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关系是成功的公共资助家庭分娩项目的关键,一项定性研究。

Relationships are the key to a successful publicly funded homebirth program, a qualitative study.

机构信息

School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia.

Western Health, Melbourne, Australia.

出版信息

Women Birth. 2023 Jul;36(4):377-384. doi: 10.1016/j.wombi.2022.12.005. Epub 2023 Jan 4.

Abstract

BACKGROUND

In Australia, publicly-funded homebirth is a relatively new option for women and their families. Two years after the inception of two publicly funded homebirth services in Victoria in 2009, a study found that midwives' experiences were more positive than doctors. There is no recent evidence on the perspectives of midwives and doctors of publicly-funded homebirth programs.

AIM

To explore the experiences of midwives and doctors participating in or supporting one publicly-funded homebirth program in Australia.

METHODS

An interpretive descriptive approach was used following individual in-depth interviews via 'Zoom'. Participants included midwives and doctors who provide or support the homebirth service at a large metropolitan health service in Melbourne's western suburbs. Data were thematically analysed.

FINDINGS

Interviews were conducted with 16 homebirth midwives, six hospital-based midwives, and nine doctors. One central theme and three sub-themes demonstrate that effective relationships are critical to a successful publicly-funded homebirth program. Collaboration, teamwork, and mutual respect across professions were reported to be integral to success. The midwife-woman relationship was highly valued and especially important to provide continuity during transfers to the hospital where this occurred.

DISCUSSION

Effective relationships underpin collaborative practice and are critical for safe healthcare. Shared common learning opportunities such as simulation training sessions and multi-professional forums to discuss cases were perceived to assist the development of these relationships.

CONCLUSION

Effective relationships within and between midwives and doctors are key to collaborative practice, which underpins a successful publicly-funded homebirth service. Health services can support this by maintaining a respectful and supportive culture amongst staff.

摘要

背景

在澳大利亚,为女性及其家庭提供公共资金资助的家庭分娩是一个相对较新的选择。在 2009 年维多利亚州设立两项公共资金资助的家庭分娩服务两年后,一项研究发现,助产士的经验比医生更积极。目前没有关于参与或支持澳大利亚公共资金资助的家庭分娩项目的助产士和医生观点的最新证据。

目的

探索参与或支持澳大利亚一个公共资金资助的家庭分娩项目的助产士和医生的经验。

方法

采用解释性描述方法,通过“Zoom”进行个人深入访谈。参与者包括在墨尔本西郊一家大型大都市卫生服务机构提供或支持家庭分娩服务的助产士和医生。对数据进行主题分析。

结果

对 16 名家庭分娩助产士、6 名医院助产士和 9 名医生进行了访谈。一个中心主题和三个子主题表明,有效的关系对于成功的公共资金资助的家庭分娩项目至关重要。跨专业的协作、团队合作和相互尊重被报告为成功的关键因素。助产士与妇女的关系受到高度重视,特别是在需要转移到医院的情况下,这对提供连续性非常重要。

讨论

有效的关系是协作实践的基础,对安全的医疗保健至关重要。共享共同的学习机会,如模拟培训课程和多专业论坛讨论病例,被认为有助于发展这些关系。

结论

助产士和医生之间和内部的有效关系是协作实践的关键,这是成功的公共资金资助的家庭分娩服务的基础。卫生服务机构可以通过在员工中保持尊重和支持的文化来支持这一点。

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