Midwifery最新文献_第10页

Midwives’ adaptation of their practice, role, and scope to ensure access to sexual and reproductive services during humanitarian crises: A scoping review 助产士调整其实践、角色和范围，以确保在人道主义危机期间获得性服务和生殖服务：范围审查。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-20 DOI: 10.1016/j.midw.2024.104065

Susana E Ku Carbonell , Patricia Ogba , Meredith Vanstone , Christy Gombay , Elizabeth K Darling

Problem

Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises.

Background

Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances.

Aim

To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care.

Study methods

Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework.

Findings

We identified 3329 records, of which forty-two were included. Midwives’ prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice.

Conclusion

The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises.

问题：对助产士和助产士主导的干预措施在危机期间的适应性进行研究和综合的研究有限：背景：有证据表明，助产士是在混乱时期满足性健康和生殖健康护理需求的关键，而且她们会在这些情况下进行调整以继续提供服务。目标：绘制全球助产士在危机期间提供护理时的调整图。次要目标包括确定哪些助产士进行了调整、调整了哪些服务、如何调整以及接受护理的人群：研究方法：采用 Levac 对 Arksey 和 O'Malley 方法的修改进行范围审查。研究方法：采用 Levac 对 Arksey 和 O Malley 方法进行修改后的方法进行范围界定，包括英文和西班牙文的出版物和灰色文献，研究设计和日期不受限制。采用惠顿和麦西弗（Wheaton and Maciver）的适应性框架对数据进行了提取和映射：我们发现了 3329 条记录，其中 42 条被纳入。助产士之前的培训对适应性有影响。助产士适应了 COVID-19 大流行、流行病、自然灾害和第二次世界大战。她们在医院和社区环境中围绕提供产前、分娩、产后和避孕护理进行了调整。但是，没有具体数据确定人口统计数据。助产士的适应与她们的实践、角色和实践范围有关：有限的可用证据确定了助产士为确保提供服务所面临的挑战、创造性和互助活动。证据高度集中在孕产妇保健服务方面。需要进一步开展高质量的研究，以便更深入地了解助产士主导的护理如何适应指导可持续的应对措施，确保在危机期间获得性健康和生殖健康服务。

{"title":"Midwives’ adaptation of their practice, role, and scope to ensure access to sexual and reproductive services during humanitarian crises: A scoping review","authors":"Susana E Ku Carbonell , Patricia Ogba , Meredith Vanstone , Christy Gombay , Elizabeth K Darling","doi":"10.1016/j.midw.2024.104065","DOIUrl":"10.1016/j.midw.2024.104065","url":null,"abstract":"<div><h3>Problem</h3><p>Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises.</p></div><div><h3>Background</h3><p>Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances.</p></div><div><h3>Aim</h3><p>To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care.</p></div><div><h3>Study methods</h3><p>Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework.</p></div><div><h3>Findings</h3><p>We identified 3329 records, of which forty-two were included. Midwives’ prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice.</p></div><div><h3>Conclusion</h3><p>The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001487/pdfft?md5=dcda4cf888abb5a6a229f2f6be3d6bc2&pid=1-s2.0-S0266613824001487-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534804","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

The experience of miscarriage and its impact on prenatal attachment during the following pregnancy: A mixed-methods study 流产的经历及其对怀孕后产前依恋的影响：混合方法研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-19 DOI: 10.1016/j.midw.2024.104072

Myriam Chemouny, Jaqueline Wendland

Background

In France, miscarriage affects nearly 200,000 women every year. This life event may generate negative effects on the mother-child relationship and the mother's mental health in the following pregnancy.

Objectives

To investigate the influence of body satisfaction, partner support, resilience and previous experience of a miscarriage on prenatal attachment in pregnant women.

Design

This is a cross-sectional mixed-methods study. Women answered an online questionnaire in the period between November 2022 to April 2023.

Participants

267 French pregnant women who had previously experienced a miscarriage were recruited for this study.

Measurements

Study outcomes included prenatal attachment, resilience, partner support, history of previous pregnancies and miscarriages, the current pregnancy, and questions relating to body experience.

Findings

Participants who reported a high investment in the current pregnancy, high partner support and a positive image of their body had higher levels of prenatal attachment. The experience of miscarriage also seems to influence prenatal attachment: pregnancy investment at the time of miscarriage had a positive influence, while medical experience had no significant impact. While the global resilience score was not related to prenatal attachment, sense of control was positively linked to prenatal attachment.

Key conclusions and implications for practice

These results highlight the importance of considering miscarriage as a perinatal loss with potential for long-lasting impact on women, which deserves particular attention from professionals. Enhancing partner support and helping women build a positive image of their pregnant body can also have a role in fostering prenatal attachment to the foetus.

