助产专业学生核心胜任力调查

目的了解助产专业学生的核心胜任力现状。方法采用助产士核心胜任力量表对112名助产专业学生进行调查。结果助产专业学生毕业时核心胜任力总均分为(3.77±0.51)分,低于湖南省助产士核心胜任力总均分,其中分娩期保健、产后保健及新生儿保健得分较高,孕前保健得分较低,学生实习前后孕期、分娩期、产后、新生儿保健的核心胜任力得分及核心胜任力总均分比较,差异有统计学意义(P0.05)。结论助产专业学生的培养在学校教育层面仍存在一些问题,应加强助产教育,提高助产专业学生的核心胜任力水平。     

北京市助产士核心胜任力现状及影响因素的调查研究

目的:了解北京市助产士的核心胜任力现状,并分析其影响因素。方法:采用助产士核心胜任力量表对北京市24家二级以上医院的283名助产士进行横断面调查。结果:助产士核心胜任力总均分为4.02±0.47。其中分娩期保健能力、孕期保健能力和产后保健能力3个方面能力较好,而孕前保健能力、公共卫生保健能力和新生儿保健能力三个方面相对薄弱。多元回归分析发现,助产工作年限、职务、编制是助产士核心胜任力的影响因素(P<0.05)。结论:北京市助产士核心胜任力水平总体较好,但仍有进一步提升的空间,以满足孕产妇及家属日益增长的服务需求,以及助产士工作范畴拓展和助产专业发展的需要。管理者应根据医院自身情况,对不同特征的助产士实施针对性的培训和管理策略,提高助产士的核心胜任力水平。     

河南省基层医院助产士核心胜任力调查分析

目的调查河南省基层医院助产现状,分析一般自我效能感和学习型组织与核心胜任力的关系。方法采用助产士核心胜任力量表、一般自我效能感量表和护理学习型组织量表对河南省34家基层医院的245名助产士进行问卷调查。结果 (1)助产士多为初级职称,初始学历较低,本科仅有17(6.9%)人;(2)助产士核心胜任力总均分(4.02±0.53)分,孕前保健、新生儿保健和公共卫生保健得分较低;(3)不同累计进修时间及最高学历助产士核心胜任力差异无统计学意义(P0.05);(4)核心胜任力和各维度得分与其一般自我效能感得分及护理学习型组织得分有正相关关系(P0.01)。结论基层医院助产士的初始学历、职称层次较低,核心胜任力有限,对孕妇的全程服务意识不强,一般的临床再教育效果又不显著。建议在助产士规范化培训中,应重视对基层医院助产士进修培训,使这一群体在应对生育高峰中发挥更大的作用。     

集中群组孕期保健模式的临床效果评价

目的探讨集中群组孕期保健模式的临床应用效果。方法选取2018年5-8月在兰州大学第一医院产科门诊就诊的孕28~34周的孕妇72例为研究对象,根据孕妇意愿分为干预组和对照组,每组各36例。对照组给予常规孕期保健模式干预,干预组给予集中群组孕期保健模式干预。分析干预前后孕妇分娩恐惧得分、助产士核心胜任力得分及妊娠结局等临床指标的差异。结果干预组孕妇分娩恐惧水平、剖宫产率明显下降,住院期间纯母乳喂养率明显提高,与对照组比较,差异均有统计学意义(均P<0. 05)。干预前后,助产士核心胜任力总均分显著提高,差异有统计学意义(P<0. 05)。结论集中群组孕期保健模式对保健者、孕妇及妊娠结局均具有积极促进作用,值得在临床推广与应用。     

川东北地区助产士的核心胜任力

目的评价川东北地区助产士核心胜任力现状,分析助产士核心胜任力总体情况及对其的影响因素。方法采用一般资料调查表和助产士核心胜任力量表对川东北地区各级医院助产士进行问卷调查。结果川东北地区助产士核心胜任力总均分为(4.11±0.52)分;助产士核心胜任力得分与年龄、助产工作年限、职称、婚姻状况、聘任形式具有相关性。结论川东北地区助产士核心胜任力水平较高,应将产科模式调整为助产士主导的模式,建立完善助产士教育体系和继续教育,提高助产士核心胜任力水平。     

