Midwifery最新文献_第10页

Cross-cultural adaptation and validation of the “AprendeLact” questionnaire to Portuguese “AprendeLact”问卷对葡萄牙语的跨文化适应与验证。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-25 DOI: 10.1016/j.midw.2025.104621

Cristian Martín-Vázquez , Agueda Cervera-Gasch , Rosa María Dos Santos Moreira , Marta Arias-Crespo , Cláudia Patricia Da Costa Brás , Cristina Liébana-Presa

Background

Breast milk is the optimal nourishment a mother can provide for her child. Although many mothers aspire to breastfeed, such efforts necessitate support and guidance from qualified healthcare professionals.

Aim

Translation and Cross-Cultural Adaptation of the “AprendeLact” Questionnaire on Breastfeeding Knowledge into Portuguese

Methods

A cross-sectional validation study involving translation, content validity, test-retest reliability, and internal consistency was conducted. Descriptive and bivariate analyses were performed on sociodemographic variables and questionnaire outcomes. Fifty-seven undergraduate nursing and postgraduate maternal and obstetric health students from the Coimbra School of Nursing were randomly selected through cluster sampling.

Findings

The results demonstrated high internal consistency (Kuder–Richardson formula 20 [KR-20] = 0.87) and excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.899). The average score achieved was 12.246 ± 5.23 points. The highest-scoring item was number 6, related to “colostrum,” while the lowest-scoring item was number 5, which assessed the “utility of the e-lactancia website.”

Conclusions

The “AprendeLact” questionnaire was cross-culturally adapted and validated into Portuguese for undergraduate nursing and postgraduate maternal and obstetric health students. Findings revealed limited breastfeeding knowledge among the students, particularly regarding practical aspects. Factors associated with higher levels of knowledge included being female, being in the final years of a bachelor’s degree, participating in clinical placements related to breastfeeding, attending training activities, engaging in breastfeeding support groups, or having been breastfed as a child.

背景：母乳是母亲能为孩子提供的最佳营养。虽然许多母亲渴望母乳喂养，但这种努力需要合格的保健专业人员的支持和指导。目的：“AprendeLact”母乳喂养知识问卷的葡萄牙语翻译与跨文化适应方法：采用横断面验证研究，包括翻译、内容效度、重测信度和内部一致性。对社会人口学变量和问卷结果进行描述性和双变量分析。通过整群抽样随机抽取科英布拉护理学院的57名护理本科和研究生产妇和产科保健专业学生。结果表明：研究结果具有较高的内部一致性（Kuder-Richardson公式20 [KR-20] = 0.87）和良好的重测信度（类内相关系数[ICC] = 0.899）。平均得分为12.246±5.23分。得分最高的是第6项，与“初乳”有关，而得分最低的是第5项，评估的是“e-lactancia网站的实用性”。结论：“AprendeLact”问卷经跨文化改编并验证为葡萄牙语，适用于本科护理专业和研究生孕产妇和产科健康专业的学生。调查结果显示，学生的母乳喂养知识有限，特别是在实践方面。与知识水平较高相关的因素包括：女性、在本科学位的最后几年、参加与母乳喂养有关的临床实习、参加培训活动、参加母乳喂养支持小组或在儿童时期接受过母乳喂养。

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引用次数: 0

International news November 2025 2025年11月国际新闻

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-10-06 DOI: 10.1016/j.midw.2025.104620

引用次数: 0

The role of midwives in shaping postnatal care after perineal trauma: Women's perspectives on midwifery support – A qualitative study 助产士在会阴创伤后塑造产后护理中的作用：妇女对助产支持的看法-一项定性研究

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-05 DOI: 10.1016/j.midw.2025.104590

Beata Gidaszewski , Laura Tan , Jennifer King , Seng Chua , Dharmintra Pasupathy , Mary Steen , Marjan Khajehei

Background

Postnatal care following perineal trauma is crucial, yet many women report unmet physical, emotional, and educational needs during recovery.

