Die "gute Geburt" - Ergebnis richtiger Entscheidungen? Zur Kritik des gegenwärtigen Selbstbestimmungsdiskurses vor dem Hintergrund der Ökonomisierung des Geburtshilfesystems
Titelübersetzung:Is a "good birth" the result of the "right" choices? A critique of the current discourse on self-determination in light of the economization of obstetric services
Autor/in:
Jung, Tina
Quelle: GENDER - Zeitschrift für Geschlecht, Kultur und Gesellschaft, 9 (2017) 2, S 30-45
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Inhalt: "Selbstbestimmung, informed choice und informed consent sind zu Schlüsselbegriffen in der Geburtshilfe avanciert. Dabei fällt die Popularität des gegenwärtigen Selbstbestimmungsdiskurses in eine Zeit, in der die Geburtshilfe im Zeichen der neoliberalen Ökonomisierung einem tiefgreifenden Wandel unterliegt, der sich u.a. in einer deutlichen Verschlechterung der strukturellen Rahmenbedingungen der Versorgungsqualität von schwangeren und gebärenden Frauen und in einer Abwertung von somatisch-beziehungsorientierten Momenten von Geburtsbegleitung zeigt. Der Beitrag untersucht, welche Bedeutungsverschiebungen das Verständnis von Selbstbestimmung durchlaufen und welche Effekte dies aktuell für schwangere und gebärende Frauen in der Geburtshilfe hat. Gezeigt wird, dass und wie der derzeitige Selbstbestimmungsdiskurs in der Geburtshilfe dazu beiträgt, die Verantwortung für das Gelingen einer 'guten' Geburt auf die Frauen zu verschieben und gleichzeitig den Verlust jener somatisch-beziehungsorientierten Bedingungen, auf die es für eine gute Geburtshilfe ankommt, zu legitimieren. Im Beitrag wird dafür plädiert, Selbstbestimmung nicht länger als Frage der Information, der Vorbereitung und der Entscheidung zu verstehen, sondern als Frage der Befähigung zu Urteilskraft, die Momente der Angewiesenheit, Achtsamkeit, Fürsorge, Schmerz, Angst, aber auch Kraft, Lust und Freude einschließen kann." (Autorenreferat)
Inhalt: "Self-determination, informed choice and informed consent have become important keywords in obstetric and midwifery practice. The popularity of the current discourse on self-determination coincides with the fact that obstetrics is increasingly being subjected to neoliberal economization and is thereby undergoing profound change. This change manifests itself, above all, in the fact that the structural framework of care for pregnant and birthing women is clearly deteriorating, and in that the somatic relationship-oriented aspects of obstetrics and midwifery are being devalued. I analyze the shift in our understanding of what self-determination is and I also map out the current effects of this shift on pregnant women and women in labour. Furthermore, I illustrate that, and in what way, the current discourse on self-determination in obstetric and midwifery practice leads to the fact that the responsibility for a “good” birth is being transferred onto women. This signifies a loss of the particular temporality and the somatic phenomena the woman in labour experiences. In my conclusion I argue that self-determination should no longer be understood as a question of information, preparation and decision, but rather as enabling judgement, which includes aspects of dependence, awareness, care, pain, fear, but also power, desire and joy." (author's abstract)
Schlagwörter:Selbstbestimmung; self-determination; Geburtshilfe; obstetrics; Ökonomisierung; economization; Schwangerschaft; pregnancy; Gesundheitsversorgung; health care; Qualität; quality; Feminismus; feminism; woman; Gesundheit; health; Federal Republic of Germany
SSOAR Kategorie:Frauen- und Geschlechterforschung, Medizinsoziologie
Dokumenttyp:Zeitschriftenaufsatz
Quality gap of family health care services in Kashan health centers: an Iranian viewpoint
Autor/in:
Sabahi Bidgoli, Mohammad; Kebriaei, Ali; Moosavi, Sayed Gholamabas
Quelle: International Letters of Social and Humanistic Sciences, (2016) 70, S 14-20
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Inhalt: Patients' viewpoints are commonly used to assess quality of care in diverse healthcare organizations. This permits managerial decisions to be made based on knowledge rather than conjecture. The purpose of the current study is to investigate quality gap of family health care through measuring differences between clients' perceptions and expectations at Kashan city health centers in Iran.Methodology: A cross-sectional design was applied in 2013. The study sample was composed of 384 women clients of family health services randomly selected from Kashan city health centers. The SERVQUAL questionnaire was used for data collection. Service quality gap was measured by computing the difference between the rating respondents assign to expectations and perceptions statements. For pair wise comparison of the expectations and perceptions the Wilcoxon Signed Rank test was used. Internal consistency of the scale was confirmed with Cronbach's Alpha coefficients (.81 for expectations and .84 for perceptions).Findings: In all dimensions of the services a significant (P<0.001) negative quality gap was observed. The maximum quality gap was in the tangibility (-0.60±0.37) and the minimum one was in the responsiveness (-0.41±0.31) dimension. The findings of the research demonstrated that there was negative gap between clients' expectations and perceptions in all dimensions of the services. Thus, family health care managers should apply improvements in all five dimensions of the services.
