Pope R, Graham L, Patel S
School of Educational Studies, University of Surrey, Guildford GU2 5XH, Surrey, UK.
Int J Nurs Stud. 2001 Apr;38(2):227-38. doi: 10.1016/s0020-7489(00)00034-1.
Changes over the past decade have emphasised the individual service user and their relationship with the health service. Within the maternity services this has been interpreted as woman-centred care a result of key initiatives; the Winterton Report (House of Commons, 1992. Maternity Services. Second Report of the Health Committee (Winterton Report), Vol. 1. HMSO, London) and Changing Childbirth (DoH, 1993a, Changing childbirth: reports of the expert maternity group parts 1 & 2. HMSO, London). Changing Childbirth outlined key principles of the maternity services and the need for the woman (and her partner, if she wishes) to be the focus of care. The key principles are choice, continuity and control. High quality care depends on the recognition of individuals as having unique needs which continues to be reflected within contemporary policy documents (DoH, 1997, The new NHS: modern and dependable. HMSO, London). This paper presents findings related to the provision of woman-centred care from a national research and development study. The study design incorporated (i): a national survey which was undertaken with midwives, midwife supervisors and doctors; and (ii): in-depth case studies in which information was obtained through interviews with midwives, midwife supervisors, educators, managers, doctors and mothers. Midwives, at all levels, are involved in changing maternity service provision and adapting to new systems of care which aim to increase continuity of care and carer for the woman. The researchers sought to understand how woman-centred care was interpreted and experienced in practice. The findings have been used to identify the continuing educational needs of midwives, and to develop an open learning educational package to meet identified need. The curriculum was designed to enhance the move towards the provision of a more integrated woman-centred service.
过去十年的变化突出了个体服务使用者及其与医疗服务的关系。在产科服务中，这被解读为以女性为中心的护理，这是一些关键举措的结果；《温特顿报告》（下议院，1992年。产科服务。卫生委员会第二次报告（温特顿报告），第1卷。英国皇家文书局，伦敦）和《改变分娩方式》（卫生部，1993年a，《改变分娩方式：专家产科小组报告第1和第2部分》。英国皇家文书局，伦敦）。《改变分娩方式》概述了产科服务的关键原则以及女性（及其伴侣，如果她愿意）成为护理焦点的必要性。关键原则是选择、连续性和控制权。高质量的护理取决于认识到个体有独特需求，这一点在当代政策文件中仍有体现（卫生部，1997年，《新国民保健服务：现代且可靠》。英国皇家文书局，伦敦）。本文介绍了一项全国性研发研究中与提供以女性为中心的护理相关的研究结果。该研究设计包括：（i）：对助产士、助产士督导员和医生进行的全国性调查；以及（ii）：深入案例研究，通过与助产士、助产士督导员、教育工作者、管理人员、医生和母亲进行访谈获取信息。各级助产士都参与到改变产科服务提供方式以及适应旨在增加女性护理连续性和护理人员连续性的新护理系统中。研究人员试图了解以女性为中心的护理在实践中是如何被解读和体验的。研究结果已被用于确定助产士持续的教育需求，并开发一个开放式学习教育包以满足确定的需求。该课程旨在促进向提供更综合的以女性为中心的服务迈进。
