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This might hurt: Healthcare provider’s experience of managing pain during intrauterine device insertions in Victoria, Australia 这可能会造成伤害:澳大利亚维多利亚州的医疗保健提供者在宫内节育器插入过程中处理疼痛的经验。
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-05 DOI: 10.1016/j.srhc.2025.101153
Hannah Wood , Cassandra Caddy , Henrietta Williams , Cathy Watson , Jacqueline Coombe

Background

Intrauterine devices (IUDs) are highly effective long-acting reversible contraceptives (LARCs) with relatively low uptake in Australia. They are typically inserted in primary care settings by trained general practitioners. Most patients report some pain during this procedure, yet health care provider (HCP) perspectives on pain management during IUD insertions is not well understood.

Methods

Individual semi-structured online interviews were conducted in 2024 with 16 HCPs who have inserted at least one IUD (outside of a training context) since 2020, in Victoria, Australia. Data were thematically analysed.

Results

Four themes were identified: managing pain requires diverse and adaptable strategies, conflicts in duty of care, awareness of and response to patient’s expected and actual pain, and systemic barriers to pain management. Participants felt that a standardised approach to pain management for IUD insertions was unsuitable, and pain management for this procedure requires patient preparation and flexible pharmaceutical and non-pharmaceutical strategies. Maintaining patient-centred care whilst inserting the IUD and managing pain was challenging, particularly as participants observed discrepancies in verbal and non-verbal cues from patients. Clinical and structural barriers impacted their ability to provide this level of care.

Conclusion

Most participants expressed satisfaction with current pain management methods, and some pain was viewed as expected for this procedure, revealing a possible disconnect between provider and patient expectations. Findings indicate that updated clinical guidelines, funding that reflects the time and skill required to complete this procedure and improved access to IUD insertions under anaesthetic would better support HCPs in mitigating their patient’s pain.
背景:宫内节育器(iud)是一种高效、长效、可逆的避孕药具(LARCs),在澳大利亚的使用率相对较低。它们通常由训练有素的全科医生插入初级保健机构。大多数患者在此过程中报告一些疼痛,但卫生保健提供者(HCP)对宫内节育器插入过程中疼痛管理的看法尚未得到很好的理解。方法:2024年在澳大利亚维多利亚州对16名自2020年以来至少植入了一个宫内节育器(在培训背景之外)的HCPs进行了个人半结构化在线访谈。对数据进行主题分析。结果:确定了四个主题:管理疼痛需要多样化和适应性策略,护理责任的冲突,对患者预期和实际疼痛的认识和反应,以及疼痛管理的系统性障碍。与会者认为,宫内节育器插入疼痛管理的标准化方法是不合适的,该过程的疼痛管理需要患者准备和灵活的药物和非药物策略。在插入宫内节育器和控制疼痛的同时保持以患者为中心的护理是具有挑战性的,特别是当参与者观察到患者口头和非口头暗示的差异时。临床和结构障碍影响了他们提供这种水平护理的能力。结论:大多数参与者对目前的疼痛管理方法表示满意,并且一些疼痛被认为是预期的,这表明提供者和患者期望之间可能存在脱节。研究结果表明,更新的临床指南,反映完成该程序所需时间和技能的资金,以及在麻醉下改善宫内节育器插入的可及性,将更好地支持HCPs减轻患者的痛苦。
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引用次数: 0
The experience of working alone as midwives in small-scale municipalities – a qualitative study with emphasis on professional loneliness 在小型城市作为助产士独自工作的经验——一项强调职业孤独的定性研究。
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-28 DOI: 10.1016/j.srhc.2025.101150
Kristine Bjelland, Vigdis Aasheim, Eline Skirnisdottir Vik, Elisabeth Hemnes Aanensen

Objective

To examine how midwives in small-scale municipalities in Norway experience working alone, with emphasis on professional loneliness.

Method

This qualitative study was conducted using semi-structured interviews with twelve midwives. The data were analysed using Systematic Text Condensation as described by Malterud.

Results

The experience of working alone was described in terms of managing municipality’s maternity service independently, having an extensive practice and responsibility, feeling a duty to maintain up-to-date knowledge, and recognising the critical value of professional networks, both locally and centrally.

