IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-14 DOI: 10.1016/j.midw.2024.104240

Kate Buchanan , Kate Dawson , Jacqueline Taylor , Sara Bayes

Background

Globally, midwifery is facing a potential workforce crisis. A significant number of midwives intending to leave the profession often cite burnout as contributing to this decision. While it has been reported that work-life balance is a key element in deciding to stay in midwifery, little is known about what constitutes work-life balance and the barriers to achieving this.

Aim

The aim of this study was to explore what work-life balance means to Australian midwives, and to determine its crucial features.

Methods

Qualitative Description methodology was used for this study. Data were collected from 31 midwives in Australia working in hospital settings, and different models of care. Data were collected using open ended questions via an online survey. Thematic analysis with a socio-institutional lens was applied to the data.

Findings

The findings were organised to three themes: ‘Tipping the balance: The socio-institutional factors that shape midwives’ work-life balance; ‘Taking it home: The unique occupational characteristics of midwifery emotion work’ and ‘Finding harmony: Midwifery agency fosters presence and joy’. Together these explain the macro-, meso- and micro- level factors that characterise midwives’ work-life balance.

Conclusion

The concept of work-life ‘blending’ is proposed as a more accurate depiction for midwifery than ‘balance’, where integration of work and life can be beneficial if autonomy and midwifery role and professional identity are valued. The majority of midwives are women who carry a significant domestic burden outside of work, and gender affirming structural changes to better support the role and full scope of the midwives to facilitate blending of work and life in a way that works for them are recommended.

背景：在全球范围内，助产士正面临着潜在的劳动力危机。大量打算离开助产士行业的助产士往往认为职业倦怠是做出这一决定的原因。据报道，工作与生活的平衡是决定是否留在助产士行业的一个关键因素，但人们对什么是工作与生活的平衡以及实现这一平衡的障碍知之甚少：方法：本研究采用定性描述法。数据收集自澳大利亚 31 名在医院环境和不同护理模式下工作的助产士。通过在线调查使用开放式问题收集数据。采用社会机构视角对数据进行主题分析：研究结果：研究结果分为三个主题："打破平衡：调查结果：研究结果分为三个主题："平衡：影响助产士工作与生活平衡的社会制度因素；"把工作带回家：助产士情感工作的独特职业特征 "和 "寻找和谐：助产机构促进临场感和愉悦感"。这些内容共同解释了助产士工作与生活平衡的宏观、中观和微观因素：与 "平衡 "相比，工作与生活 "融合 "的概念更适合助产士，如果自主性、助产士角色和职业认同得到重视，工作与生活的融合是有益的。大多数助产士都是妇女，她们在工作之余还要承担大量的家务负担，因此建议进行性别平权结构改革，以更好地支持助产士的角色和全部工作范围，从而以适合她们的方式促进工作与生活的融合。

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引用次数: 0

International News January 2025 2025 年 1 月国际新闻

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-13 DOI: 10.1016/j.midw.2024.104234

Elizabeth Duff

引用次数: 0

The future of midwifery care and education in Belgium: A discussion paper. 比利时助产护理和教育的未来：讨论文件。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-12 DOI: 10.1016/j.midw.2024.104237

Régine Goemaes, Mieke Embo, Ana Belen Hernandez-Garcia, Katelijne De Koster, Geneviève Castiaux, Naziha Hammoucha, Feride Sulejmani, Katrien Beeckman, Annick Bogaerts

Background: Advanced education of midwives acting during the first 1000 days in life is key in optimum care provision for intergenerational health and wellbeing.

Aim: This paper provides a comprehensive analysis of the current context of midwifery care and (inter)national trends in midwifery education. Gaps for optimizing midwifery education in Belgium are defined.

Results: Societal, medical, and technological changes including medicalization of birth impact the midwife's profession and competency requirements. The World Health Organization demands adapted midwifery competency frameworks to meet these changes and achieve universal health coverage by 2030. While the European Union's directives address the recognition of professional qualifications of midwives, basic midwifery programs in Europe range from vocational to master's programs. In Belgium, basic midwifery programs are direct-entry bachelor programs; however, the program length varies according to the region. A horizon scanning by the Belgian Health Care Knowledge Center concluded that an extension and advancement of the current midwifery program are urgently needed to enable midwives to fulfil an autonomous role in accordance with national laws and international directives.

