Ruby Emma, Brunton Ginny, Rack Joanne, Al Balkhi Sofia, Banfield Laura, Grenier Lindsay N, Ghandi Shikha, Ahmed Maisha, Hutton Eileen Katherine, Darling Elizabeth Kathleen, Mattison Christina, Kaufman Karyn, Murray-Davis Beth
McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.
BMJ Open. 2024 Dec 12;14(12):e087698. doi: 10.1136/bmjopen-2024-087698.
The 2014 Lancet Series on Midwifery developed the Quality of Maternal and Newborn Care (QMNC) framework outlining care needed for all childbearing people and newborns. Furthermore, this was a global call to action to invest in research capacity building. While evidence-informed care is a cornerstone of midwifery practice, there has been limited exploration of how Canadian midwifery research priorities within the Canadian context align with the global framework. In response to the call from the Lancet series, this scoping review aimed to investigate the current strengths and gaps of midwifery research in Canada. Secondarily, our goal was to map existing Canadian evidence to the QMNC framework to guide future priority setting and build research capacity.
A scoping review.
We searched nine electronic databases for articles up to 2022, inclusive: AMED (Allied and Complementary Medicine), CINAHL, EconLit, EMBASE, HealthSTAR, MEDLINE, PsycINFO, EmCare and Web of Science.
We included research conducted by (a) Canadian midwives on Canadian and non-Canadian populations, (b) international midwives on Canadian midwifery populations or (c) non-midwife researchers on Canadian midwifery populations.
We analysed data using categories from the Lancet Series' QMNC framework. At least two independent reviewers conducted screening and data extraction.
We identified 590 articles for inclusion. Most Canadian midwifery research is related to organisation of care and care providers, clinical practice categories including promoting normal physiological processes during pregnancy, research pertaining to prenatal and intrapartum periods, and policy. Research gaps included neonatal and postpartum outcomes, midwifery education, and midwifery values and philosophy. Lastly, there were gaps in the number of randomised trials and systematic reviews, which may impact guidance of clinical decision-making.
There has been an exponential increase in midwifery-led research in Canada. Assessment against the QMNC framework has highlighted gaps related to research conduct, clinical and non-clinical research focuses. Identifying midwifery research priorities is an important next step of consolidating Canadian research evidence. Future directions may include collaboration with midwifery stakeholders to prioritise research topics related to improving care for clients, strengthening the profession and building research capacity.
《柳叶刀》2014年助产系列文章制定了孕产妇和新生儿护理质量(QMNC)框架,概述了所有孕产妇和新生儿所需的护理。此外,这是一项呼吁全球采取行动投资于研究能力建设的倡议。虽然基于证据的护理是助产实践的基石,但对于加拿大背景下的助产研究重点如何与全球框架保持一致,目前的探索还很有限。为响应《柳叶刀》系列文章的呼吁,本范围综述旨在调查加拿大助产研究目前的优势和不足。其次,我们的目标是将加拿大现有的证据映射到QMNC框架,以指导未来的优先事项设定并建设研究能力。
范围综述。
我们检索了九个电子数据库,查找截至2022年(含)的文章:联合与补充医学数据库(AMED)、护理学与健康领域数据库(CINAHL)、经济文献数据库(EconLit)、荷兰医学文摘数据库(EMBASE)、健康之星数据库(HealthSTAR)、医学期刊数据库(MEDLINE)、心理学文摘数据库(PsycINFO)、循证医学数据库(EmCare)和科学引文索引数据库(Web of Science)。
我们纳入了以下研究:(a)加拿大助产士针对加拿大和非加拿大人群开展的研究;(b)国际助产士针对加拿大助产人群开展的研究;(c)非助产士研究人员针对加拿大助产人群开展的研究。
我们使用《柳叶刀》系列文章QMNC框架中的类别对数据进行分析。至少两名独立评审员进行筛选和数据提取。
我们确定了590篇纳入文章。加拿大的大多数助产研究与护理组织和护理提供者、临床实践类别(包括促进孕期正常生理过程)、产前和产时相关研究以及政策有关。研究空白包括新生儿和产后结局、助产教育以及助产价值观和理念。最后,随机对照试验和系统评价的数量存在空白,这可能会影响临床决策指导。
加拿大由助产士主导的研究呈指数级增长。对照QMNC框架进行评估突出了与研究开展、临床和非临床研究重点相关的差距。确定助产研究重点是巩固加拿大研究证据的重要下一步。未来的方向可能包括与助产利益相关者合作,优先考虑与改善客户护理、加强该专业和建设研究能力相关的研究主题。