Women's satisfaction with intrapartum fetal surveillance: A mixed-method study within the STan Australian randomised controlled trial (START)

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2024-09-27 DOI:10.1016/j.midw.2024.104193

Madeleine Benton , Amy Salter , Chris Wilkinson , Bronni Simpson , Deborah Turnbull

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引用次数: 0

Abstract

Background

Childbirth satisfaction can impact short and long‐term health outcomes. In an Australian-first randomised controlled trial (RCT) (ACTRN1261800006268), two techniques for intrapartum fetal surveillance were compared; ST analysis (STan) as an adjunct to cardiotocography (CTG) compared to CTG alone. The aim was to determine if CTG+STan can reduce emergency caesarean section rates whilst maintaining or improving neonatal outcomes. This study compared women's experiences of and satisfaction with the two techniques of intrapartum fetal surveillance.

Methods

N = 970 women were recruitment to the RCT between 2018 and 2021. We invited a consecutive sub-set of women (approximately the first half of the trial participants, n = 527) to complete a questionnaire at eight weeks postnatal. The analysis principle was intention to treat.

Results

Of the n = 527 invited women, n = 207 completed the questionnaire (n = 113/265, CTG+STan; n = 94/265, CTG alone). Birth satisfaction was similar in both arms. Women in the CTG+STan arm reported higher satisfaction with staff competency in monitoring and more likely to disagree that they would prefer different monitoring methods in future labours. Qualitative findings highlighted, the main perceived difference between techniques was the use of the fetal scalp electrode (FSE), always used with CTG+STan and when clinically necessary utilised with CTG. Women viewed the FSE positively, as it allowed for greater mobility.

Conclusions

CTG+STan, provides comparable outcomes in terms of satisfaction with labour experience and monitoring. Findings should inform consumer-based information on electronic fetal surveillance, addressing common misconceptions among women and care providers about the potential use of a FSE.

Trial registration

ANZCTR, ACTRN1261800006268. Registered on 19 January 2018.

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妇女对产前胎儿监护的满意度：澳大利亚 STan 随机对照试验 (START) 中的混合方法研究

背景分娩满意度会影响短期和长期的健康结果。在澳大利亚的一项首例随机对照试验（RCT）（ACTRN1261800006268）中，对两种产前胎儿监护技术进行了比较：ST分析（STan）作为心动图（CTG）的辅助手段与单独使用CTG进行比较。目的是确定 CTG+STan 能否降低紧急剖宫产率，同时维持或改善新生儿预后。本研究比较了产妇对两种产时胎儿监护技术的体验和满意度。方法在 2018 年至 2021 年期间，RCT 共招募了 970 名产妇。我们邀请连续的子集妇女（约为试验参与者的前半部分，n = 527）在产后八周完成问卷调查。结果在受邀的527名妇女中，207人完成了问卷调查（其中113/265人，CTG+STan；94/265人，仅使用CTG）。两组的分娩满意度相似。CTG+STan组的产妇对工作人员的监测能力满意度较高，而且更有可能不同意在今后的分娩中采用不同的监测方法。定性研究结果表明，两种监测技术的主要区别在于胎儿头皮电极（FSE）的使用。结论 CTG+STan 在分娩体验和监测的满意度方面具有可比性。研究结果应为基于消费者的电子胎儿监护信息提供参考，消除妇女和护理提供者对FSE潜在用途的常见误解。注册日期：2018年1月19日。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.