为子痫前期和子痫患者提供硫酸镁的观点：坦桑尼亚达累斯萨拉姆的助产士中进行的定性研究。
Perspectives of providing magnesium sulfate to patients with preeclampsia and eclampsia: A qualitative study amongst nurse-midwives in Dar es Salaam, Tanzania.
机构信息
Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Nursing Management, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
出版信息
PLoS One. 2024 Aug 7;19(8):e0308382. doi: 10.1371/journal.pone.0308382. eCollection 2024.
BACKGROUND
Preeclampsia and eclampsia are among the leading direct causes of maternal death and morbidity worldwide. Up to 34% of maternal deaths in Tanzania are due to preeclampsia/ eclampsia. Magnesium sulfate is recommended for preventing and treating convulsions in women with Preeclampsia or eclampsia. However, evidence suggests limited knowledge of its dosage and proper toxicity assessment after administration among health care providers.
AIM OF THE STUDY
This study explored nurse-midwives' perspectives on providing MgSO4 to patients with preeclampsia or eclampsia in Tanzania.
MATERIALS AND METHODS
A descriptive exploratory qualitative study using in-depth interviews was conducted to understand nurse-midwives' perspectives on providing magnesium sulfate to patients with PE/E. Nineteen nurse-midwives were interviewed from three hospitals in the Dar es Salaam region. We used a semi-structured interview guide in Kiswahili language to collect data. All interviews were digitally recorded and transcribed verbatim. We analyzed data using inductive content analysis.
RESULTS
This study revealed that nurse-midwives provide magnesium sulfate to save the lives of women and their unborn children. Nurse-midwives reasoned that confidence in their skill enhances provision of magnesium sulfate. However, they were concerned about its effect on the progress of labour. Ineffective use of magnesium sulfate emerged from inadequate training, an unsupportive work environment, and underutilization of the existing guidelines.
CONCLUSION
Nurse-midwives have clear drive to provide magnesium sulfate to women with preeclampsia or eclampsia. However, inadequate training, underutilization of guidelines and unsupportive work environment lead to ineffective use of magnesium sulfate. Targeted practical training should be emphasized for nurse-midwives mastery of clinical competencies.
背景
子痫前期和子痫是全球孕产妇死亡和发病的主要直接原因之一。坦桑尼亚高达 34%的孕产妇死亡是由子痫前期/子痫引起的。硫酸镁被推荐用于预防和治疗子痫前期或子痫患者的抽搐。然而，有证据表明，医护人员对其剂量的认识有限，并且在给药后对其毒性评估不足。
研究目的
本研究探讨了坦桑尼亚助产士对给子痫前期或子痫患者使用硫酸镁的看法。
材料和方法
采用描述性探索性定性研究方法，对来自达累斯萨拉姆地区的 3 家医院的 19 名助产士进行了深入访谈，以了解助产士对给患有 PE/E 的患者使用硫酸镁的看法。我们使用半结构式访谈指南以斯瓦希里语收集数据。所有访谈均进行了数字录音和逐字记录。我们使用归纳内容分析法对数据进行分析。
结果
本研究表明，助产士使用硫酸镁是为了挽救妇女及其未出生婴儿的生命。助产士认为，对自己技能的信心增强了硫酸镁的使用。然而，他们担心硫酸镁会影响分娩的进展。培训不足、工作环境支持不足以及对现有指南的利用不足导致硫酸镁使用效果不佳。
结论
助产士有明确的意愿为子痫前期或子痫患者提供硫酸镁。然而，培训不足、对指南的利用不足以及工作环境支持不足导致硫酸镁使用效果不佳。应强调对助产士进行有针对性的实践培训，以掌握临床技能。
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