Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.
BMC Health Serv Res. 2023 Oct 19;23(1):1122. doi: 10.1186/s12913-023-10051-3.
Research shows that interventions to protect the sensitive physiological process of birth by improving the birthing room design may positively affect perinatal outcomes. It is, however, crucial to understand the mechanisms and contextual elements that influence the outcomes of such complex interventions. Hence, we aimed to explore care providers' experiences of the implementation of a new hospital birthing room designed to be more supportive of women's birth physiology.
This qualitative study reports on the implementation of the new birthing room, which was evaluated in the Room4Birth randomised controlled trial in Sweden. Individual interviews were undertaken with care providers, including assistant nurses, midwives, obstetricians, and managers (n = 21). A content analysis of interview data was conducted and mapped into the three domains of the Normalisation Process Theory coding manual: implementation context, mechanism, and outcome.
The implementation of the new room challenged the prevailing biomedical paradigm within the labour ward context and raised the care providers' awareness about the complex interplay between birth physiology and the environment. This awareness had the potential to encourage care providers to be more emotionally present, rather than to focus on monitoring practices. The new room also evoked a sense of insecurity due to its unfamiliar design, which acted as a barrier to integrating the room as a well-functioning part of everyday care practice.
Our findings highlight the disparity that existed between what care providers considered valuable for women during childbirth and their own requirements from the built environment based on their professional responsibilities. This identified disparity emphasises the importance of hospital birthing rooms (i) supporting women's emotions and birth physiology and (ii) being standardised to meet care providers' requirements for a functional work environment.
ClinicalTrials.gov: NCT03948815, 14/05/2019.
研究表明，通过改善分娩室设计来保护分娩这一敏感生理过程的干预措施可能会对围产期结局产生积极影响。然而，了解影响此类复杂干预措施结果的机制和背景因素至关重要。因此，我们旨在探讨护理人员在实施新的分娩室方面的经验，该分娩室旨在更支持女性的分娩生理。
本定性研究报告了新分娩室的实施情况，该实施情况在瑞典的 Room4Birth 随机对照试验中进行了评估。对包括助理护士、助产士、产科医生和管理人员在内的护理人员（n=21）进行了个人访谈。对访谈数据进行了内容分析，并映射到正常化进程理论编码手册的三个领域：实施背景、机制和结果。
新房间的实施挑战了分娩病房环境中占主导地位的生物医学模式，并提高了护理人员对分娩生理学与环境之间复杂相互作用的认识。这种认识有可能鼓励护理人员更加关注情感投入，而不是关注监测实践。新房间由于其不熟悉的设计也引起了不安全感，这成为将房间整合为日常护理实践的一个功能部分的障碍。
我们的研究结果强调了护理人员认为在分娩期间对女性有价值的东西与他们根据专业职责对建筑环境的要求之间存在差异。这种差异突出表明，医院分娩室需要满足以下要求：(i) 支持女性的情感和分娩生理；(ii) 标准化，以满足护理人员对功能工作环境的要求。
ClinicalTrials.gov：NCT03948815，2019 年 5 月 14 日。
