Midwifery最新文献_第9页

“Being on the edge, longing for the hand that shows the way”- A meta-synthesis of women's experiences of midwife support during the latent phase “处于边缘，渴望得到指引道路的手”——对女性在潜伏期助产士支持经历的综合分析

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-18 DOI: 10.1016/j.midw.2025.104616

Karin Glad , Lena Miberg , Viola Nyman

Background

Women admitted to hospital during the latent phase are at higher risk of various interventions. Maternity care should enable informed decision-making and provide continuous support throughout the different labour phases.

Aim

To synthesise available research on women's experiences of labour ward midwife support during the latent phase.

Methods

A meta-synthesis as outlined by Walsh and Downe was conducted to generate a nuanced understanding of the findings from qualitative studies. A search using key words was undertaken in the following databases: PubMed, Cinahl, Scopus, Web of science and Psycinfo. Papers were included if published since 2014, in the English language and contained qualitative data addressing the study aim.

Findings

A total of nine studies were included. The result was divided into three themes: Telephone calls - being listened to or not, Video calls - seeing and being seen, In-person meeting – trying to pass the admission test. Women could feel either satisfied or dissatisfied after a phone call, video call, or visit to the labour ward; hence the form of contact was not the most significant factor, but how the midwife met and treated the woman.

Synthesis

Women who sought professional support, emphasized the need for a sensitive and individualized approach. The midwife—via phone, video, or in person—held the authority to decide on admission.

Conclusion

This meta-synthesis clearly highlights the gap in available care between the late stage of pregnancy and the active phase of labour, as well as the focus of midwives in labour ward care.

背景：潜伏期住院的妇女接受各种干预措施的风险更高。产妇保健应使产妇能够作出明智的决策，并在整个分娩阶段提供持续的支持。目的综合现有研究资料，探讨产房助产人员对产妇潜伏期支持的体会。方法采用Walsh和Downe概述的综合方法，对定性研究的结果进行细致入微的理解。使用关键词在PubMed、Cinahl、Scopus、Web of science和Psycinfo等数据库中进行检索。纳入2014年以后发表的英文论文，并包含针对研究目的的定性数据。研究结果共纳入9项研究。测试结果被分为三个主题：电话通话——被监听或不监听；视频通话——看到和被看到；面对面会议——试图通过入学考试。妇女可以通过电话、视频通话或访问产房来感到满意或不满意；因此，接触的形式并不是最重要的因素，重要的是助产士如何认识和对待妇女。寻求专业支持的妇女强调需要一种敏感和个性化的方法。助产士——通过电话、视频或亲自——有权决定是否入院。结论本综合研究明确了妊娠晚期和产程活跃期可获得护理的差距，以及助产士在产程病房护理中的重点。

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引用次数: 0

Development and preliminary testing of a scenario-based instrument to measure nutrition literacy of pregnant women 开发和初步测试基于场景的工具，以衡量孕妇的营养素养

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-17 DOI: 10.1016/j.midw.2025.104613

Tzu-Ling Chen , Li-Ling Liao , Mi-Hsiu Wei , Yueh-Yin Fang , Chia-Hsun Wu

Background

Nutrition literacy (NL) during pregnancy is important for both mothers and infants. The present study aimed to develop a scenario-based instrument to measure the NL abilities of pregnant women and test the validity and reliability of this instrument.

Methods

The development of the instrument comprised six phases: (1) identification of key domains through literature review; (2) a Delphi survey; (3) development of a scenario-based test; (4) evaluation of content validity; (5) pilot test; and (6) assessment of the instrument’s psychometric properties.

Results

A convenience sample of 489 pregnant Taiwanese women was used to assess NL via a 22-item scenario-based scale across four domains: “understand”, “analyse”, “appraise”, and “apply”. Item Response Theory analysis showed that most items provided the greatest precision for respondents with low to moderate ability levels (θ = −3 to 0). Confirmatory factor analysis supported a second-order, four-factor model. Internal consistency was acceptable (Cronbach’s α = 0.78), and item-total correlations ranged from 0.31 to 0.53 (p < 0.001), indicating strong reliability.

