Beier Liesa, Thaqi Qendresa, Luyben Ans, Kimmich Nina, Naef Rahel
Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland.
Department of Medical Sciences, Private University in the Principality of Liechtenstein, Triesen, Liechtenstein.
Eur J Midwifery. 2024 Sep 24;8. doi: 10.18332/ejm/192696. eCollection 2024.
Effective collaborative practice between midwives and obstetricians improves patient safety and obstetrical outcomes, but its implementation remains challenging. Therefore, its determinants need to be better understood. This study examined factors impacting collaborative practice (CP) between these professional groups.
This study was a cross-sectional survey that took place in Swiss hospital labor wards in 2021. Collaborative practice perceptions of 70 midwives (57.4% response rate) and 44 obstetricians (29.0% response rate) were assessed using the Interprofessional Collaboration Scale, with the score serving as the main outcome. A total of 13 individual, behavioral, and organizational predictors were analyzed by multiple linear regression.
Participants rated collaborative practice with a median score of 3.1 (IQR: 2.8-3.4) out of a maximum score of 4.0. Results showed that five predictors significantly influenced collaborative practice: type of profession (β= -0.180; 95% CI: -0.296 - -0.040, p=0.011), trust/respect (β=0.343; 95% CI: 0.085-0.040, p=0.000), shared visions/goals (β=0.218; 95% CI: 0.030-0.204, p=0.009), workplace (β=0.253; 95% CI: 0.089-0.445, p=0.004) and shared power (β=0.163; 95% CI: 0.042-0.222, p=0.015). The model explained 66% of the variance (adjusted R2) in collaborative practice in labor wards.
This study has identified key factors influencing CP in Swiss labor wards: workplace characteristics that require tailored CP models, and a power-sharing culture that fosters trust, respectful interactions and shared goals, requiring active exchange between midwives and obstetricians.
助产士和产科医生之间有效的协作实践可提高患者安全性和产科结局，但实施起来仍具有挑战性。因此，需要更好地了解其决定因素。本研究调查了影响这些专业群体之间协作实践（CP）的因素。
本研究是一项横断面调查，于2021年在瑞士医院的分娩病房进行。使用跨专业协作量表评估了70名助产士（回复率57.4%）和44名产科医生（回复率29.0%）对协作实践的看法，得分作为主要结果。通过多元线性回归分析了总共13个个体、行为和组织预测因素。
参与者对协作实践的评分中位数为3.1（四分位距：2.8 - 3.4），满分是4.0。结果表明，五个预测因素对协作实践有显著影响：职业类型（β = -0.180；95%置信区间：-0.296 - -0.040，p = 0.011）、信任/尊重（β = 0.343；95%置信区间：0.085 - 0.040，p = 0.000）、共同愿景/目标（β = 0.218；95%置信区间：0.030 - 0.204，p = 0.009）、工作场所（β = 0.253；95%置信区间：0.089 - 0.445，p = 0.004）和权力共享（β = 0.163；95%置信区间：0.042 - 0.222，p = 0.015）。该模型解释了分娩病房协作实践中66%的方差（调整后的R2）。
本研究确定了影响瑞士分娩病房CP的关键因素：需要量身定制CP模式的工作场所特征，以及促进信任、相互尊重的互动和共同目标的权力共享文化，这需要助产士和产科医生之间积极交流。
