Perdok Hilde, Jans Suze, Verhoeven Corine, van Dillen Jeroen, Batenburg Ronald, Mol Ben Willem, Schellevis François, de Jonge Ank
Department of Midwifery Science, AVAG and the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Community Genetics at the EMGO(+) Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Royal Dutch Organisation of Midwives, Utrecht, The Netherlands.
Midwifery. 2016 Jun;37:9-18. doi: 10.1016/j.midw.2016.03.011. Epub 2016 Apr 1.
the current division between midwife-led and obstetrician-led care creates fragmentation in maternity care in the Netherlands. This study aims to gain insight into the level of consensus among maternity care professionals about facilitators and barriers related to integration of midwife-led and obstetrician-led care. Integration could result in more personal continuity of care for women who are referred during labour. This may lead to better birth experiences, fewer interventions and better outcomes for both mother and infant.
a descriptive study using a questionnaire survey of 300 primary care midwives, 100 clinical midwives and 942 obstetricians.
the Netherlands in 2013.
131 (response 44%) primary care midwives, 51 (response 51%) clinical midwives and 242 (response 25%) obstetricians completed the questionnaire.
there was consensus about the clinical midwife caring for labouring women at moderate risk of complications. Although primary care midwives themselves were willing to expand their tasks there was no consensus among respondents on the tasks and responsibilities of the primary care midwife. Professionals agreed on the importance of good collaboration between professionals who should work together as a team. Respondents also agreed that there are conflicting interests related to the payment structure, which are a potential barrier for integrating maternity care.
this study shows that professionals are positive regarding an integrated maternity care system but primary care midwives, clinical midwives and obstetricians have different opinions about the specifications and implementation of this system.
our findings are in accordance with earlier research, showing that it is too early to design a blueprint for an integrated maternity care model in the Netherlands. To bring about change in the maternity care system, an implementation strategy should be chosen that accounts for differences in interests and opinions between professionals.
目前荷兰助产士主导的护理和产科医生主导的护理之间的划分造成了孕产妇护理的碎片化。本研究旨在深入了解孕产妇护理专业人员对于助产士主导的护理和产科医生主导的护理整合的促进因素和障碍的共识水平。整合可能会为分娩期间转诊的女性带来更个性化的持续护理。这可能会带来更好的分娩体验、更少的干预措施以及对母亲和婴儿都更好的结局。
一项描述性研究，采用问卷调查法，调查对象为300名初级护理助产士、100名临床助产士和942名产科医生。
2013年的荷兰。
131名（回复率44%）初级护理助产士、51名（回复率51%）临床助产士和242名（回复率25%）产科医生完成了问卷。
对于照顾有中度并发症风险的分娩妇女的临床助产士，存在共识。尽管初级护理助产士自己愿意扩大其任务，但受访者对于初级护理助产士的任务和职责没有达成共识。专业人员一致认为专业人员之间良好协作的重要性，他们应该作为一个团队共同工作。受访者还一致认为，薪酬结构存在利益冲突，这是整合孕产妇护理的一个潜在障碍。
本研究表明，专业人员对综合孕产妇护理系统持积极态度，但初级护理助产士、临床助产士和产科医生对该系统的具体细节和实施有不同意见。
我们的研究结果与早期研究一致，表明在荷兰设计综合孕产妇护理模式的蓝图还为时过早。为了在孕产妇护理系统中带来变革，应该选择一种考虑到专业人员之间利益和意见差异的实施策略。
