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使用国家胎儿运动信息手册对患者延误的影响。

Effect of the use of a national information brochure about fetal movements on patient delay.

机构信息

Department of Obstetrics and Gynaecology, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands.

Department of Obstetrics and Gynaecology, Zuyderland Medical Centre, Henri Dunantstraat 5, 6419 PC Heerlen, The Netherlands.

出版信息

Women Birth. 2019 Apr;32(2):131-136. doi: 10.1016/j.wombi.2018.06.015. Epub 2018 Jul 11.

Abstract

BACKGROUND

Perinatal audits in the Netherlands showed that stillbirth was nearly always preceded by a period of reduced fetal movements. Patient or caregiver delay was identified as a substandard care factor.

AIM

To determine whether the use of a new information brochure for pregnant women on fetal movements results in less patient delay in contacting their maternity caregiver.

METHODS

A pre- and post-survey cohort study in the Netherlands, including 140 women in maternity care with a singleton pregnancy, expecting their first child. All participating women filled out a baseline questionnaire, Cambridge Worry Scale and pre-test questionnaire at the gestational age of 22-24 weeks. Subsequently, the intervention group received a newly developed information brochure on fetal movements. At a gestational age of 28 weeks, all women received the post-test questionnaire. Multiple regression analyses were used.

FINDINGS

Per-protocol analysis showed less patient delay in the intervention group compared to the control group (Odds Ratio 0.43; 95% Confidence Interval 0.17-0.86, p=0.02). A significant linear relation was observed between reading the information brochure and an increase of knowledge about fetal movements (B=1.2, 95% Confidence Interval 1.0-1.4, p<0.001). Maternal concerns did not affect patient delay to report reduced fetal movements.

CONCLUSION

Use of an information brochure regarding fetal movements has the potential to reduce patient delay and increase knowledge about reduced fetal movements. A national survey to determine the effect of an information brochure about reduced fetal movements on patient delay and stillbirth rates is needed.

摘要

背景

荷兰的围产期审计显示,胎儿停止活动几乎总是发生在胎儿活动减少的一段时间之前。患者或护理人员的延迟被认为是护理标准不足的一个因素。

目的

确定为孕妇提供关于胎儿运动的新信息手册是否会减少患者联系其产妇护理人员的延迟。

方法

在荷兰进行了一项预-后调查队列研究,纳入了 140 名在妇产科接受单胎妊娠、期待第一个孩子的孕妇。所有参与的女性在妊娠 22-24 周时填写了基线问卷、剑桥担忧量表和预测试问卷。随后,干预组收到了一份新开发的关于胎儿运动的信息手册。在妊娠 28 周时,所有女性都收到了后测问卷。使用多变量回归分析。

发现

与对照组相比,干预组的患者延迟时间更短(优势比 0.43;95%置信区间 0.17-0.86,p=0.02)。在阅读信息手册和增加对胎儿运动的了解之间观察到显著的线性关系(B=1.2,95%置信区间 1.0-1.4,p<0.001)。产妇的担忧并不影响报告减少的胎儿运动的患者延迟时间。

结论

使用关于胎儿运动的信息手册有可能减少患者延迟,并增加对减少的胎儿运动的了解。需要进行全国性调查,以确定关于减少的胎儿运动的信息手册对患者延迟和死产率的影响。

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