Conclusion

The validated Nutrition Literacy Scale is psychometrically sound and suitable for research, clinical use, and future interventions to improve NL and dietary behaviours during pregnancy.

怀孕期间的营养素养（NL）对母亲和婴儿都很重要。本研究旨在开发一种基于情境的测量孕妇NL能力的工具，并对该工具的效度和信度进行检验。方法该仪器的开发分为六个阶段：(1)通过文献综述确定关键域；(2)德尔菲调查；(3)开发基于场景的测试；(4)内容效度评价；(5)先导试验；(6)评估仪器的心理测量特性。结果本研究采用基于情境的22项量表，在“理解”、“分析”、“评价”和“应用”四个领域对489名台湾孕妇进行了NL评估。项目反应理论分析表明，大多数项目对低至中等能力水平（θ =−3 ~ 0）的被调查者提供了最大的精度。验证性因子分析支持二阶四因子模型。内部一致性是可以接受的（Cronbach 's α = 0.78），项目-总相关性在0.31至0.53之间（p < 0.001），表明具有很强的信度。结论经验证的营养素养量表在心理测量学上是合理的，适合于研究、临床使用和未来的干预措施，以改善怀孕期间的营养素养和饮食行为。

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引用次数: 0

Development and pilot test of a CTG skills test for midwives 助产士CTG技能测试的开发和试点测试

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-17 DOI: 10.1016/j.midw.2025.104614

Maija Männistö , Kristiina Heinonen , Marja Härkänen , Reeta Lamminpää

Background

High-quality obstetric care promotes maternal safety and fetal well-being. Modern cardiotocography (CTG) interpretation emphasises fetal physiology rather than isolated heart rate patterns, aiming to reduce unnecessary interventions and improve outcomes. Misinterpretation of CTG remains a key contributor to substandard perinatal care. Assessing interpretation skills is essential for evaluating competence and measuring the effects of training. Regular assessment supports clinical proficiency, identifies educational needs, and ultimately enhances the quality and safety of childbirth.

Aim

This study aimed to develop and pilot a CTG skills test to assess midwives' interpretation skills.

Methods

The skills test was constructed based on the existing literature and the content validity was evaluated by an expert panel (n = 8) through two rounds of online surveys. The pilot test was conducted at one birthing unit with midwives (n = 12) to assess the feasibility of the test. Data were analysed with inductive content analysis and quantitative methods, including the content validity index and descriptive statistics.

Results

The CTG skills test was validated through expert review and a pilot study. It showed excellent content validity (S-CVI/Ave = 0.94). Experts and midwives found it relevant but challenging, especially in fetal physiology. Revisions made to the test improved the clarity and usability of the test. The skills test is suitable for assessing CTG competence and identifying training needs.

Conclusions

CTG interpretation is crucial for safe childbirth, making midwives' competence and training essential for quality obstetric care. This validated skills test helps to assess CTG skills, identify training needs, and enhance delivery safety.

高质量的产科护理促进孕产妇安全和胎儿健康。现代心脏造影（CTG）解释强调胎儿生理学，而不是孤立的心率模式，旨在减少不必要的干预和改善结果。对CTG的误解仍然是围产期护理不合格的一个关键因素。评估口译技能对于评估能力和衡量培训效果至关重要。定期评估有助于提高临床熟练程度，确定教育需求，并最终提高分娩质量和安全性。目的本研究旨在开发和试点CTG技能测试，以评估助产士的口译技能。方法在现有文献的基础上编制技能测验，采用专家小组（n = 8）两轮在线问卷对内容效度进行评估。试点测试在一个分娩单位进行，助产士（n = 12），以评估测试的可行性。数据分析采用归纳性内容分析和定量方法，包括内容效度指标和描述性统计。结果CTG技能测试通过专家评审和试点研究得到了验证。内容效度极好（S-CVI/Ave = 0.94）。专家和助产士认为这是相关的，但具有挑战性，特别是在胎儿生理学方面。对测试所做的修订提高了测试的清晰度和可用性。技能测试适合评估CTG的能力和确定培训需求。结论sctg解读对安全分娩至关重要，助产士的能力和培训对产科护理质量至关重要。这项经过验证的技能测试有助于评估CTG技能，确定培训需求，并提高交付安全性。

