助产士职业感染的预防

医务人员因工作性质、工作环境的特殊性，常常暴露各种现存的或潜在的危险因素中，助产士更是在这种特殊环境中从事护理专业的群体。她们经常暴露于被产妇血液、体液、羊水污染以及锐器损伤的危险因素中，具有感染引发某种疾病的潜在危险。然而紧张、繁重、高风险的工作，使她们忽略了自我保护。现就助产士职业感染的因素及预防措施进行综述，旨在引起相关人员的重视，在提高医疗护理质量的同时，维护助产士的健康。     

有性传播疾病的产妇分娩过程中防护与分析

目的了解分娩产妇性传播疾病（STD）情况。探讨助产士操作中STD感染防护措施，减少职业性感染的产生。方法针对产妇STD传播途径和危险性，采取有效消毒隔离措施及防止锐器伤发生。结果2003年1月～2004年12月在我院住院分娩产妇5224例，其中STD病例43例，根据统计发现发病率逐年增加。结论通过采取有效消毒隔离措施，重视自身防护，达到降低助产士职业性感染几率的目的。     

Training for midwives in motivational interviewing

Introduction  There is no integrative concept for smoking cessation in pregnancy in Germany. Women in difficult social situations need basic and personally oriented counselling to support their health effectively. Midwives meet the requirements to give the necessary support to women. Motivational Interviewing  One part of the EURO-scip III project was, to develop and execute trainings in Motivational Interviewing for midwives, which is described in this article. The aim of the training was to give midwives an understanding of Motivational Interviewing developed by Miller and Rollnick (1991) and on how to use it in the field with pregnant women to quit smoking during pregnancy. The characteristics of the Mi-Training for midwives: Compared to MI in the field of drug addiction the two days of training focus for example on the training of counselling strategies during the initial stages (towards contemplation). Stages  The theoretical background of the stages of change and the revolving-door schema of smoking is transferred into practice in three parts:

助产士与外科护士心理健康状况比较及分析

目的了解助产士心理健康状况,探讨影响其心理健康状况的因素。方法采用抑郁自评量表(SDS)以及护士职业压力评定量表,分别对35名助产士和47名外科病房护士进行调查分析。结果助产士SDS均值为(42.14±5.32),高于外科病房护士的(38.65±5.40)(P<0.01);助产士抑郁症状发生率为41.5%,高于外科病房护士的27.3%(P<0.05)。助产士的压力源平均得分均高于外科护士。结论助产士抑郁症状发生率明显高于外科病房护士;产房工作特点和工作环境是影响助产士心理健康的主要原因。     

我院助产士接生考核结果分析及对策

目的 分析助产士接生考核结果,为制定相应的培训措施提供依据.方法 成立考核小组,制定接生流程及考核评分标准,对所有助产士进行考核.比较不同助产工龄的助产士考核成绩差异,总结考核中常见不足.结果 工龄0~3年的助产士考核平均成绩低于工龄3年以上的助产士,差异有统计学意义（P＜0.001）,工龄3~5年的助产士与工龄5年以上的助产士考核平均成绩差异无统计学意义.考核中常见的不足有沟通、隐私保护、会阴麻醉技术等.结论 低年资助产士要加强接生技能的培训;要加强助产士会阴麻醉技术、沟通能力、患者隐私权等相关知识培训.     

Midwives’ perceptions and experiences of caring for women who experience perinatal mental health problems: An integrative review

Backgroundperinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period.Aimto synthesise primary research on midwives’ perceived role in Perinatal Mental Health (PMH).Designintegrative review.MethodsWhittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed. Studies were included if they met the following criteria: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2006 to February 2016, where the population of interest were midwives and the outcomes of interest were their perceived role in the management of women with PMH problems. The methodological quality of studies was assessed using the relevant CASP (Critical Appraisal Skills Programmes, 2014) criteria for quantitative and qualitative research studies. Data extraction, quality assessment and thematic analysis were conducted.Findingsa total of 3323 articles were retrieved and 22 papers were included in the review (15 quantitative, 6 qualitative and one mixed method study). The quality of the studies included was good overall. Two overarching themes emerged relating to personal and professional engagement. Within personal engagement four sub themes are presented: knowledge, skills, decision making and attitude. Within professional engagement four themes are presented: continuous professional development, organisation of care, referral, and support.Conclusions and implications for practicethe findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit.     

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.     

The effect of midwifery care on rates of cesarean delivery

Objective

To examine whether changing to a midwifery-led maternity service model was associated with a lower national rate of cesarean delivery.

Methods

We analyzed trends in the rate of cesarean delivery per 1000 live births between 1996 and 2010 in New Zealand. Estimates of relative increases in rate were calculated via Poisson regression for several maternal age groups over the study period.

Results

Rates of cesarean delivery increased over the study period, from 156.9 per 1000 live births in 1996 to 235 per 1000 in 2010: a crude increase of 49.8%. Increasing trends were apparent in each age group, with the largest increases occurring before 2003 and relatively stable rates in the subsequent period. The smoothed estimate showed that the increase in cesarean rate across all age groups was 43.7% (95% confidence interval, 41.6–45.8) over the 15-year period.

Conclusion

A national midwifery-led care model was not associated with a decreased rate of cesarean delivery but, instead, with an increase similar to that in other high-resource countries. This indicates that other factors may account for the increase. Further research is needed to examine maternity outcomes associated with different models of maternity care.     

Midwife-led care unit for ‘low risk’ pregnant women in a Japanese hospital

Objectives.?To examine the obstetric outcomes of our ‘low risk’ pregnant women under the midwife-led delivery care compared with those under the obstetric shared care.

Methods.?A retrospective cohort study compared outcomes of labor under midwife ‘primary’ care with those under obstetric shared care. The factors examined were: maternal age, parity, gestational age at delivery, length of labor, augmentation of labor pains, delivery mode, episiotomy, perineal laceration, postpartum hemorrhage, neonatal birth weight, Apgar score, and umbilical artery pH. In this study, pregnant women were initially considered ‘low risk’ at admission when they had no history of medical, gynecological, or obstetric problems and no complications during the present pregnancy.

Results.?There were 1031 pregnant women initially considered ‘low risk’ at admission. At admission, 878 of them (85%) requested to give birth under midwife care; however 364 of these women (42%) were transferred to obstetric shared care during labor. The average length of labor under the midwife ‘primary’ care was significantly longer than that under the obstetric shared care. However, there were no significant differences in the rate of prolonged labor (≥24?h). There were no significant differences in other obstetric or neonatal outcomes between the two groups.

Conclusions.?There was no evidence indicating that midwife ‘primary’ care is unsafe for ‘low risk’ pregnant women. Therefore, midwifery care is recommended for ‘low risk’ pregnant women.     

丽水地区助产士对新生儿隐睾知识掌握现状的调查与分析

目的对丽水地区助产士掌握新生儿隐睾知识的现状进行调查分析。方法自行设计助产士隐睾相关知识调查问卷,采用整群抽样法,对丽水地区18家县级及以上医院150名注册助产士进行调查。结果 150名助产士隐睾相关知识总分平均(13.53±4.25)分(最高分24分),及格率42.67%;助产士的新生儿隐睾相关知识得分与年龄、护龄、职称、学历、有无参加培训和医院级别无相关性(P>0.05)。结论丽水地区助产士对新生儿隐睾知识掌握较差,有必要对助产士进行新生儿隐睾知识的专业实践培训。