The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings
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DOI：
10.1186/s12978-017-0450-y
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发表时间：
2018-01-05
影响因子：
3.4
通讯作者：
Shennan, Andrew H.
中科院分区：
文献类型：
--
作者：
Nathan, Hannah L.;Boene, Helena;Shennan, Andrew H.
背景：生命体征测量可以识别需要紧急治疗或转诊的孕妇和产后妇女。在资源匮乏的环境中，医护人员获得适合其环境和培训的准确生命体征测量设备的机会有限。摇篮生命体征警报（VSA）是一种测量血压和脉搏的新型设备，在怀孕期间准确，专为低资源环境设计。其交通信号灯预警系统提醒保健工作者需要加强对高血压、出血或败血症妇女的护理。本研究评估的可用性和可接受性的摇篮VSA device.Methods：在印度，莫桑比克和尼日利亚和三级医院在南非的社区和初级保健环境进行评价。采用有目的抽样方法召集了155次访谈和6个焦点小组，其中包括使用该设备的医护人员（n = 205）和孕妇及其家人（n = 41）。访谈和焦点小组以当地语言进行，并进行录音、转录和翻译成英文以供分析。主题分析进行了使用先验的主题框架，以及一个归纳的approach.Results：大多数医护人员认为摇篮设备易于使用和准确。交通信号灯预警系统得到了一致好评，给了医护人员决策的信心和专业感。然而，南非的少数人认为手动充气很累，特别是在测量肥胖和高血压女性的生命体征时（n = 4），一些南非医护人员不信任该设备的准确性（n = 7）。孕妇一致喜欢摇篮装置。交通信号灯预警系统让妇女和他们的家人更好地了解生命体征的重要性，在怀孕和产后period.Conclusion：摇篮设备是很好地接受来自一系列国家和设施水平的医护人员，包括那些没有以前的生命体征测量经验。这一装置促使妇女参加初级保健，并鼓励她们接受治疗和转诊。
Background: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device.Methods: Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach.Results: Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device's accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period.Conclusion: The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.