| ObjectivesThrough the study of domestic and foreign literature,combined with the clinical status of midwifery in China,the author constructs a questionnaire and investigates the attitudes and preferences of midwives to "hands off/poised" method.Through the national cross-sectional study of midwives,the author understands the current tendency of midwives to "hands off/poised method in China.At the same time,it explores the influencing factors of midwives'choice and attitude to "hands off/poised"methods,and grasps the current educational ways of this technology in China,which can provide reference for the follow-up improvement of midwifery education and clinical training programs.At the same time,the study investigate the choice of terms by midwives so as to provide a basis for the construction of standardized terminology of "hands off/poised" methods in the future.Method1?Delphi method:After consulting literature,clinical observation and qualitative interviews,the questionnaire was preliminarily formulated.Ten experts conducted two rounds of expert consultation on the questionnaire of midwives,preferences and attitudes towards "hands off/poised methods and confirm the final questionnaire.2?Evaluate the reliability and validity of the questionnaire:After clinical observation and interviews,combined with literature,the questionnaire items were established,and the questionnaire was termed after expert consultation and evaluation.In November 2017,180 midwives from 10 hospitals in Zhejiang Province were pre-adjusted.The reliability and validity of the questionnaire were evaluated by Cronbanch's alpha coefficient,test-retest reliability and content validity analysis.3?Cross-sectional study:A questionnaire survey was conducted among midwives in China through respondent driven sampling method,and 5225 valid questionnaires were collected for statistical analysis.Results1?Expert consultation's results:In this study,20 questionnaires were sent out in two rounds of exper tconsultation,and 20 valid questionnaires were eollected,with a positive coeffieient of 100%.The two rounds authority coefficient of experts were 0.95,0.96.The coordination coefficient of two rounds were 0.166.0.337.2?The results of the reliability and validity of the questionnaire:The CVI of the constructed questionnaire was 0.93 after expert consultation,the coefficient of Cronbach's alpha was 0.859 and the test-retest reliability was 0.953,which showed that the reliability and validity of the questionnaire were good.3?The results of cross-sectional study:3.1 The preference of midwives for " hands off/poised methods is 55.8%in China.3.2 82.5%received theory education and 67.1%receivedSkill training.Midwives of all ages received more theoretical education than skill training,Among them,induction training and continuing education are the most common ways for "hands off/poised" methods.3.3 Univariate analysis showed that age,the highest educational background,hospital attributes,hospital grade,total time worked in delivery room,theoretical education and skill training were the influencing factors of midwives'preference for "hands off/poised" methods(P<0.05).Logistic regression analysis showed that hospital attributes,total time worked in delivery room,theoretical education and skill training were the influencing factors of midwives' preference(P<0.05).3.4 The average seore of midwives'attitudes towards,hands off/poised,in China is(3.14+0.38).The harm of perineal laceration should be informed consent of the pregnant women,the clinical judgment of midwives should give priority to the way of perineal protection during natural delivery,the current education and training of midwives should include "hands off/poiesd" methods,the highest scores were found in the three items of related courses.There were significant differences in attitude between different age,sex and total time worked in delivery room(P<0.05).3.5 The average score of standardized technology for "hands off/poised" was(3.46+0.575).42.4%of midwives chose "hands poised" as the standardized technology.Conclusions1?The reliability and validity of the questionnaire of midwives'preferences and attitudes towards "hands off/poised" are good,and it can be used for study.2?Midwives in China will give priority to"hands off/poised" methods for natural delivery.3?Hospital attributes,total time worked in the delivery room,and acceptance of theoretical education and skill training will affect midwives'choice of perineal management.4?The theoretical education and skill training of "hands off/poised" are still not universal.More people have received theoretical education than skill training.The induction training(pre-job education)is the most common way of education and training,followed by academic conferences and continuing education.5?Midwives have a positive attitude towards "hands off/poised",and there is a high demand for education,training and social promotion of this technology.There are significant differences in attitude scores among different working years,ages and gender of delivery rooms.6?Chinese midwives hope to standardize the terminology and operation of unprotected perineal delivery technology.For the choice of terminology,"moderate perineal protection" is the most favored term for midwives. |
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