Midwives’ competence in interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng: An explanatory sequential mixed-methods study

Q2 Nursing

International Journal of Africa Nursing Sciences Pub Date : 2025-01-01 DOI:10.1016/j.ijans.2025.100825

Sanele Lukhele , Fhumulani Mavis Mulaudzi , Rodwell Gundo

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Abstract

Background

Cardiotocograph (CTG) tracing is a routine intrapartum care procedure for women who have been diagnosed with high-risk pregnancy. The aim of the CTG is to identify fetuses that are at risk in order to expedite delivery.

Purpose

To asssess midwives’ competence in the interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng.

Methods

An explanatory sequential mixed-methods approach was used. During phase one, 122 midwives in Johannesburg and Tshwane District filled in self-administered questionnaires, and during phase two, 30 midwives took part in semi-structured qualitative interviews. The data from both phases was analyzed separately and then integrated using the Pillar Integration Process.

Results

The Pillar Integration Process led to the identification of six pillars: 1) substandard CTG interpretation training leads to a lack of understanding of key concepts; 2) absence of norms and standards pertaining to CTG interpretation training; 3) Essential Steps in Managing Obstetric Emergencies (ESMOE) training does not result in improved CTG interpretation scores; 4) lack of standardization of CTG interpretation guidelines causes confusion among interpreters; 5) level of knowledge of foundational concepts of CTG interpretation affects clinical judgment; and 6) CTG interpretation skill is a combination of understanding of CTG characteristics, fetal heart rate pattern, fetal physiology and clinical context.

Conclusion

The results highlighted a knowledge deficit in CTG interpretation and shortfalls in the current CTG training programs. This can be remediated by the development of a CTG training program which is benchmarked with existing programs which have demonstrated good knowledge scores of participants over a long period.

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助产士对豪登省公立医院产时心照术的解释能力：一项解释性顺序混合方法研究

背景心动图（CTG）追踪是诊断为高危妊娠妇女的常规产时护理程序。CTG的目的是识别有风险的胎儿，以便加快分娩。目的评价豪登省公立医院助产士对产时心电图的解释能力。方法采用解释序列混合方法。在第一阶段，约翰内斯堡和茨瓦内区的122名助产士填写了自我管理的问卷，在第二阶段，30名助产士参加了半结构化的定性访谈。两个阶段的数据分别进行分析，然后使用支柱集成过程进行集成。结果支柱整合过程确定了六个支柱：1)CTG口译培训不合格导致对关键概念的理解不足；2)缺乏CTG口译培训的规范和标准；3)产科急诊管理基本步骤（ESMOE）培训没有提高CTG口译分数；4) CTG口译指南缺乏标准化，译员之间存在混淆；5) CTG解读基本概念的知识水平影响临床判断；6) CTG解读技能是对CTG特征、胎儿心率模式、胎儿生理和临床情况的综合理解。结论本研究结果突出了CTG口译的知识缺陷和当前CTG培训计划的不足。这可以通过开发CTG培训计划来弥补，该计划以现有计划为基准，这些计划在很长一段时间内证明了参与者的良好知识分数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Africa Nursing Sciences Nursing-Nursing (all)

CiteScore

2.40

自引率

0.00%

发文量

114

审稿时长

21 weeks

期刊介绍： International Journal of Africa Nursing Sciences (IJANS) is an international scientific journal published by Elsevier. The broad-based journal was founded on two key tenets, i.e. to publish the most exciting research with respect to the subjects of Nursing and Midwifery in Africa, and secondly, to advance the international understanding and development of nursing and midwifery in Africa, both as a profession and as an academic discipline. The fully refereed journal provides a forum for all aspects of nursing and midwifery sciences, especially new trends and advances. The journal call for original research papers, systematic and scholarly review articles, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing as related to nursing and midwifery in Africa, technical reports, and short communications, and which will meet the journal''s high academic and ethical standards. Manuscripts of nursing practice, education, management, and research are encouraged. The journal values critical scholarly debate on issues that have strategic significance for educators, practitioners, leaders and policy-makers of nursing and midwifery in Africa. The journal publishes the highest quality scholarly contributions reflecting the diversity of nursing, and is also inviting international scholars who are engaged with nursing and midwifery in Africa to contribute to the journal. We will only publish work that demonstrates the use of rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of nursing and midwifery as it relates to the Africa context.