Wallace Louise M, Kosmala-Anderson Joanna
Health Services Research Centre, Coventry University, Coventry, UK.
Matern Child Nutr. 2006 Oct;2(4):217-31. doi: 10.1111/j.1740-8709.2006.00070.x.
The study examined the training needs of paediatricians and general practitioners (GPs). Respondents rated their competence on 23 breastfeeding support skills, importance of update in the next 2 years, actual and potential helpfulness of different forms of professional updates, and accessibility in the next 2 years. The perception of organizational barriers to breastfeeding support and practitioners' knowledge of policies and guidance on breastfeeding were also examined. The sample comprised 120 paediatricians and 57 GPs. Response rates were estimated as between 4% and 29%, depending upon the method of recruitment. Although both groups rated themselves as fairly competent in most of the skill areas, they welcomed training in key areas of practice. Paediatricians identified more areas for update than GPs (t = 3.44; d.f. = 178; P < 0.00001). Those who believed that they were less competent in clinical skills were least likely to seek update (r = 0.35; P < 0.00001). Practical forms of training were most often welcomed. Only 47% of GPs and 62.5% of paediatricians had access to a local breastfeeding policy. There were evident gaps in knowledge on key aspects of public health policy, which could influence local practice; for example, 50.8% of GPs and 47.5% of paediatricians identified a younger age for introducing solids than the minimum according to current government guidance. Organizational barriers to breastfeeding support were experienced by all respondents. Recommendations include purposively targeting training to those least likely to seek training, and developing effective self-study and observational methods of learning. All training should be evaluated and implemented alongside breastfeeding policies and clinical leadership to improve the practice of all healthcare practitioners.
该研究调查了儿科医生和全科医生的培训需求。受访者对自身在23项母乳喂养支持技能方面的能力、未来两年更新知识的重要性、不同形式专业更新的实际和潜在帮助以及未来两年获取相关资源的难易程度进行了评分。研究还考察了对母乳喂养支持的组织障碍的认知以及从业者对母乳喂养政策和指南的了解情况。样本包括120名儿科医生和57名全科医生。根据招募方法的不同，回复率估计在4%至29%之间。尽管两组人员都认为自己在大多数技能领域具备一定能力，但他们仍希望在关键实践领域接受培训。儿科医生认为需要更新知识的领域比全科医生更多（t = 3.44；自由度 = 178；P < 0.00001）。那些认为自己临床技能较差的人寻求知识更新的可能性最小（r = 0.35；P < 0.00001）。最受欢迎的培训形式是实践培训。只有47%的全科医生和62.5%的儿科医生能够获取当地的母乳喂养政策。在公共卫生政策的关键方面存在明显的知识差距，这可能会影响当地的实践；例如，50.8%的全科医生和47.5%的儿科医生确定开始添加辅食的年龄低于当前政府指南规定的最低年龄。所有受访者都经历过母乳喂养支持的组织障碍。建议包括有针对性地为最不可能寻求培训的人提供培训，开发有效的自学和观察性学习方法。所有培训都应进行评估，并与母乳喂养政策和临床指导一起实施，以改善所有医护人员的实践。