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引用次数: 0

Socioeconomic deprivation as a risk factor for stillbirth: A case-control study 社会经济剥夺是死产的危险因素：一项病例对照研究

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-17 DOI: 10.1016/j.midw.2025.104615

Jessica V. Keane , Paul Corcoran , Sara Leitao , Joye McKernan , Edel Manning , Keelin O’Donoghue , Richard A. Greene

Background

Stillbirth is a devastating outcome for families. Identifying and addressing risk factors is of crucial importance. Level of deprivation has been linked to adverse perinatal outcomes, including stillbirth.

Methods

An observational case-control study was conducted, matching cases of stillbirth (n = 127) with a control cohort of live births (n = 266, ratio 2:1). Retrospective data on maternal characteristics, pregnancy details and neonatal outcomes from 2018–2021 was collected from a tertiary maternity unit in the Republic of Ireland. The Pobal HP Deprivation Index was used to categorise small areas into levels of deprivation. Maternal age, parity, BMI, booking visit gestation were considered potential confounding factors. Statistical analysis using SPSS, included: descriptive statistics, Chi-squared tests, T-tests. Logistic regression for crude and multivariate analysis, including odds ratio calculations, were used to identify differences in risk of stillbirth across the deprivation levels and categories of confounding factors.

Results

The results demonstrated no statistically significant correlation between level of deprivation and risk of having a stillbirth (p = 0.288) in this sample. When readjusted into quintiles of deprivation, a slightly higher representation of stillbirth was noted in the more deprived levels, though not statistically significant. When examining by cause of death, there was a significant association between deprivation and placental causes of death (p = 0.048). High BMI was consistently associated with stillbirth, while late booking visit gestation and advanced maternal age also showed associations.

Conclusions

This study found no clear link between deprivation and stillbirth but observed higher placental-related stillbirth in deprived quintiles, emphasising the need for further national research.

死产对家庭来说是一种毁灭性的结果。识别和处理风险因素至关重要。贫困程度与包括死产在内的不良围产期结局有关。方法采用观察性病例-对照研究，将死产病例（127例）与活产对照队列（266例，比例为2:1）进行配对。从爱尔兰共和国的一家三级产科病房收集了2018-2021年孕产妇特征、妊娠细节和新生儿结局的回顾性数据。全球HP剥夺指数用于将小区域划分为剥夺程度。产妇年龄、胎次、BMI、预约妊娠被认为是潜在的混杂因素。统计分析采用SPSS，包括：描述性统计、卡方检验、t检验。使用Logistic回归进行粗分析和多变量分析，包括优势比计算，以确定剥夺水平和混杂因素类别之间死产风险的差异。结果在该样本中，剥夺程度与死产风险之间无统计学意义的相关性（p = 0.288）。当重新调整到贫困的五分位数时，在更贫困的水平上，死产的比例略高，尽管没有统计学意义。当检查死亡原因时，剥夺与胎盘死亡原因之间存在显著关联（p = 0.048）。高BMI一直与死胎有关，而预约妊娠较晚和高龄产妇也显示出相关。结论：这项研究没有发现剥夺与死产之间的明确联系，但观察到剥夺五分之一的胎盘相关死产较高，强调需要进一步的国家研究。

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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 : 2025-09-16 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

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 : 2025-09-15 DOI: 10.1016/j.midw.2025.104599

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

引用次数: 0

Food adaptations and challenges during early pregnancy: A qualitative exploration of women’s experience 怀孕早期的食物适应和挑战：对妇女经验的定性探索

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-13 DOI: 10.1016/j.midw.2025.104609

Cindy Chevalley Gerber , Isabelle Carrard , Marielle Schmied , Raphaël Hammer

Background

Maternal nutrition is a significant factor influencing both fetal and maternal health. Barriers to healthy eating during pregnancy have been mostly investigated in terms of nutritional awareness and compliance with nutritional guidelines. However, little is known about women’s experiences of changing dietary practices in the first trimester of pregnancy specifically.

