妇女对提高母婴医院护理质量的建议：意大利的一项定性研究，采用世卫组织标准作为分析框架。
Women's suggestions on how to improve the quality of maternal and newborn hospital care: a qualitative study in Italy using the WHO standards as framework for the analysis.
机构信息
WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.
出版信息
BMC Pregnancy Childbirth. 2020 Apr 6;20(1):200. doi: 10.1186/s12884-020-02893-0.
BACKGROUND
A recent systematic review identified very few studies on women's views on how to improve the quality of maternal and newborn care (QMNC). This study aimed at exploring the suggestions provided by women, after hospital delivery in Italy, on how to improve the QMNC.
METHODS
A questionnaire, containing open questions to capture suggestions on how to improve QMNC, was used to collect suggestions of mothers who gave birth a tertiary care referral hospital in Northeast Italy, between December 2016 and September 2018. Two authors independently used thematic analysis to analyse women's comments, using the WHO Standards for improving the QMNC as framework for the analysis.
RESULTS
Overall 392 mothers provided a total of 966 comments on how to improve the QMNC. Overall 45 (11.5%) women made suggestions pertinent to "provision of care", 222 (56.6%) to the "experience of care", 217 (55.4%) to "physical or to human resources". The top five suggestions were: 1) increase presence of a companion during the whole hospitalization (28.3% of women); 2) improve bathrooms and showers (18.4%); 3) improve effective communication from staff (14.0%); 4) improve staff professionalism, empathy, and kindness (13.5%); 5) increase support and information on how to provide care to the newborn (11.2%). Overall, 158 (16.4%) suggestions could not be classified in any WHO Standards, and among these most (72.1%) were related to physical structures, such as: decrease the number of patients per room; create areas for visitors; avoid case mixing in the same room; reduce rooming-in/better support the mother. Overall 62 (15.8%) women expressed appreciations.
CONCLUSIONS
Collecting the women's views on how to improve the QMNC after hospital delivery highlighted critical inputs on aspects of care that should be improved in the opinion of service-users. More investments should be made for establishing routine systems for monitoring patients experience of care. Data collected should be used to improve QMNC. WHO Standards may be further optimized by adding items emerging as relevant for women in high-income countries.
背景
最近的一项系统评价发现，关于女性如何提高母婴保健质量（QMNC）的研究很少。本研究旨在探讨意大利一家三级保健转诊医院分娩后的女性对改善 QMNC 的建议。
方法
使用包含捕捉改善 QMNC 建议的开放性问题的问卷，于 2016 年 12 月至 2018 年 9 月在意大利东北部的一家三级保健转诊医院收集产妇的建议。两位作者独立使用主题分析来分析女性的意见，并使用世卫组织改善 QMNC 的标准作为分析框架。
结果
共有 392 名母亲对如何改善 QMNC 提出了共计 966 条意见。共有 45 名（11.5%）女性对“护理提供”提出了建议，222 名（56.6%）对“护理体验”提出了建议，217 名（55.4%）对“物理或人力资源”提出了建议。前五项建议为：1）增加住院期间陪伴者的数量（28.3%的女性）；2）改善浴室和淋浴设施（18.4%）；3）改善工作人员的有效沟通（14.0%）；4）提高工作人员的专业精神、同理心和友善度（13.5%）；5）增加对如何照顾新生儿的支持和信息（11.2%）。总体而言，158 项（16.4%）建议无法归入任何世卫组织标准，其中大多数（72.1%）与物理结构有关，例如：减少每个病房的患者人数；创建访客区；避免同一病房内病例混合；减少母婴同室/更好地支持母亲。共有 62 名（15.8%）女性表示赞赏。
结论
收集女性对分娩后如何改善 QMNC 的意见，突出了服务使用者认为应改进护理方面的关键投入。应加大投入，建立监测患者护理体验的常规系统。应利用收集到的数据来改善 QMNC。世卫组织标准可通过增加对高收入国家女性相关的项目进行进一步优化。
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