在围产期服务中探索妇女再创伤经历的综合评论。

Jennifer Gordon, Andrew Hunter, Fiona Callanan, Clare Kiely, Annmarie Grealish
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引用次数: 0

摘要

引言有证据表明,再次创伤会对接受围产期服务的妇女产生不利影响。全世界每五名妇女中就有一名有童年逆境史。18%到 34% 的妇女经历过心理创伤,而心理创伤是众所周知的慢性精神疾病发病的风险因素。关于妇女在围产期护理环境中的再创伤经历以及如何预防再创伤的发生,目前还缺乏相关证据。本研究旨在对妇女的再创伤经历进行综合回顾,以确定围产期服务中的预防措施:本综合综述遵循 Whittemore 和 Knafl 的 5 阶段框架,因为该框架允许将不同的研究方法纳入并整合到证据的总体综合中。我们对 5 个数据库(Web of Science、MEDLINE、CINAHL、ASSIA 和 PsychINFO)进行了系统检索,由于该主题领域发表的研究较少,因此没有设定日期、语言或地域限制。本综述根据《系统综述和元分析首选报告项目》指南进行编写和报告:结果:15 项研究符合纳入标准,并被纳入专题综合。综述发现,所有研究的参与者都有儿童性虐待、性虐待和强奸史。确定了三个主要主题和次主题:(1)激活(次主题:分娩姿势、亲密程序、与医护人员的沟通、失控);(2)结果(次主题:情绪反应);以及(3)减少或预防再创伤的干预措施(次主题:医护人员的角色、筛查虐待和创伤史):讨论:我们的研究结果表明,妇女在围产期服务中正在经历再创伤,有证据表明,临床环境中正在采用正式的方法来防止再创伤的发生。本研究首次探讨了围产期服务中造成再创伤的因素,并提出了减少围产期护理环境中有害做法的建议。
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An Integrative Review Exploring Womens' Experiences of Retraumatization Within Perinatal Services.

Introduction: Evidence indicates that retraumatization has a detrimental effect for those women who are accessing perinatal services. One in five women worldwide has a history of childhood adversity. Between 18% and 34% of women experience trauma, which is a well-known risk factor for the onset of chronic mental health disorders. There is a lack of evidence on women's experiences on retraumatization in perinatal care settings and how to prevent retraumatization from occurring. The purpose of this study was to conduct an integrative review on women experiences of retraumatization to determine preventive measures within perinatal services.

Methods: This integrative review followed Whittemore and Knafl's 5-stage framework as it allows for the inclusion and integration of diverse research methodologies into an overall synthesis of the evidence. A systematic search of 5 databases was conducted (Web of Science, MEDLINE, CINAHL, ASSIA, and PsychINFO) with no date, language, or geographical limits set due to the paucity of research published in this subject area. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: Fifteen studies met the inclusion criteria and were included in the thematic synthesis. The review identified that participants across the studies had a history of child sexual abuse, sexual abuse, and rape. Three main themes plus subthemes were identified: (1) activating (subthemes: positions in labor, intimate procedures, communications with health care professionals, loss of control); (2) outcomes (subtheme: emotional responses); and (3) interventions reducing or preventing retraumatization (subthemes: role of the health care professional, screening for abuse and history of trauma).

Discussion: Our findings demonstrate that women are experiencing retraumatization in perinatal services, and there is evidence of formalized approaches being applied in clinical settings to prevent retraumatization from occurring. This study is the first to examine the factors that contribute to retraumatization in perinatal services and make recommendations to reduce the harmful practices in place in perinatal care settings.

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