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基于不同社会文化背景下女性经历的孕产妇保健脆弱性定性研究

Qualitative Study of Maternity Healthcare Vulnerability Based on Women's Experiences in Different Sociocultural Context.

作者信息

Silva-Fernández Claudia Susana, Garrosa Eva, Ramiro-Cortijo David

机构信息

Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, 28049 Madrid, Spain.

Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, 28049 Madrid, Spain.

出版信息

Nurs Rep. 2025 Mar 18;15(3):105. doi: 10.3390/nursrep15030105.

Abstract

Unfulfillment of maternity rights in healthcare is a global problem associated with abuse, neglect and discrimination, known as obstetrics and gynecology (OB/GYN) vulnerability. Women's perceptions of their experience are a keystone to improving maternity healthcare. The aim of this study was to evaluate the women's perceptions of the vulnerability of maternity rights and the associated risk and protective factors. This study was carried out by qualitative techniques based on the analysis of a semi-structured interview applied to six women in the postpartum period with pregnancy assistance and birth in Spain and Colombia between February and August of 2024. A triangulation analysis was performed about the perceptions of the concept, experiences and risk and protective factors of OB/GYN vulnerability. The free-access ATLAS.ti software was used. OB/GYN vulnerability is generally perceived by women with a psychological impact. Women think that their own factors (emotion management, social support, attitude to change and beliefs), health professional factors (burnout, empathy and social skills) and health institution factors (workload, centralization in technical and protocols, humanization, quality and access to recourses) have an influence to modulate the vulnerability of rights in maternity healthcare. It is necessary for health systems to move from a protocol-centered to a person-centered model, particularly in maternity healthcare. This model should include the biopsychosocial needs of women and allow for their participation. Health institutions need to evaluate their processes and minimize burnout in health professionals. In addition, there are factors affecting OB/GYN vulnerability not only in childbirth but also during pregnancy and postpartum.

摘要

在医疗保健中,孕产妇权利未得到实现是一个全球性问题,与虐待、忽视和歧视相关,即妇产科(OB/GYN)脆弱性。女性对自身经历的看法是改善孕产妇医疗保健的关键。本研究的目的是评估女性对孕产妇权利脆弱性以及相关风险和保护因素的看法。本研究采用定性技术,基于对2024年2月至8月期间在西班牙和哥伦比亚接受妊娠援助并分娩的6名产后女性进行的半结构化访谈分析。对妇产科脆弱性的概念、经历以及风险和保护因素的看法进行了三角分析。使用了免费的ATLAS.ti软件。女性普遍认为妇产科脆弱性具有心理影响。女性认为自身因素(情绪管理、社会支持、对变化的态度和信念)、卫生专业人员因素(职业倦怠、同理心和社交技能)以及卫生机构因素(工作量、技术和协议的集中化、人性化、质量和资源获取)会影响调节孕产妇医疗保健中权利的脆弱性。卫生系统有必要从以协议为中心的模式转变为以人 为中心的模式,尤其是在孕产妇医疗保健方面。这种模式应包括女性的生物心理社会需求,并允许她们参与。卫生机构需要评估其流程,并尽量减少卫生专业人员的职业倦怠。此外,影响妇产科脆弱性的因素不仅存在于分娩期间,还存在于孕期和产后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14d1/11945914/b1e7b5957437/nursrep-15-00105-g001.jpg

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