社区卫生服务站疾病预防控制相关工作指标结果分析

目的分析2017年北京市海淀区社区卫生服务绩效及基本公共卫生服务考核结果中疾病预防控制相关工作指标对整体结果的影响。方法对2017年北京市海淀区44家社区卫生服务站的绩效及基本公共卫生服务考核结果进行统计学分析。结果海淀区44家社区卫生服务站考核结果中预防接种得分、公共卫生合计得分数据不服从正态分布,综合业务总分、总分及标化总分数据分布均属于正态分布。(1)是否开展预防接种工作与综合业务总分的差异的统计学差异有意义(r=0. 740,P <0. 05),与总分的差异有统计学意义(r=0. 727,P <0. 05),与标化总分的差异有统计学意义(r=0. 727,P <0. 05);(2)预防接种得分排名与公共卫生合计得分排名差异没有统计学意义(r=-0. 149,P> 0. 05),与综合业务总分排名差异没有统计学意义(r=-0. 085,P>0. 05),与总排名差异没有统计学意义(r=-0. 113,P> 0. 05);(3)公共卫生合计得分排名与综合业务总分排名之间差异有统计学意义(r=0. 921,P <0. 05),与综合业务总分排名差异有统计学意义(r=0. 927,P <0. 05),与总排名差异有统计学意义(r=0. 989,P <0. 05)。结论对考核指标需更加科学客观的设置,各机构应避免唯结果导向,既要重视总分,也要重视每项指标分数。在未来疾病预防控制相关工作上应持续加强改进,均衡施力。     

四川省36所医院医院感染预防与控制人员岗位胜任力现状调查及影响因素

目的 了解四川省医院感染预防与控制人员的岗位胜任力现状并分析其影响因素。方法 采用便利抽样,于2021年12月-2022年2月对四川省医院感染控制部门以及临床科室专职或兼职从事感控工作的相关人员,发放《医院感染预防与控制人员岗位胜任力自评量表》进行问卷调查。结果 最终系统回收问卷255份,有效问卷253份,回收有效率为99.21%。结果显示,253名调查对象的岗位胜任力自评总分处于中等水平;在核心维度的得分中,专业发展能力自评得分最低,个人特征品质得分最高。在子维度中,学习能力和监测能力得分较低。其余子维度自评得分均在5分以上。单因素分析结果显示,医院感染预防与控制人员所在医院类型、学位水平、参加感控培训、感控人员类别在岗位胜任力得分上差异具有统计学意义(P<0.05)。多元线性回归分析结果显示,医院感染预防与控制人员参加感控培训、学位水平、感控人员类别是岗位胜任力的影响因素(P<0.05)。结论重视医院感染预防与控制人员的整体队伍建设,合理设置医院感控部门人员结构,推广实行医院感控督察员制度,尤其是加大感控相关培训力度,能提升医院感染预防与控制人员的岗位胜任力,促进我省各...     

西安市3所三级甲等医院临床护士同情心疲乏与岗位胜任力的现况分析

目的 了解西安市3所三级甲等医院临床护士同情心疲乏和岗位胜任力的现状及两者的关系，为研究和制定提高岗位胜任力、降低护士同情心疲乏程度的干预方案提供依据。方法 2022年3—4月间，采用方便抽样的方法，以电子问卷的方式对西安市3所三级甲等医院的211名临床护士进行调查。调查工具为综合医院护士胜任力调查问卷和中文版同情心疲乏简短量表，并对数据进行分析。结果 临床护士的同情心疲乏得分为（47.24±23.32）分，岗位胜任力得分为（145.88±16.34）分。不同健康状况和收入满意度的临床护士同情心疲乏总分及各维度得分比较，差异均有统计学意义（均P<0.01）；不同收入满意度和健康状况的临床护士岗位胜任力总分及各维度得分比较，差异均有统计学意义（均P<0.05）。同情心疲乏与岗位胜任力呈负相关（P<0.01）。岗位胜任力、子女情况、收入满意度、健康状况均是护士同情心疲乏的影响因素（均P<0.05）。结论 西安市3所三级甲等医院临床护士的同情疲乏处于中等水平，岗位胜任力处于偏高水平。护理管理者应更加注重护士的内在情绪，可通过培养并提高临床护士的岗位胜任力以降低其同情心...     

