Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6523 GA, Nijmegen, the Netherlands.
BMC Health Serv Res. 2021 Nov 13;21(1):1233. doi: 10.1186/s12913-021-07269-4.
In the past decade, acute obstetric care (AOC) has become centralised in many high-income countries. In this qualitative study, we explored how stakeholders in maternity care perceived and experienced adaptations in the organisation of maternity care in areas in the Netherlands where AOC was centralised.
A heterogenic group of fifteen maternity care stakeholders, including patients, were purposively selected for semi-structured interviews. An inductive thematic analysis was used.
Three main themes were identified: (1) lack of involvement. (2) the process of making adaptations in the organisation of maternity care. (3) maintaining quality of care. Stakeholders in this study were highly motivated to maintain a high quality of maternity care and therefore made adaptations at several organisational levels. However, they felt a lack of involvement during the planning of centralisation of AOC and highlighted the importance of a collaborative process when making adaptations after centralisation of AOC.
Regions with AOC centralisation plans should invest time and money in change management, encourage early involvement of all maternity care stakeholders and acknowledge centralisation of AOC as a professional life event with associated emotions, including a feeling of unsafety.
在过去的十年中，许多高收入国家的产科急症护理（AOC）已经集中化。在这项定性研究中，我们探讨了在荷兰的产科急症护理集中化的地区，产妇护理利益相关者如何感知和体验产妇护理组织的适应性变化。
采用半结构式访谈，有目的地选择了十五名不同背景的产妇护理利益相关者，包括患者。采用归纳主题分析方法。
确定了三个主要主题：（1）缺乏参与感。（2）组织产科护理适应的过程。（3）维持护理质量。本研究的利益相关者非常有动力保持高质量的产妇护理，因此在几个组织层面上进行了适应性调整。然而，他们感到在 AOC 集中化的规划过程中缺乏参与，并强调在 AOC 集中化后进行适应性调整时，协作过程的重要性。
有 AOC 集中化计划的地区应该投入时间和资金进行变革管理，鼓励所有产妇护理利益相关者尽早参与，并承认 AOC 的集中化是一个与情绪相关的职业生活事件，包括不安全的感觉。
