Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras

Detalhes bibliográficos
Autor(a) principal: Yesica Yolanda Rangel-Flores
Data de Publicação: 2019
Outros Autores: Luis Eduardo Hernández-Ibarra, Alexia Guadalupe Martínez-Ledezma, Minerva García-Rangel
Tipo de documento: Artigo
Idioma: spa
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889
Resumo: The objectives were to analyze the experiences of survivors of maternal near miss based on the three delays model and to identify the obstacles to this process in the state of San Luis Potosí, Mexico. In 2016-2017, a qualitative study was performed with 27 women who had experienced maternal near miss in public hospitals between 2014 and 2016. The informants were selected with theoretical sampling and interviewed at their homes. Data analysis was based on the theoretical framework proposed by Strauss & Corbin. The categories associated with the first delay were: (1) missed opportunities for identification of maternal near miss; (2) failure of the women to voice their symptoms out of fear of reprimand; (3) dilemma between fear and the faith that a higher power will solve the problem; and (4) development of the perception of obstetric risk. The second delay involved: (1) lack of urban transportation infrastructure to access healthcare services; (2) lack of regulation of transportation costs; (3) lack of clarity on itineraries and critical routes to access care; and (4) lack institutional coordination for timely transportation. The third delay involved: (1) institutional refusal of care; (2) deficient infrastructure, personnel, and equipment; and (3) lack of expertise and experience in the healthcare personnel. The shared experiences reveal challenges for public policies and inter-sector work to improve the results in maternal near miss.
id FIOCRUZ-5_d65aaf8e5a0c90e624b51944866e5868
oai_identifier_str oai:ojs.teste-cadernos.ensp.fiocruz.br:article/6889
network_acronym_str FIOCRUZ-5
network_name_str Cadernos de Saúde Pública
repository_id_str
spelling Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demorasNear Miss SaludPreeclampsiaSalud MaternaUrgencias MédicasInvestigación CualitativaThe objectives were to analyze the experiences of survivors of maternal near miss based on the three delays model and to identify the obstacles to this process in the state of San Luis Potosí, Mexico. In 2016-2017, a qualitative study was performed with 27 women who had experienced maternal near miss in public hospitals between 2014 and 2016. The informants were selected with theoretical sampling and interviewed at their homes. Data analysis was based on the theoretical framework proposed by Strauss & Corbin. The categories associated with the first delay were: (1) missed opportunities for identification of maternal near miss; (2) failure of the women to voice their symptoms out of fear of reprimand; (3) dilemma between fear and the faith that a higher power will solve the problem; and (4) development of the perception of obstetric risk. The second delay involved: (1) lack of urban transportation infrastructure to access healthcare services; (2) lack of regulation of transportation costs; (3) lack of clarity on itineraries and critical routes to access care; and (4) lack institutional coordination for timely transportation. The third delay involved: (1) institutional refusal of care; (2) deficient infrastructure, personnel, and equipment; and (3) lack of expertise and experience in the healthcare personnel. The shared experiences reveal challenges for public policies and inter-sector work to improve the results in maternal near miss.El objetivo fue analizar las experiencias de sobrevivientes de morbilidad materna extrema, para desde el enfoque de las tres demoras, identificar los determinantes que obstaculizan este proceso en el estado de San Luis Potosí, México. Durante 2016-2017, se realizó un estudio cualitativo con 27 mujeres que vivieron un evento de este tipo entre 2014 y 2016 en hospitales públicos. Las informantes fueron seleccionadas mediante muestreo teórico y entrevistadas en sus domicilios. El análisis de datos se realizó desde la propuesta de teoría fundamentada de Strauss & Corbin, las categorías asociadas con la primera demora fueron: (1) oportunidades pérdidas para la identificación de morbilidad materna extrema, (2) temor de comunicar el malestar frente a la descalificación, (3) entre el miedo y la fe en que algo superior resolverá, (4) desarrollo de la percepción del riesgo obstétrico. Con la segunda demora: (1) falta de ordenamiento urbano para el traslado, (2) ausencia de regulación de costos del traslado, (3) falta de claridad sobre los itinerarios y rutas críticas para acceder a la atención, (4) coordinación institucional para el traslado oportuno; y finalmente con la tercera: (1) rechazo institucional, (2) deficiencias de infraestructura, personal y equipo, y (3) entre la experiencia y la falta de ella del personal de salud. Las experiencias compartidas evidencian retos en materia de política pública y trabajo intersectorial para mejorar los resultados en materia de morbilidad materna extrema.O objetivo foi analisar as experiências de sobreviventes de morbidade materna extrema para, a partir da abordagem das três demoras, identificar