Aim

To explore women’s experiences and perceptions of postnatal care after perineal trauma, with a focus on midwifery support.

Design

This qualitative study was part of the Yoni Study, which assessed effectiveness of a perineal pain management guideline.

Methods

The study was conducted in a large tertiary hospital in Australia, and recruited women who sustained perineal trauma after vaginal birth. Participants completed surveys at 24–48 h, 7 days, and 12 weeks postnatal. Free text comments were analysed using reflexive thematic analysis, with a focus on negative comments, revealing 88 coding instances that highlighted unmet needs.

Results

The analysis revealed an overarching theme of unmet needs and expectations, underpinned by five interrelated subthemes: lack of postnatal support and education, overlooked physical recovery needs, emotional isolation, judgment around newborn care, and inconsistent advice. While many women reported positive care experiences, systemic constraints such as early discharge and understaffing limited personalised support, intensifying anxiety and reducing confidence in self-care.

Conclusion

Addressing systemic limitations and enhancing personalised midwifery support are critical for improving postnatal outcomes. Proactive, culturally sensitive education and emotional care are essential to meet the diverse needs of women recovering from perineal trauma.

背景会阴创伤后的产后护理是至关重要的，然而许多妇女报告在恢复过程中未满足身体、情感和教育需求。目的探讨会阴创伤后妇女的产后护理经验和认识，重点是助产支持。本定性研究是Yoni研究的一部分，该研究评估会阴疼痛管理指南的有效性。方法本研究在澳大利亚一家大型三级医院进行，招募阴道分娩后持续会阴创伤的妇女。参与者在出生后24-48小时、7天和12周完成调查。使用反思性主题分析分析了自由文本评论，重点是负面评论，揭示了88个突出未满足需求的编码实例。结果分析揭示了未满足需求和期望的总体主题，以及五个相互关联的子主题：缺乏产后支持和教育，忽视身体恢复需求，情绪孤立，对新生儿护理的判断以及不一致的建议。虽然许多妇女报告了积极的护理经历，但系统限制，如提前出院和人手不足，限制了个性化支持，加剧了焦虑，降低了自我护理的信心。结论解决系统局限性，加强个性化助产支持是改善产后结局的关键。积极主动、文化敏感的教育和情感护理对于满足从会阴创伤中恢复的妇女的各种需求至关重要。

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引用次数: 0

A qualitative analysis of postpartum women’s experiences with urinary incontinence and physical activity 产后女性尿失禁与身体活动的定性分析

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1016/j.midw.2025.104591

Lisa VanWiel , Olivia Butler , Lucas J. Carr , Jessica Gorzelitz , William T. Story , Kara M. Whitaker

Problem

The postpartum period is associated with low physical activity, and increased risk of activity-related adverse health conditions.

Background

Urinary incontinence (UI) is a prevalent postpartum condition associated with low physical activity which protects against many adverse postpartum health conditions. However, little is known about how postpartum women experience UI and physical activity.

Study Aims

Thematically analyse how and why UI is associated with postpartum physical activity.

Methods

A purposive sample of postpartum participants with UI (n=30) were recruited from a larger study. Semi-structured in-depth interviews were conducted to understand postpartum women’s experiences with UI and activity. Interview transcripts were dual-coded using Dedoose qualitative software and thematically analysed using an interpretive phenomenology framework.

Findings

Six themes emerged: 1) Physical activity decreases in the postpartum period; 2) UI is one of many influences on postpartum activity; 3) Postpartum women stop activity, decrease intensity, or use compensatory strategies in response to UI; 4) UI is a threat to women’s identity, mental health, and social health; 5) Women with UI have unmet needs; and 6) Postpartum women with UI want activity interventions designed by qualified health professionals.

Discussion

Postpartum women should be screened for UI and low physical activity. More work is needed to develop interventions within and outside of the healthcare system aimed at addressing UI and low physical activity in the postpartum period.

