Abstract
Objective Under the guidance of the Structure-Process-Outcome framework, this study aims to construct a sensitive indicator system for midwifery practice quality using evidence-based nursing methods. The goal is to enhance the quality of midwifery practice for healthcare providers, provide a positive childbirth experience for mothers and their families, and offer decision-making evidence for evaluating the quality of midwifery practice. Methods Based on Donabedian's Structure-Process-Outcome three-dimensional quality structure model as the theoretical framework, this study employed literature review, Delphi expert consultation, and Analytic Hierarchy Process (AHP) to construct a sensitive indicator system for midwifery practice quality. Results A total of 16 articles were included. After screening, analyzing, and organizing the literature, the research team extracted relevant indicators to construct the initial draft of the midwifery practice quality evaluation indicator system. Following two rounds of expert consultation, a total of 42 sensitive indicators were identified, including 9 structural indicators, 21 process indicators, and 12 outcome indicators. The AHP results indicated that the consistency ratio (CR) values for all hierarchical indicators ranged from 0 to 0. 0571, all of which were less than 0. 1. This suggests that there was no logical error within the indicator system, and the weight distribution was consistent. Conclusion The sensitive indicator system for midwifery practice quality constructed in this study demonstrates high reliability, scientific rigor, comprehensiveness, and practicality. It can serve as an assessment tool for clinically evaluating the effectiveness of midwifery practice and provide decision-making evidence for improving the quality of midwifery practice and enhancing maternal comfort during childbirth. (目的 在“结构—过程—结果”模型的指导下, 利用护理循证方法, 构建助产实践护理质量敏感指标体系, 以达到提高医务人员助产实践质量、给产妇和家属带来美好分娩体验及为助产实践质量评价提供决策证据的目的。方法 以Donabedian提出的“结构—过程—结果”三维质量结构模型为理论框架, 采用文献回顾、德尔菲专家函询、层次分析法构建助产实践质量敏感指标体系。结果 本研究最终纳入16篇文献。研究小组对文献进行筛选、分析、整理后提取出相关指标内容, 构建助产实践质量评价指标体系初稿并进行两轮专家函询, 最终形成敏感指标42项, 其中结构指标9项、过程指标21项、结果指标12项。层次分析结果显示, 各层级指标判断矩阵CR值范围为0～0. 0571, 均＜0. 1, 通过一致性检验。提示指标体系中各级指标间无逻辑错误, 权重结果有效。结论 本研究构建的产房助产实践质量敏感指标体系具有较高的可靠性、科学性、全面性及实用性, 可为临床评价助产实践效果提供评估工具, 为改进助产实践质量、提高产妇舒适分娩提供一定的决策依据。)