Through the client’s eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period

BMC Pregnancy and Childbirth

Research Article

Mark Gotink¹  Magda M. Boere-Boonekamp²  Ariana Need³  Cherelle M.V. van Stenus⁴  Anneke Sools⁵ 

[1] Department of Youth Healthcare, GGD Twente, P.O. Box 1400, 7500 BK, Enschede, The Netherlands;Institute for Innovation and Governance Studies, Department of Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands;Institute for Innovation and Governance Studies, Department of Public Administration, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands;Institute for Innovation and Governance Studies, Departments of Public Administration, and Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands;Institute for Innovation and Governance Studies. Department of Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands;

关键词: Client experiences;    Pregnancy;    Transfers of care;    Narratives;    Quality aspects;    Perinatal healthcare;   

DOI  :  10.1186/s12884-017-1369-6

 received in 2017-02-03, accepted in 2017-06-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe client experience is an important outcome in the evaluation and development of perinatal healthcare. But because clients meet different professionals, measuring such experiences poses a challenge. This is especially the case in the Netherlands, where pregnant women are often transferred between professionals due to the nation’s approach to risk selection. This paper explores questions around how clients experience transfers of care during pregnancy, childbirth, and the neonatal period, as well as how these experiences compare to the established quality of care aspects the Dutch Patient Federation developed.MethodNarratives from 17 Dutch women who had given birth about their experiences with transfers were collected in the Netherlands. The narratives, for which informed consent was obtained, were collected on paper and online. Storyline analysis was used to identify story types. Story types portray patterns that indicate how clients experience transfers between healthcare providers. A comparative analysis was performed to identify differences and similarities between existing quality criteria and those clients mentioned.ResultsFour story types were identified: 1) Disconnected transfers of care lead to uncertainties; 2) Seamless transfers of care due to proper collaboration lead to positive experiences; 3) Transfers of care lead to disruption of patient-provider connectedness; 4) Transfer of care is initiated by the client to make pregnancy and childbirth dreams come true. Most of the quality aspects derived from these story types were identified as being similar or complementary to the Dutch Patient Federation list. A ‘new’ aspect identified in the clients’ stories was the influencing role of prior experiences with transfers of care on current expectations, fears, and wishes.ConclusionsTransfers of care affect clients greatly and influence their experiences. Good communication, seamless transfers, and maintaining autonomy contribute to more positive experiences. The stories also show that previous experiences influence client’s expectations for the next pregnancy, childbirth, and transfers of care.

【 授权许可】

CC BY   
© The Author(s). 2017