Midwifery最新文献

{"title":"‘Hands on’, ‘hands off’ or ‘hands poised’? Exploring intrapartum midwifery decision making through ethnographic research","authors":"","doi":"10.1016/j.midw.2024.104105","DOIUrl":"10.1016/j.midw.2024.104105","url":null,"abstract":"<div><h3>Issue</h3><p>Injury to the perineal tissues during childbirth is a frequent occurrence with most women likely to experience perineal injury during a first birth which, in some cases, can lead to significant long-term morbidity. The techniques used to minimise perineal injury are frequently termed ‘hands on’ and ‘hands poised’ or ‘hands off’. These terms are often undefined and used inconsistently in the literature, making it difficult to identify the best available evidence to inform midwifery practice.</p></div><div><h3>Aim</h3><p>This study aimed to answer the research questions: What do midwives do to minimise perineal injury during birth and what influences their decision-making?</p></div><div><h3>Methods</h3><p>An ethnographic study was undertaken during 2016 in a maternity unit in the southeast of England. Data were collected through participant-observation, ethnographic and semi-structured interviews and analysed using thematic analysis, informed by the pedagogic theory of threshold concepts.</p></div><div><h3>Findings</h3><p>31 midwives participated in the study. Evidence-based decision-making to minimise perineal injury during birth was identified as a complex concept. Within the context of threshold concept theory, three main themes were identified that contributed to the complexity: troublesome language, troublesome knowledge, and troublesome environments.</p></div><div><h3>Conclusions</h3><p>Midwifery decision-making in the context of minimising perineal injury during birth is more varied and conceptually complex than has been previously described. Identification of the various aspects of troublesomeness in this context suggests that this element of practice is a midwifery threshold concept. Addressing this within midwifery curricula and practice education to enable evidence-based decision-making is important.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001888/pdfft?md5=78d8c612f00d9013c91775679fe27e79&pid=1-s2.0-S0266613824001888-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697046","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}

{"title":"Education of postpartum hemorrhage management clinical skills among midwifery students in Malawi: a qualitative study","authors":"Charity Kabondo ,&nbsp;Ingrid Tjoflåt ,&nbsp;Eva Christina Furskog-Risa ,&nbsp;Lily Kumbani ,&nbsp;Ursula Kafulafula","doi":"10.1016/j.midw.2024.104106","DOIUrl":"10.1016/j.midw.2024.104106","url":null,"abstract":"<div><h3>Background</h3><p>Unskilled health professionals in healthcare systems are contributing to the high numbers of maternal mortality in Malawi. It is therefore essential that midwifery students acquire postpartum hemorrhage management clinical skills, especially in view of high maternal mortality, with postpartum hemorrhage being the leading cause. However, there is limited evidence on how the teaching is conducted with regard to students’ learning of PPH management clinical skills.</p></div><div><h3>Purpose</h3><p>This study aimed to describe the current teaching of postpartum hemorrhage management clinical skills in undergraduate nursing and midwifery program in Malawi.</p></div><div><h3>Methods</h3><p>The study applied a qualitative exploratory descriptive design. Data were collected through ten individual interviews with lecturers and three focus group discussions with twenty-four students in a midwifery education program in Malawi. The data were analyzed using thematic analysis.</p></div><div><h3>Results</h3><p>Two themes emerged from the data analysis: (1) there are various teaching and learning approaches for PPH management in use and (2) unpreparedness of midwifery students in postpartum hemorrhage management for patient care.</p></div><div><h3>Conclusion</h3><p>The present study demonstrated that teaching of postpartum hemorrhage management clinical skills in an undergraduate nursing and midwifery programme in Malawi focuses on theoretical knowledge rather than practical skills, leaving midwifery students unprepared for postpartum hemorrhage management during clinical practice. The findings from the present study may provide knowledge guiding revision of the curriculum for the undergraduate nursing and midwifery programme in Malawi to consider global standards of midwifery education; enhance the lecturer to student ratio to provide the students with appropriate supervision; and to employ innovative teaching and learning strategies that promote peer education and skills practice among midwifery students. In addition, to conduct more research related to various teaching approaches in nursing and midwifery educational programs and among qualified midwives in Malawi.</p></div><div><h3>Statement of significance</h3><p>Postpartum hemorrhage management education in undergraduate nursing and midwifery programme in Malawi focuses more on theory than clinical skills. Improving midwifery students' acquisition of PPH management clinical skills is needed to ultimately help lower Malawi's maternal mortality ratio.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600568","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}

