A qualitative study exploring junior paediatricians', midwives', GPs' and mothers' experiences and views of the examination of the newborn baby

Abstract

Acknowledgements:The work was funded as part of the UK NHS Health Technology Assessment Programme (grant 94/40/05). Opinions and conclusions are those of the authors and not the funders. Thanks are due to Julie Hayes for comments on the paper and study design, and to Morag McKinnon for interviewing five of the GPs and five of the SHOs. We are indebted to the midwives, SHOs, GPs and mothers who were interviewed.3 Exploring experiences and views: A qualitative study of the opinions of junior paediatricians, midwives, GPs and mothers about the routine examination of the newborn Objective: To explore the experiences and attitudes of midwives, junior paediatricians (SHOs), GPs, and mothers towards the neonatal examination. To provide an appreciation of their views on the purpose and value of the examination, who is appropriate to carry it out, and when and where it should take place. Design:The research used semi-structured interviews, which were exploratory and interactive in form, in order to examine the range and diversity of experiences and attitudes towards the neonatal examination. Setting: Southeast EnglandParticipants: Four samples were purposively selected for interview, to include ten each of midwives, SHOs, GPs and recently delivered mothers. SHOs were currently working in paediatric departments of a district general or teaching hospital and their experience of conducting newborn examinations ranged from several months to several years. Midwives included both those trained in the newborn examination and currently conducting examinations, and those not so trained and not carrying out he examination.Most of the midwives had been qualified for over ten years and had a wide range of clinical experience in hospital and community settings. The GPs were from ten practices in two Health Authorities and all had some experience of conducting neonatal 4 examinations. Of the mothers, a few had their babies examined at home by midwives, others in hospital by an SHO. Mothers included those with a family history of problems relevant to the examination, those with previous pregnancy complications and others with no problems or complications. Some were first time mothers.

Examination of the newborn: The innocent heart murmur

“…It has been stated in the work of Walton and Edwards (2002) nationwide survey of the US that junior doctors are not adequately trained for this role. While this is an American study, similar opinion reigns in the UK (Hall and Elliman, 2003;Lee et al, 2001;Bloomfield et al, 2003). On the other hand, there is research that suggests that midwives are in a better position to fulfil the aims of the examination Walker, 1999;Hall, 1999;Lomax, 2001;Lumsden, 2002;Wolke et al, 2002;Rogers et al, 2003;Williamson et al, 2005;Lee, 2006), as it is recognised that midwives are in a unique position to provide health advice and promote health education (Mitchell, 2002).…”

Die berufliche Praxis von Hebammen in der ambulanten Wochenbettbetreuung: eine Literaturanalyse

“…In 2 Studien stehen die Interaktionen zwischen Hebammen und Frauen im Vordergrund [37,41]. 2 weitere Forschungsartikel beschäftigen sich mit der Rolle von Hebammen bei der Untersuchung des Neugeborenen [42,43].…”

“…Eine widersprüchliche Stillberatung durch verschiedene Betreu- ungspersonen führt dazu, dass Frauen hinsichtlich ihres Selbstvertrauens und ihrer Fähigkeiten negativ beeinflusst werden [44]. Viele Studien verweisen außerdem auf einen Zusammenhang zwischen einer individuellen und kontinuierlichen Betreuung von Mutter und Kind und einer möglichen stärkeren persönlichen Zufriedenheit der Hebamme mit ihrer Arbeit [28,29,42,43]. Ob die Kontinuität einer Betreuungsperson in allen Phasen von Schwangerschaft, Geburt und Wochenbett umgesetzt werden kann, hängt von verschiedenen Faktoren ab.…”

“…Aus der Perspektive anderer Berufsgruppen wie Pädiatern und Allgemeinmedizinern haben Hebammen eine bessere Beziehung zu den Müttern, gewährleisten mehr Kontinuität in der Betreuung und diskutieren häufiger Gesundheitsaspekte mit den Frauen als Pädiater [42].…”

Die berufliche Praxis von Hebammen in der ambulanten Wochenbettbetreuung

“…Dies führen die Autorinnen der Studie auf strukturelle Rahmenbedingungen zurückwie den hohen Arbeitsanfall und darauf, dass Hebammen gleichermaßen für Mutter und Kind verantwortlich sind [35]. Aus der Perspektive anderer Berufsgruppen (wie Pädiater und Allgemeinmediziner) haben Hebammen eine bessere Beziehung zu den Müttern, gewährleisten mehr Kontinuität in der Betreuung und diskutieren häufiger Gesundheitsaspekte mit den Frauen als Pädiater [37].…”