Objective: To improve a model of nurse-midwifery service to attain a quality corresponding to the social context and patients’ needs and to investigate the satisfaction, problems and possibility of quality development of the nurse-midwifery service.
Material and Methods: The subjects of this study comprised 78 administrators, nurse-midwives, and patients of central hospitals and community hospitals before improving the service and 78 after improving the service. The instruments was a questionnaire investigating the satisfaction of administrators, nurse-midwifes, and patients. The Cronbach’s alpha reliability of the instruments was .76 and .85 respectively. Data analysis on general information was performed by the use of descriptive statistics. Qualitative data were analyzed using content analysis technique. The Wilcoxon signed ranks test was employed to compare the satisfaction of the administrators and nurse-midwives with the quality of the service of the nurse-midwives before and after quality development of the service. The Mann-Whitney U test in SPSS was used to compare the satisfaction of patients and the quality of the nurse-midwifery service before and after quality development of the service.
Results: The model of quality development of nurse-midwifery service at both central hospitals and community hospitals covered several aspects. That is, the service system should be convenient and quick. There should be training to improve nursemidwives in terms of their personality, relationship with patients, and guidelines on quality service. Moreover, there should be training on their knowledge of normal newborn babies and new-born babies with complications. For satisfaction, it was found that at central hospitals and community hospitals administrators, nurse-midwives and patients were highly satisfied both before and after development. There was no statistically significant difference between before and after development in any subject group.
Conclusion: The quality development of the nurse-midwifery service using participatory action research helped the nursemidwives to be more alert and aware of service quality. It also encouraged the nurse-midwives to use a holistic approach in their service, focusing on patients. Moreover, they gave greater importance to patients’ needs although the satisfaction of both nursemidwives and patients before and after the development showed no statistically significant difference.