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孕产妇险些死亡的亲身经历:坦桑尼亚乞力马扎罗地区的一项定性研究

Lived experiences of maternal near misses: a qualitative study in the Kilimanjaro Region, Tanzania.

作者信息

Sengoka Enna G, Björling Gunilla, Mahande Michael J, Mattsson Janet, Masenga Gileard

机构信息

School of Health and Welfare, Jönköping University, Jönköping, Sweden.

Faculty of Nursing, Kilimanjaro Christian Medical Centre (KCMC) University, Moshi, Tanzania.

出版信息

Reprod Health. 2025 May 26;22(1):92. doi: 10.1186/s12978-025-02018-w.

Abstract

BACKGROUND

In recent years, Tanzania has significantly reduced maternal mortality rates; however, pregnant women in Tanzania still face severe health risks and complications. The rate of maternal near misses is nearly 60% higher in Tanzania compared to other low-income countries. Women who survive severe complications during pregnancy or childbirth may experience long-lasting adverse effects, such as poor physical health, impaired sexual function, psychological distress, and a decreased quality of life. Therefore, our research aimed to understand the lived experiences of Tanzanian women who survived severe maternal complications within their cultural and social context.

METHOD

By using the Sub-Saharan Africa criteria for near misses, twelve (12) women who survived severe maternal complications were recruited between August and September 2022. The study utilized a descriptive qualitative design with an inductive approach to explore women's lived experiences of a maternal near miss. The participants were purposively sampled and interviewed face-to-face in the hospital or their homes six weeks after discharge from the hospital. Recorded interviews were transcribed and analysed using Graneheim and Lundman's content analysis.

RESULTS

The analysis revealed four themes and eight subthemes. The themes were living with severe maternal complications, impact on social life, perception of obstetric care services and person-centred care. The informants described pain experiences, weakness, fear, financial difficulties, neglect, long waiting times, and a lack of information. However, they also mentioned a need for increased awareness of danger signs, care satisfaction, and the importance of close relatives' social support.

CONCLUSION

Maternal near misses have a great impact on women's physical, financial, and mental well-being. Women also experience long service waiting times, communication barriers, and neglect. Good healthcare, person-centred care, patient education, and psychological support can improve women's lived experiences.

摘要

背景

近年来,坦桑尼亚大幅降低了孕产妇死亡率;然而,坦桑尼亚的孕妇仍面临严重的健康风险和并发症。与其他低收入国家相比,坦桑尼亚的孕产妇险些死亡发生率高出近60%。在孕期或分娩期间经历严重并发症后幸存下来的女性可能会遭受长期的不良影响,如身体健康不佳、性功能受损、心理困扰以及生活质量下降。因此,我们的研究旨在了解在其文化和社会背景下经历过严重孕产妇并发症的坦桑尼亚女性的生活经历。

方法

采用撒哈拉以南非洲地区的险些死亡标准,于2022年8月至9月招募了12名经历过严重孕产妇并发症的女性。该研究采用描述性定性设计和归纳法,以探索女性险些发生孕产妇死亡的生活经历。参与者是经过有目的抽样的,并在出院六周后在医院或其家中进行面对面访谈。对记录的访谈进行转录,并使用格兰内海姆和伦德曼的内容分析法进行分析。

结果

分析揭示了四个主题和八个子主题。主题分别是患有严重孕产妇并发症的生活、对社会生活的影响、对产科护理服务的认知以及以患者为中心的护理。受访者描述了疼痛经历、虚弱、恐惧、经济困难、被忽视、等待时间长以及信息缺乏等情况。然而,他们也提到需要提高对危险信号的认识、护理满意度以及近亲社会支持的重要性。

结论

孕产妇险些死亡对女性的身体、经济和心理健康有很大影响。女性还经历了漫长的服务等待时间、沟通障碍和被忽视的情况。良好的医疗保健、以患者为中心的护理、患者教育和心理支持可以改善女性的生活经历。

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