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产科和助产护理中的跨专业协作——助产士与医生视角的多组比较

Interprofessional Collaboration in Obstetric and Midwifery Care-Multigroup Comparison of Midwives' and Physicians' Perspective.

作者信息

Schulz Anja Alexandra, Wirtz Markus Antonius

机构信息

Research Methods in Health Sciences, University of Education Freiburg, Kunzenweg 21, 79117 Freiburg, Germany.

出版信息

Healthcare (Basel). 2025 Jul 24;13(15):1798. doi: 10.3390/healthcare13151798.

Abstract

: Interprofessional collaboration (IPC) is considered fundamental for integrated, high-quality woman-centered care. This study analyzes concordance/differences in the perspectives of midwives and physicians on IPC and Equitable Communication (EC) in prenatal/postpartum (PPC) and birth care (BC). : The short form of the ICS Scale (ICS-R with eight items) adapted for the midwifery context, and the EC scale (three items) were completed by 293 midwives and 215 physicians in Germany. Profession- and the setting-specific differences were analyzed using -tests and ANOVA with repeated measurements. Confirmatory factor analysis with nested model comparisons test the fairness of the scales. : Midwives' ratings of all IPC aspects were systematically lower than physicians' in both care settings (variance component professional group: = 0.227/ 0.318), esp. for EC ( = 1.22-1.41). Both groups rated EC higher in BC. The setting effect was less pronounced among physicians for the ICS-R items than among midwives. Violations of test fairness reveal validity deficiencies when using the aggregated EC sum score for group comparisons. : Fundamental professional differences were found in the IPC assessment between physicians and midwives. The results enhance the understanding of IPC dynamics and provide starting points for action to leverage IPC's potential for woman-centered care.

摘要

跨专业协作(IPC)被认为是提供综合、高质量的以女性为中心的护理的基础。本研究分析了助产士和医生在产前/产后(PPC)及分娩护理(BC)中对IPC和公平沟通(EC)的观点的一致性/差异。

在德国,293名助产士和215名医生完成了适用于助产士情境的ICS量表简版(ICS-R,共8个项目)以及EC量表(3个项目)。使用t检验和重复测量方差分析来分析职业和特定环境的差异。通过嵌套模型比较的验证性因素分析来检验量表的公平性。

在两种护理环境中,助产士对所有IPC方面的评分均系统地低于医生(方差成分专业组:= 0.227 / 0.318),尤其是在EC方面(= 1.22 - 1.41)。两组在BC中对EC的评分更高。对于ICS-R项目,医生中的环境效应不如助产士中明显。当使用汇总的EC总分进行组间比较时,违反测试公平性表明存在效度缺陷。

在IPC评估中发现了医生和助产士之间存在根本性的专业差异。研究结果增进了对IPC动态的理解,并为发挥IPC在以女性为中心的护理中的潜力提供了行动起点。

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