LGBTQ2S+孕妇尊重关怀和歧视措施的信度和效度

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-03-20 DOI:10.1016/j.midw.2025.104391

Molly R. Altman , Kathrin Stoll , Teresa van Winkle , Brittany Ferrell , Kodiak R.S. Soled , Nicholas Rubashkin , Indra Lusero , Meghan Eagen-Torkko , Juno Obedin-Maliver , Saraswathi Vedam , Birth Includes Us Community Steering Council

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引用次数: 0

摘要

问题：在女同性恋、男同性恋、双性恋、变性人、酷儿、双性恋者和其他性/性别少数群体（LGBTQ2S+）群体中，没有有效的尊重围产期护理措施。LGBTQ2S+群体在卫生保健环境中经常遭受不尊重和歧视。虽然已经开发了一些工具和量表来衡量尊重围产期（产妇）护理，但尚未在LGBTQ2S+社区中进行调整或验证。目的本研究的目的是验证三个测量尊重围产期护理方面的量表在LGBTQ2S+妊娠护理体验研究中的应用。方法对“出生包括我们”（Birth Includes Us）试点研究的数据进行分析，这些数据是通过社区开发的调查收集的，该调查评估了LGBTQ2S+家庭的妊娠护理经验。我们评估了三种适应工具的心理测量特性，即交叉日常歧视指数（indid）、自主和决策测量（MADM）和尊重测量指数（MORi）。结果：所有适应的量表都表现良好，所有测量的Cronbach's alpha都大于0.8。MADM和MORi的孕前和孕期护理版本的量表得分分别为0.38和0.37，表明这些护理经历彼此之间存在显著差异。在LGBTQ2S+家庭中，改编版的indid、MADM和MORi在孕前和孕期护理经验方面表现良好，这将对未来研究这些社区中尊重围产期护理至关重要。结论我们建议使用这些经过验证的措施来评估和解决LGBTQ2S+个人和家庭在妊娠相关护理体验方面的不平等问题。

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Reliability and validity of measures of respectful care and discrimination for LGBTQ2S+ pregnant people

Problem

There are no measures of respectful perinatal care validated within Lesbian, Gay, Bisexual, Transgender, Queer, Two-Spirit, and other sexual/gender minoritized (LGBTQ2S+) communities.

Background

The LGBTQ2S+ community frequently experiences disrespect and discrimination in health care settings. While several instruments and scales have been developed to measure respectful perinatal (maternity) care, none have yet been adapted nor validated within the LGBTQ2S+ community.

Aims

The aim of this study is to validate three scales measuring aspects of respectful perinatal care for use within LGBTQ2S+ pregnancy care experience research.

Methods

This analysis of data from the ‘Birth Includes Us’ pilot study was collected via a community-developed survey assessing pregnancy care experiences of LGBTQ2S+ families. We assessed the psychometric properties of three adapted instruments, the Intersectional Day-to-Day Discrimination Index (InDI-D), the Measure of Autonomy and Decision Making (MADM), and the Measure of Respect index (MORi).

Findings

All adapted scales performed well, with Cronbach's alphas greater than 0.8 across all measures. Scale scores for the preconception and pregnancy care versions of the MADM and MORi were 0.38 and 0.37 respectively, indicating that these care experiences were significantly different from one another.

Discussion

The adapted versions of the InDI-D, MADM, and MORi performed well among LGBTQ2S+ families in their preconception and pregnancy care experiences and will be essential for future studies examining respectful perinatal care among these communities.

Conclusion

We recommend utilization of these validated measures to assess and address inequities in pregnancy-related care experiences for LGBTQ2S+ individuals and families.

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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.