Hong Kong Journal of Gynaecology Obstetrics and Midwifery

Volume 1 Number 2, December 2000
Abstract

Assessing Women in Pregnancy and Labour: Is it Better to Palpate? A Perspective From Midwives

Celi MY MAK Registered Nurse & Midwife,
Hong Soo WONG Consultant,
Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong

Traditionally, midwives have used non-invasive 'hands-on' assessment skills such as abdominal palpation to assess maternal and fetal condition in pregnancy and labour. It is a quick and accurate assessment tool. Moreover, care and concern could be demonstrated to the women by the 'human touch' that accompanies abdominal palpation. However, the increasing utilization of medical technological means e.g. ultrasound (USG) and cardiotocography (CTG) for fetal and maternal assessment has largely replaced the 'human touch'. Consequently, the practice of abdominal palpation is employed less frequently and the art may be devalued or lost. Identification of midwives' attitudes, knowledge, practice and confidence in abdominal palpation may help to shed some light to the value of this art at present. In this study, a self-reporting questionnaire was used to examine 51 midwives' attitudes, knowledge, practice, and confidence in performing abdominal palpation in Hong Kong. It was found that the midwives had positive attitudes, moderate employment of the practice, but inadequate knowledge and confidence in performing abdominal palpation. The implications for enhancing the knowledge, skill and confidence in this art are discussed. (HKJGOM 2000 ; 1 : 86 - 95)

Keywords : abdominal palpation, midwife, knowledge, confidence, attitude

作者:麥美炎(註明護士)/黃康素(婦產科顧問醫生)
地址:九龍瑪嘉烈醫院道2-10號瑪嘉烈醫院婦產科

傳統產科檢查上,腹部觸診是一項迅速及準確的評估技巧,所以助產士常運用此非入侵性方式評估產婦及胎兒在懷孕及生產期間的情況,同時助產士亦可透過腹部觸診及會診中的接觸,與產婦建立互信關係,亦可給予產婦一份愛心與關懷。然而,隨著科技一日千里和醫學科技的運用,超音波或連續胎兒監察檢查已取代上述的『人性的接觸』作為評估產婦及胎兒情況的主要工具。因此,腹部觸診的應用亦相對地減少,而此技巧的藝術價值亦漸被忽視或甚至消失。基於上述情況,本文希望透過助產士對腹部觸診的態度、知識、技巧及應用時信心程度,進一步闡明此技巧的價值。在過程中,採用問卷調查作評估工具,對本港五十一位助產士作出調查,從問卷調查中顯示部份助產士對腹部觸診採取了正面及積極的態度,在臨床上亦有適當的應用機會。然而調查中亦顯示其知識、技巧及信心程度卻仍有不足之處,所以本文就此情況作出了相對的建議。


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