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。     

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。     

滇西北助产士核心胜任力调查

目的调查滇西北地区助产士基本情况,评估助产士核心胜任力水平,分析影响因素,为少数民族地区助产专业教育及管理者提供政策制定和管理的参考依据。方法采用助产士核心胜任力量表对滇西北地区公立医院的83名助产士进行问卷调查。结果助产士核心胜任力总分为(3. 51±0. 47)分。各维度得分由高到低为产后保健、孕期保健、分娩保健、新生儿保健、孕前保健、公共卫生保健。助产士年龄、助产工龄、岗前培训时间与核心胜任力总分及各维度得分有相关性。不同医院等级、婚姻状况、专业背景、在职教育的助产士孕前保健得分比较差异有统计学意义(P<0. 05)。不同专业背景的助产士孕期保健得分比较差异有统计学意义(P<0. 05)。不同医院等级的助产士公共卫生保健得分比较差异有统计学意义(P<0. 05)。结论滇西北地区助产士核心胜任力整体水平较差。应适当提高助产士准入制度,并为在岗助产士提供相关培训,提高助产士核心胜任力。     

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。     

二级医院护士长胜任力分布现状:基于潜在类别模型的分析

利用潜在类别模型分析技术对二级医院护士长胜任力分布进行探讨,发现3-class模型能够较好地解释护士长胜任力潜在类别。探测到的三个类别分别为"个体能力驱动型","团队能力驱动型"和"能力认知缺乏型",当前二级医院护士长多为"个体能力驱动型"。通过对二级医院胜任力的分布现状进行研究,可以有效的了解二级医院护士长的胜任力水平,并制定有针对性的培养发展方式,逐步提高我国二级医院护士长的岗位胜任力水平。     

江苏省助产职业岗位能力需求调查分析与思考

目的:通过调查研究(调研)了解助产职业岗位对助产士知识、能力和素质的要求,为合理设置助产专业课程,制定课程标准提供依据。方法:采用自制助产职业岗位能力调查表对29所医院的产房护士长和助产士进行调查,被调查者对助产职业岗位在知识、能力和素质方面具体要求项目的重要性进行勾选。结果:岗位能力需求中“专科助产及护理基本操作技能”满分比最高,重要性赋值最高;其次是“护理学科专科知识”、“护理学科基础知识”。结论:助产教育决策者和教师要充分考虑临床一线的需求,合理设置课程,制定课程标准,才能培养出专科技能水平高,人文素质修养好,受用人单位欢迎的实用性人才。     

贵州省766名医院感染管理专职人员岗位胜任力及专业发展能力现状调查

目的 分析贵州省医院感染管理专职人员岗位胜任力及专业发展能力现状。方法 基于便利抽样原则,于2022年5-6月对贵州省9个市(州)220所医疗机构766名医院感染管理专职人员岗位胜任力水平及专业发展能力开展问卷调查。结果 全省766名医院感染管理专职人员岗位胜任力自评总分为(5.057±1.159)分,核心条目中专业发展能力自评得分最低,为(4.655±1.250)分,专业发展能力子条目综合知识自评得分最低,为(3.997±1.518)分;多因素分析结果显示,医院感染管理专职人员的年龄、职称、平均月收入、一线抗疫经历和办公软件应用水平是影响岗位胜任力水平和专业发展能力的影响因素,其中有一线抗疫经历人员的岗位胜任力(β=0.236,P=0.003)和专业发展能力(β=0.213,P=0.014)高于无一线抗疫的人员。结论 贵州省医院感染管理专职人员整体岗位胜任力处于中等偏上水平,专业发展能力是拉低总体胜任力综合得分的关键因素,主要体现在综合知识掌握能力薄弱,有一线抗疫经历的医院感染管理专职人员利于专业发展能力。     

