卫生工作者对分娩前后孕产妇和新生儿保健质量的看法:在世界卫生组织欧洲地区的 12 个国家开展的 "改善欧洲地区孕产妇和新生儿护理"(IMAgiNE EURO)项目的结果。

IF 4.5 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Global Health Pub Date : 2024-09-06 DOI:10.7189/jogh.14.04164
Emanuelle Pessa Valente, Ilaria Mariani, Arianna Bomben, Sandra Morano, Michael Gemperle, Marina Ruxandra Otelea, Céline Miani, Helen Elden, Antigoni Sarantaki, Raquel Costa, Barbara Baranowska, Martina König-Bachmann, Sigrun Kongslien, Daniela Drandić, Virginie Rozée, Antonella Nespoli, Alessia Abderhalden-Zellweger, Ioana Nanu, Stephanie Batram-Zantvoort, Karolina Linden, Dimitra Metallinou, Heloísa Dias, Urszula Tataj-Puzyna, Elisabeth D'Costa, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elise de La Rochebrochard, Simona Fumagalli, Susanne Grylka-Baeschlin, Claudia Mariana Handra, Mehreen Zaigham, Eirini Orovou, Catarina Barata, Beata Szlendak, Christoph Zenzmaier, Eline Skirnisdottir Vik, Alina Liepinaitienė, Zalka Drglin, Maryse Arendt, Emma Sacks, Marzia Lazzerini
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引用次数: 0

摘要

背景:卫生工作者(HWs)对孕产妇和新生儿护理质量(QMNC)的看法并未得到常规收集。在这项横断面研究中,我们旨在记录世界卫生组织(WHO)在 12 个欧洲国家的医护人员对分娩前后孕产妇和新生儿护理质量的看法。方法:在 2020 年 3 月至 2023 年 3 月期间,参与孕产妇/新生儿护理工作至少一年的医护人员回答了一份经过验证的基于世卫组织标准的在线调查问卷,该问卷收集了 40 项提高孕产妇和新生儿护理质量的措施。结果:对 4143 名受访者的数据进行了分析。在 40 项质量措施中,有 39 项措施至少有 20% 的保健工作者表示 "需要改进",各国的情况差异很大。健康妇女/新生儿管理的有效培训(n = 2748,66.3%)、知情同意工作辅助工具的可用性(n = 2770,66.9%)和妇女/新生儿权利的有效培训(n = 2714,65.5%)中,表示 "需要改进 "的保健人员比例最高。总体而言,64.8%(n = 2684)的受访者表示保健人员数量不足以提供适当的护理(葡萄牙为 66.3%,波兰为 86.6%),22.4%的受访者描述了工作人员审查制度(德国为 16.3%,波兰为 56.7%)。所有国家报告的 QMNC 指数都很低(波兰的中位数 (MD) = 210.60,四分位数间距 (IQR) = 155.71,273.57;挪威的中位数 = 277.86;四分位数间距 (IQR) = 244.32,308.30)。八个国家的 "医疗体验 "领域得分明显低于其他领域(P 0.05)。多变量分析证实,各国的 QMNC 差异很大。有结论的保健工作者:来自 12 个欧洲国家的保健工作者报告称,QMNC 存在明显差距,与 COVID-19 的流行趋势缺乏关联。需要对 QMNC 进行常规监测并采取有针对性的行动,以改善医疗服务,造福使用者和医疗服务提供者:注册:ClinicalTrials.gov NCT04847336。
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Health workers' perspectives on the quality of maternal and newborn health care around the time of childbirth: Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region.

Background: Health workers' (HWs') perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs' perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries.

Methods: HWs involved in maternal/neonatal care for at least one year between March 2020 and March 2023 answered an online validated WHO standards-based questionnaire collecting 40 quality measures for improving QMNC. A QMNC index (score 0-400) was calculated as a synthetic measure.

Results: Data from 4143 respondents were analysed. For 39 out of 40 quality measures, at least 20% of HWs reported a 'need for improvement', with large variations across countries. Effective training on healthy women/newborns management (n = 2748, 66.3%), availability of informed consent job aids (n = 2770, 66.9%), and effective training on women/newborns rights (n = 2714, 65.5%) presented the highest proportion of HWs stating 'need for improvement'. Overall, 64.8% (n = 2684) of respondents declared that HWs' numbers were insufficient for appropriate care (66.3% in Portugal and 86.6% in Poland), and 22.4% described staff censorship (16.3% in Germany and 56.7% in Poland). The reported QMNC index was low in all countries (Poland median (MD) = 210.60, interquartile range (IQR) = 155.71, 273.57; Norway MD = 277.86; IQR = 244.32, 308.30). The 'experience of care' domain presented in eight countries had significantly lower scores than the other domains (P < 0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P < 0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P > 0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with <10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P < 0.001).

Conclusions: HWs from 12 European countries reported significant gaps in QMNC, lacking association with COVID-19 pandemic trends. Routine monitoring of QMNC and tailored actions are needed to improve health services for the benefit of both users and providers.

Registration: ClinicalTrials.gov NCT04847336.

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来源期刊
Journal of Global Health
Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.10
自引率
2.80%
发文量
240
审稿时长
6 weeks
期刊介绍: Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
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