Experiencias de mujeres sobrevivientes a morbilidad materna extrema en México, un estudio cualitativo desde el modelo de las tres demoras
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
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. |
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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 |