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探讨面临心理社会逆境的女性在怀孕前、怀孕中和怀孕后对脆弱性的认知:使用主题分析的定性访谈研究。

Exploring perceptions of vulnerability among women facing psychosocial adversity before, during and after pregnancy: A qualitative interview-study using thematic analysis.

机构信息

Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.

Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.

出版信息

Sex Reprod Healthc. 2024 Sep;41:100999. doi: 10.1016/j.srhc.2024.100999. Epub 2024 Jun 17.

Abstract

OBJECTIVE

The term 'vulnerable' is often used to describe women facing psychosocial adversity during pregnancy, implying a heightened risk of experiencing suboptimal pregnancy outcomes. While this label might facilitate the pathway to appropriate care, it can be perceived as stigmatizing by the women it intends to help, which could deter their interaction with healthcare services. This study explores how women facing psychosocial adversity before, during and after pregnancy perceive the concept of vulnerability and experience being labeled as such.

METHODS

We conducted a thematic analysis of semi-structured, in-depth interviews. Through purposive sampling targeting maximum variation, ten women of diverse backgrounds were included.

RESULTS

Three central themes emerged: defining vulnerability, embracing vulnerability and the feeling of being stigmatized. Women perceived vulnerability as an inability to adequately care for themselves or their children, necessitating additional support alongside routine antenatal care. Acceptance of the 'vulnerable' label came when it also acknowledged their proactive efforts and strengths to improve their situation. Conversely, if discussions surrounding vulnerability failed to recognize women's agency - specifically, their personal journeys and the courage needed to seek support - the label was perceived as stigmatizing.

CONCLUSIONS

Addressing vulnerability effectively in maternity care requires a nuanced, patient-centered approach, acknowledging both the challenges and strengths of women facing psychosocial adversities. Emphasizing personal narratives and their courage in seeking support can mitigate the stigmatizing effects of the 'vulnerable' label. Integrating these narratives into maternal healthcare practices can foster deeper connections with the women involved, enhancing the overall quality of care.

摘要

目的

“脆弱”一词常用来描述妊娠期间面临心理社会逆境的女性,暗示其经历不良妊娠结局的风险增加。虽然这个标签可能为她们提供了获得适当护理的途径,但对其意图帮助的女性来说,可能会被视为污名化,从而阻碍她们与医疗保健服务的互动。本研究探讨了妊娠前、妊娠期间和妊娠后面临心理社会逆境的女性如何看待脆弱性概念以及被贴上此类标签的体验。

方法

我们对半结构化深入访谈进行了主题分析。通过针对最大变异性的目的性抽样,纳入了背景各异的 10 名女性。

结果

出现了三个核心主题:定义脆弱性、接受脆弱性和被污名化的感觉。女性将脆弱性视为无法充分照顾自己或孩子的能力,需要在常规产前护理之外提供额外的支持。当“脆弱”标签也承认她们主动努力和改善处境的力量时,她们会接受这个标签。相反,如果围绕脆弱性的讨论未能认识到女性的能动性——特别是她们的个人经历和寻求支持所需的勇气——那么这个标签就会被视为污名化。

结论

在产妇保健中有效地处理脆弱性需要一种细致入微、以患者为中心的方法,既要承认面临心理社会逆境的女性所面临的挑战,也要承认她们的优势。强调个人经历和她们寻求支持的勇气可以减轻“脆弱”标签的污名化影响。将这些叙述纳入产妇保健实践中,可以与相关女性建立更深入的联系,提高整体护理质量。

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