Gregory Soma, Caffrey Louise, Daly Deirdre, Sheaf Greg
School of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland.
School of Nursing and Midwifery, Trinity Centre for Maternity Care Research (TCMCR), Trinity College Dublin, Dublin, Ireland.
Scand J Caring Sci. 2025 Sep;39(3):e70086. doi: 10.1111/scs.70086.
Woman/person-centred care is a key policy objective for maternity services in many high-income countries, both strategically and in terms of service delivery. This approach to care prioritises the individual woman's needs and aspirations over those of professionals or institutions. However, the concept remains ambiguous and practical implementation guidelines are lacking, leading to concerns that it is being practised tokenistically.
To explore how woman-centred care in maternity services in high-income countries is experienced and understood by women and professionals.
A rapid review was conducted to synthesise evidence on woman-centred care from women's and clinicians' perspectives. Five bibliographic databases, CINAHL, Maternity and Infant Care, MEDLINE, PsycINFO and Web of Science, were searched systematically in December 2023. Citations eligible for inclusion were peer-reviewed quantitative, qualitative and mixed-methods empirical studies conducted in high-income countries and literature reviews reporting on studies conducted in high-income countries. Title and abstract screening, full-text screening, data extraction and quality appraisal were performed, with 10% of records double-screened to ensure consistency and minimise bias. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Extracted data were synthesised thematically.
In total, 5295 records were retrieved; after deduplication, 2707 records were screened, and 24 studies met the inclusion criteria. The review identified inconsistencies in how woman-centred care was experienced and understood at all levels of service provision, from policy directives to institutional practices. Diverse understandings of woman-centred care among stakeholders were found to influence interactions. Several studies revealed that professionals' varying interpretations affected their attitudes and approaches to care, while some women were found to hold differing expectations about woman-centred care provision.
To realise the policy intention of woman-centred care, further context-specific investigations are needed to provide evidence and evaluation to inform implementation strategies.
以女性/个人为中心的护理是许多高收入国家产科服务的一项关键政策目标，无论是在战略层面还是服务提供方面。这种护理方法将女性个人的需求和愿望置于专业人员或机构之上。然而，这一概念仍然模糊不清，缺乏实际实施指南，导致人们担心它只是形式上的做法。
探讨高收入国家产科服务中以女性为中心的护理在女性和专业人员中的体验和理解方式。
进行了一项快速综述，以综合从女性和临床医生角度获得的关于以女性为中心护理的证据。2023年12月，系统检索了五个文献数据库，即护理学与健康照护数据库（CINAHL）、母婴护理数据库、医学期刊数据库（MEDLINE）、心理学文摘数据库（PsycINFO）和科学引文索引数据库（Web of Science）。纳入标准为在高收入国家进行的经同行评审的定量、定性和混合方法实证研究，以及报告在高收入国家进行的研究的文献综述。进行了标题和摘要筛选、全文筛选、数据提取和质量评估，对10%的记录进行了双盲筛选，以确保一致性并尽量减少偏差。使用混合方法评估工具评估方法学质量。对提取的数据进行了主题综合分析。
共检索到5295条记录；去重后，筛选了2707条记录，24项研究符合纳入标准。该综述发现，从政策指令到机构实践，在服务提供各级对以女性为中心护理的体验和理解存在不一致。利益相关者对以女性为中心护理存在多种理解被发现会影响互动。几项研究表明专业人员的不同解释影响了他们的护理态度和方法，而一些女性对以女性为中心护理的提供也有不同期望。
为实现以女性为中心护理这一政策意图，需要进一步针对具体情况进行调查研究，以提供证据和评估，为实施策略提供参考。
