Women and Birth最新文献_第4页

Sex, gender identity and women’s health research and equality: An urgent need for clarity of language and accurate data collection 性别、性别认同与妇女健康研究和平等：迫切需要清晰的语言和准确的数据收集。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101854

Karleen D. Gribble , Leonie Callaway , Melissa Raven , Julie P. Smith , Jenny Gamble , Hannah G. Dahlen

Background

With the rise in salience of the concept of gender identity, changes are being made to language and data collection with major implications for women’s health research and equality. Specifically, language referring to women is being desexed and data collection on sex diminishing. In 2023, Australia’s National Health and Medical Research Council (NHMRC) undertook public consultations on two draft guidance documents discussing use of the words 'woman'/'women' when describing the involvement of pregnant women in research, and sex and gender identity data collection. We collaborated in writing and gathering support for responses to both consultations.

Discussion

We advocated retaining sexed usage of woman/women when sex was relevant, emphasising that addressing sexism and the female data gap requires identifying women as a group and emphasised the need to avoid confusion, dehumanisation, and exclusion of disadvantaged groups. We expressed concern that data collection on gender identity is supplanting that on sex, and sex data is not being accurately collected. We recommended the NHMRC prioritise data accuracy, guide researchers on when and how to collect sex data, and recognise that individuals do not universally apply gender identity to themselves. These issues have international relevance as pressure to desex language and prioritise gender identity data is occurring world-wide. The NHMRC has now finalised its data collection guidance, unfortunately our concerns were largely ignored.

Conclusion

Researchers and clinicians globally must urgently participate in policy discussion regarding the importance of sexed language and accurate sex data, to protect individual and population health and data and research integrity.

背景：随着性别认同概念的日益突出，语言和数据收集正在发生变化，对妇女健康研究和平等产生重大影响。具体来说，涉及女性的语言正在被去性别化，关于性别的数据收集正在减少。2023年，澳大利亚国家卫生和医学研究委员会（NHMRC）就两份指导文件草案进行了公众咨询，讨论了在描述孕妇参与研究时使用“妇女”/“妇女”一词，以及性别和性别认同数据收集。我们合作撰写和收集对这两项协商的答复的支持。讨论：我们主张在与性别相关的情况下保留对woman/women的性别用法，强调解决性别歧视和女性数据差距需要将女性视为一个群体，并强调需要避免混淆、非人性化和排斥弱势群体。我们对性别认同数据的收集正在取代性别数据，以及性别数据的收集不准确表示担忧。我们建议NHMRC优先考虑数据的准确性，指导研究人员何时以及如何收集性别数据，并认识到个人并不普遍地将性别认同应用于自己。这些问题具有国际相关性，因为世界各地都在面临消除语言性别差异和优先考虑性别认同数据的压力。NHMRC现在已经完成了数据收集指导，不幸的是，我们的担忧在很大程度上被忽视了。结论：全球的研究人员和临床医生必须紧急参与有关性别语言和准确性别数据重要性的政策讨论，以保护个人和人口健康以及数据和研究的完整性。

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引用次数: 0

Exploring Australian knowledge and practice for maternal postnatal transition of care between hospital and primary care: A scoping review 探索澳大利亚的知识和实践的产妇产后过渡护理之间的医院和初级保健：范围审查。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101852

Jennifer E. Green , Nicole Ang , Ben Harris-Roxas , Kathleen Baird , Heike Roth , Amanda Henry

Problem

Despite the significance of the perinatal period, postnatal care remains insufficient for optimising long-term health.

Background

The perinatal period is a vulnerable time in a woman’s life-course health trajectory. Supporting transitions from hospital to primary care is essential to promote health and guide evidence-based follow-up care.

Aim

The aims are to (i) explore existing knowledge and practice in Australia regarding maternal postnatal transitions of care between hospital and primary care and (ii) understand the enablers and barriers to implementing optimal postnatal discharge and handover of care from the maternity to primary health setting.

Methods

A scoping review was conducted according to PRISMA-ScR guidelines. Medline, Embase, CINAHL, Scopus and The Cochrane Library were searched using MeSH terms, subject headings and keywords. Full-text articles in English were included from 1st January 2010–8 th June 2024.

