Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada.
PLoS One. 2024 Jul 9;19(7):e0304815. doi: 10.1371/journal.pone.0304815. eCollection 2024.
Mothers have a significant influence on family dynamics, child development, and access to family services. There is a lack of literature on the typical Canadian maternal experience and its influence on access to services for mothers despite recognizing the importance of mothers. A cross-sectional study was conducted to address this research gap that employed Andersen's Behavioral Model of Health Service Use in conjunction with a feminist lens. A total of 1,082 mothers who resided in Newfoundland and Labrador (NL) participated in a province-wide survey in 2017 and reported on their wellbeing, family life, and healthcare utilization. Stepwise binomial logistic regressions and linear regressions were used to predict initiation and continued service utilization within the preceding 12 months, respectively. Mothers who participated in this survey were older, and were more likely to be in a relationship than those in the Canadian census, while no difference was observed in annual income. Approximately half of mothers accessed services for themselves over the previous 12-months, with the overwhelming majority accessing services for their children. Medical services were the most likely to be utilized, and mental health and behavioural services were the most likely services to be needed, but not available. Sociodemographic (e.g., age, education attainment), familial relationships and role satisfaction, health need, and health practices predicted maternal initiation and continued use of services, with a larger number of variables influencing maternal service initiation as compared to continuous use of services. Sociodemographic (e.g., maternal age, community population), maternal social support, health need, and maternal health practices predicted maternal access of at least one child service while family relationships, health need, and maternal health practices predicted maternal use of a range of child services conditional on initial access. These results can support the provincial health system to better support access to care by acknowledging the interdependent nature of maternal and child health care utilization. They also highlight the importance of equitable healthcare access in rural locations. Results are discussed in terms of their clinical relevance to health policy.
母亲对家庭动态、儿童发展和家庭服务的获取有重大影响。尽管认识到母亲的重要性，但关于典型的加拿大母亲体验及其对母亲获取服务的影响的文献却很少。本研究采用横断面研究设计，利用安德森健康服务利用行为模型（Andersen's Behavioral Model of Health Service Use）并结合女性主义视角，以解决这一研究空白。2017 年，在纽芬兰和拉布拉多省（NL）进行了一项全省范围的调查，共有 1082 名母亲参与了调查，报告了她们的幸福感、家庭生活和医疗保健利用情况。分别采用逐步二项逻辑回归和线性回归来预测 12 个月内服务的初始利用和持续利用。参与该调查的母亲年龄较大，与加拿大人口普查相比，更有可能处于恋爱关系中，而年收入则没有差异。在过去的 12 个月里，大约有一半的母亲为自己获得了服务，绝大多数母亲是为孩子获得了服务。医疗服务是最有可能被利用的，心理健康和行为服务是最有可能需要但无法提供的服务。社会人口统计学因素（如年龄、教育程度）、家庭关系和角色满意度、健康需求和健康实践预测了母亲服务的初始利用和持续利用，与连续利用服务相比，更多的变量影响了母亲服务的初始利用。社会人口统计学因素（如母亲年龄、社区人口）、母亲社会支持、健康需求和母亲健康实践预测了母亲至少获得一项儿童服务，而家庭关系、健康需求和母亲健康实践预测了母亲在初始获得后使用一系列儿童服务。这些结果可以支持省级卫生系统更好地支持获得护理，承认母婴保健利用的相互依存性质。它们还强调了在农村地区实现公平获得医疗保健的重要性。结果从临床角度讨论了其对卫生政策的意义。
