PRECEDE模式培训方案对助产士实施新生儿早期基本保健技术的效果研究  

Study on the effect of PRECEDE model training program on the implementation of early essential newborn care among midwives

作　　者：莫小慧 罗琳雪[3] MO Xiaohui;LUO Linxue(Obstetrical Department,Liuzhou Tradtional Chinese Medical Hospital,Liuzhou 545001,Guangxi,China;School of Nursing,Youjiang Medical University for Nationalties,Baise 533000,Guangxi,China;Nursing Department,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]广西柳州市中医医院产科,广西柳州545001 [2]右江民族医学院护理学院,广西百色533000 [3]右江民族医学院附属医院护理部,广西百色533000

出　　处：《右江医学》2023年第8期712-718,共7页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210466);右江民族医学院附属医院高层次人才科研项目(R20196346)。

摘　　要：目的评价基于PRECEDE构建的促进助产士实施新生儿早期基本保健(early essential newborn care,EENC)技术培训方案的临床应用效果。方法于2020年8月至2021年8月选取2所医院产科37名助产士为研究对象,采用基于PRECEDE构建的EENC培训方案进行干预,观察干预前后助产士的EENC理论成绩与EENC实操考核成绩。干预前、干预结束1个月后分别观摩160例经阴道分娩孕产妇分娩过程的90 min母婴皮肤接触率、晚断脐率、1 min新生儿窒息发生率、5 min新生儿窒息发生率、新生儿重度窒息发生率、早开奶率、出院当天纯母乳喂养率。应用SPSS 25.0软件对数据进行分析。结果干预前后,助产士EENC理论成绩比较差异有统计学意义[(80.81±6.23)分vs(92.45±4.07)分,P<0.001];EENC实操考核成绩比较差异有统计学意义[(75.13±5.34)分vs(89.56±4.20)分,P<0.001]。干预结束1个月后,90 min母婴皮肤接触率、晚断脐率、早开奶率和出院当天纯母乳喂养率均高于干预前(P<0.001);1 min新生儿窒息发生率、5 min新生儿窒息发生率、新生儿重度窒息发生率与干预前比较差异无统计学意义(P>0.05)。结论基于PRECEDE模式的EENC培训方案可提高助产士EENC知识掌握度及行为依从率,促进母婴健康。Objective To evaluate the clinical effect of promoting midwives to implement early essential newborn care(EENC)training program based on PRECEDE.Methods 37 midwives in obstetrical departments from 2 hospitals were selected as research subjects,and an EENC training program based on PRECEDE was used for intervention,and EENC theoretical and practical assessment scores of midwives were observed before and after the intervention.Before and one month after the intervention,90 min skin-to-skin contact rate of mothers and infants,late umbilical cord disconnection rate,1 min neonatal asphyxia rate,5 min neonatal asphyxia rate,severe neonatal asphyxia rate,early lactation rate,and exclusive breast-feeding rate on the day of discharge among 160 pregnant and postpartum women who underwent vaginal deliveries were observed.SPSS 25.0 software was used to analyze the data.Results Before and after the intervention,there was statistically significant difference in the EENC theoretical scores of midwives([80.81±6.23]points vs[92.45±4.07]points,P<0.001),and difference in the EENC practical scores of midwives was statistically significant([75.13±5.34]vs[89.56±4.20],P<0.001).One month after the end of the intervention,the 90 min skin-to-skin contact rate of mothers and infants,the late umbilical cord disconnection rate,the early lactation rate and the exclusive breast-feeding rate on the day of discharge were higher than those before the intervention(P<0.001).There was no statistically significant difference in the incidence of 1 min neonatal asphyxia rate,5 min neonatal asphyxia rate,and severe neonatal asphyxia rate before and after intervention(P>0.05).Conclusion EENC training program based on PRECEDE mode can improve midwives'mastery of EENC knowledge and behavior compliance rate,and promote maternal and infant health.

关 键 词：PRECEDE模式 助产士 新生儿 早期基本保健 

分 类 号：R473.71[医药卫生—护理学]