Midwifery最新文献_第9页

Multilevel modelling of the determinants of low birth weight in frontier, outermost and underdeveloped regions: Evidence from the Indonesian National Socioeconomic Survey (2019–2021) 前沿、最外围和欠发达地区出生体重不足决定因素的多层次建模：印度尼西亚全国社会经济调查（2019-2021年）的证据。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-08-06 DOI: 10.1016/j.midw.2024.104136

Nuzul Qur'aniati , Ulfia Fitriani Nafista , Prilyandari Dina Saputri , Fildzah Cindra Yunita , Mundakir , Alison Hutton , Linda Sweet

Background

The prevalence of low-birthweight infants is increasing in Indonesia. A low birth weight can have a negative effect on a child's development. Understanding the factors influencing low birth weight may enable preventative actions.

Aim

To analyse the determinant factors of low-birthweight infants in frontier, outermost and underdeveloped regions in Indonesia.

Methods

A cross-sectional study was conducted using a secondary dataset from the Indonesian National Socioeconomic Survey, 2019–2021. The sample included 27,678 inhabitants aged 16–64 years. The Indonesian regions of Nusa Tenggara Timur, Nusa Tenggara Barat, Sulawesi Tengah, Sulawesi Tenggara, Gorontalo, Maluku, Maluku Utara, Papua and Papua Barat were included. A multilevel logistic regression was conducted to determine the relationship between variables. p < 0.05 was considered to indicate significance in the fixed-effects model findings.

Findings

Women who lived in a rural area [OR 1.176, 95 % confidence interval (CI) 0.088–0.235] and had never used contraception (OR 1.227, 95 % CI 0.096–0.313) were more likely to have low-birthweight infants. In contrast, water resources, social assistance/welfare, maternal age and gross domestic product per capita had no significant effect on the prevalence of low-birthweight infants.

Discussion and conclusion

Living in a rural area and lifetime non-use of contraception were found to be significant risk factors for low birth weight in frontier, outermost and underdeveloped regions in Indonesia. Increasing health facilities in rural areas and establishing programmes on the use of contraception may be positive strategies to reduce the prevalence of low-birthweight infants.

背景在印度尼西亚，低出生体重儿的发病率正在上升。低出生体重会对儿童的发育产生负面影响。目的：分析印尼前沿、最外围和欠发达地区低出生体重儿的决定因素：利用2019-2021年印度尼西亚全国社会经济调查的二级数据集进行了一项横断面研究。样本包括 27678 名 16-64 岁的居民。印度尼西亚的努沙登加拉省、努沙登加拉巴拉特省、苏拉威西腾格里省、苏拉威西腾格里省、戈龙塔罗省、马鲁古省、马鲁古乌塔拉省、巴布亚省和巴布亚巴拉特省均被纳入研究范围。为确定变量之间的关系，进行了多层次逻辑回归。在固定效应模型的研究结果中，P < 0.05 为显著性：居住在农村地区（OR 1.176，95 % 置信区间 (CI)：0.088-0.235）和从未采取避孕措施（OR 1.227，95 % 置信区间 (CI)：0.096-0.313）的妇女更有可能生育低体重儿。相比之下，水资源、社会援助/福利、产妇年龄和人均国内生产总值对低体重儿的发生率没有显著影响：在印度尼西亚的边境地区、最外围地区和欠发达地区，生活在农村地区和终生不使用避孕药具是导致低出生体重儿的重要风险因素。在农村地区增加医疗设施和制定避孕计划可能是降低低出生体重儿发生率的积极策略。

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引用次数: 0

Experiences of workplace conflicts by midwives and implications for their wellbeing in selected hospitals in the Northern Region of Ghana 加纳北部地区部分医院助产士的工作场所冲突经历及其对助产士福祉的影响。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-08-04 DOI: 10.1016/j.midw.2024.104133

Tobias Tseer , Nathalie Dakubo , Sabina Adongo

Aim

Conflicts are ubiquitous in human societies and manifest in varied forms and scales within societies, communities and organisations. While many studies have investigated workplace conflicts, least attention has been paid to how midwives differently experience these conflicts and the impacts of these conflicts on their wellbeing. This study fills this gap by investigating the multifaceted impact of workplace conflicts on the wellbeing of midwives.

Method

The study employed a purely qualitative approach within the analytical framework of the Stress Theory of organisational conflicts. Thirty-five participants were selected for the study through an expert purposive sampling technique. Interviews and Focus Group Discussions were used to collect primary data for the study. Collected data were analysed using an inductive thematic analytical technique.