Discussion: Basic midwifery education anno 2023 does not fit (1) the changes in women's health towards 2030; (2) the future demands regarding midwifery competence, and (3) the current and future demands for autonomy according to the legal frameworks.

Conclusion: An extension and advancement of the basic midwifery programs are needed to sufficiently arm midwives to meet changes they are confronted with. Therefore, a debate involving all stakeholders concerned with the future of midwifery care and education is recommended.

背景：目的：本文全面分析了助产士护理的现状和助产士教育的（国家间）趋势。结果：结果：社会、医疗和技术的变化，包括分娩医疗化，对助产士的职业和能力要求产生了影响。世界卫生组织要求调整助产士能力框架，以应对这些变化，并在 2030 年前实现全民医保。虽然欧盟的指令涉及对助产士专业资格的认可，但欧洲的助产士基础课程从职业课程到硕士课程不等。在比利时，基础助产士课程是直接入学的本科课程，但课程长度因地区而异。比利时医疗保健知识中心（Belgian Health Care Knowledge Center）的一项前景扫描得出结论，当前的助产士课程亟需扩展和提升，以使助产士能够根据国家法律和国际指令发挥自主作用：讨论：2023 年的助产士基础教育不符合（1）2030 年前妇女健康的变化；（2）未来对助产士能力的要求；（3）当前和未来根据法律框架对自主性的要求：结论：需要扩展和提高基本助产课程，以充分武装助产士，应对他们所面临的变化。因此，建议就助产士护理和教育的未来开展一场由所有利益相关者参与的辩论。

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引用次数: 0

“With an unwanted pregnancy, we are looking for midwives in the neighbourhood to show us what to do.” Stakeholder perceptions of midwife-led woman-centred comprehensive abortion care in the province of Kinshasa, Democratic Republic of Congo: a qualitative descriptive study "意外怀孕后，我们希望附近的助产士能告诉我们该怎么做"。刚果民主共和国金沙萨省利益相关者对助产士主导的以妇女为中心的综合人工流产护理的看法：定性描述研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-12 DOI: 10.1016/j.midw.2024.104238

Kirsty M Bourret , Marie Chantal Kankolongo , Nadia Lobo , Désiré Banga , Elisa Maffioli , Marie Klingberg-Allvin

Problem

Midwives are an essential yet underutilised health human resource for improving unsafe abortion outcomes and increasing abortion access and contraceptive care.

Background

In Democratic Republic of Congo (DRC), morbidity and mortality resulting from unsafe abortions are alarmingly high. The recent ratification of the Maputo Protocol in 2018 has made safe abortion accessible. National implementation strategies recognise midwives as providers of comprehensive abortion care (CAC), yet there is little understanding of their current role in its provision.

Aim

To understand the obstacles and facilitators in integrating the midwifery model of CAC in DRC's health system.

Methods

A qualitative descriptive design was used to explore health system stakeholders' perceptions regarding the midwifery model of CAC in Kinshasa, DRC. Data sources included n = 43 key informant interviews and n = 2 FGDs. Results were member-checked with DRC Midwives’ Association (SCOSAF) members.

Findings

Findings highlight midwives provided all aspects of CAC, with attention to the psycho-social well-being of their clients and acted as health service navigators in the community. Appropriate midwifery legislation, scope of practice that includes CAC, administrative support and remuneration, and better access to continuing education are facilitating health system factors for the midwifery model of CAC. Finally, SCOSAF, the Midwives’ Association, played an influential role in the implementation, positively supporting CAC integration by midwives.

Discussion

Understanding health system levers and the involvement of Midwives’ Associations are important considerations when integrating and sustaining the midwifery model of CAC. Gender transformative approaches are appropriate given systemic gender inequities inherent in midwifery.