{"title":"Effect of kangaroo mother care on cerebral oxygenation, physiological parameters, and comfort levels in late-premature infants: A randomized controlled trial","authors":"","doi":"10.1016/j.midw.2024.104096","DOIUrl":"10.1016/j.midw.2024.104096","url":null,"abstract":"<div><h3>Objective</h3><p>To measure the effects kangaroo mother care (KMC) on the regional cerebral oxygen saturation (rSO₂) measured with near-infrared spectroscopy (NIRS) in premature infants and to study the physiological stability and comfort of the infants during such interventions.</p></div><div><h3>Design</h3><p>This was a prospective, single-centered, single-blind, 2-arm, parallel-group randomized controlled trial conducted.</p></div><div><h3>Settings</h3><p>The study was carried out in a tertiary neonatal intensive care unit in Medical Faculty Hospital in Konya/Turkey.</p></div><div><h3>Participants</h3><p>Premature infants born between 24 and 36⁺⁶ weeks. Participants were randomly assigned to one of two groups: kangaroo care (<em>n</em> = 20) and control groups (<em>n</em> = 20). The rSO₂, oxygen saturation (%SpO₂), heart rate (HR), respiratory rate, body temperature, and comfort levels of the infants were evaluated in three stages.</p></div><div><h3>Findings</h3><p>In the 60th min measurement of the intervention group, rSO₂, body temperature, heart rate, respiratory rate, and, comfort level, the comfort level was found to be higher and significant in the 30th and 60th min measurements (<em>p</em> &lt; 0.001). In the intervention group, the rSO₂ (<em>p</em> &lt; 0.001), body temperature (<em>p</em> &lt; 0.001), HR (<em>p</em> &lt; 0.001), SpO₂ (<em>p</em> &lt; 0.001), respiratory rate (<em>p</em> &lt; 0.001), and comfort levels (<em>p</em> &lt; 0.001) scores with the control group and the group × time interaction was significant.</p></div><div><h3>Key conclusions</h3><p>KMC moderately increased the rSO₂ levels and also created a moderate effect size on the physiological parameters and comfort levels of the newborns, which implicates its short-term benefits for premature infants.</p></div><div><h3>Practice implications</h3><p>KMC may be beneficial in stabilizing rSO₂ and physiological parameters and increasing comfort in premature infants. The trial was registered in ClinicalTrials.gov (identifier: NCT04725435).</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638522","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}

{"title":"Assessment of the psychometric properties of the Italian version of the midwifery student evaluation of practice (MIDSTEP-IT): A validity and reliability study. [Letter]","authors":"","doi":"10.1016/j.midw.2024.104100","DOIUrl":"10.1016/j.midw.2024.104100","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691789","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}

{"title":"Midwife-attended planned home births versus planned hospital births in Spain: Maternal and neonatal outcomes","authors":"Lucia ALCARAZ-VIDAL ,&nbsp;Ramon ESCURIET ,&nbsp;Roser PALAU-COSTAFREDA ,&nbsp;Fatima LEON-LARIOS ,&nbsp;Gemma ROBLEDA","doi":"10.1016/j.midw.2024.104101","DOIUrl":"10.1016/j.midw.2024.104101","url":null,"abstract":"<div><h3>Background</h3><p>The debate on the safety and outcomes of home versus hospital births highlights the need for evidence-based evaluations of these birthing settings, particularly in Catalonia where both options are available.</p></div><div><h3>Aim</h3><p>To compare sociodemographic characteristics and maternal and neonatal outcomes between low-risk women opting for home versus hospital births in Catalonia, Spain.</p></div><div><h3>Methods</h3><p>This observational cross-sectional study analysed 3,463 low-risk births between 2016 and 2018, including 2,713 hospital and 750 home births. Researchers collected sociodemographic data, birthing processes, and outcomes, using statistical analysis to explore differences between the settings.</p></div><div><h3>Findings</h3><p>Notable differences emerged: Women choosing home births typically had higher education levels and were predominantly Spanish. They were 3.43 times more likely to have a spontaneous birth and significantly less likely to undergo instrumental births than those in hospitals. Home births were associated with higher utilization of non-pharmacological analgesia and a more pronounced tendency to iniciate breastfeeding within the first hour post birth and stronger inclination towards breastfeeding. Hospital births, conversely, showed higher use of the lithotomy position and epidural analgesia. There were no significant differences in neonatal outcomes between the two groups.</p></div><div><h3>Conclusions and implication for practice</h3><p>Home births managed by midwives offered better obstetric and neonatal outcomes for low-risk women than hospital births. These results suggest home birth as a safe, viable option that promotes natural birthing processes and reduces medical interventions. The study supports the integration of midwife-led home birth into public health policies, affirming its benefits for maternal and neonatal health.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824001840/pdfft?md5=1f9946b7e6ea8b3d31bfd834c3bc636c&pid=1-s2.0-S0266613824001840-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603873","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}

