Research progress in postpartum visit competency
Postpartum visits are an important component of maternal and child health management services. Grassroots maternal and child health care personnel provide face-to-face health care services within one week after the delivery and discharge of the mother, including follow-up, observation, physical examination, and health guidance. High level postpartum visits can reduce maternal and neonatal mortality rates, improve disease management and referral capabilities, increase the success rate of breastfeeding, and ensure the physical and mental health of mothers and newborns. However, China lacks detailed rules and standards for postpartum visits, and the abilities of healthcare personnel vary greatly, making it difficult to meet healthcare needs. This article systematically elaborates on the elements, meanings, current status, influencing factors, improvement strategies, and evaluation methods of postpartum visit ability through literature review, providing references for related research and ability improvement.
1 Literature search and results
The researchers searched seven databases, including China National Knowledge Infrastructure, Wanfang, Web of Science, etc., from their establishment to July 1, 2023. Using keywords such as "perinatal period" and "competence" in both Chinese and English, 24 valid articles were screened, including 11 in Chinese and 13 in English. The focus was on postpartum visit ability research, excluding studies that did not conduct visits within 42 days postpartum and only provided designated health services.
2 Elements of Postpartum Visit Ability
The elements of postpartum visit ability include three dimensions: health assessment, health education, and communication and coordination. Specific abilities involve assessing the physical and mental health status of mothers and newborns, conducting targeted health education, completing postpartum visit arrangements, and handling postpartum visit information.
Current Status of Postpartum Visit Ability
Discussed the current status of postpartum visitation ability. In terms of health assessment, over 43% of certified social health activists possess neonatal health skills, and community child health nurses can effectively plan postpartum visit arrangements, assess maternal risks, and provide referral services. Community health personnel have a medium to high sensitivity in identifying signs of danger in newborns, but there is a lack of judgment in low-temperature treatment. In terms of health education, there are limitations for visiting personnel in breastfeeding and contraception guidance, and there is a gap between the postpartum visit needs of mothers and the actual health services they receive. The needs of postpartum women for health education mainly include postpartum health guidance, postpartum psychological guidance, breastfeeding guidance, and newborn health guidance, and there are certain differences in the needs of multiparous and primiparous women. In order to improve the quality of postpartum visit services and meet the diverse needs of mothers, it is necessary to conduct in-depth investigations into the needs of mothers and their families, update postpartum visit service items, and provide personalized health care services. In terms of communication and coordination skills, healthcare workers have the ability to actively listen and express themselves, but there are limitations in their skills of establishing connections. This may be due to the fact that postpartum visit services are mostly carried out by community women's or children's healthcare workers, who mainly receive medical education and training, and rarely involve specialized communication skills training.
4 Factors influencing postpartum visits
The friendliness, technical skills, infant health guidance, and personalized service capabilities of the interviewees in postpartum visit services have an impact. Research indicates that insufficient skills training affects the evaluation of newborn healthcare. There are problems such as shortage of staff, inconvenient transportation, and scattered townships in areas with limited health resources. In the future, service quality can be improved by strengthening capacity building, establishing collaborative mechanisms, and using mobile platforms.
5 Strategies for Improving Postpartum Visit Ability
Explored various strategies to enhance postpartum visitation abilities. Section 5.1 emphasizes the reform of teaching methods, such as watching videos, role-playing, and simulated teaching, to enhance students' understanding of postpartum and neonatal health care. Section 5.2 discusses home visit skills training, including case exercises, lectures, group discussions, and simulated home visit exercises, which can improve nurse skills and maternal satisfaction. Section 5.3 studied the effectiveness of standardized postpartum visit procedures and pointed out that standardized processes and operations can improve the evaluation of home visitors by mothers. Future research needs to explore the differences in the effectiveness of different training methods, in order to select the most suitable training method and improve postpartum visit abilities from the perspective of standardized processes.
6 Methods for Assessing Postpartum Visit Ability
Twenty one studies were introduced to evaluate postpartum visitation ability using methods such as self-designed questionnaires, interview outlines, or focus groups. Among them, three studies used relatively objective evaluation methods: one study investigated the implementation of China's postpartum health service policies, using a survey questionnaire on the health of pregnant women, newborns, and children and neonatal health indicators to evaluate the coverage of postpartum health care; One study evaluated the communication skills of community healthcare workers using the Home Visit Communication Skills Scale; One study used the evaluation results of designated physicians as the gold standard to measure the effectiveness of healthcare personnel in identifying neonatal risk signs and determining referrals. At present, there is a lack of tools for comprehensive evaluation of postpartum visit ability. In the future, corresponding evaluation indicators and tools can be considered for development.
7 Conclusion
Postpartum visitation personnel have the ability in basic examinations and health education, but there are deficiencies in professional healthcare services. Ability training can enhance the competence level of service providers and related professionals, improve maternal satisfaction, but the existing research evidence is weak. Lack of tools for comprehensive assessment of postpartum visit ability. In the future, it is necessary to develop clear evaluation indicators and tools for postpartum visit abilities, and implement targeted capacity building plans. There are limitations to this article, such as language limitations in the literature, limitations on the time range of visits, and inconsistent reporting indicators for results. Future research should broaden its perspective, incorporate health system factors into analysis, focus on the impact of resource allocation, policy support, and management mechanisms, and combine larger sample sizes and more representative studies to promote the development of personalized and high-quality postpartum visit services.
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