背景介绍在法国，每年有近 20 万名妇女流产。这一生命事件可能会对母子关系和母亲在接下来怀孕期间的心理健康产生负面影响：调查身体满意度、伴侣支持、复原力和流产经历对孕妇产前依恋的影响：设计：这是一项横断面混合方法研究。参与者：本研究招募了267名曾有过流产经历的法国孕妇：研究结果包括产前依恋、复原力、伴侣支持、既往怀孕和流产史、本次怀孕以及与身体体验相关的问题：研究结果：对当前妊娠投入较多、获得伴侣支持较多以及对自己的身体有积极看法的受试者具有较高的产前依恋水平。流产经历似乎也会影响产前依恋：流产时的妊娠投资具有积极影响，而医疗经历则没有显著影响。虽然总体复原力得分与产前依恋无关，但控制感与产前依恋呈正相关：这些结果强调了将流产视为围产期损失的重要性，它可能会对妇女产生长期影响，值得专业人员特别关注。加强对伴侣的支持和帮助妇女建立对其怀孕身体的积极形象，也有助于促进产前对胎儿的依恋。

{"title":"The experience of miscarriage and its impact on prenatal attachment during the following pregnancy: A mixed-methods study","authors":"Myriam Chemouny, Jaqueline Wendland","doi":"10.1016/j.midw.2024.104072","DOIUrl":"10.1016/j.midw.2024.104072","url":null,"abstract":"<div><h3>Background</h3><p>In France, miscarriage affects nearly 200,000 women every year. This life event may generate negative effects on the mother-child relationship and the mother's mental health in the following pregnancy.</p></div><div><h3>Objectives</h3><p>To investigate the influence of body satisfaction, partner support, resilience and previous experience of a miscarriage on prenatal attachment in pregnant women.</p></div><div><h3>Design</h3><p>This is a cross-sectional mixed-methods study. Women answered an online questionnaire in the period between November 2022 to April 2023.</p></div><div><h3>Participants</h3><p>267 French pregnant women who had previously experienced a miscarriage were recruited for this study.</p></div><div><h3>Measurements</h3><p>Study outcomes included prenatal attachment, resilience, partner support, history of previous pregnancies and miscarriages, the current pregnancy, and questions relating to body experience.</p></div><div><h3>Findings</h3><p>Participants who reported a high investment in the current pregnancy, high partner support and a positive image of their body had higher levels of prenatal attachment. The experience of miscarriage also seems to influence prenatal attachment: pregnancy investment at the time of miscarriage had a positive influence, while medical experience had no significant impact. While the global resilience score was not related to prenatal attachment, sense of control was positively linked to prenatal attachment.</p></div><div><h3>Key conclusions and implications for practice</h3><p>These results highlight the importance of considering miscarriage as a perinatal loss with potential for long-lasting impact on women, which deserves particular attention from professionals. Enhancing partner support and helping women build a positive image of their pregnant body can also have a role in fostering prenatal attachment to the foetus.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001554/pdfft?md5=b33d37fb1886889a9dafbff66b758fc4&pid=1-s2.0-S0266613824001554-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469337","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

A very, very lonely, unmagical time. The lived experience of perinatal anxiety: A longitudinal interpretative phenomenological analysis 一段非常、非常孤独、没有魔力的时光。围产期焦虑的生活体验：纵向解释现象学分析。

IF 2.6 3区医学 Q1 Nursing

Midwifery

Pub Date : 2024-06-17 DOI: 10.1016/j.midw.2024.104070

Kelda J Folliard , Kenda Crozier , Meghana M Wadnerkar Kamble

Problem

Minimal longitudinal qualitative evidence examining lived experience of anxiety over the perinatal continuum limits holistic understanding of the course of antenatal and postnatal anxiety.

Background

Perinatal anxiety has deleterious effects on the mother and infant and is more commonly experienced yet less well investigated than perinatal depression.

Aim and method

To explore women's experiences living with perinatal anxiety to increase understanding of the condition; inform support given by midwives and other health professionals and provide practice, education, and research recommendations. Five women were interviewed at three timepoints, producing 15 datasets. Data was analysed using longitudinal interpretative phenomenological analysis.

Findings

Nine Group Experiential Themes emerged: the anxious mother, transformation, sets of ears and the anxious pregnancy (antenatal); baby as external focus, returning to oneself and the emotional unknown (early postnatal); and moving on, and shifting sands (late postnatal). Three Longitudinal Experiential Concepts explicated lived experience over time: maternal eyes, transforming existence, and emotional kaleidoscope. The lived experience of perinatal anxiety was revealed as socially constructed, with relationships with self, others, and the world key. The collision between anxiety and motherhood as social constructs provides perinatal anxiety with its unique characteristics.

Conclusion

Midwives and other healthcare professionals should understand the significance of perinatal anxiety, enabling disclosure of stigmatising and uncomfortable feelings without judgement. Research examining whether perinatal specific screening tools should be used by midwives and exploring the relationship between perinatal anxiety and depression is recommended. Education for clinicians on the significance of perinatal anxiety is essential.