Results

The findings highlight the multifaceted impact of conflict on both the professional and personal well-being of midwives. Conflicts induce severe physical and psychological strains on midwives, generate fears, angst, and anxieties, and disrupt social harmony prompting exclusion and discrimination among midwives in the hospital.

Conclusion

We argue that apart from task-demand generated stress, workplace conflicts prompt both physical and psychological stress on midwives which culminate into a myriad of physical, emotional, and mental health issues.

Implication for Practice

Initiation of conflict resolution and mediation training programs for midwives so as to equip them with essential skills for effectively managing and resolving workplace conflicts. Setting up internal grievance mechanisms for midwives in their work places and training of midwives on social skills, and stress management skills.

目的：冲突在人类社会中无处不在，并在社会、社区和组织中以不同的形式和规模表现出来。虽然许多研究都对工作场所的冲突进行了调查，但对助产士如何以不同的方式体验这些冲突以及这些冲突对其福祉的影响却关注得最少。本研究通过调查工作场所冲突对助产士福祉的多方面影响，填补了这一空白：本研究在组织冲突压力理论的分析框架内采用了纯粹的定性方法。通过专家目的性抽样技术挑选了 35 名参与者参与研究。研究采用访谈和焦点小组讨论的方式收集原始数据。采用归纳式专题分析技术对收集到的数据进行了分析：研究结果凸显了冲突对助产士职业和个人福祉的多方面影响。冲突给助产士造成了严重的生理和心理压力，产生了恐惧、焦虑和不安，破坏了社会和谐，导致医院中的助产士受到排斥和歧视：我们认为，除了因工作需要而产生的压力外，工作场所的冲突也会给助产士带来生理和心理上的压力，最终导致一系列生理、情感和心理健康问题：为助产士启动冲突解决和调解培训计划，使她们掌握有效管理和解决工作场所冲突的基本技能。在工作场所为助产士建立内部申诉机制，对助产士进行社交技能和压力管理技能培训。

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引用次数: 0

A response to the UK all party parliamentary group (APPG) report on birth trauma 对英国各党派议会小组（APPG）关于出生创伤报告的回应。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-08-03 DOI: 10.1016/j.midw.2024.104131

Kirstie Coxon , Kerry Evans , Gill Thomson

引用次数: 0

Enhancing the competencies of obstetrical nurses and midwives in high-risk pregnancy management through simulation-based training in Lao people's democratic republic: A pilot study 在老挝人民民主共和国，通过模拟培训提高产科护士和助产士处理高危妊娠的能力：试点研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-08-02 DOI: 10.1016/j.midw.2024.104132

Ratree Sirisomboon , Sasitara Nuampa , Jarunee Leetheeragul , Metpapha Sudphet , Kanjana Pimol , Sudhathai Sirithepmontree , Lamngeun Silavong

Background

Simulation-based training has been widely used as a valuable strategy for learning and evaluating clinical skills at different levels of nursing and midwifery education. The impact of simulation training on intensive management for high-risk pregnancy in a low-resource setting has been limited.

Aim

To examine the effect of simulation-based training with low-fidelity mannequins on obstetrical nurses and midwives’ knowledge, attitude, and skills for high-risk pregnancy management in a low-resource setting.

Method

During September 2023, twenty-five obstetrical nurses or midwives who worked in five tertiary public hospitals in Vientiane Prefecture participated in the three-day training workshops for intensive management in high-risk pregnant women and newborns that used a simulation-based training approach integrating problem-based learning. The evaluated criteria of knowledge, attitudes, and skills pre- and post-test scores were statistically compared.

Findings

Workshop trainees demonstrated an increase significantly in knowledge for high-risk pregnancy management (p = 0.012), attitude toward high-risk pregnancy management (p = 0.000), and attitude toward simulation-based training design (p = 0.002). The clinical skills were used on the simulation performance checklist, and the pre-posttest gain in overall performance scores had a statistically significant difference (p = 0.000). The mean score of postpartum hemorrhage management skills was 11.48±2.23, which increased the highest score among all skills.

Conclusions

The simulation-based training in high-risk pregnancy management improves the knowledge, attitude, and skills of nurses and midwives in low-resource settings. Next steps include direct observation of trainees in the clinical setting to assess their competence in ensuring patient safety, achieving positive pregnancy outcomes, and enhancing satisfaction.

