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[法国自由职业助产士在新冠疫情危机期间的远程会诊经验]

[Experiences of teleconsultation by French liberal midwives during the COVID-19 crisis].

作者信息

Baumann Sophie, Gaucher Laurent, Mahrez Inès, Gautier Sylvain, Rousseau Anne

机构信息

Université de Versailles – Saint-Quentin-en-Yvelines – UFR Simone-Veil Santé – Montigny-le-Bretonneux – France.

Geneva School of Health Sciences – University of Applied Sciences – Genève – Suisse. Inserm U1290 – Université Claude-Bernard Lyon 1 – Lyon – France.

出版信息

Sante Publique. 2022;34(6):821-832. doi: 10.3917/spub.226.0821.

Abstract

CONTEXT

In the context of the COVID-19 pandemic, the French government has authorized the practice of teleconsultations for midwives since March 20th. A questionnaire survey of 1491 liberal midwives reported that 88.5% of them had implemented this practice. We therefore wished to explore their motivations and the way in which they have integrated this new practice modality into their practice.

METHODS

We conducted 22 semi-structured interviews with liberal midwives who had implemented teleconsultations since their authorization. The study was conducted between May and July 2020 and ended when saturation of the results was reached. A content analysis was used to identify recurrences and exceptions in the discourse.

RESULTS

The main motivations of the liberal midwives for offering teleconsultations were to maintain access to care for women and their own professional activity. They pointed to a number of limitations, including the issue of professional secrecy and guaranteed confidentiality, and inequality of access to care in relation to the digital divide. The integration of teleconsultation into their practice has made it possible to highlight and enhance the support work carried out by midwives, which until now has not been very visible or recognized.

CONCLUSION

Midwives quickly adopted teleconsultations, which have been made permanent since the confinement. This tool helps to ensure continuity of care but also raises new questions about equal access to care.

摘要

背景

在新冠疫情背景下,自3月20日起法国政府已授权助产士进行远程会诊。一项针对1491名自由职业助产士的问卷调查显示,其中88.5%的人已实施了这种做法。因此,我们希望探究她们的动机以及将这种新的诊疗方式融入其实践的方式。

方法

我们对自获得授权以来就实施远程会诊的自由职业助产士进行了22次半结构化访谈。该研究于2020年5月至7月进行,在结果达到饱和时结束。采用内容分析法来识别话语中的重复内容和例外情况。

结果

自由职业助产士提供远程会诊的主要动机是保持妇女获得护理的机会以及她们自身的专业活动。她们指出了一些限制,包括职业保密和保证机密性的问题,以及与数字鸿沟相关的护理可及性不平等问题。将远程会诊融入她们的实践使得助产士所开展的支持工作得以凸显和加强,而在此之前这项工作一直不太明显或未得到认可。

结论

助产士迅速采用了远程会诊,自居家隔离以来这一做法已成为常态。这个工具有助于确保护理的连续性,但也引发了关于护理平等可及性的新问题。

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