产程护理缺失现状及影响因素分析  

Current status of missed nursing care during labor and its influencing factors Ding Shenglan

作　　者：丁胜兰 张轶岚 王清霞 付秀娟 王鑫 Ding Shenglan;Zhang Yilan;Wang Qingxia;Fu Xiujuan;Wang Xin(Department of Birth Room,Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,China;Department of Nursing,Chengdu Women′s and Children′s Central Hospital,School of Medicine,University of Electronic Science and technology of China,Chengdu 611731,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院产房,成都611731 [2]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院护理部,成都611731

出　　处：《中国实用护理杂志》2024年第34期2673-2681,共9页Chinese Journal of Practical Nursing

基　　金：中华医学会杂志社2022-2023年护理学科研究课题(CMAPH-NRD2022033)。

摘　　要：目的调查产程护理缺失发生的现状及原因,并分析护理缺失的相关影响因素。方法采用便利抽样法,于2023年2—4月选取西南地区14所不同等级医疗机构的491名助产士作为研究对象,采用一般信息调查表、中文版产程护理缺失量表进行横断面调查。采用多重线性回归分析方法对产程护理缺失的影响因素进行分析。结果491名助产士中,男6名,女485名;≤30岁194名,31~40岁205名,≥41岁92名。80.45%(395/491)的助产士报告了在过去1周内至少有1项产程护理活动的缺失,单项产程护理活动的缺失率为13.24%(65/491)~53.36%(262/491)。产程护理缺失的条目均分为(1.49±0.58)分,基础护理、必要护理和产后护理3个维度的条目均分分别为(1.67±0.68)、(1.36±0.56)、(1.51±0.70)分;缺失原因条目均分为(1.82±0.71)分,沟通、人力资源和物力资源3个维度的条目均分分别为(1.75±0.73)、(1.97±0.87)、(1.74±0.83)分。多重线性回归分析结果显示性别、月均收入水平、加班时间是否计入总有效工作时长是产程护理缺失的独立影响因素(均P<0.05)。结论产程护理缺失现状有待改善,其中基础护理缺失最为普遍,且受人口社会学等因素的影响,人力资源因素是护理缺失的重要原因,应采取针对性措施,以减少护理缺失的发生。ObjectiveTo investigate the current state of missed nursing care during labor,explore the reasons why nursing care was missed,and examine the influencing factors of missed nursing care.MethodsData were collected from 14 medical institutions of different levels in southwest China using a convenience sampling from February to April,2023.A total of 491 midwives were included.A cross-sectional survey was conducted using a general information questionnaire and the Chinese version of the Perinatal Missed Care.Multiple linear regression analysis was conducted to identify the influencing factors on missed nursing care.ResultsAmong 491 midwives,there are 6 males and 485 females.194 midwives aged≤30,205 midwives aged 31-40 years,and 92 midwives aged≥41 years.80.45%(395/491)of midwives reported missing at least one item of nursing care during labor in the past week,and the missing rate of single item ranged from 13.24%(65/491)to 53.36%(262/491).The average score across 23 items of missed nursing care during labor was 1.49±0.58.The average scores of items spanning the three dimensions of basic care,necessary care and postnatal care were 1.67±0.68,1.36±0.56,and 1.51±0.70,respectively.The average score of 13 items representing reasons for missed nursing care was 1.82±0.71.The average scores of items in three dimensions of communication,labor resources,and material resources were 1.75±0.73,1.97±0.87,and 1.74±0.83,respectively.The multiple linear regression analyses showed that gender,monthly average income level,and whether overtime hours were included in total working hours were independently associated with missed nursing care(all P<0.05).ConclusionsThe current state of missed nursing care during labor needs to be improved.Missed basic care is common,and labor resources are the significant reasons,and is influenced by factors such as demographic and sociological factors.Human resource factors are an important reason for nursing deficiency,and targeted measures should be taken to reduce the occurrence of nursing de

关 键 词：横断面研究 助产士 产程 护理缺失 影响因素 

分 类 号：R473.71[医药卫生—护理学]