比较中国低、高孕产妇死亡率省份之间的助产士自我感知基本能力。
Comparison of midwives' self-perceived essential competencies between low and high maternal mortality ratio provinces in China.
机构信息
School of Nursing, Peking University, Beijing, China.
School of Nursing, Hebei Medical University, Shijiazhuang, China.
出版信息
J Clin Nurs. 2020 Dec;29(23-24):4733-4747. doi: 10.1111/jocn.15514. Epub 2020 Oct 16.
AIMS AND OBJECTIVES
To present and compare midwives' self-perceived essential competencies in regions with different maternal mortality ratios, and explore possible competency-related factors.
BACKGROUND
In China, there is an urgent need for high-quality maternal health care with equal access, as the regional disparity in the maternal mortality ratio remains a big challenge. Midwives' essential competencies refer to the minimum knowledge, skills, and professional behaviours required by midwives, and directly affect the quality of maternal care they provide. However, there is very limited literature evaluating Chinese midwives' essential competencies, especially for midwives working in regions with high maternal mortality ratios.
DESIGN
A cross-sectional survey design.
METHODS
The national cross-sectional study using an online questionnaire was conducted with a convenience sample of 2,022 midwives working in regions with different maternal mortality ratios. The STROBE guideline for cross-sectional studies was used in this study.
RESULTS
Midwives rated themselves higher on their essential competencies in intrapartum care and lower on their essential competencies in assisting or performing the operative vaginal delivery. Specifically, when compared to those from regions of low maternal mortality ratios, midwives from regions with high maternal mortality ratios reported comparatively poor self-perceived essential competencies, especially in the area of detecting and treating pregnancy and childbirth-related complications. The factors influencing midwives' self-perceived essential competencies included majors, education levels, years of experience as a midwife, participation in teaching, and access to in-service training.
CONCLUSION
In regions with high maternal mortality ratios, improving midwives' essential competencies is a key priority. Furthermore, it is recommended that midwifery education could be conducted in universities, and relevant regulations could be developed to enable midwives to provide a wider scope of care, thereby promoting the development of the midwifery workforce in China.
RELEVANCE TO CLINICAL PRACTICE
Understanding self-perceived essential competencies of Chinese midwives working in regions with different maternal mortality ratios could guide the midwifery workforce, management, especially midwives' capability building.
目的和目标
呈现并比较不同孕产妇死亡率地区助产士自我感知的基本能力,并探讨可能与能力相关的因素。
背景
在中国,高质量的母婴保健服务需要平等获得,因为地区间孕产妇死亡率的差异仍然是一个巨大的挑战。助产士的基本能力是指助产士所需的最低知识、技能和专业行为,直接影响他们提供的母婴保健质量。然而,评估中国助产士基本能力的文献非常有限,特别是针对在孕产妇死亡率较高地区工作的助产士。
设计
采用横断面调查设计。
方法
本研究采用便利抽样方法,对来自不同孕产妇死亡率地区的 2022 名助产士进行了全国性的横断面在线问卷调查。本研究遵循 STROBE 横断面研究指南。
结果
助产士在分娩期护理方面自我评估的基本能力较高,而在协助或实施阴道分娩方面自我评估的基本能力较低。具体来说,与来自孕产妇死亡率较低地区的助产士相比,来自孕产妇死亡率较高地区的助产士报告自我感知的基本能力较差,特别是在发现和处理妊娠和分娩相关并发症方面。影响助产士自我感知基本能力的因素包括专业、教育水平、助产士工作年限、参与教学和获得在职培训。
结论
在孕产妇死亡率较高的地区,提高助产士的基本能力是当务之急。此外,建议在大学开展助产教育,并制定相关规定,使助产士能够提供更广泛的护理范围,从而促进中国助产士队伍的发展。
临床意义
了解在不同孕产妇死亡率地区工作的中国助产士自我感知的基本能力,可以指导助产士队伍、管理层,特别是助产士的能力建设。