Objective:To explore the breastfeeding guidance experience of international board certified lactation consultants (IBCLC) in China, so as to provide reference for promoting breastfeeding guidance in China.Methods:This study adopted a descriptive phenomenological approach. From October 2021 to June 2022, purposive sampling was used to select 15 IBCLC from 8 provinces and cities who provided breastfeeding support. The semi-structured in-depth interview was used for data collection, and the Giorgi method was used to analyze the data and extract themes.Results:A total of 4 themes were extracted, namely, a sense of need, a sense of meaning and value, a sense of resistance at work and a sense of expectation for the future.Conclusions:The needs of the public and the improvement of IBCLC guidance capabilities are the foundation for providing breastfeeding guidance. The realization of self-worth and the attention and support of family, society, and hospital managers are conducive to the development of breastfeeding guidance.

围绕不同移动健康干预方式在改善宫颈癌筛查依从性、提高筛查率中的具体应用,以及实行移动健康干预措施的思考与展望等方面进行综述,旨在为移动健康干预方式用于提高宫颈癌筛查率提供借鉴.

Objective:To understand the current situation of scientific research ability and training needs of community nurses in China.Methods:The convenient sampling method was used to select 3 633 community nurses from 16 provinces/autonomous regions/municipalities from June to August 2021 to investigate. The contents of the questionnaire included general information, Self-Assessment Scale of Scientific Research Ability for Nursing Staff, scientific research attitude and training needs. A total of 3 633 questionnaires were recovered, of which 3 561 were valid, with an effective recovery rate of 98.0%. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of the total score of self-assessment of scientific research ability of community nurses.Results:The total score of scientific research ability of 3 561 community nurses was 39.00 (28.00, 60.00) . The results of multiple linear regression analysis showed that nursing working years, highest education, received research courses/training, working experience in academic organizations/academic journals, participating in academic conferences or above the municipal level in the past 5 years and having plans to improve academic qualifications in the next 5 years were the influencing factors of scientific research ability of community nurses ( P<0.05) , jointly explained 15.4% of the total variance (adjusted R2=0.154, P<0.001) . Community nurses had training needs in data collection and organization, scientific research design, literature retrieval, scientific research topic selection, data statistical analysis and statistical software operation and submission skills. Conclusions:Subjective self-assessment scientific research ability and objective scientific research output of community nurses need to be improved and key scientific research talents need to be cultivated.

Objective:To investigate the status quo of postnatalcare in the community in Beijing.Methods:A qualitative study on the status quo of postnatal care was conducted using semi-structured interview between June and September 2019. Eighteen health workers who undertook postnatal care in the community for more than 3 years from 16 municipal districts in Beijing were chosen as interviewees. The content analysis method was used to analyze the interview data.Results:A total 178 868 words from 18 interviewees were transcribed. Four themes were extracted including: ①Lack of resources and information, and difficulties in implementation; ②Poor allocation of human resources, and lower personnel treatment; ③Inadequate depth and poor quality of services; ④Insufficient social attention, and interference from commercial institutions.Conclusion:For the existing problems in the postnatal care in the community, it is recommended to increase the financial investment and human resource allocation to improve the postnatal visits, as well as to strengthen the supervision of commercial puerperal health management agencies.

目的 深入探讨初产妇产后与家人共同养育婴幼儿的母乳喂养体验.方法 采用描述性现象学方法,于2019年12月至2020年4月,以目的抽样法选取北京丰台区妇幼保健院的23例产妇作为访谈对象,应用Colaizzi七步分析法进行资料分析.结果 经过提炼分析,归纳为两个主题:主题一:促进成功母乳喂养的因素,具体包括①共同的母乳喂养目标;②合理分工,团结协作;③各种形式的母乳喂养支持;④良好的沟通交流;主题二:对共同养育母乳喂养的期望,具体包括①更多的情感支持;②配偶更积极主动的参与;③祖辈更合理的参与.结论 共同养育理论对改善初产妇的母乳喂养体验有一定的指导意义,护理人员应引导家庭给予产妇更多的支持,如信息支持、情感支持等,必要时可开展共同养育的家庭干预项目,帮助家庭成员共同适应这一阶段,以充分发挥家庭的作用.

