Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing最新文献

Objective: To examine awareness of the vaginal microbiome and vaginal microbiota transplant, willingness to undergo vaginal microbiota transplant, and factors that influence the decision to undergo the procedure.

Design: Cross-sectional descriptive survey study.

Setting: Online distribution from October 2024 to January 2025.

Participants: Respondents (N = 210) who self-identified as women (n = 198), men (n = 2), gender nonconforming (n = 14), transgender (n = 3), other (n = 2), and not specified (n = 2) and had vaginas.

Methods: The survey included questions about patient demographics, gynecologic and pelvic symptoms and conditions, and vaginal microbiota transplantation awareness and willingness. We used descriptive statistics to summarize the quantitative data and conducted conventional content analysis to examine responses to open-ended questions about factors to undergo vaginal microbiota transplantation.

Results: Most respondents (n = 176, 83.8%) had not heard of vaginal microbiota transplant. However, more than 50% of respondents were willing or very willing to undergo vaginal microbiota transplantation for each presented indication: prevent yeast infections, bacterial vaginosis, or cytolytic vaginosis (n = 131, 62.4%); reduce risk of sexually transmitted infections (n = 130, 61.9%); alleviate menstrual pain (n = 126, 60.0%); prevent urinary tract infections (n = 126, 60.0%); alleviate vaginal symptoms (n = 120, 57.1%); prevent preterm births (n = 119, 56.7%). We identified five categories from 180 responses about factors that influenced the decision to undergo vaginal microbiota transplantation: Evidence, Procedure Logistics, Health Care Factors, Personal Factors, and Donor Health.

Conclusion: Increased awareness about the vaginal microbiome and vaginal microbiota transplantations is necessary. Factors that influence willingness to undergo the procedure should be addressed in designing and implementing this new intervention.

Objective: To identify and describe health literacy interventions for pregnant women in developing countries, including characteristics, implementation strategies, and cultural adaptations.

Data sources: MEDLINE, Embase, Cochrane Library, CINAHL, Education Resources Information Center, reference lists, and Google Scholar.

Study selection: We considered reports of studies published from the inception of each database through December 24, 2024. We included studies in which researchers evaluated interventions designed to improve health literacy among pregnant women who received antenatal care in clinical or community settings. We included studies regardless of language. We excluded conference abstracts, essays, dissertations, review articles, and studies that did not meet inclusion criteria after full-text review.

Data extraction: We extracted information on author(s), year of publication, country, study design, setting, type of intervention, delivery strategies, factors influencing health literacy, and reported outcomes.

Data synthesis: We grouped and described studies according to the reported interventions. We included 23 studies conducted across Africa (n = 18), Asia (n = 4), and the Caribbean (n = 1). Identified interventions included group-based education (n = 8), one-on-one education (n = 11), mobile health interventions (n = 5), peer educator-based programs (n = 1), and community-based approaches (n = 3). Most interventions were delivered within antenatal care clinics, and some were delivered in community settings. Participatory strategies, such as storytelling, role-playing, and culturally tailored communication, were commonly used.

Conclusion: Health literacy interventions strengthen communication, knowledge, and health-care-seeking behaviors; however, challenges related to access to health care services, sustainability, and cultural adaptation underscore the need for intervention designs that meet local health care contexts in developing countries.

Objective: To evaluate the removal and expulsion rates of intrauterine devices (IUDs) inserted immediately after delivery of the placenta 1 year after birth.

Design: Retrospective chart review.

Setting: University of Arkansas for Medical Sciences (UAMS) Women and Infant Service Line.

Participants: Patients who gave birth and elected to receive IUDs at UAMS from August 1, 2021 to September 30, 2023 (N = 641).

Methods: We collected data from charts of patients who received IUDs within 10 min of delivery of the placenta. We analyzed and reported the de-identified data using descriptive statistics.

Results: The overall IUD removal rate was 10.3% (n = 66), the expulsion rate was 5.1% (n = 33), and 84.5% (n = 542) of the IUDs remained in place.

Conclusion: Our organization achieved low IUD removal and expulsion rates. One potential explanation is that our providers received structured education on immediate postpartum IUD insertion techniques and used prenatal patient-centered counseling practices. Our findings highlight the need for further study of our approach to improve outcomes related to IUD insertion immediately after delivery of the placenta.

Objective: To explore midwives' experiences of precepting in relation to the demands of clinical practice.

Design: Secondary, supplementary qualitative data analysis.

Setting: Virtual interviews.

Participants: A total of 18 midwives (16 certified nurse-midwives and 2 certified midwives) who practiced in New Jersey.

Methods: We used data from a primary study of in-depth, semistructured interviews conducted from June 2023 to February 2024. We used qualitative description methodology and analyzed data using content analysis. We organized relevant codes using the major categories of the differentiated job demands-resources model, in which job demands are classified as hindrances or challenges and resources that can mitigate strain are identified.

Results: We found that precepting had a paradoxical effect on respondents' well-being. In the absence of adequate resources, precepting exacerbated exhaustion and in some cases led respondents to reduce or withdraw from teaching responsibilities. Conversely, when supported by collegial collaboration, shared responsibility, and personal agency in accepting students, precepting was a meaningful source of professional purpose and renewal.

Conclusions: Although precepting can foster professional engagement and renewal, it may also increase strain and contribute to burnout, particularly within health systems already facing staffing shortages and high turnover. The dual nature of precepting in midwifery underscores the role of system-level support in sustaining the midwifery workforce and clinical education.

Objective: To provide a conceptual understanding of the breastfeeding experiences, challenges, and support needs of women in the workforce.

Data sources: PubMed, CINAHL, and PsycINFO.

Study selection: We included reports of primary qualitative studies that were published from 2014 to 2024 in which researchers described the breastfeeding experiences of women in the workforce. We selected 13 reports for inclusion with a combined sample size of 188 women aged 20 to 48 years.

Data extraction: We extracted the following data from included studies: methodological characteristics (sample size, qualitative design, data analysis, data collection, and length of interview), demographic characteristics of participants (country, age group, employment setting/type, nature of work, and length of paid leave), direct participant quotes, and key concepts and themes about the breastfeeding experiences of women in the workforce.

Data synthesis: Using a published method for meta-ethnography, we synthesized the extracted data and identified four overarching themes, each with three subthemes: Juggling Milk and a Paycheck (subthemes: Torn Between Desk and Cradle, The Balancing Act, and Milk on the Clock), The Emotional Dance of Motherhood (subthemes: Hearts Full, Minds at Ease; Shadows of Exhaustion; and Against the Odds), The Village in Question (subthemes: Whispers and Judgments, Absent Anchors, and Hands That Hold), and The Policy Pendulum (subthemes: Written But Not Real, Clocking Out From Care, and When Care and Career Collide: Influence on Work). These themes and subthemes highlighted logistical challenges, inadequate workplace policies, the importance of supportive environments, women's emotional stress, and women's resilience.

Conclusion: Our findings indicate that structural, emotional, social, and policy-related factors shaped the breastfeeding experiences of the participants in the included articles. We emphasize the need for targeted interventions and workplace policies to optimize breastfeeding experiences and outcomes among women in the workforce.

High-quality maternal-infant interaction is essential to promote the optimal growth and development of children. The role of the nurse in providing assessment, interventions, and guidance to mothers of infants from birth to 1 year of age is vital to enhance maternal-infant interactions. In this article, we highlight the significance of maternal-infant interaction and examine challenges families face in developing high-quality maternal-infant interaction. Evidence-based recommendations for health and social policies for nursing and clinical practice are provided to mitigate challenges to the development of maternal-infant interaction.