Conclusion

Further research is needed to understand the impact of the midwifery model of CAC in DRC.

问题：助产士是改善不安全人工流产结果、增加人工流产机会和避孕护理的重要卫生人力资源，但却未得到充分利用。背景：在刚果民主共和国（刚果（金）），不安全人工流产导致的发病率和死亡率高得惊人：在刚果民主共和国（DRC），不安全堕胎导致的发病率和死亡率高得惊人。最近于 2018 年批准的《马普托议定书》使安全堕胎成为可能。国家实施战略承认助产士是全面堕胎护理（CAC）的提供者，但人们对助产士目前在提供CAC方面的作用了解甚少。目的：了解将助产士CAC模式纳入刚果民主共和国医疗系统的障碍和促进因素：方法：采用定性描述设计，探讨刚果民主共和国金沙萨卫生系统利益相关者对助产CAC模式的看法。数据来源包括 n = 43 次关键信息提供者访谈和 n = 2 次 FGD。调查结果与刚果民主共和国助产士协会（SCOSAF）成员进行了核对：调查结果显示，助产士提供了 CAC 的各个方面，关注客户的社会心理健康，并在社区中充当健康服务导航员。适当的助产立法、包括 CAC 在内的执业范围、行政支持和薪酬，以及更好地接受继续教育，都是促进助产 CAC 模式的卫生系统因素。最后，助产士协会 SCOSAF 在实施过程中发挥了有影响力的作用，积极支持助产士整合 CAC：讨论：了解卫生系统的杠杆作用和助产士协会的参与是整合和维持 CAC 助产模式的重要考虑因素。考虑到助产过程中固有的系统性性别不平等问题，性别变革方法是适当的：需要进一步开展研究，以了解 CAC 助产模式在刚果民主共和国的影响。

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引用次数: 0

Effectiveness of supporting lifestyle change in pregnant mothers with obesity through the wearable internet-of-things (SLIM) -intervention on self-efficacy in weight management in pregnant women: A quasi-experimental trial 通过可穿戴物联网（SLIM）干预支持肥胖孕产妇改变生活方式对孕妇体重管理自我效能的影响：准实验性试验。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-09 DOI: 10.1016/j.midw.2024.104235

Johanna Saarikko , Anna Axelin , Emilia Huvinen , Amir M. Rahmani , Terhi Kolari , Hannakaisa Niela-Vilén

Background

Half of women with overweight gain excessive weight during pregnancy. Perceived self-efficacy plays a significant role in adherence to healthy behaviours, especially in turning points of life, such as a pregnancy.

Objectives

To assess the effectiveness of the Supporting lifestyle change in pregnant mothers with obesity through the wearable internet-of-things (SLIM)-intervention in terms of improving self-efficacy in eating and physical activity and preventing excessive weight gain of pregnant women with overweight. The second aim was to evaluate the fidelity of the intervention implementation.

Methods

Pregnant women with overweight (N = 54) attending maternity clinics in Southwest Finland between 2021 and 2023, were recruited using convenience sampling. The SLIM-intervention included: health technology, motivational interviewing, feedback, and goal setting. The intervention was implemented in prenatal visits in maternity clinics continuing to 12 weeks postpartum. The change in self-efficacy was measured with Weight Efficacy Life-Style Questionnaire (score 0–180) and Self-Efficacy for Physical Activity Scale (score 5–25) with repeated measures in three timepoints. Data on weight were collected from patient records.

Results

The levels of self-efficacy were high throughout the study period and there were no significant changes in self-efficacy in eating (p = 0.650) or physical activity (p = 0.936). Most of the women (N = 9/10), whose gestational weight gain was within recommendations or less, managed to lose weight during the postpartum period (p < 0.001).

Conclusions

Although the intervention was not effective in improving self-efficacy, the importance of recommended gestational weight gain on better postpartum weight management was highlighted. A long follow-up time was valuable for examination of changes over time and understanding trends, patterns, and outcomes of the study.

