Development of the HARMONI Holistic Midwifery Care Model Based on Interdisciplinary Interventions for Pregnant Women with High-Risk Pregnancy: A Descriptive Qualitative Study

Abstract

Background: High-risk pregnancy management is typically centered on a biomedical approach, often neglecting the psychological, social, spiritual, and nutritional aspects of the mother. Therefore, a comprehensive midwifery care model that includes interdisciplinary collaboration is necessary. This descriptive qualitative study was conducted in three phases which include (1) literature review following PRISMA guidelines, (2) Focus Group Discussion (FGD) with 10 participants, and (3) Expert Panel consisting of five experts. Data analysis applied a descriptive qualitative method with methodological triangulation to ensure the validity of the model. The literature review identified 5 relevant articles that present the integration of biopsychosocial and spiritual factors in high-risk pregnancy care. FGD uncovered five main themes, namely the experiences and holistic needs of high-risk pregnant women, family support and engagement, the physical focus of midwifery care, the significance of early detection and interprofessional collaboration, as well as the role of health workers in delivering holistic care. Furthermore, Expert Panel stressed the importance of enhancing interdisciplinary concepts, incorporating psychosocial and spiritual elements into clinical practice, and establishing guidelines for implementing the model. Based on these results, the HARMONI (Holistic, Active, Responsive, Multidisciplinary, Oriented, Nurturing, and Integrated) holistic midwifery care model was developed. The HARMONI Model introduced an innovative approach to holistic, interdisciplinary midwifery care for high-risk pregnant women. It aimed to enhance the quality of life for both mothers and fetuses by integrating bio-psycho-social-spiritual dimensions through collaborative interprofessional team efforts.