实施助产主导护理模式的障碍和促进因素:定性系统审查
Andreia Soares Goncalves1, Márcia Pestana-Santos2, Christine McCourt3
1Department of Nursing and Midwifery, Escola Superior de Saúde, Instituto Politécnico de Viana do Castelo, Rua Dom Moisés Alves Pinho, 4900-314 Viana do Castelo, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal; CINTESIS@RISE - Innovation & Development in Nursing, Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; Health Sciences Research Unit: Nursing (UICISA:E), Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal.
助产士主导的护理模式提供了好处,但面临着实施阻力. 本综述从利益相关方的角度确定了关键障碍和促进者,以指导成功的整合战略.
科学领域:
- 医疗保健实施科学 医疗保健实施科学
- 孕产妇和新生儿的健康
- 定性研究综合 定性研究综合
背景情况:
- 助产士主导的护理模式为母亲和新生儿提供了显著的短期和长期优势,以及经济和可持续性的好处.
- 尽管已证明有好处,但在全球范围内实施助产士主导的护理模式面临着相当大的阻力.
研究的目的:
- 探索和综合利益相关者对实施助产主导护理模式的障碍和促进者的看法.
- 确定影响从医生主导或共享护理转向助产士主导模式的因素.
主要方法:
- 符合乔安娜·布里格斯研究所指导方针的定性系统审查.
- 根据实施研究综合框架的指导,对来自七项纳入研究的数据进行了主题综合.
- 使用ConQual评估可信度和可靠性.
主要成果:
- 14个利益相关者识别的发现 (5个促进因素,9个障碍因素) 被分类为四个实施领域:创新,外部环境,内部环境和个人.
- 影响实施的关键主题包括成本,当地态度,政策,兼容性,以客户为中心以及能力.
- 利益相关者包括妇女,助产士,医生和教育工作者.
结论:
- 基于证据的策略对于克服已识别的障碍和加强助产士主导护理的促进者至关重要.
- 基于实施科学的具体背景策略对于可持续的整合至关重要.
- 强调政策制定和利益相关者参与对于成功实施至关重要.
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