Mother and Infant Research Unit, School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
Maternity Services, Ninewells Hospital, NHS Tayside, Dundee, UK.
Birth. 2020 Dec;47(4):378-388. doi: 10.1111/birt.12512. Epub 2020 Dec 1.
Innovative midwifery schemes must be robustly evaluated to establish whether they should be modified or can be replicated. Assessing quality of care can help to ascertain a scheme's acceptability and effectiveness. We used an established quality care framework as a benchmark in our qualitative evaluation of a combined continuity of caregiver and planned home birth scheme in Scotland.
Qualitative evaluation of stakeholder perceptions using the Quality Maternal and Newborn Care Framework was the basis for six focus groups and two one-to-one interviews with stakeholders (new mothers, partners, midwives). A thematic analytical approach was used.
The qualitative evaluation found universal approval among participants. Flexible working patterns helped to nurture positive relationships, and information and support were highly valued. The principal themes-Organization of Care/Work Culture; Information and Support; Relationships-were strongly inter-related. They shared several subthemes, notably continuity of caregiver, flexible family-centered care, and the benefits of being at home. Flexibility and mutual respect helped women to express autonomy and develop agency. Women related their birth experiences to friends, family, and colleagues, thereby helping to normalize home birth.
This qualitative evaluation of an innovative scheme used an established quality framework as a benchmark against which to assess stakeholder experiences. This approach helped to identify the critical codependence of factors involved in care delivery, which in turn helps to identify lessons for others considering similar schemes. Although our evaluation relates to one specific scheme, identifying the scheme's critical quality care aspects may assist others when planning similar schemes.
创新性的助产方案必须经过严格评估，以确定其是否需要修改或可以复制。评估护理质量有助于确定方案的可接受性和有效性。我们在苏格兰的连续助产士和计划家庭分娩方案的定性评估中，使用了既定的优质护理框架作为基准。
采用定性评估方法，使用产妇和新生儿护理质量框架，对利益相关者的看法进行评估，这是对利益相关者（新妈妈、伴侣、助产士）进行六次焦点小组讨论和两次一对一访谈的基础。采用主题分析方法。
定性评估发现，参与者普遍认可。灵活的工作模式有助于培养良好的关系，信息和支持受到高度重视。主要主题——护理/工作文化的组织；信息和支持；关系——紧密相关。它们有几个共同的主题，特别是连续的照顾者、灵活的以家庭为中心的护理以及在家分娩的好处。灵活性和相互尊重有助于妇女表达自主权和发展能动性。妇女向朋友、家人和同事讲述自己的分娩经历，从而有助于使家庭分娩正常化。
本研究对一项创新性方案进行了定性评估，使用既定的质量框架作为基准，评估利益相关者的经验。这种方法有助于确定护理提供中涉及的因素的关键相互依存性，从而有助于为其他考虑类似方案的人提供经验教训。尽管我们的评估涉及一个特定的方案，但确定方案的关键优质护理方面可能有助于其他人在规划类似方案时提供参考。
