Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Netherlands; Institute for Healthcare - School of Midwifery, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, Netherlands; Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, Belgium.
Sanquin Research, Plesmanlaan 125, 1066 CX Amsterdam, Netherlands.
Women Birth. 2019 Dec;32(6):e567-e575. doi: 10.1016/j.wombi.2019.01.003. Epub 2019 Jan 24.
Woman-centred care is a philosophy for midwifery care management of the childbearing woman. There is no mutually recognised internalised way in midwifery to provide woman-centred care.
To reveal midwives' distinct perspectives about woman-centred care.
A Q-methodology study amongst 48 Dutch community-based midwives who rank-ordered 39 statements on woman-centred care, followed by semi-structured interviews to motivate their ranking. By-person factor analysis was used to derive latent views, representing midwives (factors) with similar attitudes towards woman-centred care. The qualitative data was used to aid interpretation of the factors.
Four distinct factors emerged: (1) the humane midwife, containing two twinning factors: (1+) The philosophical midwife, who is the woman's companion during childbearing in being an authentic individual human being; (1-) the human-rights midwife, who is the woman's advocate for achieving autonomy and self-determination regarding care during the childbearing period. (2) The quality-of-care midwife, who regards good perinatal health outcomes, responsive care and positive maternal experiences as benchmarks for the quality of woman-centred care. (3) The job-crafting midwife, who focuses on self-organisation while seeking balance between the childbearing woman, herself as a professional and an individual and as a colleague.
CONCLUSION/IMPLICATIONS: Each factor represented specific perspectives feeding into woman-centred practice. Although the humane midwife seems to represent the dominant and preferable perspective of woman-centred care, awareness and exploration of and reflection on the thoughts patterns represented by the four different perspectives, should be considered in education and professional development of (student)midwives of be(com)ing a woman-centred midwife.
以人为本地护理是一种助产护理管理产妇的哲学。在助产领域，没有被普遍认可和内化的方法来提供以人本地护理。
揭示助产士对以人本地护理的独特观点。
对 48 名荷兰社区助产士进行了 Q 方法学研究，他们对 39 个以人本地护理的陈述进行了排序，并进行了半结构化访谈，以激发他们的排序。逐人因素分析用于得出潜在的观点，代表对以人本地护理有相似态度的助产士（因素）。定性数据用于辅助对因素的解释。
出现了四个不同的因素：（1）人道的助产士，包含两个双重因素：（1+）作为产妇在分娩期间的伴侣的哲学助产士，作为一个真实的个体存在；（1-）人权助产士，作为产妇在分娩期间争取自主权和自我决定的倡导者。（2）护理质量助产士，她将良好的围产期健康结果、响应性护理和积极的产妇体验视为以人本地护理质量的基准。（3）工作塑造助产士，她专注于自我组织，同时在产妇、她作为专业人士和个体以及作为同事之间寻求平衡。
结论/意义：每个因素都代表了特定的观点，这些观点都融入了以人本地实践。尽管人道的助产士似乎代表了以人本地护理的主导和首选观点，但在（学生）助产士的教育和专业发展中，应该考虑到对以人本地护理的四种不同观点的思维模式的认识、探索和反思。