Conclusions

UI negatively influences physical activity in the postpartum period and impacts postpartum mental health. Interventions are desired to treat UI and improve postpartum physical activity.

产后活动量低，与活动相关的不良健康状况的风险增加有关。尿失禁（UI）是一种常见的产后疾病，与低体力活动有关，可以预防许多不良的产后健康状况。然而，人们对产后女性如何经历尿失速和体育活动知之甚少。研究目的：从主题上分析尿失速与产后身体活动的关系。方法从一项更大的研究中招募了30名产后尿失尿患者。通过半结构化的深度访谈，了解产后女性的UI和活动经历。访谈记录使用Dedoose定性软件进行双重编码，并使用解释现象学框架进行主题分析。研究发现：1)产后体力活动减少；2) UI是影响产后活动的众多因素之一；3)产后妇女停止活动、降低强度或采取代偿策略应对尿失禁；4) UI是对女性身份、心理健康和社会健康的威胁；5)患尿失禁的妇女需求未得到满足；产后尿失尿妇女需要由合格的卫生专业人员设计的活动干预措施。产后妇女应筛查尿失禁和低体力活动。更多的工作需要在医疗保健系统内外制定干预措施，旨在解决产后UI和低体力活动。结论sui对产后体力活动产生负面影响，并影响产后心理健康。干预措施是需要治疗尿失禁和改善产后身体活动。

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引用次数: 0

Sustaining continuity of carer in practice: a service evaluation of a local maternity system in Northwest England 在实践中维持护理人员的连续性：对英格兰西北部地方产妇系统的服务评估。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-08 DOI: 10.1016/j.midw.2025.104603

Anna Byrom , Gill Thomson , Naseerah Akooji , Claire Feeley

Where midwifery is integrated fully into health systems, evidence demonstrates that relational, midwifery-led continuity of carer (MCoC) improves biopsychosocial outcomes for birthing women, people and babies. MCoC is where one or a small team of midwives are the lead carer throughout the childbearing continuum regardless of place of birth, pre-existing or emerging risk factors; working with multidisciplinary professionals if required. In England, wide-scale system changes and implementation were underway to scale up MCoC. However, this was halted due to multiple complexities following the pandemic and ongoing staffing issues. Our mixed method study carried out in 2021 was an external research evaluation across a region of four NHS sites who were at different stages of MCoC implementation. Here we report qualitative insights capturing the successes and challenges in four different contexts to help guide the reintroduction of MCoC services. Recruitment was conducted via stakeholder events and social media; included 123 survey participants (68 providing qualitative data) and 28 interview participants. Thematic analysis was carried out with a global thematic network approach to interpret the data. One global theme of ‘Making it Work: Sustaining MCoC’ was developed comprising of four organising themes - ‘making a difference’, ‘making a start’, ‘making it count’, and ‘making it fit’. Collectively, these findings highlight what works well for staff, families, and the service, alongside MCoC challenges and how to overcome them. These findings offer practical insights to support successful implementation - ‘making it work: future transformations’ – critical to the ongoing sustainability of a service wide transformation.

在助产充分纳入卫生系统的地方，有证据表明，由助产主导的关系性照护连续性（MCoC）可改善分娩妇女、人和婴儿的生物、心理和社会结果。产妇监护是指一个或一个小的助产士团队在整个生育过程中担任主要护理人员，而不管出生地点、已有或新出现的风险因素如何；如有需要，可与多学科专业人员合作。在英国，大规模的系统变革和实施正在进行，以扩大MCoC的规模。然而，由于大流行后的多重复杂性和持续的人员配置问题，这一工作暂停了。我们在2021年进行的混合方法研究是对处于MCoC实施不同阶段的四个NHS站点区域的外部研究评估。在这里，我们报告定性的见解，抓住在四种不同环境中的成功和挑战，以帮助指导重新引入MCoC服务。通过利益相关者活动和社交媒体进行招聘；包括123名调查参与者（68名提供定性数据）和28名访谈参与者。专题分析采用全球专题网络方法来解释数据。其中一个全球主题是“让它发挥作用：保持MCoC”，包括四个组织主题：“做出改变”、“开始”、“让它有意义”和“让它合适”。总的来说，这些发现突出了对工作人员、家庭和服务有效的方法，以及mcc面临的挑战以及如何克服这些挑战。这些发现为支持成功实施提供了实际的见解——“使其有效：未来的转型”——这对服务范围转型的持续可持续性至关重要。

