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分娩期管理中的沟通发展点:发展中背景下的一项诠释性多案例研究

Development spots in communication during the management of the intrapartum period: An interpretive multiple case study in a developing context.

作者信息

M'Rithaa Doreen K M, Fawcus Susan R, De la Harpe Margaretha, Korpela Mikko

机构信息

Department of Nursing and Midwifery, Stellenbosch University.

出版信息

Afr J Prim Health Care Fam Med. 2017 Jul 31;9(1):e1-e6. doi: 10.4102/phcfm.v9i1.1239.

Abstract

BACKGROUND

Health care activities are influenced by information communication between women during pregnancy, birth and motherhood and skilled birth attendants (SBAs) and further, between the health care workers during the continuum of care. Therefore, effective information communication processes (ICP) within and between health care facilities are a requirement for appropriate management of patients or clients. The management of the intrapartum period requires swift responses while managing critical information required for further referral and management processes. The involvement of multiple actors at different times with the same client carries the risk of communication breakdown at different points and at different levels of care. The information communicated during the intrapartum period is critical and should be accurate, timely and more importantly appropriate to enable better maternal and neonatal outcomes.

PURPOSE

The purpose of this article is to discuss the complexities around ICP identified within a developing context that influence the management of the intrapartum period.

METHODS

Multi-method, multiple case study approach was used to analyse two case studies. Only the challenges from one case study (A) are discussed in this article. In-depth interviews were conducted with the SBAs. The role of observer-as-participant was utilised during the observation; field notes and document review methods were used to gather the data. Thematic analysis and activity analysis were applied to analyse the data.

RESULTS

The findings identified challenges with information and communication that influenced the management of the intrapartum period.

CONCLUSION

This study exhibited the challenges identified as development points that can influence the management of the intrapartum period. These challenges were also identified as desirable changes from the present state depending on the perspective of the actor.

摘要

背景

孕期、分娩期及产后女性与熟练的助产人员(SBAs)之间的信息交流,以及在连续护理过程中医护人员之间的信息交流,都会对医疗保健活动产生影响。因此,医疗机构内部及之间有效的信息交流流程(ICP)是对患者或客户进行适当管理的必要条件。分娩期的管理需要迅速做出反应,同时要管理好进一步转诊和管理流程所需的关键信息。在不同时间多个行为主体参与同一位客户的护理,存在在不同护理点和不同护理层面出现沟通障碍的风险。分娩期所交流的信息至关重要,应该准确、及时,更重要的是恰当,以便实现更好的孕产妇和新生儿结局。

目的

本文旨在探讨在发展环境中确定的影响分娩期管理的信息交流流程的复杂性。

方法

采用多方法、多案例研究方法分析两个案例研究。本文仅讨论其中一个案例研究(A)中的挑战。对熟练的助产人员进行了深入访谈。观察期间采用了参与观察法;使用现场记录和文件审查方法收集数据。采用主题分析和活动分析方法对数据进行分析。

结果

研究结果确定了影响分娩期管理的信息和沟通方面的挑战。

结论

本研究展示了被确定为可影响分娩期管理的发展要点的挑战。根据行为主体的视角,这些挑战也被确定为相对于当前状态的理想变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ebc/5566129/0c2a3575a595/PHCFM-9-1239-g001.jpg

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