问题：很少有纵向定性证据研究围产期焦虑的生活经历，这限制了对产前和产后焦虑过程的全面了解：背景：围产期焦虑症会对母亲和婴儿造成有害影响，与围产期抑郁症相比，围产期焦虑症更常见，但研究却较少：目的和方法：探讨围产期焦虑症妇女的生活经历，以增进对该疾病的了解；为助产士和其他医疗专业人员提供支持提供依据，并提供实践、教育和研究建议。五名妇女在三个时间点接受了访谈，共产生了 15 个数据集。采用纵向解释现象学分析法对数据进行了分析：出现了九个群体体验主题：焦虑的母亲、转变、耳鬓厮磨和焦虑的怀孕（产前）；婴儿作为外部焦点、回归自我和情感未知（产后早期）；以及继续前进和风云变幻（产后晚期）。三个纵向体验概念阐释了随着时间推移而产生的生活体验：母性之眼、生存转变和情感万花筒。围产期焦虑的生活体验是社会建构的，与自我、他人和世界的关系是关键。作为社会建构的焦虑与母性之间的碰撞使围产期焦虑具有其独特性：助产士和其他医疗保健专业人员应了解围产期焦虑症的重要意义，使其能够在不被评判的情况下披露其耻辱感和不舒服的感觉。建议对助产士是否应使用围产期特定筛查工具以及围产期焦虑与抑郁之间的关系进行研究。对临床医生进行有关围产期焦虑症重要性的教育至关重要。

{"title":"A very, very lonely, unmagical time. The lived experience of perinatal anxiety: A longitudinal interpretative phenomenological analysis","authors":"Kelda J Folliard , Kenda Crozier , Meghana M Wadnerkar Kamble","doi":"10.1016/j.midw.2024.104070","DOIUrl":"10.1016/j.midw.2024.104070","url":null,"abstract":"<div><h3>Problem</h3><p>Minimal longitudinal qualitative evidence examining lived experience of anxiety over the perinatal continuum limits holistic understanding of the course of antenatal and postnatal anxiety.</p></div><div><h3>Background</h3><p>Perinatal anxiety has deleterious effects on the mother and infant and is more commonly experienced yet less well investigated than perinatal depression.</p></div><div><h3>Aim and method</h3><p>To explore women's experiences living with perinatal anxiety to increase understanding of the condition; inform support given by midwives and other health professionals and provide practice, education, and research recommendations. Five women were interviewed at three timepoints, producing 15 datasets. Data was analysed using longitudinal interpretative phenomenological analysis.</p></div><div><h3>Findings</h3><p>Nine Group Experiential Themes emerged: the anxious mother, transformation, sets of ears and the anxious pregnancy (antenatal); baby as external focus, returning to oneself and the emotional unknown (early postnatal); and moving on, and shifting sands (late postnatal). Three Longitudinal Experiential Concepts explicated lived experience over time: maternal eyes, transforming existence, and emotional kaleidoscope. The lived experience of perinatal anxiety was revealed as socially constructed, with relationships with self, others, and the world key. The collision between anxiety and motherhood as social constructs provides perinatal anxiety with its unique characteristics.</p></div><div><h3>Conclusion</h3><p>Midwives and other healthcare professionals should understand the significance of perinatal anxiety, enabling disclosure of stigmatising and uncomfortable feelings without judgement. Research examining whether perinatal specific screening tools should be used by midwives and exploring the relationship between perinatal anxiety and depression is recommended. Education for clinicians on the significance of perinatal anxiety is essential.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001530/pdfft?md5=8e24339b0e62928095e6866d50bd1544&pid=1-s2.0-S0266613824001530-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432190","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

Maternity support workers’ experiences of workplace trauma and post-traumatic stress symptoms 产妇支持工作者的工作场所创伤经历和创伤后应激症状。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-17 DOI: 10.1016/j.midw.2024.104071

Pauline Slade , Charlotte Smart , Charlotte Krahé , Helen Spiby

Background

Maternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses.

Objectives

We aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms.

Methods

MSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression.

Findings

Of 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (n = 13) participants had probable PTSD, while a further 5.7 % (n = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events.

Conclusions and clinical implications

MSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.

背景：孕产妇支持工作者（MSW）目前是孕产妇工作队伍的重要组成部分。她们的工作环境有可能暴露于创伤事件，但人们对她们的暴露率或心理反应知之甚少：我们的目的是确定报告遭受过创伤性工作事件的医务工作者的比例，以及随之而来的创伤后应激障碍（PTSD）的发生率。我们还旨在确定与创伤后应激障碍相关的因素，描述职业倦怠、移情和功能障碍的水平，并探讨它们与创伤后应激障碍症状的潜在关联：我们通过皇家助产士学院向所有助产士成员发送的通讯以及学院助产士 Facebook 页面上的社交媒体招募助产士。参与者填写了一份在线调查问卷。他们提供了有关人口统计学细节、工作角色和创伤事件暴露的信息，并填写了涵盖与工作事件相关的创伤后应激障碍症状、相关功能障碍、职业倦怠和移情的问卷。我们通过相关性和多元回归对数据进行了分析：在 98 名受访者中，有 88 人曾接触过创伤性工作事件；其中 79 人是通过亲身经历，9 人是通过听说创伤性事件。在这些受访者中，14.8%（13 人）可能患有创伤后应激障碍，另有 5.7%（5 人）达到亚临床阈值。超过三分之一（35.2%）的样本表现出高度的情绪衰竭，这是职业倦怠的一个主要特征，27.3%的样本报告工作功能受损。创伤后应激障碍症状与年龄较小、移情关注度较高以及直接暴露于创伤性围产期事件有关：医务社工在工作中经常会遇到创伤性事件，有可能患上与工作相关的创伤后应激障碍。虽然我们的方法无法区分因果关系，但年轻且更具移情能力的工作人员似乎面临更大的风险。还必须指出的是，调查是在 COVID-19 大流行期间进行的，调查结果可能会受到这一背景的影响。需要将医务社工纳入常规计划，为工作中受到创伤的员工提供支持。

