Midwifery最新文献_第5页

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2026-01-01

引用次数: 0

Association between previous perinatal death and subsequent pregnancy outcomes in Low-and Middle-Income Countries: A systematic review and meta-analysis 中低收入国家先前围产期死亡与随后妊娠结局之间的关系：一项系统回顾和荟萃分析

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-23 DOI: 10.1016/j.midw.2025.104696

Bekalu Getnet Kassa , Yvonne Karen Parry , Molla Mesele Wassie , Lauren Elizabeth Lines

Background

Perinatal death is a significant public health concern affecting millions of women globally. It is a crucial indicator for evaluating the health status of a woman. There is limited evidence on how prior perinatal death influences subsequent pregnancy outcomes.

Aim

This systematic review examines the association between perinatal death and subsequent adverse pregnancy outcomes among women in Low-and Middle-Income Countries.

Methods

This study followed PRISMA guidelines, and a systematic search was conducted using eight databases (Scopus, Emcare, Medline, Cochrane Library, ProQuest for dissertations, CINAHL, Web of Science, and PsycINFO) from inception to 2nd May 2024. Data were extracted using the standard Joanna Briggs Institute tool for observational studies, assessed for quality using the GRADE criteria, and analysed using STATA 18 statistical software. A random-effect model was used to pool the estimates of the association between perinatal death and subsequent adverse outcomes.

Findings

A total of 3674 articles were screened, and fifty full-text manuscripts were included in the systematic review and meta-analysis. The finding showed that the rate of perinatal loss among women who had a history of perinatal death was 29.7 deaths per 1000 births. The risk of preterm birth, low birth weight, preeclampsia, perinatal death, stillbirth, miscarriage, and early neonatal death were increased after perinatal death.

Conclusions

A significant number of women in LMICs are suffering due to perinatal death. Similarly, this review demonstrated that women with a history of perinatal death face an increased risk of adverse pregnancy outcomes. Thus, these findings are vital for healthcare professionals to offer effective counselling, monitoring, support, and interventions for women with such a history. Moreover, informing relevant stakeholders is essential for designing and implementing appropriate care strategies.

Review registration

CRD42024541357

围产期死亡是影响全球数百万妇女的重大公共卫生问题。这是评价妇女健康状况的一个重要指标。关于先前围产期死亡如何影响随后的妊娠结局的证据有限。目的：本系统综述探讨了中低收入国家妇女围产期死亡与随后不良妊娠结局之间的关系。方法本研究遵循PRISMA指南，从研究开始至2024年5月2日，系统检索了8个数据库（Scopus、Emcare、Medline、Cochrane Library、ProQuest for thesis、CINAHL、Web of Science和PsycINFO）。使用观察性研究的标准Joanna Briggs Institute工具提取数据，使用GRADE标准评估质量，并使用STATA 18统计软件进行分析。随机效应模型用于汇总围产期死亡与随后不良后果之间的关联估计。结果共筛选了3674篇文章，50篇全文稿件被纳入系统评价和meta分析。调查结果显示，有围产期死亡史的妇女的围产期死亡率为每1000例分娩29.7例死亡。早产、低出生体重、先兆子痫、围产期死亡、死产、流产和早期新生儿死亡的风险在围产期死亡后增加。结论中低收入国家妇女围产期死亡比例较高。同样，这篇综述表明，有围产期死亡史的妇女面临不良妊娠结局的风险增加。因此，这些发现对于医疗保健专业人员为有此类病史的妇女提供有效的咨询、监测、支持和干预至关重要。此外，告知相关利益攸关方对于设计和实施适当的护理战略至关重要。回顾registrationCRD42024541357

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引用次数: 0

International News February 2026 2026年2月国际新闻

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-23 DOI: 10.1016/j.midw.2025.104694

Elizabeth Duff (International News Editor)

引用次数: 0

Shared decision-making ability among women with postpartum urinary incontinence: A mixed-methods study to inform midwifery practice 产后尿失禁妇女的共同决策能力：一项为助产实践提供信息的混合方法研究。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-17 DOI: 10.1016/j.midw.2025.104693

Jie Li , Yingying Zhang , Wenjun Tang , Shurong Huang , Quanlei Li , Wenzhi Cai

Problem

Pelvic floor physical therapy (PFPT) is the first-line treatment for postpartum urinary incontinence (PPUI), but barriers such as limited access and low engagement in decision-making reduce adherence.