背景：模拟训练作为一种学习和评估临床技能的重要策略，已被广泛应用于不同层次的护理和助产教育中。目的：研究低保真人体模型模拟训练对产科护士和助产士在低资源环境下管理高危妊娠的知识、态度和技能的影响：2023 年 9 月，在万象县 5 家三级公立医院工作的 25 名产科护士或助产士参加了为期 3 天的高危孕妇和新生儿重症监护培训班。对知识、态度和技能等评估标准的前后测试得分进行了统计比较：研修班学员在高危妊娠管理知识（p = 0.012）、对高危妊娠管理的态度（p = 0.000）和对模拟培训设计的态度（p = 0.002）方面均有显著提高。临床技能被用于模拟成绩检查表，总成绩在测试前-测试后的增益差异有统计学意义（p = 0.000）。产后出血处理技能的平均得分为（11.48±2.23）分，在所有技能中得分最高：结论：基于模拟的高危妊娠管理培训提高了低资源环境中护士和助产士的知识、态度和技能。下一步工作包括直接观察学员在临床环境中的表现，以评估他们在确保患者安全、实现积极妊娠结果和提高满意度方面的能力。

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引用次数: 0

Assessment of professional empowerment among midwives in selected LAC: A multisite descriptive study 评估选定拉丁美洲和加勒比地区助产士的专业能力：一项多地点描述性研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-08-02 DOI: 10.1016/j.midw.2024.104130

Lorena Binfa , Loreto Pantoja , Laura Valli , Alicia Cillo , Sandra Zapiola , Elsa Peralta , Mirian Solis , Zaida Zagaceta , Emma Salazar , Socorro Mancía , Gabriel Cavada , Jennifer Foster

Objective

to identify the perception of professional empowerment among midwives in selected Latin American countries (LA). Specifically, this study aimed to compare i) the global level of empowerment among midwives in different LA countries, ii) the scores according to the different dimensions of the scale, and iii) scores according to area the of expertise.

Design

A quantitative, observational, analytical, cross-sectional and multisite study using an adaptation of the Perceptions Midwifery Empowerment Scale (PEMS).

Settings

Clinical, educational and managerial midwifery positions in 5 LA countries belonging to a Latin American Research Network in Midwifery. All the participating countries reported a similar profile regarding type of education, association and regulation procedures.

Participants

A total of 1127 responses from midwives with different professional backgrounds were included in the study.

Findings

A total mean score of 73.28 (74.23–72.03) points was reported. Chile reported the lowest score of empowerment compared to the other countries, while Argentina reported the highest. Midwives' perceptions of empowerment within their area of expertise, primary health care (PHC) was the area of reference, and gynaecology reported a significantly lower score. Midwives working in management were significantly more empowered compared with those in other areas. Midwives who had continuous education and postgraduate studies were the most empowered. Regarding the provision of woman-centred Care, Chile and El Salvador differed significantly from Argentina (reference), while Uruguay reported a significantly higher score in this dimension. Midwives working in hospital wards reported significantly lower scores compared to those working in PHC.

Key conclusions and implications for practice

This study suggests that midwifery programmes in the LA countries would benefit from prioritising professional empowerment, especially in the areas of hospital practice, where midwives' perceptions of empowerment were most limited.

目标：确定选定拉丁美洲国家（LA）助产士对专业赋权的看法。具体而言，本研究旨在比较 i) 不同拉美国家助产士的总体赋权水平；ii) 根据量表不同维度得出的分数；iii) 根据专业领域得出的分数：设计：一项定量、观察、分析、横断面和多地点研究，使用改编的助产士赋权量表（PEMS）：背景：属于拉丁美洲助产研究网络的 5 个拉丁美洲国家的临床、教育和管理助产职位。所有参与调查的国家在教育类型、协会和监管程序方面的情况相似：研究共收到 1127 份来自不同专业背景的助产士的回复：总平均分为 73.28（74.23-72.03）分。与其他国家相比，智利的赋权得分最低，而阿根廷的赋权得分最高。助产士对其专业领域内赋权的看法，初级保健（PHC）是参考领域，妇科报告的得分明显较低。与其他领域的助产士相比，在管理领域工作的助产士明显更有能力。受过继续教育和研究生课程的助产士最有权力。在提供 "以妇女为中心的护理 "方面，智利和萨尔瓦多与阿根廷（参考）有显著差异，而乌拉圭在这一维度的得分明显较高。在医院病房工作的助产士的得分明显低于在初级保健中心工作的助产士：本研究表明，洛杉矶地区国家的助产士计划应优先考虑专业授权，尤其是在医院实践领域，因为助产士对授权的认识最为有限。

