鼓励使用产前皮质类固醇治疗促进胎儿成熟的方法:一项随机对照试验
L C Leviton1, R L Goldenberg, C S Baker
1Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 35294-0033, USA. lleviton@hb.soph.uab.edu
JAMA
|January 19, 1999
概括
积极传播策略显著增加了产前皮质类固醇的使用,用于早产儿的胎儿成熟. 这一专注的努力改善了标准方法,提高了医生实践的变化.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 产前皮质类固醇对于早产的胎儿成熟至关重要,但尚未得到充分利用.
- 证据支持它们的好处,但临床采用仍然不够理想.
研究的目的:
- 评估不同传播策略在增加产前皮质类固醇使用方面的有效性.
- 为了比较一个专注的,积极的传播方法与通常的传播方法.
主要方法:
- 一个随机试验,涉及27个三级保健机构.
- 机构被分配到通常的传播或积极的,专注的传播国家卫生研究院 (NIH) 建议.
- 积极传播包括长达一年的教育计划,医生和护士参与,大轮,提醒和反.
主要成果:
- 积极传播显著增加了使用皮质类固醇的几率.
- 在活跃传播地点,皮质类固醇使用率上升了108% (从32.9%上升到68.3%).
- 常见的传播站点增加了75% (从33.0%增加到57.6%).
结论:
- 集中,积极的传播努力,结合改变医生实践的策略,比单独的通常传播更有效.
- 这种方法增强了采用基于证据的治疗方法,如产前皮质类固醇.
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