评估医疗机构救治严重产后出血能力的质性访谈  

A Qualitative Interview was Conducted to Assess the Ability of Different Medical Institutions to Treat Severe Postpartum Hemorrhage

作　　者：贾艳菊[1] 王孟 崔洪艳[1] 陈叙[1] JIA Yan-ju;WANG Meng;CUI Hong-yan;CHEN Xu(Department of Obstetrics,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China)

机构地区：[1]天津市中心妇产科医院产科,300100

出　　处：《国际妇产科学杂志》2024年第3期329-335,共7页Journal of International Obstetrics and Gynecology

基　　金：国家重点研发计划(2021YFC2701505)。

摘　　要：目的:探讨医疗机构救治严重产后出血能力的现状和评估指标,为进一步建立不同级别医疗机构救治能力评估体系、规范救治流程及完善分级诊疗和转诊体系提供依据和建议。方法:于2022年2—11月采用目的抽样法选取35名基层医院医护人员及30名三级医院医护人员共65名为研究对象,进行严重产后出血救治能力相关质性半结构化访谈。依据扎根理论法,应用质性分析软件Nvivo11析出概念类属和核心主题,总结目前不同级别医疗机构救治严重产后出血中存在的问题。结果:析出严重产后出血救治能力相关44个初始概念、21个副概念及4个核心主题,围绕4个核心主题构建了不同级别医疗机构严重产后出血救治能力评估指标池。目前医疗机构救治严重产后出血时存在不同程度的设施设备及药品不足、人员配备未达要求、救治技术熟练度欠佳及救治流程不规范的问题。结论:鉴于医疗机构严重产后出血救治能力参差不齐且无统一评估标准,初步形成了救治能力评估指标池,建议各级医院根据指标池,进一步规范救治流程及完善分级诊疗和转诊体系,以期提高严重产后出血的救治能力。Objective:To explore the evaluation indexes of the ability of medical institutions to treat severe postpartum hemorrhage,it provides the basis and suggestions for the establishment of the evaluation system of the rescue ability of different medical institutions,the standardization of the rescue process and the improvement of the graded diagnosis and treatment referral.Methods:From February 2022 to November 2022,65 health care workers from 35 primary hospitals and 30 tertiary hospitals were selected by purposive sampling to participate in semi-structured interviews regarding their ability to manage severe postpartum hemorrhage.Based on the grounded theory,the concept categories and core themes were analyzed by qualitative analysis software Nvivo11,and the existing problems in the treatment of severe postpartum hemorrhage in different medical institutions were summarized.Results:44 initial concepts,21 sub-concepts and 4 core themes related to the ability to treat severe postpartum hemorrhage were analyzed,the evaluation index pool of the ability to treat severe postpartum hemorrhage in different levels of medical institutions was constructed around 4 core themes.There are some problems in medical institutions in treating severe postpartum hemorrhage,such as lack of facilities,equipment and drugs,unqualified personnel,unskilled treatment technique and irregular treatment procedure.Conclusions:The ability of medical institutions to treat severe postpartum hemorrhage is uneven and there is no uniform evaluation standard,in order to improve the ability to treat severe postpartum hemorrhage,this study initially formed the evaluation index pool of rescue ability,and suggested that hospitals at all levels should further standardize the rescue process and perfect the grading diagnosis and treatment and referral system.

关 键 词：严重产后出血 救治能力 质性研究 半结构化访谈 扎根理论法 

分 类 号：R714.461[医药卫生—妇产科学]