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

مراجع

  1. Chimtembo LK, Maluwa A, Chimwaza A, Chirwa C, Pindani M. Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi. Open J Nurs 2013; 3:343-50.
  2. Dhaher E, Mikolajezyk RT, Maxwell AE, Kramer A. Factor associated with lack of potential care among Palestine women: a cross-sectional study of three clinics in the West Bank. BMC Pregnancy Childbirth 2008; 8:26-35.
  3. Roohi M, Alizadeh Charandabi SM. Mothers’ problems experienced during the first year of postpartum and their association with the kind of childbirth in Mahabad, Iran, 2011. Iran J Obstet Gynecol Infertil 2012; 15(23):28-37. (Persian).
  4. McGovern P, Dowd B, Gjerdingen D, Gross CR, Kenney S, Ukestad L, et al. Postpartum health of employed mothers 5 weeks after childbirth. Ann Fam Med 2006; 4(2):156-67.
  5. Mirzaee K, Shakeri MT. Maternal knowledge on postpartum care in healthcare centers of Mashhad, Iran in 2013. J Midwifery Reprod Health 2015; 3(4):456-64.
  6. Ghodsbin F, Yazdani K, Jahanbin I. Impact of supportive efforts on the quality of life primiparous women in the first six week after delivery. Iran J Obstet Gynecol Infertil 2012; 15(17):17-24. (Persian).
  7. Jahani Shourab N, Ghaffari Sardasht F, Jafarnejad F, Esmaili H. Assessment of prenatal care process based on donabedian model in Mashhad health centers. Iran J Obstet Gynecol Infertil 2013; 16(53):7-17. (Persian).
  8. Mohseni M, Bahadoran P, Abedi H. The quality of postpartum care from mothers’ viewpoint. Hakim 2009; 12(1):27-34. (Persian).
  9. Taghizadeh ZI, Rezaiepour A, Mehran AB, Alimoradi Z. Usage of communication skills by midwives and its relation to clients’ satisfaction. Hayat 2006; 12(4):47-55. (Persian).
  10. Varghese J, Rajagopal K. A study to evaluate the level of satisfaction perceived by postnatal mothers following nursing care in postnatal wards as expressed by themselves. J Biol Agricult Healthcare 2012; 2(6):101-11.
  11. Aghlmand S, Akbari F. Method to assess the quality of health services. Sixth International Conference on quality management, Tehran, Iran; 2005.
  12. Bruce J. Fundamental elements of the quality of care: a simple framework. Stud Fam Plann 1990; 21(2):61-91.
  13. Nounez Jose G. Educational material prepared in the workshop of quality improvement of reproductive health/family planning. Trans: Eslamloo F. Golstan, Iran: Ministry of Health and Medical Education publication; 2001. (Persian).
  14. Turan JM, Bulut A, Nalbant H, Ortayl N, Akalın AK. The quality of hospital-based antenatal care in Istanbul. Stud Fam Plann 2006; 37(1):49-60.
  15. Nanbakhsh H, Salarilak S, Islamloo F, Aglemand S. Assessment of women’s satisfaction with reproductive health services in Urmia University of Medical Sciences. East Mediterr Health J 2008; 14(3):605-14.
  16. Peter ND. Patient satisfaction with intrapartum and postpartum nursing care. Buea: Bachelor in Nursing Sciences (BNS); 2009.
  17.  Simbar M, Alizadeh DZ, Abed SZ, Alavi MH. Assessment of quality of care in postpartum wards of Shaheed Beheshti medical university hospital. Pejouhandeh 2005; 10(1):45-9. (Persian).
  18. Wiegers TA. Adjusting to motherhood: maternity care assistance during the postpartum period: how to help new mothers cope. J Neonatal Nurs 2006; 12(5):163-71.
  19. Araban M, Karimy M, Tavousi M, Shamsi M, Niakan Kalhori S, Khazaiyan S, et al. Quality of midwifery care provided to women admitted. J Shahid Beheshti Sch Nurs Midwifery 2013; 23(81):5893. (Persian).
  20. Simbar M, Nahidi F, Akbarzadeh A. Assessment of quality of prenatal care in Shahid Beheshti University of medical sciences health centers. Payesh 2012; 11(4):529-44. (Persian).
  21. Farrokhi F, Khadivzadeh T. The quality of midwives in providing of prenatal care in urban health centers, affiliated. J Mashhad Univ Med Sci 2008; 7(3):203-10. (Persian).
  22. Mansour Lamadah S, El–Nagger NS. Mothers' satisfaction regarding quality of postpartum nursing care and discharge teaching plan at ain shams maternity and gynecological hospital. Int J Curr Res 2014; 6(7):7545-51.
  23. Buchko BL, Gutshall CH, Jordan ET. Improving quality and efficiency of postpartum hospital education. J Perinat Educ 2012; 21(4):238–47.
  24.  Oladapo OT, Iyaniwura CA, Sule-Odu AO. Quality of antenatal services at the primary care level in southwest Nigeria. Afr J Reprod Health 2008; 12(3):71-92.
  25. Baghiani MM, Esfandiari R, Nazari M. Comparison of the effect of written or speech communication skills training of health staff on clients' satisfaction of Shiraz health centers. Toloo-e-Behdasht 2012; 11(1):32-40. (Persian).
مجله زنان، مامایی و نازایی ایران
دوره 18، شماره 177 - شماره پیاپی 177
هفته سوم دی ماه 1394
دی 1394
صفحه 1-10

فایل ها

هم رسانی

ارجاع به این مقاله

آمار