antenatal care

产前保健
  • 文章类型: Journal Article
    背景:患者体验是围产期护理质量的重要组成部分。高收入国家的移徙妇女经常报告比非移徙妇女更多的负面经历,但欧洲的证据参差不齐.在这项研究中,我们比较了两个移民与非移民的经历,考虑到社会经济特征。
    方法:我们调查了出生在比利时的母亲,北非,和撒哈拉以南非洲(n=877)使用移民友好型产妇护理问卷的改编版本。使用多个对应分析创建了两个患者体验评分:a)与医疗保健专业人员的信息和沟通以及对妊娠护理的总体满意度,和b)以患者为中心的方面和对分娩护理的满意度。通过描述性分析和多变量逻辑回归,我们估计了母亲特征与每个得分的关联。
    结果:总体而言,在沟通(83%)和以患者为中心的护理(86%)方面报告了积极的经验.语言能力低的北非移民有较高的负面沟通经验(尤其是理解信息的问题)(ORa:2.30,95CI1.17-4.50),无论社会经济地位如何。在有语言障碍的女性中,88%的人从未被提供过专业翻译,依靠家庭成员进行翻译。以患者为中心的护理与产妇出生地区无关,但年龄较大的母亲对其评价较低。那些在比利时居住时间较长的人,和更高的多数人语言能力。
    结论:在比利时,围产期护理经验总体上是积极的,尽管与移民的沟通并不理想。语言障碍,单身母亲,不稳定的住房增加了沟通问题。我们的发现强调了改善与移民和社会经济弱势妇女的信息交流的必要性。
    BACKGROUND: Patient experience is an important part of perinatal care quality. Migrant women in high-income countries often report more negative experiences than non-migrants, but evidence in Europe is patchy. In this study, we compared the experiences of two migrant populations with non-migrants, taking into account socioeconomic characteristics.
    METHODS: We surveyed mothers born in Belgium, North-Africa, and Sub-Saharan Africa (n = 877) using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. Two patient experience scores were created using multiple correspondence analyses: a) information and communication with healthcare professionals and overall satisfaction with pregnancy care, and b) patient-centred aspects and satisfaction with delivery care. Through descriptive analyses and multivariable logistic regressions we estimated the associations of maternal characteristics with each score.
    RESULTS: Overall, positive experiences were reported in terms of communication (83 %) and patient-centred care (86 %). North African immigrants with low language proficiency had higher odds of negative communication experience (especially problems understanding information) (ORa: 2.30, 95 %CI 1.17-4.50), regardless of socioeconomic position. Among women with language barriers, 88 % were never offered a professional interpreter, relying on family members for translation. Patient-centred care was not associated with maternal birth region but was rated more negatively by older mothers, those with longer residence in Belgium, and higher majority-language proficiency.
    CONCLUSIONS: In Belgium, perinatal care experiences were generally positive, although communication with immigrants was suboptimal. Language barriers, single motherhood, and unstable housing increased communication issues. Our findings underline the necessity to improve information-exchange with immigrants and socioeconomically vulnerable women.
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  • 文章类型: Journal Article
    背景:随着个人产前护理(I-ANC)在整个撒哈拉以南非洲地区的使用增加,关于个人护理与团体护理是否可能产生更好的结果的问题已经出现。我们实施了一项基于小组的产前护理(G-ANC)试验,以确定其对加纳孕妇的分娩准备和并发症准备(BPCR)的影响。
    方法:我们在加纳东部地区的14个医疗机构中进行了一项整群随机对照试验,比较了G-ANC与常规产前护理的差异。我们招募了怀孕前三个月的妇女,在怀孕期间参加八次两小时的互动小组会议。会议由接受过G-ANC方法培训的助产士提供便利,除了小组讨论和活动外,还进行了临床评估。在五个时间点收集数据,结果是比较基线(T0)至妊娠34周至分娩后3周(T1)的危险体征识别,BPCR的11点加法标度,以及构成量表的个别项目。
    结果:1285名参与者完成了T0和T1评估(N=668I-ANC,N=617,G-ANC)。在T1时,G-ANC参与者能够识别出比I-ANC参与者明显更多的妊娠危险体征(G-ANC与I-ANC中的1.7至2.2,p<0.0001)。G-ANC组的总体BPCR评分明显高于I-ANC组。显示最大增长的BPCR要素包括安排紧急运输(I-ANC从1.5%增加到11.5%,而G-ANC从2%增加到41%(p<0.0001)),并节省了运输费用(I-ANC组的19-32%与G-ANC组的19-73%(p<0.0001))。在I-ANC组中,确定陪同该妇女到该设施的人的比例从1%上升到3%。G-ANC组的2-20%(p<0.001)。
    结论:与常规产前护理相比,G-ANC显著增加了加纳东部农村地区妇女的BPCR。鉴于这次干预的成功,有必要在未来努力优先实施G-ANC。
    背景:ClinicalTrials.gov标识符:NCT04033003(25/07/2019)。
    协议可在以下网址获得:https://www。ncbi.nlm.nih.gov/pmc/articles/PMC9508671/。
    BACKGROUND: As utilization of individual antenatal care (I-ANC) has increased throughout sub-Saharan Africa, questions have arisen about whether individual versus group-based care might yield better outcomes. We implemented a trial of group-based antenatal care (G-ANC) to determine its impact on birth preparedness and complication readiness (BPCR) among pregnant women in Ghana.
