Lundgren Ingela, Dencker Anna, Berg Marie, Nilsson Christina, Bergqvist Liselotte, Ólafsdóttir Ólöf-Ásta
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur J Midwifery. 2022 Apr 1;6:16. doi: 10.18332/ejm/146084. eCollection 2022.
Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice.
A mixed method study based on an implementation of MiMo was carried out in a labor ward at a university hospital in Sweden, with another labor ward as a reference. The qualitative core component was a secondary analysis of focus groups with midwives after the implementation. The supplemental quantitative components were oxytocin use for augmentation of labor and women's childbirth experiences before and after the implementation.
The midwives viewed MiMo as a useful tool for comprehending the birthing woman holistically, and for identifying what might disturb the birth process. Hindering factors were a lack of organizational stability and time, and midwives' unwillingness to understand the model. Oxytocin use decreased significantly only in the implementation ward (p=0.002) and a significant difference was found between wards in the post-implementation period (p=0.004). However, logistic regression analyses showed that the interaction between ward and time period, controlling for age, epidural use, and birth outcome, was not significant (p=0.304), indicating that the decrease was not significantly related to the implementation. Childbirth experience did not differ before and after the implementation.
By using MiMo in practice, midwives have a tool for comprehending the woman holistically and identifying disturbing factors during the birth. However, more research is needed for further implementation that should focus on the potential as well as hindering factors.
不同国家已开发出助产模式的理论模型，但很少有模型得到评估。本研究评估了以妇女为中心的助产护理模式（MiMo）在实际中的实施情况。
在瑞典一家大学医院的产房开展了一项基于MiMo实施情况的混合方法研究，另一个产房作为对照。定性核心部分是对实施后助产士焦点小组讨论的二次分析。补充定量部分是实施前后催产素用于引产的情况以及产妇的分娩体验。
助产士认为MiMo是全面理解产妇以及识别可能干扰分娩过程因素的有用工具。阻碍因素包括缺乏组织稳定性和时间，以及助产士不愿理解该模式。仅在实施病房催产素使用显著减少（p = 0.002），且在实施后两个病房之间存在显著差异（p = 0.004）。然而，逻辑回归分析表明，在控制年龄、硬膜外麻醉使用和分娩结局后，病房与时间段之间的交互作用不显著（p = 0.304），这表明减少情况与实施并无显著关联。实施前后分娩体验没有差异。
在实践中使用MiMo，助产士有了全面理解产妇和识别分娩过程中干扰因素的工具。然而，需要更多研究以进一步实施，应关注潜在因素和阻碍因素。
