产后护理指征与方法学质量:指南的系统评价
Postpartum care indications and methodological quality:a systematic review of guidelines.
作者信息
Yang Ming, Yue Wei, Han Xinrui, Hu Chunhong, Sun Xiaoning, Luo Jianghe
机构信息
School of Nursing, Guangzhou University of Chinese Medicine, No. 232, Waihuan East Road, Guangzhou University City, Panyu District, Guangzhou, Guangdong China.
Department of Spleen and Stomach, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China.
出版信息
Z Gesundh Wiss. 2022;30(9):2261-2275. doi: 10.1007/s10389-021-01629-4. Epub 2021 Jul 19.
BACKGROUND
The coverage of postpartum care is not ideal, and has not been used very well due to not enough attention being paid to the puerperal women and newborns, especially in developing countries. Practice guidelines on postpartum care provide beneficial practice guidance and help to reduce maternal mortality. However, little is known about the credibility and consistency of those guidelines. This systematic review was conducted to summarize main postpartum care indications and appraise methodological quality of guidelines.
METHODS
Seven literature databases and guideline development institutions and organizations of obstetrics and maternity care were searched. Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesized consistent and non-consistent recommendations using the content analysis approach.
RESULTS
Twenty-nine guidelines were included and a total of eight postpartum care indications were identified. Most guidelines focused on care indications and interventions including exclusive breastfeeding, maternal nutrition, home visit, infant or newborn care and sexuality, contraception, and birth spacing. However, indications such as pain or weight management, pelvic floor muscle training, abdominal rehabilitation, and mental health got less attention. Additionally, the overall quality of all involving postpartum care guidelines is relatively good and acceptable.
CONCLUSIONS
Guidelines developed by NICE, RANO, and WHO indicated higher methodological quality. For postpartum care indications, most guidelines are incomplete. Variation in practice guidelines for postpartum care recommendations exists. In the future, implementation research into shared decision-making, as well as further high-quality research to broaden the evidence base for postpartum care indications is recommended.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s10389-021-01629-4.
背景
产后护理的覆盖情况并不理想,由于对产妇和新生儿缺乏足够关注,其应用效果也不佳,尤其是在发展中国家。产后护理实践指南提供了有益的实践指导,有助于降低孕产妇死亡率。然而,对于这些指南的可信度和一致性却知之甚少。本系统评价旨在总结产后护理的主要指征并评估指南的方法学质量。
方法
检索了七个文献数据库以及妇产科护理的指南制定机构和组织。两名评审员使用AGREE II工具独立评估指南质量,并采用内容分析法综合一致和不一致的建议。
结果
纳入了29项指南,共确定了八项产后护理指征。大多数指南侧重于护理指征和干预措施,包括纯母乳喂养、孕产妇营养、家访、婴儿或新生儿护理以及性健康、避孕和生育间隔。然而,疼痛或体重管理、盆底肌肉训练、腹部康复和心理健康等指征受到的关注较少。此外,所有涉及产后护理的指南总体质量相对较好且可接受。
结论
由英国国家卫生与临床优化研究所(NICE)、放射肿瘤学和神经肿瘤学(RANO)以及世界卫生组织(WHO)制定的指南显示出较高的方法学质量。对于产后护理指征,大多数指南并不完整。产后护理建议的实践指南存在差异。未来,建议开展关于共同决策的实施研究,以及进一步开展高质量研究以拓宽产后护理指征的证据基础。
补充信息
在线版本包含可在10.1007/s1
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