Hawaii Pacific University, Kaneohe, Hawaii, USA.
J Midwifery Womens Health. 2011 Mar-Apr;56(2):94-102. doi: 10.1111/j.1542-2011.2010.00021.x. Epub 2011 Feb 28.
A critical analysis of the CenteringPregnancy model of care research has not been conducted across studies. The aims of this project were to describe 1) the conceptual components of the CenteringPregnancy practice model, 2) the characteristics of the CenteringPregnancy literature, and 3) the research methods and outcomes across the CenteringPregnancy research literature.
An integrative literature review methodology was used to assess the CenteringPregnancy literature published between 1994 and 2009.
The sample consisted of 26 articles (14 narrative descriptions, 10 quantitative studies, 1 mixed methods study, and 1 qualitative study) published predominantly in nursing and midwifery journals. The majority of quantitative studies were exploratory or quasi-experimental and longitudinal designs with the exception of 1 large, federally funded, randomized, controlled trial. Variables were individual and community level outcomes, which were not uniformly operationally defined or measured consistently across studies. Significant results for prenatal care attendance rates, adequate prenatal care, and breastfeeding rates were reported in a number of studies. Other results were often mixed or nonsignificant.
Positive outcomes for the CenteringPregnancy model have been suggested by research findings to date but require more systematic approaches to developing knowledge about the factors inherent in this model that promote participant behavior changes, which lead to better perinatal outcomes as well as circumstances that maximize the effectiveness of this model. Areas for improving the strength of the evidence are discussed. Building consistently demonstrated relationships across studies is essential for creating the evidence base on which practice decisions can be made. Further research is required for developing clarity and understanding about this model's effectiveness.
目前尚未对围产期保健模式的研究进行全面的批判性分析。本项目的目的是描述 1）围产期保健实践模式的概念组成部分，2）围产期保健文献的特点，以及 3）围产期保健文献中的研究方法和结果。
采用综合文献综述方法评估了 1994 年至 2009 年间发表的围产期保健文献。
样本由 26 篇文章组成（14 篇叙事描述、10 篇定量研究、1 篇混合方法研究和 1 篇定性研究），主要发表在护理和助产期刊上。大多数定量研究是探索性或准实验性和纵向设计，只有 1 项大型联邦资助的随机对照试验除外。变量是个体和社区层面的结果，在研究中没有统一地进行操作定义或测量。许多研究报告了产前护理出勤率、充分产前护理和母乳喂养率的显著结果。其他结果则往往不一致或不显著。
迄今为止的研究结果表明，围产期保健模式产生了积极的结果，但需要更系统的方法来发展关于促进参与者行为改变的固有因素的知识，这些因素可以带来更好的围产期结果，并最大限度地提高这种模式的效果。讨论了提高证据力度的领域。在研究之间建立一致的关系对于创建可以做出实践决策的证据基础至关重要。需要进一步研究来明确和理解该模型的有效性。