Conclusion

Working alone had both positive and negative impacts, and this study gives a deeper insight into professional loneliness as a challenge. A broader approach is necessary to uncover the consequences of working alone for individual midwives and the overall quality of service.
目的:研究挪威小型城市的助产士如何独自工作,重点是职业孤独。方法:采用半结构化访谈法对12名助产士进行定性研究。使用Malterud描述的system Text Condensation对数据进行分析。结果:独自工作的经验被描述为独立管理市政产科服务,有广泛的实践和责任,感觉有责任保持最新的知识,并认识到专业网络的关键价值,地方和中央。结论:独自工作既有积极的影响,也有消极的影响,本研究对职业孤独作为一种挑战有了更深入的了解。有必要采取更广泛的方法来揭示单独工作对个别助产士和整体服务质量的影响。
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引用次数: 0
Maternal physical health and breastfeeding problems in Croatia: national online survey of new mothers 克罗地亚产妇身体健康和母乳喂养问题:对新妈妈的全国在线调查。
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-27 DOI: 10.1016/j.srhc.2025.101149
Lisa H Amir , Daniela Drandić , Anita Pavičić Bošnjak , Ana Vidović Roguljić , Gill Thomson , Irena Zakarija-Grković

Objective

To document maternal physical health and breastfeeding problems in the first six months after giving birth in Croatia during the pandemic.

Methods

We conducted a cross-sectional study using an online questionnaire between February and April 2022 among resident Croatian women who had enrolled in the RODA (‘Parents in Action’) online antenatal course. Women aged 18 + years, who had given birth in a Croatian maternity facility between February 2020 and December 2021 were eligible. The questionnaire contained 75 items, covering sociodemographic characteristics, hospital practices, community support, maternal mental and physical health.

Results

Postpartum health and breastfeeding items were completed by 1760 participants. Most women were primiparous (80 %, n = 1420) and 72 % birthed vaginally (n = 1274). Major physical health issues were fatigue (28 %; n = 487), back pain (14 %; n = 252), and haemorrhoids (10 %; n = 171). Urinary incontinence was a minor problem for 23 % (n = 397), somewhat of a problem for 8 % (n = 139) and a major problem for 4 % (n = 67).The most common breastfeeding problems were nipple pain/damage 50 % (n = 885), difficulty attaching 43 %, (n = 761), low milk supply 28 % (n = 490), mastitis 22 % (n = 391), engorgement 22 % (n = 393), breast refusal 22 % (n = 381), and too much milk 22 % (n = 380).

Conclusion

Consistent with reports of maternal postpartum health in other countries, women in Croatia experienced many physical health challenges in the six months after childbirth. Most women described problems with breastfeeding; the frequency of pain associated with breastfeeding is concerning. Healthcare systems need to provide effective assistance to enable new mothers to establish breastfeeding without nipple pain and damage even during times of emergency measures.
目的:记录大流行期间克罗地亚产妇分娩后头六个月的身体健康和母乳喂养问题。方法:我们在2022年2月至4月期间对参加RODA(“父母在行动”)在线产前课程的克罗地亚居民妇女进行了一项横断面研究。2020年2月至2021年12月期间在克罗地亚产科设施分娩的18岁以上妇女有资格。调查表包含75个项目,包括社会人口特征、医院做法、社区支助、产妇身心健康。结果:1760名参与者完成了产后健康和母乳喂养项目。大多数妇女为初产(80%,n = 1420), 72%为顺产(n = 1274)。主要的身体健康问题是疲劳(28%,n = 487)、背痛(14%,n = 252)和痔疮(10%,n = 171)。尿失禁是23% (n = 397)的小问题,8% (n = 139)的大问题,4% (n = 67)的大问题。最常见的母乳喂养问题是乳头疼痛/损伤50% (n = 885),附着困难43% (n = 761),奶量不足28% (n = 490),乳腺炎22% (n = 391),充血22% (n = 393),拒乳22% (n = 381),奶量过多22% (n = 380)。结论:与其他国家关于产妇产后健康的报告一致,克罗地亚妇女在分娩后6个月内经历了许多身体健康方面的挑战。大多数妇女描述了母乳喂养的问题;与母乳喂养相关的疼痛频率令人担忧。卫生保健系统需要提供有效的援助,使新妈妈即使在采取紧急措施时也能在没有乳头疼痛和损伤的情况下进行母乳喂养。
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引用次数: 0
Work motivation among midwives in medium-sized labour wards in Denmark – An interview study 丹麦中型产房助产士的工作动机——一项访谈研究
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-26 DOI: 10.1016/j.srhc.2025.101151
Aleksandra Storm , Maiken Fabricius Damm , Caroline Moos , Christina Prinds

