The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital.
The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital.
复制标题
DOI：
10.1186/1472-6874-11-53
复制
发表时间：
2011-11-25
期刊：
影响因子：
--
通讯作者：
Fraser W
中科院分区：
文献类型：
--
作者：
Behruzi R;Hatem M;Goulet L;Fraser W
考虑到目前相当比例的高危妊娠被转介到三级医院，以及相当比例的低产科风险妇女仍然在这些医院寻求护理，因此，重要的是要探讨影响这些医院分娩经验的因素，特别是人性化分娩护理的概念。本研究的目的是探讨组织和文化因素，作为提供人性化的产科护理在一个高度专业化的，大学附属医院在加拿大魁北克省，在提供的障碍或促进。选择了单一的案例研究设计。研究样本包括来自不同学科的17名专业人员和管理人员，以及研究期间在医院分娩的157名妇女。收集的数据通过半结构化访谈，现场记录，参与者的意见，自填问卷，文件和档案。进行了描述性和定性演绎内容分析，并尊重伦理考虑。高度专业化医院的外部和内部层面都可以促进或阻碍这些机构中分娩护理实践的人性化，无论是独立的还是整体的。发现的最大促进因素是：关怀和以家庭为中心的护理模式，专业人员和管理人员提供人性化分娩护理的环境，除了医疗干预护理，以提高妇女及其子女的安全性，保证和舒适度，提供无痛分娩的设施，陪伴和探视规则，处理患者的精神和宗教信仰。提到最多的障碍是：医护专业人员短缺，专业人员之间缺乏足够的沟通，利益相关者希望专业化而不是人性化，对医疗表现的过度估计，最后是医院的培训环境导致太多的医护专业人员，因此，缺乏隐私和连续性的护理。在研究的高度专业化的大学附属医院中，出生时的医疗干预和技术是出生人性化的对立因素的论点并没有被视为一个问题。
Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care. The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care. The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital.
登录
查看更多内容
影响因子：
1.8
作者：
Backes, Dirce Stein;Koerich, Magda Santos;Erdmann, Alacoque Lorenzini
通讯作者：
Erdmann, Alacoque Lorenzini
影响因子：
2.7
作者：
De Koninck, M;Blais, R;Gagnon, C
通讯作者：
Gagnon, C
DOI：
10.1016/s1701-2163(16)32757-8
发表时间：
2008-03-01
影响因子：
1.8
作者：
Dzakpasu, Susie;Kaczorowski, Janusz;Neusy, Elisabeth
通讯作者：
Neusy, Elisabeth
影响因子：
2.5
作者：
Jimenez, Vania;Klein, Michael C.;Mason, Catherine
通讯作者：
Mason, Catherine
影响因子：
0.9
作者：
Hausman, Bernice L.
通讯作者：
Hausman, Bernice L.