Objective:To explore the effect of breastfeeding intervention scheme based on co-parenting theory on the breastfeeding of primiparas.Methods:The convenient sampling method was adopted to select 67 primiparal and their 67 spouses who underwent prenatal check-ups in the Obstetrics Clinic of Fengtai Maternal & Child Health Hospital in 2019 as the research objects. The 35 primiparas and their 35 spouses whose expected delivery date was from October to November 2019 were set as the control group and 32 primiparas and their 32 spouses whose expected delivery date was from December 2019 to January 2020 were set as the experimental group. The control group was given breastfeeding knowledge education and answers to questions through WeChat groups, while the experimental group received breastfeeding nursing intervention based on co-parenting theory on the basis of the control group. The rate of exclusive breastfeeding, the simplified Chinese version of Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) score, the Brief Coparenting Relationship Scale (Brief CRS) score of primiparas, and the Chinese version of Iowa Infant Feeding Attitude Scale (IIFAS) score of the spouses of primiparas at 6 weeks postpartum were compared between the two groups.Results:The rate of exclusive breastfeeding in the experimental group at 6 weeks postpartum was 87.5% (28/32) , which was higher than 77.1% (27/35) in the control group, but the difference was not statistically significant (χ 2=0.432, P>0.05) . In the experimental group, the score of inner activity dimension of the simplified Chinese version of BSES-SF was (20.78±5.05) , the total score of the Brief CRS was (71.84±8.60) and the total score of the Chinese version of IIFAS among spouses of primiparas was (63.38±7.25) , which were higher than (16.94±4.78) , (67.00±10.94) , (59.89±5.92) of the control group, and the differences were statistically significant ( t=3.196, 2.002, 2.166; P<0.05) . Conclusions:The breastfeeding intervention scheme based on co-parenting theory can improve the attitude of spouses of primiparas to infant feeding and co-parenting perception of primiparas, and the effect of the intervention on improving the rate of exclusive breastfeeding and self-efficacy of breastfeeding needs to be further verified.

社会支持对于孕产妇母乳喂养的重要性已受到研究者的广泛关注和认同.社会支持有利于增加母亲母乳喂养的启动和持续时间,从而提高母乳喂养率.但由于多方面原因,社会支持的作用未得到充分发挥.本文综述了国内外关于社会支持在促进孕产妇母乳喂养中的作用、存在的问题及干预策略,为今后更好地开展母乳喂养健康教育工作和促进母乳喂养的干预研究提供参考.

Objective:To explore the feasibility and teaching effect of the "Mini-online Internship" of gynecology and obstetrics nursing jointly developed by colleges and universities, and provide a reference for the development of online practical teaching.Methods:The convenient sampling method was used to select class 1 and 2 nursing undergraduates in Grade 2018 of the School of Nursing of Peking Union Medical College as the research object. The "Mini-online Internship" of gynecology and obstetrics nursing was carried out for 1 week in June 2020. After the class was over, the self-designed "Mini-online Internship" Teaching Effect Questionnaire was used to conduct a survey. A total of 143 questionnaires were distributed and 137 valid questionnaires were returned with an effective response rate of 95.80%.Results:The overall evaluation of 135 students with the "Mini-online Internship" was satisfied, goal accomplished and helpful, and the overall evaluation of 137 students with school teachers and clinical teaching teachers was satisfied, goal accomplished and helpful. The ranking of students' satisfaction with the arrangement of learning content from high to low was: online operation video introduction, online operation live broadcast, online ward environment introduction, online EXCEL questioning, and the teacher focused on answering questions, online PPT lectures, online medical record discussion, offline data distribution and self-study before class, online group case report, as well as online group inquiring.Conclusions:Colleges and universities cooperate and complete the "Mini-online Internship" teaching work of obstetrics and gynecology nursing for nursing undergraduates. Students are satisfied with the "Mini-online Internship" and teaching goals are completed.

本文主要介绍2018年世界卫生组织(WHO)发布的首部母乳喂养咨询指南,该指南是在系列WHO支持母乳喂养的政策以及文件的基础上发表的,共给出6个推荐意见.本文主要对这6个推荐意见进行解读,并结合我国在母乳喂养咨询方面的现状以及探索给予建议,以期为促进我国母乳喂养咨询的政策改革以及实施提供参考.

目的 了解目前女大学生对生殖器官炎症保健知识的了解程度,对疾病的态度与应对行为.方法 对332名在校女大学生进行问卷调查.结果 332人中与异性有性行为者占12.0％,有明确生殖器官炎症诊断的人占7.8％,认为自己可能患生殖器官炎症的占13.2％.结论 女大学生缺乏生殖器官相关的保健知识.学校应该向同学们提供系统、全面的生殖健康教育.