Registration

The trial was registered at the Clinicaltrials.gov register platform (ID NCT04826861) on March 17th, 2021.

背景：半数超重妇女在怀孕期间体重增加过多。自我效能感在坚持健康行为方面发挥着重要作用，尤其是在人生的转折点，如怀孕期间：评估通过可穿戴物联网（SLIM）干预对肥胖孕产妇生活方式改变的支持效果，以提高肥胖孕产妇在饮食和体育锻炼方面的自我效能，防止体重增加过多。第二个目的是评估干预实施的忠实性：方法：在 2021 年至 2023 年期间，在芬兰西南部产科诊所就诊的超重孕妇（N = 54）均为方便抽样调查对象。SLIM干预包括：健康技术、动机访谈、反馈和目标设定。干预措施在产科诊所的产前检查中实施，一直持续到产后 12 周。自我效能的变化通过体重效能生活方式问卷（0-180 分）和体育活动自我效能量表（5-25 分）进行测量，并在三个时间点进行重复测量。体重数据来自患者病历：在整个研究期间，患者的自我效能感水平都很高，在饮食（P= 0.650）和体育锻炼（P= 0.936）方面的自我效能感没有显著变化。大多数妇女（9/10）的妊娠体重增加在建议范围内或更少，但在产后期间体重成功下降（p < 0.001）：尽管干预措施在提高自我效能方面效果不佳，但却强调了建议的妊娠体重增加对产后更好地控制体重的重要性。较长的随访时间对于检查随时间推移而发生的变化以及了解研究的趋势、模式和结果非常有价值：该试验于 2021 年 3 月 17 日在 Clinicaltrials.gov 注册平台注册（ID NCT04826861）。

{"title":"Effectiveness of supporting lifestyle change in pregnant mothers with obesity through the wearable internet-of-things (SLIM) -intervention on self-efficacy in weight management in pregnant women: A quasi-experimental trial","authors":"Johanna Saarikko , Anna Axelin , Emilia Huvinen , Amir M. Rahmani , Terhi Kolari , Hannakaisa Niela-Vilén","doi":"10.1016/j.midw.2024.104235","DOIUrl":"10.1016/j.midw.2024.104235","url":null,"abstract":"<div><h3>Background</h3><div>Half of women with overweight gain excessive weight during pregnancy. Perceived self-efficacy plays a significant role in adherence to healthy behaviours, especially in turning points of life, such as a pregnancy.</div></div><div><h3>Objectives</h3><div>To assess the effectiveness of the Supporting lifestyle change in pregnant mothers with obesity through the wearable internet-of-things (SLIM)-intervention in terms of improving self-efficacy in eating and physical activity and preventing excessive weight gain of pregnant women with overweight. The second aim was to evaluate the fidelity of the intervention implementation.</div></div><div><h3>Methods</h3><div>Pregnant women with overweight (<em>N</em> = 54) attending maternity clinics in Southwest Finland between 2021 and 2023, were recruited using convenience sampling. The SLIM-intervention included: health technology, motivational interviewing, feedback, and goal setting. The intervention was implemented in prenatal visits in maternity clinics continuing to 12 weeks postpartum. The change in self-efficacy was measured with Weight Efficacy Life-Style Questionnaire (score 0–180) and Self-Efficacy for Physical Activity Scale (score 5–25) with repeated measures in three timepoints. Data on weight were collected from patient records.</div></div><div><h3>Results</h3><div>The levels of self-efficacy were high throughout the study period and there were no significant changes in self-efficacy in eating (<em>p</em> <em>=</em> 0.650) or physical activity (<em>p</em> <em>=</em> 0.936). Most of the women (<em>N</em> = 9/10), whose gestational weight gain was within recommendations or less, managed to lose weight during the postpartum period (<em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Although the intervention was not effective in improving self-efficacy, the importance of recommended gestational weight gain on better postpartum weight management was highlighted. A long follow-up time was valuable for examination of changes over time and understanding trends, patterns, and outcomes of the study.</div></div><div><h3>Registration</h3><div>The trial was registered at the Clinicaltrials.gov register platform (ID NCT04826861) on March 17th, 2021.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"140 ","pages":"Article 104235"},"PeriodicalIF":2.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Providing emotional care for early pregnancy loss: Development and evaluation of a new training module for healthcare providers 为早期妊娠损失提供情感关怀：为医护人员开发和评估新的培训模块。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-08 DOI: 10.1016/j.midw.2024.104233

