Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, United States.
College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas St, Charleston, SC 29425, United States.
Women Birth. 2019 Feb;32(1):16-27. doi: 10.1016/j.wombi.2018.04.016. Epub 2018 May 21.
Annually, up to 2.7 million neonatal deaths occur worldwide, and 25% of these deaths are caused by birth asphyxia. Infants born in rural areas of low-and-middle-income countries are often delivered by traditional birth attendants and have a greater risk of birth asphyxia-related mortality.
This review will evaluate the effectiveness of neonatal resuscitation educational interventions in improving traditional birth attendants' knowledge, perceived self-efficacy, and infant mortality outcomes in low-and-middle-income countries.
An integrative review was conducted to identify studies pertaining to neonatal resuscitation training of traditional birth attendants and midwives for home-based births in low-and-middle-income countries. Ten studies met inclusion criteria.
Most interventions were based on the American Association of Pediatrics Neonatal Resuscitation Program, World Health Organization Safe Motherhood Guidelines and American College of Nurse-Midwives Life Saving Skills protocols. Three studies exclusively for traditional birth attendants reported decreases in neonatal mortality rates ranging from 22% to 65%. These studies utilized pictorial and oral forms of teaching, consistent in addressing the social cognitive theory. Studies employing skill demonstration, role-play, and pictorial charts showed increased pre- to post-knowledge scores and high self-efficacy scores. In two studies, a team approach, where traditional birth attendants were assisted, was reported to decrease neonatal mortality rate from 49-43/1000 births to 10.5-3.7/1000 births.
Culturally appropriate methods, such as role-play, demonstration, and pictorial charts, can contribute to increased knowledge and self-efficacy related to neonatal resuscitation. A team approach to training traditional birth attendants, assisted by village health workers during home-based childbirths may reduce neonatal mortality rates.
全球每年有多达 270 万新生儿死亡，其中 25%的死亡是由出生窒息引起的。在中低收入国家的农村地区出生的婴儿通常由传统的接生员接生，他们面临更大的与出生窒息相关的死亡风险。
本综述旨在评估新生儿复苏教育干预措施对改善中低收入国家传统接生员知识、感知自我效能和婴儿死亡率结局的有效性。
进行了一项综合回顾，以确定与中低收入国家传统接生员和助产士进行家庭分娩的新生儿复苏培训相关的研究。有 10 项研究符合纳入标准。
大多数干预措施都是基于美国儿科学会新生儿复苏计划、世界卫生组织安全孕产指南和美国护理助产士学院生命拯救技能协议。三项专门针对传统接生员的研究报告称，新生儿死亡率降低了 22%至 65%。这些研究采用了图片和口头教学的形式，一致地解决了社会认知理论。采用技能演示、角色扮演和图片图表教学的研究显示，知识得分从预测试到后测试都有所提高，自我效能得分也很高。在两项研究中，传统接生员在团队中得到协助的方法报告称，新生儿死亡率从 49-43/1000 例降至 10.5-3.7/1000 例。
文化上合适的方法，如角色扮演、示范和图片图表，可以提高与新生儿复苏相关的知识和自我效能。在家庭分娩中，由乡村卫生工作者协助培训传统接生员的团队方法可能会降低新生儿死亡率。