Background

Shared decision-making empowers women to participate in care and improve adherence. Variations in shared decision-making ability may limit engagement.

Aim

To measure shared decision-making ability regarding PFPT and identify its influencing factors among women with PPUI through a quantitative phase, and derive midwifery support strategies based on qualitative insights.

Methods

This mixed-methods study collected quantitative and qualitative data to explore shared decision-making among women with PPUI using the Capability, Opportunity, Motivation-Behavior model. Surveys on illness perception, e-health literacy, social support, decision self-efficacy, and shared decision-making ability were completed by 528 participants. Structural equation modeling and bootstrapped mediation analyses were performed. Fourteen participants were then interviewed about their PFPT decision-making experiences.

Findings

Participants had moderate shared decision-making ability. Illness perception, e-health literacy, social support, and decision self-efficacy were positively associated with shared decision-making ability. Decision self-efficacy partially mediated these relationships: illness perception, e-health literacy, and perceived social support. Qualitative findings revealed diverse decision-making models, from shared to midwife-led approaches, and suggested strategies to enhance shared decision-making.

Discussion

Shared decision-making ability is associated with interrelated psychosocial and behavioral factors. Enhancing illness perception, e-health literacy, social support, and decision self-efficacy may be related to greater engagement of women in PFPT decisions.

Conclusion

Midwives can foster shared decision-making through tailored education, resource facilitation, family engagement, and confidence-building, potentially improving PFPT participation and outcomes.

问题：盆底物理治疗（PFPT）是产后尿失禁（PPUI）的一线治疗方法，但准入有限和决策参与度低等障碍降低了依从性。背景：共同决策使妇女能够参与护理并提高依从性。共同决策能力的差异可能会限制参与。目的：通过定量阶段测量妊高征妇女对妊高征的共同决策能力，确定其影响因素，并基于定性分析得出助产支持策略。方法：本研究采用能力、机会、动机-行为模型，收集定量和定性数据，探讨PPUI女性的共同决策。528名参与者完成了疾病感知、电子卫生素养、社会支持、决策自我效能和共同决策能力的调查。进行了结构方程建模和自举中介分析。然后对14名参与者进行了PFPT决策经验的访谈。研究结果：参与者具有中等程度的共同决策能力。疾病感知、电子健康素养、社会支持和决策自我效能感与共同决策能力呈正相关。决策自我效能感部分介导了这些关系：疾病感知、电子健康素养和感知的社会支持。定性研究结果揭示了不同的决策模式，从共享到助产士主导的方法，并提出了加强共享决策的策略。讨论：共同决策能力与相关的社会心理和行为因素有关。提高疾病认知、电子卫生知识、社会支持和决策自我效能感可能与妇女更多地参与PFPT决策有关。结论：助产士可以通过量身定制的教育、资源便利、家庭参与和建立信任来促进共同决策，从而潜在地改善PFPT的参与和结果。

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引用次数: 0

Barriers and facilitators to pelvic floor muscle exercises among postpartum women: A meta-synthesis based on the capability, opportunity, motivation, and behavior (COM-B) model 产后妇女盆底肌锻炼的障碍和促进因素：基于能力、机会、动机和行为（COM-B）模型的综合研究

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-17 DOI: 10.1016/j.midw.2025.104695

Zhouli Gui , Yingni Liang , Yiqin Huang , Qingyan Gu , Qian Li , Xixian Li , Ruotong Liu , Li OuYang , Hongwu Liao

Background

While pelvic floor muscle exercises (PFME) are recognized for preventing and treating pelvic floor dysfunction, optimal clinical implementation models remain unclear, and factors influencing postpartum adherence are incompletely understood.

Objective

This systematic review evaluated barriers and enablers to PFME adherence from the perspective of postpartum women, to inform behavioural change strategies.

