Phillippi Julia C, Holley Sharon L, Payne Kate, Schorn Mavis N, Karp Sharon M
Vanderbilt University School of Nursing, 461 21st Ave South, Nashville, TN 37240, United States.
Vanderbilt University School of Nursing, 461 21st Ave South, Nashville, TN 37240, United States.
Women Birth. 2016 Apr;29(2):160-7. doi: 10.1016/j.wombi.2015.09.007. Epub 2015 Oct 31.
Perinatal outcomes have complex causes that include biologic, maternal, structural, and societal components. We studied one urban nurse-led clinic serving women at risk for poor perinatal outcomes with superior pre-term birth rates (4%) when compared with the surrounding county (11.2%).
To explore women's perspectives of their interface with the clinic, staff, and providers to understand this exemplary model.
A qualitative descriptive approach with semi-structured interviews as the primary data source. Participants (n=50) were recruited from an urban clinic in the Southeast United States designed to serve women of low socio-economic status or who are recent immigrants.
Women greatly valued a personal connection with the nurse-midwives and staff, and felt this resulted in high-quality care. Convenient appointment times and the lack of wait for initial or subsequent appointments made care accessible. Participants reported the relaxed and helpful approach and attitudes of the office staff were essential components of their positive experience. Women valued unrushed visits to ask questions and receive information. In addition, participants felt that clinic staff were easy to reach.
While qualitative data cannot demonstrate causation, this study provides support that a compassionate and personalized approach to care motivates women to access needed services in pregnancy. Clinic staff are an essential component of the access process. Women overcame barriers to obtain personalized, culturally appropriate care provided by kind, competent practitioners. Clinic staff and practitioners should develop a connection with each woman by providing care that meets her physical, cultural, and personal needs.
围产期结局有复杂的成因，包括生物学、母体、结构和社会因素。我们研究了一家由护士主导的城市诊所，该诊所服务于有围产期不良结局风险的女性，其早产率（4%）优于周边县（11.2%）。
探讨女性对其与诊所、工作人员及医疗服务提供者互动的看法，以了解这一典范模式。
采用定性描述方法，以半结构式访谈作为主要数据来源。参与者（n = 50）从美国东南部一家城市诊所招募，该诊所专为社会经济地位低的女性或新移民女性服务。
女性非常重视与助产士和工作人员的个人联系，并认为这带来了高质量的护理。方便的预约时间以及初次或后续预约无需等待，使护理易于获得。参与者报告称，办公室工作人员轻松且乐于助人的方式和态度是她们积极体验的重要组成部分。女性重视有足够时间提问并获取信息的就诊过程。此外，参与者觉得诊所工作人员很容易联系到。
虽然定性数据无法证明因果关系，但本研究支持这样一种观点，即富有同情心和个性化的护理方式能促使女性在孕期获得所需服务。诊所工作人员是获得服务过程中的重要组成部分。女性克服了障碍，获得了由友善、称职的从业者提供的个性化、符合文化背景的护理。诊所工作人员和从业者应通过提供满足每位女性身体、文化和个人需求的护理，与她们建立联系。
