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[基于科学证据的自然分娩辅助实践实施方法:一项试点研究]

[Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study].

作者信息

Côrtes Clodoaldo Tentes, Santos Rafael Cleison Silva Dos, Caroci Adriana de Souza, Oliveira Sheyla Guimarães, Oliveira Sonia Maria Junqueira Vasconcelos de, Riesco Maria Luiza Gonzalez

机构信息

Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.

Escola de Artes, Ciências e Humanidades, Curso de Obstetrícia, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Esc Enferm USP. 2015 Oct;49(5):716-25. doi: 10.1590/S0080-623420150000500002.

Abstract

OBJECTIVE

Presenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence.

METHOD

An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%.

RESULTS

The vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made.

CONCLUSION

The study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.

摘要

目的

基于科学证据,介绍用于改善自然分娩产妇结局的知识转移方法。

方法

于2014年7月至11月在圣保罗州伊塔佩里卡达塞拉市的妇产医院开展一项干预性研究,纳入50名产妇及102份病历。采用乔安娜·布里格斯研究所的PACES工具,该工具包括临床前审核(第1阶段)、最佳实践实施(第2阶段)和随访临床审核(第3阶段)。通过Fisher精确检验比较第1阶段和第3阶段的结果,并设定5%的显著性水平对数据进行分析。

结果

大多数产妇采用了垂直体位,第1阶段和第3阶段之间存在统计学差异。从病历中发现,洗澡/淋浴、行走和缓解疼痛的按摩显著增加。在其他实践和结局方面未发现统计学差异。已确定循证实践实施过程中的障碍和困难。对变量进行了细化,对技术和数据收集工具进行了验证,并提出了干预建议。

结论

该研究发现了实施基于科学证据的实践方法以辅助自然分娩的可能性。

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