助产士和产妇支持工作者对 COVID-19 大流行第一年对英国多元化地区尊重产妇护理影响的看法：一项定性研究。
Midwives' and maternity support workers' perceptions of the impact of the first year of the COVID-19 pandemic on respectful maternity care in a diverse region of the UK: a qualitative study.
机构信息
College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Department of Obstetrics and Gynaecology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
出版信息
BMJ Open. 2022 Sep 20;12(9):e064731. doi: 10.1136/bmjopen-2022-064731.
OBJECTIVES
To explore midwives' and maternity support workers' perceptions of the impact of the COVID-19 pandemic on maternity services and understand factors influencing respectful maternity care.
DESIGN
A qualitative study. Eleven semistructured interviews were conducted (on Zoom) and thematically analysed. Inductive themes were developed and compared with components of respectful maternity care.
SETTING
Maternity services in a diverse region of the United Kingdom.
PARTICIPANTS
Midwives and maternity support workers who worked during the first year of the COVID-19 pandemic.
RESULTS
The findings offer insights into the experiences and challenges faced by midwives and maternity support workers during the first year of the COVID-19 pandemic in the UK (March 2020-2021). Three core themes were interpreted that impacted respectful maternity care: (1) communication of care, (2) clinical care and (3) support for families. 1. Midwives and maternity support workers felt changing guidance impaired communication of accurate information. However, women attending appointments alone encouraged safeguarding disclosures. 2. Maternity staffing pressures worsened and delayed care provision. The health service's COVID-19 response was thought to have discouraged women's engagement with maternity care. 3. Social support for women was reduced and overstretched staff struggled to fill this role. The continuity of carer model of midwifery facilitated supportive care. COVID-19 restrictions separated families and were considered detrimental to parents' mental health and newborn bonding. Overall, comparison of interview quotes to components of respectful maternity care showed challenges during the early COVID-19 pandemic in upholding each of the 10 rights afforded to women and newborns.
CONCLUSIONS
Respectful maternity care was impacted through changes in communication, delivery of clinical care and restrictions on social support for women and their infants in the first year of the COVID-19 pandemic. Future guidance for pandemic scenarios must make careful consideration of women's and newborns' rights to respectful maternity care.
目的
探讨助产士和产妇支持工作者对 COVID-19 大流行对产妇服务的影响的看法，并了解影响尊重产妇护理的因素。
设计
定性研究。对 11 名半结构化访谈（通过 Zoom 进行）进行了主题分析。发展了归纳主题，并将其与尊重产妇护理的组成部分进行了比较。
地点
英国一个多样化地区的产妇服务。
参与者
在 COVID-19 大流行的第一年（2020 年 3 月至 2021 年）工作的助产士和产妇支持工作者。
结果
这些发现深入了解了英国 COVID-19 大流行第一年（2020 年 3 月至 2021 年）期间助产士和产妇支持工作者的经历和面临的挑战。解释了三个核心主题，这些主题影响了尊重产妇护理：（1）护理沟通，（2）临床护理，（3）家庭支持。1. 助产士和产妇支持工作者认为，指导方针的改变阻碍了准确信息的沟通。但是，独自参加预约的妇女鼓励了安全披露。2. 产妇人员配备压力加大，护理提供延迟。卫生服务部门对 COVID-19 的反应被认为阻碍了妇女参与产妇护理。3. 妇女的社会支持减少，人员紧张的工作人员难以填补这一角色。助产士的连续护理模式促进了支持性护理。COVID-19 限制使家庭分离，并被认为对父母的心理健康和新生儿的联系有害。总的来说，将访谈引述与尊重产妇护理的组成部分进行比较表明，在 COVID-19 大流行的早期阶段，在维护赋予妇女和新生儿的 10 项权利方面存在挑战。
结论
在 COVID-19 大流行的第一年，沟通方式的改变、临床护理的提供以及对妇女及其婴儿的社会支持的限制，影响了尊重产妇护理。未来针对大流行情况的指导必须仔细考虑妇女和新生儿获得尊重产妇护理的权利。
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