Heaman M, Gupton A
Winnipeg Community and Long-Term Care Authority, University of Manitoba, Canada.
Birth. 1998 Dec;25(4):252-8. doi: 10.1046/j.1523-536x.1998.00252.x.
Bed rest at home or in the hospital is a commonly prescribed treatment for women experiencing complications of pregnancy. This focused ethnographic study examined bed rest from the high-risk pregnant woman's perspective and compared perceptions of women cared for in the home with those in hospital.
A convenience sample of 24 pregnant women who had been on bed rest for at least seven days was recruited from the antepartum unit of a tertiary care hospital and from an antepartum home care program in western Canada. Data were collected in 1994 through interviews and participant diaries. Content analysis was used to identify themes.
Bed rest had a significant emotional and social impact on pregnant women and their families in both settings. Overall, bed rest in hospital seemed to be associated with more sources of stress than at home. In hospital, women had to cope with separation from home and family, lack of privacy, hospital discomforts, and incompatible roommates, whereas women at home struggled with role reversal and the temptation to do more activity than was recommended. Stressors not unique to but exacerbated by hospitalization included concerns about the children, a sense of missing out, a sense of confinement and being a prisoner, boredom, feelings of depression and loneliness, and negative impact on the relationship with their partner.
Study findings raise questions about the appropriateness of routine prescription of bed rest. Health care professionals should propose and develop home care programs as an alternative to antepartum hospitalization.
在家或在医院卧床休息是针对有妊娠并发症的女性常用的规定治疗方法。这项重点民族志研究从高危孕妇的角度审视了卧床休息,并比较了在家接受护理的女性与在医院接受护理的女性的看法。
从一家三级护理医院的产前病房和加拿大西部的一个产前家庭护理项目中,选取了24名至少卧床休息7天的孕妇作为便利样本。1994年通过访谈和参与者日记收集数据。采用内容分析法确定主题。
在这两种情况下,卧床休息对孕妇及其家人都产生了重大的情感和社会影响。总体而言,在医院卧床休息似乎比在家中带来更多压力源。在医院里,女性不得不应对与家庭的分离、缺乏隐私、医院的不适以及不融洽的室友,而在家中的女性则在角色转换以及比建议的更多活动的诱惑中挣扎。并非住院所特有的但因住院而加剧的压力源包括对孩子的担忧、错过感、被限制和被囚禁感、无聊、抑郁和孤独感以及对与伴侣关系的负面影响。
研究结果引发了关于常规规定卧床休息是否恰当的问题。医疗保健专业人员应提议并制定家庭护理项目,作为产前住院的替代方案。