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PARENTS 2 研究:一项定性研究,探讨医疗保健专业人员和利益相关者对父母参与围产期死亡审查的看法——从“最底层”到共同学习。

PARENTS 2 Study: a qualitative study of the views of healthcare professionals and stakeholders on parental engagement in the perinatal mortality review-from 'bottom of the pile' to joint learning.

机构信息

Centre for Academic Women's Health, University of Bristol, Bristol, UK.

Women's Health, Southmead Hospital, Bristol, UK.

出版信息

BMJ Open. 2019 Feb 22;8(11):e023792. doi: 10.1136/bmjopen-2018-023792.

Abstract

OBJECTIVE

Engaging bereaved parents in the review process that examines their care before and after a perinatal death might help parents deal with their grief more effectively and drive improvements in patient safety. The objective of this study is to explore whether healthcare professionals would accept or support parent engagement in the perinatal mortality review process.

DESIGN

Qualitative focus group interviews. Transcripts were analysed with an inductive thematic approach.

SETTING

Two geographically distinct tertiary maternity hospitals in the UK.

PARTICIPANTS

Five focus groups were conducted with clinical staff including midwives, obstetricians, neonatologists, nursing staff and chaplaincy services.

RESULTS

Twenty-seven healthcare professionals unanimously agreed that parents' involvement in the perinatal mortality review process is useful and necessary. Six key themes emerged including: parental engagement; need for formal follow-up; critical structure of perinatal mortality review meeting; coordination and streamlining of care; advocacy for parents including role of the bereavement care lead; and requirement for training and support for staff to enable parental engagement.

CONCLUSIONS

Healthcare professionals strongly advocated engaging bereaved parents in the perinatal mortality review: empowering parents to ask questions, providing feedback on care, helping generate lessons and providing them with the opportunity to discuss a summary of the review conclusions with their primary healthcare professional contact. The participants agreed it is time to move on from 'a group of doctors reviewing notes' to active learning and improvement together with parents, to enable better care and prevention of perinatal death.

摘要

目的

让悲痛欲绝的父母参与审查他们在围产期死亡前后的护理过程,可能有助于他们更有效地应对悲伤,并推动患者安全的改善。本研究的目的是探讨医疗保健专业人员是否会接受或支持父母参与围产期死亡审查过程。

设计

定性焦点小组访谈。使用归纳主题方法分析转录本。

地点

英国两家地理位置不同的三级妇产医院。

参与者

包括助产士、产科医生、新生儿科医生、护理人员和牧师服务在内的五名焦点小组与临床工作人员进行了讨论。

结果

27 名医疗保健专业人员一致认为父母参与围产期死亡审查过程是有用且必要的。出现了六个关键主题,包括:父母的参与;需要进行正式的随访;围产期死亡审查会议的关键结构;协调和简化护理;倡导父母参与,包括丧亲关怀负责人的角色;以及为员工提供培训和支持的要求,以实现父母的参与。

结论

医疗保健专业人员强烈主张让悲痛欲绝的父母参与围产期死亡审查:授权父母提出问题,提供护理反馈,帮助总结经验教训,并为他们提供与初级保健专业人员联系讨论审查结论的机会。参与者一致认为,现在是时候从“一群医生审查记录”转变为与父母一起积极学习和改进,以提供更好的护理和预防围产期死亡。

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