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Methods used in prevalence studies of disrespect and abuse during facility based childbirth: lessons learned

机译：基于设施的分娩过程中对不尊重和虐待的流行研究中使用的方法：经验教训

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Background Several recent studies have attempted to measure the prevalence of disrespect and abuse (D&A) of women during childbirth in health facilities. Variations in reported prevalence may be associated with differences in study instruments and data collection methods. This systematic review and comparative analysis of methods aims to aggregate and present lessons learned from published studies that quantified the prevalence of Disrespect and Abuse (D&A) during childbirth. Methods We conducted a systematic review of the literature in accordance with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Five papers met criteria and were included for analysis. We developed an analytical framework depicting the basic elements of epidemiological methodology in prevalence studies and a table of common types of systematic error associated with each of them. We performed a head-to-head comparison of study methods for all five papers. Using these tools, an independent reviewer provided an analysis of the potential for systematic error in the reported prevalence estimates. Results Sampling techniques, eligibility criteria, categories of D&A selected for study, operational definitions of D&A, summary measures of D&A, and the mode, timing, and setting of data collection all varied in the five studies included in the review. These variations present opportunities for the introduction of biases – in particular selection, courtesy, and recall bias – and challenge the ability to draw comparisons across the studies’ results. Conclusion Our review underscores the need for caution in interpreting or comparing previously reported prevalence estimates of D&A during facility-based childbirth. The lack of standardized definitions, instruments, and study methods used to date in studies designed to quantify D&A in childbirth facilities introduced the potential for systematic error in reported prevalence estimates, and affected their generalizability and comparability. Chief among the lessons to emerge from comparing methods for measuring the prevalence of D&A is recognition of the tension between seeking prevalence measures that are reliable and generalizable, and attempting to avoid loss of validity in the context where the issue is being studied.
机译：背景技术最近的几项研究试图衡量在医疗机构分娩过程中对妇女的不尊重和虐待（D＆A）的患病率。报告的患病率变化可能与研究仪器和数据收集方法的差异有关。这种对方法的系统评价和比较分析旨在汇总和展示从已发表的研究中汲取的经验教训，这些研究量化了对分娩过程中不尊重和虐待的患病率。方法我们根据PRISMA（系统评价和荟萃分析的首选报告项目）指南对文献进行了系统的综述。五篇论文符合标准，被纳入分析。我们建立了一个分析框架，描述了流行病学研究中流行病学方法的基本要素，并列出了与每种疾病相关的常见系统错误类型。我们对所有五篇论文进行了研究方法的正面对比。使用这些工具，一名独立的审阅者对报告的患病率估算中的系统错误的可能性进行了分析。结果在本次审查中包括的五项研究中，抽样技术，资格标准，为研究选择的D＆A类别，D＆A的操作定义，D＆A的摘要度量以及数据收集的方式，时间和设置都不同。这些差异为引入偏见（尤其是选择，礼貌和回想偏见）提供了机会，并挑战了在研究结果之间进行比较的能力。结论我们的审查强调在解释或比较以前报告的基于设施的分娩期间D＆A患病率估计值时需要谨慎。迄今为止，用于量化分娩设施D＆A的研究缺乏标准化的定义，工具和研究方法，这导致报告的患病率估计可能出现系统性错误，并影响了其普遍性和可比性。比较测量D＆A患病率的方法所得出的主要教训是，认识到寻求可靠且可推广的患病率措施与在研究此问题的背景下避免有效性丧失之间的张力。

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