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Opinions of maternity care professionals about integration of care during labor for 'moderate risk' indications: A delphi study in the Netherlands

机译：产妇护理专业人员关于“中等风险”适应症在分娩期间进行护理整合的观点：荷兰的一项德尔菲研究

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Background: The percentage of referrals during labor from primary midwife-led care to obstetrician-led care has increased over the past years in The Netherlands. Most women are referred for indications with a moderate increase in risk and are looked after by clinical midwives. This study aims to provide insight into the opinions of maternity care professionals about integration of care and involvement of primary care midwives in the intrapartum care of women with "moderate risk" factors. Methods: A Delphi study consisting of three rounds was conducted. A purposively selected heterogenic panel of 50 professionals, including obstetricians, primary care midwives, clinical midwives, and obstetric nurses, answered questions anonymously. Results: Although primary care midwives would like to expand their responsibilities and tasks with respect to "moderate risk" indications, consensus among panel members was only reached concerning prolonged rupture of membranes for which the primary care midwife could remain the caregiver. Conclusion: This study shows that most participants support more integration of care during labor. The lack of consensus among Dutch maternity care professionals with regard to the distribution of responsibilities and tasks for "moderate risk" indications is a challenge. Further studies should explore how to deal with differences in opinions among professionals when integrating maternity care systems.
机译：背景：在过去的几年中，从初级助产士主导的护理到产科医生主导的护理的转诊百分比在荷兰有所增加。大多数妇女因适应症风险有所增加而被临床助产士照料。这项研究旨在为产妇护理专业人员就“中等风险”因素的产妇护理中的综合护理和初级保健助产士的参与提供见解。方法：进行了由三个回合组成的德尔菲研究。根据目的选择的由50名专业人员组成的异源小组，包括产科医生，初级保健助产士，临床助产士和产科护士，以匿名方式回答了问题。结果：尽管初级保健助产士希望扩大其在“中度风险”适应症方面的责任和任务，但小组成员仅在长时间破裂的胎膜上达成共识，而初级保健助产士仍可继续作为监护人。结论：这项研究表明，大多数参与者支持分娩期间更多的护理整合。荷兰孕产保健专业人员之间就“中等风险”适应症的责任和任务分配缺乏共识，这是一个挑战。进一步的研究应该探索在整合产妇保健系统时如何处理专业人士之间的意见分歧。

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