Smith L F
Institute of General Practice, University of Exeter.
Br J Gen Pract. 1996 Feb;46(403):101-4.
The reorganization of maternity services in England following the report Changing childbirth is likely to impinge upon general practitioners' contribution to maternity care. Professionals and managers are increasingly expected to take account of patients' views when reorganizing services.
This study aimed to elicit women's views about the involvement of general practitioners in maternity care and to establish the extent of continuity provided by general practitioners.
A prospective cohort postal questionnaire survey was undertaken in the Bath health district to elicit the views of pregnant women about the general practitioner's role in maternity care, the continuity provided, patient satisfaction and the general practitioner-patient relationship. Responses were rated on five-point Likert scales. Women completed questionnaires at 24 and eight weeks before the birth and at two and eight weeks after the birth.
Of 164 women entering the study (28 of whom were booked for home delivery and 136 for hospital delivery), 116 (71%) completed all four survey questionnaires. Of respondents 68% agreed that general practitioners play an important role in routine antenatal care and 53% that they have an important role in normal labour. These opinions appeared to be stable over time. Most women (73%) were cared for throughout their pregnancy by one general practitioner whom they knew well; such continuity was desired by nearly all the women in the study. Approximately three quarters of women were satisfied with the antenatal, postnatal and overall care provided by their general practitioner. Over half of respondents (56%) wished to get to know the doctor who would be present at the birth: the general practitioner was involved in 19 labours (16%), being present at the birth for only nine women. Women delivering at home were significantly more likely to agree with the statement that they knew the doctor present at the birth compared with those women delivering at hospital. Most women (91%) had their final six-week postnatal check with their general practitioner.
Most women in this study believed that general practitioners are important in maternity care, providing continuity of antenatal and postnatal care but not of intrapartum care. These beliefs might be an indicator of the future situation in the United Kingdom when more women give birth at home and under non-consultant care. The vocational training and continuing education of general practitioners should accommodate their possible future roles in maternity care.
继《变革分娩》报告发布后，英国对产科服务进行了重组，这可能会影响全科医生在产科护理中的贡献。在重组服务时，专业人员和管理人员越来越需要考虑患者的意见。
本研究旨在了解女性对全科医生参与产科护理的看法，并确定全科医生提供的连续性护理程度。
在巴斯健康区进行了一项前瞻性队列邮政问卷调查，以了解孕妇对全科医生在产科护理中的作用、提供的连续性护理、患者满意度以及全科医生与患者关系的看法。回答采用五点李克特量表进行评分。女性在分娩前24周和8周以及分娩后2周和8周完成问卷。
164名参与研究的女性中（其中28名计划在家分娩，136名计划在医院分娩），116名（71%）完成了所有四份调查问卷。在受访者中，68%的人认为全科医生在常规产前护理中发挥重要作用，53%的人认为他们在正常分娩中发挥重要作用。这些观点似乎随时间保持稳定。大多数女性（73%）在整个孕期都由一位她们熟悉的全科医生护理；几乎所有参与研究的女性都希望有这样的连续性护理。大约四分之三的女性对全科医生提供的产前、产后和整体护理感到满意。超过一半的受访者（56%）希望了解将在分娩时在场的医生：全科医生参与了19例分娩（16%），仅9名女性分娩时在场。与在医院分娩的女性相比，在家分娩的女性更有可能同意她们认识分娩时在场的医生这一说法。大多数女性（91%）在产后六周的最后检查是由她们的全科医生进行的。
本研究中的大多数女性认为全科医生在产科护理中很重要，提供产前和产后护理的连续性，但不提供产时护理的连续性。这些看法可能预示着在英国，当越来越多的女性在家分娩且接受非顾问医生护理时的未来情况。全科医生的职业培训和继续教育应适应他们未来在产科护理中可能扮演的角色。
