Urbutė Aivara, Paulionytė Marija, Jonauskaitė Domicelė, Machtejevienė Eglė, Nadišauskienė Rūta J, Dambrauskas Žilvinas, Dobožinskas Paulius, Kliučinskas Mindaugas
Department of Obstetrics and Gynecology, Herlev University Hospital, Herlev, Denmark; Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2017;53(6):403-409. doi: 10.1016/j.medici.2018.01.006. Epub 2018 Feb 8.
There are only few training programs in obstetric emergencies currently in use and only some of them were evaluated with an adequate sample of participants. Therefore, we present the evaluation of the novel Standardized Trainings in Obstetrical Emergencies (STrObE), conducted in Lithuania. The aim of this study was to analyze whether participants' self-reported knowledge and confidence increased after the trainings, and whether the impact of the trainings was long-lasting.
Data was collected across the majority of hospitals providing secondary and tertiary obstetrical care in Lithuania in 2015. A total of 650 obstetricians-gynecologists and midwives attended the trainings; 388 (response rate 59.7%) of them filled in the initial questionnaire before the trainings, 252 (64.9%) immediately after, 160 (41.2%) 6 weeks after, and 160 (41.2%) 6 months after the trainings, which was the final sample for the analyses. Participants used a Likert-type scale to evaluate their knowledge and confidence about management of urgent obstetrical situations: vacuum-assisted vaginal delivery, shoulder dystocia, postpartum hemorrhage, preeclampsia/eclampsia, early preterm labor, and dystocia. We assessed how participants' self-reported knowledge and confidence changed after the trainings (compared to before the trainings) and how long the effect was retained for.
The mean score of self-reported knowledge in obstetrical emergencies increased immediately after the trainings comparing to the scores before the trainings (P<0.001) and it did not differ further between the three time points after the trainings (i.e. immediately, 6 weeks, and 6 months; P>0.05). The same pattern was observed for self-reported confidence scores. The increase in self-reported knowledge and confidence after the trainings was stable. Moreover, the self-reported knowledge and confidence gains were greater for those participants with lower work experience, although benefit was seen across all experience levels.
STrObE improved participants' self-reported knowledge and confidence and lasting positive effects were observed for at least 6 months after the initial trainings. Moreover, the trainings were more beneficial for those with lower work experience, although they benefited all the participants.
目前产科急症方面的培训项目较少，且仅有部分项目经过足够数量参与者的评估。因此，我们展示了在立陶宛开展的新型产科急症标准化培训（STrObE）的评估情况。本研究的目的是分析培训后参与者自我报告的知识和信心是否增加，以及培训的影响是否持久。
2015年在立陶宛大多数提供二级和三级产科护理的医院收集数据。共有650名妇产科医生和助产士参加了培训；其中388人（回复率59.7%）在培训前填写了初始问卷，252人（64.9%）在培训后立即填写，160人（41.2%）在培训后6周填写，160人（41.2%）在培训后6个月填写，这160人是分析的最终样本。参与者使用李克特量表评估他们对紧急产科情况管理的知识和信心，这些情况包括：真空辅助阴道分娩、肩难产、产后出血、先兆子痫/子痫、早产和难产。我们评估了培训后（与培训前相比）参与者自我报告的知识和信心如何变化，以及这种效果能持续多久。
与培训前的分数相比，培训后产科急症自我报告知识的平均分数立即增加（P<0.001），且在培训后的三个时间点（即立即、6周和6个月）之间没有进一步差异（P>0.05）。自我报告的信心分数也观察到相同模式。培训后自我报告的知识和信心的增加是稳定的。此外，工作经验较少的参与者自我报告的知识和信心提升更大，尽管所有经验水平的参与者都有受益。
STrObE提高了参与者自我报告的知识和信心，并且在初始培训后至少6个月观察到了持久的积极效果。此外，培训对工作经验较少的人更有益，尽管所有参与者都从中受益。
