Byrd T L, Mullen P D, Selwyn B J, Lorimor R
School of Public Health, University of Texas-Houston, El Paso 79902, USA.
Public Health Rep. 1996 Nov-Dec;111(6):536-40.
To understand why many Hispanic women begin prenatal care in the later stages of pregnancy.
The authors compared the demographic profile, insurance status, and health beliefs--including the perceived benefits of and barriers to initiating prenatal care--of low-income Hispanic women who initiated prenatal care at different times during pregnancy or received no prenatal care.
A perception of many barriers to care was associated with later initiation of care and non-use of care. Perceiving more benefits of care for the baby was associated with earlier initiation of care, as was having an eligibility card for hospital district services. Several barriers to care were mentioned by women on open-ended questioning, including long waiting times, embarrassment the physical examination, and lack of transportation.
Recommendations for practice included decreasing the number of visits for women at low risk for poor pregnancy outcomes while increasing the time spent with the provider at each visit, decreasing the number of vaginal examinations for low risk women, increasing the use of midwives, training lay workers to do risk assessment, emphasizing specific messages about benefits to the baby, and increasing general health motivation to seek preventive care through community interventions.
了解为何许多西班牙裔女性在妊娠后期才开始进行产前护理。
作者比较了在孕期不同时间开始产前护理或未接受产前护理的低收入西班牙裔女性的人口统计学特征、保险状况和健康观念，包括开始产前护理的感知益处和障碍。
对护理存在诸多障碍的认知与护理开始较晚和不使用护理有关。认为对婴儿护理有更多益处与更早开始护理有关，拥有医院区服务资格卡也是如此。在开放式询问中，女性提到了一些护理障碍，包括等待时间长、体检时感到尴尬以及缺乏交通工具。
实践建议包括减少妊娠结局不良风险较低的女性的就诊次数，同时增加每次就诊时与医护人员相处的时间，减少低风险女性的阴道检查次数，增加助产士的使用，培训非专业工作人员进行风险评估，强调对婴儿益处的具体信息，并通过社区干预增强寻求预防性护理的总体健康动机。