Lysha Lee , Katrin Gerber , Marjolein P.M. Kammers

Background

Miscarriage is a common life event that frequently causes significant grief and distress. The emotional impact of miscarriage has been shown to be strongly influenced by patients’ and partners’ experiences interacting with healthcare providers during the miscarriage diagnosis and treatment: positive experiences are associated with reduced perinatal grief, whereas negative interactions can aggravate the traumatic impact of the loss. Unfortunately, healthcare providers frequently report feeling ill-equipped and unprepared to provide adequate emotional care for miscarriage. As such, there is an urgent need for effective training material to support healthcare providers in this important care.

Method

Here, we report a quasi-experimental study evaluating the effectiveness of a new training module that we recently developed to empower healthcare providers when providing emotional care for miscarriage.

Results

Using the previously-validated Perinatal Bereavement Care Confidence Scale, we show that this module is highly effective, achieving significant increases in healthcare providers’ knowledge, bereavement support skills, and awareness after completing training. Importantly, the module was effective for each of five different staff roles (anaesthetists, midwives, nurses, obstetricians and receptionists) and for both junior and more experienced staff. Furthermore, at six-week follow-up, HCPs reported using many of the module's recommendations in their ongoing practice.

Conclusion

Altogether, this new training module is therefore an important step towards empowering healthcare providers (in all roles) in providing essential emotional care for this common and frequently highly-distressing life event.

背景介绍流产是一种常见的生命事件，经常会引起巨大的悲伤和痛苦。在流产诊断和治疗过程中，患者及其伴侣与医疗服务提供者的互动经历对流产的情绪影响很大：积极的互动经历可减少围产期的悲痛，而消极的互动经历则会加重流产带来的创伤。遗憾的是，医疗服务提供者经常表示，在为流产患者提供适当的情感护理方面，他们感到能力不足，准备不充分。因此，迫切需要有效的培训材料来支持医护人员开展这项重要的护理工作：在此，我们报告了一项准实验研究，评估了我们最近开发的新培训模块的有效性，该模块旨在增强医护人员在为流产患者提供情感护理时的能力：结果：通过使用之前经过验证的围产期丧亲护理信心量表，我们发现该模块非常有效，在完成培训后，医护人员的知识、丧亲支持技能和意识都有显著提高。重要的是，该模块对五种不同角色的医护人员（麻醉师、助产士、护士、产科医生和接待员）均有效，对初级医护人员和经验丰富的医护人员均有效。此外，在六周的随访中，高级保健人员表示在他们的日常实践中使用了模块中的许多建议：总之，这一新的培训模块是朝着增强医疗保健提供者（所有角色）的能力迈出的重要一步，使他们能够为这一常见且经常造成极大压力的生命事件提供必要的情感关怀。

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引用次数: 0

A methodological proposal for midwifery education: Asking, Learning, Telling, and Embracing Diversity (ALTE) 助产士教育方法建议：提问、学习、讲述和拥抱多样性 (ALTE)。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-02 DOI: 10.1016/j.midw.2024.104230

Rahime Aydin Er , Merve Mergen , Aslıhan Akpinar

Objective

This study addressed the imperative for educational methodologies that effectively cultivate an understanding of diverse cultures within midwifery education curricula, particularly focusing on culture-based practices in the professional milieu. The primary objective was to develop a comprehensive methodology for the integration of cultural competence acquisition into midwifery undergraduate education. This study endeavoured to introduce and critically assesses an educational approach tailored to facilitate the acquisition of cultural competence and sensitivity among midwifery students.