{"title":"Maternity support workers’ experiences of workplace trauma and post-traumatic stress symptoms","authors":"Pauline Slade , Charlotte Smart , Charlotte Krahé , Helen Spiby","doi":"10.1016/j.midw.2024.104071","DOIUrl":"10.1016/j.midw.2024.104071","url":null,"abstract":"<div><h3>Background</h3><p>Maternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses.</p></div><div><h3>Objectives</h3><p>We aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms.</p></div><div><h3>Methods</h3><p>MSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression.</p></div><div><h3>Findings</h3><p>Of 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (<em>n</em> = 13) participants had probable PTSD, while a further 5.7 % (<em>n</em> = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events.</p></div><div><h3>Conclusions and clinical implications</h3><p>MSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001542/pdfft?md5=c22fc290498ae9316e26d13a0976b266&pid=1-s2.0-S0266613824001542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555218","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

Underlying beliefs of preventive health behaviours among women with a history of gestational diabetes mellitus: A descriptive qualitative study 有妊娠糖尿病史的妇女对预防保健行为的基本信念：描述性定性研究

IF 2.6 3区医学 Q1 Nursing

Midwifery

Pub Date : 2024-06-15 DOI: 10.1016/j.midw.2024.104068

Mei Qi Ang , Xi Vivien Wu , Hong-Gu He

Aims

To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their postpartum period in Singapore.

Methods

This paper reports on the qualitative arm of a mixed method study. The qualitative descriptive design was adopted. Individual interviews were conducted between 7th September 2020 and 25th September 2020 using a semi-structured interview guide. Data collected were analysed using thematic analysis.

Results

A total of 18 women completed the interview. The participants’ ages ranged from 26 to 40 years with a mean age of 33.17 years (SD= 4.09). The duration since childbirth was 8.78 months (SD = 1.35). Through thematic analysis, five themes were developed: lifestyle adjustment, self-motivation, supportive environment, barriers to practising a healthy lifestyle, and risk perception. A total of 14 subthemes emerged from the five main themes. The beliefs of women with a history of GDM were described according to the Theory of Planned Behaviour.

Conclusions

Having a newborn brings changes to the lifestyle of a woman and her family, which can affect the health behaviours in the postpartum period. This study revealed several novel findings relating to the unmet needs of women who had GDM, specifically to the need for information and emotional support to safely resume healthy behaviours after childbirth, for which participants have provided suggestions on how to enhance the continuity of care in the postpartum period.

目的探讨新加坡产后期间预防性保健行为水平较低的有 GDM 病史妇女的预防性保健行为的基本信念。研究采用了定性描述设计。采用半结构化访谈指南，在 2020 年 9 月 7 日至 2020 年 9 月 25 日期间进行了个别访谈。对收集到的数据进行了主题分析。参与者的年龄从 26 岁到 40 岁不等，平均年龄为 33.17 岁（SD= 4.09）。产后持续时间为 8.78 个月（SD=1.35）。通过主题分析，共形成了五个主题：生活方式调整、自我激励、支持性环境、实行健康生活方式的障碍和风险认知。五大主题共产生了 14 个次主题。根据 "计划行为理论"，对有 GDM 病史的妇女的信念进行了描述。这项研究揭示了一些与患过 GDM 的妇女的未满足需求有关的新发现，特别是她们需要信息和情感支持，以便在产后安全地恢复健康行为，为此，参与者就如何加强产后护理的连续性提出了建议。

{"title":"Underlying beliefs of preventive health behaviours among women with a history of gestational diabetes mellitus: A descriptive qualitative study","authors":"Mei Qi Ang , Xi Vivien Wu , Hong-Gu He","doi":"10.1016/j.midw.2024.104068","DOIUrl":"10.1016/j.midw.2024.104068","url":null,"abstract":"<div><h3>Aims</h3><p>To explore the underlying beliefs of preventive health behaviours among women with a history of GDM who had low levels of preventive health behaviours during their postpartum period in Singapore.</p></div><div><h3>Methods</h3><p>This paper reports on the qualitative arm of a mixed method study. The qualitative descriptive design was adopted. Individual interviews were conducted between 7th September 2020 and 25th September 2020 using a semi-structured interview guide. Data collected were analysed using thematic analysis.</p></div><div><h3>Results</h3><p>A total of 18 women completed the interview. The participants’ ages ranged from 26 to 40 years with a mean age of 33.17 years (SD= 4.09). The duration since childbirth was 8.78 months (SD = 1.35). Through thematic analysis, five themes were developed: lifestyle adjustment, self-motivation, supportive environment, barriers to practising a healthy lifestyle, and risk perception. A total of 14 subthemes emerged from the five main themes. The beliefs of women with a history of GDM were described according to the Theory of Planned Behaviour.</p></div><div><h3>Conclusions</h3><p>Having a newborn brings changes to the lifestyle of a woman and her family, which can affect the health behaviours in the postpartum period. This study revealed several novel findings relating to the unmet needs of women who had GDM, specifically to the need for information and emotional support to safely resume healthy behaviours after childbirth, for which participants have provided suggestions on how to enhance the continuity of care in the postpartum period.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel grouping of planned coping strategies for managing the intensity of labour: A survey study of Australian nulliparous women 对控制分娩强度的计划应对策略进行新的分组：对澳大利亚无产期妇女的调查研究

