WRISK voices: A mixed-methods study of women's experiences of pregnancy-related public health advice and risk messages in the UK.
WRISK voices: A mixed-methods study of women's experiences of pregnancy-related public health advice and risk messages in the UK.
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DOI：
10.1016/j.midw.2022.103433
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发表时间：
2022-10
期刊：
影响因子：
2.7
通讯作者：
Murphy, Clare
中科院分区：
文献类型：
--
作者：
Blaylock, Rebecca;Trickey, Heather;Sanders, Julia;Murphy, Clare
妇女收到许多与怀孕有关的公共卫生信息，这些信息旨在改善婴儿和母亲的健康状况。然而，就风险状况和产妇护理系统进行谈判可能会让人感到困惑和无能为力。妇女与其医疗保健提供者之间的关系至关重要，但信任和自主权问题可能会对她们产生不利影响。我们使用了嵌套的研究设计，包括在线调查和定性访谈，以了解妇女在怀孕期间的风险信息的经验。我们有目的地对调查参与者进行抽样调查，以确保访谈人群包括很少听到声音的女性，并且受到不良风险沟通的影响不成比例。共有7 009名妇女回答了调查，34名妇女参加了访谈。与会者收到了来自各种来源的公共卫生和风险信息。数据显示，妇女希望在“安全总比后悔好”的方法和基于证据的信息和建议之间取得平衡。妇女报告说，她们得到大量信息的主题与她们认为需要更多建议的领域之间存在差异。许多参与者说，他们得到的建议相互矛盾，信息传递的方式有时会挑战他们的自主权。我们发现，年轻女性（<20岁）和BMI较高的女性在孕产护理中经历了污名化。我们的研究表明，风险沟通的重要性，尊重妇女的自主权，并相信他们对自己的怀孕作出决定。我们确定了对风险沟通分层方法的需求。虽然有些妇女很乐意采取预防性行为而不进行讨论，但其他人则希望对证据基础进行彻底检查。我们的研究结果表明，更多的个性化护理，连续性，减少HCP的判断和污名化将改善女性的体验，并可能导致更好地参与服务。
Women receive many public health messages relating to pregnancy which are intended to improve outcomes for babies and mothers. However, negotiating the risk landscape and maternity care system can feel confusing and disempowering. Relationships between women and their healthcare providers are paramount, but they can be adversely affected by issues of trust and autonomy. We used a nested study design including an online survey and qualitative interviews to gain an understanding of women's experiences of risk messages during pregnancy. We purposively sampled survey participants to ensure the interview population included women whose voices are seldom heard and are disproportionately impacted by poor risk communication. A total of 7,009 women responded to the survey, and 34 women participated in interviews. Participants received public health and risk messages from a range of sources. Data showed that women wanted a balance between a “better safe than sorry” approach and evidence-based information and advice. Women reported a discrepancy between the topics they received a lot of information on and areas in which they felt they needed more advice. Many participants said they were given conflicting advice, and the way information was delivered sometimes challenged their autonomy. We identified that younger women (<20 years old) and women with higher BMIs experienced stigmatisation in their maternity care. Our research shows the importance of risk communication that respects women's autonomy and trusts them to make decisions about their own pregnancy. We identified a need for a layered approach to risk communication. Whilst some women are happy to adopt precautionary behaviour without discussion, others will want a thorough examination of the evidence-base. Our findings suggest that more individualised care, continuity, and less judgement and stigmatisation from HCPs will improve experiences for women and may lead to better engagement with services.
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