Introduction

Midwives are essential in securing high-quality maternity care. Despite several calls to action to curb the attrition rates of midwives, it is a continuing worldwide problem. Little is known about midwiveś work motivation, and understanding this can be key to improving well-being among midwives and thus lowering attrition rates. This study specifically explored midwiveś work-life from a salutogenic perspective focusing on aspects contributing to work motivation rather reasons behind resignation rates.

Objective

To explore midwives’ experiences and perceptions of work motivation from a salutogenic perspective.

Methods

A qualitative study was conducted with 15 female midwives working in two medium-sized labor wards (approximately 1600 childbirths annually). Participants were interviewed between December 2023 and April 2024. Data was synthesized using Reflexive Thematic Analysis.

Results

The analyses resulted in three themes: labor ward size, work-life balance and recognition. Participants elaborated on how workplace size, supportive relationships, self-awareness in work practice, and recognition from patients, peers, and management were key to work motivation. Notably, one of the labor wards had a significantly high proportion of midwives with over 15 years of experience.

Conclusion

By exploring midwives’ experiences through a salutogenic lens, this study highlights key aspects that foster work motivation and professional well-being. Key motivators included manageable ward size, supportive relationships, work-life balance, and recognition from patients, colleagues, and leadership. Notably, a labor ward with a high proportion of experienced midwives exemplified how these factors can foster long-term engagement. Future research could implement different strategies to test how they improve midwives’ motivation.
助产士对于确保高质量的产妇护理至关重要。尽管有人呼吁采取行动遏制助产士的流失率,但这是一个持续存在的全球性问题。人们对助产士的工作动机知之甚少,了解这一点可能是改善助产士幸福感的关键,从而降低流失率。本研究特别从健康的角度探讨了midwiveva的工作-生活,重点关注有助于工作动机的方面,而不是辞职率背后的原因。目的从健康学的角度探讨助产士对工作动机的感受和体会。方法对两个中型产房(年分娩约1600例)的15名女助产士进行定性研究。参与者在2023年12月至2024年4月期间接受了采访。数据采用自反性主题分析进行综合。结果分析得出三个主题:劳动病房规模、工作生活平衡和认可。参与者详细阐述了工作场所的规模、相互支持的关系、工作实践中的自我意识、患者、同事和管理层的认可是工作动机的关键。值得注意的是,其中一个产房拥有超过15年经验的助产士的比例非常高。结论:本研究从健康角度探讨助产士的经验,强调了促进工作动机和职业幸福感的关键方面。主要的激励因素包括可管理的病房规模、支持性关系、工作与生活的平衡以及患者、同事和领导的认可。值得注意的是,一个有高比例经验丰富的助产士的分娩病房证明了这些因素如何能够促进长期参与。未来的研究可以实施不同的策略来测试它们如何提高助产士的积极性。
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引用次数: 0
Contraceptive-induced amenorrhea: An exploratory study of perceptions among a reproductive-age urban Southern California population 避孕药引起的闭经:一项对南加州育龄城市人口认知的探索性研究
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-23 DOI: 10.1016/j.srhc.2025.101148
Irene Masini , Emily Frisch , Rana Andary , Elisabeth McCallum , Jonathan Steller , Jasmine Patel

Objectives

To evaluate the preferences for and knowledge of contraceptive-induced amenorrhea among a reproductive age predominantly Hispanic community in Southern California.

Methods

This cross-sectional study recruited English and Spanish speaking reproductively capable participants from three outpatient clinics associated with a large academic hospital. A validated survey assessed preferences and knowledge surrounding contraceptive-induced amenorrhea. Descriptive statistics, bivariate analyses using chi-squared tests, and multivariate regression were performed to evaluate the association between demographic variables and the desire for contraceptive-induced amenorrhea, as well as its perceived safety.

