Larsen Joan Neergaard, Navne Laura Emdal, Hansson Helena, Maastrup Ragnhild, Poorisrisak Porntiva, Sørensen Jette Led, Broberg Lotte
Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
Health, VIVE, Copenhagen, Denmark.
BMJ Open. 2024 Dec 10;14(12):e086572. doi: 10.1136/bmjopen-2024-086572.
Our aim was to explore healthcare professionals' (HCPs) expectations, concerns and educational needs regarding preparing for implementing the concept of couplet care, keeping newborns in need of intensive care together with their mothers in need of obstetrical care.
A qualitative focus group study based on semistructured interviews. We analysed the data using reflexive thematic analysis. This study is part of a comprehensive research project and pre-implementation based on curriculum development principles and implementation theory.
We conducted four focus group interviews from May to June 2023 at a tertiary referral university hospital in Denmark.
Neonatologists, obstetricians, midwives and nurses (n=21) were recruited from neonatal and obstetric departments.
Neonatologists, obstetricians, midwives and nurses with various levels of postgraduate experience.
We identified the overarching theme of building bridges in relation to HCPs' expectations, concerns and educational needs and five subthemes: Enhancing meaningfulness through increased teamwork; compromising or improving patient safety; challenging professional comfort zones; encountering other cultural and ethical values; and recognising educational requirements.
HCPs widely support mother-newborn couplet care and emphasise the need for closer collaboration between neonatal and obstetric departments. Implementing couplet care is seen as meaningful, potentially enhancing the well-being of mothers and newborns and positively impacting HCPs' job satisfaction. Key concerns include patient safety, quality of treatment and care and the well-being of HCPs navigating their skills, psychological safety and professional boundaries. While the importance of couplet care for early closeness and connection is acknowledged, challenges arise in meeting diverse maternal and neonatal needs. Additional research, especially in highly specialised settings, is necessary to understand the complexities associated with changing the care paradigm for newborns and mothers to be cared for together and in implementing couplet care. We found focus groups useful as a tool for needs assessment and uncovering and adapting practices to address challenges in implementing couplet care.
我们的目标是探讨医疗保健专业人员(HCPs)对于为实施母婴同室护理概念做准备的期望、担忧和教育需求,即让需要重症监护的新生儿与需要产科护理的母亲待在一起。
基于半结构化访谈的定性焦点小组研究。我们使用反思性主题分析法对数据进行了分析。本研究是一个基于课程开发原则和实施理论的全面研究项目及实施前阶段的一部分。
2023年5月至6月,我们在丹麦的一家三级转诊大学医院进行了四次焦点小组访谈。
从新生儿科和产科招募了新生儿科医生、产科医生、助产士和护士(n = 21)。
具有不同研究生经验水平的新生儿科医生、产科医生、助产士和护士。
我们确定了与HCPs的期望、担忧和教育需求相关的总体主题“搭建桥梁”以及五个子主题:通过加强团队合作增强意义;权衡或提高患者安全;挑战专业舒适区;遇到其他文化和道德价值观;认识到教育需求。
HCPs广泛支持母婴同室护理,并强调新生儿科和产科之间需要更密切的合作。实施母婴同室护理被视为有意义的,可能会提高母亲和新生儿的幸福感,并对HCPs的工作满意度产生积极影响。主要担忧包括患者安全、治疗和护理质量以及HCPs在运用技能、心理安全和专业界限方面的幸福感。虽然母婴同室护理对于早期亲密接触和联系的重要性得到认可,但在满足不同的母婴需求方面仍存在挑战。需要进行更多研究,尤其是在高度专业化的环境中,以了解与改变新生儿和母亲共同护理的护理模式以及实施母婴同室护理相关的复杂性。我们发现焦点小组作为一种需求评估工具很有用,可用于发现并调整实践以应对实施母婴同室护理中的挑战。