کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
7331878 | 1476026 | 2015 | 9 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Fear, blame and transparency: Obstetric caregivers' rationales for high caesarean section rates in a low-resource setting
ترجمه فارسی عنوان
ترس، سرزنش و شفافیت: معقولات مراقبین مراقبت های دوران بارداری برای سطوح بالای سزارین در یک محیط کم منابع
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کلمات کلیدی
تانزانیا، بخش سزارین، تنظیم کمینه منابع، نگرش های، نگهبانان، شفافیت،
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی
In recent decades, there has been growing attention to the overuse of caesarean section (CS) globally. In light of a high CS rate at a university hospital in Tanzania, we aimed to explore obstetric caregivers' rationales for their hospital's CS rate to identify factors that might cause CS overuse. After participant observations, we performed 22 semi-structured individual in-depth interviews and 2 focus group discussions with 5-6 caregivers in each. Respondents were consultants, specialists, residents, and midwives. The study relied on a framework of naturalistic inquiry and we analyzed data using thematic analysis. As a conceptual framework, we situated our findings in the discussion of how transparency and auditing can induce behavioral change and have unintended effects. Caregivers had divergent opinions on whether the hospital's CS rate was a problem or not, but most thought that there was an overuse of CS. All caregivers rationalized the high CS rate by referring to circumstances outside their control. In private practice, some stated they were affected by the economic compensation for CS, while others argued that unnecessary CSs were due to maternal demand. Residents often missed support from their senior colleagues when making decisions, and felt that midwives pushed them to perform CSs. Many caregivers stated that their fear of blame from colleagues and management in case of poor outcomes made them advocate for, or perform, CSs on doubtful indications. In order to lower CS rates, caregivers must acknowledge their roles as decision-makers, and strive to minimize unnecessary CSs. Although auditing and transparency are important to improve patient safety, they must be used with sensitivity regarding any unintended or counterproductive effects they might have.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 143, October 2015, Pages 232-240
Journal: Social Science & Medicine - Volume 143, October 2015, Pages 232-240
نویسندگان
Helena Litorp, Andrew Mgaya, Columba K. Mbekenga, Hussein L. Kidanto, Sara Johnsdotter, Birgitta Essén,