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引用次数: 0

The dynamics of intercultural clinical encounters in times of pandemic crisis. Swedish healthcare providers’ reflections on social norms in relation to sexual and reproductive healthcare 大流行病危机时期跨文化临床接触的动态。瑞典医疗服务提供者对与性保健和生殖保健有关的社会规范的思考。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-29 DOI: 10.1016/j.midw.2024.104129

Mia Appelbäck , Aje Carlbom , Lise Eriksson , Birgitta Essén

Background

Experiences from the COVID-19 pandemic may help to better understand resilience, competences and skills for healthcare providers and the healthcare system. Within sexual and reproductive health inequalities for migrants exist and it is an area where promoting both cultural competency and healthcare equity in the clinical encounter is expected of healthcare providers yet can create tension. The aim is to explore healthcare providers experiences of encounters with migrants in the context of the pandemic and the subsequent changes in routines and norms.

Methods

A qualitative study based on semi-structured interviews with 31 healthcare providers working in sexual and reproductive healthcare in southern Sweden. Interviews were conducted during the COVID-19 pandemic influencing how healthcare providers reflected on their experiences. Analysis was done using reflexive thematic data analysis.

Findings

Healthcare providers reflected on how changes in routines increased the understanding of challenges and enablers in the intercultural encounter including the impact on communication and role of relatives and male partners. They emphasized the dynamics of culture in the clinical encounter and healthcare system through highlighting the importance of structural awareness, self-reflection and the flexibility of conducts and norms, often given a cultural connotation.

Conclusion

The COVID-19 pandemic resulted in changes of previously established routines directly affecting clinical encounters, which provided a unique opportunity for healthcare providers to reflect, with communication and self-reflection being discussed as central in complex encounters. It highlighted the dynamics of presumed deeply rooted cultural norms and the interplay with social factors affecting healthcare providers and patients alike.

背景：COVID-19 大流行的经验可能有助于更好地了解医疗服务提供者和医疗保健系统的应变能力、能力和技能。在性健康和生殖健康领域存在着对移民的不平等现象，在这一领域，医疗服务提供者应在临床接触中促进文化能力和医疗公平，但这可能会造成紧张关系。本研究旨在探讨医疗服务提供者在大流行病背景下与移民接触的经验，以及随之而来的常规和规范的变化：这项定性研究以半结构式访谈为基础，访问了瑞典南部 31 名从事性与生殖保健工作的医疗服务提供者。访谈在 COVID-19 大流行期间进行，影响了医疗服务提供者对其经历的反思。分析采用反思性专题数据分析：研究结果：医疗服务提供者反思了常规的变化如何提高了他们对跨文化接触中的挑战和有利因素的理解，包括对沟通的影响以及亲属和男性伴侣的作用。他们通过强调结构意识、自我反思以及行为和规范灵活性的重要性，强调了文化在临床接触和医疗保健系统中的动态作用，这些往往被赋予了文化内涵：COVID-19大流行改变了以往既定的常规，直接影响到临床诊疗，这为医疗服务提供者提供了一个独特的反思机会，而沟通和自我反思被认为是复杂诊疗的核心。它强调了假定的根深蒂固的文化规范的动态变化，以及影响医疗服务提供者和患者的社会因素的相互作用。

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引用次数: 0

Perinatal mental health service use in a representative sample of US women 具有代表性的美国妇女样本中围产期心理健康服务的使用情况

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-28 DOI: 10.1016/j.midw.2024.104121

Lily Pankratz , Jordana L. Sommer , Natalie Mota , Renée El-Gabalawy , Kristin Reynolds

Problem/Background

Mental health problems are prevalent during the perinatal period and mental health service use is lower among perinatal women compared to the general population.

Aim

This study examined the prevalence and variables associated with mental health service use (MHSU) among pregnant and postpartum women with a past-year mental disorder.

Methods

We analyzed nationally representative data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). Our study sample included all women aged 18 – 55 with a past year mental disorder (n = 6,295). Semi-structured interviews assessed past-year DSM-5 mental disorders, which were categorized into four groups: depressive/bipolar, anxiety, posttraumatic stress disorder, and substance use. Logistic regressions examined rates and variables associated with MHSU across perinatal status, adjusting for key sociodemographic characteristics.