Aim

To explore women’s experiences of food adaptation in the context of daily life in early pregnancy, focusing on challenges and strategies to deal with them.

Methods

Face-to-face semi-structured interviews were conducted with a purposeful sample of 20 pregnant women after 16 weeks’ gestation in Switzerland. Data analysis followed the principles of thematic analysis.

Findings

We produced three core themes – “navigating the information jungle”, “handling pregnancy symptoms”, “keeping pregnancy secret and social norms around meals” – reflecting three significant challenges women faced in early pregnancy, and eight strategies they used to deal with these challenges.

Conclusion

Our findings highlight that food adaptations in early pregnancy lie at the intersection of bodily, cognitive, emotional, and psychosocial dimensions of eating. The absence of consultation with a perinatal health professional characterises early pregnancy, fostering women’s anxiety and uncertainty in relation to nutritional recommendations. Pregnant women should be entitled to an earlier reimbursed follow-up appointment during the first trimester. A consultation with a midwife or a dietitian would be particularly well-suited to provide them with reassurance and to help them achieve healthy diet despite the challenges they encounter.

母体营养是影响胎儿和母体健康的重要因素。对怀孕期间健康饮食障碍的调查主要是在营养意识和遵守营养准则方面进行的。然而，人们对女性在怀孕前三个月改变饮食习惯的经历知之甚少。目的探讨妇女在妊娠早期日常生活中的食物适应经历，重点探讨其面临的挑战和应对策略。方法采用面对面半结构化访谈法，对20名瑞士妊娠16周的孕妇进行有目的的抽样调查。数据分析遵循主题分析原则。调查结果我们制作了三个核心主题——“在信息丛林中导航”、“处理怀孕症状”、“保守怀孕秘密和围绕饮食的社会规范”——反映了妇女在怀孕早期面临的三个重大挑战，以及她们用来应对这些挑战的八种策略。结论：我们的研究结果强调，怀孕早期的食物适应处于饮食的身体、认知、情感和社会心理维度的交叉点。没有向围产期保健专业人员咨询是早孕的特点，这助长了妇女对营养建议的焦虑和不确定。孕妇应该有权在妊娠的前三个月获得更早的报销随访预约。与助产士或营养师的咨询将特别适合为他们提供保证，并帮助他们实现健康饮食，尽管他们遇到了挑战。

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引用次数: 0

Implementation of the clinical practice guideline on intrapartum care for low-risk births in Belgium 实施临床实践指南的产中护理低风险分娩在比利时。

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-13 DOI: 10.1016/j.midw.2025.104606

Yvonne J Kuipers , Roxanne Bleijenbergh , Eveline Mestdagh

Background

The newest Belgian clinical practice guideline on intrapartum care for low-risk births requires support to facilitate its implementation, as merely presenting guidelines does not guarantee adoption by end-users.

Aim

To systematically identify and prioritise clinical questions that need greater implementation support, understand the context of barriers and facilitators to implementation, and define a set of healthcare behavioural implementation activities for Belgian maternity services.

Methods

We employed an integrated knowledge translation approach, combining the Knowledge-To-Action and Intervention Mapping frameworks. This approach involves identifying clinical questions that require enhanced implementation support, analysing barriers within the context, and defining change and performance objectives. Feedback from a Belgian multi-stakeholder consulting group and Advisory Board informed the process.

Findings

Two clinical questions require greater support for implementation: (1) initial clinical investigations during labour and (2) ongoing investigations and interventions during a low-risk birth. Barriers to applying the recommendations include individual healthcare professional factors and professional interactions. Implementation demands healthcare professionals recognise the physiological aspects of labour and birth, stay updated on the evidence, accept the evidence supporting the management of low-risk births, and involve shared decision-making while seeking the woman’s consent. Achieving behavioural change consists of shifting attitudes, intentions, knowledge, social norms, and skills.