Schlagwörter:quality; perception; Iran; Gesundheit; Erwartung; Iran; Management; Wahrnehmung; health care; Familie; Gesundheitsversorgung; expectation; public health services; Qualität; woman; management; family; health; Gesundheitsdienst; Patient; patient
SSOAR Kategorie:Medizinsoziologie
Dokumenttyp:Zeitschriftenaufsatz
Pap smears in pregnant women: knowledge of nurses working in units of primary health care
Titelübersetzung:Exame papanicolaou em gestantes: conhecimento dos enfermeiros atuantes em unidades de atenção primária à saúde
Autor/in:
Manfredi, Rocheli de Lacerda Sousa; Sabino, Leidiane Minervina Moraes de; Silva, Denise Maia Alves da; Oliveira, Emilly Karoline Freire; Martins, Mariana Cavalcante
Quelle: Revista de Pesquisa: Cuidado é Fundamental Online, 8 (2016) 3, S 4668-4673
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Inhalt: Objective: to investigate the nurses' knowledge of gynecological Pap smears performed in pregnant women attending Primary Health Units (UAPS), Fortaleza-CE. Methods: a descriptive, cross-sectional study conducted in three UAP, with a sample of 27 nurses. Data were obtained through a questionnaire and the analysis used was the Epi-info program. Results: the data showed that the majority of nurses, 17 (62,97%), does not perform the gynecological examination in pregnant women. From nurses who perform, 3 (7,4%) make the collection incorrectly. About participating in trainings on prenatal and gynecological examination, 24 (88,8%) reported previous participation. Conclusion: thus, systematic and effective training aiming to overhaul the welfare practices that are established in the family health programs are necessary.
Schlagwörter:Gesundheitsvorsorge; caregiving; knowledge; Schwangerschaft; health care; prophylaxis; nurse; Pflege; Gesundheitsversorgung; pregnancy; Krankenschwester; Prophylaxe; woman; Gynäkologie; gynecology; Wissen
SSOAR Kategorie:Medizinsoziologie, Frauen- und Geschlechterforschung
Dokumenttyp:Zeitschriftenaufsatz
Cervical cancer precursor lesions: significance for women in a referral center in brazil
Titelübersetzung:Lesões precursoras de câncer cervical: significado para mulheres em um centro de referência no brasil
Autor/in:
Melo, Rosana Oliveira de; Moreira, Rita de Càssia Rocha; Lopes, Regina Lúcia Mendonça
Quelle: Revista de Pesquisa: Cuidado é Fundamental Online, 7 (2015) 4, S 3327-3338
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Inhalt: Objective: understand the experience of women with cervical cancer precursor lesions. Method: phenomenological study, with the reduction, construction, and destruction steps. Data interpretation was performed through Heidegger's comprehensive analysis. Results: the phenomena unveiled were related to women's doubts, due to lack of diagnosis; changes in relationships with partners; difficulties in making friends; family importance; coping strategies; relationship with health professionals and distrust in care; shame and embarrassment to undergo the Pap test; and fear of death. Conclusion: it was found that there is an urgent need to resize the care for a woman with cervical cancer precursor lesions, given the challenge of understanding the need that a health professional provides care from the Heideggerian perspective, establishing a relationship of being-with-the-other, appreciating her as a subject of possibilities.
Schlagwörter:Erfahrung; experience; woman; Krebs; cancer; Gesundheitsversorgung; health care; soziale Faktoren; social factors; Phänomenologie; phenomenology; Gesundheit; health; Arzt; physician; Arzt-Patient-Beziehung; physician-patient relationship; Familie; family; soziale Beziehungen; social relations; Brasilien; Brazil; Lateinamerika; Latin America; Südamerika; South America
SSOAR Kategorie:Medizinsoziologie, Frauen- und Geschlechterforschung
Dokumenttyp:Zeitschriftenaufsatz
Perception of nurses on humanization in nursing care in immediate puerperium
Titelübersetzung:Percepção de enfermeiros sobre a humanização na assistência de enfermagem no puerpério imediato
Autor/in:
Cassiano, Alexandra do Nascimento; Araújo, Mércio Gabriel de; Holanda, Cristyanne Samara Miranda de; Costa, Roberta Kaliny de Souza
Quelle: Revista de Pesquisa: Cuidado é Fundamental Online, 7 (2015) 1, S 2051-2060
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Inhalt: Objective: To study the perception of nurses about the humanization of postpartum care in a public hospital in Seridó region, Rio Grande do Norte (RN). Method: this is an exploratory and descriptive study with a qualitative approach. The subjects were nurses who attend postpartum women during the postpartum period in hospital settings. Results: in the perception of nurses, humanization corresponds to adopting a different position before care, with the establishment of relationships wrapped in feelings of empathy, respect and affection. It also emerged the understanding that this is a complex process that involves the articulation of different levels of care, management of health institutions and good condition of infrastructure and human resources. Conclusion: the humanization is seen primarily as a subjective practice gifted of affective feelings toward the mothers, although enlarged conceptions have arisen.