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-14 DOI: 10.1016/j.midw.2024.104055

Janine Shifman , Lester E. Jones , Mary-Ann Davey , Christine E. East , Laura Y. Whitburn

Background

It is common for women to explore and plan strategies to cope during labour. These strategies are usually focused on pain control and described as either pharmacological or non-pharmacological. As labour is an individual experience, each woman should be enabled to choose strategies that best suit them, and that reflect what they feel influences their sense of capacity to cope.

Aim

By exploring women's intentions and choices of strategies, this study aimed to understand how coping strategies can better reflect women's individual needs and expectations.

Methods

Fifty-six primiparous women were recruited from one tertiary hospital in Melbourne, Australia between February and May 2021. Data were collected via a survey in late pregnancy using open-ended questions. Content and thematic analyses were used to analyse responses.

Results

Themes related to how women frame the intensity of labour, how they strive for a relationally safe environment and a need to be prepared and knowledgeable. Strategies chosen by women could be grouped into two categories: intrinsic and extrinsic. Intrinsic strategies could be self-generated by women (such as breathing techniques and movement), while extrinsic strategies required either equipment (such as a bath) or others to administer (such as epidural analgesia).

Conclusions

Women value having a range of intrinsic and extrinsic strategies that enable autonomy or require external support. This moves beyond the ‘pharmacological and non-pharmacological’ categorisation of strategies, and we propose that reframing strategies as intrinsic and extrinsic could have a number of benefits on women's sense of autonomy and utilisation of strategies. The findings provide a foundation for more targeted research into how women can be supported to individualise and implement these coping strategies in labour.

背景妇女在分娩过程中通常会探索和计划应对策略。这些策略通常侧重于疼痛控制，并被描述为药物或非药物方法。由于分娩是一种个体经历，每位妇女都应能够选择最适合自己的策略，并反映出她们认为影响其应对能力的因素。本研究旨在通过探讨妇女的意图和策略选择，了解应对策略如何能够更好地反映妇女的个人需求和期望。在妊娠晚期通过开放式问题调查收集数据。结果主题涉及妇女如何确定分娩的强度、如何努力创造一个关系安全的环境，以及需要做好准备和了解相关知识。妇女选择的策略可分为两类：内在策略和外在策略。内在策略可由产妇自己产生（如呼吸技巧和运动），而外在策略则需要设备（如洗澡）或他人实施（如硬膜外镇痛）。这超越了 "药物和非药物 "的策略分类，我们建议将策略重新定义为内在和外在策略，这对妇女的自主感和策略的使用有很多好处。这些发现为更有针对性地研究如何支持妇女在分娩过程中个性化并实施这些应对策略奠定了基础。

{"title":"Novel grouping of planned coping strategies for managing the intensity of labour: A survey study of Australian nulliparous women","authors":"Janine Shifman , Lester E. Jones , Mary-Ann Davey , Christine E. East , Laura Y. Whitburn","doi":"10.1016/j.midw.2024.104055","DOIUrl":"10.1016/j.midw.2024.104055","url":null,"abstract":"<div><h3>Background</h3><p>It is common for women to explore and plan strategies to cope during labour. These strategies are usually focused on pain control and described as either pharmacological or non-pharmacological. As labour is an individual experience, each woman should be enabled to choose strategies that best suit them, and that reflect what they feel influences their sense of capacity to cope.</p></div><div><h3>Aim</h3><p>By exploring women's intentions and choices of strategies, this study aimed to understand how coping strategies can better reflect women's individual needs and expectations.</p></div><div><h3>Methods</h3><p>Fifty-six primiparous women were recruited from one tertiary hospital in Melbourne, Australia between February and May 2021. Data were collected via a survey in late pregnancy using open-ended questions. Content and thematic analyses were used to analyse responses.</p></div><div><h3>Results</h3><p>Themes related to how women frame the intensity of labour, how they strive for a relationally safe environment and a need to be prepared and knowledgeable. Strategies chosen by women could be grouped into two categories: intrinsic and extrinsic. Intrinsic strategies could be self-generated by women (such as breathing techniques and movement), while extrinsic strategies required either equipment (such as a bath) or others to administer (such as epidural analgesia).</p></div><div><h3>Conclusions</h3><p>Women value having a range of intrinsic and extrinsic strategies that enable autonomy or require external support. This moves beyond the ‘pharmacological and non-pharmacological’ categorisation of strategies, and we propose that reframing strategies as intrinsic and extrinsic could have a number of benefits on women's sense of autonomy and utilisation of strategies. The findings provide a foundation for more targeted research into how women can be supported to individualise and implement these coping strategies in labour.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001384/pdfft?md5=6e60792823f4d1faeedb7c4c8ad99219&pid=1-s2.0-S0266613824001384-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396889","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

Validation of the Chinese version of the Whooley questions for community screening of postpartum depression 验证用于社区产后抑郁症筛查的中文版 Whooley 问题

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-14 DOI: 10.1016/j.midw.2024.104054

Xia Wu , Yanping Bai , Xiaoyu Li , Kar Keung Cheng , Wenjie Gong

Background

The study aims to validate the Whooley questions for screening postpartum depression in Chinese women in a community setting.

