探索在产前护理中实施教育片以降低妊娠期巨细胞病毒感染风险:定性研究。

IF 2.8 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Tushna Vandrevala, Amy Montague, Richard Boulton, Kirstie Coxon, Christine E Jones
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引用次数: 0

摘要

背景:先天性巨细胞病毒(CMV)感染是导致儿童感音神经性听力损失和神经残疾的主要原因。在没有获得许可的疫苗的情况下,采取以卫生为基础的措施可以降低孕妇感染 CMV 的风险,但这些措施并不是英国国民健康服务(NHS)产前保健的常规内容:方法:在规范化过程理论(NPT)的支持下,我们开展了一项探索性定性研究,调查如何在现实世界的常规产前护理环境中最好地实施、维持和加强由 CMV 短片组成的教育干预措施。我们对参与者进行了视频、半结构式访谈,这些参与者是通过有目的性的抽样调查招募的,包括来自三家英国国家医疗服务系统医院提供产前护理的助产士(n = 15),以及来自英国提供产前教育或健康信息的专业学院、组织或慈善机构的参与者(n = 15):助产士不愿意将 CMV 纳入孕早期关于降低其他感染风险的讨论中,原因是缺乏时间、知识以及产前教育中缺乏与 CMV 相关的指导或政策。然而,所有利益相关者都认为教育干预是鼓励对话和增强妇女管理风险能力的有用工具,可以克服一些已发现的障碍。讨论还发现了一些宏观层面的挑战,如筛查政策和缺乏使传播合法化的官方指南:讨论:在英国,要成功实施 CMV 教育并将其作为 NHS 常规护理的一部分,就必须提高助产士对 CMV 的认识和了解。NPT显示,服务成员之间的 "一致性 "和 "认知参与 "对于将CMV教育纳入常规实践至关重要。需要 "集体行动 "和 "反思性监测 "来维持服务变革。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the implementation of an educational film within antenatal care to reduce the risk of cytomegalovirus infection in pregnancy: A qualitative study.

Background: Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neuro-disability in childhood. In the absence of a licensed vaccine, adoption of hygiene-based measures may reduce the risk of CMV infection in pregnancy, however these measures are not routinely discussed with pregnant women as part of National Health Service (NHS) antenatal care in the United Kingdom (UK).

Methods: An exploratory qualitative study was conducted, underpinned by Normalization Process Theory (NPT), to investigate how an educational intervention comprising of a short film about CMV may best be implemented, sustained, and enhanced in real-world routine antenatal care settings. Video, semi-structured interviews were conducted with participants who were recruited using a purposive sample that comprised of midwives providing antenatal care from three NHS hospitals (n = 15) and participants from professional colleges and from organisations or charities providing, or with an interest in, antenatal education or health information in the UK (n = 15).

Findings: Midwives were reluctant to include CMV as part of early pregnancy discussions about reducing the risk of other infections due to lack of time, knowledge and absence of guidance or policies relating to CMV in antenatal education. However, the educational intervention was perceived to be a useful tool to encourage conversations and empower women to manage risk by all stakeholders, which would overcome some identified barriers. Macro-level challenges such as screening policies and lack of official guidelines to legitimise dissemination were identified.

Discussion: Successful implementation of education about CMV as part of routine NHS care in the UK will require an increase in awareness and knowledge about CMV amongst midwives. NPT revealed that 'coherence' and 'cognitive participation' between service members are vital to imbed CMV education in routine practice. 'Collective action' and 'reflexive monitoring' is required to sustain service changes.

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来源期刊
BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-
CiteScore
4.90
自引率
6.50%
发文量
845
审稿时长
3-8 weeks
期刊介绍: BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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