1213所医疗机构助产技术应用现状的调查研究  

A survey of the application of midwifery technology in 1213 medical institutions

作　　者：杨雯茜 罗碧如 徐鑫芬[2] 姜梅[3] YANG Wenqian;LUO Biru;XU Xinfen;JIANG Mei

机构地区：[1]四川大学华西第二医院产科护理部/出生缺陷与相关妇儿疾病教育部国家重点实验室,成都市610041 [2]浙江大学医学院附属妇产科医院护理部 [3]首都医科大学附属北京妇产医院护理部

出　　处：《中华护理杂志》2020年第12期1802-1807,共6页Chinese Journal of Nursing

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。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 1213 secondary and above midwifery medical institutions in22 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 midwife

关 键 词：助产适宜技术 问卷调查 产科护理 助产学 

分 类 号：R47[医药卫生—护理学]