Results

Of 209 respondents (response rate: 78.9 %), 66.5 % were Hispanic and 48.8 % identified as Christian. A majority of participants (56.5 %) would not consider a contraceptive method that would induce amenorrhea. Furthermore, a majority of participants (64.1 %) believed that contraceptive-induced amenorrhea is harmful. Belief of harm due to contraceptive-induced amenorrhea was associated with avoiding contraception that could induce amenorrhea (p < 0.001). However, participants who were discontent with menstruation statistically preferred contraceptive-induced amenorrhea (p < 0.01). No significant association was found between race and preference for contraceptive-induced amenorrhea (p = 0.89) or understanding of its safety (p = 0.34).

Conclusions

The majority of our sample would not prefer contraceptive-induced amenorrhea and feared that amenorrhea would be harmful. Given the perceived harm of contraceptive induced amenorrhea may limit the use of highly effective methods for all races, educational initiatives aimed at reviewing safety may allow for more informed patient decision-making.
目的评价南加州以西班牙裔为主的育龄人群对避孕闭经的偏好和知识。方法本横断面研究从一家大型学术医院的三家门诊诊所招募有生育能力的英语和西班牙语受试者。一项有效的调查评估了人们对避孕药引起的闭经的偏好和认识。采用描述性统计、双变量分析(使用卡方检验)和多变量回归来评估人口统计学变量与避孕闭经意愿及其感知安全性之间的关系。结果209名受访者(回复率78.9%)中,西班牙裔占66.5%,基督徒占48.8%。大多数参与者(56.5%)不考虑会导致闭经的避孕方法。此外,大多数参与者(64.1%)认为避孕药引起的闭经是有害的。相信避孕药导致闭经的危害与避免可能导致闭经的避孕有关(p < 0.001)。然而,在统计上,对月经不满意的参与者更倾向于避孕闭经(p < 0.01)。种族与避孕闭经偏好(p = 0.89)或对其安全性的了解(p = 0.34)之间无显著关联。结论绝大多数妇女不赞成避孕闭经,担心闭经对健康有害。考虑到避孕引起的闭经的危害可能会限制所有种族高效避孕方法的使用,旨在审查安全性的教育倡议可能会让患者做出更明智的决定。
{"title":"Contraceptive-induced amenorrhea: An exploratory study of perceptions among a reproductive-age urban Southern California population","authors":"Irene Masini ,&nbsp;Emily Frisch ,&nbsp;Rana Andary ,&nbsp;Elisabeth McCallum ,&nbsp;Jonathan Steller ,&nbsp;Jasmine Patel","doi":"10.1016/j.srhc.2025.101148","DOIUrl":"10.1016/j.srhc.2025.101148","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the preferences for and knowledge of contraceptive-induced amenorrhea among a reproductive age predominantly Hispanic community in Southern California.</div></div><div><h3>Methods</h3><div>This cross-sectional study recruited English and Spanish speaking reproductively capable participants from three outpatient clinics associated with a large academic hospital. A validated survey assessed preferences and knowledge surrounding contraceptive-induced amenorrhea. Descriptive statistics, bivariate analyses using chi-squared tests, and multivariate regression were performed to evaluate the association between demographic variables and the desire for contraceptive-induced amenorrhea, as well as its perceived safety.</div></div><div><h3>Results</h3><div>Of 209 respondents (response rate: 78.9 %), 66.5 <strong>%</strong> were Hispanic and 48.8 % identified as Christian. A majority of participants (56.5 %) would not consider a contraceptive method that would induce amenorrhea. Furthermore, a majority of participants (64.1 %) believed that contraceptive-induced amenorrhea is harmful. Belief of harm due to contraceptive-induced amenorrhea was associated with avoiding contraception that could induce amenorrhea (p &lt; 0.001). However, participants who were discontent with menstruation statistically preferred contraceptive-induced amenorrhea (p &lt; 0.01). No significant association was found between race and preference for contraceptive-induced amenorrhea (p = 0.89) or understanding of its safety (p = 0.34).</div></div><div><h3>Conclusions</h3><div>The majority of our sample would not prefer contraceptive-induced amenorrhea and feared that amenorrhea would be harmful. Given the perceived harm of contraceptive induced amenorrhea may limit the use of highly effective methods for all races, educational initiatives aimed at reviewing safety may allow for more informed patient decision-making.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101148"},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158794","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}
引用次数: 0
Bridging the Gap: Canadian Parents’ barriers and concerns in delivering sexuality education – A qualitative study 弥合差距:加拿大父母在提供性教育方面的障碍和担忧-一项定性研究
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-18 DOI: 10.1016/j.srhc.2025.101146
Neelam Punjani , Shannon D Scott , Amber Hussain , Tammy Lu , Farah Bandali , Sheila McDonald , Lisa Allen Scott

