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肯尼亚农村地区助产士对产后出血管理的影响因素。

Factors that influence management of postpartum hemorrhage among midwives in a rural setting in Kenya.

机构信息

Department of Community and Reproductive Health Nursing, Kenyatta University.

出版信息

Afr Health Sci. 2021 Mar;21(1):304-310. doi: 10.4314/ahs.v21i1.39.

Abstract

BACKGROUND

Postpartum hemorrhage is the cumulative blood loss of 500 milliliters or more in a spontaneous vaginal delivery and approximately 1,000 milliliters or more for caesarean section birth and a leading cause of maternal mortality1.

OBJECTIVE

The overall aim of the study was to determine midwives' factors that influence the management of PPH.

METHODS

A descriptive cross-sectional study that employed a quantitative approach through the use of a research self- administered questionnaire and an observational checklist targeting midwives were used. 85 midwives filled the questionnaire and 71 were observed respectively. The study was hospital- based conducted in Muranga County, Kenya. Convenience sampling technique was used to select the midwives in the study sites.

RESULTS

The following factors were statistically significant in influencing management of postpartum hemorrhage; age (P-value = 0.021). professional qualification (P= 0.047), experience in management of PPH (P= 0.032) and training on emergency PPH (P= 0.010), knowledge factors that were found to influence the management of PPH positively include knowledge on; prevention of PPH (p value-0.000), correct use of prophylactic uterotonic agents (P= 0.000), uterotonics use (P= 0.043), uterine massage during 3 stage of labour (P= 0.012), examination of the placenta (P= 0.034), management of PPH (P= 0.028), causes and diagnosis of PPH (P= 0.001), (Fischer's exact value= 0.043).

CONCLUSION

Results of the study indicate a statistical association between midwives' factors and management of PPH.

摘要

背景

产后出血是指自然分娩中累计失血 500 毫升或以上,剖宫产中失血约 1000 毫升或以上,是产妇死亡的主要原因之一。

目的

本研究的总体目标是确定影响产后出血管理的助产士因素。

方法

采用描述性横断面研究,通过使用研究自我管理问卷和针对助产士的观察清单,采用定量方法。85 名助产士填写了问卷,71 名助产士分别进行了观察。该研究在肯尼亚穆兰加县的一家医院进行。采用便利抽样技术在研究地点选择助产士。

结果

以下因素在影响产后出血管理方面具有统计学意义:年龄(P 值=0.021)。专业资格(P=0.047)、处理产后出血的经验(P=0.032)和紧急产后出血培训(P=0.010)。发现影响产后出血管理的知识因素包括:预防产后出血(P 值-0.000)、正确使用预防性子宫收缩剂(P=0.000)、子宫收缩剂的使用(P=0.043)、在 3 个产程中进行子宫按摩(P=0.012)、检查胎盘(P=0.034)、产后出血管理(P=0.028)、产后出血的原因和诊断(P=0.001)。

结论

研究结果表明,助产士因素与产后出血管理之间存在统计学关联。

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本文引用的文献

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Recent Advances in the Management of Major Postpartum Haemorrhage - A Review.
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