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“每个女性都应得如此”:对澳大利亚国家孕产妇战略影响的质性探索

'Every woman deserves that': A qualitative exploration of the impact of Australia's national maternity strategy.

作者信息

Medway Paula, Hutchinson Alison M, Sweet Linda

机构信息

School of Nursing and Midwifery & Centre for Quality and Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Victoria, Australia; Department for Health and Wellbeing, Government of South Australia, Australia.

School of Nursing and Midwifery & Centre for Quality and Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia.

出版信息

Women Birth. 2025 Mar;38(2):101871. doi: 10.1016/j.wombi.2025.101871. Epub 2025 Jan 21.

Abstract

BACKGROUND

Since 2019, maternity care in Australia has been guided by the national maternity policy, Woman-centred care: Strategic directions for Australian maternity services (the Strategy). The Strategy has four core values (safety, respect, choice and access), which underpin 12 principles of woman-centred care.

AIM

To describe women's experiences of receiving maternity care in Australia and explore how their care aligned with the values and principles of the Strategy.

METHODS

A qualitative descriptive approach was used. Fifty women from across Australia, including women from each of the priority populations within the Strategy, were interviewed. Data analysis was conducted using Braun and Clarke's reflexive thematic analysis.

FINDINGS

Women described how their care aligned and misaligned with the Strategy. Workforce shortages impacted their sense of safety, and they frequently had to self-advocate for individualised care that made them feel safe. Women wanted a holistic approach to care provision where they were listened to, heard, and their choices were respected by maternity care providers, but they felt the need to arm themselves with information to achieve this. They also expressed a desire for better care in the postnatal period to 12 months that included appropriate and affordable mental health support.

CONCLUSION

Receiving care that aligns with the values and principles of the Strategy is on an ad hoc basis, and maternity care provision is not consistent across Australia. A greater commitment to the implementation and adoption of the Strategy is required at a national and service level if its intent is to be fully realised.

摘要

背景

自2019年以来,澳大利亚的孕产护理一直以国家孕产政策《以女性为中心的护理:澳大利亚孕产服务战略方向》(以下简称《战略》)为指导。该《战略》有四个核心价值观(安全、尊重、选择和可及性),这些价值观是12条以女性为中心的护理原则的基础。

目的

描述澳大利亚女性接受孕产护理的经历,并探讨她们所接受的护理如何符合《战略》的价值观和原则。

方法

采用定性描述性方法。对来自澳大利亚各地的50名女性进行了访谈,包括《战略》中每个优先群体的女性。使用布劳恩和克拉克的反思性主题分析法进行数据分析。

结果

女性描述了她们所接受的护理与《战略》相符和不符的情况。劳动力短缺影响了她们的安全感,她们经常不得不为获得让自己感到安全的个性化护理而自我争取。女性希望在提供护理时采用整体方法,即她们能被倾听、意见被听取,并且她们的选择能得到孕产护理提供者的尊重,但她们觉得需要自己掌握信息才能实现这一点。她们还表示希望在产后至12个月期间能得到更好的护理,包括获得适当且负担得起的心理健康支持。

结论

接受符合《战略》价值观和原则的护理是临时性的,澳大利亚各地的孕产护理服务并不一致。如果要充分实现《战略》的意图,就需要在国家和服务层面做出更大的承诺来实施和采用该《战略》。

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