Background

Parents play a pivotal role in delivering comprehensive sexuality education (CSE) to their children. While school-based programs have expanded in many settings, parents often face cultural, informational, and emotional barriers in engaging in open discussions about sexual health. These challenges are intensified in diverse societies such as Canada, where cultural values and personal beliefs vary widely. Despite the growing recognition of parental involvement in CSE, limited research has explored Canadian parents’ perspectives on sexuality education, particularly in multicultural contexts.

Methods

We employed a community-based participatory research (CBPR) approach to examine the experiences, beliefs, and barriers Canadian parents face in providing sexuality education. Six virtual focus group discussions (FGDs) were conducted with 30 parents of children aged 0–18 years. Participants were recruited through purposeful and snowball sampling to ensure diverse representation. Data was analyzed using inductive thematic analysis to identify key themes related to parents’ understanding, approaches, and needs regarding sexuality education.

Results

Three major themes emerged (1) The holistic nature of sexuality education, emphasizing the importance of emotional, psychological, and social aspects alongside biology; (2) Timing and approaches, revealing uncertainty around when and how to initiate these conversations and a preference for child-led, ongoing dialogue; and (3) Influences of society, media, and schools, highlighting external factors shaping children’s understanding and parents’ concerns over misinformation and inconsistent educational content. Parents also reported difficulties accessing age-appropriate, culturally relevant, and accessible educational resources.

Conclusion

Canadian parents face multifaceted challenges in navigating sexuality education, shaped by cultural taboos, lack of resources, and limited confidence in initiating these discussions. The findings underline the need for inclusive, parent-focused resources, training, and policies that support caregivers in delivering accurate and age-appropriate sexuality education. Strengthening partnerships between families, schools, and healthcare systems is essential to bridge knowledge gaps and promote healthy sexual development in youth.
背景父母在为孩子提供全面的性教育(CSE)方面发挥着关键作用。虽然以学校为基础的项目在许多情况下已经扩大,但父母在参与公开讨论性健康时往往面临文化、信息和情感上的障碍。在加拿大等文化价值观和个人信仰差异很大的多元化社会中,这些挑战更加严峻。尽管越来越多的人认识到父母参与CSE,但有限的研究探索了加拿大父母对性教育的看法,特别是在多元文化背景下。方法采用基于社区的参与式研究(CBPR)方法来调查加拿大父母在提供性教育方面的经历、信念和障碍。对30名0-18岁儿童的家长进行了6次虚拟焦点小组讨论(fgd)。参与者通过有目的的滚雪球抽样来招募,以确保多样化的代表性。数据分析采用归纳主题分析,以确定与家长对性教育的理解、方法和需求相关的关键主题。结果:出现了三个主要主题:(1)性教育的整体性,强调情感、心理和社会方面的重要性;(2)时间和方法,揭示了何时以及如何启动这些对话的不确定性,以及对儿童主导的持续对话的偏好;(3)社会、媒体和学校的影响,突出了影响儿童理解的外部因素以及家长对错误信息和不一致教育内容的担忧。家长们还报告说,很难获得与年龄相适应的、与文化相关的、可获得的教育资源。结论加拿大父母在引导性教育方面面临多方面的挑战,包括文化禁忌、资源缺乏以及发起这些讨论的信心有限。研究结果强调,需要提供包容的、以家长为中心的资源、培训和政策,以支持照顾者提供准确和适龄的性教育。加强家庭、学校和卫生保健系统之间的伙伴关系对于弥合知识差距和促进青少年健康的性发展至关重要。
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引用次数: 0
Digital midwifery care – Blurring boundaries and finding new paths for midwifery care during pregnancy and postpartum: A qualitative study on Swedish midwives’ experiences 数字助产护理——模糊界限,为怀孕和产后助产护理寻找新的途径:瑞典助产士经验的定性研究。
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-15 DOI: 10.1016/j.srhc.2025.101147
Bäckström Caroline, Nilvér Helena, Lindgren Carina, Ludvigsson Elinor, Grönstervall Sabina, Moberg-Monsén Beatrice, Palmér Lina

Objective

In recent years, digital health interventions have increased in society. Swedish midwifery care is no exception, as digital solutions are increasingly being used during pregnancy and postpartum care for expectant and new parents. Therefore, the aim of this study was to explore midwives’ experiences of digital midwifery care and information during pregnancy and postpartum.