互联网+虚拟仿真实训教学对高职助产专业学生综合素养、教育氛围的影响△

目的：探究互联网+虚拟仿真实训护理教学在高职助产专业学生中的应用效果。方法：选取江苏省徐州医药高等职业学校在2021年9月-2022年7月在籍助产专业104名学生作为研究对象,按照随机数字表法分为对照组和干预组,每组各52例。对照组实施传统护理教学模式,干预组实施互联网+虚拟仿真实训护理教学模式,比较两组核心胜任能力评分、综合素养能力评分及教育氛围评分。结果：干预组在孕前保健、孕期保健、分娩期保健、新生儿保健、产后保健、公共卫生保健等核心胜任能力综合评分高于对照组（P < 0.05）;干预组的专业理论知识、临床实践操作、临床判断、分析解决问题能力、无菌观念、沟通能力等综合素养评分高于对照组（P < 0.05）;干预组的学生学术知觉、环境知觉、教师知觉以及社会知觉等教育环境综合评分高于对照组（P < 0.05）。结论：互联网+虚拟仿真实训护理教学模式有助于提升高职助产专业学生核心能力和综合素养水平。     

辽宁省助产士结构授权、心理授权与留职意愿的相关研究

目的 了解辽宁省助产士结构授权、心理授权与留职意愿现况，分析结构授权、心理授权与留职意愿的关系，为提升结构与心理授权水平、稳定助产士留职意愿提供理论依据。方法 采用便利抽样法于2020年8—9月选取辽宁省沈阳市、大连市8所三级甲等医院共206名助产士作为调查对象，采用一般人口统计学资料调查表、工作效能条件问卷、心理授权量表及护士留职意愿问卷进行调查，并对数据进行分析。结果 辽宁省助产士留职意愿总分为（24.39±4.22）分，结构授权总分为（48.87±10.29）分，心理授权总分为（46.14±8.19）分。相关分析显示，助产士结构授权总分及各维度得分与留职意愿总分及各条目得分均呈正相关（r=0.305、0.664，均P<0.01），助产士心理授权总分及各维度得分与留职意愿总分及各条目得分均呈正相关（r=0.333、0.658，均P<0.01）。多元分层回归结果显示，结构授权、心理授权对留职意愿的预测作用差异均有统计学意义（β=0.336、0.264，均P<0.01），解释变异量的22.8%。结论 辽宁省助产士结构授权处于中等水平，心理授权、留职意愿处于中等偏上水平...     

助产士核心能力培训对提升专科技能的探讨

目的探讨开展助产士核心能力培训对提升助产士专科技能的效果。方法按《专业护士核心能力建设指南》中助产士核心能力培训模块的要求,将我院产科助产士按其能力进行分级,(N1^N3级)。成立助产士核心能力培训小组,确定培训内容及目标。培训方式采取集体培训法、建立《助产士核心能力培训登记本》、实行导师制培训、鼓励自学、书写护理个案或心得体会。比较助产士培训前、后使用催产素并发症发生率、新生儿重度窒息发生率、产后出血发生率、产后尿潴留、会阴侧切发生率。比较孕产妇对助产士操作技能的满意度的改变。结果实施助产士核心能力培训后,初产妇的会阴侧切率、使用催产素并发症发生率、新生儿重度窒息发生率、产后出血发生率、产后尿潴留发生率显著降低,差异有统计学意义(p<0.05);医生、孕产妇对助产士专科技能的满意度较培训前增高,差异有统计学意义(p<0.01)。结论开展助产士核心能力培训能提升助产士的专科技能。     

Who can provide antenatal care? The views of obstetricians and midwives

Objective: To describe the types of antenatal services in NSW maternity hospitals and examine the views of midwives and obstetricians about who can provide adequate routine antenatal care.
Measurements: A mail-out questionnaire to nursing unit managers (NUMs) explored the types of antenatal services available in their hospitals. The questionnaire for 196 midwives and 114 obstetricians asked whether they believed six provider/service types could provide adequate antenatal care either alone or in conjunction with an obstetrician.
Findings: 80% of hospitals had GPs providing antenatal care, 53% had obstetricians and 3% had visiting midwives; 33% had a public antenatal clinic, 28% a shared care program with GPs and 26% midwives' antenatal clinics. Midwives were more likely than obstetricians to rate the following as able to provide adequate care alone: hospital antenatal clinic (4.7 times more likely); independent midwife (42.9x); and community midwives as an outreach hospital service (17x). Obstetricians were 8.2x more likely than midwives to rate private obstetricians as being able to provide adequate care. Midwives were more likely to perceive that independent midwives (24.7x more likely) and community midwives as an outreach hospital service (15.3x more likely) were able to provide adequate care either alone or in conjunction with an obstetrician.
Conclusion: Most NSW hospitals have GPs providing care, but midwives' clinics and independent midwives are less available. While midwives and obstetricians hold similar beliefs about GPs providing care, substantial differences emerged about the midwife's role. Such disparity in opinion may be central in providing options and consistency in care for women.     

