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[德国咨询法规下计划堕胎女性的信息与支持需求——一项定性研究]

[Information and support needs of women planning an abortion according to counselling regulations in Germany - A qualitative study].

作者信息

Jeltsch Caroline, Berger-Höger Birte

机构信息

Institut für Public Health und Pflegeforschung, Fachbereich 11 Human- und Gesundheitswissenschaften, Universität Bremen, Bremen, Deutschland.

Institut für Public Health und Pflegeforschung, Fachbereich 11 Human- und Gesundheitswissenschaften, Universität Bremen, Bremen, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2024 Dec;190-191:44-52. doi: 10.1016/j.zefq.2024.09.001. Epub 2024 Oct 29.

Abstract

BACKGROUND

For women seeking legal abortion care, access to information and care options is not transparent in Germany. This can affect health and complicate the decision-making process. In its guideline, the WHO recommends the use of evidence-based information to enable women to make informed decisions. This qualitative study aims to assess preferences and decisional needs of women in Germany.

METHOD

For the needs assessment, a qualitative study based on semi-structured guided interviews was conducted with pregnancy conflict counsellors and women who terminated a pregnancy in the past five years in Germany. These data were supplemented with social media group postings of women with pregnancy conflict experiences. All data were analysed using content-structuring analysis according to Kuckartz.

RESULTS

Three women who had undergone an abortion and two pregnancy conflict counsellors were interviewed. In addition, 89 posts from a closed social media group were analysed. Three main categories were identified: women's categorisation in value systems, factors influencing the experience of the care process and information needs of women facing conflict situations in connection with their pregnancy ("pregnancy conflict"). Abortion is considered to be stigmatised, so women rarely use existing counselling services. Overall, there is a high need for information and support among those seeking care. Concerns exist, especially with regard to the methods of abortion. The results of the study also indicate a burden caused by fragmented care, which requires a high degree of self-organisation of women.

DISCUSSION

The care situation in Germany does not meet the recommendations of the WHO guideline on safe abortion. The results indicate that care close to home and with an abortion procedure that meets women's individual preferences and thus complies with their self-determination has not yet been achieved in Germany.

CONCLUSION

Neutral and evidence-based information could be helpful to enable women to make informed decisions and reduce anxiety. It would also be desirable to increase the opportunities for women to talk about their experiences in a protected environment.

摘要

背景

对于寻求合法堕胎护理的女性而言,在德国获取信息和护理选择并不透明。这可能影响健康并使决策过程复杂化。世界卫生组织在其指南中建议使用基于证据的信息,以使女性能够做出明智的决策。这项定性研究旨在评估德国女性的偏好和决策需求。

方法

为进行需求评估,对德国的怀孕冲突顾问以及在过去五年内终止妊娠的女性开展了一项基于半结构化引导式访谈的定性研究。这些数据还补充了有怀孕冲突经历女性的社交媒体群组帖子。所有数据均根据库卡茨的内容结构化分析法进行分析。

结果

采访了三名堕胎女性和两名怀孕冲突顾问。此外,分析了一个封闭社交媒体群组的89篇帖子。确定了三个主要类别:女性在价值体系中的分类、影响护理过程体验的因素以及面临与怀孕相关冲突情况(“怀孕冲突”)的女性的信息需求。堕胎被视为受污名化的行为,因此女性很少使用现有的咨询服务。总体而言,寻求护理者对信息和支持的需求很高。尤其在堕胎方法方面存在担忧。研究结果还表明,护理碎片化造成了负担,这需要女性高度的自我组织能力。

讨论

德国的护理状况不符合世界卫生组织安全堕胎指南的建议。结果表明,德国尚未实现离家近且堕胎程序符合女性个人偏好从而符合其自主决定权的护理。

结论

中立且基于证据的信息可能有助于女性做出明智决策并减轻焦虑。增加女性在受保护环境中谈论自身经历的机会也很有必要。

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