Methods

Focus groups and individual interviews were held with fourteen Swedish midwives working within antenatal care. Data analysis was conducted using thematic analysis.

Results

The results are presented in one overall theme: Digital Midwifery Care – Blurring boundaries and finding new paths for midwifery care, and three themes: Digital midwifery care is shaped by organizational prerequisites constraining and supporting; Digital midwifery care poses challenges establishing trustful relationships, and Digital midwifery care enhances accessibility, enabling participation.

Conclusion

Digital midwifery care is experienced by midwives as blurring the boundaries and finding new paths for midwifery care. Midwives negotiate with themselves, not losing the caring relationship as a core dimension of midwifery. Digital transformation within midwifery care has altered midwives’ way of working, and thus probably also their approach to caring.
目的:近年来,数字健康干预措施在社会上有所增加。瑞典的助产护理也不例外,数字解决方案越来越多地用于孕妇和新父母的孕期和产后护理。因此,本研究的目的是探讨助产士在怀孕和产后的数字助产护理和信息的体验。方法:对14名从事产前保健工作的瑞典助产士进行焦点小组和个人访谈。数据分析采用专题分析法。结果:结果呈现在一个总体主题中:数字助产护理-模糊界限并寻找助产护理的新路径,以及三个主题:数字助产护理受到组织先决条件的限制和支持;数字助产护理对建立信任关系提出了挑战,数字助产护理提高了可及性,促进了参与。结论:数字化助产服务模糊了助产服务的界限,为助产服务开辟了新的途径。助产士与自己协商,并没有失去作为助产服务核心维度的关怀关系。助产护理的数字化转型改变了助产士的工作方式,因此可能也改变了她们的护理方法。
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引用次数: 0
Maternity care providers’ attitudes and beliefs toward weight and body size during pregnancy: A cross-sectional survey 产科护理人员对孕期体重和体型的态度和信念:一项横断面调查
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-08 DOI: 10.1016/j.srhc.2025.101145
Lauren Kearney , Bec Jenkinson , Anna Robins , Leonie Callaway , Jessica van den Heuvel , Melanie Roussin , Briony Hill

Background

Weight stigma is pervasive in society and negatively affects the quality of maternity care for women with larger bodies. Healthcare providers’ attitudes and beliefs about weight and larger bodied people contribute to experiences of weight stigma, yet the extent of weight stigma attitudes and beliefs in Australian maternity care providers is not known.

Objective

This study aimed to explore maternity care providers’ attitudes and beliefs regarding weight and body size during pregnancy.

Methods

A cross-sectional survey with Australian maternity care providers, using the Fat Attitudes Assessment Toolkit (FAAT), with an open-ended ‘any other comments’ text response, was undertaken. Quantitative responses were analysed using descriptive statistics and qualitative inductive content analysis.

Results

Maternity care providers (n = 243) from across Australia responded to the survey. Responses indicated a strong emphasis on empathy towards larger bodied pregnant women, with providers acknowledging the socioeconomic and societal impact on the complexity of weight and body size. Responses also highlighted providers’ internalised weight stigma. Free-text responses reflected mixed views on the balance between addressing health risks and avoiding weight stigma, with a need for more resources and education on weight-inclusive care.