Results

Eighteen studies were included, 14 focused on care in specific states and four Australia-wide. Maternal postnatal transition of care between hospital and primary care varied. Critical components of care that were valued by women and healthcare providers and promoted effective care transitions were grouped into four concepts: “Woman-centred discharge planning and process”, “Integrated care”, “Follow-up care” and “Continuity of care". Discharge communication across Australian health services is diverse. Women and healthcare providers require clear discharge communication that highlights complications, guides follow-up and promotes continuity.

Conclusion

Australian postnatal transition between hospital and primary care is inconsistent and ineffective. Lack of robust handover between services hinders evidence-based follow-up care after postnatal discharge from hospital, particularly following pregnancy complications.

问题：尽管围产期很重要，但产后护理仍然不足以优化长期健康。背景：围产期是妇女一生健康轨迹中的一个脆弱时期。支持从医院到初级保健的过渡对于促进健康和指导循证后续护理至关重要。目的：目的是：（一）探索澳大利亚关于医院和初级保健之间产妇产后护理过渡的现有知识和实践；（二）了解实现最佳产后出院和从产妇到初级保健机构的护理移交的促进因素和障碍。方法：根据PRISMA-ScR指南进行范围审查。Medline, Embase， CINAHL， Scopus和Cochrane Library使用MeSH术语，主题标题和关键词进行检索。全文英文文章收录于2010年1月1日至8日 至2024年6月。结果：纳入了18项研究，14项关注特定州的护理，4项关注全澳大利亚的护理。产妇产后在医院和初级保健之间的护理过渡各不相同。受到妇女和保健提供者重视并促进有效护理过渡的护理的关键组成部分分为四个概念：“以妇女为中心的出院计划和程序”、“综合护理”、“后续护理”和“护理的连续性”。澳大利亚各卫生服务机构的出院沟通是多种多样的。妇女和保健提供者需要明确的出院沟通，突出并发症，指导后续工作并促进连续性。结论：澳大利亚产后医院和初级保健之间的过渡是不一致和无效的。服务之间缺乏强有力的交接，阻碍了产后出院后的循证随访护理，特别是在妊娠并发症发生后。

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引用次数: 0

Understanding preconception health in Australia through the lens of people of reproductive age: Implications for care providers 从育龄人群的角度了解澳大利亚的孕前健康：对护理提供者的影响。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101857

Edwina Dorney , Kate Cheney , Loretta Musgrave , Karin Hammarberg , Ray Rodgers , Kirsten I. Black

Problem

Limited awareness about the importance of preconception health is a recognised barrier to preparing for pregnancy.

Background

Opportunities exist to improve the health of future parents through preconception care. One of the recognised barriers to pregnancy preparation is a lack of knowledge and a lack of presentation for information and care.

Aim

To explore the understanding of “preconception health” amongst people of reproductive age in Australia to inform the delivery of preconception care.

Methods

A qualitative descriptive study using online interviews with people of reproductive age in Australia. Recruitment was via social media (Facebook). Interview transcripts were analysed thematically.

Findings

Of the 20 women and five men we interviewed, all acknowledged the importance of preparing for pregnancy. Despite broadly understanding the concept, most participants had limited understanding of the details of preconception health. To increase their knowledge, participants’ preferred sources of information included education in schools, reputable online sources, primary and maternity healthcare providers, and community members with lived experience.

Discussion

People in Australia are keen to learn about preparing for pregnancy and appreciate this as important. Suggested avenues to improve awareness and understanding about optimal preconception health included through school education, primary and reproductive healthcare providers, and online resources. This can improve understanding and behaviours before first and subsequent pregnancies.

Conclusion

Preconception care requires a life-course approach, beginning with universal education through schools, enhanced by readily accessible reputable online resources, and access to trusted primary and maternity care providers. Maternity care providers can be key drivers in this process.

问题：对孕前健康的重要性认识有限是公认的孕前准备障碍。背景：存在通过孕前护理改善未来父母健康的机会。公认的孕前准备障碍之一是缺乏知识和缺乏信息和护理的介绍。目的：探讨澳大利亚育龄人口对“孕前保健”的理解，为孕前保健的提供提供信息。方法：对澳大利亚育龄人群进行在线访谈，进行定性描述性研究。招聘是通过社交媒体（Facebook）进行的。访谈记录按主题进行分析。调查结果：在我们采访的20名女性和5名男性中，所有人都承认为怀孕做准备的重要性。尽管广泛了解这一概念，但大多数参与者对孕前健康的细节了解有限。为了增加他们的知识，参与者首选的信息来源包括学校教育、信誉良好的在线资源、初级和产妇保健提供者以及有实际经验的社区成员。讨论：澳大利亚人热衷于学习如何为怀孕做准备，并认为这很重要。建议通过学校教育、初级保健和生殖保健提供者以及在线资源提高对最佳孕前保健的认识和理解。这可以提高初次怀孕和随后怀孕前的认识和行为。结论：孕前保健需要一种贯穿整个生命周期的方法，从学校普及教育开始，通过易于获得的信誉良好的在线资源和可信赖的初级和产科保健提供者来加强。产妇保健提供者可以成为这一进程的关键驱动因素。