Schlagwörter:Krankenpflege; nursing; Gesundheitsversorgung; health care; woman; Geburt; birth; Pflegeperson; caregiver; Wahrnehmung; perception; Humanisierung; humanization; soziale Beziehungen; social relations; Emotionalität; emotionality; Krankenschwester; nurse
SSOAR Kategorie:Medizinsoziologie, Frauen- und Geschlechterforschung
Dokumenttyp:Zeitschriftenaufsatz
Sociodemographic factors associated with mortality of women in fertile age in Rio Grande do Norte
Titelübersetzung:Fatores sociodemográficos associados com a mortalidade de mulheres em idade fértil no Rio Grande do Norte
Autor/in:
Lima, Iraci Duarte de; França, Thaís Lorena Barbosa de; Silva, Juliano José; Silva, Kamila Maiane Pessoa da
Quelle: Revista de Pesquisa: Cuidado é Fundamental Online, 6 (2014) 4, S 1464-1474
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Inhalt: Objective: Identifying sociodemographic factors associated with mortality of women in fertile age in Rio Grande do Norte in the period from 2006 to 2010. Method: a descriptive, quantitative study with collected data through the Mortality Information System and processed by the test of association chi-square. Results: 59.1% of the deaths occurred from preventable causes and the main underlying causes: cancer, heart disease and circulatory system and external causes. Deaths grow proportionally with age and were associated with: educational attainment, occupation and origin of the institution of occurrence. Conclusion: the results indicate weaknesses in the quality of care and point to the need of investing in actions that reduce inequality in access to primary care services that ensure quality and resolution at all levels of health care.
Schlagwörter:woman; Gesundheit; health; Sterblichkeit; mortality; Ursache; cause; Gesundheitsversorgung; health care; soziale Faktoren; social factors; demographische Faktoren; demographic factors; Brasilien; Brazil; Lateinamerika; Latin America; Südamerika; South America
SSOAR Kategorie:Medizinsoziologie, Frauen- und Geschlechterforschung
Dokumenttyp:Zeitschriftenaufsatz
Inequality in health care utilization in Germany? Theoretical and empirical evidence for specialist consultation
Titelübersetzung:Ungleichheit bei der medizinischen Versorgung in Deutschland? Theoretische und empirische Evidenz für den Facharztbesuch
Autor/in:
Gruber, Stefan; Kiesel, Markus
Quelle: Journal of Public Health, 18 (2010) 4, S 351-365
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Inhalt: Aim: In view of increasing concern about a two-class system in the German health care sector, this study investigates the relevance of health insurance schemes and other socioeconomic characteristics to the level of specialist health care provision. Subjects and Methods: Referring to Ronald M. Andersen’s model of health care utilization and more content-based approaches, we implement a negative binomial hurdle regression to estimate the number of specialist visits within the last 12 months. Our data source is the German sample of the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2004. Results: The results show that men’s number of specialist visits is markedly sensitive to predisposing and enabling factors, whereas women’s health care utilization depends less on such socioeconomic characteristics. With reference to previous findings concerning general practitioner consultation, the assumption of a bipolar health care system providing general practitioner care primarily to the statutory insured and specialist care to the privately insured is supported empirically as to men. Education, which is considered to be highly correlated with health lifestyles, has a positive effect on medical health care. Every additional year of education increases by about 10% the probability of men seeking specialist consultation. Furthermore, the results indicate an unfavorable situation for the self-employed concerning health care because of their specific employment situation and health insurance coverage. Discussion: The research results suggest the existence of relevant differences in the amount of specialist consultation according to health insurance and other socioeconomic features. Further research could concentrate on the question of whether these inequalities in utilization levels indicate overprovision or underprovision of ambulant health care. Moreover, we recommend longitudinal research that is particularly suited to detangle age and cohort effects.
Schlagwörter:theory-practice; Theorie; statistische Analyse; health care delivery system; Facharzt; Gesundheitswesen; compulsory health insurance; Federal Republic of Germany; Theorie-Praxis; private health insurance; private Krankenversicherung; man; gesetzliche Krankenversicherung; inequality; statistical analysis; Lebenserwartung; medical specialist; model; health care; life expectancy; Modell; Gesundheitsversorgung; woman; Mann; theory; Ungleichheit; Specialist consultation; Health care utilization; Health insurance; Supply-induced demand; Hurdle regression
SSOAR Kategorie:Medizinsoziologie, Gesundheitspolitik
Dokumenttyp:Zeitschriftenaufsatz