Disabled women's experiences of accessing and utilising maternity services when they are affected by domestic abuse: a critical incident technique study.
Disabled women's experiences of accessing and utilising maternity services when they are affected by domestic abuse: a critical incident technique study.
复制标题
DOI：
10.1186/s12884-015-0616-y
复制
发表时间：
2015-08-20
影响因子：
3.1
通讯作者：
Taylor J
中科院分区：
文献类型：
--
作者：
Bradbury-Jones C;Breckenridge JP;Devaney J;Kroll T;Lazenbatt A;Taylor J
妇女及其婴儿有权平等获得高质量的产妇护理。然而，当妇女属于两种或两种以上的弱势群体时，她们在获得和利用服务方面可能面临多重、复合的障碍。残疾妇女遭受家庭虐待的可能性是非残疾妇女的三倍。家庭虐待可能会影响保健服务的获得和利用，残疾人一般无法获得最佳的保健服务。尽管如此，人们对残疾和家庭虐待对妇女获得产妇护理的复合影响知之甚少。这项研究的目的是确定妇女如何对待产妇护理服务、她们对服务的期望以及她们是否能够得到她们需要和想要的护理类型。我们在苏格兰进行了一项定性的关键事件技术研究。从理论上讲，我们借鉴了安徒生的医疗保健使用模型。该模型是一致的，我们的兴趣，妇女的打算/实际使用的孕产妇服务和促进者和障碍，影响他们获得护理。数据是在2013年通过一对一访谈产生的。5名妇女参加了调查，她们共同报告了45起与获得和利用孕产服务有关的重大事件。映射到基础的理论框架，我们的研究结果表明，四个领域的态度，知识，社会规范和感知控制是塑造产妇护理经验的重要因素。工作人员的积极态度和赋予妇女控制自己护理的权力，对于影响妇女获得和利用孕产妇保健服务至关重要。此外，这些都是周期性的，保健使用的后果和结果成为影响未来保健决定的有利或不利因素的一部分，需要进一步考虑制定战略，在这种情况下接触和招聘妇女。这将为代表性不足和被压制的声音提供一个机会。
Women and their babies are entitled to equal access to high quality maternity care. However, when women fit into two or more categories of vulnerability they can face multiple, compound barriers to accessing and utilising services. Disabled women are up to three times more likely to experience domestic abuse than non-disabled women. Domestic abuse may compromise health service access and utilisation and disabled people in general have suboptimal access to healthcare services. Despite this, little is known about the compounding effects of disability and domestic abuse on women’s access to maternity care. The aim of the study was to identify how women approach maternity care services, their expectations of services and whether they are able to get the type of care that they need and want. We conducted a qualitative, Critical Incident Technique study in Scotland. Theoretically we drew on Andersen’s model of healthcare use. The model was congruent with our interest in women’s intended/actual use of maternity services and the facilitators and barriers impacting their access to care. Data were generated during 2013 using one-to-one interviews. Five women took part and collectively reported 45 critical incidents relating to accessing and utilising maternity services. Mapped to the underpinning theoretical framework, our findings show how the four domains of attitudes; knowledge; social norms; and perceived control are important factors shaping maternity care experiences. Positive staff attitude and empowering women to have control over their own care is crucial in influencing women’s access to and utilisation of maternity healthcare services. Moreover these are cyclical, with the consequences and outcomes of healthcare use becoming part of the enabling or disabling factors affecting future healthcare decisions.Further consideration needs to be given to the development of strategies to access and recruit women in these circumstances. This will provide an opportunity for under-represented and silenced voices to be heard.