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引用次数: 0

Risk of suicide and postpartum depression in women who feel they were treated inadequately during childbirth 认为自己在分娩期间受到不适当治疗的妇女自杀和产后抑郁的风险。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101858

Juan Miguel Martínez-Galiano , Ana Rubio-Alvárez , Ana Ballesta-Castillejos , Inmaculada Ortiz-Esquinas , Miriam Donate-Manzanares , Antonio Hernández-Martínez

Background

Postpartum depression and suicide are two of the most frequent mental health disorders in the perinatal period and have an increasing trend.. An increasing number of women report receiving inadequate treatment during childbirth care. There are no studies that relate inadequate treatment to any of these mental health disorders; those that exist are very limited and have not used validated instruments. We proposed to determine if there is an association between inadequate treatment and/or abuse during childbirth care with the risk of postpartum depression (PPD) and the risk of suicidality in women during the perinatal stage.

Methods

An observational study was carried out with postpartum women in Spain. Information was collected on sociodemographic and obstetric variables, among others. Edinburgh Postnatal Depression Scale was used to determine the risk of postpartum depression and item 10 for the risk of suicide, and the Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ) was used to determine the women's perception of having been treated inadequately during childbirth. Adjusted ORs and their 95 % CI were calculated.

Results

1579 women participated. Women with CARE-MQ scores above the 90th percentile had a higher probability of risk of suicidal ideation (aOR of 2.89; 95 %CI: 1.60–5.04) and postpartum depression (aOR of 3.17; 95 %CI: 1.94–5.18) compared to those who had scores lower than the 50th percentile. On the contrary, factors associated with a lower probability of suicidal ideation and PPD were: higher economic income and attendance at prenatal education.

Conclusion

Women who perceived that they experienced a situation of inadequate treatment during childbirth were more likely to be at risk of postpartum depression and risk of suicide.

背景：产后抑郁和自杀是围产期最常见的两种心理健康障碍，并有上升趋势。越来越多的妇女报告在分娩护理期间得不到充分的治疗。没有研究表明治疗不足与任何这些精神健康障碍有关；那些现有的非常有限，并且没有使用经过验证的仪器。我们建议确定在分娩护理过程中治疗不当和/或虐待是否与围产期妇女产后抑郁（PPD）和自杀风险之间存在关联。方法：对西班牙产后妇女进行观察性研究。收集了关于社会人口和产科变量等方面的资料。采用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）测定产后抑郁风险和项目10测定自杀风险，采用《分娩虐待与尊重评价-产妇问卷》（CARE-MQ）测定产妇在分娩过程中受到不适当对待的感觉。计算调整后的or及其95% % CI。结果：1579名女性参与。CARE-MQ得分高于第90百分位的女性有更高的自杀意念风险(aOR为2.89；95 %CI: 1.60-5.04)和产后抑郁(aOR为3.17；95 %CI: 1.94-5.18)与那些得分低于50百分位的人相比。相反，与自杀意念和产后障碍发生率较低相关的因素是：较高的经济收入和参加产前教育。结论：认为自己在分娩过程中治疗不足的妇女更有可能患产后抑郁症和自杀的风险。

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引用次数: 0

Suboptimal care factors and stillbirths during the COVID-19 pandemic in Victoria: A state-wide linkage study of stillbirths and Consultative Council on Obstetric and Paediatric Mortality and Morbidity case reviews 维多利亚州COVID-19大流行期间的次优护理因素和死产：一项关于死产和产科和儿科死亡率和发病率咨询委员会病例审查的全州联系研究。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101855

Lisa Hui , Melvin B. Marzan , Kirsten R. Palmer , Carmel Walsh , Lisa Begg , Susan McDonald , Tanya Farrell , Mark Umstad

Problem

The COVID-19 pandemic affected perinatal outcomes globally, with some regions reporting an increase in stillbirths.