Conclusion

Maternity care providers are aware of the complexities of caring for larger bodied women. Tailored interventions that promote empathy and reduce weight-based discrimination are recommended.
社会上普遍存在对体重的耻辱感,这对体型较大的女性的产科护理质量产生了负面影响。医疗保健提供者对体重和体型较大的人的态度和信念有助于体重耻辱的经历,但澳大利亚产妇保健提供者的体重耻辱态度和信念的程度尚不清楚。目的探讨产科护理人员对孕期体重和体型的态度和信念。方法采用“肥胖态度评估工具包”(FAAT)对澳大利亚产科护理提供者进行横断面调查,并采用开放式的“任何其他评论”文本回复。定量分析采用描述性统计和定性归纳内容分析。结果来自澳大利亚各地的产妇护理提供者(n = 243)对调查做出了回应。回应表明,医生们强烈强调对体型较大的孕妇的同情,并承认体重和体型的复杂性对社会经济和社会的影响。回应还强调了医疗服务提供者对体重的内在偏见。自由文本答复反映了对解决健康风险和避免体重污名之间的平衡的不同看法,需要更多的资源和关于体重包容性护理的教育。结论产科护理人员意识到照顾体型较大的妇女的复杂性。建议采取量身定制的干预措施,促进同理心,减少基于体重的歧视。
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引用次数: 0
Proactive versus standard support of labor in the latent phase – A randomized, controlled clinical trial 潜伏期分娩的主动支持与标准支持-一项随机对照临床试验
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-05 DOI: 10.1016/j.srhc.2025.101144
Marit Larsen , Maria Underdal , Øyvind Salvesen , Negin Sadati , Ingebjørg Laache , Møyfrid Brenne Fehn , Raija Dahlø , Stine Bernitz , Eszter Vanky

Objective

Long latent phase of labor with subsequent prolonged total labor duration increases the risk of obstetric interventions and complications. We explored whether Proactive Support of Labor (PSL) compared to Standard Support of Labor (SSL) in the latent phase, reduces the rate of complicated deliveries in nulliparous women.

Design

Randomized, controlled trial (RCT).

Methods

A single-center RCT, at St. Olav’s University Hospital of Trondheim, Norway, including 356 nulliparous women in the latent phase of labor with a singleton pregnancy, cephalic presentation and spontaneous term onset of labor.

Main outcome measures

The composite rate of complicated deliveries, defined as instrumental delivery, caesarean section (CS), estimated blood loss >500  ml, intrapartum temperature >38.00 °C, shoulder dystocia, perineal laceration grade III or IV, or Apgar score <7 at 5  min.

Results

We found no difference in the composite rate of complicated deliveries, 40 % vs 34 % respectively, (OR = 1.3 (95 % CI = 0.8–2.0), p-value = 0.302), or the individual components of complicated deliveries, between PSL and SSL groups. In the PSL group, both the duration of labor and the individual maximum dosage of oxytocin were reduced. The number of vaginal examinations and transfer to neonatal intensive care unit in the PSL and SSL groups were similar. More women in the PSL group received epidural analgesia.

Conclusion

Proactive support of labor in the latent phase did not reduce the rate of complicated deliveries, but shortened labor duration, with lower maximum oxytocin dosage. Proactive support of labor may be considered as an alternative option for some nulliparous women to prevent a long latent phase of labor, without compromising maternal or newborn safety.
目的产程潜伏期过长和总产程延长增加了产科干预和并发症的风险。我们探讨了主动分娩支持(PSL)与标准分娩支持(SSL)在潜伏期是否可以降低无产妇女的复杂分娩率。随机对照试验(RCT)。方法在挪威特隆赫姆圣奥拉夫大学医院进行一项单中心随机对照试验,纳入356例处于产程潜伏期、单胎妊娠、头位分娩和自然足月分娩的产妇。主要结局指标复杂分娩的复合率,定义为器械分娩、剖宫产(CS)、估计出血量(500 ml)、产时温度(38.00℃)、肩难产、会阴撕裂III级或IV级,或5分钟Apgar评分(7分)。结果我们发现复杂分娩的复合率无差异,分别为40% vs 34% (or = 1.3 (95% CI = 0.8-2.0), p值= 0.302),或复杂分娩的各个组成部分。在PSL和SSL组之间。PSL组产程持续时间和个体最大催产素用量均有所减少。PSL组和SSL组的阴道检查次数和转到新生儿重症监护病房的次数相似。PSL组更多的妇女接受硬膜外镇痛。结论潜伏期积极助产并不能降低复杂分娩的发生率,但能缩短产程,降低最大催产素用量。对于一些无产妇女来说,在不影响产妇或新生儿安全的情况下,积极支持分娩可能被视为一种替代选择,以防止长时间的分娩潜伏期。
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引用次数: 0
“The Best of Both Worlds” a content analysis of midwives’ perspectives on using ultrasound for labour progress assessment “两全其美”内容分析助产士对使用超声波进行产程评估的观点
IF 1.7 3区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-02 DOI: 10.1016/j.srhc.2025.101142
Elsa Ruth Gylfadóttir , Hulda Hjartardóttir , Valgerður Lísa Sigurðardóttir

Background

Midwives in labour wards at high-tech hospitals have witnessed significant technological advancements. Ultrasound devices for assessing labour progress may offer advantages over traditional vaginal examinations. However, it is important to examine the views of care providers before introducing this new technology.