Design

The Asking, Learning, Telling, and Embracing Diversity (ALTE) method, which was developed for use in the “History and Philosophy of Midwifery” course curriculum, was evaluated within the framework of instructor experiences and feedback from students.

Setting

Kocaeli University Faculty of Health Sciences, Department of Midwifery in Türkiye.

Participants

A cohort of midwifery students enrolled in the History and Philosophy of Midwifery course between 2011 and 2016 (N = 95).

Findings

The ALTE method, which is characterized by a student-cantered approach and active participation facilitation, presents an opportunity to enhance student engagement and foster active learning. Student feedback underscored that ALTE, emphasizing active participation, is perceived as an instructive and enriching educational approach, diverging from conventional didactic teaching methods. The ALTE method has emerged as an effective instrument for instilling cultural competence within midwifery education.

Key conclusions

The implementation of the ALTE method empowered midwifery students from diverse geographical backgrounds to discern varied cultural codes and traditional practices. This methodology facilitated the identification of commonalities across regions, exploration of preserved cultural values, and scrutiny of potential advantages, disadvantages, and risks associated with such practices concerning maternal and neonatal well-being. Notably, ALTE exhibited commendable efficacy in fostering cultural sensitivity, active learning, acquisition of communication and presentation skills, peer learning, development of cultural competence, and critical thinking skills.

目的本研究探讨了在助产士教育课程中有效培养对不同文化的理解的教育方法的必要性，尤其关注专业环境中基于文化的实践。研究的主要目的是开发一种将文化能力培养融入助产士本科教育的综合方法。本研究致力于介绍和批判性评估一种为促进助产士学生获得文化能力和敏感性而量身定制的教育方法：设计：在教师经验和学生反馈的框架内，对 "助产历史与哲学 "课程中使用的 "提问、学习、讲述和拥抱多样性"（ALTE）方法进行评估：地点：土耳其科贾埃利大学健康科学学院助产学系：2011年至2016年期间，一批助产士学生选修了助产士历史与哲学课程（N = 95）：ALTE方法的特点是以学生为中心的方法和主动参与的促进方式，为提高学生参与度和促进主动学习提供了机会。学生的反馈强调，ALTE 强调主动参与，被视为一种具有启发性和丰富性的教育方法，有别于传统的说教式教学方法。ALTE 方法已成为在助产士教育中灌输文化能力的有效工具：ALTE 方法的实施增强了来自不同地域背景的助产士学生辨别不同文化规范和传统习俗的能力。这种方法有助于发现不同地区的共性，探索保留的文化价值观，并仔细研究与这些习俗有关的孕产妇和新生儿福利的潜在优势、劣势和风险。值得注意的是，ALTE 在培养文化敏感性、主动学习、掌握交流和表达技能、同伴学习、发展文化能力和批判性思维能力方面表现出了值得称道的功效。

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引用次数: 0

Dutch maternity care providers’ attitudes toward and support of young fathers: A cross-sectional survey-based study 荷兰产科护理人员对年轻父亲的态度和支持：基于横断面调查的研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-11-02 DOI: 10.1016/j.midw.2024.104229

Justine van de Beek , Femke Hilverda , Violet Petit-Steeghs , Anna Petra Nieboer

Background

Given their often-vulnerable circumstances, young fathers’ childcare involvement is precarious. Despite the potential benefits of receiving professional support, young fathers experience exclusion or suboptimal support in maternity care. Insights into maternity care providers’ attitudes toward young fathers and their perspectives on the support they provide to this group are, however, lacking. Such insights could be helpful to better align support with young fathers’ needs.

Aim

The study objectives were to examine maternity care providers’ attitudes toward young fathers and their perspectives on the support they provide to them, assess relationships between the two and investigate differences between and within occupational groups.

Method

An online survey study was conducted with 183 Dutch midwives and maternity nurses.

Findings

Maternity care providers reported positive attitudes and high levels of support. They indicated that they provide mainly affirmative support, followed by emotional, informational, and instrumental support. All forms of support correlated significantly with positive attitudes. Maternity nurses had higher positive attitude and support scores than did midwives, with the largest difference observed for instrumental support.

