McInnes Rhona J, Martin Caroline J Hollins, MacArthur Juliet
Maternal Health & Consultant Midwife for NHS Lothian, School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN.
School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh EH11 4BN, Scotland, UK.
Midwifery. 2018 Nov;66:103-110. doi: 10.1016/j.midw.2018.07.007. Epub 2018 Aug 9.
Midwifery continuity of carer (MCC) models result in better clinical outcomes for women and offer midwives a superior way of working when compared to other models of maternity care. Implementing a MCC model, a key recommendation of the Scottish Government Maternity and Neonatal Strategy Best Start, requires significant restructuring of maternity services and changes to midwives' roles. Careful evaluation is therefore required to monitor and understand how the policy affects care providers and users. Realist evaluation is an appropriate methodology for evaluating programmes of change set within complex social organisations, such as health services, and can help to understand variations in outcomes and experiences. This paper presents the approach taken using the principles of realist evaluation to identify key programme theories, which then informed an evaluation framework and a midwives' evaluation tool. The comprehensive survey-tool developed for midwives has the potential to be used more widely to evaluate comparable strategic change in this area.
与其他产科护理模式相比，助产士连续性照护（MCC）模式能为女性带来更好的临床结局，也为助产士提供了更优质的工作方式。实施MCC模式是苏格兰政府《孕产妇和新生儿战略：最佳开端》的一项关键建议，这需要对产科服务进行重大重组，并改变助产士的角色。因此，需要进行仔细评估，以监测和了解该政策如何影响护理提供者和使用者。现实主义评估是评估复杂社会组织（如卫生服务机构）内部变革计划的合适方法，有助于理解结果和体验的差异。本文介绍了运用现实主义评估原则来确定关键项目理论的方法，这些理论随后为评估框架和助产士评估工具提供了依据。为助产士开发的综合调查工具有可能得到更广泛的应用，以评估该领域类似的战略变革。
