背景:COVID-19大流行对孕产妇护理的提供提出了挑战。IMAgineEURO研究调查了20多个国家大流行期间孕产妇和新生儿护理的质量,包括瑞士。
目的:本研究旨在了解女性在COVID-19大流行期间在瑞士医疗机构遭受不尊重和虐待的经历。
方法:数据是通过REDCap®的匿名在线调查收集的。在2020年3月至2022年3月期间分娩并在IMAgineEURO问卷中回答开放式问题的妇女被纳入研究。使用国际助产士联合会RESPECT工具包作为分析框架,对妇女的评论进行了定性主题分析。
结果:本研究的数据来源由妇女对IMAgINEEURO问卷中开放式问题的回答提供的199条评论组成。对这些评论的分析表明,在COVID-19大流行期间,医疗机构存在明显的不尊重和滥用模式。这些模式包括非自愿护理,无视妇女的选择和生育偏好;不体面的护理,其特点是不尊重的态度和缺乏医疗专业人员的同理心;以及被遗弃和忽视的感觉,包括在分娩和与新生儿分离期间拒绝陪伴。卫生机构的组织和人力资源不足被认为是造成不尊重护理的因素。据报道,与医疗保健专业人员的移情关系是积极经验的基石。
结论:瑞士的医疗机构在产妇护理中表现出不尊重和滥用的缺陷。大流行的背景可能带来了新的挑战,损害了尊重护理的某些方面。新冠肺炎危机也起到了放大镜的作用,可能揭示和加剧医疗保健系统中先前存在的差距和结构性弱点,包括人员不足。
结论:这些发现应指导宣传工作,敦促决策者和卫生机构分配足够的资源,以确保在大流行期间及以后提供尊重和高质量的产妇保健。
BACKGROUND: The COVID-19 pandemic has challenged the provision of maternal care. The IMAgiNE EURO study investigates the Quality of Maternal and Newborn Care during the pandemic in over 20 countries, including Switzerland.
OBJECTIVE: This study aims to understand women\'s experiences of disrespect and abuse in Swiss health facilities during the COVID-19 pandemic.
METHODS: Data were collected via an anonymous online survey on REDCap®. Women who gave birth between March 2020 and March 2022 and answered an open-ended question in the IMAgiNE EURO questionnaire were included in the study. A qualitative thematic analysis of the women\'s comments was conducted using the International Confederation of Midwives\' RESPECT toolkit as a framework for analysis.
RESULTS: The data source for this study consisted of 199 comments provided by women in response to the open-ended question in the IMAgiNE EURO questionnaire. Analysis of these comments revealed clear patterns of disrespect and abuse in health facilities during the COVID-19 pandemic. These patterns include non-consensual care, with disregard for women\'s choices and birth preferences; undignified care, characterised by disrespectful attitudes and a lack of empathy from healthcare professionals; and feelings of abandonment and neglect, including denial of companionship during childbirth and separation from newborns. Insufficient organisational and human resources in health facilities were identified as contributing factors to disrespectful care. Empathic relationships with healthcare professionals were reported to be the cornerstone of positive experiences.
CONCLUSIONS: Swiss healthcare facilities showed shortcomings related to disrespect and abuse in maternal care. The pandemic context may have brought new challenges that compromised certain aspects of respectful care. The COVID-19 crisis also acted as a magnifying glass, potentially revealing and exacerbating pre-existing gaps and structural weaknesses within the healthcare system, including understaffing.
CONCLUSIONS: These findings should guide advocacy efforts, urging policy makers and health facilities to allocate adequate resources to ensure respectful and high-quality maternal care during pandemics and beyond.