Methods

The Whooley questions was translated into Chinese following Beaton's intercultural debugging guidelines. From December 1, 2020 to June 30, 2021, primary maternal and child health workers in Kaifu District and Changsha County in Changsha City recruited women aged 18 years or older who had recently given birth during home visits within seven days of discharge from hospital. Participants women completed the Whooley questions online and underwent a diagnostic interview for DSM-IV within 7 days of the visit. We evaluated Cronbach's alpha, split-half reliability, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and optimal cut-off value of the Whooley questions.

Results

Of the 3,004 eligible women, 1,862 completed the Whooley questions and diagnostic interviews. Sixty-two women (3.3%) were diagnosed with depressive disorders. The Cronbach's alpha coefficient was 0.64, the split-half reliability was 0.64. The optimal cut-off value was when at least one questions was answered “yes”, with an AUC of 0.84 (SE=0.03, 95%CI 0.78–0.90, P<0.001), sensitivity of 0.77 (95%CI 0.65–0.87), specificity of 0.89 (95%CI 0.88–0.90), PPV of 0.20 (95%CI 0.15–0.25) and NPV of 0.99 (95%CI 0.98–1.00).

Conclusion

This study shows that the Chinese version of the Whooley questions is a reliable tool for screening postpartum depression in the community, but it may lead to many false positive cases.

背景本研究旨在验证在社区环境中筛查中国妇女产后抑郁的Whouoley问题。方法按照Beaton的跨文化调试指南将Whouoley问题翻译成中文。2020年12月1日至2021年6月30日，长沙市开福区和长沙县的基层妇幼保健人员在出院7天内的家访中招募了18岁及以上的产妇。参与调查的妇女在线填写了胡利问题，并在访问后 7 天内接受了 DSM-IV 诊断访谈。我们评估了Cronbach's alpha、分半信度、ROC曲线下面积（AUC）、灵敏度、特异性、阳性预测值（PPV）、阴性预测值（NPV）以及Wholey问题的最佳临界值。62名妇女（3.3%）被诊断为抑郁障碍。克朗巴赫α系数为0.64，分半信度为0.64。最佳临界值是至少有一个问题回答 "是"，AUC 为 0.84（SE=0.03，95%CI 0.78-0.90，P<0.001），灵敏度为 0.77（95%CI 0.65-0.87），特异性为 0.89（95%CI 0.88-0.90），PPV 为 0.20（95%CI 0.结论本研究表明，中文版Wholey问题是在社区筛查产后抑郁症的可靠工具，但可能会导致许多假阳性病例。

{"title":"Validation of the Chinese version of the Whooley questions for community screening of postpartum depression","authors":"Xia Wu , Yanping Bai , Xiaoyu Li , Kar Keung Cheng , Wenjie Gong","doi":"10.1016/j.midw.2024.104054","DOIUrl":"10.1016/j.midw.2024.104054","url":null,"abstract":"<div><h3>Background</h3><p>The study aims to validate the Whooley questions for screening postpartum depression in Chinese women in a community setting.</p></div><div><h3>Methods</h3><p>The Whooley questions was translated into Chinese following Beaton's intercultural debugging guidelines. From December 1, 2020 to June 30, 2021, primary maternal and child health workers in Kaifu District and Changsha County in Changsha City recruited women aged 18 years or older who had recently given birth during home visits within seven days of discharge from hospital. Participants women completed the Whooley questions online and underwent a diagnostic interview for DSM-IV within 7 days of the visit. We evaluated Cronbach's alpha, split-half reliability, area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and optimal cut-off value of the Whooley questions.</p></div><div><h3>Results</h3><p>Of the 3,004 eligible women, 1,862 completed the Whooley questions and diagnostic interviews. Sixty-two women (3.3%) were diagnosed with depressive disorders. The Cronbach's alpha coefficient was 0.64, the split-half reliability was 0.64. The optimal cut-off value was when at least one questions was answered “yes”, with an AUC of 0.84 (SE=0.03, 95%CI 0.78–0.90, P<0.001), sensitivity of 0.77 (95%CI 0.65–0.87), specificity of 0.89 (95%CI 0.88–0.90), PPV of 0.20 (95%CI 0.15–0.25) and NPV of 0.99 (95%CI 0.98–1.00).</p></div><div><h3>Conclusion</h3><p>This study shows that the Chinese version of the Whooley questions is a reliable tool for screening postpartum depression in the community, but it may lead to many false positive cases.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The reliability and validity of the Postpartum Partner Support Scale among Chinese women 中国妇女产后伴侣支持量表的信度和效度

IF 2.6 3区医学 Q1 Nursing

Midwifery

Pub Date : 2024-06-13 DOI: 10.1016/j.midw.2024.104067

Xiaojuan Su , Huifang Wang , Karen McQueen , Cindy-Lee Dennis , Yuezhen Zhang , Meide Chen , Guihua Liu

Background

The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China.