Midwives as Providers of Prenatal Care in Finland—Past and Present

This study analyzes the role of the midwife in prenatal care by exploring the history of the midwifery profession in Finland and by interviewing midwives. Midwifery education started in Finland in the beginning of the 19th century due to the utilitarian population policy aiming to reduce the high infant mortality rate. Because of a shortage of physicians professional midwives attained an important status in the care of births. With industrialization a state-directed welfare policy with state-subsidized health care developed. After World War II, the midwifery were legally defined as care during pregnancy, delivery, and the postpartum period. In the 1950s, the scope of work of midwifery was further altered because hospital deliveries had become routine. Some midwives provided prenatal care in ambulatory maternity health centers while others worked in hospitals managing normal childbirths. Separate midwifery education ended in 1968 and resumed 1986. Since 1972, public health nurses have increasingly provided prenatal and postnatal care in maternity centers, and specialized nurses have managed normal childbirths. In the future, public health nurses may totally replace midwives in prenatal care, and the role of midwives may return to care of normal deliveries. Midwife interviews revealed the "medicalization" of pregnancy caused both by physicians and midwives' own medical concept of pregnancy and by clients' demands for good care.     

深圳市宝安区流动人口孕前保健依从性的影响因素及模式探索

目的对深圳市宝安区流动人口孕前保健依从性进行调查,分析其影响因素,对提高流动人口孕前保健依从性的模式进行探索,为优生优育提供依据。方法选取深圳市宝安区流动人口1 300名女工进行研究,采用自制调查问卷进行调查,观察流动人口孕前保健依从性的影响因素;对相关因素进行单因素及多因素Logistic回归分析。647名愿意接受干预模式为观察组,653名不愿接受干预措施为对照组。观察组实施孕前保健系统知识培训、系统化管理模式及现代化信息管理技术进行干预,比较两组孕前保健依从性情况,分析统计参加孕前保健和未参加孕前保健的女工计划妊娠率、不孕不育发生率、流产率、合并症发生率和出生缺陷儿等指标的差异性。结果 1 300名调查对象收回有效调查问卷1 279份,经单因素分析发现:不同年龄阶段、不同收入、不同职业人群孕前保健参与率比较,差异无统计学意义(P0.05);但不同文化程度人群孕前保健参与率比较,差异有统计学意义(P0.05);经多因素Logistic回归分析发现,不同文化程度是影响孕前保健参与率的独立危险因素(P0.05)。观察组孕前保健的依从性高于对照组(P0.05);参加孕前保健者的计划妊娠率高于未参加孕前保健者,流产率、合并症发生率和出生缺陷儿低于未参加孕前保健者,差异均有统计学意义(P0.05)。结论影响流动人口孕前保健依从性的影响因素较多,应加强卫生服务系统建设,做好孕妇信息跟踪,定期进行相关培训,保证孕妇孕期保健的依从性,为优生优育提供基础。     

Midwives as providers of prenatal care in Finland--past and present

This study analyzes the role of the midwife in prenatal care by exploring the history of the midwifery profession in Finland and by interviewing midwives. Midwifery education started in Finland in the beginning of the 19th century due to the utilitarian population policy aiming to reduce the high infant mortality rate. Because of a shortage of physicians professional midwives attained an important status in the care of births. With industrialization a state-directed welfare policy with state-subsidized health care developed. After World War II, the midwifery were legally defined as care during pregnancy, delivery, and the postpartum period. In the 1950s, the scope of work of midwifery was further altered because hospital deliveries had become routine. Some midwives provided prenatal care in ambulatory maternity health centers while others worked in hospitals managing normal childbirths. Separate midwifery education ended in 1968 and resumed 1986. Since 1972, public health nurses have increasingly provided prenatal and postnatal care in maternity centers, and specialized nurses have managed normal childbirths. In the future, public health nurses may totally replace midwives in prenatal care, and the role of midwives may return to care of normal deliveries. Midwife interviews revealed the "medicalization" of pregnancy caused both by physicians and midwives' own medical concept of pregnancy and by clients' demands for good care.     

