Department of Gynecology and Obstetrics, The Regional Hospital in Horsens, Sundvej 30C, Horsens, Denmark.
Department of Gynecology and Obstetrics, Regional Hospital West Jutland, Gl. Landevej 61, Herning, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Midwifery. 2020 Jul;86:102706. doi: 10.1016/j.midw.2020.102706. Epub 2020 Mar 14.
The birth rate in Denmark is increasing, and the rate of births by caesarean section has increased to more than 20%. Thus, the obstetric departments have been put under pressure to identify new solutions to optimize the maternity care system, in which early discharge might be considered. The aim of this study was to explore parents' experiences of the postnatal care after planned caesarean section with focus on factors that support or hinder early discharge.
An interpretive, hermeneutic approach was chosen, using qualitative interviews with multiparous women and their partners. Data analysis was performed using thematic analysis.
Twelve women and partners were recruited from two hospital-based maternity units in Denmark. The inclusion criteria were low-risk Danish-speaking multiparous women having a planned caesarean section with a singleton pregnancy (gestational age between 37+0 and 41+6 weeks). Seven sets of parents were discharged before 28 h and five were discharged after 48 h.
Three main themes were identified as important for timing of discharge: (1) Setting for recovery (2) Views on length of stay, and (3) Preparation and individual planning. All parents valued the safe and supportive environment at the hospital, but several preferred early discharge as they felt more comfortable in their home environment and wanted to be together as a family with all siblings. When considering appropriate time of discharge, the main issues were that pain was manageable, that breastfeeding was initiated successfully and that professional support was available after discharge. Finally, early discharge required preparation and planning and the parents stressed the importance of knowing that they would not be discharged unless they felt ready.
A clear link was observed between the care package the parents received and their views on the optimal time of discharge. Based on our findings it seems likely that a significant proportion of parents will accept and feel confident about early discharge if individual circumstances are taken into account in the antenatal planning of a caesarean section.
丹麦的出生率正在上升，剖腹产率已上升到 20%以上。因此，产科部门面临着寻找新解决方案的压力，以优化产妇护理系统，其中提前出院可能是一种考虑。本研究旨在探讨父母在计划剖腹产后的产后护理体验，重点关注支持或阻碍提前出院的因素。
采用解释性、诠释学方法，对来自丹麦的多产妇及其伴侣进行定性访谈。使用主题分析进行数据分析。
从丹麦的两家医院的产科单位招募了 12 名女性及其伴侣。纳入标准为低风险、会说丹麦语的多产妇，计划进行剖腹产，单胎妊娠（孕龄 37+0 至 41+6 周）。7 组父母在 28 小时前出院，5 组在 48 小时后出院。
确定了三个对出院时间重要的主题：（1）恢复环境；（2）对住院时间的看法；（3）准备和个人计划。所有父母都重视医院安全和支持性的环境，但也有一些人更喜欢提前出院，因为他们在自己的家庭环境中感到更舒适，并希望与所有兄弟姐妹一起作为一个家庭团聚。在考虑适当的出院时间时，主要问题是疼痛可以控制，母乳喂养成功启动，并且在出院后可以获得专业支持。最后，提前出院需要准备和计划，父母强调了只有在他们感到准备好的情况下才不会出院的重要性。
父母对护理套餐的看法与他们对出院最佳时间的看法之间存在明显联系。根据我们的研究结果，如果在剖腹产的产前计划中考虑到个人情况，似乎有相当一部分父母会接受并对提前出院有信心。
