Development and early implementation of telemonitoring of complicated pregnancies – A qualitative study with the perspectives of health professionals

IF 2.6 3区医学 Q1 NURSING Midwifery Pub Date : 2024-08-18 DOI:10.1016/j.midw.2024.104149

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Abstract

Background

Telemonitoring may offer promising opportunities in health care. In obstetric health care, there is a need to expand and improve digitalization. Nevertheless, there is limited knowledge based on healthcare professionals' perspectives regarding the use of telemedicine and remote cardiotocography during pregnancy, as well as its implementation.

Aim

To explore the perspectives of health-care professionals who manage telemonitoring of complicated pregnancies.

Design and setting

A qualitative interview study undertaken in a hospital with a tertiary obstetric unit in Northen Denmark.

Methods

Based on a purposive sample strategy, 11 semi-structured interviews of health-care professionals involved in the management of telemonitoring in women with complicated pregnancies were conducted and analyzed using a reflexive thematic analytical approach.

Findings

The findings are assembled into two main themes. The experience of relevance to own practice: included the embedded potentials in telemonitoring providing women-centred care, but also challenges related to the implementation of a new technology. Experience of challenges and potential in day-to-day operation: included frustrations regarding the technological devices and software, working experiences increasing confidence in telemonitoring, and perspectives on the required interdependence across departments.

Conclusion

This study adds important knowledge to support awareness and reflection on how challenges impact the successful implementation of telemonitoring in obstetric and midwifery care. This includes knowledge of important processes and resources to ensure ongoing implementation and evaluation. Implementation strategies and collaborations to support a multiple-level system change, such as an interdisciplinary team, seem crucial to minimize challenges, build shared visions, and engage staff.

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复杂妊娠远程监护的开发和早期实施--从医疗专业人员的角度进行的定性研究。

背景：远程监控可为医疗保健提供大有可为的机会。在产科医疗保健中，有必要扩大和改进数字化。然而，从医护人员的角度来看，他们对孕期远程医疗和远程心动图的使用及其实施的了解还很有限。目的：探讨管理复杂妊娠远程监护的医护人员的观点：在丹麦北部一家设有三级产科的医院进行的定性访谈研究：根据目的性抽样策略，对参与复杂妊娠妇女远程监护管理的专业医护人员进行了 11 次半结构化访谈，并采用反思性主题分析方法对访谈结果进行了分析：研究结果分为两大主题。与自身实践相关的经验：包括远程监护在提供以妇女为中心的护理方面所蕴含的潜力，但也包括与实施新技术相关的挑战。日常操作中的挑战和潜力：包括技术设备和软件方面的挫折、增强对远程监控信心的工作经验，以及对跨部门相互依存所需的观点：这项研究增加了重要的知识，有助于认识和思考在产科和助产护理中成功实施远程监护所面临的挑战。这包括了解确保持续实施和评估的重要流程和资源。支持多层次系统变革的实施策略和合作（如跨学科团队）对于最大限度地减少挑战、建立共同愿景和吸引员工参与似乎至关重要。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.