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引用次数: 0

Investigation of the validity and reliability of the Turkish version of the Comprehensive Breastfeeding Knowledge Scale 土耳其语版母乳喂养综合知识量表的效度和信度调查。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-26 DOI: 10.1016/j.midw.2025.104624

Merve Yazar Renkyorgancı , Emel Ege , Emine Geçkil , Jennifer Abbass-Dick , Cindy-Lee Dennis

Objective

This study was conducted to test the validity and reliability of the Turkish version of the Comprehensive Breastfeeding Knowledge Scale.

Method

This methodological study was carried out between July 1, 2023, and May 1, 2024, in the Department of Obstetrics and Gynecology at a university hospital. Approvals were obtained from the original scale author, the ethics committee, the institution where data were collected, and the participants. The study sample comprised 350 participants, including 200 primiparous pregnant women and 150 postpartum women. For validity, the Content Validity Ratio (CVR) and Content Validity Index (CVI) were used to assess language and content validity, and Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to evaluate construct validity. For reliability, item analyses were conducted, and the Intraclass Correlation Coefficient (ICC) and Paired t-Test were used to determine test-retest reliability, while Cronbach’s alpha coefficient was employed to assess internal consistency.

Results

Of the women who participated in the study, 57.1 % were pregnant and 42.9 % were in the postpartum period. Among the participants, 39.7 % were between the ages of 18 and 25, 38.9 % were high school graduates, and 51.4 % had received breastfeeding education. EFA results revealed that the scale maintained a three-factor structure consistent with the original scale, the items were distributed across the factors in a similar manner, factor loadings ranged from 0.50 to 0.65, and the explained variance was 37.3 %. The CFA results indicated excellent model fit with a chi-square/df ratio of 1.912, and good fit indices, including GFI (0.904), RMSEA (0.051), and CFI (0.894).

Conclusion

The findings of this study demonstrate that the Turkish version of the Comprehensive Breastfeeding Knowledge Scale is a valid and reliable measurement tool for assessing breastfeeding knowledge among primiparous pregnant and postpartum women. The scale can be utilized in descriptive studies evaluating breastfeeding knowledge and in experimental studies aimed at improving breastfeeding knowledge, as a pre-test and post-test assessment tool.

目的：本研究对土耳其版母乳喂养综合知识量表的效度和信度进行检验。方法：本方法学研究于2023年7月1日至2024年5月1日在某大学附属医院妇产科进行。获得原始量表作者、伦理委员会、数据收集机构和参与者的批准。研究样本包括350名参与者，其中包括200名初产妇和150名产后妇女。效度方面，采用内容效度比（CVR）和内容效度指数（CVI）评估语言和内容效度，采用探索性因子分析（EFA）和验证性因子分析（CFA）评估构念效度。信度采用项目分析，采用类内相关系数（Intraclass Correlation Coefficient， ICC）和配对t检验确定重测信度，采用Cronbach’s alpha系数评估内部一致性。结果：参与研究的妇女中，57.1%为孕妇，42.9%为产后。在参与者中，39.7%的人年龄在18 - 25岁之间，38.9%的人高中毕业，51.4%的人接受过母乳喂养教育。结果表明，该量表与原量表保持一致的三因子结构，各因子之间的分布基本一致，因子负荷范围为0.50 ~ 0.65，解释方差为37.3%。CFA结果表明，模型拟合良好，卡方/df比为1.912，拟合指数良好，包括GFI（0.904）、RMSEA（0.051）和CFI（0.894）。结论：本研究结果表明，土耳其版母乳喂养综合知识量表是评估初产妇和产后妇女母乳喂养知识的有效和可靠的测量工具。该量表可用于评价母乳喂养知识的描述性研究和旨在提高母乳喂养知识的实验性研究，作为测试前和测试后的评估工具。

