Towards an integrated perinatal care pathway for vulnerable women: The development and validation of quality indicators |
| |
| Institution: | 1. Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium;2. Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium;3. Social Care Department, Artevelde University of Applied Sciences, Ghent, Belgium;4. Department of Public Health, Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium;5. University Hospital Brussels, Nursing and Midwifery Research Unit, Belgium;6. Vrije Universiteit Brussel (VUB), Nursing and Midwifery Research Unit, Faculty of Medicine and Pharmacy & Universitair Ziekenhuis Brussel, Belgium;7. Verpleeg- en vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Belgium;8. Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium;1. Sanprobi Sp.z o.o. Sp K., Szczecin, Poland;2. Department of Biochemistry and Human Nutrition, Pomeranian Medical University, Szczecin, Poland;3. Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland;1. Mind, Brain and Behaviour Centre (CIMCYC). Faculty of Psychology, University of Granada, Granada, Spain;2. Personality, Assessment and Psychological Treatment Department, Faculty of Psychology, University of Granada, Granada, Spain;3. Nursing Department. Faculty of Health Sciences, University of Granada, Granada, Spain;4. Obstetrics and Gynaecology Department, University Hospital San Cecilio, Granada, Granada, Spain;5. Department of Pharmacology, CIBERehd, Faculty of Pharmacy, University of Granada, Granada, Spain;1. Rotterdam University of Applied Sciences, Research Centre Innovations in Care, Rotterdam, The Netherlands;2. Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands;1. University Hospitals Coventry and Warwickshire NHS Trust Coventry CV2 2DX, NIHR 70@70 Senior Midwife Research Leader, Centre for Sports, Exercise and Life Sciences (CSELS), Coventry University, Coventry CV1 5FB, United Kingdom;2. University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom;1. School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN;2. Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK, G4 0BA |
| |
| Abstract: | ObjectiveDevelopment and validation of a set of quality indicators for vulnerable women during the perinatal period.DesignA three-phase method was used. Phase 1 consisted of a literature review to identify publications for the development of care domains and potential QIs, as well as a quality assessment by the research team. In phase 2 an expert panel assessed the set of concept QIs in a modified three-round Delphi survey. Finally, semi-structured interviews with vulnerable women were conducted as a final quality assessment of a set of indicators (phase 3). Ethical approval was obtained from the ethics committee of the University Hospital Brussels and from the Ethics Committees of all the participating hospitals.SettingThe Flemish Region and the Brussels Capital Region in Belgium.ParticipantsHealthcare and social care professionals (n = 40) with expertise in the field of perinatal care provision for vulnerable families. Vulnerable women (n = 11) who gave birth in one of the participating hospitals.FindingsThe literature review resulted in a set of 49 potential quality indicators in five care domains: access to healthcare, assessment and screening, informal support, formal support and continuity of care. After assessment by the expert panel and vulnerable women, a final set of 21 quality indicators in five care domains was identified. First of all, organisation of care must involve an integrated multidisciplinary approach taking account of financial, administrative and social barriers (care domain 1: access to healthcare). Second, qualitative care includes the timely initiation of care, a general screening of the various aspects of vulnerability (biological, psychological, social and cognitive) and a risk assessment for all women (care domain 2: assessment and screening). Vulnerable women benefit from intensive formal and informal support taking account of individual needs and strengths (care domain 3: formal support; care domain 4: informal support). Finally, continuity of care needs to be guaranteed in line with vulnerable woman's individual needs (care domain 5: continuity of care).Key conclusions and implications for practiceImplementing quality indicators in existing and new care pathways offers an evidence-based approach facilitating an integrated view promoting a healthy start for woman and child. These quality indicators can assist healthcare providers, organisations and governmental agencies to improve the quality of perinatal care for vulnerable women. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
