Department of Public Health, Vrije Universiteit Brussel (VUB), Jette, Belgium; Department of Nursing and Midwifery Research Group (NUMID), Universitair Ziekenhuis Brussel (UZ Brussel), Jette, Belgium.
Department of Public Health, Vrije Universiteit Brussel (VUB), Jette, Belgium; Department of Nursing and Midwifery Research Group (NUMID), Universitair Ziekenhuis Brussel (UZ Brussel), Jette, Belgium.
Midwifery. 2024 Dec;139:104166. doi: 10.1016/j.midw.2024.104166. Epub 2024 Aug 30.
Despite increasing interest in Group Care worldwide, implementation is challenging.
Group Care is an evidence-based perinatal care model including three core components: health assessment, interactive learning, and community building. It has several advantages for service users and providers compared to individual perinatal care.
We aimed to identify anticipated challenges when implementing Group Care, and to develop a supporting tool based on these challenges.
Context analyses through Rapid Qualitative Inquiries were conducted in 26 sites in seven countries to gain insight into the anticipated challenges when implementing Group Care. Data triangulation and investigator triangulation were applied. The context analyses generated 330 semi-structured interviews with service users and other stakeholders, 10 focus group discussions, and 56 review meetings with the research teams.
We identified six surface structure anticipated challenges categories (content, materials, facilitators, timing, location, group composition), and five deep structure anticipated challenges categories (health assessment, scheduling Group Care into regular care, enrolment, (possible) partner organisations, financials) occurring in all participating sites, leading to the development of the Anticipated Challenges Framework.
Completing the Anticipated Challenges Framework raises awareness of anticipated challenges if sustainable Group Care implementation is to succeed and encourages the initiation of a concrete action plan to tackle these challenges. Application of the framework may offer important insights to health systems administrators and other key stakeholders before implementing Group Care. In the medium- and long-term, insights gained may lead to greater possibilities for sustainability and to the most cost-effective approaches for implementing Group Care.
尽管全球对团体护理的兴趣日益增加，但实施仍具有挑战性。
团体护理是一种循证围产期护理模式，包括三个核心组成部分：健康评估、互动式学习和社区建设。与个体围产期护理相比，它对服务使用者和提供者具有多项优势。
我们旨在确定实施团体护理时预期会遇到的挑战，并基于这些挑战开发一种支持工具。
在七个国家的 26 个地点进行了快速定性调查的情境分析，以深入了解实施团体护理时预期会遇到的挑战。应用了数据三角剖分和调查员三角剖分。情境分析生成了 330 次与服务使用者和其他利益相关者的半结构化访谈、10 次焦点小组讨论和 56 次与研究团队的审查会议。
我们确定了六个表层结构预期挑战类别（内容、材料、促进者、时间安排、地点、群体组成）和五个深层结构预期挑战类别（健康评估、将团体护理纳入常规护理、登记、（可能的）伙伴组织、财务），这些类别在所有参与的地点都存在，导致了预期挑战框架的发展。
如果要成功实现可持续的团体护理实施，完成预期挑战框架可以提高对预期挑战的认识，并鼓励制定具体的行动计划来应对这些挑战。在实施团体护理之前，框架的应用可能会为卫生系统管理者和其他利益相关者提供重要的见解。从中长期来看，获得的见解可能会为可持续性和实施团体护理的最具成本效益的方法带来更大的可能性。