Methods

Nine databases (CINAHL, PubMed, Web of Science, Embase, Cochrane Library, SinoMed, CNKI, Wanfang, VIP) were searched from inception to July 1, 2025. Eligible studies included qualitative and mixed-methods designs reporting qualitatively extractable data on barriers/enablers to postpartum PFME. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment Criteria. Thematic analysis mapped findings to the Capability, Opportunity, Motivation–Behaviour (COM-B) model.

Results

After screening 968 abstracts and 134 full texts, 9 studies were included (8 qualitative studies and 1 mixed-methods study). The research identified barriers and facilitators related to the following domains:physical capacity (e.g.pre-pregnancy exercise foundation and childbirth trauma and pain), psychological capacity (e.g.lack of knowledge about pelvic floor health, intergenerational misperceptions, and sexual stigma hindering communication), physical opportunity (e.g.time constraints, and digital tool empowerment), social opportunities (e.g.quality of healthcare services and family support networks), reflective motivation (e.g.risk perception-driven, immediate feedback reinforcement, uncertainty about exercise effectiveness), and automatic motivation (e.g.convenience of exercise behaviour, boredom during the process, body image needs, and external care and encouragement).

Conclusion

The study findings identified key factors influencing postpartum women's engagement in pelvic floor muscle exercises and proposed several intervention strategies. Given the paucity of existing qualitative studies on this topic, additional research is warranted to further elucidate the complex, interacting factors that affect postpartum women's adherence to pelvic floor muscle training regimens.

背景：虽然盆底肌运动（PFME）被认为可以预防和治疗盆底功能障碍，但最佳的临床实施模式尚不清楚，影响产后依从性的因素也不完全清楚。目的：本系统综述从产后妇女的角度评估PFME依从性的障碍和促进因素，为行为改变策略提供信息。方法：检索从建库至2025年7月1日的9个数据库（CINAHL、PubMed、Web of Science、Embase、Cochrane Library、SinoMed、CNKI、万方、VIP）。合格的研究包括定性和混合方法设计，报告了产后PFME障碍/促进因素的定性可提取数据。研究质量采用乔安娜布里格斯研究所定性评估标准进行评估。专题分析将结果映射到能力，机会，动机-行为（COM-B）模型。结果：筛选968篇摘要和134篇全文后，纳入9项研究（8项定性研究和1项混合方法研究）。研究确定了与以下领域相关的障碍和促进因素：身体能力（如孕前锻炼基础和分娩创伤和疼痛）、心理能力（如缺乏对盆底健康的了解、代际误解和阻碍沟通的性耻辱）、身体机会（如时间限制和数字工具授权）、社会机会（如医疗服务质量和家庭支持网络）、反思动机（如风险感知驱动、即时反馈强化、运动效果的不确定性）和自动动机（如运动行为的便利性、过程中的无聊感、身体形象需求、外部关怀和鼓励）。结论：本研究发现了影响产后妇女参与盆底肌运动的关键因素，并提出了一些干预策略。鉴于现有关于这一主题的定性研究的缺乏，需要进一步的研究来进一步阐明影响产后妇女坚持盆底肌肉训练方案的复杂的、相互作用的因素。

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引用次数: 0

Women’s experiences of pain relief and easing intensity through vocalisations during childbirth: A qualitative study 妇女在分娩过程中通过发声缓解疼痛和缓解强度的经验：一项定性研究。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-11 DOI: 10.1016/j.midw.2025.104690

Laura A. Zinsser , Eva Marie Engebakken Flaathen

Background

Childbirth pain is an individual and diverse experience; it differs from other pain as it is productive and purposeful. Some women do like to give birth without pharmacological pain relief. These women use diverse coping strategies and tools. One tool is vocalisations like vocal-toning, to master childbirth.

Aim

To explore, explain and interpret women’s experience with vocalisations to master the intensity and pain during childbirth.

Methods

In-depth interviews were conducted with 18 women postpartum. These women had a physiological birth free from pharmacological pain relief and vocalised. Braun and Clarke’s Reflexive Thematic Analysis was used to analyse the data.

