Warmelink J Catja, Wiegers Therese A, de Cock T Paul, Klomp Trudy, Hutton Eileen K
Midwifery Science, AVAG, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands; Midwifery Academy Amsterdam Groningen, The Netherlands.
Netherlands institute for health services research (NIVEL), Utrecht, The Netherlands.
Midwifery. 2017 Dec;55:45-52. doi: 10.1016/j.midw.2017.08.010. Epub 2017 Sep 6.
Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians. More insight is needed into the professional working relations of primary care midwives in the Netherlands before major changes are made OBJECTIVE: To assess how satisfied primary care midwives are with collaboration with other maternity care providers and to assess the relationship between their 'satisfaction with collaboration' and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics (accessibility). The aim of this study was to provide insight into the professional working relations of primary care midwives in the Netherlands.
Our descriptive cross-sectional study is part of the DELIVER study. Ninety nine midwives completed a written questionnaire in May 2010. A Friedman ANOVA test assessed differences in satisfaction with collaboration with six groups of maternity care providers. Bivariate analyses were carried out to assess the relationship between satisfaction with collaboration and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics.
Satisfaction experienced by primary care midwives when collaborating with the different maternity care providers varies within and between primary and secondary/tertiary care. Interactions with non-physicians (clinical midwives and MCA(O)) are ranked consistently higher on satisfaction compared with interactions with physicians (GPs, obstetricians and paediatricians). Midwives with more work experience were more satisfied with their collaboration with GPs. Midwives from the southern region of the Netherlands were more satisfied with collaboration with GPs and obstetricians. Compared to the urban areas, in the rural or mixed areas the midwives were more satisfied regarding their collaboration with MCA(O)s and clinical midwives. Midwives from non-Dutch origin were less satisfied with the collaboration with paediatricians. No relations were found between the overall mean satisfaction of collaboration and work-related and personal characteristics and attitude towards work.
Inter-professionals relations in maternity care in the Netherlands can be enhanced, especially the primary care midwives' interactions with physicians and with maternity care providers in the northern and central part of the Netherlands, and in urban areas. Future exploratory or deductive research may provide additional insight in the collaborative practice in everyday work setting.
跨专业协作在有效的孕产妇护理中被认为至关重要。荷兰正在开展国家项目以加强跨专业关系，改善所有孕产妇护理提供者之间的沟通，从而提高孕产妇护理质量。然而，对于基层护理助产士与其他孕产妇护理提供者（如全科医生、孕产妇护理协助组织（MCAO）、孕产妇护理助理（MCA）、产科医生、临床助产士和儿科医生）协作的满意度了解甚少。在做出重大改变之前，需要更深入了解荷兰基层护理助产士的专业工作关系。
评估基层护理助产士对与其他孕产妇护理提供者协作的满意度，并评估她们“协作满意度”与助产士个人及工作相关特征、她们对工作的态度以及协作特征（可及性）之间的关系。本研究旨在深入了解荷兰基层护理助产士的专业工作关系。
我们的描述性横断面研究是DELIVER研究的一部分。99名助产士于2010年5月完成了一份书面问卷。采用弗里德曼方差分析检验评估与六组孕产妇护理提供者协作的满意度差异。进行双变量分析以评估协作满意度与助产士个人及工作相关特征、她们对工作的态度以及协作特征之间的关系。
基层护理助产士在与不同孕产妇护理提供者协作时所体验到的满意度在基层护理与二级/三级护理内部及之间存在差异。与非医生（临床助产士和MCA（O））的互动在满意度方面的排名始终高于与医生（全科医生、产科医生和儿科医生）的互动。工作经验更丰富的助产士对与全科医生的协作更满意。荷兰南部地区的助产士对与全科医生和产科医生的协作更满意。与城市地区相比，在农村或混合地区，助产士对与MCA（O）和临床助产士的协作更满意。非荷兰籍的助产士对与儿科医生的协作不太满意。未发现协作的总体平均满意度与工作相关及个人特征以及工作态度之间存在关联。
荷兰孕产妇护理中的跨专业关系可以得到加强，特别是基层护理助产士与医生以及荷兰北部和中部地区及城市地区的孕产妇护理提供者之间的互动。未来的探索性或演绎性研究可能会在日常工作环境中的协作实践方面提供更多见解。