    METHODS: We conducted a cluster randomized controlled trial comparing G-ANC to routine antenatal care in 14 health facilities in the Eastern Region of Ghana. We recruited women in their first trimester to participate in eight two-hour interactive group sessions throughout their pregnancies. Meetings were facilitated by midwives trained in G-ANC methods, and clinical assessments were conducted in addition to group discussions and activities. Data were collected at five timepoints, and results are presented comparing baseline (T0) to 34 weeks\' gestation to 3 weeks post-delivery (T1) for danger sign recognition, an 11-point additive scale of BPCR, as well as individual items comprising the scale.
    RESULTS: 1285 participants completed T0 and T1 assessments (N = 668 I-ANC, N = 617, G-ANC). At T1, G-ANC participants were able to identify significantly more pregnancy danger signs than I-ANC participants (mean increase from 1.8 to 3.4 in G-ANC vs. 1.7 to 2.2 in I-ANC, p < 0.0001). Overall BPCR scores were significantly greater in the G-ANC group than the I-ANC group. The elements of BPCR that showed the greatest increases included arranging for emergency transport (I-ANC increased from 1.5 to 11.5% vs. G-ANC increasing from 2 to 41% (p < 0.0001)) and saving money for transportation (19-32% in the I-ANC group vs. 19-73% in the G-ANC group (p < 0.0001)). Identifying someone to accompany the woman to the facility rose from 1 to 3% in the I-ANC group vs. 2-20% in the G-ANC group (p < 0.001).
    CONCLUSIONS: G-ANC significantly increased BPCR among women in rural Eastern Region of Ghana when compared to routine antenatal care. Given the success of this intervention, future efforts that prioritize the implementation of G-ANC are warranted.
    BACKGROUND: ClinicalTrials.gov Identifier: NCT04033003 (25/07/2019).
    UNASSIGNED: Protocol Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508671/ .
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  • 文章类型: Journal Article
    孕妇对Ante-NatalCare(ANC)的满意度对于提高其质量和提供标准化的医疗保健服务至关重要。然而,在埃塞俄比亚,孕妇对产前保健的满意度和相关因素的研究有限,特别是在研究领域。因此,本研究旨在评估Wogera区接受产前护理的孕妇的满意度和相关因素.
    2024年3月至4月在Wogera区进行了基于设施的横断面研究。共有458名在医疗机构参加ANC的孕妇被纳入研究。使用面试官管理的结构化问卷来获得本研究的必要信息,并使用系统随机抽样来选择研究参与者。使用多变量和二元逻辑回归分析来确定每个独立变量对结果(满意度)的影响。
    孕妇对产前保健服务的总体满意度为92.1%(95%CI:89.5,94.5%)。其中大多数(98.3%)对提供者的问候感到满意,而97.8%对服务费用感到满意,但孕妇对等待时间看卫生工作者的满意度较低,厕所的清洁,和供水。孕妇满意度与家庭主妇职业状况相关[AOR=3.05,95%CI:1.02,9.15],公务员职业状况[AOR=4.02,95%CI:1.02,15.85],年龄≥25[AOR=2.78,95%CI:1.05,1.74],关于计划生育的建议[AOR=7.29,95%CI:3.08,17.05],1次ANC访视[AOR=3.61,95%CI:1.84,8.74]和2次妊娠的调查对象孕妇[AOR=4.55,95%CI:1.88,11.03]是满意度水平的预测因素.