高职助产专业人才岗位能力、知识和素质要求的调查

目的：了解陕西省各级医院助产专业的人才结构现状、需求情况及医院对助产人员岗位能力、知识、素质要求。方法自制调查问卷,对①助产岗位基本情况;②助产岗位群对助产人员的职业能力、知识、素质要求进行调查,并对数据进行分析。结果所调查的各级医院均认为现有助产士学历水平及数量不能满足临床需求,社会对助产岗位人员的岗位能力、知识和素质要求较高。现有专职助产士学历中专占39．15％、大专占51．91％、本科及以上占8．94％,不同级别医院助产士学历构成差异有统计学意义（χ2＝9．95,P＜0．05）;专业助产士数量省巿级医院有52．17％缺编,县区级医院有27．75％缺编。结论各医疗机构急需增加专科及其以上学历的高素质技能型助产人才,因此应扩大培养规模,提高教育质量,使助产专业人才具备更高的能力、知识和素质,以满足助产岗位需求的高素质技能型人才。     

1949-2008年中国助产政策演变过程及其影响因素分析

目的 通过探讨我国1949-2008年助产政策演变过程及其影响因素,旨在促进助产体制的改革和发展.方法 运用文献研究和比较研究从社会学角度分析1949-2008年中国助产政策的演变过程.结果 建国后助产政策演变过程分三个阶段:独立的助产政策、停滞的助产政策、分化的助产政策.结论 中国没有独立的助产专业管理体制,助产政策制定落后于发达国家;助产士应积极倡导助产改革,国家须重新认识助产士职能,制定新的助产政策.     

济南市三级甲等综合医院新护士岗位胜任力水平的相关性分析

目的分析济南市三级甲等综合医院新护士的岗位胜任力水平及其影响因素,为新护士岗位胜任力评价体系的建立和规范化培训方案的修订与深入开展提供参考依据。方法 2018年6月,采用问卷调查法,使用济南市三级综合医院新护士一般资料调查表和护理岗位胜任力量表,对济南市3所三级甲等综合医院入职2年内的新护士进行便利抽样调查。结果济南市三级甲等综合医院新护士岗位胜任力水平总分为327.53±46.96,各维度得分:程序运用能力52.73±8.57,危重病人救护能力48.22±8.16,健康教育能力53.72±8.72,沟通能力51.27±7.23,管理能力60.73±9.08,专业发展能力60.86±9.32。胜任力水平相关因素的回归分析中,是否为应届生、护士信念水平及职称水平纳入回归方程,差异均有统计学意义(均P0.05)。结论济南市三级甲等综合医院新护士的岗位胜任力处于中等水平,提高医院规范化培训管理水平、管理内容水平以及护士信念水平均可提高新护士岗位胜任力水平。     

Suitable but requiring support: How the midwifery model of care offers opportunities to counsel the vaccine hesitant pregnant population

Uptake of vaccination during pregnancy in Canada is lower than comparator countries. A recommendation from a trusted perinatal healthcare provider is a key opportunity to promote vaccine uptake and improve confidence. This study aims to identify barriers and opportunities to vaccination in midwifery care. Seventeen semi-structured telephone interviews with practicing midwives, educators and public health professionals with immunization training experiences were conducted. Documents pertaining to the midwifery profession (approx. 50) were reviewed. Inductive thematic analysis identified logistical, interprofessional, and information barriers preventing Canadian midwives from administering vaccines and counseling clients about vaccination, as well as opportunities to address each barrier. Key interventions at the level of logistics, training, and client information materials would help address barriers to the integration of midwives into the provision and recommendation of vaccines in perinatal care across Canada.     

Piercing the veil: the marginalization of midwives in the United States

This paper investigates the marginalization of certified nurse-midwives (CNMs) in the US. This marginalization occurs despite ample evidence demonstrating that a midwifery model delivers high-quality cost-effective care. Currently midwives attend only 7% of births, compared to 50-75% of births in other developed countries. Given the escalating costs of health care and relatively poor maternal and child health indicators in comparison with other developed countries, these findings are disturbing. This paper investigates this paradox through a qualitative case study of two prestigious but declining midwifery services in a large US city. Fifty-two multi-sited in-depth interviews were conducted along with an analysis of relevant archival sources. It was found that institutions successfully altered maternity care and diminished midwifery services without accountability for their actions. These findings illuminate the larger political-economic forces that shape the marginalization of midwifery in the US.     

