European Journal of Midwifery最新文献

Introduction: The United Nations define violence against women (VAW) as any gender-based violence that causes mental, physical, or economic harm and restricts freedom. The topic has not been studied before in the context of the midwifery curriculum in Estonia. The purpose of the study is to investigate the attitudes of midwife students towards VAW.

Methods: This pilot study followed a mixed-methods approach. The study population consisted of 77 midwifery students at Tallinn Health Care College from 2022-2023. The online survey was distributed to all Tallinn Health Care College midwifery students. The pilot study is used to validate the questionnaire and obtain initial information.

Results: The results show that the midwife students of this study have personal experiences and exposures to different types of violence, and some midwife students had sociocultural misconceptions about VAW. Midwife students have limited knowledge of the impact of violence on women's health and the legislation regarding violence. Midwife students stated that they would not be able to properly help the woman as a victim, as they lack knowledge, skills, and experience, which is an unfortunate factor.

Conclusions: The present pilot study showed that midwife students' attitudes towards VAW need improvement. The study raises the need to investigate midwife students' attitudes towards VAW with a larger sample, better-designed method, and validated questionnaire. Topics related to violence should be included in the midwifery curriculum, along with developing practical skills.

Introduction: Student midwives exposed to effective systems of midwifery care in other countries can consider how aspects of this knowledge can translate into their healthcare system to improve maternal and infant perinatal outcomes. An optional short-term study abroad (STSA) experience was developed for US midwifery graduate students to expose them to the UK healthcare system, where midwives are considered the primary professionals for the care of the childbearing family. This qualitative study explored the influence of an STSA experience on US midwifery graduate students' learning of midwifery in the UK.

Methods: Ten midwife student participants wrote pre- and post-trip narratives in the US and daily diary entries during their week in the UK. A grounded theory approach guided the content analysis. The themes were derived from the NVivo software data by three midwife researchers who value global health learning experiences. Analysis was shared with participants to ensure its trustworthiness.

Results: Themes that emerged included: 'Another viewpoint', encapsulating curiosity and comparison of US and UK midwifery; 'Eye-opening', capturing surprise at noted differences between US and UK midwifery practice; and 'Goals met and influenced', expressing how their learning is anticipated to shape their professional identities and career trajectories going forward.

Conclusions: US student midwives exposed to functional systems in countries where midwifery care is fully integrated, broadened their views of midwifery care and practice. They became inspired to make positive changes in the US. Educational opportunities for midwifery students, such as STSA experiences, can positively influence self-confidence and professional identity.

Introduction: Although the Lithuanian government increases funding for the cervical cancer prevention program every year, the incidence and mortality rates of cervical cancer are among the highest in Europe. In order to improve the prevention policy regarding cervical cancer, it is necessary to investigate the implementation of the cervical cancer prevention policy in one of the regions in Lithuania.

Methods: A quantitative survey method using a questionnaire, was applied in one of the regions of Lithuania. The study was conducted in the period 1-18 April 2022. During the study, 213 residents of the investigating region were interviewed.

Results: Respondents evaluated the cervical cancer prevention program in the investigated region positively, but not all women received invitations to participate in this program. The research revealed that the residents of the city of investigation have received this invitation more often than the women living in other districts.

Conclusions: Women's opinion about the effectiveness of the cervical cancer prevention program is positive. Still, there is an emphasis on the wish that this program could be used from an the age of 25 years and continue to 59 years. The prevention program could be carried out more often than is currently established.

Introduction: Effective collaborative practice between midwives and obstetricians improves patient safety and obstetrical outcomes, but its implementation remains challenging. Therefore, its determinants need to be better understood. This study examined factors impacting collaborative practice (CP) between these professional groups.

Methods: This study was a cross-sectional survey that took place in Swiss hospital labor wards in 2021. Collaborative practice perceptions of 70 midwives (57.4% response rate) and 44 obstetricians (29.0% response rate) were assessed using the Interprofessional Collaboration Scale, with the score serving as the main outcome. A total of 13 individual, behavioral, and organizational predictors were analyzed by multiple linear regression.

Results: Participants rated collaborative practice with a median score of 3.1 (IQR: 2.8-3.4) out of a maximum score of 4.0. Results showed that five predictors significantly influenced collaborative practice: type of profession (β= -0.180; 95% CI: -0.296 - -0.040, p=0.011), trust/respect (β=0.343; 95% CI: 0.085-0.040, p=0.000), shared visions/goals (β=0.218; 95% CI: 0.030-0.204, p=0.009), workplace (β=0.253; 95% CI: 0.089-0.445, p=0.004) and shared power (β=0.163; 95% CI: 0.042-0.222, p=0.015). The model explained 66% of the variance (adjusted R2) in collaborative practice in labor wards.

Conclusions: This study has identified key factors influencing CP in Swiss labor wards: workplace characteristics that require tailored CP models, and a power-sharing culture that fosters trust, respectful interactions and shared goals, requiring active exchange between midwives and obstetricians.

Introduction: Preterm birth continues to be one of the most significant contributors to perinatal death. This study aims to evaluate the quality of antenatal care provided to women delivering preterm.