    孕妇对产前护理的满意度很高,受两次或两次以上怀孕等因素的影响,ANC第一次访问的时间,计划生育建议,年龄≥25岁,做家庭主妇或公务员.努力应该集中在减少等待时间上,确保干净的水源,并改善医疗机构的厕所卫生,以维持这种满意度。具体来说,设施应简化任命,维护安全的饮用水源,和升级厕所更好的舒适和卫生。
    UNASSIGNED: Pregnant women\'s satisfaction with Ante-Natal Care (ANC) is crucial for improving its quality and providing standardized healthcare services. However, studies on pregnant women\'s satisfaction with antenatal care and associated factors are limited in Ethiopia, particularly in the study area. Therefore, this study aimed to assess satisfaction and associated factors among pregnant women receiving antenatal care in Wogera district.
    UNASSIGNED: A facility-based cross-sectional study was conducted in Wogera district from March to April 2024. A total of 458 pregnant women who attended ANC at health facilities were included in the study. Interviewer -administered structured questionnaire was used to obtain the necessary information for this study and systematic random sampling was used to select the study participants. Multivariable and binary logistic regression analysis was used to identify the effect of each independent variable on the outcome (satisfaction).
    UNASSIGNED: The overall satisfaction of antenatal care services among pregnant women was 92.1% (95% CI: 89.5, 94.5%). The majority (98.3%) of them were satisfied by the provider\'s greeting and 97.8% were satisfied by the cost of service but pregnant women were less satisfied by waiting time to see the health workers, cleanness of the toilet, and water supply. Satisfaction of pregnant women was associated with housewife occupational status [AOR = 3.05, 95% CI: 1.02, 9.15], civil servants occupational status [AOR = 4.02, 95% CI: 1.02, 15.85], age ≥25 [AOR = 2.78, 95% CI: 1.05, 1.74], advice on family planning [AOR = 7.29, 95% CI: 3.08, 17.05], one ANC visit [AOR = 3.61, 95% CI: 1.84, 8.74] and the respondents pregnant women who have ≥2 pregnancy [AOR = 4.55, 95% CI: 1.88, 11.03] were the predictors of level of satisfaction.
    UNASSIGNED: Pregnant women\'s satisfaction with antenatal care was high, influenced by factors such as having two or more pregnancies, timing of the first ANC visit, family planning advice, age ≥25 years, and being a housewife or civil servant. Efforts should focus on reducing wait times, ensuring clean water access, and improving latrine hygiene at healthcare facilities to sustain this satisfaction. Specifically, facilities should streamline appointments, maintain safe drinking water sources, and upgrade toilets for better comfort and hygiene.
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  • 文章类型: Journal Article
    背景:尽管取得了进展,印度儿童营养不良的患病率仍然是全球最高的。
    目的:我们旨在评估产前期间功能整合干预包对儿童生长参数的影响。
    方法:这是一项干预后的随访研究,该研究于2018年至2019年之间在西孟加拉邦三个地区的妊娠早期妇女中进行,印度。孕妇从研究人员那里获得了一揽子增强干预措施,这些干预措施补充了根据国家方案提供给她们的干预措施,包括怀孕登记时的体重指数测量,每月体重监测,有针对性的饮食咨询,在每天的anganwadi中心访问期间,有监督的补充营养摄入和铁-叶酸补充。在2021年进行的当前随访研究中,来自同一地区的年龄匹配的孕妇在与原始研究相同的时期内怀孕,并在国家运行的计划下接受了标准护理。研究人员收集了2018-19年产前检查时记录的产妇身高和连续体重的数据,以及出生和婴儿特征。在2021年的随访期间测量了儿童的身高和体重,用于计算发育迟缓的相对风险,使用广义线性模型浪费和体重不足,了解干预在婴儿期以外的持续影响。追踪了八百九个母子二叉(406个干预;403个比较)。
    结果:干预组和对照组妇女的中位年龄分别为23岁(IQR20-25)和25岁(IQR24-27)。干预组妇女的妊娠体重增加中位数较高(9vs.8公斤,p=0.04)。干预组和对照组的低出生体重患病率分别为29.3%(119/406)和32.0%(129/403)。在12-35个月大的时候,干预组女性所生的孩子发育迟缓的风险显着降低(RR=0.65,95%CI0.44-0.94),消瘦(RR=0.57,95%CI0.33-0.97)和体重不足(RR=0.61,95%CI0.42-0.88)。
    结论:这些结果表明,功能整合和加强常规产前护理服务,包括对孕妇进行有针对性的营养咨询,可以对产后早期的儿童营养不良产生远端有益影响。
    BACKGROUND: Despite progress, the prevalence of childhood undernutrition in India remains amongst the highest globally.
