Physical Accessibility of Routine Prenatal Care for Women with Mobility Disability
Physical Accessibility of Routine Prenatal Care for Women with Mobility Disability
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DOI：
10.1089/jwh.2015.5385
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发表时间：
2015-12-01
影响因子：
3.5
通讯作者：
Ecker, Jeffrey L.
中科院分区：
文献类型：
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作者：
Iezzoni, Lisa I.;Wint, Amy J.;Ecker, Jeffrey L.
背景：常规产前护理包括体检和体重测量。对于医疗诊断设备（例如检查台和体重秤）的使用障碍是否会影响身体残疾孕妇的产前护理，人们知之甚少。方法：我们使用半结构化、开放式访谈方案对 22 名女性进行了 2 小时的深入电话访谈。所有女性在怀孕前都有严重的行动困难，并且在过去 10 年内分娩过婴儿。我们通过社交网络招募了大多数参与者。我们使用使用过的 NVivo 软件对采访记录文本进行排序，并进行传统的内容分析来确定主要主题。结果：受访者的平均（标准差）年龄为 34.8（5.3）岁。大多数是白人，受过良好教育，收入较高； 8 名女性患有脊髓损伤，4 名女性患有脑瘫，10 名女性患有其他疾病； 18 个使用过的轮式助行器。一些妇女产科医生配备了可调节高度的检查床，这方便了身体检查时的转移。其他女性很难转移到固定高度的检查台上，只能坐在轮椅上接受检查。家庭成员和/或临床工作人员有时协助转移；一些妇女报告了对转移安全的担忧。没有女性报告说她们的产前护理临床医生经常在方便的体重秤上称重。有些人在怀孕期间从未称过体重。结论：检查台和体重秤难以接近，阻碍了部分身体残疾孕妇进行常规产前体检和体重测量。这代表护理不合格。可调节高度的检查台和轮椅无障碍体重秤可以显着改善对身体残疾孕妇的护理和舒适度。
Background: Routine prenatal care includes physical examinations and weight measurement. Little is known about whether access barriers to medical diagnostic equipment, such as examination tables and weight scales, affect prenatal care among pregnant women with physical disabilities. Methods: We conducted 2-hour, in-depth telephone interviews with 22 women using a semistructured, open-ended interview protocol. All women had significant mobility difficulties before pregnancy and had delivered babies within the prior 10 years. We recruited most participants through social networks. We sorted interview transcript texts using used NVivo software and conducted conventional content analyses to identify major themes. Results: Interviewee's mean (standard deviation) age was 34.8 (5.3) years. Most were white, well-educated, and higher income; 8 women had spinal cord injuries, 4 cerebral palsy, and 10 had other conditions; 18 used wheeled mobility aids. Some women's obstetricians had height adjustable examination tables, which facilitated transfers for physical examinations. Other women had difficulty transferring onto fixed height examination tables and were examined while sitting in their wheelchairs. Family members and/or clinical staff sometimes assisted with transfers; some women reported concerns about transfer safety. No women reported being routinely weighed on an accessible weight scale by their prenatal care clinicians. A few were never weighed during their pregnancies. Conclusions: Inaccessible examination tables and weight scales impede some pregnant women with physical disabilities from getting routine prenatal physical examinations and weight measurement. This represents substandard care. Adjustable height examination tables and wheelchair accessible weight scales could significantly improve care and comfort for pregnant women with physical disabilities.