Northern Adelaide Local Health Network, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, 5112 South Australia, Australia; The University of Adelaide, North Terrace, Adelaide 5005, South Australia, Australia.
The University of Adelaide, North Terrace, Adelaide 5005, South Australia, Australia.
Midwifery. 2020 Apr;83:102632. doi: 10.1016/j.midw.2020.102632. Epub 2020 Jan 15.
A maternity service in Australia recently implemented an 'Enhanced recovery after Elective Caesarean' pathway, which includes antenatal preparation and facilitates an active role in postnatal recovery such as encouraging mobility and early cessation of fasting. The pathway includes next day discharge for women and their babies after elective caesarean section and safely transitions maternity care from hospital to home with community midwifery care. While enhanced recovery has been implemented in a number of surgical procedures to reduce hospital stay and to improve patient outcomes it has only been considered for elective caesarean sections in more recent years. Given this, enhanced recovery is not well established or researched in obstetric contexts. Furthermore, women's experiences with reduced hospital stays post-caesarean, particularly next day discharge, is limited. A qualitative explorative descriptive study of women's experiences with the pathway and the associated early transition home will help to inform clinical practice and the research evidence base.
Eleven interviews were conducted with women who had experienced the pathway and next day discharge. Thematic analysis was conducted.
Three major themes and twelve sub-themes emerged from the data. Major themes identified were women's general experience of an enhanced recovery pathway, their experiences following arrival at home and support at home. All women interviewed were satisfied with the pathway and home recovery. However, there are a number of aspects of care that are essential to a positive experience. This includes excellent support from social networks, healthcare staff and home midwifery care; well managed pain relief; and adequate and timely information, including reassurance that they or their baby could remain in hospital if required.
This study takes a woman-centred perspective adding to both literature and practice.
澳大利亚的一家产科服务机构最近实施了“择期剖宫产术后强化康复”方案，该方案包括产前准备，并促进产妇在产后恢复中的积极作用，如鼓励产妇活动和尽早停止禁食。该方案包括择期剖宫产术后产妇和婴儿的次日出院，并通过社区助产士护理安全地将产妇护理从医院过渡到家庭。虽然强化康复已在许多外科手术中实施，以缩短住院时间并改善患者预后，但近年来才考虑将其应用于择期剖宫产。鉴于此，强化康复在产科环境中尚未得到很好的建立或研究。此外，女性在剖宫产术后缩短住院时间，特别是次日出院的经历有限。本研究对女性对该方案的体验以及相关的早期家庭过渡进行了定性探索性描述，有助于为临床实践和研究证据基础提供信息。
对经历过该方案和次日出院的 11 名女性进行了访谈。采用主题分析方法。
从数据中得出了三个主要主题和十二个子主题。确定的主要主题是女性对强化康复方案的总体体验、她们在回家后的体验以及在家中的支持。所有接受采访的女性都对该方案和家庭康复感到满意。然而，有一些护理方面是积极体验的关键。这包括来自社交网络、医护人员和家庭助产士的出色支持；良好的疼痛管理；以及充足和及时的信息，包括保证如果需要，他们或他们的婴儿可以留在医院。
本研究从女性为中心的角度出发，为文献和实践增添了新的内容。
