Suchergebnisse

Background: During pregnancy, childbirth and puerperium, women receive care from a range of health professionals, particularly midwives. To assess the current situation of maternity care for women with physical disabilities in Austria, this study investigated the perceptions and experiences of health professionals who have provided care for women with disabilities during pregnancy, childbirth and postpartum. Methods: The viewpoints of the participating health professionals were evaluated by means of semistructured interviews followed by an inductive qualitative content analysis of the interview transcripts, as proposed by Mayring. Results: Four main categories emerged from the inductive content analysis: (i) structural conditions and accessibility, (ii) interprofessional teamwork and cooperation, (iii) action competence, and (iv) diversity-sensitive attitudes. According to the participating health professionals, the structural conditions were frequently not suitable for providing targeted group-oriented care services. Additionally, a shortage of time and staff resources also limited the necessary flexibility of treatment measures in the care of mothers with physical disabilities. The importance of interprofessional teamwork for providing adequate care was highlighted. The health professionals regarded interprofessionalism as an instrument of quality assurance and team meetings as an elementary component of high-quality care. On the other hand, the interviewees perceived a lack of action competence that was attributed to a low number of cases and a corresponding lack of experience and routine. Regarding diversity-sensitive attitudes, it became apparent that the topic of mothers with physical disabilities in care posed challenges to health professionals that influenced their natural handling of the interactions. Conclusion: The awareness of one's own attitudes towards diversity, in the perinatal context in particular, influences professional security and sovereignty as well as the quality of care of women with disabilities. There is a need for optimization in the support and care of women with physical disabilities during pregnancy, childbirth and puerperium.

ZUSAMMENFASSUNG Hintergrund: Obwohl die Vorteile von interprofessioneller Betreuung belegt sind und Schwangere in der Schweiz die Wahlfreiheit haben, wird die Mehrzahl ausschliesslich von ärztlicher Seite betreut. Ziel: Darstellung von ExpertInnenwissen zu Einflussfaktoren auf das Gelingen bzw. das Misslingen von interprofessioneller Schwangerenvorsorge durch Hebammen und GynäkologInnen. Forschungsfrage: Wie sieht Best Practice in der interprofessionellen Schwangerenvorsorge durch Hebammen und GynäkologInnen in der Schweiz aus? Methode: Fünf teilstrukturierte Gruppen- und Paarinterviews mit sechs Hebammen und fünf Ärztinnen, die in der Schweiz interprofessionelle Schwangerenvorsorge durchführten. Diese wurden transkribiert und anhand der qualitativen Inhaltsanalyse ausgewertet. Ergebnisse: Es werden Inhalte zu den Best Practice Themen Werte, Wissen und Kontext geliefert. Ein neues Thema, zwischenmenschliche Ebene und Arbeitskultur, wurde als zusätzliches Element einer gelingenden interprofessionellen Schwangerenvorsorge erkannt. Schlussfolgerung: Es gibt nicht 'die beste' Organisation interprofessioneller Schwangerenvorsorge. Wichtiger ist ein Konzept, welches alle Beteiligten vertreten, und eine gute zwischenmenschliche Beziehung. Die Umsetzung bringt politische, ökonomische, gesellschaftliche und organisatorische Herausforderungen mit sich. ABSTRACT Background: Although the advantages of interprofessional care have been proven and pregnant women in Switzerland have free choice of caregivers, most of them are cared for exclusively by physicians. Objective: To collect expert knowledge on the factors determining success or failure of interprofessional collaboration between midwives and gynaecologists within antenatal care in Switzerland. Research question: What does best practice look like in interprofessional antenatal care provided by midwives and gynaecologists in Switzerland? Methods: Five semi-structured dyadic and group interviews with six midwives and five gynaecologists who provide interprofessional antenatal care in Switzerland. Interviews were transcribed verbatim and qualitative content analysis was applied. Findings: Content was provided to topics of best practice like values, knowledge and context. A new topic, interpersonal relationships and workplace culture, emerged as an additional element for the success of interprofessional antenatal care. Conclusions: A "best" internal organisation for interprofessional collaboration does not exist. More important are a clear concept, supported by all participants, and good interpersonal relationhips among caregivers. Implementation presents political, economic, social and organisational challenges.