德语国家 COVID-19 大流行期间孕产妇和新生儿护理质量的女性感知：来自 IMAgiNE EURO 项目的研究结果，比较了德国、瑞士和奥地利的数据。
Women 's perception on the quality of maternal and newborn care during the COVID-19 pandemic in German-speaking countries: Findings from the IMAgiNE EURO project comparing data from Germany, Switzerland and Austria.
机构信息
Research Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
Research Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
出版信息
Midwifery. 2025 Jan;140:104209. doi: 10.1016/j.midw.2024.104209. Epub 2024 Oct 11.
PROBLEM
Restrictions during the COVID-19 pandemic compromised maternal and newborn care.
BACKGROUND
Countries in the German speaking area share several clinical care guidelines but differed significantly in the strictness of COVID-19 protective measures.
AIM
To investigate the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic in the German-speaking area and explore associations between the reorganisational changes due to COVID-19 and QMNC, as described with WHO Standards-based Quality Measures.
METHODS
As part of the IMAgiNE EURO study (ClinicalTrials.gov: NCT04847336), we conducted an online survey on the QMNC in the German-speaking area, including women who gave birth in Germany, Switzerland, and Austria. Descriptive statistics, Spearman rank correlation coefficient and multivariable quantile regression were used.
FINDINGS
Out of a total of 70,721 women accessing the online questionnaire, 1,875 were included (Germany: n = 1,053, Switzerland: n = 494, Austria: n = 328). Significant differences across countries were found in Quality Measures. In Switzerland, women scored Quality Measures more favourable than in Germany and Austria in all four sub-indexes of QMNC. In Austria, Quality Measures gaps in the sub-index 'Experience of care' were higher. The sub-index 'Reorganisational changes due to COVID-19' correlated weakly to strongly with the other sub-indexes (between r = 0.33 and r = 0.62, p < 0.001 for all correlations).
DISCUSSION
Midwives and other health professional should pay particular attention to the provision of respectful, high-quality care.
CONCLUSION
To effectively improve QMNC, further research is essential to monitor the quality of care and develop targeted interventions beyond the COVID-19 pandemic addressing inherent challenges in the organisation and delivery of care.
问题
COVID-19 大流行期间的限制措施损害了母婴保健。
背景
德语区国家有几个共同的临床护理指南，但 COVID-19 保护措施的严格程度有很大差异。
目的
调查 COVID-19 大流行期间德语区的母婴保健质量，并探讨 COVID-19 导致的组织变革与 WHO 基于标准的质量措施所描述的母婴保健质量之间的关联。
方法
作为 IMAgiNE EURO 研究的一部分（ClinicalTrials.gov：NCT04847336），我们对德语区的母婴保健质量进行了一项在线调查，包括在德国、瑞士和奥地利分娩的妇女。使用描述性统计、Spearman 秩相关系数和多变量分位数回归进行分析。
结果
在总共 70721 名访问在线问卷的妇女中，有 1875 名被纳入（德国：n=1053，瑞士：n=494，奥地利：n=328）。在国家之间发现了质量措施的显著差异。在瑞士，女性在母婴保健的所有四个子指数中对质量措施的评分均优于德国和奥地利。在奥地利，“由于 COVID-19 导致的组织变革”子指数的质量措施差距更大。“由于 COVID-19 导致的组织变革”子指数与其他子指数之间存在弱至强的相关性（所有相关性的 r 值在 0.33 到 0.62 之间，p<0.001）。
讨论
助产士和其他卫生专业人员应特别注意提供尊重、高质量的护理。
结论
为了有效提高母婴保健质量，进一步的研究对于监测护理质量和制定有针对性的干预措施至关重要，这些干预措施不仅要针对 COVID-19 大流行，还要解决组织和提供护理方面的固有挑战。
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