Conclusion

Maternity care providers reported positive attitudes and high levels of support provided to young fathers, which stands in contrast with the father's experience of support. This difference suggests that having positive attitudes and the intention to deliver high levels of support are not by definition sufficient to meet young fathers’ support needs. Attention should also be paid to the forms and manners of support provided.

背景：鉴于年轻父亲的弱势处境，他们在育儿方面的参与岌岌可危。尽管获得专业支持有潜在的好处，但年轻父亲在产科护理中仍会受到排斥或得不到最佳支持。然而，我们还缺乏对产科护理提供者对年轻父亲的态度以及他们为这一群体提供支持的观点的了解。目的：研究目标是考察产科护理提供者对年轻父亲的态度以及他们对年轻父亲所提供支持的看法，评估两者之间的关系，并调查职业群体之间和职业群体内部的差异：对 183 名荷兰助产士和产科护士进行了在线调查研究：产科护理提供者报告了积极的态度和高度的支持。她们表示，她们主要提供肯定性支持，其次是情感、信息和工具性支持。所有形式的支持都与积极态度密切相关。产科护士的积极态度和支持得分均高于助产士，其中工具性支持的差异最大：产科护理人员对年轻父亲的态度积极，支持程度高，这与父亲的支持体验形成了鲜明对比。这种差异表明，拥有积极的态度和提供高水平支持的意愿并不足以满足年轻父亲的支持需求。还应注意提供支持的形式和方法。

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引用次数: 0

Midwives’ knowledge, attitude, practices, and experiences toward trauma-informed abortion care in urban district hospitals in Rwanda 卢旺达城市地区医院助产士对创伤知情人工流产护理的认识、态度、做法和经验

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-10-30 DOI: 10.1016/j.midw.2024.104228

Yvonne Delphine Nsaba Uwera , Aimable Nkurunziza , Michael Habtu , Jean Pierre Ndayisenga , Madeleine Mukeshimana , Donatilla Mukamana , Justine Bagirisano , Jean Bosco Henri Hitayezu , Marie Laetitia Ishimwe Bazakare , Olive Tengera , Gerard Kaberuka , Jean Pierre Nganabashaka

In Rwanda, many abortion services are not currently providing trauma-informed abortion care (TIAC) due to laws that restrict service provision and the incorporation of potentially traumatizing procedures with little attention to the woman's experience and support needs. Midwives working in abortion services often lack adequate training to effectively support clients with trauma. The authors aim to evaluate midwives’ knowledge, attitudes, practices, and experiences toward TIAC. A mixed-method design was used. In quantitative, all midwives were invited to participate. In qualitative, purposive sampling was applied, and four focus group discussions with eight participants each were conducted. Of the 167 midwives who participated in this study, 86.2% demonstrated sufficient knowledge of TIAC, 83.8% had thorough experience of TIAC, and 62.3% reported a negative attitude toward TIAC. Respondents with an advanced diploma were more likely to have satisfactory knowledge than those with a bachelor's degree, and the workplace institution influenced TIAC practice. Males had a more positive attitude compared to their female counterparts. Moreover, respondents with more knowledge of and positive attitudes toward TIAC were significantly more likely to have good practice. Four themes were identified: a) conceptualization and practice of TIAC; b) TIAC as an essential practice in quality care; c) physical environment as a hindrance of TIAC; and d) dynamics of caring leading to secondary trauma. Providing TIAC training to midwives is essential for shifting negative attitudes. Hospitals need to enhance their infrastructure and offer resources to address the challenges of abortion services, including mitigating secondary trauma among healthcare workers.

