Abstract: Objective　To understand the current situation of high-risk early warning assessment ability for midwives in Guangzhou, and to analyze its influencing factors. Methods　From September 2020 to June 2021, a self-compiled questionnaire survey was conducted among midwives from 6 hospitals in Guangzhou by the objective sampling method. The content of the questionnaire included three parts, namely basic information, self-assessment of midwives' high-risk early warning assessment ability, and the training status of midwives' high-risk early warning assessment ability. χ² test was used for the count data, and independent sample t test or one-way ANOVA was used for the measurement data. Results　A total of 148 valid questionnaires were collected, with an effective recovery rate of 91.4% (148/162). All midwives in the survey were female, 40.5% (60/148) of midwives were aged from 26 to 35 years old, 65.5% (97/148) of midwives were in grade 3A hospitals, 81.8% (121/148) of midwives had a bachelor's degree or above, and 61.5% (91/148) of midwives had strict training and assessment standards in their hospitals. The main reasons affecting midwives' high-risk early warning assessment ability were that the relevant departments of hospitals did not pay attention to it and the hospital conditions were limited. The higher the midwives' age, working experience, and professional titles were, the stronger the ability of high-risk early warning assessment they had (all P<0.05). The attention paid to midwives' high risk early warning assessment ability by grade 3A hospitals was higher than that by grade 3B and below hospitals, with a statistically significant difference (χ²=15.32, P=0.02); 48.0% (12/25) of midwives in grade 2 and below hospitals did not meet the requirements of high-risk pregnancy training, which was higher than 30.8% (8/26) in grade 3B hospitals and 21.6% (21/97) in grade 3A hospitals (χ²=9.65, P=0.04). Conclusion　At present, the midwives' overall high-risk early warning assessment ability is in an intermediate level in Guangzhou. It is suggested to establish unified training system and examination standard of relevant early warning, so as to improve the ability of high-risk early warning assessment in a normalizing way.

Key words: Midwives, High-risk early warning, Situation, Influencing factors

摘要： 目的　了解广州市助产士高危预警评估能力现状，分析其影响因素。方法　2020年9月至2021年6月，采用目的抽样法对广州市6所医院的助产士采取自行编制的问卷进行调查，调查内容包括基本资料、助产士高危预警评估能力的自我鉴定、助产士高危预警评估能力的培训现状3部分。计数资料采用χ²检验，计量资料采用独立样本t检验或方差分析。结果　共回收有效问卷148份，有效回收率91.4%（148/162），调查的助产士均为女性，40.5%（60/148）的助产士年龄为26～35岁，有65.5%（97/148）的助产士分布在三级甲等医院，81.8%（121/148）的助产士有本科及以上学历，有61.5%（91/148）助产士所在医院有严格的培训及考核标准，医院相关部门不重视和医院条件有限是影响助产士高危预警评估能力高低的主要原因；助产工作年限越高、年龄越大、职称越高，高危预警评估能力越强（均P<0.05）。三级甲等医院对助产士高危预警评估能力的重视程度高于三级乙等和二级及以下医院，差异有统计学意义（χ²=15.32，P=0.02）。在助产士是否满足医院高危妊娠的相关培训方面，二级及以下医院有48.0%（12/25）助产士不满足，高于三级乙等医院30.8%（8/26）和三级甲等医院21.6%（21/97），差异有统计学意义（χ²=9.65，P=0.04）。结论　目前广州市助产士对高危预警的评估整体处于中等水平，建议制定相关高危预警评估能力的统一培训制度和考核标准，以规范化提高助产士临床的高危预警评估能力。

关键词: 助产士, 高危预警, 现状, 影响因素