Oakley D, Murtland T, Mayes F, Hayashi R, Petersen B A, Rorie C, Andersen F
Center for Nursing Research, School of Nursing, University of Michigan, Ann Arbor 48109-0482, USA.
J Nurse Midwifery. 1995 Sep-Oct;40(5):399-409. doi: 10.1016/0091-2182(95)00053-m.
Prenatal and intrapartum care provided to 1,181 women, all meeting risk requirements for nurse-midwifery care, by certified nurse-midwives (n = 471) and obstetricians (n = 710) are compared using indicators of physical and of educational/psychosocial components of maternity care. Data are from clinical records and questionnaires completed by the women. Bivariate analyses show that the two provider groups differ on some, but not all, processes of care. When the woman's evolving health status, personal characteristics, and preferences are controlled, there are significant differences that confirm two models of care. The nurse-midwifery approach emphasizes educational/psychosocial care and restrained, individualized use of technology. The obstetrics approach emphasizes more routine use of state-of-the-art technology. This study contributes new information to substantiate different models but also shows that both provider groups use elements of both. The difference in emphasis should encourage collaborative practice, given the shared basis for maternity care, whether it is provided by certified nurse-midwives or obstetricians.
对1181名均符合助产护理风险要求的女性，由认证助产士（n = 471）和产科医生（n = 710）提供的产前和产时护理，使用孕产妇护理的身体指标以及教育/心理社会指标进行比较。数据来自临床记录和女性填写的问卷。双变量分析表明，两个医护人员群体在部分而非全部护理过程上存在差异。当控制女性不断变化的健康状况、个人特征和偏好时，存在显著差异，证实了两种护理模式。助产护理模式强调教育/心理社会护理以及对技术的适度、个性化使用。产科护理模式强调更多地常规使用最先进的技术。本研究提供了新信息以证实不同模式，但也表明两个医护人员群体都使用了两种模式的要素。鉴于孕产妇护理的共同基础，无论由认证助产士还是产科医生提供护理，重点的差异都应鼓励协作实践。
