以质量求发展,以服务铸品牌

护理学报 ›› 2024, Vol. 31 ›› Issue (24): 33-36.doi: 10.16460/j.issn1008-9969.2024.24.033

• 文献研究 • 上一篇    下一篇

正常分娩中非必要干预的研究进展

赵阳1, 王岚1, 尹雪梅2   

  1. 1.天津医科大学 护理学院, 天津 300070;
    2.天津市中心妇产科医院 护理部, 天津 300199
  • 收稿日期:2024-07-16 出版日期:2024-12-25 发布日期:2025-01-09
  • 通讯作者: 尹雪梅(1970-),女,天津人,学士,主任护师,护理部主任,硕士研究生导师。E-mail:yxm3120@sina.com
  • 作者简介:赵阳(1988-),女,山东济南人,博士,讲师。
  • 基金资助:
    天津市教委科研计划项目(2022SK207)

  • Received:2024-07-16 Online:2024-12-25 Published:2025-01-09

摘要: 目的 阐述正常分娩中非必要干预的研究进展,为开展相关研究、制定减少或避免正常分娩中非必要干预的策略提供借鉴。方法 总结国内外相关文献,对正常分娩中非必要的干预及其影响因素和解决策略进行综述。结果 正常分娩过程中存在较多非必要的干预,其受医务人员认知和技能水平、产妇个体差异与偏好、卫生服务系统等方面因素的影响,解决策略研究在方法上存在诸多不足之处。结论 减少或避免正常分娩中过多干预的策略研究在数量、方法和评价方面尚存不足,未来需针对我国的临床情境,在影响因素分析的基础上,采用科学、系统的研究设计和评价方法,探索有效的解决策略。

关键词: 正常分娩, 非必要干预, 影响因素, 策略

中图分类号: 

