Preferences and deficits in midwifery care in Germany from the perspective of users and midwives: a qualitative explorative study

背景：在国际上，缺乏能够指导助产士循证护理并为其提供信息的研究。在德国，到目前为止，还没有研究议程或任何研究具体解决用户(妇女、生活伙伴、家庭)在助产士保健方面的优先事项。为了探索不忽视用户需求、兴趣和偏好的卫生保健问题、干预措施或结果，不仅在研究项目中呼吁用户的参与，而且已经在确定研究优先顺序和研究问题的过程中呼吁用户的参与[1]。目的：研究项目的目的是确定用户和助产士对助产士护理的偏好，并推断助产士护理和助产士研究的主导主题。方法：本定性探索性研究项目参照Gadamer[2]的解释学方法设计，旨在加深和广泛地理解其他观点。首先，这是通过开放的方法和研究团队与参与者和数据的反思对话来实现的，其次是通过数据收集和分析的迭代过程。在12个月的时间框架内，将有14个焦点小组与用户和助产士一起调查他们在助产护理方面的主观感知偏好或缺陷。参与者将通过基于不同人相关特征的对比抽样技术在两个不同的状态下进行选择。为了维护基于数据的理解，研究人员将在文本段落不清楚的情况下通过电话给各自的参与者打电话。作为参与者的使用者和助产士以及看门人的权利将得到保障。在分析中，将确定助产士护理的重要主题及其在各自背景下对使用者和助产士的意义的指示性陈述。这些可能涉及助产护理的某些时间点、方面、条件、影响因素、干预措施和结果。相关性：本研究项目将为德国未来制定与助产护理相关的研究议程提供重要的经验基础。这不仅将使未来的助产研究建立在用户偏好的基础上，还将促进德国基于证据的助产护理。

Background: Internationally, research is lacking which may have the capacity to guide and inform evidence-based care by midwives. In Germany, so far there is neither a research agenda nor any research that specifically addresses the priorities of users (women, life partnerships, families) regarding their health care by midwives. In order to explore health care problems, interventions, or outcomes that do not neglect the needs, interests and preferences of users, the participation of users has been called for not only in research projects, but already in the process of identifying research priorities and research questions [1].Objectives:The aim of the research project is to identify the preferences regarding midwifery care by both users and midwives and to deduce dominant themes for maternity care and midwifery research.Methods: This qualitative explorative research project is designed with reference to the hermeneutic approach according to Gadamer [2], which aims at a deepened and broad understanding of other perspectives. First, this is realized by an open approach and a reflective dialogue with the participants and the data by the research team, and secondly by an iterative process in data collection and analysis.Within a time frame of 12 months, there will be 14 focus groups with users and midwives in order to investigate their subjectively perceived preferences, or deficits, in midwifery care. The participants will be selected in two different states by means of a contrasting sampling technique based on various person-related characteristics. In order to safeguard an understanding that is based in data, the researchers will in case of unclear text passages call the respective participant by phone. The rights of users and midwives as participants as well as those of gatekeepers will be safeguarded.In the analysis, indicative statements for important themes of midwifery care and their meaning for the users and midwives in their respective context will be identified. These may refer to certain points in time, aspects, conditions, influencing factors, interventions, and outcomes of midwifery care.Relevancy: This research project will provide a significant empirical basis for the future development of a research agenda relating to midwifery care in Germany. This will not only base future midwifery research on user preferences, but also advance evidence-based midwifery care in Germany.