    OBJECTIVE: We aimed to evaluate the impact of a functional integration interventional package during the antenatal period on childhood growth parameters.
    METHODS: This is a post-interventional follow-up study of a maternal nutrition interventional study conducted between 2018 and 2019 among women in their first trimester of pregnancy from three districts in West Bengal, India. Pregnant women received a package of augmented interventions from study staff which supplemented those provided to them under the state-run programmes, that included body-mass-index measurement at pregnancy registration, monthly weight monitoring, targeted dietary counselling, supervised supplementary nutrition intake and iron-folic acid supplementation during daily anganwadi center visits. In the current follow-up study conducted in 2021, age-matched pregnant women from the same areas who were pregnant during the same period as in the original study and had received standard-of-care under the state-run programmes were recruited into a comparison group. Study staff collected data regarding maternal height and serial weights that were recorded at antenatal visits in 2018-19, and birth and infant characteristics. Child height and weight were measured during the follow-up visit in 2021, which were used to calculate the relative risks of stunting, wasting and underweight using generalized linear models, to understand the sustained impact of the intervention beyond infancy. Eight-hundred-nine mother-child dyads (406 intervention; 403 comparison) were followed.
    RESULTS: Median age of women in the intervention and comparison group was 23 (IQR 20-25) and 25 (IQR 24-27) years respectively. Median gestational-weight-gain was higher amongst intervention group women (9 vs. 8 kg, p = 0.04). Low-birth-weight prevalence was 29.3% (119/406) and 32.0% (129/403) in the intervention and comparison group. At 12-35 months of age, children born to women in the intervention group had significantly reduced risk of stunting (RR = 0.65, 95% CI 0.44-0.94), wasting (RR = 0.57, 95% CI 0.33-0.97) and underweight (RR = 0.61, 95% CI 0.42-0.88).
    CONCLUSIONS: These results indicate that functional integration and strengthening of routine antenatal care services including targeted nutritional counselling to expectant mothers can have distal beneficial effects on childhood undernutrition beyond the immediate post-natal period.
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  • 文章类型: Journal Article
    本研究使用2017年孟加拉国卫生设施调查(BHFS)的数据,调查了孟加拉国优质产前护理(ANC)服务的患病率和准备情况的决定因素。我们使用多项逻辑回归评估了所选因素与准备指数之间的关联。我们发现ANC服务的可用性和质量存在显著差距,只有4.26%的卫生设施提供优质的ANC服务,与城市设施相比,农村设施显示出较低的准备状态(RRR:0.13;95%CI:0.06-0.31;p<0.001)。与公立医院或诊所相比,社区诊所和私立医院中或高准备的可能性较低。拥有专门护理的医疗机构更有可能证明愿意提供高质量的ANC服务。政策建议包括增加医疗保健资金,执行ANC指南,加强对卫生设施的监测和评估,提高了社区意识。这些措施应该改善ANC,整体健康结果,和公共卫生政策。
    This study investigates the prevalence and determinants of readiness for quality antenatal care (ANC) services in Bangladesh using data from the 2017 Bangladesh Health Facility Survey (BHFS). We assessed the association between selected factors and the readiness index using multinomial logistic regression. We identified a significant gap in the availability and quality of ANC services, only 4.26% of health facilities provide quality ANC services, with rural facilities showing lower readiness compared to urban facilities (RRR:0.13; 95% CI: 0.06-0.31; p < 0.001). Community clinics and private hospitals have a lower likelihood of medium or high readiness compared to public hospitals or clinics. Health facilities with specialized care are more likely to demonstrate readiness for quality ANC services. Policy recommendations include increased healthcare funding, implementation of ANC guidelines, strengthened monitoring and evaluation of health facilities, and heightened community awareness. These measures should improve ANC, overall health outcomes, and public health policies.