Background

Melbourne, Australia, experienced one of the longest and most stringent pandemic lockdowns.

Aim

To compare stillbirth rates for singleton pregnancies > 20 weeks’ gestation before and during the pandemic and examine differences in suboptimal care factors.

Methods

January 2018 to December 2021 data on singleton births ≥ 20 weeks in Victoria were extracted and linked to stillbirths in the Consultative Council on Obstetric and Paediatric Mortality and Morbidity database. Statistical comparisons of patient characteristics, pregnancy outcomes, and suboptimal care factors were performed between the pre-pandemic period (2018–19) and the pandemic years (2020, 2021).

Results

Among 302,528 singleton births, 2244 stillbirths were recorded. The stillbirth rate was higher in the first pandemic year (0.81 %) compared with pre-pandemic years (0.73 %) and the second pandemic year (0.70 %) (p = 0.04). No stillbirths were directly attributable to maternal COVID-19 infection. The proportion of stillbirths with suboptimal care factors was similar across periods (p > 0.05). 'Barriers to engaging care' increased in frequency as a contributing factor (p < 0.001). 'Organizational factors' were more common in 2020 (p < 0.001), while suboptimal care related to healthcare personnel was less common in 2021 (p < 0.001). Disadvantaged and non-Australian-born women were more likely to experience suboptimal care.

Discussion

Significant fluctuations in stillbirth rates were observed during the pandemic, with a temporary rise in 2020. Barriers to accessing care were a notable factor.

Conclusion

Embedding woman-centred care to address structural inequities is essential for supporting families and creating a just health system.

问题：COVID-19大流行影响了全球围产期结局，一些地区报告死产增加。背景：澳大利亚墨尔本经历了最长、最严格的疫情封锁之一。目的：比较大流行前和期间妊娠20周单胎妊娠bb0 的死产率，并检查次优护理因素的差异。方法：提取维多利亚州2018年1月至2021年12月≥ 20周的单胎分娩数据，并将其与产科和儿科死亡率和发病率咨询委员会数据库中的死胎相关联。在大流行前时期（2018- 2019年）和大流行年份（2020年、2021年）之间对患者特征、妊娠结局和次优护理因素进行了统计比较。结果：在302528例单胎分娩中，有2244例死产。死产率在大流行第一年（0.81 %）高于大流行前年份（0.73 %）和大流行第二年（0.70 %）（p = 0.04）。没有死产直接归因于母体感染COVID-19。各时期护理因素不理想的死产比例相似（p > 0.05）。作为一个促成因素，“参与护理的障碍”的频率增加了（p ）讨论：在大流行期间观察到死产率的大幅波动，在2020年暂时上升。获得保健的障碍是一个显著因素。结论：将以妇女为中心的护理纳入解决结构性不平等问题，对于支持家庭和建立公正的卫生系统至关重要。

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引用次数: 0

How do midwives learn about, understand, and integrate Cultural Safety into their care of First Nations women and families? A qualitative exploration 助产士如何了解、理解文化安全并将其融入对原住民妇女和家庭的护理中？定性探索。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2025.101868

Moira Williamson , Tanya S. Capper , Rachelle M. Chee , Bridget Ferguson , Katie Lentell , Kelly Haynes

Problem

Midwives are required to provide care based on Cultural Safety for First Nations women and families. Recent literature has suggested that midwives' understanding of Cultural Safety and how it translates into their practice differs widely. This disparity requires further exploration.

Background

The Australian professional midwifery codes and standards state that there is a requirement to provide care based on Cultural Safety. It is critical to understand how First Nations people’s history and culture impacts their health and wellbeing, requiring midwives to recognise how this may impact care.

Aim

To determine Australian midwives’ knowledge and understanding of Cultural Safety and how this translates into their practice when caring for First Nations women and families.

Methods

A qualitative study was undertaken. Data were collected via semi-structured interviews with 12 midwives practicing in Australia. Data were transcribed and thematically analysed.

Findings

Three themes were identified: ‘Society and Systems’, ‘Knowingness versus Understanding’, and ‘Personal Qualities, Engagement and Partnerships’ which highlight the strengths and deficits of Cultural Safety education and its integration into midwifery practice in Australia.