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引用次数: 0

Corrigendum to “Witnessing a loss and the lived experiences of physicians, nurses, and midwives providing care in perinatal loss in Turkey: A phenomenological study” [Midwifery 149 (2025) 104577] “目睹损失和医生，护士和助产士在土耳其围产期损失提供护理的生活经验：现象学研究”的勘误表[助产士149(2025)104577]。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-15 DOI: 10.1016/j.midw.2025.104599

Gül Büşra Altunay , Merve Yazar Renkyorgancı , Emel Ege , Şerife Didem Kaya

引用次数: 0

Postnatal bedsharing advice, risk and exploitation: a feminist analysis 产后同床建议、风险和剥削：女权主义分析

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-16 DOI: 10.1016/j.midw.2025.104612

Anna Melamed

Problem

Breastfeeding is beneficial to babies and mothers. Postnatal bedsharing is evidenced to support breastfeeding and maternal wellbeing. Advice against bedsharing creates a barrier to breastfeeding. It also frames women as an inherent risk to their baby, something statistically untrue in the absence of known risk factors. Women are advised to both breastfeed, and to not bedshare, which sets up a contradiction. Telling mothers they are simultaneously a risk to, and a resource for, the baby, can lead to exhaustion, shame, confusion and difficulties breastfeeding.

Discussion

To investigate this seeming contradiction in UK breastfeeding and bedsharing advice I examine the risk discourse and Douglas’ conception of risk and pollution. To explain why women’s bodies are a site of contestation, and why some risks (overlaying) are amplified over others (lower breastfeeding rates or maternal exhaustion) I use radical materialist feminism. I argue that risk discourses and taboos around bedsharing are part of a patriarchal ontology of the sovereign individual which denies the intrinsic interdependence and relationality. Denying the centrality of the mother-baby dyad as a relation is part of the mechanism of exploitation of women. The bedsharing advice reduces the woman’s subjectivity and agency, which is to the detriment of mothers and babies because their wellbeing is interdependent.

Conclusion

The prevalence of bedsharing advice is explained by an ontology in which individuals are imagined as a risk and/or a resource to one another. The driving force is not the wellbeing and support of the dyad, but exploitation of women and re-enforcement of patriarchal logic. Women-centred feminist postnatal advice would better support the dyad.

Tweetable abstract

Advice against postnatal bedsharing positions women as a risk and resource, to the detriment of the mother-baby dyad and breastfeeding, and in service of patriarchal exploitation of women as a resource.

母乳喂养对婴儿和母亲都有益。事实证明，产后同床共枕有助于母乳喂养和孕产妇健康。反对同床共枕的建议会阻碍母乳喂养。它还将女性定义为婴儿的内在风险，在缺乏已知风险因素的情况下，这在统计上是不正确的。建议女性既要母乳喂养，又不要同床，这就形成了矛盾。告诉母亲，她们既是婴儿的风险，也是婴儿的资源，可能会导致精疲力竭、羞耻、困惑和母乳喂养困难。为了调查英国母乳喂养和同床建议之间的矛盾，我研究了风险话语和道格拉斯关于风险和污染的概念。为了解释为什么女性的身体是争论的焦点，以及为什么一些风险（叠加）比其他风险（低母乳喂养率或母亲疲惫）被放大，我使用了激进的唯物主义女权主义。我认为，关于共床的风险话语和禁忌是主权个人的父权本体论的一部分，它否认了内在的相互依存和关系。否认母子关系的中心地位是剥削妇女机制的一部分。同床共枕的建议降低了女性的主观性和能动性，这对母亲和婴儿都是有害的，因为她们的幸福是相互依存的。结论共用床建议的流行可以用一种本体论来解释，在这种本体论中，个体被想象成彼此的风险和/或资源。其驱动力并不是对两分制的幸福和支持，而是对女性的剥削和父权逻辑的重新实施。以女性为中心的女权主义产后建议会更好地支持两分制。反对产后同床共枕的建议将女性视为一种风险和资源，不利于母婴和母乳喂养，并为父权制对女性的剥削服务。

