Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia.
Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia.
Women Birth. 2023 Sep;36(5):469-480. doi: 10.1016/j.wombi.2023.05.006. Epub 2023 Jul 3.
Little is known about midwives' views and wellbeing when working in an all-risk caseload model.
Between March 2017 and December 2020 three maternity services in Victoria, Australia implemented culturally responsive caseload models for women having a First Nations baby.
Explore the views, experiences and wellbeing of midwives working in an all-risk culturally responsive model for First Nations families compared to midwives in standard caseload models in the same services.
A survey was sent to all midwives in the culturally responsive (CR) model six-months and two years after commencement (or on exit), and to standard caseload (SC) midwives two years after the culturally responsive model commenced. Measures used included the Midwifery Process Questionnaire and Copenhagen Burnout Inventory (CBI).
35 caseload midwives (19 CR, 16 SC) participated. Both groups reported positive attitudes towards their professional role, trending towards higher median levels of satisfaction for the culturally responsive midwives. Midwives valued building close relationships with women and providing continuity of care. Around half reported difficulty maintaining work-life balance, however almost all preferred the flexible hours to shift work. All agreed that a reduced caseload is needed for an all-risk model and that supports around the model (e.g. nominated social workers, obstetricians) are important. Mean CBI scores showed no burnout in either group, with small numbers of individuals having burnout in both groups.
Midwives were highly satisfied working in both caseload models, but decreased caseloads and more organisational supports are needed in all-risk models.
在全风险病例管理模式下，助产士的观点和幸福感知之甚少。
2017 年 3 月至 2020 年 12 月，澳大利亚维多利亚州的三个产妇服务机构为生育第一民族婴儿的妇女实施了具有文化响应能力的病例管理模式。
探讨与同一服务中标准病例管理模式下的助产士相比，在全风险文化响应模式下为第一民族家庭工作的助产士的观点、经验和幸福感。
在文化响应（CR）模式启动六个月和两年后（或退出时）向所有 CR 模式的助产士发送了一份调查，在文化响应模式启动两年后向标准病例管理（SC）助产士发送了一份调查。使用的措施包括助产过程问卷和哥本哈根倦怠量表（CBI）。
35 名病例管理助产士（19 名 CR，16 名 SC）参与了研究。两组都对自己的专业角色持积极态度，文化响应型助产士的满意度呈上升趋势。助产士重视与妇女建立密切关系并提供连续性护理。大约一半的人报告说难以平衡工作和生活，但几乎所有人都更喜欢灵活的工作时间而不是轮班工作。所有人都同意，全风险模式需要减少病例数，并且该模式周围的支持（例如指定的社会工作者、产科医生）很重要。CBI 平均分数表明两组都没有倦怠，两组都有少数人出现倦怠。
助产士在两种病例管理模式下都非常满意，但全风险模式需要减少病例数和更多的组织支持。