Findings

Compared to non-perinatal women 18–55 with a past-year mental disorder (38.5 %), postpartum women had reduced odds of MHSU (23.6 %; AOR = 0.56, p < 0.05), and pregnant women also sought services less than non-perinatal women (32.6 %; AOR = 0.89 p > 0.05). All groups had increased odds of MHSU when individuals had a greater number of mental disorders (AORs = 1.78 – 2.75, p = 0.01 and p < 0.001). Physical health conditions were also associated with increased odds of MHSU among all groups, except postpartum women (AORs = 1.26 – 1.62, p = 0.05, p < 0.001).

Discussion/Conclusion

Results highlight that over 60 % of perinatal women with mental disorders do not receive mental health services. This emphasizes the importance of mental health screening for perinatal women, particularly in the postpartum period.

问题/背景围产期妇女普遍存在心理健康问题，而与普通人群相比，围产期妇女使用心理健康服务的比例较低。方法我们分析了 2012 年至 2013 年全国酒精及相关疾病流行病学调查（N = 36309）中具有全国代表性的数据。我们的研究样本包括所有在过去一年中患有精神障碍的 18 - 55 岁女性（n = 6295）。半结构式访谈对过去一年的 DSM-5 精神障碍进行了评估，并将其分为四类：抑郁/躁郁症、焦虑症、创伤后应激障碍和药物使用。Logistic 回归分析了不同围产期状况下与 MHSU 相关的比率和变量，并对主要社会人口特征进行了调整。研究结果与 18-55 岁非围产期妇女（38.5%）过去一年患有精神障碍相比，产后妇女患 MHSU 的几率降低（23.6%；AOR = 0.56，p < 0.05），孕妇寻求服务的次数也少于非围产期妇女（32.6%；AOR = 0.89，p > 0.05）。当个人患有较多精神障碍时，所有群体发生 MHSU 的几率都会增加（AOR = 1.78 - 2.75，p = 0.01 和 p < 0.001）。除产后妇女外，身体健康状况也与所有群体中发生 MHSU 的几率增加有关（AORs = 1.26 - 1.62，p = 0.05，p <0.001）。讨论/结论结果表明，60% 以上患有精神障碍的围产期妇女没有接受心理健康服务。这强调了对围产期妇女进行心理健康筛查的重要性，尤其是在产后阶段。

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引用次数: 0

Explore the lived childbirth experiences, challenges following childbirth, and coping strategies of teenage mothers: A qualitative meta-synthesis 探索少龄母亲的分娩经历、产后挑战和应对策略：定性元综合

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-26 DOI: 10.1016/j.midw.2024.104128

Lebeza Alemu Tenaw , Fei Wan Ngai , Katherine Lam

Problem

Worldwide, 16 million girls give birth during adolescence each year, which has negative health, social, and economic consequences for adolescent women's future.

Background

Childbirths occurring between the ages of 13-19, before teenage girls have reached the age of maturity to handle the parenting role, are often unplanned.

Objective

The aim of this study was to gain a comprehensive understanding of lived childbirth experiences, identify the challenges of early motherhood, and explore the coping strategies employed by teenage mothers to overcome these challenges during the transition to motherhood.

Methods

Six commonly cited databases were used to retrieve articles using the SPIDER framework. We utilized the Walsh and Downe quality appraisal tool, which is considered the most appropriate fit for the current qualitative meta-synthesis. The thematic analysis approach was used to draw conclusions and generate hypotheses.

Results

This meta-synthesis showed that teenage mothers often encounter negative reactions from their partners, families, and communities due to their early childbirth. They face numerous challenges, including parenting incompetency, school dropout, conflict between adolescent interests and maternal responsibilities, emotional disturbance, and financial problems. Social support and self-efficacy are the main coping strategies to navigate these challenges and attain maternal competencies.

Conclusion and implications

Families, peers, and midwives play a crucial role in providing parenting lessons for teenage mothers. Encouraging teenage mothers to believe in their capacities is an important coping strategy to facilitate a smoother motherhood transition. Further studies are needed to test the effectiveness of self-efficacy and social support interventions on teenage mothers’ parenthood role attainment and in preventing mental health problems following childbirth.

