Bloomfield Linda, Townsend Joy, Rogers Catherine
Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts, AL10 9AB, UK.
Midwifery. 2003 Mar;19(1):37-45. doi: 10.1054/midw.2002.0323.
to explore the experiences and attitudes of midwives, junior paediatricians (SHOs), GPs, and mothers to the examination of the newborn baby. To provide an appreciation of their views on several issues, in particular the purpose and value of the examination, who is thought to be appropriate to carry it out and when and where it should take place.
qualitative using semi-structured interviews, which were exploratory and interactive, in order to examine the range and diversity of experiences and attitudes to the neonatal examination.
South-east England.
four samples were purposefully selected to include ten each of midwives, SHOs, GPs and recently delivered mothers. SHOs were currently working in paediatric departments of a district general hospital or teaching hospital and their experience of conducting examinations of the newborn baby ranged from several months to several years. Midwives included both those trained in the examination and currently conducting examinations, and those not so trained and not carrying out the examination. Most of the midwives had been qualified for over ten years and had a wide range of clinical experience in hospital and community settings. The GPs were from ten practices in two Health Authorities and all had some experience of conducting neonatal examinations. Of the mothers, a few had had their babies examined at home by midwives, others in hospital by an SHO. Mothers included those with a family history of problems relevant to the examination, those with previous pregnancy complications and others with no problems or complications. Some were first-time mothers.
all groups perceived the examination to be a useful screening tool providing reassurance to parents. They considered both midwives and SHOs to be appropriate professionals to carry out the examination, if adequately trained. Most thought that midwives have a better rapport with mothers, are able to provide continuity of care and more often discuss health-care issues than do SHOs. Few SHOs reported receiving any formal training in the examination of the newborn baby.
the extension of the practice of midwives examining the newborn baby following relevant training would be acceptable to all stakeholders. The implications of increased demands on the midwives' workload may need to be considered.
探讨助产士、初级儿科医生（住院医师）、全科医生以及母亲们对新生儿检查的体验和态度。了解他们对若干问题的看法，特别是检查的目的和价值、认为适合进行检查的人员以及检查的时间和地点。
采用半结构化访谈进行定性研究，访谈具有探索性和互动性，以考察对新生儿检查的体验和态度的范围及多样性。
英格兰东南部。
有目的地选取了四个样本，每个样本包括十名助产士、住院医师、全科医生以及刚分娩的母亲。住院医师目前在地区综合医院或教学医院的儿科部门工作，他们进行新生儿检查的经验从几个月到几年不等。助产士包括接受过检查培训且目前正在进行检查的人员，以及未接受培训且不进行检查的人员。大多数助产士已取得资格超过十年，在医院和社区环境中拥有广泛的临床经验。全科医生来自两个卫生当局的十个诊所，都有进行新生儿检查的经验。在母亲中，一些人的婴儿由助产士在家中检查，另一些人的婴儿在医院由住院医师检查。母亲们包括有与检查相关问题家族史的人、有既往妊娠并发症的人以及其他无问题或并发症的人。一些是初为人母者。
所有群体都认为该检查是一种有用的筛查工具，能让家长安心。他们认为如果接受了充分培训，助产士和住院医师都是进行检查的合适专业人员。大多数人认为助产士与母亲的关系更好，能够提供连续性护理，并且比住院医师更常讨论医疗保健问题。很少有住院医师报告接受过新生儿检查的任何正规培训。
在相关培训后，助产士对新生儿进行检查的做法扩大将为所有利益相关者所接受。可能需要考虑对助产士工作量增加的影响。