Methods: This was a retrospective, descriptive, longitudinal review of all women who had antenatal care within a single Australian tertiary hospital and delivered spontaneously between 24 and 37 weeks of gestation, using an auditable scoring system assessing potential interventions for prevention of preterm birth. The review was limited to singleton pregnancies without fetal abnormalities delivering between January 2013 and April 2015. The audit tool was developed by reference to established 'best practice' guidance for prediction and prevention of preterm birth based on Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines and published literature. Different pathways were assessed for women deemed either low- or high-risk at the outset of antenatal care.

Results: A series of 161 pregnancies that delivered preterm (between 24 and 37 weeks' gestation) were reviewed. The quality of antenatal care was scored 'good' in 42.9% and 50% of high-risk and low-risk women, respectively. Care was scored 'adequate', with room for improvement in 51.4% and 45.2% of the two corresponding groups. The main deficiencies in care were recorded evidence of assessment of cervical length (absent in 35% of cases) and failure to screen for bacterial vaginosis in high-risk women.

Conclusions: Auditing antenatal care for prevention of preterm birth allows identification of suboptimal practice allowing service improvement and potential intervention for preterm birth prevention.

Introduction: Empathy plays an important role in midwifery care, not only for the women but also for midwives. The Midwifery Empathy Scale (MES) was developed to assess the empathy levels of midwives and midwifery students. The purpose of this study was the translation and validation of the MES for an Austrian sample.

Methods: A total of 277 midwives working in Austria completed the questionnaire of the MES. The psychometric measurements that were performed included explanatory factor analysis using a varimax rotation and principal components analysis. Moreover, the internal consistency of the MES was assessed with reliability coefficients. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and a Bartlett's test of sphericity were carried out.

Results: Principal components analysis showed seven orthogonal factors. KMO measure of sample adequacy = 0.724 and Bartlett's test of sphericity = 1058.904 (df=231, p<0.0001). The MES showed an acceptable overall internal consistency: Cronbach's alpha was found to be 0.721 and the Guttman split-half coefficient was 0.611. The findings of our study confirm the multidimensionality of MES, demonstrating a seven-factor structure which contained subscales reflecting empathy and emotional connection. The mean total score of Austrian midwives' responses to the MES was 44.80 with scores ranging from 24 to 81.

Conclusions: This study shows that the German version of the Midwifery Empathy Scale is a reliable instrument for evaluating the empathy levels of midwives and midwifery students in Austria. The German MES could be used in the selection and education of future midwives as well as in connection with empathy trainings of midwives.

This article explores the Quality of Provider Interaction (QPI) within maternity care, spotlighting its crucial role in positive childbirth experiences. It emphasizes the need for trust-based relationships between women and their care providers, a necessity amplified by the profound neurohormonal sensitivities experienced during labor. Drawing from the 'Optimizing the birth environment' COST DEVOTION CA18211 Working Group, this article aims to provide insights and stimulate discussion on how to mitigate birth trauma and improve childbirth experiences. The study evolved through discussions on QPI, engagement with the group, a review of COST Action research, and conference contributions, leading to essential recommendations. From our dialogue and evaluation of existing literature, we identified four pivotal aspects critical to enhancing QPI: 1) Empathy and emotional availability, 2) Trauma-informed maternity care, 3) Integrating woman-centered individual and institutional attitudes, and 4) Empowering language use. We examine how these elements influence women's emotional and psychological well-being throughout childbirth and beyond, underscoring their critical contribution. This article proposes a framework to improve maternity care by enhancing the Quality of Provider Interaction (QPI). It offers practical recommendations for refining care protocols and language guidelines, emphasizing the importance of respectful, secure birthing environments. Adopting care models that prioritize high-quality provider interactions is crucial for the well-being of women and their families.

Introduction: Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.

Methods: A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.

Results: Women were six times (OR=0.15; 95% CI: 0.0-0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35-0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ²(1)= -0.37, p=0.542].

Conclusions: This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.

Clinical trial registration: The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.

Identifier: ID ACTRN12623000807651.

Introduction: The study aimed to compare the impact of the physiotherapeutic method combined with TENS and physiotherapy alone on post-cesarean pain levels and the time required for intestinal peristalsis recovery. The study was conducted at the Specialist Hospital in Kraków, from January to March 2020.

Methods: The study was designed as a parallel randomized controlled trial (RCT). Participants were randomly assigned to one of three groups: TENS (n=52), nTENS (n=50) and control group (n=34), based on block randomization of 6. The allocation sequence was provided using a computer-generated random list. The participants were 136 postpartum primiparous women after cesarean birth, aged ≥18 years, having a healthy newborn, with no contradictions to TENS. The TENS group received a physiotherapeutic procedure involving a 20-minute exercise program plus a 40-minute session of TENS. The nTENS group received physiotherapeutic procedure alone, and the control group was under the routine care of midwives. The pain was assessed using the Numerical Rating Scale (NRS) at 6, 7, 12 and 24 hours after cesarean birth and twice during verticalization.

Results: TENS and nTENS groups had decreased pain intensity immediately after the intervention compared to the control group (p=0.002, p=0.027, respectively). During the first stage of the verticalization, the smallest increase in pain was observed in the TENS (p=0.044 compared to nTENS, p=0.000 compared to the control group). Within the increase in the pain score, the intestinal peristalsis recovery time was longer. In both groups undergoing physical therapy, a shortened recovery time of intestinal peristalsis was demonstrated (p=0.000).

Conclusions: The proposed physiotherapy program, combined with TENS and instruction, proved effective in relieving post-cesarean pain and accelerating the time to first defecation and should be considered part of the standard patient management program in maternity units.