Davey Mary-Ann, Brown Stephanie, Bruinsma Fiona
Mother and Child Health Research, La Trobe University, Carlton, Victoria 3053, Australia.
Birth. 2005 Dec;32(4):262-71. doi: 10.1111/j.0730-7659.2005.00384.x.
Continuity of care and of caregiver are thought to be important influences on women's experience of maternity care. The aim of this study was to analyze the influence of two aspects of continuity of caregiver in the antenatal period on women's overall rating of antenatal care: the extent to which women saw the same caregiver throughout pregnancy, and the extent to which women thought that their caregiver knew and remembered them and their progress from one visit to the next.
An anonymous, population-based postal survey was conducted of 1,616 women who gave birth in a 14-day period in September 1999 in Victoria, Australia. Multivariate methods were used to analyze the data.
Most women saw the same caregiver at each antenatal visit (77%), and thought that caregivers got to know them (65%). This finding varied widely among different models of maternity care. Before adjustment, women were much more likely to describe their antenatal care as very good if they always or mostly thought the caregiver got to know them (OR 5.86, 95% CI 4.3, 7.9), and if they always or mostly saw the same caregiver at each visit (OR 2.91, 95% CI 2.0, 4.3). Adjusting for sociodemographic factors, parity, risk status of the pregnancy, and several specific aspects of antenatal care revealed that seeing the same caregiver was no longer associated with rating of care (adjusted OR 0.65, 95% CI 0.3,1.2), but women who thought that caregivers got to know and remember them remained much more likely to rate their care highly (adjusted OR 3.18, 95% CI 2.0, 5.1).
These findings suggest that changing the delivery of antenatal care to increase women's chances of seeing the same caregiver at each visit is not by itself likely to improve the overall experience of care, but time spent personalizing each encounter in antenatal care would be well received. The analysis also confirmed the importance that women place on quality interactions with their doctors and midwives.
连续的护理服务和护理人员被认为是影响女性孕产护理体验的重要因素。本研究的目的是分析产前护理中护理人员连续性的两个方面对女性产前护理总体评价的影响：女性在整个孕期见到同一名护理人员的程度，以及女性认为其护理人员了解并记住她们以及她们每次就诊进展情况的程度。
对1999年9月在澳大利亚维多利亚州14天内分娩的1616名女性进行了一项基于人群的匿名邮寄调查。采用多变量方法分析数据。
大多数女性在每次产前检查时都见到同一名护理人员（77%），并且认为护理人员了解她们（65%）。这一发现因不同的孕产护理模式而有很大差异。在进行调整之前，如果女性总是或大多认为护理人员了解她们（比值比5.86，95%置信区间4.3，7.9），以及如果她们每次就诊时总是或大多见到同一名护理人员（比值比2.91，95%置信区间2.0，4.3），那么她们将自己的产前护理描述为非常好的可能性要大得多。在对社会人口统计学因素、产次、妊娠风险状况以及产前护理的几个具体方面进行调整后发现，见到同一名护理人员与护理评价不再相关（调整后的比值比0.65，95%置信区间0.3，1.2），但认为护理人员了解并记住她们的女性仍然更有可能对护理给予高度评价（调整后的比值比3.18，95%置信区间2.0，5.1）。
这些发现表明，改变产前护理的提供方式以增加女性每次就诊时见到同一名护理人员的机会，其本身不太可能改善整体护理体验，但在产前护理中花时间使每次接触个性化将会受到欢迎。该分析还证实了女性重视与医生和助产士进行高质量互动的重要性。
