通过基于模拟的教育提高坦桑尼亚学生助产护士预防产后出血的知识、技能和态度：一项前后对照的准实验研究。
Improving Tanzanian student nurse-midwives' knowledge, skills and attitude in postpartum hemorrhage prevention through simulation-based education: a pre-post quasi experimental study.
作者信息
Faustine Rose, Tjoflåt Ingrid, Risa Eva Christina Furskog, Rogathi Jane, Mahande Michael Johnson
机构信息
School of Nursing, KCMC University, P. o. Box 2240, Moshi, Tanzania.
Faculty of Health Sciences, University of Stavanger, P.o Box 8600, Stavanger, 4036, Norway.
出版信息
BMC Pregnancy Childbirth. 2025 Apr 23;25(1):471. doi: 10.1186/s12884-025-07590-4.
BACKGROUND
Postpartum hemorrhage is a leading cause of maternal deaths in Tanzania, highlighting the critical need for effective training for student nurse-midwives in ordinary diploma programs. The study aimed to determine the changes in knowledge, skills, self-confidence, and satisfaction in preventing and managing postpartum hemorrhage among student nurse-midwives after the simulation-based education method is being used.
METHODS
A pre-post quasi-experimental study design without a control group was conducted to assess the impact of simulation-based education on student nurse-midwives' knowledge, skills, self-confidence, and satisfaction regarding the prevention and management of postpartum hemorrhage at one college of health and allied sciences in the northern Tanzania. A total of 55 student nurse-midwives were included. Data were collected using structured self-administered questionnaires related to knowledge, skill check, self-confidence, and satisfaction. Descriptive statistics, bivariate analysis using T-tests and Chi-square tests, as well as multiple regression models, were employed to analyze the data. A p-value of less than 0.05 was used to assess statistically significant differences in the adjusted mean (Beta Coefficient) between the post-intervention and pre-intervention periods.
RESULTS
The results indicated that student nurse-midwives experienced a significant improvement in knowledge and skills after simulation-based education method (p < 0.001). Additionally, the multiple regression analysis revealed that knowledge scores were notably higher at endline of the study compared to the baseline, with an effect size of (AβC = 11.7; 95% CI: 11.0-12.5) and 13.9(12.7-15.1) respectively. Furthermore, students reported high level of self-confidence and satisfaction regarding their abilities in preventing and managing postpartum hemorrhage after simulation, as assessed using the unadjusted Bloom technique.
CONCLUSION
The results revealed that simulation-based education was an effective pedagogical method for improving student nurse-midwives knowledge, skills, self-confidence, and satisfaction in the prevention and management of postpartum hemorrhage.
背景
产后出血是坦桑尼亚孕产妇死亡的主要原因，这凸显了为普通文凭课程中的学生助产护士提供有效培训的迫切需求。本研究旨在确定采用基于模拟的教育方法后，学生助产护士在预防和处理产后出血方面的知识、技能、自信心和满意度的变化。
方法
在坦桑尼亚北部一所健康与联合科学学院，采用无对照组的前后准实验研究设计，以评估基于模拟的教育对学生助产护士在产后出血预防和处理方面的知识、技能、自信心和满意度的影响。总共纳入了55名学生助产护士。使用与知识、技能检查、自信心和满意度相关的结构化自填式问卷收集数据。采用描述性统计、使用T检验和卡方检验的双变量分析以及多元回归模型对数据进行分析。使用小于0.05的p值来评估干预后和干预前调整均值（β系数）之间的统计学显著差异。
结果
结果表明，基于模拟的教育方法使学生助产护士的知识和技能有了显著提高（p < 0.001）。此外，多元回归分析显示，与基线相比，研究末期的知识得分显著更高，效应量分别为（AβC = 11.7；95%可信区间：11.0 - 12.5）和13.9（12.7 - 15.1）。此外，使用未调整的布鲁姆技术评估发现，学生在模拟后对自己预防和处理产后出血的能力报告了较高的自信心和满意度。
结论
结果表明，基于模拟的教育是一种有效的教学方法，可提高学生助产护士在预防和处理产后出血方面的知识、技能、自信心和满意度。
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