Monitored but not sufficiently guided - A qualitative descriptive interview study of maternity care experiences and needs in women with chronic medical conditions
Monitored but not sufficiently guided - A qualitative descriptive interview study of maternity care experiences and needs in women with chronic medical conditions
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DOI：
10.1016/j.midw.2021.103167
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发表时间：
2021-11-08
期刊：
影响因子：
2.7
通讯作者：
de Wolff, Mie G.
中科院分区：
文献类型：
--
作者：
Hansen, Mette K.;Midtgaard, Julie;de Wolff, Mie G.
目的：探讨接受专科产科护理的不同类型长期病患者的产科护理经验及需要。设计：定性描述性研究。背景：一家高度专业化的医院，为丹麦哥本哈根的高危妊娠妇女提供产科护理。参与者14名有目的地选择的妇女由于一种或多种慢性疾病而在一家大型三级医院接受专科产科护理。方法：在2018年1月至2019年6月期间进行了个人深入访谈（n = 14）。使用专题分析进行分析。结果：确定了一个总体主题：有指导但没有得到充分指导。三个主要主题展开这一总体主题是：慢性病作为决定怀孕护理，育龄妇女作为信使和翻译，以及分娩后被遗弃的感觉。关键结论：在各种类型的慢性疾病，妇女表示需要增加专业产妇护理的连续性。医疗保健专业人员应该帮助患有慢性疾病的妇女浏览医疗保健系统并解释复杂的信息。对实践的影响：怀孕应该被认为是一个重要的生活事件，即使育龄妇女是生活在一个慢性疾病，专业人员应该强调怀孕的发展不复杂的方面。关于产后慢性疾病的预期发展和对母乳喂养的关切的信息最好在怀孕期间解决。持续的护理对妇女特别重要，可以减轻妇女在怀孕期间的一些担忧。
Objective: To explore maternity care experiences and needs of women with various types of chronic medical conditions receiving specialised maternity care. Design A qualitative descriptive study. Setting: A highly specialised hospital providing maternity care to women with high-risk pregnancies in Copenhagen, Denmark. Participants Fourteen purposefully selected women referred to specialist maternity care at a large tertiary hospital due to one or more chronic medical conditions. Methods: Individual in-depth interviews (n = 14) were performed between January 2018 and June 2019. Analysed using thematic analysis. Results: One overarching theme was identified: Monitored but not sufficiently guided. Three main themes unfolding this overarching theme were: Chronic condition as determining pregnancy care, Childbearing woman as messenger and interpreter, and Feelings of abandonment after giving birth. Key conclusions: Across various types of chronic medical conditions, women expressed a need for increased continuity in specialised maternity care. Healthcare professionals should help women with chronic medical conditions navigate the healthcare system and interpret complex information. Implications for practice: Pregnancy should be recognised as a significant life event, even though the childbearing woman is living with a chronic medical condition, and professionals should emphasise the aspects of pregnancy that develop uncomplicated. Information about the anticipated development of chronic medical conditions postpartum and concerns regarding breastfeeding could preferably be addressed during pregnancy. Continuity of care was particularly important to the women and could relieve some of the worrying women experienced during pregnancy.