Discussion

Health systems providing maternity care remain rooted in Western biomedical philosophies, which influences the practice of Cultural Safety at all levels. Midwives are beginning to understand the ongoing impact of colonisation on the health and wellbeing of First Nations families, but still face challenges when striving to provide culturally safe care.

Conclusion

Cultural Safety must be valued at an organisational level, in which midwives can engage in authentic, maternity-based educational programs led by suitably prepared educators.

问题：要求助产士为原住民妇女和家庭提供基于文化安全的护理。最近的文献表明，助产士对文化安全的理解以及如何将其转化为实践存在很大差异。这种差异需要进一步探讨：澳大利亚专业助产士守则和标准规定，必须提供基于文化安全的护理。了解原住民的历史和文化如何影响他们的健康和福祉至关重要，这就要求助产士认识到这可能会如何影响护理工作。目的：确定澳大利亚助产士对文化安全的认识和理解，以及在护理原住民妇女和家庭时如何将其转化为实践：方法：开展一项定性研究。通过对 12 名在澳大利亚执业的助产士进行半结构化访谈收集数据。对数据进行了转录和主题分析：确定了三个主题：社会与系统"、"了解与理解 "以及 "个人素质、参与与合作"，这些主题突出了澳大利亚文化安全教育及其与助产实践相结合的优势与不足：讨论：提供孕产妇护理的医疗系统仍然根植于西方生物医学理念，这影响了文化安全在各个层面的实践。助产士开始了解殖民化对原住民家庭健康和福祉的持续影响，但在努力提供文化安全护理时仍面临挑战：文化安全必须在组织层面得到重视，助产士可以在这些组织中参与由准备充分的教育者领导的、以孕产为基础的真实教育计划。

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引用次数: 0

Intrapartum hydration assessment and management: A cross-sectional survey of Australian and New Zealand maternity units 产时补水评估和管理：澳大利亚和新西兰产科单位的横断面调查。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101865

Brianne G. McIntyre , Debbie Massey , Nigel Lee , Lauren Kearney

Background

Hydration assessment and management during labour play an important role in maternal and newborn outcomes. Studies indicate that clinical practice is inconsistent, with limited consensus evident in clinical guidelines. Current practices in fluid management across public and private maternity units within Australia and New Zealand remain unknown. Respondents highlighted the importance of maternal hydration assessment and management to well-being. However, inconsistencies were noted in the documentation, medication use and adherence to clinical protocols.

Aim

Our study aimed to investigate unit-level clinical practice regarding intrapartum hydration assessment and management across Australian and New Zealand private and public hospitals. The scope of this study focuses on fluid management during both spontaneous and induced labour.

Method

We conducted a cross-sectional, descriptive survey to assess the fluid management practices of Australian and New Zealand maternity services.

Results

Of the 307 eligible maternity units, 89 participated (responding key informants included midwives, obstetricians, managers, and educators). All acknowledged the importance of maternal intrapartum hydration assessment and management. However, variations existed in assessment methods, with urine colour (87.6 %, n = 78) and frequency (84.3 %, n = 75), as well as maternal and fetal vital sign assessments (83.1 %, n = 74) being most prevalent. Documentation format and tools varied, and midwives identified this as their role. Despite the significance attributed to hydration by clinicians, not all felt confident in their capabilities to assess or manage intrapartum hydration. Free-text responses emphasised the significance of this topic from an educational perspective.

Conclusion

Respondents highlighted the significance of maternal intrapartum hydration assessment and maternal and newborn well-being management. However, inconsistent documentation, medication usage, including intravenous fluids, and clinical protocols were evident.

背景：产程中的水分评估和管理在孕产妇和新生儿结局中起着重要作用。研究表明临床实践是不一致的，在临床指南中有有限的共识。目前，澳大利亚和新西兰公立和私立妇产单位的流动管理做法尚不清楚。答复者强调了产妇水合作用评估和管理对健康的重要性。然而，在文件、药物使用和对临床方案的依从性方面注意到不一致。目的：本研究旨在调查澳大利亚和新西兰私立和公立医院在分娩时水合作用评估和管理方面的单位临床实践。本研究的范围侧重于自然分娩和引产期间的液体管理。方法：我们进行了一项横断面描述性调查，以评估澳大利亚和新西兰产科服务的流体管理实践。结果：在307个符合条件的产科单位中，有89个参与了调查（回答的关键信息提供者包括助产士、产科医生、管理人员和教育工作者）。所有人都承认产妇产时水分评估和管理的重要性。在评估方法,然而,也存在与尿颜色(87.6 % n = 78)和频率(84.3 % n = 75),以及孕产妇和胎儿的生命体征评估(83.1 % n = 74)是最流行的。文件格式和工具各不相同，助产士认为这是她们的角色。尽管临床医生认为水合作用很重要，但并非所有人都对自己评估或管理产时水合作用的能力充满信心。自由文本的回答从教育的角度强调了这一主题的重要性。结论：受访者强调了产妇产时水分评估和母婴健康管理的重要性。然而，文件、药物使用（包括静脉输液）和临床方案明显不一致。

