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首页> 外文期刊>International breastfeeding journal >The bumpy road to implementing the Baby-Friendly Hospital Initiative in Austria: a qualitative study
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The bumpy road to implementing the Baby-Friendly Hospital Initiative in Austria: a qualitative study

机译：奥地利实施“爱婴医院倡议”的坎road之路：定性研究

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Background The Baby-Friendly Hospital Initiative (BFHI) aims to promote and support breastfeeding. Globally, around 20,000 facilities have been designated Baby-Friendly. In Austria, however, only 16% of the maternity units have received BFHI-certification. Internationally, few studies have investigated facilitating or hindering factors for BFHI implementation. The need to extend BFHI-certification rates has been investigated previously, but little is known about why maternity units decide to become BFHI-certified, how BFHI is installed at the unit level, and which factors facilitate or impede the operation of the BFHI in Austria and how barriers are overcome. Methods Using a qualitative approach, (health) professionals’ perceptions of the selection, installation, as well as facilitators of and barriers to the BFHI were investigated. 36 semi-structured interviews with persons responsible for BFHI implementation (midwives, nurses, physicians, quality manager) were conducted in three Austrian maternity units. Data were analyzed using thematic analysis. Results Interviewees mentioned several motives for selecting the BFHI, including BFHI as a marketing tool, improvement of existing services, as well as collaboration between different professional groups. In each hospital, “change agents” were identified, who promoted the BFHI, teamed up with the managers of other professional groups and finally, with the manager of the unit. Installation of BFHI involved the adoption of project management, development and dissemination of new standards, and training of all staff. Although multiple activities were planned to prepare for actually putting the BFHI into practice, participants mentioned not only facilitating, but also several hindering factors. Interpretations of what facilitated or impeded the operation of BFHI differed among and between professional groups. Conclusion Successful implementation of the BFHI in Austria depends on a complex interplay of multiple factors including a consensual “bottom-up” selection process, followed by a multifaceted installation stage. Even these activities may be perceived as a hindrance for non-BFHI-certified hospitals. Findings also suggest that despite active preparation, several barriers have to be overcome when BFHI is actually incorporated into routine practices. BFHI seems to pose a great challenge to health professionals’ work routines and, thus, clear structural changes of such routines as well as ongoing monitoring and support activities are required.
机译：背景婴儿医院倡议（BFHI）旨在促进和支持母乳喂养。在全球范围内，大约有20,000个设施被指定为“爱婴”。但是，在奥地利，只有16％的生育单位获得了BFHI认证。在国际上，很少有研究调查BFHI实施的促进或阻碍因素。先前已经研究了提高BFHI认证率的必要性，但是对于为什么产妇单位决定获得BFHI认证，如何在单位级别安装BFHI以及哪些因素在奥地利促进或阻碍BFHI的运作知之甚少以及如何克服障碍。方法采用定性方法，调查（卫生）专业人员对BFHI的选择，安装以及促进因素和障碍的看法。在奥地利的三个孕妇单位中，对负责BFHI实施的人员（助产士，护士，医师，质量经理）进行了36次半结构化访谈。使用主题分析对数据进行分析。结果受访者提到了选择BFHI的几种动机，包括BFHI作为一种营销工具，改善现有服务以及不同专业团体之间的合作。在每家医院中，确定了“变革推动者”，他们推动了BFHI，与其他专业团体的经理一起，最后与该部门的经理合作。 BFHI的安装涉及项目管理的采用，新标准的制定和传播以及所有员工的培训。尽管计划进行多项活动来为实际实施BFHI做准备，但参与者不仅提到了便利，而且提到了一些阻碍因素。专业团体之间和之间对促进或阻碍BFHI运作的解释不同。结论在奥地利成功实施BFHI取决于多种因素的复杂相互作用，包括共识的“自下而上”选择过程，以及随后的多方面安装阶段。即使这些活动也可能被视为未经BFHI认证的医院的障碍。研究结果还表明，尽管进行了积极的准备，但实际上将BFHI纳入常规实践时仍需要克服一些障碍。 BFHI似乎对卫生专业人员的工作程序构成了巨大挑战，因此，需要对这些程序进行明确的结构更改以及持续的监视和支持活动。

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