Razi Journal of Medical Sciences

fa بررسی دانش و نگرش پرسنل بخش نوزادان بیمارستان‌های شهر کرمان در مورد مراقبت آغوشی نوزاد نارس توسط مادر: یک مطالعه مقطعی Investigating the Knowledge and Attitude of Personnel Regarding the Kangaroo Mother Care for Premature Infants in the Neonatal Department of Kerman Hospitals: A Cross-Sectional Study نوزادان Neonatology پژوهشي Research <div style="text-align: justify;">زمینه و هدف: مراقبــت آغوشــی مادر یـک روش اسـتاندارد بـر پایـه تمـاس پوســت بــا پوســت مــادر و نــوزاد است که مــیتــوان در نــوزادان تــرم و نــارس بــه کار بــرد. هدف مطالعه حاضر، بررسی دانش و نگرش پرسنل بخش نوزادان بیمارستان‌های شهر کرمان در مورد مراقبت آغوشی نوزاد نارس توسط مادر بود. روش کار: مطالعه توصیفی-مقطعی حاضر در سال 1400-1399 روی 87 پرستار بخش نوزادان بیمارستانهای شهر کرمان انجام شد. این افراد بهصورت سرشماری انتخاب شدند. ابزار جمعآوری دادهها پرسش نامه سه قسمتی شامل «اطلاعات دموگرافیک»، پرسش نامه «تعیین میزان دانش در مورد مراقبت آغوشی نوزاد» و پرسش نامه «تعیین میزان نگرش در مورد مراقبت آغوشی نوزاد» بود. برای تجزیهوتحلیل دادهها از نرمافزار SPSS نسخه 26 استفاده شد. سطح معنیداری 05/0 در نظر گرفته شد. یافته ها: میانگین نمره دانش و نگرش پرستاران بخش نوزادان در مورد مراقبت آغوشی، بهترتیب، 73/4±53/53 و 96/3±59/36 بود. نمره دانش پرستاران با سابقه کار در بخش نوزادان همبستگی مثبت و معنی داری داشت (272/0=r و 011/0=P). بین میانگین نمره دانش پرستاران با سطح تحصیلات ارتباط معنی داری وجود داشت؛ به طوری که نمره دانش در افراد دارای تحصیلات کارشناسی ارشد بیشتر از سایر افراد بود (001/0>P). میانگین نمره دانش و نگرش پرستاران بیمارستان های دانشگاهی به طور معنی داری بیشتر از پرستاران بیمارستان های خصوصی بود. نتیجه گیری: این مطالعه دانش خوبی از مراقبت آغوشی را در بین پرستاران بخش نوزادان نشان داد، اگرچه بالاتر از سطح نگرش آن ها بود. همچنین، با افزایش سابقه کار و سطح تحصیلات، دانش پرستاران بهطور معنیداری افزایش یافت. بههرحال، آموزش مداوم و بازآموزی کارکنان مراقبت‌های بهداشتی در مورد مراقبت آغوشی توصیه میشود.  </div> <div style="text-align: justify;"> Background & Aims: The birth of premature infants is one of the important challenges of the health system in Iran and the world. Every year, 15 million premature infants are born worldwide (1). Iran is also one of the regions with a high prevalence of premature births, and about 10% of them are premature and underweight (2). Low birth weight and premature birth are significantly associated with infant mortality. In addition, the problems caused by the care of premature infants and the various complications that are placed on the developmental process of these infants can affect the personality of individuals, families and society (3). In addition, taking care of such infants imposes a heavy burden on the social and health systems of society (4). Since the causes and factors of premature infants are mostly unknown, effective interventions in this field are limited. In addition, advanced technology in this field (for example, incubators) is either not available or is not used properly due to the lack of skilled workers (5). In addition, incubators often unnecessarily separate infants from their mothers and deprive them of skin-to-skin contact, so Kangaroo mother care (KMC) in which the infant is cared for in skin-to-skin contact with the mother, introduced as a suitable alternative for the incubation care of premature infants who have overcome the initial problems (6). This approach is both effective and cost-effective (7). Methods: This cross-sectional study was conducted on 87 nurses in the neonatal department of Kerman hospitals in 2020-2021. These people were selected by census. The criteria for entering the study was working in the neonatal department of one of the hospitals in Kerman city. Inability to communicate with the person or non-cooperation and his/her consent to participate in the study was considered as the criteria for excluding from the study. The data collection tool was a three-part questionnaire including "demographic information", "determining the level of knowledge about KMC" and a "determining the level of attitude about KMC". Due to the epidemic of covid-19 and the inability to visit in person to complete the questionnaires, the questionnaire link was sent to each person through virtual networks and the questionnaire was completed online by the participants. Descriptive statistics (frequency, percentage, mean and standard deviation), analytical (Spearman Correlation Coefficient, Mann-Whitney and Kruskal-Wallis test) and SPSS version 26 software were used for data analysis. Results: The average score of knowledge and attitude of nurses about KMC was 53.53±4.73 and 36.59±3.96, respectively. The knowledge score of the nurses in the neonatal department of Kerman hospitals regarding KMC had a positive and significant correlation with work experience in the neonatal department (P=0.011). While there was no significant correlation with the age and work experience of nurses (P<0.05). There was no significant correlation between nurses' attitude scores with age, work experience, and work experience in the neonatal department (P<0.05). The results showed that the largest number of nurses