天津市孕期保健工作开展现状及孕产妇需求调查

目的：了解天津市孕期保健工作开展的现状以及孕产妇对孕期保健服务的需求,为进一步提高孕期保健服务质量提供依据。方法：采用方便抽样的方法选取2017年4月在天津市四所三级甲等综合性医院以及一所妇产专科医院的产科门诊进行问卷调查,内容包括孕妇一般资料,孕期保健现状调查,孕产妇孕期保健需求调查表,对孕期保健服务形式等的意见和建议等。结果：有86.7%的孕妇能够在本次妊娠中严格按照孕期要求进行孕期保健,有41.3%的孕妇在孕期接受过助产士的保健服务,有69.9%的孕妇对目前孕期保健满意。孕妇对孕期保健知识的需求依次为孕期营养及合理用药、新生儿护理相关知识、孕期相关疾病的预防与治疗、母婴自我监测、分娩方式的选择和应对、母乳喂养相关知识、分娩镇痛相关知识、产褥期的科学应对、心理情绪变化的调整。结论：目前天津市的孕期保健工作开展效果较好,但仍有孕妇对孕期保健服务不满,应当大力开展相关工作,增加孕期保健形式,提高孕期保健服务质量。     

助产士门诊对低危初产妇分娩意向改变影响的质性研究

目的：了解助产士门诊的开设对于首次助产士门诊分娩意向为剖宫产的低危孕产妇分娩意向改变的体验,为助产士门诊的开设提供依据。方法：运用质性研究的方法,对符合纳入标准的16例低危孕产妇在助产士门诊进行深度访谈,用现象学方法分析访谈资料。结果：助产士门诊首次分娩意向为剖宫产的低危孕妇主要体验有四个方面：分娩意向的改变;自然分娩疼痛的客观认知及有效心理建设;助产士门诊多元化、长跨度、一对一的宣教形式;产时应对能力的提升。结论：助产士门诊的介入能够改变低危初产妇分娩意向,增加自然分娩的信心及应对能力,给孕妇正性分娩体验。     

Written nutrition communication in midwifery practice: What purpose does it serve?

Objective

to obtain an in-depth understanding of verbal and written nutrition communication in Dutch midwifery practice.

Design, setting and participants

data were collected by recording 12 initial antenatal consultations (12 weeks into the pregnancy) with primiparous women from four Dutch midwifery practices spread over The Netherlands, followed by two semi-structured qualitative interviews with the women. The interviews were undertaken on the day after the consultation and two weeks later.

Findings

analysis of the recordings revealed that a nutrition brochure was offered in an information pack, but it was not used or referred to by the midwives. Verbally, clients were informed about healthy nutrition in general terms. Specific, personally relevant nutrition-related questions and motivators of nutrition behaviour were rarely clarified and addressed. Midwives tried to create a good relationship with their clients by being friendly, complimentary, confirmative and supportive. Women appreciated talking about nutrition with the midwife because of her expertise. The subsequent interviews with the women revealed, however, that nutrition communication took place relatively late in pregnancy at a point when women were more interested in ‘hearing the baby's heart beat’. Furthermore, clients seldom looked through the nutrition brochure at home.

Key conclusion

the provision of a nutrition brochure does not serve any real purpose.

Implications for practice

to reach optimal synergy between verbal and written nutrition communication in midwifery practice, midwives should actively refer to a nutrition brochure in addition to verbal communication. Moreover, health organisations should realise that the provision of nutrition brochures to midwives does not mean that these brochures will be used as an integral part of midwives’ nutrition communication with clients.     

Nurse‐Midwife and Scientist: Stuck in the Middle?

The nurse-midwife and scientist share similar ethos (fundamental attitudes that guide action); yet, in their respective professional roles, ethos can translate into actions that appear discordant. Discord can lead to resolution, when examined through the primary principles of ethical conduct: autonomy, beneficence, nonmalfeasance, and justice.     

助产士主导伙伴式导乐陪伴分娩193例临床观察

目的：探讨助产士主导伙伴式导乐陪伴分娩的临床效果。方法：选取2010年8月-2012年8月在本院分娩的386例产妇,按照随机数字表法将其分为观察组和对照组各193例。对照组产妇给予常规护理措施,观察组产妇在常规护理基础上加以伙伴式导乐陪伴分娩,比较两组产妇分娩方式、产后出血率、新生儿窒息率及总产程时间。结果：观察组自然分娩率为84.5%,对照组自然分娩率为65.3%;观察组自然分娩率显著高于对照组（P〈0.05）;观察组产妇产后出血率、新生儿窒息率及总产程时间均显著低于对照组（P〈0.05）。结论：在产妇分娩时应用助产士主导伙伴式导乐分娩,可有效提高自然分娩率,缩短产程,降低产后出血率和新生儿窒息率,值得在临床上应用和推广。     

江西省县级医院助产士肩难产的知、信、行现状分析

目的：调查分析江西省县级医院助产士肩难产知、信、行现状。方法采用自制调查问卷,对在江西省县级医院的96名助产士进行问卷调查。结果此次参与调查的助产士均对肩难产有所了解,并知晓该状况为产科急症。且100%的助产士愿意利用业余时间参加肩难产应对培训。43.75%的助产士表示未接受过相应培训,或接受的培训形式单一,时间较短。结论应加强对县级医院助产士肩难产的培训,真正做到知、信、行合而为一。     

中国助产士人力资源现状调查研究

目的通过调查了解全国的助产士人力资源现状。方法 2017年12月—2018年11月,通过判断抽样和便利抽样法选取中国妇幼保健协会成员机构中的三级和二级医院作为调查对象,使用自行编制的中国助产士人力资源现状调查表进行数据收集,调查单位覆盖国内22个省、自治区、直辖市。结果共发放问卷1 254份,共回收有效问卷1 213份,问卷的有效率为97.4%;国内产科平均床位使用率为90%;平均每所医院拥有助产士12名,以25～34岁、工作年限<10年、初级职称的助产士为主;助产士的平均外出培训率为12%;不同等级和类型医院的年分娩量、产科床位使用率、助产士人数和构成比较,差异有统计学意义(P<0.05)。结论国内助产士的人员紧缺状况有所缓解但人力仍不足,助产士的学历提升,但助产人员内部构成仍不合理,且不同等级和类型助产医疗机构的资源利用率不同,需进一步开展助产专科教育和培训,优化助产士人力资源配置,实现合理利用助产资源。     

助产士的护理风险及管理分析

目的:研究分析助产士的护理风险以及对助产士的管理模式进行分析.方法:对2010年10月～2011年10月间入院生产的162例产妇的进行分组护理,分为实验组和对照组.对照组进行常规的助产士护理工作,实验组选用针对各项护理风险作出积极应对措施并且有特定制度管理的助产士进行护理工作;对比两组产妇对护理工作的满意度.结果:实验组产妇的生活质量远远高于对照组,差异具有统计学意义(P<0.05).另外实验组的产妇较之对照组的有更顺利的生产过程.结论:对助产士的护理工作应该提出一个健全的管理体制,针对各项可能的风险也应该做出完善的处理工作.