Discussion

The identified barriers to implementing recommendations emphasise the crucial role of interpersonal dynamics in successful guideline implementation. Therefore, policies should tackle structural challenges within Belgian maternity care.

Conclusion

To enhance maternity care services, communication, collaboration, and mutual understanding across professional boundaries are needed.

背景：最新的比利时临床实践指南的产中护理低风险分娩需要支持，以促进其实施，因为仅仅提出的指导方针并不能保证采用的最终用户。目的：系统地识别和优先考虑需要更多实施支持的临床问题，了解实施障碍和促进因素的背景，并为比利时产科服务定义一套医疗保健行为实施活动。方法：采用综合知识翻译方法，结合知识到行动和干预绘图框架。这种方法包括确定需要加强实施支持的临床问题，分析环境中的障碍，并确定变革和绩效目标。比利时多方利益攸关方咨询小组和咨询委员会的反馈意见为这一进程提供了信息。研究结果：两个临床问题需要更多的支持来实施：(1)分娩期间的初步临床调查；(2)低风险分娩期间的持续调查和干预。应用这些建议的障碍包括个人医疗保健专业因素和专业相互作用。实施要求保健专业人员认识到分娩和分娩的生理方面，随时了解最新的证据，接受支持低风险分娩管理的证据，并在征求妇女同意的同时参与共同决策。实现行为改变包括转变态度、意图、知识、社会规范和技能。讨论：已确定的实施建议的障碍强调了人际动态在成功实施指南中的关键作用。因此，政策应解决比利时产妇保健中的结构性挑战。结论：加强产科保健服务，需要跨专业的沟通、协作和相互理解。

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引用次数: 0

Deserts of disparity: Social vulnerability’s role in maternity care gaps 差距的沙漠：社会脆弱性在产妇保健差距中的作用

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-13 DOI: 10.1016/j.midw.2025.104608

Angelo Cadiente , Jamie Chen , Bryan Pilkington

Purpose

To determine the relationship between maternity care deserts and social vulnerability.

Study Design

1084 counties from the March of Dimes (2019–2021) and the CDC/ATSDR Social Vulnerability Index (SVI, 2020) across 11 U.S. states were assessed. Linear regression models analyzed the relationships between social vulnerability, obstetric providers, and uninsured women.

Results

SVI did not bear any statistical influence on maternity care desert classifications (r = -0.050, p = 0.101). However, higher SVI was correlated with fewer obstetric providers (β = -0.524, p < 0.001) and higher uninsured rates (β = 0.151, p < 0.001). Socioeconomic vulnerability (r = -0.143, p < 0.001) and household characteristics (r = -0.146, p < 0.001) were associated with reduced maternity care access, while racial and ethnic minority status (r = 0.064, p = 0.036) and housing type and transportation (r = 0.165, p < 0.001) were associated with greater access.

Discussion

Counties with greater vulnerability in socioeconomic status and household characteristics tended to have fewer obstetric providers available and higher proportions of uninsured women, indicating a double burden of social risk and limited medical infrastructure. Counties with greater vulnerability in racial and ethnic minority status and housing type and transportation were paradoxically associated with greater availability of maternity care resources, suggesting that despite diverse communities experiencing poor outcomes, they have the medical means available.

Conclusions

Our findings suggest that barriers to maternity care extend beyond resource availability, requiring efforts that address systemic barriers and equitable resource allocation.