目的 调查产妇产褥期健康管理(puerperal health management,PHM)期望与感知现状并进行分析,为优化PHM服务提供参考.方法 2019年4月-6月,采用自行编制的"PHM期望与感知现状调查问卷"对北京市某医院产科门诊产后复查的产妇进行调查.该调查问卷包括产妇身心恢复、婴儿照顾、社会支持及产妇期待的健康管理方式4个维度,共21个条目;量表的Cronbach's α系数为0.937,KMO值为0.730,共提取6个公因子,累计解释76.9％的变异.结果 共调查699名产褥期产妇,19项PHM服务中,除妊娠期糖尿病产妇的血糖、妊娠期高血压产妇的血压监测指导及糖尿病、乙肝等产妇的母乳喂养指导2项外,其余各项服务的产妇期望与感知现状间均有差异(P＜0.001).婴儿常见疾病预防、观察与护理知识,婴儿抚触指导,母乳喂养指导,产后体重管理,日常婴儿养育技能评估与指导,产后用药指导6项PHM服务的产妇期望与感知现状差距较大.结论 产妇PHM期望与感知现状间存在差距,建议相关部门加大对PHM服务的经费投入,强化质量监管,社区医护人员也应不断提升自身业务能力,以满足产妇不断提高的需求.

死产的发生不仅会给孕产妇及其家庭带来巨大的心理负担和伤害,同时也给社会带来较大的经济负担,然而死产却较少受到国家以及公众的关注,照护支持方式的效果也存在差异.本文将对经历死产的女性的心理问题及其照护支持的研究进行综述,旨在为改进照护方式,提高死产女性的心理健康提供依据和参考.

该文回顾了国内外医学院校现有的护理本科生母乳喂养课程和相关高校对本科生的母乳喂养教学探索的研究,对其中的教学内容、教学方法、教学评价进行了总结,以期对我国护理本科生母乳喂养教学改革提供借鉴.

目的 分析北京市孕妇孕期保健服务利用情况及孕妇孕期产前检查次数的影响因素,为提高孕期保健服务利用水平和孕期保健的公平性提供参考.方法 以2012年12月至2018年8月期间在北京市高碑店社区卫生服务中心登记围产保健信息的孕产妇作为研究对象,了解孕妇孕期保健服务利用情况并分析产前检查次数的影响因素.结果 共纳入孕妇6201例,平均年龄(29.92±4.15)岁.纳入对象中,孕13周前建立《北京市母子健康档案》(建册)者4462例(71.96％);孕13周前进行初次产检者6117例(98.65％);平均产检次数(9.79±2.10)次,其中产检次数为5次及以上的孕妇6003例(96.81％).多因素逐步线性回归分析结果显示,妊娠时间(双独二孩期间:t=2.011;单独二孩期间:t=8.213)、民族(t=-2.358)、户籍地(外嫁京:t=2.484;本市户籍:t=2.749)、孕次(t=-2.057)、高危妊娠(t=-4.563)、初次产检孕周(t=-8.383)及建册孕周(t=-5.744)均是孕妇产检次数的影响因素(均P<0.05).结论 北京市孕妇建立《北京市母子健康档案》、初次产检等孕期保健利用情况较好.但不同特征的妇女产检次数存在差异,"全面二孩政策"开放后孕妇平均产检次数减少,双外市户籍孕妇及初次产检和建立《北京市母子健康档案》较晚的孕妇产检次数较少.

目的:比较北京市某社区不同户籍类型孕产妇在围产期保健服务利用上的差异.方法:采用卡方检验对北京市高碑店社区卫生服务中心的围产保健记录系统7063例记录数据进行分析.结果:不同户籍孕产妇在叶酸开始服用时间、初次产前检查孕周等9方面均有差异(P<0.05).孕妇及配偶均为外地户籍者妊娠期、产褥期保健服务的利用情况较差,外地嫁入北京的孕产妇产褥期保健服务利用情况最好(P<0.05).结论:孕妇及配偶均为外地户籍者应予以重点关注.

ObjectiveTo investigate the correlation between midwives' critical thinking ability and clinical decision⁃making perception.MethodsA total of 536 midwives from all over the country were surveyed by the Chinese Critical Thinking Disposition Inventory (CTDI⁃CV) and Clinical Decision⁃Making in Nursing Scale(CDMNS).The correlation between both was analyzed.ResultsThe average total score of CTDI⁃CV was 290.43±34.23.Among the scores of each dimension,the score of inquisitiveness subscale was the highest (45.43±7.87),while the score of truth⁃seeking subscale was the lowest(37.84±7.44).The average total score of CDMNS was 134.15±11.23.Among the scores of all dimensions, the score of implementation effect of repeated evaluation was the highest (34.12±4.22),while the score of re⁃searching related information was the lowest(32.58±3.41).Correlation analysis showed that midwives'critical thinking had significant positive relationship with clinical decision⁃making perception(r=0.674，P<0.01).ConclusionsThe midwives have a positive critical thinking ability,and have medium level clinical decision⁃making perception.Critical thinking ability can influence the clinical decision⁃making perception.It is beneficial to improve the clinical decision⁃making ability of the midwives by improving the critical thinking ability.

