School of Nursing, McMaster University, Hamilton, ON.
The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON.
J Obstet Gynaecol Can. 2020 Sep;42(9):1121-1128. doi: 10.1016/j.jogc.2020.02.114. Epub 2020 Jul 19.
To determine health care providers' familiarity with and use of the Society of Obstetricians and Gynaecologists of Canada's (SOGC's) 2010 Alcohol Use and Pregnancy Consensus Clinical Guidelines and to identify barriers and enablers that affected guideline uptake.
We conducted an online pan-Canadian survey of midwives, obstetricians, family physicians, and nurses. The survey was divided into five sections: knowledge, SOGC guidelines, screening and intervention practices, attitudes and beliefs, and demographic information.
Just over half of the 588 respondents who provided care to pregnant women or to women of childbearing age were familiar with and used the guidelines. Most respondents screened for alcohol use by asking women about alcohol consumption, but relatively few used a screening questionnaire. Approximately two-thirds of respondents provided brief intervention and referral to harm reduction or treatment services. Enablers of guideline adherence included knowledge about the risks of alcohol in pregnancy, perceived responsibility to identify and address at-risk drinking, and a belief that women are motivated to reduce their alcohol consumption if pregnant or planning to become pregnant. Lack of confidence in ability to use screening questionnaires and to provide brief intervention, as well as a lack of belief in the effectiveness of both practices, were barriers to use.
Strategies are needed to improve familiarity with and uptake of the Alcohol Use and Pregnancy Consensus Clinical Guidelines. Particular attention should be given to education and training regarding the use of validated screening questionnaires and brief intervention practices.
确定医疗保健提供者对加拿大妇产科医生协会(SOGC)2010 年酒精使用与妊娠共识临床指南的熟悉程度和使用情况,并确定影响指南实施的障碍和促进因素。
我们对加拿大各地的助产士、产科医生、家庭医生和护士进行了在线泛加调查。该调查分为五个部分:知识、SOGC 指南、筛查和干预措施、态度和信念以及人口统计信息。
在 588 名为孕妇或育龄妇女提供护理的受访者中,略多于一半的人熟悉并使用了这些指南。大多数受访者通过询问女性饮酒情况来筛查酒精使用情况,但相对较少使用筛查问卷。约三分之二的受访者提供简短的干预措施和减少伤害或治疗服务的转介。遵守指南的促进因素包括了解妊娠期间饮酒的风险、认为有责任识别和处理高危饮酒问题,以及相信女性如果怀孕或计划怀孕,有动机减少饮酒量。缺乏使用筛查问卷和提供简短干预的信心,以及对这两种实践效果的缺乏信心,是使用的障碍。
需要采取策略来提高对酒精使用与妊娠共识临床指南的熟悉程度和实施率。应特别注意针对使用经过验证的筛查问卷和简短干预实践的教育和培训。