had a bachelor's degree. There was a significant relationship between the average knowledge score and the level of education, so that the knowledge score of people with master's education was higher than other people (P=0.001). The average knowledge score of university hospitals nurses was significantly higher than nurses of private hospitals (P=0.01). In addition, the average score of the attitude of the nurses in university hospitals was significantly higher than nurses in private hospitals (P=0.0001). While there was no significant relationship between their attitude score and education level (P=0.745). Conclusion: The results of Okoh et al. study showed a high level of knowledge (90.4%) about KMC among Nigerian health workers, which exceeded their level of attitude (86.6%) (8). In a study conducted by Abdalla and et al. with the aim of identifying barriers to implementation of facility-based KMC for preterm and low birth weight infants, only two pediatricians had heard of KMC. However, they all wanted to use it in their units. The lack of knowledge of mothers, health workers and the community and the health culture of the community were the two main obstacles to the implementation of KMC. Financial support, staff training and separate departments were needed to protect mothers' privacy. For the implementation of KMC, informed practitioners were important for the development of evidence-based policies (7). Singh et al. study showed that it is necessary to change the attitude of health care workers about KMC and its benefits in order to implement this type of care as best as possible (9). In a systematic review study, one of the important obstacles to not implementing and promoting KMC was the lack of knowledge of health sector personnel and their lack of education. A group that was aware of this type of care and its implementation method did not want to promote it (10). Anyway, as the results of the present study and previous studies showed, the lack of awareness among the personnel of the neonatal department, health staff, mother, family and society is one of the obstacles to the implementation of KMC. It should be noted that KMC is a complex intervention that is based on behavior and includes several elements. The success of the implementation requires a lot of participation of users and stakeholders, and future research, including the design and testing of specific intervention models to improve uptake, is necessary. Therefore, measures should be taken to increase the awareness of the health staff, especially the personnel of the neonatal department and the nurses who take care of mothers and their infants, and the society, in order to remove these obstacles and use this simple intervention with great benefits. The immediate effect of KMC is to prevent prolonged separation of mother and low birth weight infant, which can lead to increased complications, insufficient volume of breast milk, poor growth, and poor mother-infant bonding (11). In the present study, the knowledge score of neonatal ward nurses about KMC had a positive and significant correlation with work experience in the neonatal ward. In Okoh et al. study, the level of knowledge of health workers in Nigeria about KMC increased with increasing work experience up to 20-16 years (8). In our study, the largest number of nurses had a bachelor's degree. In addition, there was a significant relationship between the average knowledge score of neonatal ward nurses and the level of education, so that the knowledge score of people with master's education was higher than other people. In Namnabati et al. study, about 94% of the nurses had a bachelor's degree and the rest had a master's degree (12), while in Singh et al. study, none had a master's degree (9). The results of our study showed that the mean score of knowledge and attitude of the nurses in the neonatal department of university hospitals was significantly higher than nurses in private hospitals were. Perhaps one of the reasons for this result is that educational programs are more widely implemented in educational-therapeutic centers.  </div> دانش, نگرش, روش مراقبت آغوشی مادر, نوزاد نارس, پرستاران Knowledge, Attitude, Kangaroo-Mother Care Method, Premature Infants, Nurses 1 9 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8052-1&slc_lang=fa&sid=1 Fatemeh Sabzevari فاطمه سبزواری 3900319475328460090282 3900319475328460090282 No MD, Department of Pediatrics, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran استادیار طب نوزادی و پیرامون تولد، گروه اطفال، بیمارستان افضلی پور، دانشگاه علوم پزشکی کرمان، کرمان، ایران Mohammad Ali Motasadizadeh Zarandi محمدعلی متصدی زاده زرندی 3900319475328460090283 0009-0002-7528-1890 No MD, Kerman University of Medical Sciences, Kerman, Iran پزشکی عمومی، دانشگاه علوم پزشکی کرمان، کرمان، ایران Fatemeh Karami Robati فاطمه کرمی رباطی f.karami@kmu.ac.ir 3900319475328460090284 3900319475328460090284 Yes MSc, Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran کارشناس ارشد کتابداری و اطلاع رسانی پزشکی، واحد توسعه تحقیقات بالینی، بیمارستان افضلی پور، دانشگاه علوم پزشکی کرمان، کرمان، ایران