影响妇女决定先前剖腹产后分娩方式的因素:一个元民族学
Emma L Hamilton1, Karen McLaughlin2, Lyndall Mollart2
1BMid (hons), School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW, Australia.
概括
了解影响妇女在剖腹产后下一次分娩决定的因素至关重要. 提供基于证据的信息的支持性医疗保健提供者是剖腹产后阴道分娩 (VBAC) 或重复剖腹产的知情选择的关键.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 生殖健康 生殖健康
背景情况:
- 全球剖腹产率的上升有助于增加母亲和新生儿的风险.
- 可选重复的CS (ERCS) 显著推动了这一增长,带来了不必要的风险.
- 剖腹产后的阴道分娩 (VBAC) 是一个安全的替代方案,但其吸收仍然很低.
研究的目的:
- 确定影响妇女在剖腹产后 (NBAC) 下次分娩方式决策的因素.
- 支持考虑VBAC或ERCS的女性做出明智的选择.
主要方法:
- 在多个数据库 (CINAHL,Embase,Medline等) 中进行了系统的文献搜索. ) 的情况.
- 包括了高质量,同行评审的英语初级研究文章.
- 使用诺布利特和哈尔的七步方法的元民族学,综合了包含的研究的主题.
主要成果:
- 分析了14篇主要研究文章,涉及287名女性 (VBAC重点) 和1861名女性加上311个博客 (VBAC和ERCS).
- 影响决策的关键主题包括:卫生专业人员的影响,以前的分娩经历的影响,对最佳分娩经验的渴望,以及对控制的需要.
- 卫生专业人员的影响力成为主要因素.
结论:
- 卫生专业人员对妇女在剖腹产后分娩方式的决定有很大的影响.
- 支持共享决策,明确的基于证据的风险/收益信息以及解决恐惧是必不可少的.
- 医疗保健提供者需要提高技能,以便向妇女汇报初级CS指示,并管理对未来分娩的期望.
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