{"title":"“The needs of women in the postpartum period: A scoping review.”","authors":"Mónica Vaz Sendas,&nbsp;Maria João Freitas","doi":"10.1016/j.midw.2024.104098","DOIUrl":"10.1016/j.midw.2024.104098","url":null,"abstract":"<div><h3>Background</h3><p>The postpartum period is critical and challenging for women, implying emotional, physical, social and spiritual changes. For a positive postpartum experience, it is important to receive consistent information and support from health professionals. However, this is not always the case, as care is more focused on the newborn, forgetting the needs of the puerperal woman.</p></div><div><h3>Aim</h3><p>The review aimed to map the published scientific knowledge about women's needs in the postpartum period.</p></div><div><h3>Methods</h3><p>A Scoping Review was carried out, according to the method proposed by The Joanna Briggs Institute, in the MEDLINE Complete, MedicLatina and CINAHL Complete databases, and were selected articles since 2017 that answered the research question \"What is the available evidence on women's needs in the postpartum period?\". For the selection of articles, the eligibility criteria were defined.</p></div><div><h3>Results</h3><p>A total of 6,647 articles were identified. After the exclusion of duplicate articles and the application of the eligibility criteria, at the end of the process, 27 articles were included in the review. The extracted data were grouped into four categories, which summarize the needs of women in the postpartum period: support, sharing, care and preparation for the postpartum period.</p></div><div><h3>Conclusion</h3><p>In the articles analysed, women reveal that they do not feel prepared for the postpartum period and identify several unmet needs, so health education and parenting skills training during pregnancy are essential to improve the postpartum experience and the transition to parenthood.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580216","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}

{"title":"The relationship of depression, anxiety, and stress with pregnancy symptoms and coping styles in pregnant women: A multi-group structural equation modeling analysis","authors":"Sibel Kiyak","doi":"10.1016/j.midw.2024.104103","DOIUrl":"10.1016/j.midw.2024.104103","url":null,"abstract":"<div><h3>Background</h3><p>The changes during pregnancy can increase susceptibility to mental health problems such as depression, anxiety and stress, which is why coping strategies are so important. The aim of this study is to investigate the relationships between depression, anxiety, stress, pregnancy symptoms and coping styles in pregnant women across trimesters, using a multigroup structural equation model.</p></div><div><h3>Methods</h3><p>This cross-sectional and correlational study was conducted with 301 pregnant women who applied to the prenatal clinic of a state university's medical faculty. A hypothetical model was created based on transactional stress and coping theory and literature reviews. Data were collected using a participant information form, the Depression Anxiety Stress Scale, the Pregnancy Symptom Inventory and the Stress Coping Styles Scale.</p></div><div><h3>Results</h3><p>Among pregnant women, 40.9 % had symptoms of stress, 52.8 % of anxiety and 37.2 % of depression. Pregnancy symptoms and emotion-focused coping are positively associated with depression, anxiety, and stress (<em>β</em> = 0.468–0.590; <em>β</em> = 0.222–0.373 respectively). Problem-focused coping is negatively associated with depression, anxiety, and stress. (<em>β</em> = -0.255:-0.389). Problem-focused coping is negatively associated with pregnancy symptoms in the whole sample (<em>β</em> = -0.121) and in the third trimester (<em>β</em> = -0.124). The model explained 51 % of the variance in the 1st, 42 % in the 2nd, and 64 % in the 3rd trimesters.</p></div><div><h3>Conclusion</h3><p>This study showed that problem-focused coping strategies are negatively associated with depression, anxiety and stress and play an important protective role in this context. These findings contribute to understanding the factors affecting mental health during pregnancy and emphasize the importance of developing problem-focused coping skills for pregnant women.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580217","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}

