助产士参与创伤性分娩体验质性研究的Meta整合

目的 系统评价助产士参与创伤性分娩体验的质性研究,为促进助产士心理健康及助产学科发展提供参考。方法 计算机检索PubMed、CINAHL、Web of Science、Scopus、Embase、SinoMed、中国社会科学引文索引、中国知网、万方和维普数据库关于助产士参与创伤性分娩体验的质性研究,检索时限为建库至2020年12月。采用澳大利亚乔安娜布里格斯研究所质性研究质量评价标准进行文献质量评价,使用汇集性整合方法对结果进行整合。结果 共纳入12篇研究,提炼出104个结果,归纳形成了10个类别,综合得出4个整合结果。整合结果1：分娩创伤事件对助产士造成严重的身心及职业影响;整合结果2：助产士会采取不同的策略来应对分娩创伤事件;整合结果3：助产实践中面临多重困境,影响助产士对分娩创伤事件的体验;整合结果4：参与创伤性分娩后,助产士渴望获得心理支持。结论 分娩创伤事件会给助产士造成严重影响。助产士应正视负性情绪,学会积极应对;医疗机构应合理配置产科资源,缓解助产实践面临的困境;管理者应重视助产士参与创伤性分娩的体验,提供心理支持,促进助产士的身心健康。     

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。     

Midwifery,nursing and medical care on the high seas: An immigration voyage to colonial Australia 1848–1849

BackgroundThe lives of individuals are infinitely fascinating, especially when viewed at the intersection of their relationship with other people and their environment. Of interest in this article are the incidents of childbirth and the role of midwife and doctor in these crucial life events. Perhaps of greater significance is the story of those on board this one voyage of the Steadfast within the grand narrative of British immigration to Australia in the nineteenth century.AimThis article aims to demonstrate that it was the human cargo and their need of health care in the voyage of the Steadfast, which contributed to the historical narrative of immigration and quarantine, the prelude to life in the colonial environment.MethodThis is qualitative research using historical methodology involving the selection of available documents. The primary document sourced is that of the surgeon-superintendent’s journal on the Steadfast. The methodology used is narrative, recording the medical information as well as providing background context for the main characters for the purpose of situating them in the immigration story.FindingsHealth care, particularly maternity care, on immigration ships was limited. Birthing at sea was a dangerous process for an immigrant woman often resulting in her death, the death of her infant or both mother and child could perish. If disease occurred during the sea voyage, then quarantine of the ship and passengers was instigated on arrival at Sydney Harbour.DiscussionThis article draws on the journal notes of the surgeon superintendent which logs the health incidents of immigrants requiring midwifery, nursing and medical care on a sea voyage from London to the colony of New South Wales in the mid-nineteenth century. This article focuses on the maternity events and the necessity for quarantine measures to prevent the spread of infectious diseases in the colony of New South Wales.     

Effects of music medicine on premenstrual symptoms levels and quality of life: A randomized controlled trial

BackgroundPremenstrual syndrome is an important health problem affecting women of reproductive age. This study aimed to show that music medicine can be used to reduce the premenstrual syndrome levels and increase the quality of life of women.DesignA prospective, single-blinded randomized controlled trial.MaterialsThe study was conducted between January and April 2021 on 97 college students. The participants consisted of women over 20 years of age and suffering from premenstrual syndrome. The participants were randomized into music and control groups.ResultsImmediately post-intervention, the women in the experimental groups had significantly higher reduced premenstrual syndrome levels and an improved quality of life. Music and control groups were evaluated with The Premenstrual Syndrome Scale (PMSS) and the short form of the Short of World Health Organization quality of life questionnaire (WHOQOL‐BREF). Comparing these two groups, music significantly reduced the premenstrual syndrome level after application (PMSS-1123.23 ± 32.06 vs. 105.90 ± 27.55, respectively, PMSS-2 94.21 ± 28.42 vs. 119.44 ± 27.29, respectively, p < .05). Comparing the music medicine and control groups had significantly increased WHOQOL-BREF scores (Physical, psychological, and environmental) after the application (13.71 vs. 13.14; 14.33 vs. 15.44 vs.14.66, respectively, p < .05).ConclusionPremenstrual symptoms were significantly reduced in the music medicine group than the control group. Additionally, music medicine improves the quality of life.     

助产士核心胜任力量表在北京市助产士中的适用性研究

目的 评价助产士核心胜任力量表在北京市助产士中应用的信度和效度,探讨此量表的适用性.方法 采用助产士核心胜任力量表,对北京市32家医院的369名助产士进行测评,对量表进行信度和效度分析.结果 助产士核心胜任力量表有较好的内部一致性(Cronbach's α系数为0.950)和稳定性(重测信度为0.832).54个条目在提取的6个公因子中的分布与原量表结构基本一致,累积贡献达68.405％.量表能够区分不同特征助产士的核心胜任力水平,具有较好的判别效度.结论 助产士核心胜任力量表具有良好的信度和效度,适用于我国助产士核心胜任力的评价.但仍需多区域扩大样本进行量表的适用性评价,以推动量表的完善和推广应用.     