  • R473.71
[1] Miller S, Abalos E, Chamillard M, et al.Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide[J]. Lancet, 2016, 388(10056): 2176-2192. DOI: 10.1016/S0140-6736(16)31472-6.
[2] Ye J, Chen Y, Yang H, et al.A nationwide cross-sectional survey of episiotomy practice in China[J].Lancet Reg Health West Pac, 2022, 19: 100345. DOI: 10.1016/j.lanwpc.2021.100345.
[3] Alfirevic Z, Devane D, Gyte GM, et al. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour[J]. Cochrane Database Syst Rev,2017,2(2):Cd006066.DOI:10.1002/14651858.CD006066.
[4] Aasheim V, Nilsen ABV, Reinar LM, et al. Perineal techniques during the second stage of labour for reducing perineal trauma[J]. Cochrane Database Syst Rev, 2017, 6(6): Cd006672. DOI: 10.1002/14651858.CD006672.pub3.
[5] Augustsson H, Ingvarsson S, Nilsen P, et al.Determinants for the use and de-implementation of low-value care in health care: a scoping review[J]. Implement Sci Commun, 2021, 2(1): 13. DOI: 10.1186/s43058-021-00110-3.
[6] Ingvarsson S, Hasson H, von Thiele Schwarz U, et al. Strategies for de-implementation of low-value care-a scoping review[J]. Implement Sci, 2022, 17(1): 73. DOI: 10.1186/s13012-022-01247-y.
[7] Raudasoja AJ, Falkenbach P, Vernooij RWM, et al.Randomized controlled trials in de-implementation research: a systematic scoping review[J]. Implement Sci, 2022, 17(1): 65. DOI: 10.1186/s13012-022-01238-z.
[8] Zhao JQ, Li SA, Graham ID, et al.A call for de-implementation research and clinical practice in Chinese healthcare[J].BMJ,2022,377:o1203.DOI: 10.1136/bmj.o1203.
[9] Iyengar K, Jain M, Thomas S, et al.Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India[J]. BMC Pregnancy Childbirth,2014, 14: 270. DOI: 10.1186/1471-2393-14-270.
[10] Maude RM, Skinner JP, Foureur MJ.Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women[J]. BMC Pregnancy Childbirth, 2014, 14: 184. DOI: 10.1186/1471-2393-14-184.
[11] World Health Organization.WHO Recommendations: intrapartum care for a positive childbirth experience[EB/OL].[2023-12-01] https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/
[12] SIGN.A guideline developer's handbook[EB/OL].[2024-03-08] https://www.sign.ac.uk/media/2026/sign50_2019.pdf
[13] Zhao Y, Lu H, Zang Y, et al.A systematic review of clinical practice guidelines on uncomplicated birth[J]. BJOG, 2020, 127(7): 789-797.DOI: 10.1111/1471-0528.16073.
[14] de Souza KCR, da Silva TPR, Damasceno AKC, et al. Coexistence and prevalence of obstetric interventions:an analysis based on the grade of membership[J]. BMC Pregnancy Childbirth, 2021, 21(1): 618. DOI: 10.1186/s12884-021-04092-x.
[15] Akyıldız D, Çoban A, Gör Uslu F, et al.Effects of obstetric interventions during labor on birth process and newborn health[J]. Florence Nightingale J Nurs, 2021, 29(1): 9-21. DOI: 10.5152/FNJN.2021.19093.
[16] Çalik KY, Karabulutlu Ö, Yavuz C.First do no harm- interventions during labor and maternal satisfaction: a descriptive cross-sectional study[J]. BMC Pregnancy Childbirth, 2018, 18(1): 415. DOI: 10.1186/s12884-018-2054-0.
[17] Gu C, Wang X, Zhang Z, et al.Pregnant women's clinical characteristics, intrapartum interventions, and duration of labour in urban China: a multi-center cross-sectional study[J]. BMC Pregnancy Childbirth, 2020, 20(1): 386. DOI: 10.1186/s12884-020-03072-x.
[18] Zhao Y,Lu H,Lu J,et al.Implementation of normal childbirth guidelines among midwives:adherence and influencing factors[J]. Women Birth, 2024, 37(1): 215-222. DOI: 10.1016/j.wombi.2023.09.005.
[19] 杨雯茜, 罗碧如, 徐鑫芬, 等. 1213所医疗机构助产技术应用现状的调查研究[J]. 中华护理杂志, 2020, 55(12): 1802-1807.
[20] Wagner M.Episiotomy: a form of genital mutilation[J]. Lancet(London, England), 1999, 353(9168):1977-1978. DOI:10.1016/S0140-6736(05)77197-X.
[21] World Health Organization.Guidelines on basic newborn resuscitation[EB/OL].[2023-12-01].https://iris.who.int/bitstream/handle/10665/75157/9789241503693_eng.pdf;jsessionid=0D9585721F9A4E06B1695B3F477D1692?sequence=1
[22] Walker DS, Shunkwiler S, Supanich J,et al.Labor and delivery nurses' attitudes toward intermittent fetal monitoring[J]. Journal of midwifery & women's health, 2001, 46(6): 374-380.
[23] 漆洪波, 段然. 产程中持续胎心监护的现在与将来[J]. 中国实用妇科与产科杂志, 2019, 35(4): 369-372. DOI:10.19538/j.fk2019040101.
[24] 王晓娇, 张铮, 闵辉, 等. 助产人员正常产程管理实践的质性研究[J]. 护理学杂志, 2021, 36(2): 48-50.
[25] Prusaczyk B, Swindle T, Curran G.Defining and conceptualizing outcomes for de-implementation: key distinctions from implementation outcomes[J]. Implement Sci Commun, 2020, 1: 43. DOI: 10.1186/s43058-020-00035-3.
[26] 谢润生, 徐东, 李慧, 等. 医疗卫生领域中实施科学的研究方法[J]. 中国循证医学杂志, 2020, 20(9): 1104-1110.
[1] 李丹妮, 邱丽燕, 吴隆燕, 谭铮可可, 陈欣, 杨丽. 前交叉韧带损伤日间手术患者恐动症的潜在剖面分析及影响因素研究[J]. 护理学报, 2025, 32(4): 12-17.
[2] 杜易梅, 刘莉, 郭立丽, 卢吉, 付苗苗, 刘杰. 妇科恶性肿瘤患者性健康研究进展[J]. 护理学报, 2025, 32(4): 28-33.
[3] 李长娥, 徐真真, 张文忠, 吴燕, 季红. 新生儿父母脐带血储存决策影响因素的定性研究[J]. 护理学报, 2025, 32(3): 74-78.
[4] 魏利, 赵兴颖, 刘佳, 何雨璇, 陈晓梅, 杨雪, 鲜继淑, 杨燕妮. 神经外科重症住院患者家庭照顾者照顾负担及影响因素分析[J]. 护理学报, 2025, 32(2): 1-6.
[5] 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12.
[6] 刘畅, 张维, 王翠雪, 岳鹏. ICU实施非限制性探视制度的影响因素研究进展[J]. 护理学报, 2025, 32(1): 34-38.
[7] 王进波, 吴姗, 黄蓉蓉, 陈代凤, 洪梅, 李审绥. 头颈癌患者自杀影响因素及干预的研究进展[J]. 护理学报, 2025, 32(1): 39-43.
[8] 刘冠琳, 宋开兰, 孟祥文, 栾奕, 李燕, 杨金红, 陈健鹏. 安宁疗护从业者死亡教育工作困难及应对策略的质性研究[J]. 护理学报, 2025, 32(1): 73-78.
[9] 陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35.
[10] 曹娟, 李方, 于跃, 戴丽, 杨丹丹, 李志华, 徐欣怡, 戴琪, 陈柯宇. 食管癌术后静脉血栓栓塞症风险预测模型的构建及验证[J]. 护理学报, 2024, 31(8): 63-68.
[11] 朱心悦, 嵇冰聪, 蓝雪芬, 季晓珍. 糖尿病患者电子健康素养研究进展[J]. 护理学报, 2024, 31(7): 36-39.
[12] 李莹, 周志欢. ICU护理缺失的研究进展[J]. 护理学报, 2024, 31(6): 43-46.
[13] 黄鑫, 余丽君, 张二明, 哈丽娜. 稳定期COPD患者的能量摄入现状及影响因素分析[J]. 护理学报, 2024, 31(5): 12-16.
[14] 方天露, 刘俐惠. 基于SWOT-CLPV 分析模型的管理策略在互联网+护理服务中的实践[J]. 护理学报, 2024, 31(4): 29-32.
[15] 张思爱, 赖翠薇, 李佳佳, 张亚军, 汪张毅, 张正涛, 法天锷. 护士专业态度的影响因素研究进展[J]. 护理学报, 2024, 31(4): 38-41.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!