School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
School of Nursing and Midwifery Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; College of Nursing and Midwifery Charles Darwin University, 815 George Street Haymarket, NSW 2000, Australia.
Midwifery. 2021 Jul;98:102986. doi: 10.1016/j.midw.2021.102986. Epub 2021 Mar 11.
Although midwifery-led continuity of care is associated with superior outcomes for mothers and babies, it is not available to all women. Issues with implementation and sustainability might be addressed by improving how it is led and managed - yet little is known about what constitutes the optimal leadership and management of midwifery-led continuity models.
Following a systematic search of academic databases for relevant publications, 25 publications were identified. These were analysed, thematically to clarify (dis)similar themes, and lexically, to clarify how words within the publications travelled together.
The publications were replete with three key themes. First, leadership - important yet challenged. Second, management of organisational change; barriers and enhancers. Third, promotors of sustainable models of care. Complementarily, the lexical analysis suggests that references to midwives and leadership among the publications did not typically travel together, as reported in the publications and were distant to one another, although management was inter-connected to both and to change. Leadership and management were not closely coupled with midwives or relationships with women.
Midwifery leadership matters and can be enacted irrespective of position or seniority. Midwifery-led continuity of care models can be better managed via a multipronged approach. Improved leadership and management can help sustain such care. Although there was a perceived need for midwifery leadership, there did not seem to be an association between leadership and midwives in the lexical analysis. Many publications focused on the style theory of leadership and the transformational style theory.
Instead of focusing on leaders and the presumption of a leadership scarcity, it might be more beneficial to start focusing within, looking with a new lens on leadership within midwifery at all levels. It might also be constructive for the profession to investigate a more progressive form of leadership, one that is relational and focuses on leadership rather than on the leader.
尽管助产士主导的连续性护理与母婴的更好结果相关，但并非所有妇女都能获得。通过改进其领导和管理方式，可能会解决实施和可持续性方面的问题——然而，对于助产士主导的连续性模式的最佳领导和管理方式，人们知之甚少。
在对相关出版物的学术数据库进行系统搜索后，确定了 25 篇出版物。对这些出版物进行了分析，通过主题分析来澄清（不）相似的主题，并通过词汇分析来澄清出版物中词汇之间的相互关系。
这些出版物充满了三个关键主题。首先，领导力——重要但具有挑战性。其次，组织变革的管理；障碍和促进因素。第三，促进可持续护理模式。此外，词汇分析表明，出版物中对助产士和领导力的提及通常不会像出版物中所报告的那样一起出现，而且彼此之间相距甚远，尽管管理与两者以及变革相互关联。领导力和管理与助产士或与妇女的关系没有紧密结合。
助产士的领导力很重要，可以在没有职位或级别限制的情况下发挥作用。可以通过多管齐下的方法更好地管理助产士主导的连续性护理模式。提高领导力和管理能力有助于维持这种护理。尽管人们认为需要助产士的领导力，但词汇分析似乎并没有将领导力与助产士联系起来。许多出版物侧重于领导风格理论和变革型领导风格理论。
与其关注领导者和领导力稀缺的假设，不如开始关注内部，用新的视角审视各级助产士的领导力。对于该专业来说，调查一种更具进步性的领导方式，一种关注领导力而不是领导者的领导方式，可能也具有建设性。