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  • 文章类型: Journal Article
    背景:通过解决身体和心理社会需求,团体护理(GC)改善健康相关行为,同行支持,父母与提供者的互动,并可能改善分娩结局。因此,鼓励全球实施GC。实施之前的上下文分析对于阐明哪些因素可能支持或阻碍实施至关重要。
    方法:比较了在荷兰和苏里南进行的上下文分析,以确定与医疗保健专业人员(HCP)认为的GC可实施性相关的因素。对荷兰和苏里南医疗保健专业人员进行了32次半结构化访谈。使用框架方法对录音进行逐字转录和编码。实施研究综合框架指导了面试指南和编码树的开发。
    结果:外部环境:两国对资金的担忧浮出水面。由于医疗保险覆盖面有限,额外费用将限制苏里南的可访问性。在荷兰,助产士担心由于支持一对一护理的报销政策而导致收入下降。内部设置:一个荷兰人和三个苏里南人设施中没有适当的GC空间。在荷兰,关于GC实施的角色划分比苏里南更明确。
    方法:来自两国的HCP期望增加社会支持,妇女的健康知识,和护理的连续性(R)。个人/创新交付者:自我效能感和动机是两国实施GC的相互交织的决定因素。个人/创新接受者:竞争需求可能会降低两国对GC的接受度。虽然荷兰的HCP优先考虑与母亲进行公开对话,苏里南人方案小组鼓励加入合作伙伴。
    方法:提出了提高GC意识的活动。语言障碍是荷兰人关注的问题,但苏里南人不关注。
    结论:虽然两国在外部环境中发现了最显著的差异,它们滴流并影响上下文的所有层次。最终,在稍后的阶段,过程评估将显示我们在实施之前确定的那些外部设置障碍是否实际上阻碍了GC的实施。医疗保健系统的变化将确保两国的持续实施,而这一结论将成为一个更一般的讨论:当上下文分析揭示了无法用可用的时间和资源来解决的障碍时,如何进行。
    BACKGROUND: By addressing physical and psychosocial needs, group care (GC) improves health-related behaviours, peer support, parent-provider interactions and may improve birth outcomes. Hence, global implementation of GC is encouraged. Context analyses prior to implementation are vital to elucidate which local factors may support or hinder implementation.
    METHODS: Contextual analyses conducted in the Netherlands and Suriname were compared to identify the factors relevant to the implementability of GC as perceived by healthcare professionals (HCPs). 32 semi-structured interviews were conducted with Dutch and Surinamese healthcare professionals. Audio recordings were transcribed verbatim and coded using the Framework approach. The Consolidated Framework for Implementation Research guided the development of the interview guide and of the coding tree.
    RESULTS: Outer setting: Concerns regarding funding surfaced in both countries. Due to limited health insurance coverage, additional fees would limit accessibility in Suriname. In the Netherlands, midwives dreaded lower revenue due to reimbursement policies that favour one-on-one care. Inner setting: Appropriate space for GC was absent in one Dutch and three Surinamese facilities. Role division regarding GC implementation was clearer in the Netherlands than in Suriname.
    METHODS: HCPs from both countries expected increased social support, health knowledge among women, and continuity of care(r). Individuals/innovation deliverers: Self-efficacy and motivation emerged as intertwined determinants to GC implementation in both countries. Individuals/innovation recipients: Competing demands can potentially lower acceptability of GC in both countries. While Dutch HCPs prioritised an open dialogue with mothers, Surinamese HCPs encouraged the inclusion of partners.
    METHODS: Campaigns to raise awareness of GC were proposed. Language barriers were a concern for Dutch but not for Surinamese HCPs.
