Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study.
Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study.
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DOI：
10.1186/1471-2393-12-29
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发表时间：
2012-04-13
影响因子：
3.1
通讯作者：
Hutton E
中科院分区：
文献类型：
--
作者：
Sword W;Heaman MI;Brooks S;Tough S;Janssen PA;Young D;Kingston D;Helewa ME;Akhtar-Danesh N;Hutton E
人们非常关注产前护理在促进妇女及其婴儿健康方面的充分利用。使用的充分性考虑到开始产前护理的时间和就诊的次数。然而，越来越多的证据表明，产前护理的质量可能比充分使用更重要。我们研究的目的是探讨妇女和护理人员对优质产前护理的看法，为新工具“产前护理质量问卷”的项目开发提供信息。我们报告了问卷开发第一步所产生的主题。使用定性描述方法。对从加拿大五个城市中心招募的 40 名孕妇和 40 名产前护理人员进行了半结构化访谈。使用归纳开放然后模式编码来分析数据。分析的最后一步使用演绎方法将出现的主题分配到反映研究概念框架的更广泛的类别中。多纳贝迪安的优质医疗保健模型的三个主要类别是护理结构、临床护理流程和人际护理流程。护理主题的结构包括可及性、物理环境以及工作人员和护理提供者的特征。临床护理流程的主题包括健康促进和疾病预防、筛查和评估、信息共享、护理连续性、妊娠非药物化和以妇女为中心。人际关怀过程的主题是尊重的态度、情感支持、平易近人的互动方式和花时间。贯穿整个数据的一个反复出现的主题反映了妇女与其产前护理提供者之间以信任为特征的有意义的关系的重要性。虽然护理结构的某些方面被认为是优质产前护理的关键方面，但临床和人际护理流程对于优质护理至关重要。这些过程很重要，因为它们在减轻不良后果、促进妇女参与自己的护理以及让妇女参与护理方面发挥着作用。研究结果提出了产前护理的规划、实施和评估的关键考虑因素。最值得注意的是，护理应该以女性为中心，并将共同决策作为一个基本要素。
Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and interpersonal care processes emerged as being most essential to quality care. These processes are important as they have a role in mitigating adverse outcomes, promoting involvement of women in their own care, and keeping women engaged in care. The findings suggest key considerations for the planning, delivery, and evaluation of prenatal care. Most notably, care should be woman-centred and embrace shared decision making as an essential element.
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影响因子：
2.5
作者：
Oropesa, RS;Landale, NS;Kenkre, TS
通讯作者：
Kenkre, TS
影响因子：
2.5
作者：
Proctor, S
通讯作者：
Proctor, S
影响因子：
120.7
作者：
DONABEDIAN, A
通讯作者：
DONABEDIAN, A
影响因子：
3.2
作者：
Novick, Gina;Sadler, Lois S.;Knafl, Kathleen A.
通讯作者：
Knafl, Kathleen A.
影响因子：
12.7
作者：
KOTELCHUCK, M
通讯作者：
KOTELCHUCK, M