| Autor: |
Groenen CJM; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands., Kremer JAM; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands., IntHout J; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands., Meinders MJ; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands., van Duijnhoven NTL; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands., Vandenbussche FPHA; Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. |
| Abstrakt: |
To improve both the active involvement of pregnant women in their maternal health and multidisciplinary collaboration between maternal care professionals, we introduced a personal health record (PHR) in routine maternity care. We studied the effects of this intervention on the percentage of uncomplicated births, women's perspectives on quality of care, and the collaboration between health care professionals. We performed a stepped-wedge cluster randomized controlled trial with four clusters and 13 maternity health centers (community-based midwife practices and hospitals) in one collaborative area. In total, 7350 pregnant women and 220 health care professionals participated. Uncomplicated births accounted for 51.8% (95% CI 50.1-53.9%) of total births in the control group and 55.0% (CI 53.5-56.5%) of total births in the intervention group ( p = 0.289). Estimated means revealed that the differences detected in the stepped-wedge study were due to time and not the intervention. Women's perspectives on quality of care and collaboration between health care professionals revealed no relevant differences between the control and intervention groups. The introduction of the PHR resulted in no significant effect on the chosen measures of quality of maternal care. The suggested positive effect in the raw data was a local trend which was less visible in the national database, and thus might be related to subtle changes toward an improved collaborative culture in the study region. |