Results

Four themes emerged: ‘Changing the pain experience through sound’, outlines the ease of pain during vocal-toning. ‘Balancing internal birthing intensity by using sound’, describes the experienced relief of internal pressure and intensity through vocalisations. ‘Experiencing tricky moments while vocal-toning’, provides detailed insights in moments when the pain can rise, by taking a breath or losing the ‘right’ tone. ‘Mastering the childbirth process with sound as an essential element: "the number one means of coping with pain"’ portrays the experienced meaningfulness of sound work for childbirth.

Conclusion

Vocalisations eased the intensity and pain or made it more bearable for the participants. It were combined with other coping strategies and tools, but vocalisations were essential for nearly all participants to master childbirth. Midwives and other birth companions can support women in finding the ‘right’ tone through joined vocal-toning, indicating a deeper sound.

背景：分娩疼痛是一种个体的、多样的经历；它不同于其他痛苦，因为它是富有成效的和有目的的。有些妇女确实喜欢在没有药物止痛的情况下分娩。这些女性使用不同的应对策略和工具。一种工具是发声，比如音调，来掌握分娩。目的：探讨、解释和解读女性在分娩过程中通过发声来掌握分娩的强度和疼痛。方法：对18名产后妇女进行深度访谈。这些妇女有一个生理分娩，没有药物疼痛缓解和发声。使用Braun和Clarke的反身性主位分析来分析数据。结果：出现了四个主题：“通过声音改变疼痛体验”，概述了在发声过程中疼痛的缓解程度。“通过声音来平衡内部分娩强度”，描述了通过发声来缓解内部压力和强度。“体验调音时的棘手时刻”，在疼痛加剧的时刻，通过呼吸或失去“正确”的音调，提供了详细的见解。“以声音为基本要素掌握分娩过程：“应对疼痛的第一手段””描绘了声音工作对分娩的体验意义。结论：发声减轻了强度和疼痛或使参与者更容易忍受。它与其他应对策略和工具相结合，但发声对几乎所有参与者掌握分娩至关重要。助产士和其他产伴可以帮助女性找到“正确”的音调，通过联合发声音调，表明声音更低沉。

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引用次数: 0

Distinct dyadic coping patterns in couples managing gestational diabetes mellitus: a latent profile analysis 不同的二元应对模式的夫妇管理妊娠糖尿病：一个潜在的概况分析。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-11 DOI: 10.1016/j.midw.2025.104692

Qian Xu , Rong-rong Han , Lei Zeng , Ke Sun , Pei-pei Luo , Juan-juan Zhao , Ling-ling Gao

Problem

No studies have identified dyadic coping patterns in couples managing gestational diabetes mellitus (GDM).

Background

While male partners are often involved in GDM management, their involvement exerts mixed effects.

Aim

This study aims to (1) identify dyadic coping patterns among GDM couples, (2) compare self-management behaviors among identified patterns, and (3) examine potential predictors associated with each pattern.

Methods

A cross-sectional study was conducted in Guangzhou, China, from September 2024 to January 2025. 200 GDM couples completed the Chinese version of the Couple Collaborative Management Scale and the GDM Knowledge Questionnaire. Pregnant women also completed the GDM Self-management Behavior Scale. Latent profile analysis was employed to identify subgroups of dyadic coping.

Findings

Three latent patterns emerged: Class 1 (low-positive/low-negative group; 20.0%), Class 2 (high-positive/high-negative group; 12.0%), and Class 3 (high-positive/low-negative group; 68.0%). Significant differences in self-management behaviors were observed across classes. History of adverse obstetric outcomes, paternal GDM knowledge, and maternal dyadic appraisal were significant predictors of class membership.

Discussion

The findings provide healthcare professionals with a deeper understanding of couple interactions in GDM management and how these interactions function within this context.

Conclusion

Approximately one-third of couples exhibited suboptimal dyadic coping patterns. To optimize GDM management, healthcare professionals are recommended to routinely screen couples for maladaptive patterns and implement tailored dyadic interventions to facilitate more functional couple interactions.

