Ängeby Karin, Ternström Elin
Women's Department and Centre for Clinical Research Education, County Council of Värmland, Karlstad, Sweden.
School of Health and Welfare, Dalarna University, Falun, Sweden.
Eur J Midwifery. 2024 Feb 19;8. doi: 10.18332/ejm/176698. eCollection 2024.
Positive birth experiences can be a decisive factor in the well-being and future health of both women and their newborns. The quality of care is a multidimensional concept influenced by the external structure of the organization, the administrative qualities of the environment, and the individual patient's preferences about care. The aim was to describe women's preferences and experiences concerning support and treatment, and their perception of quality of care during all phases of labor and the postnatal period.
Free-text comments of 635 women from four different open comment questions were analyzed. A qualitative content analysis was conducted in two steps: an inductive phase followed by a deductive phase using the Quality of care from a Patient's Perspective framework (QPP).
A total of 1148 free-text comments were coded; and 10 sub-categories were created and inserted under the QPP framework covering the latent meaning of the sub-category. Five of the sub-categories were sorted under the identity-oriented approach, four under physical-technical conditions, and one under the sociocultural atmosphere and reflected the women's experiences and needs regarding support and treatment during early labor, the active phase of labor, and the postnatal period.
High-quality care and support are important aspects for women during childbirth, irrespective of the phase of labor or postnatal period. The need for individualized care, active participation in one's own birth and using a family centered approach were also emphasized. Organizational factors influenced the quality of care and were particularly noticeable during birth.
积极的分娩体验可能是影响女性及其新生儿幸福感和未来健康的决定性因素。护理质量是一个多维度概念,受组织的外部结构、环境的管理特质以及个体患者对护理的偏好影响。目的是描述女性在分娩各阶段及产后对支持和治疗的偏好与体验,以及她们对护理质量的认知。
分析了来自四个不同开放式评论问题的635名女性的自由文本评论。采用定性内容分析法分两步进行:归纳阶段,随后使用患者视角的护理质量框架(QPP)进行演绎阶段。
共对1148条自由文本评论进行了编码;创建了10个子类别,并将其纳入QPP框架,涵盖子类别潜在含义。其中5个子类别归类于身份导向方法,4个归类于物理技术条件,1个归类于社会文化氛围,反映了女性在分娩早期、活跃期及产后对支持和治疗的体验与需求。
无论分娩阶段或产后时期如何,高质量护理和支持对女性分娩过程都很重要。还强调了个性化护理、积极参与自身分娩过程以及采用以家庭为中心方法的必要性。组织因素影响护理质量,在分娩期间尤为明显。