Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period
Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period
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DOI：
10.1186/1471-2393-13-174
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发表时间：
2013-09-13
影响因子：
3.1
通讯作者：
Gray, Ron
中科院分区：
文献类型：
--
作者：
Redshaw, Maggie;Malouf, Reem;Gray, Ron
背景：据估计，在英国分娩的妇女中有 9.4% 患有一种或多种限制性长期疾病，这些疾病可能导致残疾，影响怀孕、分娩和早期养育子女。据我们所知，尚未对具有全国代表性的人群对残疾妇女的生育经历进行过大规模研究。方法：对代表护理质量委员会的英国国家卫生服务信托基金 2010 年对妇女进行的一项调查数据进行了二次分析。英国有 144 家信托公司参与了此次邮政调查。女性自我认定为残疾，如果年龄不满 16 岁或婴儿死亡，则被排除在外。这份 12 页的结构化调查问卷包含产前、临产、分娩和产后护理等部分，内容涵盖获取、信息、沟通和选择。描述性和调整分析比较了残疾和非残疾组。分别对五个残疾亚组进行比较：身体残疾、感觉障碍、心理健康状况、学习障碍和患有一种以上残疾的妇女。结果：残疾妇女占总样本（24,155 人）的 6.14%（1,482 人），并且似乎比非残疾妇女更多地使用生育服务。大多数人对自己的护理持积极态度，并表示有足够的机会和参与，但母乳喂养的可能性较小。不同类型残疾妇女的经历存在差异：身体残疾妇女更多地使用产前和产后服务，但在分娩和分娩方面的选择较少；那些有感觉障碍的妇女的经历与非残疾妇女几乎没有什么不同，但她们更有可能在分娩前见过工作人员；有精神健康障碍的妇女也更多地使用服务，但对沟通和支持更加挑剔；有学习障碍和多重残疾的妇女最不可能报告积极的产妇护理经历。结论：这项全国性研究描述了与非残疾妇女相比，残疾妇女在怀孕、分娩和产后护理方面的经历。虽然在许多领域没有差异，但有证据表明特定群体适当地接受了更多护理。需要改进的领域包括婴儿喂养和个性化护理中更好的沟通。
Background: It has been estimated that 9.4% of women giving birth in the United Kingdom have one or more limiting longstanding illness which may cause disability, affecting pregnancy, birth and early parenting. No large scale studies on a nationally representative population have been carried out on the maternity experiences of disabled women to our knowledge.Method: Secondary analysis of data from a survey of women in 2010 by English National Health Service Trusts on behalf of the Care Quality Commission was undertaken. 144 trusts in England took part in the postal survey. Women self-identified with disability and were excluded if less than 16 years of age or if their baby had died. The 12 page structured questionnaire with sections on antenatal, labour and birth and postnatal care covered access, information, communication and choice. Descriptive and adjusted analyses compared disabled and non-disabled groups. Comparisons were made separately for five disability subgroups: physical disability, sensory impairment, mental health conditions, learning disability and women with more than one type of disability.Results: Disabled women comprised 6.14% (1,482) of the total sample (24,155) and appeared to use maternity services more than non-disabled women. Most were positive about their care and reported sufficient access and involvement, but were less likely to breastfeed. The experience of women with different types of disability varied: physically disabled women used antenatal and postnatal services more, but had less choice about labour and birth; the experience of those with a sensory impairment differed little from the non-disabled women, but they were more likely to have met staff before labour; women with mental health disabilities also used services more, but were more critical of communication and support; women with a learning disability and those with multiple disabilities were least likely to report a positive experience of maternity care.Conclusion: This national study describes disabled women's experiences of pregnancy, child birth and postnatal care in comparison with non-disabled women. While in many areas there were no differences, there was evidence of specific groups appropriately receiving more care. Areas for improvement included infant feeding and better communication in the context of individualised care.