问题：目前还没有研究确定妊娠期糖尿病（GDM）夫妻的二元应对模式。背景：虽然男性伴侣经常参与GDM的管理，但他们的参与产生了混合效应。目的：本研究旨在(1)识别GDM夫妇的二元应对模式，(2)比较识别模式之间的自我管理行为，(3)研究每种模式相关的潜在预测因素。方法：于2024年9月至2025年1月在中国广州进行横断面研究。200对GDM夫妻完成了中文版的《夫妻协同管理量表》和《GDM知识问卷》。孕妇还完成了GDM自我管理行为量表。潜在剖面分析用于识别二元应对的亚群。结果：出现了3种潜在模式：1类（低阳性/低阴性组；20.0%）、2类（高阳性/高阴性组；12.0%）和3类（高阳性/低阴性组；68.0%）。不同班级的自我管理行为存在显著差异。不良产科结局史、父亲GDM知识和母亲二元评价是班级成员的重要预测因素。讨论：研究结果使医疗保健专业人员更深入地了解GDM管理中的夫妻相互作用以及这些相互作用在这种情况下如何发挥作用。结论：约三分之一的夫妻表现出次优的二元应对模式。为了优化GDM管理，建议医疗保健专业人员定期筛查夫妻的不适应模式，并实施量身定制的二元干预措施，以促进更有效的夫妻互动。

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引用次数: 0

Maternal and neonatal waterbirth outcomes in a Brazilian freestanding birth centre: a cross-sectional study 巴西独立分娩中心的产妇和新生儿水分娩结局：一项横断面研究

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-09 DOI: 10.1016/j.midw.2025.104691

Pamela Vicente Nakazone , Nathalie Leister , Thaís Trevisan Teixeira , Carla Marins Silva , Christine McCourt , Maria Luiza Gonzalez Riesco

Problem and Background: While international studies support the safety and benefits of waterbirth, this practice is still restricted in many Brazilian services, with few opportunities for birthing people to choose this option for labour and birth. Aim: To analyse maternal and neonatal outcomes in assisted waterbirths versus land births in a Brazilian freestanding birth centre. Methods: We conducted a cross-sectional study using retrospective data from 2012 to 2024. Maternal and neonatal outcomes of 919 waterbirths were compared to 2,805 land births, including perineal tear and repair, postpartum haemorrhage, retained placenta, maternal and neonatal transfers, neonatal resuscitation, and Apgar scores. Odds ratios (OR), rate ratios (RR) and adjusted odds ratios (aOR) were calculated, and multivariate analysis considered previous vaginal birth as a confounder variable. The significance level was 5 %. Findings: Waterbirth was associated with a lower likelihood of perineal tear (aOR, 0.75; 95 % CI, 0.65-0.87; P < .001), perineal repair (OR, 0.73; 95 % CI, 0.62-0.86; P < .001) and postpartum haemorrhage (aOR, 0.76; 95 % CI, 0.64-0.90; P < .002). Discussion: The findings align with international evidence that associates waterbirth with reduced perineal trauma and postpartum haemorrhage. Unlike some studies that suggest increased neonatal risks, no adverse outcomes were observed in this study. Conclusion: Waterbirth was not associated with any additional risk to people with straightforward pregnancies. The results support the option of waterbirth as an informed choice for this population birthing in freestanding birth centres.

