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加纳一家三级医院助产士子痫前期培训需求的横断面研究。

Pre-eclampsia training needs of midwives in a Ghanaian tertiary hospital: A cross-sectional study.

机构信息

College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia.

School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.

出版信息

Nurse Educ Pract. 2024 Feb;75:103872. doi: 10.1016/j.nepr.2024.103872. Epub 2024 Jan 16.

Abstract

AIM

This study aimed to assess the specific clinical and non-clinical training needs of midwives and determine their preferred approach to enhancing performance.

BACKGROUND

Pre-eclampsia remains one of the leading causes of maternal deaths in low and middle-income countries. Pre-eclampsia-related deaths may be due to reduced midwifery knowledge and inadequate management. Therefore, a training needs assessment is vital in identifying gaps in practice, especially, in poorly resourced settings for maximal use of training resources.

DESIGN

A hospital-based cross-sectional study.

SETTING

The largest tertiary hospital in Ghana.

METHODS

An online version of the validated WHO Hennessy-Hicks Training Needs Analysis questionnaire was used to assess midwives' training needs on the management of pre-eclampsia. The tool has good psychometric properties and was used to assess 1) midwives' confidence in performing tasks, 2) the importance of the task to their role and 3) their preferred performance improvement approach. Data analysis adhered to the guidelines specified in the Hennessy-Hicks Training Needs Analysis Questionnaire and the priority training requirements of the midwives were assessed through descriptive statistics and a series of independent t-tests.

RESULTS

Among the 250 midwives who responded, most possessed 1-5 years of experience (74.7 %). All 28 tasks were viewed by midwives as essential responsibilities in pre-eclampsia management. Midwives had the greatest need for training in research/audit and clinical skills domains respectively (p < 0.001, 95 % confidence interval: 1.08-1.47, Cohen's-D = 1.27; and p < 0.001, 95 % confidence interval: 0.69-1.06, Cohen's-D = 0.87). The foremost primary training necessity, as recognised by midwives, was undertaking health promotion activities, including antenatal health education (MD= 0.43, 95 % confidence interval: 0.29-0.57). Training courses were identified as the preferred approach to address training needs and improve overall proficiency.

CONCLUSION

Midwives in Ghana require comprehensive training covering research and clinical-based competencies to improve pre-eclampsia management. Considering the pivotal role of Ghanaian midwives in safeguarding maternal well-being, there is a compelling need to enhance the calibre of midwifery services. These findings can guide stakeholders in countries with comparable healthcare contexts in creating effective, resource-efficient training programs that avoid counterproductivity, ultimately supporting national initiatives to enhance pre-eclampsia management and the quality of care.

摘要

目的

本研究旨在评估助产士的具体临床和非临床培训需求,并确定他们提高绩效的首选方法。

背景

子痫前期仍然是中低收入国家产妇死亡的主要原因之一。子痫前期相关死亡可能是由于助产士知识减少和管理不足所致。因此,培训需求评估对于确定实践中的差距至关重要,特别是在资源匮乏的环境中,以便最大限度地利用培训资源。

设计

基于医院的横断面研究。

地点

加纳最大的三级医院。

方法

使用经过验证的世界卫生组织 Hennessy-Hicks 培训需求分析问卷的在线版本,评估助产士在子痫前期管理方面的培训需求。该工具具有良好的心理测量学特性,并用于评估 1)助产士执行任务的信心,2)任务对其角色的重要性,3)他们首选的绩效改进方法。数据分析遵循 Hennessy-Hicks 培训需求分析问卷中规定的指南,通过描述性统计和一系列独立 t 检验评估助产士的优先培训需求。

结果

在 250 名回应的助产士中,大多数人拥有 1-5 年的经验(74.7%)。所有 28 项任务均被助产士视为子痫前期管理的基本职责。助产士最需要培训的领域分别是研究/审核和临床技能领域(p < 0.001,95%置信区间:1.08-1.47,Cohen's-D = 1.27;p < 0.001,95%置信区间:0.69-1.06,Cohen's-D = 0.87)。助产士认为最首要的初级培训需求是开展健康促进活动,包括产前健康教育(MD=0.43,95%置信区间:0.29-0.57)。培训课程被确定为解决培训需求和提高整体能力的首选方法。

结论

加纳的助产士需要全面的培训,涵盖研究和基于临床的能力,以改善子痫前期管理。考虑到加纳助产士在保障产妇福祉方面的关键作用,迫切需要提高助产服务的质量。这些发现可以为具有类似医疗保健背景的国家的利益相关者提供指导,制定有效、资源高效的培训计划,避免适得其反,最终支持国家举措,以改善子痫前期管理和护理质量。

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