Erasmus MC, University Medical Centre Rotterdam, Department of Obstetrics and Gynaecology, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
Erasmus MC, University Medical Centre Rotterdam, Department of Obstetrics and Gynaecology, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Research Agency Care2Research, Niasstraat 7, 1095 TS, Amsterdam, the Netherlands.
Midwifery. 2022 Apr;107:103274. doi: 10.1016/j.midw.2022.103274. Epub 2022 Feb 8.
To explore healthcare providers' views on improving preconception care in their region.
Mixed-methods study.
Working conferences aimed to educate healthcare providers on preconceptional risk factors and conduct a region-specific analysis of barriers and facilitators for implementing preconception care, were organised in ten municipalities in the Netherlands.
250 healthcare providers of various disciplines attended a working conference and participated in the study.
Participants were asked to both fill out a questionnaire concerning statements and experiences with preconception care and to participate in a workshop, to identify barriers and facilitators for the implementation of a local preconception care program. Almost all healthcare providers suggested that the responsibility for providing preconception care consultations lies within primary care (general practitioners (n = 239; 95.6%) and midwives (n = 236; 94.4%)). Professionals other than midwives found it significantly more difficult to start a conversation about a wish to conceive compared to midwives (26.8% versus 20.2%, p-value = 0.006) and felt less competent to provide preconceptional information (32.3% versus 15.1%, p-value = <0.001). Innovative facilitators were mentioned to improve reaching the target population with preconceptional information, i.e. the use of social media and local ambassadors.
While the responsibility for providing preconception care consultations is best suited with primary care, many other healthcare providers involved may act as referrers towards preconception care. Still, approximately 1 in 7 midwives (strongly) disagree with the statement that it is part of their job to provide preconceptional information to couples with a wish to conceive.
There is a need for integrating preconception care in many curricula and postgraduate courses, especially for non-midwives, to improve the delivery of preconception care. Insights in the suggested barriers and facilitators can improve the implementation of (local) preconception care programs.
探讨医疗保健提供者对改善本地区孕前保健的看法。
混合方法研究。
在荷兰的十个城市组织了旨在为医疗保健提供者提供关于孕前风险因素的教育，并对实施孕前保健的障碍和促进因素进行区域特定分析的工作会议。
250 名来自不同学科的医疗保健提供者参加了工作会议并参与了研究。
要求参与者填写一份关于孕前保健的陈述和经验的问卷，并参加一个研讨会，以确定实施当地孕前保健计划的障碍和促进因素。几乎所有医疗保健提供者都认为提供孕前保健咨询的责任在于初级保健（全科医生（n=239；95.6%）和助产士（n=236；94.4%））。除了助产士之外的专业人员发现与助产士相比，更难就怀孕愿望开始对话（26.8%对 20.2%，p 值=0.006），并且觉得提供孕前信息的能力较低（32.3%对 15.1%，p 值<0.001）。为了提高将孕前信息传递给目标人群的效果，提出了一些创新的促进因素，例如使用社交媒体和当地的宣传大使。
虽然提供孕前保健咨询的责任最适合初级保健，但许多其他参与的医疗保健提供者可以充当孕前保健的转诊人。尽管如此，大约每 7 名助产士中就有 1 名（强烈）不同意提供孕前信息是他们工作的一部分的说法。
需要将孕前保健纳入许多课程和研究生课程中，特别是对于非助产士而言，以改善孕前保健的提供。对建议的障碍和促进因素的了解可以改善（地方）孕前保健计划的实施。