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引用次数: 0

Evaluating a midwifery leadership programme: a process evaluation study 评估助产领导方案：过程评估研究。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101853

Malin Bogren , Paridhi Jha , Bharati Sharma , Kerstin Erlandsson

Background

Despite global support for midwifery leadership investment, there is a notable lack of scientific evaluations of leadership programmes worldwide for midwives. The Government of India’s Midwifery Initiative launched the Midwifery Leadership Programme to enhance the leadership capacity of state-level midwifery leaders.

Aim

To evaluate the Midwifery Leadership Programme in India using implementation science as a framework.

Methods

A qualitative research design using the UK Medical Research Council guidance for process evaluation of a 12-week midwifery leadership programme in India. Data were collected through focus group discussions (n=6) with midwives and medical doctors, who have responsibility in maternal and child health services, midwifery education, practice and regulation, and individual interviews (n=3) with programme directors and a government representative, resulting in an individual participant total of 22. Transcribed discussions were analysed guided by an evaluation framework, using content analysis.

Results

The midwifery leadership programme was successfully implemented in terms of fidelity, dose, and reach, with continuous adaptations. Having the programme’s design, structure, and content tailor-made for the Indian context was valued highly. Easy-to-follow assignments led to state-level action plans, while participants’ motivation and improved communication skills enhanced leadership capacity.

Conclusions

This study demonstrates the utility of a process evaluation framework in evaluating midwifery education programmes, using the Midwifery Leadership Programme in India as an example. It is recommended that future research on evaluating midwifery education initiatives adopt implementation science frameworks to evaluate both the implementation process and the mechanisms driving programmes' impact for change, thereby informing the design and delivery of effective midwifery education programmes.

背景：尽管全球支持助产士领导力投资，但全球范围内明显缺乏对助产士领导力项目的科学评估。印度政府的助产行动发起了助产领导规划，以提高邦一级助产领导人的领导能力。目的：以实施科学为框架评估印度助产领导计划。方法：采用英国医学研究理事会指导的定性研究设计，对印度为期12周的助产领导方案进行过程评估。通过与负责妇幼保健服务、助产教育、实践和监管的助产士和医生进行焦点小组讨论（n=6）以及与方案主任和一名政府代表进行个人访谈（n=3）收集数据，个人参与者共计22人。在评估框架的指导下，使用内容分析对记录的讨论进行分析。结果：助产领导方案在保真度、剂量和覆盖范围等方面成功实施，并不断进行调整。该课程的设计、结构和内容都是为印度量身定制的，受到了高度重视。易于遵循的任务导致了国家级的行动计划，而参与者的动机和沟通技巧的提高提高了领导能力。结论：本研究展示了过程评估框架在评估助产教育方案中的效用，以印度助产领导方案为例。建议未来评估助产教育倡议的研究采用实施科学框架来评估实施过程和推动方案变革影响的机制，从而为有效的助产教育方案的设计和实施提供信息。

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引用次数: 0

Midwives’ and nurses’ experiences of providing postnatal care in partnership: A cross-sectional study 助产士和护士合作提供产后护理的经验：一项横断面研究。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101851

Kyle Ernst , Georgia Griffin , Monique S. Rose , Andrew Szabo , Stuart Watson , Zoe Bradfield

Problem

It is unknown whether the deployment of registered nurses to assist midwives in the provision of postnatal care eases the burden of workforce shortages.

Background

The largest public maternity health service in Western Australia began employing registered nurses in 2022 to assist midwives with the provision of postnatal care on maternity wards in response to staffing shortages, exacerbated by COVID-19.

Aim

To explore midwives’ and registered nurses’ experiences of providing postnatal care on maternity wards together.

