Chiba Yoko, Hayashi Risako, Kita Yuri, Takeshita Mai
Department of Nursing, Kyoto College of Nursing, 1-21 Mibu-higashitakada-cho Nakagyo-ku Kyoto, 604-8845, Japan.
Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Heliyon. 2023 Jul 27;9(8):e18747. doi: 10.1016/j.heliyon.2023.e18747. eCollection 2023 Aug.
We aimed to clarify the content of care provided by midwives working in hospitals and clinics in Japan and the unmet needs in midwifery care from mothers' perspectives.
This study employed a qualitative approach through semi-structured interviews.
Fifteen Japanese women, whose youngest singleton children were aged 12-18 months, were asked to recall their experiences with midwives, from pregnancy through the first postpartum year. Verbatim records were analyzed using thematic analysis.
Seven themes regarding the care provided by midwives were generated: confirmation of physical condition, maintenance and promotion of perinatal physiological process, support for better preparation for childbirth, assistance in labour and childbirth, support for a new life with a baby at home, support for the family, and care for comfort and confidence as a mother. Unmet needs were identified in all themes, except for 'confirmation of physical condition' and 'support for the family'. Ten subthemes, under the five themes of unmet needs, were integrated into three categories: midwives' responses to potential concerns, lack of continuity of care, and lack of personalised care.
Midwives in hospitals and clinics in Japan mainly provided care from pregnancy to one-month postpartum, in line with global core competencies. However, they could respond more effectively to the potential concerns of women, and provide continuous, personalised care more sufficiently. Improving working environments for midwives and collaborating with postpartum public health services are key to addressing these unmet needs of women, leading to women-centred care.
我们旨在阐明日本医院和诊所中助产士提供的护理内容，以及从母亲的角度来看助产士护理中未满足的需求。
本研究采用半结构化访谈的定性方法。
15名最小的单胎孩子年龄在12至18个月之间的日本女性被要求回忆她们从怀孕到产后第一年与助产士的经历。使用主题分析法对逐字记录进行分析。
产生了七个关于助产士提供护理的主题：身体状况确认、围产期生理过程的维持和促进、为分娩做好更好准备的支持、分娩协助、在家中与婴儿开启新生活的支持、对家庭的支持以及作为母亲的舒适和自信护理。除了“身体状况确认”和“对家庭的支持”这两个主题外，在所有主题中都发现了未满足的需求。在未满足需求的五个主题下的十个子主题被整合为三类：助产士对潜在担忧的回应、护理连续性的缺乏以及个性化护理的缺乏。
日本医院和诊所的助产士主要在怀孕至产后一个月期间提供护理，这与全球核心能力相符。然而，他们可以更有效地回应女性的潜在担忧，并更充分地提供持续的个性化护理。改善助产士的工作环境并与产后公共卫生服务合作是解决女性这些未满足需求的关键，从而实现以女性为中心的护理。
