检查接受性和可行性对退伍军人接受VA产妇护理福利的doula干预计划的可行性
Kristin M Mattocks1, Lael Ngangmeni2, Valerie Marteeny3
1VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; University of Massachusetts Chan Medical School, Worcester, Massachusetts.
概括
基于社区的杜拉护理对于接受VA产科护理的孕妇退伍军人来说是可行的和可以接受的. 该计划有望改善对退伍军人的文化响应,创伤信息支持,特别是那些具有高风险因素的退伍军人.
科学领域:
- 围产期健康 围产期健康
- 医疗保健服务研究 医疗服务研究
- 退伍军人事务 医疗保健 医疗保健
背景情况:
- 获得退伍军人事务部 (VA) 购买的产科护理的孕妇退伍军人经常面临独特的心理社会和产科挑战.
- 现有的产妇护理模式可能无法完全满足不同退伍军人群体的特定需求,包括那些遭受军事性创伤或高度抑郁症状的人.
研究的目的:
- 评估为怀孕的退伍军人提供基于社区的杜拉护理计划的可行性和可接受性.
- 评估杜拉支持对VA医疗保健系统内母亲和婴儿健康结果的影响.
主要方法:
- 在两个VA医疗中心与社区杜拉机构合作实施了一项试点计划.
- 经过认证的杜拉提供了全面的支持,包括产前教育,产后支持和产后跟踪.
- 用干预措施的可接受性 (AIM) 和定性反来衡量参与者的接受度;健康结果在分娩后被跟踪.
主要成果:
- 该计划表现出高可行性,在被提名退伍军人中,录取率为74%,评估完成率为59%.
- 参与者,主要是黑人和多年退伍军人,服务相关残疾和军事性创伤率高,报告高满意度 (87%的积极分娩经验) 和接受度 (平均AIM得分为4.3).
- 剖腹产产率为17%,70%的人表示有兴趣在未来使用杜拉服务.
结论:
- 基于社区的杜拉护理对于围产退伍军人来说是一个可行的和高度可接受的干预措施,特别是那些具有显著的心理社会和产科风险的人.
- 将杜拉服务整合到VA产科护理中,可以提供文化响应,创伤知情的支持,增强对有色退伍军人的护理.
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