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西澳大利亚州分娩中心至三级妇产医院的产时转诊现象:伴侣的总体经历

The phenomenon of intrapartum transfer from a western Australian birth centre to a tertiary maternity hospital: The overall experiences of partners.

作者信息

Kuliukas Lesley, Hauck Yvonne, Duggan Ravani, Lewis Lucy

机构信息

School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, Western Australia, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, PO Box 134, Subiaco, Western Australia 6904, Australia.

School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, Western Australia, Australia.

出版信息

Midwifery. 2015 May;31(5):e87-93. doi: 10.1016/j.midw.2015.01.010. Epub 2015 Jan 29.

Abstract

AIM

the aim of this Western Australian study was to describe the overall labour and birth experience of partners within the context of an intrapartum transfer occurring from a low risk midwifery-led, woman-centred unit to an obstetric unit.

DESIGN

a descriptive phenomenological design was used. 15 male partners were interviewed in the first 8 weeks post partum between July and October, 2013 to explore their experience of the intrapartum transfer.

SETTING

a midwifery-led birth centre set on the grounds of a tertiary maternity referral hospital.

PARTICIPANTS

partners of women who were transferred from the birth centre to the onsite tertiary hospital due to complications during the first and second stages of labour.

FINDINGS

five main themes emerged: (1) 'emotional roller coaster'; (2) 'partner׳s role in changing circumstances' with subthemes: 'acknowledgement for his inside knowledge of her' and 'challenges of being a witness'; (3) 'adapting to a changing model of care' with subthemes: 'moving from an inclusive nurturing and continuity model' and 'transferring to a medicalised model'; (4) 'adapting to environmental changes' with subthemes: 'feeling comfortable in the familiar birth centre', 'going to the place where things go wrong' and 'Back to comfortable familiarity afterwards' and (5) 'coming to terms with altered expectations around the labour and birth experience'.

KEY CONCLUSIONS

partners acknowledged the benefits of midwifery continuity of care, however, noted that as partners they also provided essential continuity as they felt they knew their woman better than any care provider. Partners found it difficult to witness their woman׳s difficult labour journey. They found the change of environment from birth centre to labour ward challenging but appreciated that experienced medical assistance was at hand when necessary. Being able to return to the birth centre environment was acknowledged as beneficial for the couple. Following the transfer experience partners asked for the opportunity to debrief to clarify and better understand the process.

IMPLICATIONS FOR PRACTICE

findings may be used to inform partners in childbirth education classes about what to expect when transfer takes place and offer the opportunity for them to debrief after the birth. Finally, themes can provide insight to maternity care professionals around the emotions experienced by partners during intrapartum transfer to enhance informed choice, involvement in care and empathetic support.

摘要

目的

这项西澳大利亚州的研究旨在描述在分娩期从低风险的以助产士主导、以产妇为中心的单位转诊至产科单位的情况下,伴侣的总体分娩经历。

设计

采用描述性现象学设计。在2013年7月至10月产后的前8周内,对15名男性伴侣进行了访谈,以探究他们在分娩期转诊中的经历。

背景

一家位于三级妇产转诊医院内的由助产士主导的分娩中心。

参与者

在第一产程和第二产程因并发症从分娩中心转诊至现场三级医院的产妇的伴侣。

结果

出现了五个主要主题:(1)“情绪过山车”;(2)“伴侣在情况变化中的角色”,其子主题为:“认可他对她内心的了解”和“作为见证者的挑战”;(3)“适应不断变化的护理模式”,其子主题为:“从包容、滋养和连续性模式转变”和“转向医疗化模式”;(4)“适应环境变化”,其子主题为:“在熟悉的分娩中心感到舒适”、“前往事情出错的地方”和“之后回到舒适的熟悉环境”;(5)“接受对分娩经历期望的改变”。

主要结论

伴侣们认可助产士连续性护理的益处,但指出作为伴侣,他们也提供了至关重要的连续性,因为他们觉得自己比任何护理提供者都更了解自己的伴侣。伴侣们发现很难见证自己伴侣艰难的分娩过程。他们发现从分娩中心到产房的环境变化具有挑战性,但也感激在必要时能获得经验丰富的医疗援助。能够回到分娩中心环境被认为对夫妻双方有益。经历转诊后,伴侣们要求有机会进行汇报,以澄清并更好地理解这一过程。

对实践的启示

研究结果可用于在分娩教育课程中告知伴侣转诊时会发生什么,并为他们在分娩后提供汇报的机会。最后,这些主题可为产科护理专业人员提供关于伴侣在分娩期转诊期间所经历情绪的见解,以增强明智的选择、参与护理和共情支持。

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