Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, The Netherlands.
Department of Obstetrics and Gynaecology, Erasmus MC, Room Wk-221, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Matern Child Health J. 2022 Mar;26(3):451-460. doi: 10.1007/s10995-021-03340-y. Epub 2022 Jan 9.
There has been increasing awareness of perinatal health and organisation of maternal and child health care in the Netherlands as a result of poor perinatal outcomes. Vulnerable women have a higher risk of these poor perinatal outcomes and also have a higher chance of receiving less adequate care. Therefore, within a consortium, embracing 100 organisations among professionals, educators, researchers, and policymakers, a joint aim was defined to support maternal and child health care professionals and social care professionals in providing adequate, integrated care for vulnerable pregnant women.
Within the consortium, vulnerability is defined as the presence of psychopathology, psychosocial problems, and/or substance use, combined with a lack of individual and/or social resources. Three studies focussing on population characteristics, organisation of care and knowledge, skills, and attitudes of professionals regarding vulnerable pregnant women, were carried out. Outcomes were discussed in three field consultations.
The outcomes of the studies, followed by the field consultations, resulted in a blueprint that was subsequently adapted to local operational care pathways in seven obstetric collaborations (organisational structures that consist of obstetricians of a single hospital and collaborating midwifery practices) and their collaborative partners. We conducted 12 interviews to evaluate the adaptation of the blueprint to local operational care pathways and its' embedding into the obstetric collaborations.
Practice-based research resulted in a blueprint tailored to the needs of maternal and child health care professionals and social care professionals and providing structure and uniformity to integrated care provision for vulnerable pregnant women.
由于围产期结局不佳，荷兰越来越重视围产期健康和母婴保健组织。弱势妇女发生这些不良围产期结局的风险更高，获得不充分保健的机会也更高。因此，在一个由 100 个专业人员、教育工作者、研究人员和政策制定者组成的联盟中，确定了一个共同目标，即为母婴保健专业人员和社会保健专业人员提供支持，以向弱势孕妇提供充分、综合的保健。
在该联盟中，弱势定义为存在精神病理学、社会心理问题和/或物质使用，同时缺乏个人和/或社会资源。开展了三项研究，重点关注人口特征、保健组织以及专业人员在弱势孕妇方面的知识、技能和态度。在三次实地咨询中讨论了结果。
对研究结果以及实地咨询进行讨论后，制定了蓝图，随后根据七个产科合作组织（由一家医院的产科医生和合作助产实践组成的组织结构）及其合作伙伴的当地运作护理途径进行了调整。我们进行了 12 次访谈，以评估蓝图对当地运作护理途径的调整及其在产科合作中的嵌入情况。
基于实践的研究产生了一份蓝图，根据母婴保健专业人员和社会保健专业人员的需求进行了调整，为弱势孕妇的综合保健提供了结构和一致性。