问题全世界每年有 1600 万名少女在青春期生育，这对少女的健康、社会和经济未来造成了负面影响。背景13-19 岁的少女还没有达到为人父母的成熟年龄，她们的生育往往是计划外的。本研究旨在全面了解少女的生育经历，确定过早成为母亲所面临的挑战，并探讨少女母亲在向母亲角色过渡的过程中为克服这些挑战而采取的应对策略。我们使用了沃尔什和唐恩质量评估工具，该工具被认为最适合当前的定性元综合研究。我们采用了主题分析方法来得出结论并提出假设。结果这项元综合研究表明，由于早育，少龄母亲经常会遇到来自伴侣、家庭和社区的负面反应。她们面临着许多挑战，包括育儿无能、辍学、青少年兴趣与母亲责任之间的冲突、情绪障碍和经济问题。社会支持和自我效能感是应对这些挑战并获得母亲能力的主要策略。鼓励未成年母亲相信自己的能力是一种重要的应对策略，有助于她们更顺利地过渡到母亲角色。还需要进一步的研究来检验自我效能感和社会支持干预对少女母亲实现为人父母的角色以及预防产后心理健康问题的有效性。

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引用次数: 0

Researchers’ perspectives of self-agency within a context of violence and harm in maternity care 研究人员对孕产妇护理中暴力和伤害背景下自我代理的看法

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-25 DOI: 10.1016/j.midw.2024.104120

Gill Thomson , Marie-Clare Balaam

Problem

There is an increasing awareness of the prevalence of obstetric violence within maternity care and that some women and birthing people are at greater risk of experiencing violence and harm.

Background

Supporting self-agency for women and birthing people in maternity care may be a way of addressing the disparities in vulnerability to violence and harm.

Aim

To explore researchers’ perspectives of self-agency for women from different backgrounds, what inhibits and prevents self-agency, and how self-agency can be enabled.

Methods

A qualitative research design was undertaken underpinned by a reproductive justice framework. Group interviews were held with researchers working with perinatal women/birthing people with histories and experiences of violence and abuse. Reflexive thematic analysis using Bronfenbrenner's ecological systems theory was undertaken.

Findings

12 participants took part in two group interviews. Two themes were developed: ‘defining self-agency’ and ‘ecological influences on self-agency’.

Discussion

The findings identify how self-agency should not be perceived as an intrinsic attribute, but rather is underpinned by exogenous and endogenous influences. Whether and how self-agency is enacted is determined by interacting factors that operate on a micro, meso and macro level perspective. Self-agency is undermined by factors including immigration policies and sociocultural perspectives that can lead to under-resourced and judgemental care, other intersectional factors can also lead to some individuals being more vulnerable to violence and harm.

Conclusion

Implications from this work include strategies that emphasise woman-centred care, staff training and meaningful organisational change to optimise positive health and wellbeing.

问题人们越来越意识到产科护理中产科暴力的普遍性，以及一些妇女和分娩者遭受暴力和伤害的风险更大。背景支持产科护理中妇女和分娩者的自我管理可能是解决易受暴力和伤害的差异的一种方法。目的探索研究人员对来自不同背景的妇女的自我行为能力的看法，什么因素阻碍和阻止了自我行为能力的发展，以及如何才能实现自我行为能力。研究人员与有暴力和虐待历史和经历的围产期妇女/分娩者进行了小组访谈。采用布朗芬布伦纳的生态系统理论进行了反思性专题分析。研究结果 12 名参与者参加了两次小组访谈。研究结果表明，自我行为能力不应被视为一种内在属性，而是受到外在和内在因素的影响。自我行为能力是否以及如何发挥，取决于微观、中观和宏观层面的相互作用因素。包括移民政策和社会文化观点在内的各种因素都会削弱自我行为能力，从而导致护理资源不足和评判性护理，其他交叉因素也会导致某些人更容易受到暴力和伤害。

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引用次数: 0

Harnessing partnerships to strengthen global midwifery education to improve quality maternal and newborn health care: The Alliance to Improve Midwifery Education (AIME) 利用伙伴关系加强全球助产教育，提高孕产妇和新生儿保健质量：改善助产教育联盟（AIME）

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-25 DOI: 10.1016/j.midw.2024.104111

Sarah Bar-Zeev , Duncan Shikuku , Caroline Homer , Rachel Smith , Pandora Hardtman , Geeta Lal , Suzanne Stalls , Chisato Masuda , Felicity Copeland , Anna Af Ugglas , Sally Pairman , Tedbabe Degefie Hailegebriel , Charles Ameh

引用次数: 0