Qualitative Analysis of the Lived Experience of Reproductive and Pediatric Health Care in the Military Health Care System.

Autor:	Musilli MG; Department of Gynecologic Surgery & Obstetrics, Naval Medical Center San Diego, San Diego, CA 92134, USA., Fuller SM; Department of Gynecologic Surgery & Obstetrics, Naval Medical Center San Diego, San Diego, CA 92134, USA., Wyatt B; Department of Gynecologic Surgery & Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Ryals TR; Department of Obstetrics and Gynecology, Navy Medicine Readiness and Training Command Bremerton, Bremerton, WA 98312, USA., Haischer-Rollo G; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Drumm CM; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Vereen RJ; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Plowden TC; Department of Gynecologic Surgery & Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Blevins EM; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA., Spalding CN; Department of Nursing, Sharp Healthcare System, San Diego, CA 92123, USA., Konopasky A; Department of Medical Education, Geisel School of Medicine at Dartmouth , Hanover, NH 03755, USA., Lutgendorf MA; Department of Gynecologic Surgery & Obstetrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Jazyk:	angličtina
Zdroj:	Military medicine [Mil Med] 2024 May 23. Date of Electronic Publication: 2024 May 23.
DOI:	10.1093/milmed/usae238
Abstrakt:	Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and Methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants. (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)
Databáze:	MEDLINE
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