HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Delémont, Switzerland.
Geneva University Hospitals and University of Geneva Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, Geneva, Switzerland.
PLoS One. 2023 Jul 5;18(7):e0286852. doi: 10.1371/journal.pone.0286852. eCollection 2023.
Inspired by the six quality-of-care goals developed by the Institute of Medicine, woman-centred care (WCC) as model of care is used in maternity services as it gives an emphasis on the woman as an individual and not her status as a patient. Bringing stronger attention to women's needs and values, is proven to have clear benefits for perinatal outcomes, but fails to be known or recognised by healthcare professionals' (HCPs) and implemented. Using a mixed-methods approach, this study aimed to explore HCPs definitions of WCC and identify the degree of agreement and knowledge regarding perinatal indicators when a WCC model of care is implemented. The quantitative part was carried using a self-administered questionnaire with perinatal indicators identified from the literature. Semi-structured interviews were realized using a purposive sample of 15 HCPs and an interview grid inspired by Leap's WCC model. The study was conducted in the maternity of a university hospital in French-speaking part of Switzerland. Out of 318 HCPs working with mothers and their newborns, 51% had already heard of WCC without being familiar with Leap's model. The HCPs were aware of the positive perinatal care outcomes when WCC was implemented: women's satisfaction (99.2%), health promotion (97.6%), HCP's job satisfaction (93.2%) and positive feelings about their work (85.6%), which were strongly emphasised in the interviews. The respondents reported institutional difficulties in implementing the model such as administrative overload and lack of time. The positive outcomes of WCC on spontaneous deliveries and improved neonatal adaptation were known by most HCPs (63.4% and 59.9%, respectively). However, fewer than half of the HCPs highlighted the model's positive effects on analgesia and episiotomies or its financial benefits. Knowledge of quality-of-care outcomes (i.e women's satisfaction, positive impact on practice…) was prevalent among most of HCPs. Without adhering to a common definition and without a specific model for consensus, most providers have integrated some aspects of WCC into their practice. However, specific perinatal indicators remain largely unknown, which may hinder the implementation of WCC.
受美国医学研究所提出的六项护理质量目标的启发，以妇女为中心的护理（WCC）作为一种护理模式，在产科服务中得到了应用，因为它强调了妇女作为个体的身份，而不是她作为患者的身份。更加关注妇女的需求和价值观，已被证明对围产期结局有明显的益处，但未能得到医护人员（HCPs）的了解或认可，也未能付诸实施。本研究采用混合方法，旨在探讨 HCPs 对 WCC 的定义，并确定在实施以妇女为中心的护理模式时，对围产期指标的认同和了解程度。定量部分采用了一种自我管理问卷，其中的围产期指标是从文献中确定的。半结构化访谈采用目的抽样法，对 15 名 HCPs 进行访谈，并使用 Leap 的 WCC 模型作为访谈提纲。该研究在瑞士法语区的一所大学医院的产科进行。在与母亲及其新生儿一起工作的 318 名 HCPs 中，有 51%的人听说过 WCC，但并不熟悉 Leap 的模式。HCPs 意识到实施 WCC 时会产生积极的围产期护理结果：妇女满意度（99.2%）、促进健康（97.6%）、HCP 工作满意度（93.2%）和对工作的积极感受（85.6%），这些在访谈中被强烈强调。受访者报告了在实施该模式时遇到的机构困难，如行政负担过重和缺乏时间。大多数 HCPs（分别为 63.4%和 59.9%）了解 WCC 对自然分娩和新生儿适应的积极影响。然而，不到一半的 HCPs 强调了该模式对镇痛和会阴切开术的积极影响，或其经济效益。大多数 HCPs 都了解护理质量结果（即妇女满意度、对实践的积极影响……）。大多数提供者没有遵循共同的定义，也没有达成共识的特定模式，而是将 WCC 的某些方面融入到他们的实践中。然而，具体的围产期指标仍然知之甚少，这可能会阻碍 WCC 的实施。
