Exploring the perspectives of healthcare professionals on the most significant health disparities observed in perinatal settings: A qualitative study

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-03-11 DOI:10.1016/j.midw.2025.104366

Kayleigh A. Gregory , Madelyn J. Hill , Mastano Dzimbiri , Ashley L. Merianos

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引用次数: 0

Abstract

Background

Perinatal mood disorders impact an estimated 15–21% of pregnant and postpartum women and are the leading cause of maternal mortality. Research indicates that social and economic factors, racism, and persistent stress contribute to maternal and infant health outcomes. Healthcare professionals can play a key role in assisting perinatal mothers with their mental health and addressing systemic disparities that may impact access to care. Understanding healthcare professionals’ perceptions is the first step in tailoring existing evidence-based interventions, implementing training in perinatal settings, and providing patient-centered care during this period.

Methods

We used a purposive sampling technique to recruit 19 providers comprising of

OBGYN providers, nurse practitioners, and certified nurse midwives who work in the United States; specifically, Ohio, Kentucky, and Indiana. Semi-structured interviews with open-ended interview questions were conducted. Qualitative data were analyzed using thematic analysis, and main themes emerged from the transcripts.

Results

Five major themes were identified regarding the most significant health disparities observed in OBGYN practice in the Midwest area: (1) location-based disparities in access and support for perinatal care; (2) barriers to accessing perinatal care; (3) intersecting health risks; (4) racial disparities; (5) navigating isolation.

Conclusions

Study findings provide a comprehensive view of the health disparities perceived by these healthcare professionals during the perinatal period. These findings offer insight into the systemic inequities that affect maternal and infant outcomes. Overall, results may offer evidence for improving cultural competency in the medical setting and providing a greater understanding of the complex interplay of factors that influence outcomes for mothers and infants.

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探索医疗保健专业人员对围产期环境中观察到的最显著健康差异的看法：一项定性研究

围产期情绪障碍影响约15-21%的孕妇和产后妇女，是孕产妇死亡的主要原因。研究表明，社会和经济因素、种族主义和持续的压力对孕产妇和婴儿的健康结果有影响。卫生保健专业人员可以在帮助围产期母亲的心理健康和解决可能影响获得护理的系统性差异方面发挥关键作用。了解卫生保健专业人员的看法是调整现有循证干预措施、在围产期环境中实施培训和在此期间提供以患者为中心的护理的第一步。方法采用有目的抽样方法，招募19名在美国工作的妇产科医生、执业护士和注册助产士；特别是俄亥俄州、肯塔基州和印第安纳州。采用开放式访谈问题进行半结构化访谈。定性数据分析采用主题分析，主要主题从成绩单中浮现。结果在中西部地区的妇产科实践中，发现了五个最显著的健康差异：(1)围产期护理的可及性和支持程度的地区差异；(2)获得围产期护理的障碍；(3)交叉健康风险；(4)种族歧视；(5)导航隔离。结论研究结果提供了这些卫生保健专业人员在围产期感知到的健康差异的全面观点。这些发现为了解影响孕产妇和婴儿结局的系统性不平等提供了洞见。总的来说，结果可能为提高医疗环境中的文化能力提供证据，并对影响母亲和婴儿结果的因素的复杂相互作用提供更好的理解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.