os determinantes que obstaculizam esse processo no estado de San Luis Potosí, México. No período 2016-2017 foi efetuado um estudo qualitativo com 27 mulheres que experimentaram um evento deste tipo, entre 2014 e 2016, em hospitais públicos. As informantes foram selecionadas por meio de uma amostragem teórica e foram entrevistadas em seus domicílios. A análise de dados foi feita através da proposta da teoria fundamentada de Strauss & Corbin, as categorias associadas com a primeira demora foram: (1) oportunidades perdidas para a identificação de morbidade materna extrema, (2) temor em comunicar o mal estar frente à desqualificação, (3) entre o medo e a fé aguardando em que algo superior achará a solução, (4) desenvolvimento da percepção do risco obstétrico. Com a segunda demora: (1) falta de infraestrutura urbana para a transferência, (2) ausência de regulação de custos de transferência, (3) falta de transparência acerca dos itinerários e rumos críticos para acessar ao atendimento, (4) coordenação institucional para a transferência oportuna; e finalmente com a terceira: (1) rejeição institucional, (2) deficiências da infraestrutura, equipe e equipamento, e (3) entre a esperteza e a falta de experiência da equipe de saúde. As experiências compartilhadas evidenciam desafios ao respeito de política pública e trabalho intersetorial para melhorar os resultados em matéria de morbidade materna extrema.Reports in Public HealthCadernos de Saúde Pública2019-09-16info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889Reports in Public Health; Vol. 35 No. 9 (2019): SeptemberCadernos de Saúde Pública; v. 35 n. 9 (2019): Setembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889/14932https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889/14933Yesica Yolanda Rangel-FloresLuis Eduardo Hernández-IbarraAlexia Guadalupe Martínez-LedezmaMinerva García-Rangelinfo:eu-repo/semantics/openAccess2024-03-06T15:29:35Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/6889Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:07:53.706792Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
title Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
spellingShingle Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
Yesica Yolanda Rangel-Flores
Near Miss Salud
Preeclampsia
Salud Materna
Urgencias Médicas
Investigación Cualitativa
title_short Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
title_full Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
title_fullStr Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
title_full_unstemmed Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
title_sort Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
author Yesica Yolanda Rangel-Flores
author_facet Yesica Yolanda Rangel-Flores
Luis Eduardo Hernández-Ibarra
Alexia Guadalupe Martínez-Ledezma
Minerva García-Rangel
author_role author
author2 Luis Eduardo Hernández-Ibarra
Alexia Guadalupe Martínez-Ledezma
Minerva García-Rangel
author2_role author
author
author
dc.contributor.author.fl_str_mv Yesica Yolanda Rangel-Flores
Luis Eduardo Hernández-Ibarra
Alexia Guadalupe Martínez-Ledezma
Minerva García-Rangel
dc.subject.por.fl_str_mv Near Miss Salud
Preeclampsia
Salud Materna
Urgencias Médicas
Investigación Cualitativa
topic Near Miss Salud
Preeclampsia
Salud Materna
Urgencias Médicas
Investigación Cualitativa
description The objectives were to analyze the experiences of survivors of maternal near miss based on the three delays model and to identify the obstacles to this process in the state of San Luis Potosí, Mexico. In 2016-2017, a qualitative study was performed with 27 women who had experienced maternal near miss in public hospitals between 2014 and 2016. The informants were selected with theoretical sampling and interviewed at their homes. Data analysis was based on the theoretical framework proposed by Strauss & Corbin. The categories associated with the first delay were: (1) missed opportunities for identification of maternal near miss; (2) failure of the women to voice their symptoms out of fear of reprimand; (3) dilemma between fear and the faith that a higher power will solve the problem; and (4) development of the perception of obstetric risk. The second delay involved: (1) lack of urban transportation infrastructure to access healthcare services; (2) lack of regulation of transportation costs; (3) lack of clarity on itineraries and critical routes to access care; and (4) lack institutional coordination for timely transportation. The third delay involved: (1) institutional refusal of care; (2) deficient infrastructure, personnel, and equipment; and (3) lack of expertise and experience in the healthcare personnel. The shared experiences reveal challenges for public policies and inter-sector work to improve the results in maternal near miss.
publishDate 2019
dc.date.none.fl_str_mv 2019-09-16
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889
dc.language.iso.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889/14932
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6889/14933
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 35 No. 9 (2019): September
Cadernos de Saúde Pública; v. 35 n. 9 (2019): Setembro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
_version_ 1798943387532918784