Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth
Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth
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DOI：
10.1016/j.socscimed.2018.02.013
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发表时间：
2018-03-01
影响因子：
5.4
通讯作者：
Franck, Linda
中科院分区：
文献类型：
--
作者：
McLemore, Monica R.;Altman, Molly R.;Franck, Linda
背景资料：慢性压力是早产的一个已知风险因素，但人们对医疗保健经验如何增加或减轻感知压力知之甚少。在这项研究中，我们描述了54名妇女的颜色从弗雷斯诺，奥克兰，和旧金山弗朗西斯科，加州，社会和/或医疗风险因素为早产birth.Methods：这项研究是一个次要的焦点小组数据分析的一部分，集中在一个更大的项目，专注于病人和社区参与早产research。讲英语和西班牙语的妇女，年龄18岁或以上的社会和/或医疗风险因素的pretren出生参加了两个焦点小组，相隔六周。从第一焦点小组的数据包括在此analysis.Results：五个主题出现了从专题分析的成绩单。参与者描述了在医疗保健遇到的不尊重，包括种族主义和歧视的经验;与各级工作人员的紧张互动;未满足的信息需求;和不一致的社会支持。尽管有这些不利的经历，但妇女对养育子女和新生儿护理充满信心。参与者对改善医疗保健系统的建议包括：更加关注生育计划，多个医疗保健提供者之间更好的沟通，在临床遇到患者时更仔细地倾听，增加对社会计划的支持，如加州的黑人婴儿健康，以及减少对过去癌症史和/或儿童保护服务参与的依赖。这项研究中的妇女认为她们的产前保健在很大程度上是一种不尊重和压力的经历。我们的研究结果增加了越来越多的文献，即有色人种妇女在医疗保健遇到歧视，种族主义和不尊重，他们认为这会影响他们和婴儿的健康。
Background: Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth.Methods: This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for pretenn birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis.Results: Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement.Discussion: The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.