医疗服务提供者对先兆子痫后心血管疾病风险的认知：赞比亚卢萨卡五家医疗机构的一项试点研究。
Healthcare providers' knowledge of cardiovascular disease risk after preeclampsia: A pilot of five healthcare facilities in Lusaka, Zambia.
作者信息
Mukosha Moses, Bramham Kate, Zambala Lizzy, Ketty Lubeya Mwansa, Mercy Mwangu Luwi, Mwila Chiluba, Mudenda Steward, Vwalika Bellington
机构信息
Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Division of Women's Health, Women's Health Academic Centre, King's College London and King's Health Partners, St Thomas' Hospital, London SE1 7EH, United Kingdom.
出版信息
Pregnancy Hypertens. 2024 Dec;38:101163. doi: 10.1016/j.preghy.2024.101163. Epub 2024 Oct 10.
OBJECTIVE
To assess Healthcare providers (HCPs') knowledge of cardiovascular disease risk after preeclampsia across five healthcare facilities in Lusaka, Zambia.
STUDY DESIGN
A cross-sectional study was conducted at selected health facilities in Lusaka Zambia from August 5, 2023, to October 31, 2023. A self-administered questionnaire was distributed among obstetricians, general practitioners, registered nurse midwives, registered nurses, enrolled nurses, enrolled midwives, medical licentiates, and registered public health nurses. The knowledge scores were calculated for each participant, and Logistic regression was used to assess the predictors of high knowledge of cardiovascular disease risk after preeclampsia.
MAIN OUTCOME
The overall mean knowledge score of cardiovascular disease risk after preeclampsia was 4.7/7 (67.1 %). The majority correctly reported hypertension 101 (92.7 %), Ischemic heart disease 84 (77.1 %), Stroke 83 (76.2 %), and kidney disease 75(68.8 %) as future conditions associated with preeclampsia. Knowledge and practice had a significant but moderate negative correlation (r = -0.21, p = 0.037). Compared to obstetricians/general practitioners, registered nurse midwives (adjusted odds ratio [aOR] = 0.21, 95 % CI: 0.05-0.80, p = 0.023) and enrolled midwives/enrolled nurses/medical licentiates/registered public health nurses (aOR = 0.15, 95 % CI: 0.03-0.91, p = 0.039) were less likely to have high knowledge. Additionally, HCPs with 5-10 years (aOR = 7.15, 95 % CI: 1.99-25.72, p = 0.003) and more than 15 years of work experience (aOR = 3.21, 95 % CI: 1.03-9.99, p = 0.017) were more likely to have high knowledge than those with less than five years.
CONCLUSION
Most HCPs were knowledgeable about the future risk of cardiovascular diseases after preeclampsia. Nevertheless, positive behavioral change interventions may be required to address the disconnect between knowledge and practice.
目的
评估赞比亚卢萨卡五家医疗机构中医护人员对先兆子痫后心血管疾病风险的认知情况。
研究设计
于2023年8月5日至2023年10月31日在赞比亚卢萨卡选定的医疗机构开展一项横断面研究。向产科医生、全科医生、注册护士助产士、注册护士、在册护士、在册助产士、有行医执照者以及注册公共卫生护士发放自填式问卷。计算每位参与者的知识得分，并采用逻辑回归分析评估先兆子痫后心血管疾病风险高认知度的预测因素。
主要结果
先兆子痫后心血管疾病风险的总体平均知识得分为4.7/7（67.1%）。大多数人正确报告高血压101例（92.7%）、缺血性心脏病84例（77.1%）、中风83例（76.2%）以及肾病75例（68.8%）为与先兆子痫相关的未来疾病。知识与实践存在显著但中等程度的负相关（r = -0.21，p = 0.037）。与产科医生/全科医生相比，注册护士助产士（调整优势比[aOR]=0.21，95%置信区间：0.05 - 0.80，p = 0.023）以及在册助产士/在册护士/有行医执照者/注册公共卫生护士（aOR = 0.15，95%置信区间：0.03 - 0.91，p = 0.039）具有高认知度的可能性较小。此外，工作经验为5 - 10年（aOR = 7.15，95%置信区间：1.99 - 25.72，p = 0.003）以及超过15年的医护人员比工作经验少于5年的人员具有高认知度的可能性更大。
结论
大多数医护人员了解先兆子痫后心血管疾病的未来风险。然而，可能需要采取积极的行为改变干预措施来解决知识与实践之间的脱节问题。
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