新形势下上海市社区母婴保健服务开展现状的质性研究  

A Qualitative Study on the Status of Maternal and Infant Health Services in Shanghai Communities under the New Situation

作　　者：马晓霞 石济顺 钮利华 陈宁清 丁焱[2] MA Xiaoxia;SHI Jishun;NIU Lihua;CHEN Ningqing;DING Yan(School of Nursing,Fudan University,Shanghai 200032,China;Nursing Department,Obstetrics and Gynaecology Hospital,Fudan University,Shanghai 200090,China;Office of Kongjiang Community Health Service Center,Yangpu District,Shanghai 200082,China;Administrative Department,Maternal and Child Health Department,Qingpu Distinct,Shanghai 201700,China)

机构地区：[1]复旦大学护理学院,上海市200032 [2]复旦大学附属妇产科医院护理部,上海市200090 [3]上海市杨浦区控江社区卫生服务中心办公室,200082 [4]上海市青浦区妇幼保健所行政科,201700

出　　处：《中国全科医学》2024年第28期3529-3534,共6页Chinese General Practice

基　　金：上海市科技计划项目(22692113100);上海市申康医院发展中心管理研究项目(2022SKMR-11)。

摘　　要：背景随着我国出生人口的断崖式下降及生育政策的接连调整,重新审视母婴保健服务的广度和深度是必然的,但这也给母婴保健服务的重要供给方——社区卫生服务机构带来了巨大的挑战。目的了解上海市社区母婴保健工作开展的现况,以期为提升社区母婴保健服务水平提供建议和依据。方法2022年8月—2023年4月,采用目的抽样法,在上海市中心城区的5家社区卫生服务中心进行参与式观察期间,对10位母婴保健服务提供者开展个人深度访谈,并组织上海市城乡结合区的12位社区母婴保健服务提供者进行焦点小组访谈。此外,邀请8位进入妇产科医联体建设的三级医院产科工作人员开展2场焦点小组访谈,从不同角度获取信息。采用内容分析法进行资料分析。结果共提炼出4个主题、11个亚主题:(1)部分保健项目落实不佳:心理保健缺乏、避孕指导难达效果、中医保健落实难度大;(2)人力队伍建设有待加强:人力资源不足、专业知识技能欠缺、工作积极性差、家庭医生团队作用甚微;(3)服务执行过程困难重重:跨区管理难度大、居民参与度低;(4)服务整合协作有待完善:上级医疗机构定位偏离、各机构间沟通协调不足。结论当前上海地区社区母婴保健服务工作仍面临诸多挑战。应充分利用医联体建设机遇加强人才队伍培养、建立创新型人力资源管理模式;在强化顶层设计、明确各层级机构任务分工的同时,完善绩效考核和激励机制,真正激发社区母婴保健服务人员的士气和服务热情。多措并举切实提高社区母婴保健服务质量,满足社区母婴保健服务需求。Background With the precipice decline of the birth population and the successive adjustment of the fertility policy in China,it is inevitable to re-examine the breadth and depth of maternal and infant health care services.Also,it has posed great challenges to the community health service institutions,which are the important suppliers of maternal and infant health care services.Objective To investigate the current status of maternal and infant health services in Shanghai communities,in order to provide suggestions and evidence for upgrading the level of primary care services for mothers and infants.Methods From August 2022 to April 2023,using purposive sampling method,the study selected 5 community health centers in the central district of Shanghai,in which in-depth personal interviews were conducted with 10 maternal and infant health service providers during participatory observation;organized a focus group interview with 12 primary health workers in the urban-rural fringe areas.In addition,8 obstetrics staff from tertiary hospitals participating the construction of obstetrics and gynecology medical consortium,were invited to conduct 2 focus group interviews to obtain information from different perspectives.The data were analyzed using the content analysis method.Results A total of 4 themes and 11 sub-themes were extracted:(1)some health care projects are poorly implemented(inadequate mental health care,ineffective contraceptive guidance,and difficulties in implementation of traditional Chinese medicine health care);(2)health talent team construction needs to be strengthened(inadequate human resources,limited professional knowledge and skills,poor motivation to work,and little role of the family physician teams);(3)the implementation process is challenging(difficulty in cross-district management and low participation of residents);(4)the services integration need to be improved(deviation in the positioning of higherlevel medical institutions and insufficient coordination among agencies).Conclusion At present,mate

关 键 词：母婴保健 社区卫生服务中心 纵向医联体 上海市 质性研究 

分 类 号：R197.1[医药卫生—卫生事业管理]