1213所医疗机构助产技术应用现状的调查研究

doi:10.3761/j.issn.0254-1769.2020.12.008

摘要/Abstract

摘要：

目的了解国内医疗机构助产技术的应用现状,为助产教育、培训及政策的制订提供依据。方法 2017年12月—2018年11月,采用自行设计的“中国助产技术开展情况调查表”,对全国22个省份的1 213所医疗机构进行调查。结果共调查672所（55.4%）三级医院、541所（44.6%）二级医院。三级医疗机构使用的助产技术中,自由体位、心理保健、全面支持、非药物镇痛、导乐陪伴分娩等助产技术的应用率高于二级医疗机构,差异具有统计学意义（均P<0.05）;二级医疗机构使用的助产技术中,剃除阴毛、经肛门评估宫口、强迫体位分娩、常规人工破膜、增加腹压等助产技术的应用率高于三级医疗机构,差异具有统计学意义（均P<0.05）。按医疗机构类型分,综合医院使用的助产技术中,自由体位分娩、导乐陪伴分娩和助产士门诊的应用率低于专科医院和妇幼保健院,差异具有统计学意义（均P<0.05）;剃除阴毛、第二产程用手扩张阴道、强迫体位分娩等助产技术的应用率高于专科医院和妇幼保健院,差异具有统计学意义（均P<0.05）。结论国内医疗机构中明显有益的助产适宜技术应用情况较好,但不同级别医院的助产技术应用不均衡,建议制订适合国内的助产适宜技术实施标准和规范,提高助产服务质量,更好地保障母婴安全。

关键词: 助产适宜技术, 问卷调查, 产科护理, 助产学

Abstract:

Objective To investigate the present application situation of the appropriate technologies of midwifery in Chinese mainland,so as to provide references for future midwifery education,training and policy-making. Methods From December 2017 to November 2018,a self-designed questionnaire was conducted to investigate the current situation of appropriate technical application in 1 213 secondary and above midwifery medical institutions in 22 provinces,municipalities or autonomous regions by purposive sampling. Results A total of 672（55.4%） tertiary hospitals and 541（44.6%） secondary hospitals were investigated. The application rates of free position,mental health care,comprehensive support,non-drug analgesia and guided music in tertiary midwifery medical institutions were all higher than those in secondary hospitals,and the differences were statistically significant（P<0.05）. The application rates of shaving pubic hair,anal evaluation,forced position,conventional artificial rupture of membrane and abdominal pressure in secondary hospitals were higher than those in tertiary midwifery medical institutions,and the differences were statistically significant（P<0.05）. According to the type of hospitals,the outpatient service rates of free position,guided delivery and midwife in general hospitals were all lower than those in specialized hospitals and maternal and child care hospitals,and the differences were statistically significant（P<0.05）. In general hospitals,the application rates of midwifery technology such as shaving pubic hair,dilating vagina with hand in the second stage of labor and forced position were higher than those in specialized hospitals and maternal and child health care hospitals,and the differences were statistically significant（P<0.05）. Conclusion The use of beneficial midwifery techniques in delivery rooms of Chinese hospitals is good,however,the use of other midwifery techniques is jagged and the application in different levels of hospitals is unbalanced. The implementation standards and norms of appropriate midwifery technology must be formulated and the quality of midwifery services should be enhanced to improve the present situation of appropriate technical application and ensure the safety of mothers and infants in China.

Key words: Appropriate Technologies of Midwifery, Questionnaires, Obstetrical Nursing, Midwifery

杨雯茜,罗碧如,徐鑫芬,姜梅. 1213所医疗机构助产技术应用现状的调查研究[J]. 中华护理杂志, 2020, 55(12): 1802-1807.

YANG Wenqian,LUO Biru,XU Xinfen,JIANG Mei. A survey of the application of midwifery technology in 1213 medical institutions[J]. Chinese Journal of Nursing, 2020, 55(12): 1802-1807.

图/表 4

表1 应给予鼓励且明显有益的助产技术应用情况[n=1213,所（百分率,%）]

Table 1 Application of demonstrably beneficial midwifery techniques that should be encouraged[n=1213,places（percentage,%）]

表2 应淘汰且明显有害或无效的助产技术应用情况[n=1213,所(百分率,%)]

Table 2 Application of midwifery techniques that should be eliminated and are obviously harmful or ineffective[ n= I 213, places( percentage ,%)]

表3 没有足够证据支持且待研究的助产技术应用情况[n=1213,所(百分率,%)]

Table 3 Application of midwifery technology to be studied without sufficient evidence [n=l 213 ,places( percentage ,%)]

表4 常用的不适当的助产技术应用情况[所(n=1213,百分率,%)]

Table 4 Application of commonly used inappropriate midw ifery techniques [n=l213, places( percentage, %)]

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