Aim

The aim is to examine the views of midwives working in a hospital labour ward regarding the use of ultrasound devices in assessing the progress of labour and explore their views of implementing such a technology to improve care for women during labour.

Method

A qualitative study was conducted, using three semi structured focus groups interviews with 16 midwives from the hospital labour ward. A purposive sample was used to capture diverse backgrounds and experiences. Content analysis was used to identify key categories and subcategories.

Results

Two main categories emerged: 1) “Art of midwifery and technology,” including a debate between clinical skills and technology, midwives’ openness to learning, and their desire to control implementation; 2) “Women and babies come first,” highlighting the importance of options, safety, and the connection with the woman.

Conclusion

Midwives support evidence-based technological advancements that benefit clients without increasing unnecessary interventions. They believe ultrasound complements traditional vaginal exams and is a valuable option for certain groups of women. Midwives need to be involved in the implementation of new methods to ensure client well-being. Further research is needed to evaluate the benefits of using ultrasound for labour progress assessment.
高科技医院产房的助产士见证了重大的技术进步。用于评估产程的超声设备可能比传统的阴道检查更有优势。然而,在引入这项新技术之前,检查护理提供者的观点是很重要的。目的调查医院产房助产士对使用超声波设备评估分娩进展的看法,并探讨她们对采用这种技术以改善产妇分娩护理的看法。方法采用三个半结构化的焦点小组访谈,对医院产房的16名助产士进行定性研究。一个有目的的样本被用来捕捉不同的背景和经历。内容分析用于确定关键类别和子类别。结果出现了两个主要类别:1)“助产艺术与技术”,包括临床技能与技术之间的辩论,助产士对学习的开放程度,以及他们控制实施的愿望;2)“女人和孩子是第一位的”,强调选择、安全以及与女人联系的重要性。结论助产士支持基于证据的技术进步,在不增加不必要干预的情况下使客户受益。他们认为超声波是传统阴道检查的补充,对某些女性群体来说是一个有价值的选择。助产士需要参与新方法的实施,以确保客户的福祉。需要进一步的研究来评估使用超声进行产程评估的好处。
{"title":"“The Best of Both Worlds” a content analysis of midwives’ perspectives on using ultrasound for labour progress assessment","authors":"Elsa Ruth Gylfadóttir ,&nbsp;Hulda Hjartardóttir ,&nbsp;Valgerður Lísa Sigurðardóttir","doi":"10.1016/j.srhc.2025.101142","DOIUrl":"10.1016/j.srhc.2025.101142","url":null,"abstract":"<div><h3>Background</h3><div>Midwives in labour wards at high-tech hospitals have witnessed significant technological advancements. Ultrasound devices for assessing labour progress may offer advantages over traditional vaginal examinations. However, it is important to examine the views of care providers before introducing this new technology.</div></div><div><h3>Aim</h3><div>The aim is to examine the views of midwives working in a hospital labour ward regarding the use of ultrasound devices in assessing the progress of labour and explore their views of implementing such a technology to improve care for women during labour.</div></div><div><h3>Method</h3><div>A qualitative study was conducted, using three semi structured focus groups interviews with 16 midwives from the hospital labour ward. A purposive sample was used to capture diverse backgrounds and experiences. Content analysis was used to identify key categories and subcategories.</div></div><div><h3>Results</h3><div>Two main categories emerged: 1) “Art of midwifery and technology,” including a debate between clinical skills and technology, midwives’ openness to learning, and their desire to control implementation; 2) “Women and babies come first,” highlighting the importance of options, safety, and the connection with the woman.</div></div><div><h3>Conclusion</h3><div>Midwives support evidence-based technological advancements that benefit clients without increasing unnecessary interventions. They believe ultrasound complements traditional vaginal exams and is a valuable option for certain groups of women. Midwives need to be involved in the implementation of new methods to ensure client well-being. Further research is needed to evaluate the benefits of using ultrasound for labour progress assessment.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101142"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005318","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}
引用次数: 0
期刊
Sexual & Reproductive Healthcare
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