目的探讨产妇保健荒漠与社会脆弱性的关系。研究设计评估了美国11个州的1084个县（2019-2021年）和CDC/ATSDR社会脆弱性指数（SVI， 2020年）。线性回归模型分析了社会脆弱性、产科服务提供者和未参保妇女之间的关系。结果ssvi对产妇护理沙漠分类无统计学影响（r = -0.050, p = 0.101）。然而，较高的SVI与较少的产科提供者（β = -0.524, p < 0.001）和较高的未参保率（β = 0.151, p < 0.001）相关。社会经济脆弱性（r = -0.143, p < 0.001）和家庭特征（r = -0.146, p < 0.001）与产妇保健机会减少有关，而种族和少数民族身份（r = 0.064, p = 0.036）和住房类型和交通（r = 0.165, p < 0.001）与产妇保健机会增加有关。在社会经济地位和家庭特征方面较为脆弱的国家，产科服务提供者较少，无保险妇女比例较高，这表明存在社会风险和医疗基础设施有限的双重负担。矛盾的是，在种族和少数民族地位、住房类型和交通方面更脆弱的县，产妇保健资源的可获得性更高，这表明，尽管不同社区的结果不佳，但它们拥有可用的医疗手段。结论我们的研究结果表明，产妇保健的障碍超出了资源可用性，需要努力解决系统障碍和公平的资源分配。

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引用次数: 0

Perception of empowerment in Spanish midwives: A cross-sectional study 西班牙助产士的赋权感知：一项横断面研究

IF 2.5 3区医学 Q1 NURSING

Midwifery

Pub Date : 2025-09-13 DOI: 10.1016/j.midw.2025.104611

Zaida Rodríguez-Puente , Agustín Rodríguez-Esteban , Francisco Javier Pérez-Rivera , Olga Arias-Gundín , Elena Andina-Díaz

Introduction

Empowerment of midwives is an important issue worldwide and lack of empowerment in midwives is associated with a decrease in job satisfaction and consequently a higher probability of job desertion. Given the international shortage of professionals, it is necessary to explore the key aspects of increasing their job satisfaction. The aim of this paper was to investigate perceptions of empowerment in Spanish midwives’ practice through the Perceptions of Empowerment in Midwifery Scale (PEMS).

Methods

A cross-sectional survey using a national sample of midwives in Spain from January to June 2023. 504 midwives were recruited from the Spanish Federation of midwives’ associations in 2023. Data were collected using the revised version of the Perception of Empowerment Scale (PEMS) translated into Spanish.

Results

The PEMS scale exhibited suitable validity. The exploratory factor analyses identified three subescales: Professional Recognition, Autonomy and Manager,Support,Skills & Resources and Autonomy. The PEMS-R-IT had good internal consistency for each proposed dimension. 54.3 % of the participants reported having autonomy in their work. There were significant differences between primary care midwives and special care midwives in the Professional recognition dimension p = .016*. Midwives working in primary care felt more recognized professionally.

Conclusions

The perception of empowerment and autonomy of Spanish midwives in maternity and postnatal wards was lower than in the primary care setting. Years of experience were not significant in feeling more autonomous. More research is needed to assess the perceptions of empowerment of midwives in Spain. This study support the psychometric quality of PEMS.

助产士的赋权是世界范围内的一个重要问题，助产士赋权不足与工作满意度下降有关，因此更有可能离职。鉴于国际上专业人才的短缺，有必要探讨提高他们工作满意度的关键方面。本文的目的是通过对助产规模（PEMS）的赋权感知来调查西班牙助产士实践中的赋权感知。方法2023年1 - 6月对西班牙助产士进行横断面调查。2023年从西班牙助产士协会联合会招募了504名助产士。数据收集使用翻译成西班牙语的授权感知量表（PEMS）的修订版。结果PEMS量表具有较好的效度。探索性因素分析确定了三个子量表：专业认可、自主与管理者、支持、技能与资源、自主。PEMS-R-IT对于每个建议的维度具有良好的内部一致性。54.3%的参与者表示在工作中有自主权。初级保健助产士与特护助产士在专业认知维度上存在显著差异p = 0.016 *。在初级保健工作的助产士感到更专业。结论西班牙助产士在产房和产后病房的赋权和自主权认知低于初级保健机构。多年的经验对感觉更自主没有显著影响。需要更多的研究来评估西班牙助产士赋权的看法。本研究支持PEMS的心理测量质量。

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