问题和背景：虽然国际研究支持水中分娩的安全性和益处，但这种做法在巴西的许多服务中仍然受到限制，产妇很少有机会选择这种分娩和分娩方式。目的：分析巴西独立分娩中心辅助水中分娩与陆地分娩的孕产妇和新生儿结局。方法：采用2012 - 2024年的回顾性数据进行横断面研究。将919例水中分娩的产妇和新生儿结局与2805例陆地分娩的产妇和新生儿结局进行比较，包括会阴撕裂和修复、产后出血、胎盘残留、产妇和新生儿转移、新生儿复苏和Apgar评分。计算优势比（OR）、比率比（RR）和调整优势比（aOR），多因素分析将既往阴道分娩作为混杂变量。显著性水平为5%。结果：水中分娩与会阴撕裂（aOR, 0.75; 95% CI, 0.65-0.87; P < 0.001）、会阴修复（OR, 0.73; 95% CI, 0.62-0.86; P < 0.001）和产后出血（aOR, 0.76; 95% CI, 0.64-0.90; P < 002）的可能性较低相关。讨论：研究结果与国际上有关水分娩与减少会阴创伤和产后出血的证据一致。与一些提示新生儿风险增加的研究不同，本研究未观察到不良后果。结论：对直接怀孕的人来说，水中分娩与任何额外的风险无关。研究结果支持将水中分娩作为在独立分娩中心分娩的明智选择。

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引用次数: 0

Understanding the use of peer support by midwives in clinical practice: A scoping review 了解助产士在临床实践中同伴支持的使用：范围审查。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-12-05 DOI: 10.1016/j.midw.2025.104686

Linda Sweet , Gina Kruger

Problem

Midwifery work is both challenging and rewarding. Midwifery is emotionally demanding, and peer support is thought to help midwives process distressing experiences such as traumatic births, perinatal loss, or professional conflict. Whilst there is evidence of preceptorship, mentoring, and clinical supervision in midwifery, the ways in which midwives give and receive peer support are not well understood.

Aim

To examine the evidence regarding the use of peer support by midwives and to map the evidence, focusing on knowledge gaps, to inform further research on how to best support midwives.

Methods

A scoping review was undertaken through four databases that index midwifery-related research. Peer-reviewed papers in English were sourced. Two midwifery researchers independently screened all titles and abstracts, then selected full texts. This was undertaken in Covidence. A thematic synthesis was undertaken in the selected papers.

Findings

Thirty articles met the inclusion criteria. The acronym ‘Strive’ was developed to represent the key concepts of peer support for midwives, including Setting (context), Trauma, Relationships, Institutional support, Validation (emotional support), and Engagement (team/managerial).

Discussion

‘STRIVE’ conveys an active, aspirational tone when the workplace setting or context is recognised, trauma may be minimised, positive relationships with the inter and intra professional team are built, institutional policies and practices support midwives, experiences perceived as stressful are validated through emotional support within the team, and the team and management are engaged in creating the positive environment and building social capital. Peer support may be enhanced if midwives are provided with education on mental health and well-being in the workplace.

Conclusion

Positive peer support is a necessity, not an indulgence, if we are to build a strong, resilient workforce and retain the midwifery workforce.

问题：助产工作既有挑战性又有回报。助产在情感上是需要的，同伴的支持被认为可以帮助助产士处理痛苦的经历，如创伤性分娩、围产期损失或职业冲突。虽然有证据表明助产士中存在指导、指导和临床监督，但助产士给予和接受同伴支持的方式尚未得到很好的理解。目的：检查关于助产士使用同伴支持的证据，并绘制证据图，重点关注知识差距，为如何最好地支持助产士的进一步研究提供信息。方法：通过四个索引助产相关研究的数据库进行范围审查。同行评议的英文论文的来源。两位助产学研究人员独立筛选所有标题和摘要，然后选择全文。这是在冠状病毒病期间开展的。对选定的文件进行了专题综合。结果：30篇文章符合纳入标准。首字母缩略词“力求”是为了代表助产士同伴支持的关键概念，包括环境（背景）、创伤、关系、机构支持、验证（情感支持）和参与（团队/管理）。讨论：当工作场所环境或背景得到认可时，“努力”传达了一种积极的、有抱负的基调，创伤可能被最小化，与专业团队之间和内部建立了积极的关系，制度政策和实践支持助产士，通过团队内部的情感支持来验证被认为有压力的经历，团队和管理层参与创造积极的环境和建立社会资本。如果向助产士提供有关工作场所心理健康和福祉的教育，则可以加强同伴支持。结论：如果我们要建立一支强大的、有弹性的劳动力队伍，并留住助产士队伍，积极的同伴支持是必要的，而不是放纵。

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引用次数: 0