Payne Janet M, Watkins Rochelle E, Jones Heather M, Reibel Tracy, Mutch Raewyn, Wilkins Amanda, Whitlock Julie, Bower Carol
BMC Pregnancy Childbirth. 2014 Nov 5;14:377. doi: 10.1186/s12884-014-0377-z.
Midwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives' knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives' perceptions of their practice in addressing alcohol consumption during pregnancy.
This cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible.
The response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states "For women who are pregnant or planning a pregnancy, not drinking is the safest option". Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%).
Nearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives' practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.
助产士是一个有影响力的职业群体，也是向女性告知孕期饮酒及其后果的关键群体。目前澳大利亚尚无关于助产士对孕期饮酒及胎儿酒精谱系障碍的知识、态度和实践的定量数据。我们旨在通过了解助产士对其在处理孕期饮酒问题方面的实践认知来缩小这一知识差距。
这项横断面研究在西澳大利亚乡村地区七个卫生区域的19个产科场所进行。在查阅文献和其他相关调查后设计了一份问卷。产科场所的助产士管理人员将问卷分发给其管理范围内的所有助产士。共邀请了334名助产士参与研究，其中（n = 245，73.4%）符合条件。
应答率为（n = 166，67.8%）。几乎所有（n = 151，93.2%）助产士都会询问孕妇孕期饮酒情况，且（n = 164，99.4%）会根据澳大利亚酒精指南提供关于饮酒的建议，该指南指出“对于怀孕或计划怀孕的女性，不饮酒是最安全的选择”。近三分之二（n = 104，64.2%）的助产士会告知孕妇孕期饮酒的影响，但他们并非总是使用推荐的酒精使用障碍识别测试（AUDIT）筛查工具（n = 66，47.5%）来评估孕期饮酒情况，也并非在需要时都进行简短干预（n = 107，70.4%）。大多数助产士认可关于筛查工具（n = 145，93.5%）、简短干预（n = 144，92.9%）以及孕期饮酒和胎儿酒精谱系障碍（FASD）方面的专业发展。
本研究中几乎所有助产士都会询问并建议孕妇关于孕期饮酒的问题，约三分之二的助产士会提供孕期饮酒影响的相关信息。我们的研究结果支持有必要为助产士提供关于筛查和简短干预方面的进一步专业发展。政策应支持助产士在孕期筛查饮酒情况并在需要时提供简短干预的实践。
