J Obstet Gynecol Neonatal Nurs. 2022 Jul;51(4):377-387. doi: 10.1016/j.jogn.2022.03.002. Epub 2022 Apr 25.
To determine what is known about postpartum education provided by nurses to women before discharge from the hospital after birth and whether current nursing practices are effective to prepare women to identify warning signs of complications, perform self-care (physical and emotional), prepare for parenting a newborn, and establish infant feeding.
We conducted a systematic search of CINAHL Plus and MEDLINE for relevant sources, including peer-reviewed articles, conference presentations, and guidelines from professional organizations, that were published in English from January 2010 through November 30, 2020.
We included sources if participants were women who had given birth to a healthy, liveborn, term infant and were receiving education in whole or in part by a nurse during the maternity hospitalization. We excluded sources with samples of high-risk women or those who gave birth to high-risk infants (preterm, congenital anomalies, neonatal abstinence syndrome). Forty-six of the sources met the inclusion criteria.
We extracted citation, type of document, country of origin, context (prenatal/postpartum or both and inpatient/outpatient or both), aim, participants (mother/father or both, sample characteristics), content of education and who provided it, outcomes or key themes, and main results.
Infant topics included breastfeeding and safe sleep, and maternal topics included breastfeeding, postpartum mood, and self-care after birth. Nurses prioritized safety, including safe sleep; preventing infant falls; decreasing infection; screening for postpartum depression; and avoiding adverse outcomes after discharge. Women focused on self-care, pain management, infant care, and parenting. Women and nurses prioritized breastfeeding. Authors of the included sources measured effectiveness by patient satisfaction, chart audit, pre- and posttests of nurses' knowledge, and breastfeeding duration. Women reported barriers to postpartum education such as limited nursing time or conflicting information.
Postpartum education is a priority, but its effectiveness is not well studied. Few maternal or infant health-centered outcomes have been measured beyond breastfeeding duration. Nursing care and nurse expertise are not easily quantified or measured. Research is needed to inform best practices for postpartum education.
确定护士在产妇出院前向其提供的产后教育内容,以及当前的护理实践是否能有效帮助产妇识别并发症的预警信号、进行自我护理(身体和情绪方面)、为新生儿护理和育儿做准备以及建立婴儿喂养方式。
我们系统地检索了 CINAHL Plus 和 MEDLINE,以获取 2010 年 1 月至 2020 年 11 月 30 日期间发表的同行评议文章、会议演讲和专业组织指南等相关资源。
如果参与者是分娩健康、足月、活产婴儿的女性,并且在产科住院期间接受护士的整体或部分教育,则纳入研究。我们排除了高危产妇或分娩高危婴儿(早产、先天畸形、新生儿戒断综合征)的研究。有 46 篇文献符合纳入标准。
我们提取了引文、文献类型、来源国、背景(产前/产后或两者兼有,门诊/住院或两者兼有)、目的、参与者(母亲/父亲或两者,样本特征)、教育内容及提供教育的人员、结果或主要主题以及主要结果。
婴儿主题包括母乳喂养和安全睡眠,产妇主题包括母乳喂养、产后情绪和产后自我护理。护士侧重于安全,包括安全睡眠;预防婴儿跌倒;减少感染;产后抑郁筛查;以及避免出院后发生不良后果。女性关注自我护理、疼痛管理、婴儿护理和育儿。女性和护士都重视母乳喂养。纳入文献的作者通过患者满意度、图表审核、护士知识的预测试和后测试以及母乳喂养持续时间来衡量有效性。女性报告了产后教育的障碍,例如护理时间有限或信息冲突。
产后教育是当务之急,但对其有效性的研究还不够充分。除了母乳喂养持续时间之外,很少有针对产妇或婴儿健康为中心的结果进行测量。护理服务和护士的专业知识不容易量化或衡量。需要研究为产后教育提供最佳实践。