Aim

To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women.

Methods

The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022.

Results

Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (p < 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth.

Conclusion

The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.

背景伴侣的支持对母婴健康和福祉的益处已得到充分证实。在中国，传统的产后仪式可能会使产妇在分娩过程中缺乏伴侣的支持，她们通常会非常依赖自己的伴侣。目的将产后伴侣支持量表（PPSS）翻译成中文，评估其心理测量学特性，并评估中国女性的产后支持情况。结果可靠度分析表明，Cronbach's α系数为0.97，分半系数为0.93，重测相关系数为0.91（p < 0.01）。项目分析和内容效度结果均在建议范围内，没有项目需要删除。探索性因素分析表明提取了一个共同因素，该因素占累积方差的 74.05%。确认性因子分析得出的 χ2/df 比值为 1.48，RMSEA 值为 0.05。一些人口统计学变量与产后伴侣支持水平明显较低有关，包括母亲和父亲年龄较大、母亲受教育程度较低、家庭收入较高、与婆家关系一般、婴儿性别为女性以及早产等。

{"title":"The reliability and validity of the Postpartum Partner Support Scale among Chinese women","authors":"Xiaojuan Su , Huifang Wang , Karen McQueen , Cindy-Lee Dennis , Yuezhen Zhang , Meide Chen , Guihua Liu","doi":"10.1016/j.midw.2024.104067","DOIUrl":"10.1016/j.midw.2024.104067","url":null,"abstract":"<div><h3>Background</h3><p>The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China.</p></div><div><h3>Aim</h3><p>To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women.</p></div><div><h3>Methods</h3><p>The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022.</p></div><div><h3>Results</h3><p>Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (<em>p</em> < 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth.</p></div><div><h3>Conclusion</h3><p>The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents 助产士学生的增强现实模拟培训及其对处理突发事件的认知、信心和技能的影响

IF 2.6 3区医学 Q1 Nursing

Midwifery

Pub Date : 2024-06-12 DOI: 10.1016/j.midw.2024.104064

Kristina Vogel , Annette Bernloehr , Tabea Willmeroth , Jonas Blattgerste , Claudia Hellmers , Nicola H. Bauer

Problem

Emergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice.

Background

Simulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched.

Aim

To investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations.

Methods

A descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (N = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills.

Results

Students rated their competence significantly better in the post-survey than in the pre-survey (p=<0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence.

Conclusion

The results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.

问题在助产士培训中，产科急诊处理对预防胎儿和产妇发病至关重要。在实践中重复这种处理往往是不可能的。背景模拟培训是对实践学习的补充，可提高实践技能，对学生和患者都有好处。有关产科急诊模拟培训的研究已经证明了这一点，但对数字模拟方法（如增强现实技术（AR））的使用研究不足。目的研究 AR 模拟培训是否会影响助产士学生在紧急情况下对知识、信心和实践技能的主观感受。模拟现实场景的主题为 "准备紧急溶血"、"为剖腹产孕妇做准备 "和 "新生儿复苏"。AR 模拟在助产课程的第四至第五学期进行。为学生（133 人）编制了一份问卷，让他们从知识、信心和实践技能三个方面对自己的能力进行自我评估。结果学生在后调查中对自己能力的评价明显高于前调查（p=<0.05）。模拟对紧急情况下的专业知识、信心和实践技能的自我评估有影响。它增强了学生在复杂情况下的程序性知识和实践技能，补充了学科知识并建立了信心。未来的研究应通过对照组来验证效果，并通过实际考试来衡量能力。

{"title":"Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents","authors":"Kristina Vogel , Annette Bernloehr , Tabea Willmeroth , Jonas Blattgerste , Claudia Hellmers , Nicola H. Bauer","doi":"10.1016/j.midw.2024.104064","DOIUrl":"10.1016/j.midw.2024.104064","url":null,"abstract":"<div><h3>Problem</h3><p>Emergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice.</p></div><div><h3>Background</h3><p>Simulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched.</p></div><div><h3>Aim</h3><p>To investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations.</p></div><div><h3>Methods</h3><p>A descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (<em>N</em> = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills.</p></div><div><h3>Results</h3><p>Students rated their competence significantly better in the post-survey than in the pre-survey (<em>p</em>=<0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence.</p></div><div><h3>Conclusion</h3><p>The results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001475/pdfft?md5=3f561d142af1ef2dbdd0efb43ab20394&pid=1-s2.0-S0266613824001475-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398064","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

Identifying psychosocial vulnerabilities in pregnancy: A mixed-method systematic review of the knowledge base of antenatal conversational psychosocial assessment tools 识别孕期社会心理脆弱性：产前对话式社会心理评估工具知识库的混合方法系统性回顾

IF 2.6 3区医学 Q1 Nursing

Midwifery

Pub Date : 2024-06-12 DOI: 10.1016/j.midw.2024.104066

Pernille Gram , Clara Graugaard Andersen , Kirsten Schultz Petersen , Marianne Stistrup Frederiksen , Louise Lund Holm Thomsen , Charlotte Overgaard

Background

Early identification of psychosocial vulnerability among expectant parents through psychosocial assessment is increasingly recommended within maternity care. For routine antenatal assessment, a strong recognition exists regarding conversational assessment tools. However, the knowledge base of conversational tools is limited, inhibiting their clinical use.