The Accuracy of Midwives' Clinical Breast Examination in Detection of Breast Lumps

Background: Screen-detected breast cancers are usually diagnosed at earlier stages. Therefore, countries withlimited resources are recommended to implement clinical breast examination (CBE) as a screening method inconjunction with mammography. Since there are so many limitations to performance of CBE by surgeons in thehealth system and CBE by midwives is more feasible, this study was conducted to test the agreement of CBE bymidwives and surgeons. Methods: One thousand and twenty seven patients with no personal history of breast cancerreceived breast physical examination by both a midwife and a surgeon and designed forms including patients’ generalinformation, cause of referral and abnormal physical findings were completed for each patient. Results: The interobserveragreement (kappa) for mass detection was 36 % (95% CI= 31% to 41%), indicating a “fair” agreementexists between the midwife’s and the surgeon’s physical examination. Sensitivity, specificity, positive and negativepredictive values of “midwife’s physical examination” to detect abnormal breast masses in comparison to “surgeon’sphysical examination” as the gold standard were 75, 67, 48, and 87 percent respectively. Conclusions: The results ofthis study do not justify the replacement of general surgeons by midwives in the health care system as the firstexaminer for clinical breast screening. Decisions about this issue need more comprehensive studies considering costeffectivenessand training procedures.     

助产士的职业危害因素及预防探讨

目的：探讨助产士的职业相关危害因素和预防措施。方法：分析助产士可能接触到的职业危害因素和相关防护措施。结果：助产士接触到的职业危害因素主要包括物理、生物、化学及社会方面。具体防护措施包括：自我防护措施、接生时防护措施、加强锐器和消毒剂防护、分娩室环境防护及加强学习培训和心理干预等。结论：充分认识和了解导致助产士危害的物理、化学、生物、社会等方面的职业损害，才能在工作中加强管理和防护，提高自我保护意识，避免工作过程中不必要的职业损害，有助于提高助产工作质量和效果。     

助产士及产科专科护士胎儿监护相关知识的问卷调查

目的 了解助产士及产科专科护士对胎儿监护相关知识的掌握程度.方法 采用自制问卷调查表对在华西第二医院参加胎儿监护相关知识培训的77名助产士及产科专科护士进行胎儿监护相关知识的调查,并对结果进行分析.结果 77名调查对象中有部分人员既往缺乏系统正规的胎儿监护相关知识培训,不能准确回答孕期胎儿监护目的内容以及胎儿电子监护的基本要素及相关知识.大部分调查对象偏重于胎儿监护的临床实践,而较忽视相应的前沿进展.结论 受调查的助产士及产科专科护士对胎儿监护的相关知识尚缺乏系统全面的认识,今后应该加强此方面的训练,以利产科质量的提高.     

Nature works best when allowed to run its course. The experience of midwives promoting normal births in a home birth setting

Objectiveto gain a deeper understanding of how midwives promote a normal birth in a home birth setting in Norway.Design/settinga qualitative approach was chosen for data collection. In-depth interviews were conducted with nine midwives working in a home birth setting in different areas in Norway. The transcribed interviews were analysed with the help of systematic text condensation.Findingsthe analysis generated two main themes: «The midwife's fundamental beliefs» and «Working in line with one's ideology». The midwives had a fundamental belief that childbirth is a normal event that women are able to manage. It is important that this attitude is transferred to the woman in order for her to believe in her own ability to give birth. The midwives in the study were able to work according to their ideology when promoting a normal birth at home. To avoid disturbing the natural birth process was described as an important factor. Also crucial was to approach the work in a patient manner. Staying at home in a safe environment and establishing a close relationship with the midwife also contributed positively to a normal birth.Key conclusionsthe midwife's attitude is important when trying to promote a normal birth. Patience was seen as essential to avoid interventions. Being in a safe environment with a familiar midwife provides a good foundation for a normal birth. The attitude of the midwives towards normal childbirth ought to be more emphasised, also in the context of maternity wards.     

参加“粤港合作培养专科护士项目”的助产专科护士工作现状调查

目的调查广东省参加“粤港合作培养专科护士项目”的助产专科护士工作现状。方法采用结构式量表，共调查到全省83．3％的赴港培训助产专科护士各方面的工作情况。结果调查对象目前全部在临床一线工作，工作内容包括了：助产士门诊、专科培训，参与科研工作，评估助产士工作质量，个案积累，负责高危产妇护理与助产，护理管理等。她们在工作、教学、科研、学术交流与学习等方面面临一些困难。结论该培训项目对助产专科的发展具有重要的意义。助产专科护士学成后做了许多有益的、开创性的工作；也需要在制度、时间、经费、科研技能、教学技能等方面的支持。