目的 观察比较初产妇与经产妇的分娩体验.方法 使用一般资料和产妇分娩体验问卷(childbirth experience questionnaire,CEQ 2.0)对北京市某三级甲等妇产专科医院的703例产妇进行分娩体验的调查,采用倾向性评分匹配法控制混杂因素,比较初产妇与经产妇分娩体验得分水平的差异.结果 206例经产妇的年龄、文化程度、职业、对孩子性别的期待、产程时间、是否使用硬膜外麻醉镇痛等一般资料,与497例初产妇的比较,差异有统计学意义(P<0.05).经倾向性评分匹配平衡初产妇和经产妇的一般资料后,132例经产妇的分娩体验总分为(76.46±10.83)分,132例初产妇的分娩体验总分为(71.89±9.77)分,差异有统计学意义(P<0.05).其中经产妇的自身能力维度得分高于初产妇(P<0.05).结论 经产妇和初产妇分娩体验中的专业支持、安全感知、参与性等维度得分差异无统计学意义.经产妇的分娩体验总分及自身能力维度优于初产妇,可能与经产妇具有分娩经验,熟悉分娩知识,有较好的心理预期有关.

目的 了解哺乳期妇女捐赠母乳知识和态度现状,以期为开展捐赠母乳宣传工作提供一定的参考和依据.方法 采用便利抽样,于2018年8—12月,利用问卷星平台在23个省或直辖市的哺乳期妇女作为调查对象.采用一般资料调查表及捐赠母乳的知识和态度问卷对489名哺乳期妇女进行调查.结果 489名哺乳期妇女,40.1％听说过捐赠母乳或母乳库,76.7％愿意捐赠母乳.本组哺乳期妇女捐赠母乳知识得分为(7.79±3.01)分,捐赠母乳的态度得分为(43.39±7.26)分.单因素分析结果显示,不同文化程度、居住情况、早产儿或低体质量儿分娩史、产次、哺乳婴儿月龄及喂养方式、自觉乳汁是否充足、医护人员是否介绍过捐赠母乳信息的哺乳期妇女,捐赠母乳知识得分比较均有差异(P<0.05).不同早产儿或低体质量儿分娩史、产次、分娩方式、哺乳婴儿月龄及喂养方式、自觉乳汁是否充足、医护人员是否介绍过捐赠母乳信息的哺乳期妇女,捐赠母乳态度得分比较均有差异(P<0.05).结论 本组哺乳期妇女的捐赠母乳知识得分处于中等水平,态度得分处于较高水平.不同特征的哺乳期妇女对捐赠母乳的认识、态度仍有差距.建议今后的捐赠母乳宣传应更针对初产及婴儿月龄较低的哺乳期妇女,且应充分发挥医护人员的引导作用.

目的:调查6个月内婴儿母亲捐赠母乳知信行现状,并分析其影响因素.方法:采用住院产妇捐赠母乳的知识和态度问卷进行网络调查.结果:回收有效问卷311份,34.1％ 的婴儿母亲听说过捐赠母乳或母乳库,74.0％ 愿意捐赠母乳,但仅2.6％ 曾捐赠母乳,3.5％ 曾使用母乳库母乳.多因素分析结果显示,年龄、文化程度、居住情况、产次、早产儿或低出生体质量儿分娩史及哺乳婴儿月龄是6个月内婴儿母亲捐赠母乳知识的影响因素;产次、泌乳量、早产儿或低出生体质量儿分娩史、医护人员的宣传及哺乳婴儿出生情况是其态度的影响因素.结论:6个月内婴儿母亲对捐赠母乳态度积极,但认识水平尚待提高,且缺少捐赠或使用母乳库母乳的行为,不同特征的母亲对捐赠母乳的认识、态度有差距.

目的 了解体外受精-胚胎移植(IVF-ET)孕妇孕期体力活动水平及影响因素,为孕妇的孕期体力活动干预提供参考.方法 以便利抽样法抽取在北京市3所三级甲等医院产科门诊产检的IVF-ET孕妇120例,采用自行设计的孕妇一般情况调查表和丹麦体力活动量表对其体力活动进行调查.结果 IVF-ET孕妇孕期每天能量消耗为(29.41±2.02) Mets,静息和轻体力活动时间占全天体力活动时间的96.84％,其能量消耗占全天总能量消耗的91.83％.多因素分析显示妊娠胎数、移植次数是IVF ET孕妇孕期体力活动的影响因素.结论 IVF-ET孕妇以静息和轻体力活动为主,体力活动水平偏低,亟需要关注并加强健康指导,以提高其体力活动水平.