Midwives' views of changing to a Continuity of Midwifery Care (CMC) model in Scotland: A baseline survey
Midwives' views of changing to a Continuity of Midwifery Care (CMC) model in Scotland: A baseline survey
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DOI：
10.1016/j.wombi.2019.08.005
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发表时间：
2020-09-01
期刊：
影响因子：
3.8
通讯作者：
McInnes, Rhona J.
中科院分区：
文献类型：
--
作者：
Martin, Caroline J. Hollins;MacArthur, Juliet;McInnes, Rhona J.
背景：有充分的证据表明，助产士护理的连续性 (CMC) 与改善临床结果、提高产妇满意度和改善助产士的工作经验相关。对组织所做的改变需要认真实施，并持续评估以监测进展情况。目标：开发一种包含多个经过验证的量表的调查工具，用于在苏格兰实施高质量助产护理连续性 (CMC) 模型之前收集基线数据（Hewitt 等人，2019）。该工具收集了服务重组之前助产士个人和职业健康状况的数据，并进行了一项纵向研究，旨在衡量助产士报告随时间的变化。本文报告了基线数据收集。方法：通过 NHS 内联网、口头、电子邮件和纸质形式与苏格兰的执业助产士 (n = 321) 共享一项在线调查。该调查引发了助产士对助产护理连续性 (CMC) 的看法；价值观和护理理念；对自己职业角色的态度；个人和职业人口统计数据；生活质量和福祉。根据新的助产护理连续性 (CMC) 模型的正面/负面意见，对心理测量态度量表进行评分并自由文本评论医学，以突出需要解决的关键问题并确定变革障碍或促进因素。调查结果：大多数助产士表示支持助产护理连续性 (CMC) 的基础理念，其中包括生理分娩和提供自主助产护理。参与者还对他们当前的角色和组织表示了积极的态度，其中一些人担心组织将如何实施所需的变革。担忧包括工作负担过重、在助产实践的某些领域缺乏技能以及缺乏支持，从而引发诉讼。结论：助产士支持支撑助产护理连续性 (CMC) 的价值观和理念，但担心不断发展的护理系统所涉及的组织变革。因此，管理层需要实施减少恐惧的策略。例如，提供准确和诚实的信息，使助产士能够自己计划、设计和实施变革，并提供情感和物质帮助。皇冠版权所有 (C) 2019 由 Elsevier Ltd 代表澳大利亚助产士学院出版。版权所有。
Background: There is good evidence that Continuity of Midwifery Care (CMC) is associated with improved clinical outcomes, greater maternal satisfaction, and improved work experiences for midwives. Changes made to the organisation require careful implementation, with on-going evaluation to monitor progress.Aim: To develop a survey tool that incorporates several validated scales, which was used to collect baseline data prior to implementing a high-quality Continuity of Midwifery Care (CMC) model in Scotland (Hewitt et al., 2019). This tool gathered data about midwives' personal and professional wellbeing prior to service reorganisation, with a longitudinal study intended to measure change in midwives' reportage across time. This paper reports the baseline data-collection.Methods: An on-line survey was shared with practising midwives (n = 321) in Scotland via the NHS intranet, verbally, email, and paper. The survey elicited midwives views about Continuity of Midwifery Care (CMC); values and philosophies of care; attitudes towards their professional role; personal and professional demographics; quality of life and wellbeing. Psychometric attitudinal scales were scored and free text comments the med according to positive/negative opinions of the new Continuity of Midwifery Care (CMC) model to highlight key concerns to be addressed and identify change barriers or facilitators.Findings: The majority of midwives indicated support for philosophies underpinning Continuity of Midwifery Care (CMC), which includes physiological birth and providing autonomous midwifery care. Participants also indicated positive attitudes towards their current role and organisation, with some worrying about how the organisation was going to implement the changes required. Worries included, receiving an overburdening workload, being deskilled in certain areas of midwifery practice, and lack of support were litigation to arise.Conclusion: Midwives support the values and philosophies that underpin Continuity of Midwifery Care (CMC), yet worry about organisational change involved in evolving systems of care. Hence, management require to implement strategies to reduce fears. For example, delivering accurate and honest information, enabling midwives to plan, design and implement changes themselves, and providing emotional and material help. Crown Copyright (C) 2019 Published by Elsevier Ltd on behalf of Australian College of Midwives. All rights reserved.