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埃塞俄比亚西南部吉马地区公立医院产科护理人员基于证据的产时护理实践及相关因素:一项横断面研究。

Evidence-based intrapartum care practice and associated factors among obstetric care providers in Jimma Zone public hospitals, southwest Ethiopia: A cross-sectional study.

作者信息

Wakjira Diriba, Andualem Eneyew Melkamu, Bekele Azmeraw, Beyene Desalew Tilahun

机构信息

School of Midwifery, Jimma University, Ethiopia.

School of Midwifery, University of Gondar, Ethiopia.

出版信息

SAGE Open Med. 2025 Jul 24;13:20503121251358969. doi: 10.1177/20503121251358969. eCollection 2025.

Abstract

BACKGROUND

Evidence-based practice in intrapartum care is critical for lowering maternal and neonatal mortality and morbidity. Evidence-based practice, according to the World Health Organization Quality of Care Framework for Maternal and Newborn Health, is an important component of intrapartum care. However, little is understood about evidence-based intrapartum care practice in Ethiopia, particularly in the study setting.

OBJECTIVE

To assess evidence-based intrapartum care practice and associated factors among obstetric care professionals in Jimma Zone public hospitals in Southwest Ethiopia.

METHODS

A facility-based cross-sectional study was carried out on 217 obstetric care providers in Jimma Zone public hospitals in southwest Ethiopia. The study used a census approach to include all eligible participants within the specified population. Data were collected from June 1 to 30, 2023, using semistructured self-administered questionnaires. The collected data were entered into EpiData version 4.6 and exported to Statistical Packages for Social Sciences version 25 for analysis. Multivariable logistic regression was run to see the association between evidence-based intrapartum care practice and predictor variables. Statistical significance was set at -values less than 0.05 in the multivariable logistic regression.

RESULTS

Overall, 41.2% (95% CI: 40.8-42.3) of obstetric care providers in Jimma Zone public hospitals used evidence-based practices for intrapartum care. Attending in-service training (AOR (95% CI): 3.5 (1.61-9.71)), accessibility of obstetric care guidelines (AOR (95% CI): 2.082 (1.222-3.547)), having regular case presentation (AOR (95% CI): 2.5 (1.234-6.743)), having knowledge (AOR (95% CI): 2.3 (1.222-3.547)), attitude of obstetric care providers (AOR (95% CI): 1.847 (1.065-3.204)), having less than 2 years of work experience (AOR (95% CI): 1.32 (1.012-3.56)), and having 2-5 years of work experience (AOR (95% CI): 3.49 (1.23-6.312)) were among factors significantly associated with evidence-based intra-partum care practice of obstetric care providers in Jimma Zone public hospitals.

CONCLUSIONS

This study indicated that the majority of obstetric care providers did not practice evidence-based intrapartum care, which requires attention from all stakeholders. It is recommended for hospitals in the Jimma Zone to make guidelines available, provide in-service trainings, and identify systematic strategies to improve the knowledge and attitude of obstetric care providers.

摘要

背景

产时护理中的循证实践对于降低孕产妇和新生儿死亡率及发病率至关重要。根据世界卫生组织孕产妇和新生儿健康护理质量框架,循证实践是产时护理的重要组成部分。然而,对于埃塞俄比亚的循证产时护理实践,尤其是在本研究环境中,人们了解甚少。

目的

评估埃塞俄比亚西南部吉马地区公立医院产科护理专业人员的循证产时护理实践及相关因素。

方法

对埃塞俄比亚西南部吉马地区公立医院的217名产科护理提供者进行了一项基于机构的横断面研究。该研究采用普查方法,将特定人群中的所有符合条件的参与者纳入其中。2023年6月1日至30日,使用半结构化自填式问卷收集数据。收集到的数据录入EpiData 4.6版本,并导出到社会科学统计软件包25版本进行分析。进行多变量逻辑回归以观察循证产时护理实践与预测变量之间的关联。在多变量逻辑回归中,统计学显著性设定为P值小于0.05。

结果

总体而言,吉马地区公立医院41.2%(95%可信区间:40.8 - 42.3)的产科护理提供者在产时护理中采用了循证实践。参加在职培训(调整后比值比(95%可信区间):3.5(1.61 - 9.71))、产科护理指南的可获取性(调整后比值比(95%可信区间):2.082(1.222 - 3.547))、定期进行病例汇报(调整后比值比(95%可信区间):2.5(1.234 - 6.743))、具备知识(调整后比值比(95%可信区间):2.3(1.222 - 3.547))、产科护理提供者的态度(调整后比值比(95%可信区间):1.847(1.065 - 3.204))、工作经验少于2年(调整后比值比(95%可信区间):1.32(1.012 - 3.56))以及工作经验为2至5年(调整后比值比(95%可信区间):3.49(1.23 - 6.312))是与吉马地区公立医院产科护理提供者循证产时护理实践显著相关的因素。

结论

本研究表明,大多数产科护理提供者未践行循证产时护理,这需要所有利益相关者予以关注。建议吉马地区的医院提供指南、开展在职培训,并确定系统性策略以提高产科护理提供者的知识和态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a99/12301604/0ca4abb1c35e/10.1177_20503121251358969-fig1.jpg

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