的专业关系、服务提供不公平、服务和临床医生之间的协作无效以及政府资金模式和政策。促进因素包括农村妇女的力量和韧性、农村社区的社会资本、灵活的护理提供和创新实践、农村文化和连续护理模式。

结论

农村围产期保健提供者认为,农村妇女面临多种障碍,这些障碍是由农村医疗保健提供中内在的复杂人际、组织、社区和政策因素造成或维持的。确定了一些可解决的因素,这些因素为农村妇女参与围产期保健制造了不必要的障碍。这些因素包括有关卫生系统、权利和期望的教育、围产期服务的公平分配、改善的专业间关系和以关怀为基础的围产期服务资金模式,无论地理位置如何。

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