Integration of midwives into the Quebec health care system. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes

This paper reports on one aspect of the evaluation of the midwifery pilot projects in Quebec: the identification of the professional and organizational factors, as well as the mode of integrating midwives into the maternity care system, that would promote the best outcomes and the autonomy of midwives. The research strategy involved a multiple-case study, in which each midwifery pilot project represented a case. Based on a qualitative approach, the study employed various sources of data: individual interviews and focus groups with key informants, site observations and analyses of written documents. Results show that midwives were poorly integrated into the health care system during the evaluation. Four main reasons were identified: lack of knowledge about the practice of midwifery on the part of other health care providers; deficiencies in the legal and organizational structure of the pilot projects; competition over professional territories; and gaps between the midwives' and other providers' professional cultures. Recommendations are provided to facilitate the integration of midwives into the health care system.     

Identifying core competencies for public health epidemiologists

BACKGROUND: Public health authorities have prioritized the identification of competencies, yet little empirical data exist to support decisions on competency selection among particular disciplines. We sought perspectives on important competencies among epidemiologists familiar with or practicing in public health settings (local to national). METHODS: Using a sequential, qualitative-quantitative mixed method design, we conducted key informant interviews with 12 public health practitioners familiar with front-line epidemiologists' practice, followed by a web-based survey of members of a provincial association of public health epidemiologists (90 respondents of 155 eligible) and a consensus workshop. Competency statements were drawn from existing core competency lists and those identified by key informants, and ranked by extent of agreement in importance for entry-level practitioners. RESULTS: Competencies in quantitative methods and analysis, critical appraisal of scientific evidence and knowledge transfer of scientific data to other members of the public health team were all regarded as very important for public health epidemiologists. Epidemiologist competencies focused on the provision, interpretation and 'translation' of evidence to inform decision-making by other public health professionals. Considerable tension existed around some potential competency items, particularly in the areas of more advanced database and data-analytic skills. INTERPRETATION: Empirical data can inform discussions of discipline-specific competencies as one input to decisions about competencies appropriate for epidemiologists in the public health workforce.     

助产士助产护理对产妇分娩质量的影响研究

目的探究助产士助产护理对产妇分娩质量的影响。方法选取2011年1月—2013年1月在我院分娩的346例产妇,随机分为实验组和对照组,对照组产妇采用常规护理分娩,实验组产妇采用助产士助产护理分娩,观察两组产妇的分娩效果和出血量,比较两组产妇的分娩质量。结果实验组产妇自然分娩148例,占86.05%,对照组产妇自然分娩108例,占62.07%,实验组产妇自然分娩率明显高于对照组产妇（P〈0.05）,具有统计学意义;实验组产妇的分娩时间、产后2 h出血量明显低于对照组产妇（P〈0.05）,具有统计学意义;实验组患者新生儿窒息评分明显高于对照组（P〈0.05）,产妇抑郁评分明显低于对照组（P〈0.05）具有统计学意义。结论在产妇的分娩过程中,采用助产士助产分娩可以有效提高产妇的自然分娩率,降低剖宫产率;缩短产妇分娩产程时间,缓解产妇痛苦;减少产妇产后2 h出血量,预防产后并发大出血;有效降低死胎率和新生儿死亡率,有效保证了产妇和新生儿的健康,值得在临床上推广使用。     

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.     

各国助产人员从事助产服务现状

了解各国助产人员从事助产服务情况及我国助产的政策、执业范围、助产教育,旨在积极倡导助产改革,制定新的助产政策。认为政府应重新认识助产士职能,在循证的基础上改革助产政策,促进中国助产专业的发展和母婴健康。     

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.