'Weighing up and balancing out': a meta-synthesis of barriers to antenatal care for marginalised women in high-income countries
'Weighing up and balancing out': a meta-synthesis of barriers to antenatal care for marginalised women in high-income countries
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DOI：
10.1111/j.1471-0528.2008.02067.x
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发表时间：
2009-03-01
影响因子：
5.8
通讯作者：
Lavender, T.
中科院分区：
文献类型：
--
作者：
Downe, S.;Finlayson, K.;Lavender, T.
在资源丰富的环境中，约 20% 的孕产妇死亡归因于未能获得充分产前护理的妇女。流行病学证据表明，其中许多妇女属于边缘群体，通常生活在相对贫困的地区。产前护理不足的原因尚未得到充分评估。为了确定影响发达国家边缘化孕妇获得产前护理的因素。我们纳入了在英语期刊上发表的发达国家的定性研究（1980-2007年）。定性研究探讨了生活在发达国家的边缘化妇女的观点，这些妇女要么没有参加任何产前护理，要么太晚或不定期进行。八项研究符合选择标准，并根据源自技术的技术进行综合元民族志。最初的接触受到妊娠晚期的认可和随后的否认或接受的影响。持续的访问似乎取决于权衡和平衡感知的收益和损失的策略。时间、金钱和社会支持方面的个人资源与服务提供问题一起被考虑，包括感知的护理质量、工作人员的可信度和文化敏感性以及相互尊重的感觉。由文化敏感的工作人员提供的非威胁性、非评判性的产前服务可能会增加边缘化妇女获得产前护理的机会。旨在提高人们对产前护理的认识和提供产前护理的机会的多机构举措也可能会增加采用率。
In high-resource settings around 20% of maternal deaths are attributed to women who fail to receive adequate antenatal care. Epidemiological evidence suggests many of these women belong to marginalised groups often living in areas of relative deprivation. Reasons for inadequate antenatal attendance have yet to be fully evaluated.To identify the factors affecting access to antenatal care for marginalised pregnant women living in developed countries.We included qualitative studies from developed countries published in English language journals (1980-2007).Qualitative studies exploring the views of marginalised women living in developed countries who either failed to attend for any antenatal care or did so late or irregularly.Eight studies fulfilled the selection criteria and were synthesised in accord with the techniques derived from meta-ethnography.Initial access is influenced by late pregnancy recognition and subsequent denial or acceptance. Continuing access appears to depend on a strategy of weighing up and balancing out of the perceived gains and losses. Personal resources in terms of time, money and social support are considered alongside service provision issues including the perceived quality of care, the trustworthiness and cultural sensitivity of staff and feelings of mutual respect.A nonthreatening, nonjudgemental antenatal service run by culturally sensitive staff may increase access to antenatal care for marginalised women. Multiagency initiatives aimed at raising awareness of, and providing access to, antenatal care may also increase uptake.