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资源匮乏地区助产士管理子痫患者的经验:一项质性描述性研究

Midwives Experiences of Managing Clients with Eclampsia in a low Resource Setting: A Qualitative Descriptive Study.

作者信息

Dartey Anita Fafa, Dzansi Gladys, Lotse Comfort Worna, Obuobisa Racheal, Afua Bosu Celestine Emefa, Afaya Agani

机构信息

School of Nursing and Midwifery, The University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ghana.

School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Legon, Ghana.

出版信息

SAGE Open Nurs. 2022 May 16;8:23779608221094542. doi: 10.1177/23779608221094542. eCollection 2022 Jan-Dec.

Abstract

OBJECTIVE

Eclampsia remains a public health issue, especially in low-resource countries worldwide. Midwives are the backbone of the pregnancy and delivery process. Midwives trained in the necessary knowledge and skills are more likely to notice early warning signals of preeclampsia and immediately help clients in such emergencies. This study explored midwives' experiences in managing patients with eclampsia in Ghana.

METHODS

This study was conducted among eight registered midwives at maternity units of two district hospitals in the Eastern Region of Ghana, using an exploratory, descriptive qualitative research design. A purposive sampling technique was adopted to select and interview participants. Interviews were audio-recorded, transcribed, and analyzed using qualitative thematic analysis. The right of participation and withdrawal from the study was respected.

FINDINGS

The three emerged overriding themes are: 1. Midwives have knowledge (warning signs, regimens, and prevention of complications) about the management of eclampsia. 2. Challenges in managing clients included inadequate equipment, staffing, and access to drugs. 3. Strategies for mitigating barriers to care for women with eclampsia (adherence to protocols, teamwork, peer mentoring and supervision, midwives' attitude, and client education.

CONCLUSION

Midwives working in underserved facilities have the knowledge and skill to monitor and manage pregnant women experiencing eclampsia. However, they need to be supported with appropriate resources and advanced equipment to ensure adherence to protocols on managing eclampsia promptly referred. Continuous training and workshops for midwives in the management of hypertension in pregnancy are recommended and the public educated on the dangers of eclampsia.

摘要

目的

子痫仍然是一个公共卫生问题,尤其是在全球资源匮乏的国家。助产士是妊娠和分娩过程的支柱。接受过必要知识和技能培训的助产士更有可能注意到子痫前期的预警信号,并在这类紧急情况下立即帮助产妇。本研究探讨了加纳助产士管理子痫患者的经验。

方法

本研究在加纳东部地区两家 district 医院产科病房的八名注册助产士中进行,采用探索性、描述性定性研究设计。采用目的抽样技术选择和访谈参与者。访谈进行录音、转录,并使用定性主题分析进行分析。尊重参与和退出研究的权利。

结果

出现的三个主要主题是:1. 助产士具备子痫管理方面的知识(预警信号、治疗方案和并发症预防)。2. 管理产妇时面临的挑战包括设备不足、人员配备不足和药品获取困难。3. 减轻子痫患者护理障碍的策略(遵守规程、团队合作、同伴指导和监督、助产士态度以及产妇教育)。

结论

在服务不足的机构工作的助产士具备监测和管理子痫孕妇的知识和技能。然而,需要为他们提供适当的资源和先进设备,以确保遵守子痫管理规程并及时转诊。建议为助产士开展关于妊娠期高血压管理的持续培训和研讨会,并对公众进行子痫危险性教育。

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