    CONCLUSIONS: While the most striking differences between both countries were found in the outer setting, they trickle down and affect all layers of context. Ultimately, at a later stage, the process evaluation will show if those outer setting barriers we identified prior to implementation actually hindered GC implementation. Changes to the health care systems would ensure sustained implementation in both countries, and this conclusion feeds into a more general discussion: how to proceed when contextual analyses reveal barriers that cannot be addressed with the time and resources available.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:怀孕期间的亲密伴侣暴力(IPV)是与不良母婴健康结局相关的重大公共卫生问题,包括抑郁症的风险增加。这项研究旨在评估基于数字授权的干预措施在减少IPV暴露孕妇抑郁症状方面的有效性。
    方法:这项干预研究是在丹麦和西班牙进行的一项队列研究中进行的。使用滥用评估屏幕(AAS)和妇女滥用筛查工具(WAST)对参加产前护理的孕妇进行IPV数字筛查。为那些筛查阳性的人提供了数字干预,包括与训练有素的IPV顾问进行3-6次视频咨询,并访问安全计划应用程序。使用混合模型回归评估从基线到随访的抑郁评分变化。
    结果:从2021年2月至2022年10月,1,545名孕妇(9.6%)在我们的人群中IPV筛查呈阳性(丹麦为8.5%,西班牙为17.0%),其中485(31.4%)符合干预标准。在那些符合条件的人中,104人(21.4%)接受了干预,55人完成(13.1%)。干预后,发现爱丁堡产后抑郁量表(EPDS)显着降低,平均差为-3.9(95%CI:-5.3;-2.4),与干预前的平均评分11.3相比。将社会人口统计学变量的分析分层并没有改变总体结果,表明EPDS评分降低,与环境或社会人口统计学因素无关。值得注意的是,该干预措施对最初EPDS评分高于抑郁截止值的女性最有效.
    结论:研究结果表明,短暂的数字干预与暴露于IPV的孕妇抑郁症状的减轻有关,特别是那些抑郁得分高的人。这突出了数字干预在提供咨询方面的潜力,并显示了由助产士和心理学家在不同环境中管理的有效性。然而,对照组的缺席强调了在解释结果时需要谨慎.
    OBJECTIVE: Intimate Partner Violence (IPV) during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women.
    METHODS: This intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the Abuse Assessment Screen (AAS) and the Women\'s Abuse Screening Tool (WAST). Those screening positive were offered a digital intervention comprising 3-6 video consultations with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression.
    RESULTS: From February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) was found, with a mean difference of -3.9 (95 % CI: -5.3; -2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off.
    CONCLUSIONS: The findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.
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  • 文章类型: Journal Article
    怀孕和分娩期间以及分娩后的医疗保健对于母亲和新生儿的生存和福祉都很重要。由于各种原因,尼泊尔的孕产妇保健面临挑战。然而,向母亲提供有关孕产妇保健的适当知识,并促进对此的积极态度,可以对孕产妇和儿童的健康结果产生重大影响。这项研究的目的是评估知识,伊拉姆母亲对孕产妇保健的态度和做法。
    对过去5年内在伊拉姆市分娩的197名母亲进行了横断面研究。该研究使用半结构化问卷进行面对面访谈来收集数据。使用描述性和推断性统计来分析数据。
    参与者总数为197。结果显示,大多数(48.22%)属于22-29岁的年龄组,参与者的平均年龄为30.2±5.37,大多数是家庭制造商(44.7%),平均结婚年龄为21.39±3.99岁,首次怀孕的平均年龄为23.9±4.33岁,与最后一个孩子的平均出生间隔为70±41.28个月.总的来说,我们发现了这些知识,对产前保健(ANC)的态度和做法为72%,83%和69%,分别。同样,知识,对产后护理(PNC)的态度和做法为39%,91%,43%,分别。
    母亲对ANC的了解令人满意,但对PNC的了解不足。大多数人对这两种做法都持积极态度。然而,尽管有足够的知识和态度,但与ANC和PNC相关的实际实践较差。
    UNASSIGNED: Healthcare during pregnancy and childbirth and after delivery is important for the survival and well-being of both the mother and the neonate. Maternal healthcare in Nepal faces challenges due to various causes. However, providing proper knowledge on maternal healthcare to mothers and promoting a positive attitude towards it can have a significant impact on maternal and child health outcomes. The objective of this study was to assess knowledge, attitude and practice towards maternal healthcare among mothers in Illam.
    UNASSIGNED: A cross-sectional study was conducted among 197 mothers in Illam municipality who gave birth within the last 5 years. The study used face-to-face interviews with a semi-structured questionnaire to collect data. Descriptive as well as inferential statistics were used to analyze the data.
