Larsson Birgitta, Thies-Lagergren Li, Karlström Annika, Hildingsson Ingegerd
Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
Department of Health Sciences, Lund University, Lund, Sweden.
Eur J Midwifery. 2021 Mar 22;5:8. doi: 10.18332/ejm/133573. eCollection 2021.
The closure of a local labor ward enhanced the possibility to initiate a continuity of midwifery care model project. Continuity models of midwifery care are a cornerstone in midwifery and women-centered care, mainly accessible in metropolitan areas. Australian studies have found continuity of midwifery care to work well in rural areas. The aim of this study is to describe midwives' experiences of developing and working in a continuity of midwifery model of care in a rural setting in Sweden.
We used a qualitative longitudinal interview with a participatory action research approach. The project was subjected to changes over time to allow the midwives to provide the best care options and to develop a model suitable for a rural area in northern Sweden.
The overarching theme, 'Developing a continuity model of midwifery care - demanding and rewarding with new insights', was based on three themes: 1) A challenging but evolving start, 2) Varying views within the midwifery group, and 3) Visions for the future. It was revealed that the midwives had to handle the grief process of the closure of the labor ward alongside their enthusiasm of being part of a continuity of midwifery care model project.
The establishment of the model in light of the labor ward closure was associated with conflict within the community and this had implications for the midwives. Midwives who are attracted to work in continuity models need to understand and incorporate the prerequisites of such models. In addition, long commuting to a labor ward requires enough midwives to maintain safety and security for the women at all times.
当地产科病房的关闭增加了启动助产护理连续性模式项目的可能性。助产护理连续性模式是助产和以妇女为中心护理的基石，主要在大都市地区可用。澳大利亚的研究发现，助产护理连续性在农村地区效果良好。本研究的目的是描述瑞典农村地区助产士在助产护理连续性模式中发展和工作的经历。
我们采用了定性纵向访谈和参与式行动研究方法。该项目随着时间的推移而变化，以使助产士能够提供最佳护理选择，并开发出适合瑞典北部农村地区的模式。
总体主题“发展助产护理连续性模式——充满挑战且收获颇丰并带来新见解”基于三个主题：1）具有挑战性但不断发展的开端，2）助产士群体内部的不同观点，3）对未来的愿景。结果显示，助产士在参与助产护理连续性模式项目的热情之外，还必须应对产科病房关闭带来的悲伤过程。
鉴于产科病房关闭而建立该模式与社区内的冲突相关，这对助产士产生了影响。被吸引到连续性模式工作的助产士需要理解并纳入此类模式的先决条件。此外，长途通勤到产科病房需要足够的助产士，以始终为产妇维持安全保障。
