Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.
Department of Society Studies, Faculty of Arts and Social Sciences, Maastricht University, Maastricht, The Netherlands.
Women Birth. 2021 Mar;34(2):145-153. doi: 10.1016/j.wombi.2020.01.014. Epub 2020 Feb 13.
Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders - parents - as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for "good practice".
We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units.
We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: "talk work" - small talk and humour - and "work beyond words" - familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves "paradoxical care", e.g., concurrent acts of "regulated spontaneity" and "informal formalities".
Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents.
Good communication and collaboration in maternity care involves "paradoxical care" requiring social sensitivity and self-reflection, skills that should be included as part of professional training.
生育护理的研究通常侧重于预防良好沟通和协作的因素，很少包括重要利益相关者——父母——作为共同研究者。为了了解荷兰生育护理中的专业人员和父母如何实现建设性的沟通与协作，我们研究了他们在诊所中的互动，寻找“良好实践”。
我们在 9 家助产士实践和 2 家产科单位使用视频反思民族志方法。
我们进行了 16 次会议，参与者在会上反思了他们临床互动的视频记录。我们发现，非正式策略促进了沟通和协作：“谈工作”——闲聊和幽默——以及“超越言语的工作”——熟悉度、使用视觉、触觉、声音和非言语手势。当使用这些策略时，参与者指出，重要的是要对背景、他人的价值观和感受以及护理的时间敏感。我们对他们敏感方式的分析表明，良好的沟通和协作涉及“矛盾的护理”，例如，同时进行“有调节的自发性”和“非正式的礼节”。
承认和加强矛盾护理技能将帮助护理人员发展应对医疗保健不断变化需求所需的能力。视频反思民族志方法提供了一种研究日常工作的创新方法，重点关注实践的非正式和隐含方面，并提供了一种自下而上的方法，将研究人员、专业人员和父母整合在一起。
生育护理中的良好沟通和协作涉及“矛盾护理”，需要社会敏感性和自我反思，这些技能应作为专业培训的一部分。