    UNASSIGNED: The total number of participants was 197. The results showed majority (48.22%) belonged to the age group of 22-29 years and the mean age of the participants was 30.2± 5.37, majority were home-makers (44.7%), mean age at marriage was 21.39±3.99 years, mean age at first pregnancy was 23.9±4.33years and mean birth spacing from last child was 70±41.28 months. Overall, we found that knowledge, attitude and practice regarding antenatal care (ANC) were 72%, 83% and 69%, respectively. Similarly, knowledge, attitude and practice regarding post-natal care (PNC) were 39%, 91%, and 43%, respectively.
    UNASSIGNED: Mothers showed satisfactory knowledge on ANC but inadequate knowledge on PNC. Most had a positive attitude towards both practices. However, actual practices related to ANC and PNC were poor despite adequate knowledge and attitude.
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  • 文章类型: Journal Article
    背景:工业4.0(I4.0)技术通过优化流程,改善了医疗保健设施的运营,导致有效的系统和工具,以协助卫生保健人员和患者。
    目的:本研究调查了I4.0技术在孕产妇保健中的当前实施和影响,明确专注于转变护理流程,治疗方法,和自动怀孕监测。此外,它进行专题景观制图,提供了这个新兴领域的细微差别的理解。在这个分析的基础上,提出了未来的研究议程,强调未来调查的关键领域。
    方法:对从Scopus数据库检索的出版物进行了文献计量分析,以研究从1985年到2022年对孕产妇保健中的I4.0技术的研究如何发展。使用搜索策略使用摘要和全文阅读来筛选符合条件的出版物。最有生产力和影响力的期刊;作者,机构\',和国家/地区对孕产妇保健的影响;使用BibliometrixR软件包(RCoreTeam)计算了当前趋势和主题演变。
    结果:使用搜索字符串共检索到1003篇英文独特论文,在实施纳入和排除标准后,保留了136篇论文,从1985年到2022年的37年。出版物的年增长率为9.53%,88.9%(n=121)的出版物在2016-2022年观察到。在主题分析中,确定了4个簇-人工神经网络,数据挖掘,机器学习,和物联网。人工智能,深度学习,风险预测,数字健康,远程医疗,可穿戴设备,移动医疗,云计算仍然是2016-2022年的主要研究主题。
    结论:本文献计量分析回顾了孕产妇保健中I4.0技术的发展和结构的最新状况,以及它们如何用于优化操作过程。具有4个绩效因素的概念框架-风险预测,医院护理,健康档案管理,和自我保健-建议改进过程。还提出了治理研究议程,收养,基础设施,隐私,和安全。
    BACKGROUND: Industry 4.0 (I4.0) technologies have improved operations in health care facilities by optimizing processes, leading to efficient systems and tools to assist health care personnel and patients.
    OBJECTIVE: This study investigates the current implementation and impact of I4.0 technologies within maternal health care, explicitly focusing on transforming care processes, treatment methods, and automated pregnancy monitoring. Additionally, it conducts a thematic landscape mapping, offering a nuanced understanding of this emerging field. Building on this analysis, a future research agenda is proposed, highlighting critical areas for future investigations.
    METHODS: A bibliometric analysis of publications retrieved from the Scopus database was conducted to examine how the research into I4.0 technologies in maternal health care evolved from 1985 to 2022. A search strategy was used to screen the eligible publications using the abstract and full-text reading. The most productive and influential journals; authors\', institutions\', and countries\' influence on maternal health care; and current trends and thematic evolution were computed using the Bibliometrix R package (R Core Team).
    RESULTS: A total of 1003 unique papers in English were retrieved using the search string, and 136 papers were retained after the inclusion and exclusion criteria were implemented, covering 37 years from 1985 to 2022. The annual growth rate of publications was 9.53%, with 88.9% (n=121) of the publications observed in 2016-2022. In the thematic analysis, 4 clusters were identified-artificial neural networks, data mining, machine learning, and the Internet of Things. Artificial intelligence, deep learning, risk prediction, digital health, telemedicine, wearable devices, mobile health care, and cloud computing remained the dominant research themes in 2016-2022.
    CONCLUSIONS: This bibliometric analysis reviews the state of the art in the evolution and structure of I4.0 technologies in maternal health care and how they may be used to optimize the operational processes. A conceptual framework with 4 performance factors-risk prediction, hospital care, health record management, and self-care-is suggested for process improvement. a research agenda is also proposed for governance, adoption, infrastructure, privacy, and security.
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