{"title":"Response to “The experience of pregnant women and their families who were infected with covid-19 before vaccination: Comment”","authors":"","doi":"10.1016/j.midw.2024.104097","DOIUrl":"10.1016/j.midw.2024.104097","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708499","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}

{"title":"Complexities of midwifery care delivered to perinatal women in prison: A qualitative study","authors":"Kathryn Cahalin ,&nbsp;Claire Clews ,&nbsp;John Pendleton ,&nbsp;Matthew Callender","doi":"10.1016/j.midw.2024.104099","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104099","url":null,"abstract":"<div><h3>Purpose</h3><p>To provide insight into the challenges faced by imprisoned perinatal women in accessing appropriate information, support, and care and the importance of the midwife's role in this context.</p></div><div><h3>Method</h3><p>This paper draws on two studies conducted in one United Kingdom (UK) women's prison over two separate time points (2019, 2021). In both qualitative evaluative studies that were descriptive in nature, semi-structured interviews were conducted with perinatal women and professionals involved in their care.</p></div><div><h3>Participants</h3><p>17 women participated across the two qualitative studies, six were pregnant, nine were on the Mother and Baby Unit (MBU) and two had given birth in the last 12 months but were not on the MBU. 12 professionals participated across the two studies.</p></div><div><h3>Results</h3><p>The studies highlight the specific challenges that perinatal women in prison face compared to their community counterparts in being able to access reliable information on pregnancy, birth, and parenting; having access to appropriate and reliable peer support and mental health support not only in terms of provision but also in terms of accessibility; and in being able to advocate for themselves or having people that can advocate for them.</p></div><div><h3>Conclusion</h3><p>These challenges arguably heighten the importance of, as well as the pressure on the midwife in this context. The authors therefore highlight the need for consideration of three factors for midwifery in this context: (1) Resourcing (2) Information provision to, and information sharing between, midwives to increase awareness of challenges faced by this cohort, and (3) Strengthening the midwife's position to support and advocate for women's perinatal mental health in prison.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607474","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}

{"title":"Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study","authors":"Maria Noonan ,&nbsp;Melissa Brown ,&nbsp;Maria Gibbons ,&nbsp;Teresa Tuohy ,&nbsp;Kevin Johnson ,&nbsp;Carmel Bradshaw ,&nbsp;Sylvia Murphy Tighe ,&nbsp;Sandra Atkinson ,&nbsp;Louise Murphy ,&nbsp;Mas Mohamad ,&nbsp;Mendinaro Imcha ,&nbsp;Niamh O'Dwyer ,&nbsp;Annmarie Grealish","doi":"10.1016/j.midw.2024.104089","DOIUrl":"10.1016/j.midw.2024.104089","url":null,"abstract":"<div><h3>Background</h3><p>Healthcare professionals have a role to play in reducing perinatal mental health related stigma.</p></div><div><h3>Aim</h3><p>To assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies.</p></div><div><h3>Design</h3><p>A single group pre-test-post-test pilot study with no control group.</p></div><div><h3>Setting(s)</h3><p>A university affiliated maternity hospital in Ireland</p></div><div><h3>Participants</h3><p>A convenience sample of registered midwives, nurses and doctors (<em>n</em> = 60) recruited from October 2020-January 2021.</p></div><div><h3>Intervention</h3><p>A twenty-minute video-based educational intervention.</p></div><div><h3>Methods</h3><p>Respondents (<em>n</em> = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (<em>n</em> = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores.</p></div><div><h3>Results</h3><p>The difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (<em>z</em> = 3.27, df=36, <em>P</em> = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (<em>z</em>= -3.368, df=59, <em>P</em> = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions.</p></div><div><h3>Conclusions</h3><p>Further research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention.</p></div><div><h3>TweetableAbstract</h3><p>: A video-based intervention can increase healthcare professionals’ knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538079","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}