Methods

A descriptive cross-sectional design was employed. Quantitative and qualitative data were collected using a paper-based survey tool. Data were analysed using descriptive and inferential statistics. Content analysis was conducted on qualitative data.

Results

70 staff participated (n= 58 midwives, n=12 nurses). Only 19.2 % of participants felt positively about their workload allocation. Most participants (62.7 %) reported a usual allocation of 6–7 mother-baby dyads to care for. Significantly more midwives preferred allocation by the shift coordinator than nurses; and significantly more nurses preferred ‘team nursing’ than midwives.

Discussion

Strategic approaches are needed to improve recruitment and retention of midwifery workforce capable of responding to periods of acute demands across the full scope of midwifery practice. Guidance concerning nurses’ scope of practice in the postnatal setting is necessary from a professional, medico-legal, governance and safety standpoint.

Conclusion

The deployment of registered nurses into postnatal wards may be of some benefit to midwives in the context of workforce shortages. Parameters must be set outlining what is within nurses’ scope of practice in the postnatal care setting.

问题：目前尚不清楚部署注册护士协助助产士提供产后护理是否减轻了劳动力短缺的负担。背景：西澳大利亚州最大的公共产科保健服务机构于2022年开始雇用注册护士，以协助助产士在产科病房提供产后护理，以应对因COVID-19而加剧的人员短缺。目的：探讨助产士与注册护士在产房共同提供产后护理的经验。方法：采用描述性横断面设计。使用纸质调查工具收集定量和定性数据。数据分析采用描述性和推断性统计。对定性数据进行内容分析。结果：参与工作人员70人（助产士58人，护士12人）。只有19.2% %的参与者对他们的工作量分配持积极态度。大多数参与者（62.7 %）报告了通常分配6-7个母亲-婴儿的照顾。更倾向于由轮班协调员分配的助产士明显多于护士；与助产士相比，更多的护士更喜欢“团队护理”。讨论：需要采取战略方法，以改善助产士队伍的招聘和保留，使其能够在整个助产实践范围内应对紧急需求。从专业、医学法律、管理和安全的角度来看，关于护士在产后环境中执业范围的指导是必要的。结论：在劳动力短缺的背景下，部署注册护士到产后病房可能对助产士有一定的好处。必须设定参数，概述护士在产后护理环境中的实践范围。

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引用次数: 0

Embedding LGBTQIA+ health equity in midwifery education: A holistic whole-of-programme approach 将LGBTQIA+健康公平纳入助产教育：全面的整体方案方法。

IF 4.4 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-01-01 DOI: 10.1016/j.wombi.2024.101850

George Parker , Fleur Kelsey , Suzanne C. Miller , Christine R. Griffiths , Alex Ker , Sally A. Baddock

Skilled midwifery care for LGBTQIA+ people is a human right, however LGBTQIA+ people have been under-served in perinatal care by the privileging of cisgender heterosexual endosex women as recipients of care. The education of midwives and other professionals to provide LGBTQIA+ inclusive care is a critical component of wider strategies to address LGBTQIA+ discrimination in perinatal care.

This paper responds to this challenge by discussing an innovative and holistic approach to introducing and embedding LGBTQIA+ health equity into one midwifery education programme in Aotearoa New Zealand. This approach harnesses opportunities in both the formal and informal curriculum and draws on the conceptual frameworks of cultural safety and humility, intersectionality, and Indigenous justice. These frameworks have informed an on-going process of reflection on, and unlearning of, cis-heteronormativity and other systemic injustices when providing perinatal care to diverse populations, for both midwifery educators and students.

为LGBTQIA+人群提供熟练的助产护理是一项人权，然而，由于将顺性异性恋内性女性作为护理对象的特权，LGBTQIA+人群在围产期护理方面得到的服务不足。教育助产士和其他专业人员提供LGBTQIA+包容性护理是解决围产期护理中LGBTQIA+歧视的更广泛战略的关键组成部分。本文通过讨论一种创新和全面的方法来应对这一挑战，将LGBTQIA+健康公平引入新西兰奥特罗阿的一个助产教育项目。这种方法利用了正式和非正式课程中的机会，并借鉴了文化安全和谦逊、交叉性和土著正义的概念框架。这些框架为助产教育工作者和学生在向不同人群提供围产期护理时，对顺异性规范和其他系统性不公正现象的反思和遗忘提供了持续的信息。

引用次数: 0