Use of a facilitated discussion model for antenatal care to improve communication.
Use of a facilitated discussion model for antenatal care to improve communication.
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DOI：
10.1016/j.ijnurstu.2015.03.018
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发表时间：
2016-02
影响因子：
8.1
通讯作者：
Chuey MR
中科院分区：
文献类型：
--
作者：
Lori JR;Munro ML;Chuey MR
背景实现健康素养是改善健康结果和国家健康的关键步骤。然而，缺乏对低资源国家的健康素养的研究，那里的孕产妇健康状况最差。ObjectivesTo研究在一组设置中使用图片卡提供集中产前护理（FANC）的有用性和可行性，以改善患者与提供者的沟通，患者参与，并提高健康素养。采用混合方法设计，使用健康素养技能框架收集试点数据。设置2014年期间，加纳阿散蒂地区的一家忙碌城区医院被用于收集数据。助产士一个设施驱动的便利助产士样本（n=6）年龄在18岁或以上，谁可以讲英语或Twi，并提供产前保健在参与医院在前一年的研究开始之前参加了study.MethodsData收集使用前测试和后测试调查，完成三个月后，组FANC实施。进行了一个半结构化的焦点小组，其中四名参与助产士和注册护士在后测试时为研究提供支持和监督（n=5）。同时分析数据，以获得广泛的理解，病人的沟通，参与，和组FANC.ResultsThere的平均沟通（t（df = 3）= 0. 541，p = 0. 626）和参与（t（df = 3）=-0. 775，p = 0. 495）得分之间的前，后测试的平均差异无显着性。然而，重点小组揭示了以下主题：（a）通过使用图片卡改善沟通;（B）通过便利小组进程加强信息共享和同行支持;以及（c）结论通过使用图片卡改善沟通，通过FANC小组加强信息共享和同伴支持，无疑为患者提供了使用额外的工具来唤起自决，并采取他们认为对改善怀孕结果最重要的行为。
BackgroundAchieving health literacy is a critical step to improving health outcomes and the health of a nation. However, there is a lack of research on health literacy in low-resource countries, where maternal health outcomes are at their worst.ObjectivesTo examine the usefulness and feasibility of providing focused antenatal care (FANC) in a group setting using picture cards to improve patient–provider communication, patient engagement, and improve health literacy.DesignAn exploratory, mixed methods design was employed to gather pilot data using the Health Literacy Skills Framework.SettingsA busy urban district hospital in the Ashanti Region of Ghana was used to gather data during 2014.ParticipantsA facility-driven convenience sample of midwives (n=6) aged 18 years or older, who could speak English or Twi, and had provided antenatal care at the participating hospital during the previous year prior to the start of the study participated in the study.MethodsData were collected using pre-test and post-test surveys, completed three months after the group FANC was implemented. A semi-structured focus group was conducted with four of the participating midwives and the registered nurse providing support and supervision for the study (n=5) at the time of the post-test. Data were analyzed concurrently to gain a broad understanding of patient communication, engagement, and group FANC.ResultsThere were no significant differences in the mean communication (t(df = 3) = 0.541,p= 0.626) and engagement (t(df = 3) = −0.775,p= 0.495) scores between the pre- and post-test. However, the focus group revealed the following themes: (a) improved communication through the use of picture cards; (b) enhanced information sharing and peer support through the facilitated group process and; and (c) an improved understanding of patient concerns.ConclusionsThe improved communication noted through the use of picture cards and the enhanced information sharing and peer support elicited through the group FANC undoubtedly provided patients with additional tools to invoke self-determination, and carry out the behaviors they thought were most important to improve pregnancy outcomes.