ارزیابی کیفیت ارائه مراقبت های پس از زایمان بر اساس مدل بروس در مراکز بهداشتی درمانی شهر مشهد سال 93-1392

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استاد گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 دانشیار گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: ارزیابی کیفیت مراقبت های بهداشتی - درمانی به عنوان یک معیار ضروری جهت ارتقای کیفیت مراقبت ها در نظر گرفته می شود که می تواند منجر به بهبود بخشیدن نتایج برنامه ها و اثربخش کردن آن‌ها شود. یکی از روش های ارزیابی کیفیت مراقبت، مدل بروس است که با کمک آن می توان به شناسایی واحدهای ضعیف و رفع کمبودها پرداخت. مطالعه حاضر با هدف ارزیابی ارائه کیفیت مراقبت های پس از زایمان بر اساس مدل بروس در مراکز بهداشتی درمانی شهر مشهد انجام شد.
روش کار: این مطالعه مقطعی در سال 93-1392 بر روی 500 نفر از مادران در 19 مرکز بهداشتی درمانی شهر مشهد انجام شد. افراد به روش نمونه گیری چند مرحله ای انتخاب شدند. ابزار گردآوری داده ها شامل پرسشنامه مشخصات واحد پژوهش و چک لیست ارزیابی مراقبت طبق مدل بروس شامل شش بُعد مهارت فنی، مشاوره و آموزش، ارتباط بین فردی، انتخاب آگاهانه، مکانیسم پیگیری، سازماندهی شرایط و خدمات بود. داده ها با استفاده از نرم افزار آماری SPSS (نسخه 16) و روش های آمار توصیفی و تحلیلی مورد تجزیه و تحلیل قرار گرفتند. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: کیفیت کلی مراقبت های پس از زایمان از سطح متوسطی برخوردار بود. در این مطالعه بُعد مهارت فنی (معاینات بالینی) و مشاوره و آموزش در مراقبت های پس از زایمان ضعیف و بقیه ابعاد شامل مهارت فنی (شرح حال گیری)، ارتباط بین فردی، مکانیسم پیگیری و انتخاب آگاهانه از سطح متوسطی برخوردار بودند. بر اساس نتایج آزمون کروسکال والیس، بین میانگین نمره ابعاد مختلف کیفیت به جز در بُعد مکانیسم پیگیری در بقیه ابعاد در مراکز بهداشتی درمانی شهر مشهد اختلاف وجود داشت (05/0>p).
نتیجه گیری: با توجه به کیفیت ضعیف معاینات بالینی و بُعد مشاوره و آموزش در این مراقبت ها و تأثیر آن در پیشگیری از عوارض دوران پس از زایمان، انجام تحقیقات بیشتر در زمینه علت کیفیت پایین این مراقبت ها پیشنهاد می شود.
کلمات کلیدی: ارزیابی کیفیت، مدل بروس، مراقبت پس از زایمان

کلیدواژه‌ها


عنوان مقاله [English]

Evaluation of the Quality of Postpartum Care Based on Bruce Model in Medical Health Centers of Mashhad City in 2013-2014

نویسندگان [English]

  • Khadijeh Mirzaee 1
  • Somayyeh Oladi Ghadikolaee 2
  • Mohamad Taghi Shakeri 3
  • Seyed Mojtaba Mousavi Bazzaz 4
1 Associate Professor, Department of Reproductive Health, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 MSc Student of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Professor, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Associate Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Evaluating quality of health and medical care is considered as an essential criteria to promote the cares' quality that can lead to improve the results of programs and their efficacy. One of the methods to assess the quality of care is Bruce model which can detect the weak units and eliminate the shortages. This study was performed with aim to evaluate the quality of postpartum care Based on Bruce Model in medical health centers of Mashhad.
Methods: This cross-sectional study was performed on 500 qualified mothers from 19 medical and health centers in Mashhad in 2013-2014. The samples were selected by multi-stage sampling method. Data collection tool included demographic questionnaire and care evaluation check-list based on Bruce model which included 6 aspects of technical skills, training and consultation, inter-personal relationship, informed selection, follow-up mechanism, organizing the services and conditions. Data was analyzed by SPSS software (version 16) and descriptive-analytical statistics. PResults: Total quality of postpartum cares was moderate. In this study, technical qualification (clinical examinations) and training and consultation in postpartum care were weak. Other aspects including technical qualification (history), inter-personal relationship, follow-up mechanism, and informed selection were moderate. Based on the Kruskal-Wallis test, there was difference between mean scores of different aspects of quality in Mashhad health centers except in the aspect of follow-up mechanism (P<0.05).
Conclusion: With regard to the poor quality of clinical examinations and training and consultation in these cares and their effects on preventing from postpartum complications, it is recommended to do more studies about the cause of weak quality of these cares.
 

کلیدواژه‌ها [English]

  • Keywords: Bruce Model
  • Postpartum Care
  • Quality assessment
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