La Trobe University, Bundoora, Victoria, Australia.
Women Birth. 2009 Dec;22(4):128-33. doi: 10.1016/j.wombi.2009.04.003. Epub 2009 May 23.
Despite limited evidence evaluating early postnatal discharge, length of hospital stay has declined dramatically in Australia since the 1980s. The recent rising birth rate in Victoria, Australia has increased pressure on hospital beds, and many services have responded by discharging women earlier than planned, often with little preparation during pregnancy. We aimed to explore the views of women and their partners regarding a number of theoretical postnatal care 'packages' that could provide an alternative approach to early postnatal care.
Eight focus groups and four interviews were held in rural and metropolitan Victoria in 2006 with participants who had experienced a mix of public and private maternity care. These included 8 pregnant women, 42 recent mothers and 2 male partners. All were fluent in English. Focus groups explored participants' experiences and/or expectations of early postnatal care in hospital and at home and their views of alternative packages of postnatal care where location of care shifted from hospital to home and/or hotel. This paper describes the packages and explores and describes what 'value' women placed on the various components of care.
Overall, women expressed a preference for what they had experienced or expected, which may be explained by the 'what is must be best' phenomenon where women place value on the status quo. They generally did not respond favourably towards the alternative postnatal care packages, with concerns about any shorter length of hospital stay, especially for first time mothers. Women were concerned about the safety and wellbeing of their new baby and reported that they lacked confidence in their ability to care for their baby. The physical presence and availability of professional support was seen to alleviate these concerns, especially for first time mothers. Participants did not believe that increased domiciliary visits compensated for forgoing the perceived security and value of staying in hospital. Women generally valued staying in hospital for the length of time they felt they needed above all other factors.
Women were concerned about shortened postnatal length of hospital stay and these concerns must be considered when changes are planned in maternity service provision. Any moves towards shorter postnatal length of stay must be comprehensively evaluated with consideration given to exploring consumer views and satisfaction. There is also a need for flexibility in postnatal care that acknowledges women's individual needs.
尽管有关早期产后出院的证据有限，但自 20 世纪 80 年代以来，澳大利亚的住院时间已大大缩短。澳大利亚维多利亚州最近的出生率上升增加了对医院床位的压力，许多服务机构通过提前出院来应对，通常在怀孕期间准备不足。我们旨在探讨女性及其伴侣对一系列理论性产后护理“套餐”的看法，这些套餐可以为早期产后护理提供替代方法。
2006 年，在维多利亚州的农村和城市地区进行了 8 个焦点小组和 4 次访谈，参与者经历了公共和私人产科护理的混合。其中包括 8 名孕妇、42 名近期母亲和 2 名男性伴侣。所有人都精通英语。焦点小组探讨了参与者在医院和家中的早期产后护理经验和/或期望，以及他们对将护理地点从医院转移到家庭和/或酒店的替代产后护理套餐的看法。本文介绍了这些套餐，并探讨和描述了女性对护理各个组成部分的重视程度。
总的来说，女性对她们所经历或期望的事情表示了偏好，这可能是由于“现状必须是最好的”现象，即女性对现状赋予了价值。他们对替代产后护理套餐的反应并不积极，特别是对初次分娩的女性来说，她们担心住院时间缩短。女性担心新生儿的安全和健康，并表示对自己照顾婴儿的能力缺乏信心。专业支持的存在和可用性被认为减轻了这些担忧，特别是对初次分娩的女性来说。参与者不相信增加家庭访问次数可以弥补失去住院的安全感和价值。女性普遍认为，住院时间是她们最需要的，超过了其他所有因素。
女性对缩短产后住院时间表示担忧，在计划改变产科服务提供时必须考虑到这些担忧。在考虑缩短产后住院时间时，必须全面评估任何举措，并考虑探索消费者的意见和满意度。还需要灵活的产后护理，以承认女性的个人需求。
