Kashani Alia, Ingberg Jessica L, Hildingsson Ingegerd
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
Eur J Midwifery. 2021 Jan 19;5:2. doi: 10.18332/ejm/131240. eCollection 2021.
Midwifery-led continuity of care models are beneficial to women and babies, but might be challenging for midwives. Several studies have, however, shown that midwives report higher job satisfaction and less burnout when working with caseload. Another challenge is to staff such models in rural areas. The aim of this study was to describe midwives' experiences of working in a caseload model in a rural region of Australia.
A qualitative descriptive approach using interviews and thematic analysis was undertaken with eleven midwives.
The overarching theme, 'A modified caseload model of care in rural Australia creates opportunities for increased job satisfaction despite the challenges involved with being on call', comprised: two themes, 'Increased job satisfaction' and 'Challenges'; one core theme, 'Being on call'; and several subthemes. Working with caseload creates job satisfaction and increases vitality and positive feelings about being a midwife. The main difficulty, as well as the necessity with this model, is the challenging aspect of being on call.
Caseload midwifery builds partnership between the woman and her midwife, it allows flexible working hours and increased autonomy, even when the work affects the midwife's social life. Being on call allows the midwife to work on the whole scope of midwifery practice and is a basis for the continuity model of care; however, being on call also represents a challenge to be overcome in order to make caseload work. Continuity models may be a means to attract midwives to work in rural areas.
由助产士主导的连续性护理模式对产妇和婴儿有益，但对助产士来说可能具有挑战性。然而，多项研究表明，助产士在采用个案管理模式工作时，工作满意度更高，职业倦怠感更低。另一个挑战是为农村地区的此类模式配备人员。本研究的目的是描述澳大利亚农村地区助产士在个案管理模式下的工作经历。
采用访谈和主题分析的定性描述方法，对11名助产士进行了研究。
总体主题为“澳大利亚农村地区改良的个案管理护理模式尽管存在随叫随到的挑战，但仍为提高工作满意度创造了机会”，包括两个主题“工作满意度提高”和“挑战”；一个核心主题“随叫随到”；以及几个子主题。采用个案管理模式工作能带来工作满意度，并增强活力以及对成为助产士的积极感受。这种模式的主要困难以及必要性在于随叫随到这一具有挑战性的方面。
个案管理助产模式建立了产妇与其助产士之间的伙伴关系，即使工作会影响助产士的社交生活，它也允许灵活的工作时间并增加自主性。随叫随到使助产士能够从事全面的助产实践工作，是连续性护理模式的基础；然而，为了使个案管理模式得以实施，随叫随到也代表着一个需要克服的挑战。连续性护理模式可能是吸引助产士到农村地区工作的一种方式。
