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寻找共同工作的方式:对实施和促进多学科和公平导向的群体妊娠护理模式以照顾难民背景的妇女的反思。

Finding our own ways of working together: reflections on implementing and facilitating a multidisciplinary and equity-oriented model of Group Pregnancy Care for women of refugee background.

机构信息

Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia.

Murdoch Children's Research Institute, Intergenerational Health, 50 Flemington Rd, Parkville, VIC, 3052, Australia.

出版信息

Midwifery. 2023 Aug;123:103709. doi: 10.1016/j.midw.2023.103709. Epub 2023 May 9.

Abstract

OBJECTIVE

This paper explores professional staff experiences of implementing and facilitating a multidisciplinary equity-oriented model of Group Pregnancy Care for women of refugee background. This model was the first of its kind in Australia and one of the first worldwide.

DESIGN AND SETTING

This exploratory descriptive qualitative study reports the process evaluation findings from the formative evaluation of Group Pregnancy Care for women of refugee background. Data were collected in Melbourne, Australia between January and March 2021 via semi-structured interviews, and analysed using reflexive thematic analysis.

PARTICIPANTS

Purposive sampling was used to recruit twenty-three professional staff involved in the implementation, facilitation, or oversight of Group Pregnancy Care.

FINDINGS

This paper reports five themes: knowledge sharing, bicultural family mentors - the critical link, finding our own ways of working together, power dynamics at the intersection of community and clinical knowledge, and system capacity for change.

KEY CONCLUSIONS

The bicultural family mentor role contributes to the cultural safety of the group, and increases the confidence and competence of professional staff through cultural bridging. Multidisciplinary cross-sector teams that collaborate well can provide cohesive care. It is possible for hospital and community-based services to establish cross-sector equity-oriented partnerships. However, there are challenges sustaining partnerships in the absence of explicit funding to support collaboration, and in context of organisational and professional inflexibility.

IMPLICATIONS FOR PRACTICE

Investing in change is necessary to achieve health equity. Creating explicit funding pathways for the bicultural family mentor workforce, multidisciplinary collaboration, and cross-sector partnerships would strengthen service capacity to provide equity-oriented care. Working towards health equity also requires a commitment to continuing professional development for professional staff and organisations to increase knowledge and capacity.

摘要

目的

本文探讨了专业人员在实施和促进以多学科为导向的面向难民背景女性的团体妊娠护理模式方面的经验。该模式在澳大利亚尚属首例,在全球范围内也属首例。

设计与设置

本探索性描述性定性研究报告了针对难民背景女性团体妊娠护理的形成性评估的过程评估结果。数据于 2021 年 1 月至 3 月期间在澳大利亚墨尔本通过半结构化访谈收集,并使用反思性主题分析进行分析。

参与者

采用目的性抽样招募了 23 名参与团体妊娠护理的实施、促进或监督工作的专业人员。

发现

本文报告了五个主题:知识共享、双语家庭导师——关键纽带、寻找我们自己的合作方式、社区和临床知识交汇处的权力动态以及系统变革能力。

主要结论

双语家庭导师角色有助于团体的文化安全,并通过文化桥梁提高专业人员的信心和能力。能够很好地协作的多学科跨部门团队可以提供凝聚力的护理。医院和社区服务机构可以建立跨部门以公平为导向的伙伴关系。然而,在缺乏明确资金支持合作以及组织和专业灵活性不足的情况下,维持伙伴关系存在挑战。

实践意义

为实现健康公平而进行投资是必要的。为双语家庭导师劳动力、多学科合作和跨部门伙伴关系创造明确的资金途径将增强服务能力,提供公平导向的护理。为实现健康公平,还需要承诺为专业人员和组织提供持续的专业发展,以增加知识和能力。

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