在卢旺达，许多人工流产服务机构目前并未提供创伤知情的人工流产护理（TIAC），原因是法律限制了服务的提供，并且在提供可能造成创伤的程序时很少关注妇女的经历和支持需求。在人工流产服务机构工作的助产士往往缺乏足够的培训，无法有效地为有创伤的客户提供支持。作者旨在评估助产士对 TIAC 的认识、态度、实践和经验。研究采用了混合方法设计。在定量分析中，邀请所有助产士参与。在定性方面，采用了目的性抽样，并进行了四次焦点小组讨论，每次有八名参与者。在参与本研究的 167 名助产士中，86.2% 的人对 TIAC 有足够的了解，83.8% 的人对 TIAC 有充分的经验，62.3% 的人对 TIAC 持消极态度。与拥有学士学位的受访者相比，拥有高级文凭的受访者更有可能对 TIAC 有满意的了解，而工作机构也会影响 TIAC 的实践。与女性受访者相比，男性受访者的态度更为积极。此外，对 TIAC 有更多了解并持积极态度的受访者更有可能拥有良好的实践。研究确定了四个主题：a) TIAC 的概念和实践；b) TIAC 是优质护理的基本实践；c) 物理环境是 TIAC 的障碍；d) 护理动态导致二次创伤。为助产士提供 TIAC 培训对于转变消极态度至关重要。医院需要加强基础设施并提供资源，以应对人工流产服务的挑战，包括减轻医护人员的二次创伤。

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Exploring mothers' perspectives on the early mother-infant relationship to inform midwifery practice: A qualitative study 探索母亲对早期母婴关系的看法，为助产实践提供参考：定性研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-10-25 DOI: 10.1016/j.midw.2024.104200

Cathy Stoodley , Lois McKellar , Jennifer Fereday , Tahereh Ziaian , Mary Steen , Ian Gwilt

Background

The mother-infant relationship plays a crucial role in individual and community health. The nature of the mother-infant relationship can influence the social and emotional development of the infant, impacting their lifelong health. Midwives are key in providing health promotion for women and babies and are ideally placed to support women during the early development of the mother-infant relationship.

Aims

This study aimed to explore new mothers' perspectives on developing the early mother-infant relationship to inform midwifery practice.

Methods

This study is phase one of a mixed-method, exploratory sequential design project. In this phase, 14 women were interviewed within six weeks of birth to explore experiences that influenced the developing relationship with their baby. To support reflection women were provided with a visual prompt activity. These interviews informed the co-design workshops to develop an intervention to support midwives to promote the early mother infant relationship. A research protocol was published prior to undertaking the study, however as this research did not seek to modify or measure any heath related outcomes it was not registered as a clinical trial.

Results

Key themes from the interviews included: making moments that matter; the role of the village; feeling like I'm winning; supportive health professionals, and forming a new family. These themes underpinned strategies to support the mother-infant relationship.

Conclusion

The findings from this study offer ways for midwives to support the emerging mother-infant relationship during the early postnatal period. Facilitating mothers to engage with their baby as well as integrating key people is important. Midwives also play a key role in building maternal confidence and competence. Further research is needed to embed and evaluate strategies in midwifery practice.

背景母婴关系对个人和社区的健康起着至关重要的作用。母婴关系的性质会影响婴儿的社交和情感发展，从而影响他们的终生健康。助产士是为妇女和婴儿提供健康促进服务的关键，是在母婴关系早期发展过程中为妇女提供支持的理想人选：本研究是一个混合方法、探索性顺序设计项目的第一阶段。在这一阶段，14 名产妇在出生后六周内接受了访谈，探讨影响她们与婴儿关系发展的经历。为了帮助妇女进行反思，还为她们提供了视觉提示活动。这些访谈为共同设计研讨会提供了信息，以开发一种干预措施，支持助产士促进早期母婴关系。在开展这项研究之前，已经发布了一份研究协议，但由于这项研究并不寻求修改或测量任何与健康相关的结果，因此没有注册为临床试验：访谈的关键主题包括：创造重要时刻；村庄的作用；感觉我赢了；支持我的医疗专业人员；组建新家庭。这些主题是支持母婴关系的策略的基础：本研究的结果为助产士在产后早期支持新的母婴关系提供了方法。促进母亲与婴儿接触以及整合关键人物非常重要。助产士在培养产妇的信心和能力方面也起着关键作用。在助产实践中嵌入和评估相关策略还需要进一步的研究。

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