上海市黄浦区孕前妇女生殖健康素养调查分析

目的 了解黄浦区孕前妇女生殖健康素养现状,为制定相应的干预方法提供依据.方法 使用随机抽样的方法,在2018年9-11月间和2019年9-11月间,分2次抽取上海市黄浦区妇幼保健所婚前和孕前保健门诊的孕前妇女共400例,进行问卷调查.结果 2019年调查对象的健康素养具备率整体得分、疾病预防领域和“叶酸的作用”和“叶酸...     

Women's satisfaction with antenatal and postnatal care: an analysis of individual and organisational factors

Abstract: A local study of consumer views of maternity services was initiated because of major shifts in the patterns of maternity service provision and use in a metropolitan region. Women who had given birth to a live infant at one of four hospitals in and near the region in the 1991 calendar year were surveyed about their satisfaction with their antenatal and postnatal care. Questionnaires were sent to 866 women and 519 responded, for an overall response rate of 62 per cent; in the second stage of the study, in-depth interviews were conducted with 50 of the women. Analyses were conducted according to the hospital and to individual sociodemographic characteristics. There were statistically significant differences in satisfaction according to women's sociodemographic characteristics and the type of hospital at which they gave birth. Women who were best off in terms of economic, educational and other social resources reported the highest levels of satisfaction. Analyses by hospital revealed important differences between different types of public hospital, and between public and private hospitals. The results suggest that changing some of the organisational features of antenatal and postnatal care provision may make a significant difference to women's experience of, and satisfaction with, maternity services; most of the organisational changes identified suggest an enhanced or extended role for midwives in the provision of antenatal and postnatal services.     

农村地区县妇幼保健院助产服务现状及优势分析

目的:调查农村地区不同类别助产机构产科服务提供情况及服务能力,对县妇幼保健院助产服务现状和优势进行分析。方法:在全国随机抽取44个地市全部助产服务机构2010年产科服务情况进行问卷调查,重点对农村地区(县和县级市)中不同类型助产机构进行分析。结果:农村助产服务机构中县妇幼保健院占6.5%,县妇幼保健院产科床位数占辖区产科总床位数的18.1%,分娩数量占辖区分娩量的42.9%,平均每个县妇幼保健院年分娩为1 259人,高于县级综合性医院和其他医疗机构。县妇幼保健院中能提供综合产科和综合新生儿科服务的比例最高分别为85.3%、61.9%,高于县级综合性医院83.1%、59.4%,并明显高于其他医疗机构32.4%、19.3%。结论:县妇幼保健院是农村地区助产服务的主要力量之一,与其他助产机构相比,县妇幼保健院在助产服务提供数量和能力方面都具有一定优势。应进一步加强对妇幼保健机构的规范化建设,以保证其职能的履行。     

Process-oriented training in breastfeeding alters attitudes to breastfeeding in health professionals

AIM: The purpose of the study was to measure the attitudes of antenatal midwives and postnatal nurses to breastfeeding before and after common, process-oriented breastfeeding training. METHOD: Antenatal centres and child-health centres in 10 municipalities were randomized to either an intervention or a control group. The antenatal midwives and postnatal nurses in the intervention group were together given process-oriented breastfeeding training and were, in addition, asked to develop a common breastfeeding policy. A previously developed instrument was used to measure the effects of a training programme on breastfeeding attitudes among midwives and postnatal nurses. It consisted of four scales measuring a person's attitudes toward breastfeeding in four dimensions: regulating, facilitating, disempowering, and breastfeeding-antipathy attitudes. A mean score was calculated for each individual on these four dimensional scales. The higher the score, the stronger the attitude. RESULTS: After one year, the intervention group reduced their scores on the regulating scale when compared with the control group (p<0.001). The intervention group decreased their scores on the regulating scale and increased their scores on the facilitating scale over the first year after training. The control group also significantly increased their scores on the facilitating scale. When the results were analysed profession-wise, the postnatal nurses in the intervention group decreased their scores on the regulating and disempowering scales and increased their scores on the facilitating scale. In contrast, the midwives in the intervention group decreased their scores only on the breastfeeding antipathy scale. The control group midwives decreased their scores on the disempowering scale. No differences were found among the postnatal nurses in the control group. CONCLUSION: Process-oriented breastfeeding training made both antenatal midwives and postnatal nurses better disposed to breastfeeding; postnatal nurses in particular improved their attitudes. Attitudes to breastfeeding tended to be stable over time, but process-oriented training lowered the scores a little on the regulating scale, suggesting that after this kind of training counsellors would find it less necessary to schedule and control the mothers' breastfeeding behaviour.