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Silva JDNGE, de Souza AM, Rosario FMD, Pinto LC. Pregnant women's knowledge and clinical management of hemolytic disease of the fetus and newborn in Pará, Brazil. Hematol Transfus Cell Ther 2024:S2531-1379(24)00255-4. [PMID: 38839547 DOI: 10.1016/j.htct.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE To evaluate the knowledge of pregnant women and the clinical management of hemolytic disease of the fetus and newborn, as well as to describe the gestational profile, risk factors and socio-epidemiological profile of pregnant women treated at two municipal health units in Belém (Pará, Brazil). METHODS This was a cross-sectional analytical study, which consisted in the application of questionnaires to pregnant women who underwent prenatal care at the municipal health units. RESULTS A total of 104 pregnant women were evaluated; most were aged between 24 and 29 years old, had high school degrees (38 %), family incomes between 1 and 2 minimum wages (45 %) and blood type O+ (43 %). Regarding the gestational profile, the participants were predominantly in the third trimester of pregnancy (49 %), started prenatal care in the first gestational trimester (81 %) and were primiparous (61 %). Failures in the management of prenatal care were observed, especially with regard to access to information about the disease, since most pregnant women did not receive information about blood incompatibility during prenatal care. This led to limited knowledge about the pathology of the disease evidenced by the fact that most of the correct answers were between Questions 0-4, which were significantly associated with the women's education and income. CONCLUSIONS Although hemolytic disease of the fetus and newborn is serious, the pregnant women in this study demonstrated little knowledge about the disease and had inadequate care by health professionals, reinforcing the importance of improving care for women's health and prenatal care.
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Affiliation(s)
| | - Andrya Maia de Souza
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil
| | | | - Laine Celestino Pinto
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Pará, Brazil; Laboratory of Experimental Neuropathology, Federal University of Pará, Biological Science Institute, Belém, Pará, Brazil.
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Ayivi-Vinz G, Bakwa Kanyinga F, Bergeron L, Décary S, Adisso ÉL, Zomahoun HTV, Daniel SJ, Tremblay M, Plourde KV, Guay-Bélanger S, Légaré F. Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review. JMIR MEDICAL EDUCATION 2022; 8:e36948. [PMID: 35318188 PMCID: PMC9112082 DOI: 10.2196/36948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory-informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory-informed tool that evaluates the impact of CPD activities on clinicians' behavioral intentions. OBJECTIVE We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals' intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. METHODS We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants' completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%). CONCLUSIONS The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. TRIAL REGISTRATION PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116492.
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Affiliation(s)
- Gloria Ayivi-Vinz
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Felly Bakwa Kanyinga
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Lysa Bergeron
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - Simon Décary
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Évèhouénou Lionel Adisso
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Unité de Soutien SSA Québec, Université Laval, Quebec, QC, Canada
| | - Sam J Daniel
- Direction du Développement Professionnel Continu, Fédération des Médecins Spécialistes du Québec, Montreal, QC, Canada
| | - Martin Tremblay
- Direction du Développement Professionnel Continu, Fédération des Médecins Spécialistes du Québec, Montreal, QC, Canada
| | - Karine V Plourde
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - Sabrina Guay-Bélanger
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - France Légaré
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Unité de Soutien SSA Québec, Université Laval, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Lin M, Liu M, Zhang S, Chen C, Wang J. Different Types of Minor Blood Group Incompatibility Causing Haemolytic Disease of Neonates in one of the National Children's Medical Centre in China. J Blood Med 2021; 12:497-504. [PMID: 34211305 PMCID: PMC8240843 DOI: 10.2147/jbm.s303633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/20/2021] [Indexed: 01/27/2023] Open
Abstract
Purpose To review the neonatal cases with different types of minor blood group incompatible haemolytic diseases in China, and to improve the clinical understanding and management. Materials and Methods Seven cases from January, 1st, 2013 to December 31st, 2019 were searched out and reviewed retrospectively. All clinical data and laboratory findings were collected. Results There were totally seven cases enrolled including three cases of MNS, three of Diego, and one of Kidd combined with Rh, anti-RhE incompatibility. Among the seven cases, two had intrauterine transfusion, two underwent exchange transfusion, five received intravenous immune globulin, five cases developed anaemia, and three of them had transfusion. But among them, only four were found to have positive antibody screening and three were confirmed HDN with antibody types antenatally. Conclusion The clinical presentation is diverse. Antibody screening followed by the technique of peak systolic velocity in the fetal middle cerebral artery (MCA-PSV) helps to filter out the severe cases.
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Affiliation(s)
- Mingchun Lin
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China.,Neonatal Fellowship Training at Children's Hospital of Fudan University, Yueqing Maternal and Child Health Hospital, Wenzhou, Zhejiang Province, People's Republic of China
| | - Meixiu Liu
- Blood Bank, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Shulian Zhang
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Chao Chen
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
| | - Jin Wang
- Neonatal Department, Children's Hospital of Fudan University, Shanghai, 201102, People's Republic of China
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