以患者为中心的尊重产妇护理:一个因素分析,将边缘化身份,信任和知情选择置于背景中
Annie Glover1,2, Carly Holman3,4, Patrick Boise3,4
1University of Montana Rural Institute for Inclusive Communities, Missoula, US. annie.glover@mso.umt.edu.
BMC pregnancy and childbirth
|April 11, 2024
概括
社会边缘化对尊重产妇护理和患者自主性产生负面影响,特别是对AI/AN个人,残疾人以及具有社会风险因素的人来说. 解决这些差异对于改善孕产妇健康结果至关重要.
科学领域:
- 孕产妇健康 孕产妇健康
- 健康差异 在健康上的差异
- 以患者为中心的护理
背景情况:
- 不断上升的孕产妇死亡率和发病率凸显出改善孕产妇护理的迫切需要.
- 显著的种族健康差异仍然存在于孕产妇健康结果中,需要紧急关注.
- 以患者为中心的产妇护理,专注于尊重和自主,通过身份,信任和知情选择来探索.
研究的目的:
- 调查以患者为中心的产妇护理经验.
- 检查身份,关系信任和知情选择对护理经验的影响.
- 了解社会边缘化与尊重产妇护理之间的关系.
主要方法:
- 从484个在过去五年内怀孕的个人收集初级数据.
- 使用了母亲尊重指数 (MORi) 和母亲决策自主权 (MADM) 尺度.
- 探索性因素分析确定了信任,知情选择和身份;双变量和多变量分析检查了它们与社会边缘化 (种族,残疾,司法参与,粮食/住房不安全) 的关系.
主要成果:
- 增加的社会边缘化与尊重产妇护理的经验减少以及患者自主权的减少相关.
- 美国印第安人/阿拉斯加原住民 (AI/AN) 个人,残疾人,以及那些有社会风险因素的人报告了更多与身份相关的不尊重和侵犯自治的情况.
- 结果证实了将社会边缘化与孕产妇护理中患者体验较差的假设.
结论:
- 以患者为中心的产妇护理必须承认更广泛的社会背景,包括权力动态,历史创伤和边缘化.
- 改善患者体验和结果的干预措施需要在患者的身份和创伤历史中进行背景化.
- 了解患者身份如何塑造医疗保健体验对于有效的干预和改善孕产妇健康结果至关重要.
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