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创伤后以跨专业合作和创伤知情围产期护理进行疗愈:一项定性案例研究。

Healing trauma with interprofessional collaboration and trauma-informed perinatal care: A qualitative case study.

机构信息

University of Alabama, Tuscaloosa, Alabama, USA.

Evidence in Motion, San Antonio, Texas, USA.

出版信息

Birth. 2023 Sep;50(3):525-534. doi: 10.1111/birt.12672. Epub 2022 Aug 29.

Abstract

BACKGROUND

The interprofessional education collaborative (IPEC) core competencies (CCs) describe standards for effective interprofessional health care practice and education; these standards are updated periodically based on stakeholder feedback. The purpose of this project was to use a qualitative case study approach to describe one multiparous birth trauma survivor's fifth birth experience with an interprofessional birth care team (IBCT) and to juxtapose her experiences and perspectives with the IPEC core competencies (IPEC CCs). This approach enabled us to identify strengths and gaps in the standards for interprofessional health care education and practice specific to perinatal care.

METHODS

One in-depth, open-ended, semi-structured interview was conducted to elicit the participant's fifth birth experience. Information from her previous births and the IPEC CCs was used to design the interview guide, and we used independent, deductive, consensus coding to identify themes from verbatim transcripts.

RESULTS

Three themes were identified: (a) Establishing a therapeutic patient-provider relationship; (b) Prioritizing communication, respect, and knowledge in person-centered care; and (c) Shared decision-making as the crux of collaborative care. The participant's narrative elevated person-centered, trauma-informed care (TIC) principles as critical to effective interprofessional birth care and as essential threads for the IPEC CCs.

CONCLUSIONS

One survivor's positive experience after prior birth trauma illustrates the critical role IPEC CCs may play in collaborative perinatal care provided by IBCTs. In our analysis, we also identify the need to explicitly incorporate TIC principles and person-centered language in health care competencies that support the standards for perinatal health care education and practice.

摘要

背景

跨专业教育合作(IPEC)核心能力(CCs)描述了有效的跨专业医疗保健实践和教育的标准;这些标准根据利益相关者的反馈定期更新。本项目的目的是使用定性案例研究方法来描述一位多产分娩创伤幸存者与跨专业分娩护理团队(IBCT)的第五次分娩经历,并将她的经历和观点与 IPEC 核心能力(IPEC CCs)进行对比。这种方法使我们能够确定围产期护理特定的跨专业医疗保健教育和实践标准的优势和差距。

方法

进行了一次深入的、开放式的、半结构化访谈,以引出参与者的第五次分娩经历。她之前分娩的信息和 IPEC CCs 被用来设计访谈指南,我们使用独立的、演绎的、共识编码来从逐字记录中识别主题。

结果

确定了三个主题:(a)建立治疗性的医患关系;(b)在以人为中心的护理中优先考虑沟通、尊重和知识;(c)共同决策是协作护理的核心。参与者的叙述提升了以人为本、以创伤为中心的护理(TIC)原则,认为这是有效的跨专业分娩护理的关键,也是 IPEC CCs 的重要线索。

结论

一位幸存者在先前分娩创伤后的积极经历说明了 IPEC CCs 在 IBCT 提供的协作围产期护理中可能发挥的关键作用。在我们的分析中,我们还确定了在支持围产期保健教育和实践标准的医疗保健能力中明确纳入 TIC 原则和以人为本语言的必要性。

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