PDF(Pubmed)
Abstract：
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).
RESULTS: 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.
CONCLUSIONS: 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.
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).
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：先天性巨细胞病毒（CMV）感染是儿童期感音神经性听力损失和神经残疾的主要原因。在没有许可疫苗的情况下，采取以卫生为基础的措施可以降低怀孕期间CMV感染的风险，然而,在英国(UK),作为国家卫生服务(NHS)产前护理的一部分,这些措施并未与孕妇进行常规讨论.
方法：进行了探索性定性研究，以归一化过程理论(NPT)为基础，为了研究如何最好地实施由一部关于CMV的短片组成的教育干预，持续,并在现实世界的常规产前护理环境中得到加强。视频,半结构化访谈是使用目的样本招募的参与者进行的，该样本包括来自三家NHS医院（n=15）的助产士提供产前护理，以及来自专业学院和组织或慈善机构的参与者，或者有兴趣，英国的产前教育或健康信息(n=15)。
结果：助产士不愿意将CMV作为早期妊娠讨论的一部分，以减少由于时间不足而导致的其他感染的风险。在产前教育中缺乏与CMV有关的指导或政策。然而,教育干预被认为是一个有用的工具，鼓励对话，并赋予妇女权力，以管理所有利益相关者的风险，这将克服一些确定的障碍。确定了宏观层面的挑战，例如筛选政策和缺乏使传播合法化的官方准则。
结论：在英国，成功实施CMV教育作为常规NHS护理的一部分，将需要提高助产士对CMV的认识和知识。NPT表明，服务成员之间的“连贯性”和“认知参与”对于在日常实践中嵌入CMV教育至关重要。需要“集体行动”和“反身监视”来维持服务更改。
方法：进行了探索性定性研究，以归一化过程理论(NPT)为基础，为了研究如何最好地实施由一部关于CMV的短片组成的教育干预，持续,并在现实世界的常规产前护理环境中得到加强。视频,半结构化访谈是使用目的样本招募的参与者进行的，该样本包括来自三家NHS医院（n=15）的助产士提供产前护理，以及来自专业学院和组织或慈善机构的参与者，或者有兴趣，英国的产前教育或健康信息(n=15)。
结果：助产士不愿意将CMV作为早期妊娠讨论的一部分，以减少由于时间不足而导致的其他感染的风险。在产前教育中缺乏与CMV有关的指导或政策。然而,教育干预被认为是一个有用的工具，鼓励对话，并赋予妇女权力，以管理所有利益相关者的风险，这将克服一些确定的障碍。确定了宏观层面的挑战，例如筛选政策和缺乏使传播合法化的官方准则。
结论：在英国，成功实施CMV教育作为常规NHS护理的一部分，将需要提高助产士对CMV的认识和知识。NPT表明，服务成员之间的“连贯性”和“认知参与”对于在日常实践中嵌入CMV教育至关重要。需要“集体行动”和“反身监视”来维持服务更改。
