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关于在肯尼亚实施质量改进协作以改善孕产妇和生殖健康的以患者为中心护理的观点。

Perspectives on implementing a quality improvement collaborative to improve person-centered care for maternal and reproductive health in Kenya.

作者信息

Giessler Katie, Seefeld Avery, Montagu Dominic, Phillips Beth, Mwangi James, Munson Meghan, Green Cathy, Opot James, Golub Ginger

机构信息

Institute for Global Health Sciences, University of California, San Francisco, Mission Hall, Box 1224, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.

Jacaranda Health, Nairobi, Kenya, Diani Close, Nairobi, Kenya.

出版信息

Int J Qual Health Care. 2020 Dec 15;32(10):671-676. doi: 10.1093/intqhc/mzaa130.

Abstract

OBJECTIVE

To understand perspectives and experiences related to participation in a quality improvement collaborative (QIC) to improve person-centered care (PCC) for maternal health and family planning (FP) in Kenya.

DESIGN AND SETTING

Semi-structured qualitative interviews were conducted with members of the QIC in four public health facilities in Kenya.

PARTICIPANTS

Clinical and nonclinical public health facility staff who had participated in the QIC were purposively sampled to participate in the semi-structured interviews.

INTERVENTION

A QIC was implemented across four public health facilities in Nairobi and Kiambu Counties in Kenya to improve PCC experiences for women seeking maternity or FP services.

MAIN OUTCOME MEASURE

Semi-structured interviews with participants of the QIC to understand perspectives and experiences associated with sensitization to and implementation of PCC behaviors in maternity and FP services.

RESULTS

Respondents reported that sensitization to PCC principles resulted in multiple perceived benefits for staff and patients alike, including improved interactions with patients and clients, deeper awareness of patient and client preferences, and improved interpersonal skills and greater job satisfaction. Respondents also highlighted system-level challenges that impeded their ability to consistently provide high-quality PCC to women, namely staff shortages and frequent turnover, high patient volumes and lack of space in their respective health facilities.

CONCLUSION

Respondents were easily able to articulate perceived benefits derived from participation in this QIC, although they were equally able to identify challenges that hindered their ability to consistently provide high-quality PCC to women seeking maternity or FP services.

摘要

目的

了解参与质量改进协作(QIC)以改善肯尼亚孕产妇健康和计划生育(FP)中以患者为中心的护理(PCC)的相关观点和经验。

设计与背景

对肯尼亚四个公共卫生机构的QIC成员进行了半结构化定性访谈。

参与者

有目的地抽取参与QIC的临床和非临床公共卫生机构工作人员参与半结构化访谈。

干预措施

在肯尼亚内罗毕和基安布县的四个公共卫生机构实施了QIC,以改善寻求孕产妇或FP服务的妇女的PCC体验。

主要观察指标

对QIC参与者进行半结构化访谈,以了解与孕产妇和FP服务中PCC行为的宣传和实施相关的观点和经验。

结果

受访者表示,对PCC原则的宣传对工作人员和患者都产生了多重益处,包括改善与患者的互动、更深入了解患者偏好、提高人际交往能力和增强工作满意度。受访者还强调了系统层面的挑战,这些挑战阻碍了他们持续为妇女提供高质量PCC的能力,即人员短缺和频繁更替、患者数量多以及各自卫生机构空间不足。

结论

受访者能够轻松阐述参与该QIC所带来的益处,尽管他们同样能够识别阻碍其持续为寻求孕产妇或FP服务的妇女提供高质量PCC的挑战。

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