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引用次数: 0

Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy 睡眠、体力活动和妊娠症状：与妊娠早期认知表现相关的因素

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-08-28 DOI: 10.1016/j.midw.2025.104585

Virginia R. Nuckols , Kristen G. Davis , Gary L. Pierce , Karin F Hoth , Mark K Santillan , Bethany Barone Gibbs , Kara M. Whitaker

Background

Women often report disruptions in cognitive performance during pregnancy. Though substantiated by objective assessments, findings have been inconsistent and potential contributing factors are not well understood.

Aim

The objective of this study was to examine the cross-sectional associations between maternal mood, stress, pregnancy-related symptoms and device measured 24-hour activity behaviors with cognitive performance in the first trimester of pregnancy.

Methods

Pregnant women (N=90) were assessed in the first trimester. Non-pregnant controls (N=73) were assessed 1-5 years after pregnancy. Depressive symptoms, (Center for Epidemiological Studies Depression Scale), stress (Perceived Stress Scale), and pregnancy-specific health related quality of life (Nausea and Vomiting during Pregnancy Health-Related Quality of Life) were evaluated using validated questionnaires, and 24-hour activity measured via actigraphy (activPAL, Actiwatch Spectrum Plus). Cognitive performance was evaluated using tests of memory, processing speed, and executive function.

Findings

Pregnant women performed lower on memory tests compared with non-pregnant women. Neither depressive symptoms nor stress were associated with lower cognitive performance in pregnancy. Physical symptoms of pregnancy (e.g., nausea, vomiting) were related to lower memory scores (β=0.32, P=0.02). Longer sleep duration was associated with better executive function performance (β=1.4, P=0.03).

Conclusion

This study demonstrates lower memory performance in the first trimester of pregnancy compared with non-pregnant controls and indicates that pregnancy symptoms and shorter sleep duration may be contributing factors.

女性经常报告在怀孕期间认知能力受到干扰。尽管客观评估证实了这一点，但调查结果并不一致，潜在的影响因素也没有得到很好的理解。目的本研究的目的是检查孕妇情绪、压力、妊娠相关症状和设备测量的24小时活动行为与妊娠前三个月认知表现之间的横断面关联。方法对90例妊娠早期妊娠妇女进行评估。未怀孕对照组（N=73）在怀孕后1-5年进行评估。使用有效问卷评估抑郁症状（流行病学研究中心抑郁量表）、压力（感知压力量表）和妊娠特定健康相关的生活质量（妊娠与健康相关的生活质量期间恶心和呕吐），并通过活动记录仪（activPAL, Actiwatch Spectrum Plus）测量24小时活动。通过记忆力、处理速度和执行功能测试来评估认知能力。研究发现：与非孕妇相比，孕妇在记忆力测试中的表现较差。怀孕期间的抑郁症状和压力与认知能力下降无关。怀孕的身体症状（如恶心、呕吐）与较低的记忆评分有关（β=0.32， P=0.02）。较长的睡眠时间与较好的执行功能表现相关（β=1.4， P=0.03）。结论本研究表明，与未怀孕的对照组相比，怀孕前三个月的记忆表现较差，并表明怀孕症状和较短的睡眠时间可能是其影响因素。

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引用次数: 0

Response to comments on Paz et al. (2025) midwifery theories: A scoping review 对Paz等人（2025）助产理论的评论的回应：范围审查

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1016/j.midw.2025.104589

Sara D.C. Paz , Andreia S. Goncalves , Filipa Sampaio , Ana Paula Prata

引用次数: 0