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目的:了解我国医务人员进行新生儿复苏的自信心水平,并对影响因素进行分析。方法:在“新生儿复苏项目”的20个项目省中,随机抽取6个省进行现场调查。每省调查1所地市级医疗保健机构和2所县级医疗保健机构,共调查18所医院。对在岗的所有产科医生、儿科医生、助产士进行新生儿复苏自信心水平问卷调查。结果:共调查121名医务人员,自信心平均得分(3.58±0.47)分。医务人员在如何进行快速评估方面的自信心得分最高,平均为3.93分;对脐静脉插管技术的自信心水平最低,平均仅为2.11分。在进行气管插管、使用扩容剂的指征及方法、小组间沟通能力和领导能力方面的自信心得分也较低。多因素分析显示,高级职称人员自信心得分高于中、初级职称人员;参加培训次数越多、参加临床抢救越多,自信心水平越高;科室建立定期考核制度者自信心水平较高。结论:新生儿复苏培训中应加强模拟操作练习,强化复苏小组间的沟通和配合,提高医务人员的自信心。同时应建立新生儿复苏的复训和考核机制,使医务人员能保持较高的技术熟练程度和自信心水平。
Objective: To understand the self-confidence level of neonatal resuscitation among medical staff in our country and to analyze the influencing factors. Methods: Sixteen provinces were randomly selected from 20 provinces under “neonatal resuscitation project” to carry out on-site investigation. A provincial-level health care institution and two county-level health care institutions were investigated in each province, and 18 hospitals were investigated. Questionnaire survey of all obstetricians, pediatricians and midwives on the job. Results: A total of 121 medical staff were investigated, with an average of 3.58 ± 0.47 confidence points. The highest self-confidence score of medical staff in terms of how to conduct rapid assessment was 3.93 on average, and the lowest level of self-confidence in umbilical vein catheterization was on average 2.11. There was also a lower score for self-confidence in tracheal intubation, use of expander instructions and methods, and inter-group communication and leadership skills. Multivariate analysis showed that the self-confidence scores of senior professional titles were higher than those of middle-level and junior titles; the more attendance training sessions, the more clinical rescue interventions, the higher the self-confidence level; the higher the self-confidence of department setting up the regular assessment system was. Conclusion: In the newborn resuscitation training, the practice of simulating operation should be strengthened to enhance the communication and coordination among the resuscitation teams so as to enhance the self-confidence of the medical staff. At the same time, rehabilitation and assessment mechanisms for neonatal resuscitation should be established so that medical personnel can maintain a high level of technical proficiency and self-confidence.