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以产妇为中心的产时护理与肯尼亚新生儿并发症的关联。

Association between person-centered maternity care and newborn complications in Kenya.

机构信息

Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

School of Medicine, Institute for Global Health Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA.

出版信息

Int J Gynaecol Obstet. 2020 Jan;148(1):27-34. doi: 10.1002/ijgo.12978. Epub 2019 Oct 9.

Abstract

OBJECTIVE

Despite the recognized importance of person-centered care, very little information exists on how person-centered maternity care (PCMC) impacts newborn health.

METHODS

Baseline and follow-up data were collected from women who delivered in government health facilities in Nairobi and Kiambu counties in Kenya between August 2016 and February 2017. The final analytic sample included 413 respondents who completed the baseline survey and at least one follow-up survey at 2, 6, 8, and/or 10 weeks. Data were analyzed using descriptive, bivariate, and multivariate statistics. Logistic regression was used to assess the relationship between PCMC scores and outcomes of interest.

RESULTS

In multivariate analyses, women with high PCMC scores were significantly less likely to report newborn complications than women with low PCMC scores (adjusted odds ratio [aOR] 0.39, 95% confidence interval [CI] 0.16-0.98). Women reporting high PCMC scores also had significantly higher odds of reporting a willingness to return to the facility for their next delivery than women with low PCMC score (aOR 12.72, 95% CI 2.26-71.63). The domains of Respect/Dignity and Supportive Care were associated with fewer newborn complications and willingness to return to a facility.

CONCLUSION

PCMC could improve not just the experience of the mother during childbirth, but also the health of her newborn and future health-seeking behavior.

摘要

目的

尽管人们已经认识到以患者为中心的护理的重要性,但关于以患者为中心的产时护理(PCMC)如何影响新生儿健康的信息却很少。

方法

本研究于 2016 年 8 月至 2017 年 2 月期间在肯尼亚内罗毕和基安布县的政府卫生机构分娩的妇女中收集了基线和随访数据。最终分析样本包括 413 名完成基线调查且至少完成一次 2、6、8 和/或 10 周随访调查的受访者。采用描述性、双变量和多变量统计分析方法对数据进行分析。使用逻辑回归评估 PCMC 评分与感兴趣结局之间的关系。

结果

在多变量分析中,PCMC 评分较高的妇女报告新生儿并发症的可能性明显低于 PCMC 评分较低的妇女(调整后的比值比[aOR]0.39,95%置信区间[CI]0.16-0.98)。报告 PCMC 评分较高的妇女也更有可能愿意返回同一机构进行下次分娩,而 PCMC 评分较低的妇女则不太愿意返回(aOR 12.72,95% CI 2.26-71.63)。尊重/尊严和支持性护理这两个领域与较少的新生儿并发症和返回医疗机构的意愿有关。

结论

PCMC 不仅可以改善产妇分娩时的体验,还可以改善新生儿的健康状况和未来的就医行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d68/7473076/a91bcc125b09/IJGO-2019-ijgo.12978-g001.jpg

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