The application effect of systematic training in birth management based on training transfer theory in midwifery alliances
基于培训迁移理论的接产系统化培训在助产联盟中的应用效果

摘要

目的 探讨基于培训迁移理论的正常分娩接产系统化培训在助产专科联盟中的应用效果。方法 通过基线调查、现况分析、文献查阅及小组讨论构建基于培训迁移理论的正常分娩接产系统化培训内容。选取广州市妇幼护理联盟及省内外助产专科联盟医院的314名助产士，采用自身前后对照法，比较培训前和培训后1个月、3个月助产士的接产行为规范、培训迁移行为得分及母婴并发症发生率。结果 （1）接产行为规范：会阴保护手法规范率、新生儿5秒内擦干启动率、延迟脐带结扎执行率等6项指标培训前后比较，差异有统计学意义（P<0.05）。（2）母婴并发症发生率：培训前（2023年全年）为4.52%（837/18526），培训后（2024年10-12月）为2.89%（140/4835），差异有统计学意义（P<0.05）。（3）培训迁移行为：培训前得分为（18.35±4.12）分，培训后1个月为（33.46±3.57）分，培训后3个月为（24.82±4.63）分，较培训后1个月有所下降，但仍高于培训前，差异有统计学意义（P<0.001）。结论 基于培训迁移理论的正常分娩接产系统化培训能规范助产士的接产行为，提高助产士的培训迁移行为，降低母婴并发症的发生，但培训后3个月迁移行为得分较培训后1个月有所下降，提示仍需开展延续培训。

Abstract

Objective To explore the application effect of systematic normal delivery training based on training transfer theory in midwifery specialty alliance.
Methods Through baseline survey, current situation analysis, literature review and group discussion, systematic training content of normal delivery was constructed based on training transfer theory. A total of 314 midwives from Guangzhou Maternal and Child Nursing Alliance and other provincial and municipal hospitals were selected. A self-controlled before-after study was used to compare the standardized delivery behaviors, training transfer behavior scores, and maternal and infant complication rates before training and at 1 month and 3 months after training.
Results (1) Six indicators of delivery behaviors including perineal protection technique, neonatal drying initiation within 5 seconds, and delayed cord clamping showed statistically significant differences before and after training (P<0.05). (2) The incidence of maternal and infant complications was 4.52% (837/18 526) before training (January to December 2023) and 2.89% (140/4 835) after training (October to December 2024) (P<0.05). (3) The training transfer behavior scores were (18.35±4.12) before training, (33.46±3.57) at 1 month after training, and (24.82±4.63) at 3 months after training; the score at 3 months was lower than that at 1 month but still higher than the pre-training level (P<0.001).
Conclusion   Systematic normal delivery training based on training transfer theory can standardize midwives' delivery behaviors, improve training transfer behaviors, and reduce maternal and infant complications. However, the score at 3 months was lower than that at 1 month, though still above the pre-training level, indicating the need for continued training.