Objective

Synthesising existing knowledge pertaining to antenatal conversational psychosocial assessment tools, including identifying characteristics, acceptability, performance, effectiveness and unintended consequences.

Design

Mixed-method systematic review based on searches in CINAHL, PubMed, Embase, PsycINFO, Cochrane and Scopus. 20 out of 5394 studies were included and synthesised with a convergent integrated approach using a thematic analysis strategy.

Findings

We identified seven antenatal psychosocial assessment tools that partially or completely utilised a conversational approach. Women's acceptability was high, and tools were generally found to support person-centred communication and the parent-health care professional relationship. Evidence regarding effectiveness and performance of conversational tools was limited. Unintended consequences were found, including some women having negative experiences related to assessment of intimate partner violence, lack of preparation and lack of relevance. High acceptability was reported by health care professionals who considered the tools as valuable and enhancing of identification of vulnerability. Unintended consequences, including lack of time and competencies as well as discomfort when assessment is very sensitive, were reported.

Conclusions

Evidence regarding conversational tools' effectiveness and performance is limited. More is known about the acceptability of conversational tools, which is generally highly acceptable among women and health care professionals. Some unintended consequences of the use of included conversational tools were identified.

背景越来越多的产科护理机构建议通过社会心理评估来早期识别准父母的社会心理脆弱性。在常规产前评估中，对话式评估工具得到了广泛认可。目的综合与产前对话式社会心理评估工具相关的现有知识，包括确定其特点、可接受性、性能、有效性和意外后果。设计基于在 CINAHL、PubMed、Embase、PsycINFO、Cochrane 和 Scopus 的检索，采用混合方法进行系统综述。在 5394 项研究中，我们纳入了 20 项研究，并采用主题分析策略对这些研究进行了综合归纳。妇女对这些工具的接受度很高，而且普遍认为这些工具支持以人为本的沟通以及父母与医疗保健专业人员之间的关系。有关对话式工具的有效性和性能的证据有限。研究发现了一些意想不到的后果，包括一些妇女在评估亲密伴侣暴力、缺乏准备和缺乏相关性方面的负面体验。据报道，医护专业人员对对话工具的接受度很高，他们认为对话工具很有价值，能增强对脆弱性的识别。有报告称，会话工具会产生意想不到的后果，包括缺乏时间和能力，以及在评估非常敏感时会产生不适感。人们对对话工具的可接受性了解较多，妇女和医护人员对对话工具的接受程度普遍较高。使用对话工具会产生一些意想不到的后果。

{"title":"Identifying psychosocial vulnerabilities in pregnancy: A mixed-method systematic review of the knowledge base of antenatal conversational psychosocial assessment tools","authors":"Pernille Gram , Clara Graugaard Andersen , Kirsten Schultz Petersen , Marianne Stistrup Frederiksen , Louise Lund Holm Thomsen , Charlotte Overgaard","doi":"10.1016/j.midw.2024.104066","DOIUrl":"10.1016/j.midw.2024.104066","url":null,"abstract":"<div><h3>Background</h3><p>Early identification of psychosocial vulnerability among expectant parents through psychosocial assessment is increasingly recommended within maternity care. For routine antenatal assessment, a strong recognition exists regarding conversational assessment tools. However, the knowledge base of conversational tools is limited, inhibiting their clinical use.</p></div><div><h3>Objective</h3><p>Synthesising existing knowledge pertaining to antenatal conversational psychosocial assessment tools, including identifying characteristics, acceptability, performance, effectiveness and unintended consequences.</p></div><div><h3>Design</h3><p>Mixed-method systematic review based on searches in CINAHL, PubMed, Embase, PsycINFO, Cochrane and Scopus. 20 out of 5394 studies were included and synthesised with a convergent integrated approach using a thematic analysis strategy.</p></div><div><h3>Findings</h3><p>We identified seven antenatal psychosocial assessment tools that partially or completely utilised a conversational approach. Women's acceptability was high, and tools were generally found to support person-centred communication and the parent-health care professional relationship. Evidence regarding effectiveness and performance of conversational tools was limited. Unintended consequences were found, including some women having negative experiences related to assessment of intimate partner violence, lack of preparation and lack of relevance. High acceptability was reported by health care professionals who considered the tools as valuable and enhancing of identification of vulnerability. Unintended consequences, including lack of time and competencies as well as discomfort when assessment is very sensitive, were reported.</p></div><div><h3>Conclusions</h3><p>Evidence regarding conversational tools' effectiveness and performance is limited. More is known about the acceptability of conversational tools, which is generally highly acceptable among women and health care professionals. Some unintended consequences of the use of included conversational tools were identified.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001499/pdfft?md5=80a7e68ece0a7de1f98dbf2c3221dc83&pid=1-s2.0-S0266613824001499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141404631","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