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Revista Da Escola de Enfermagem Da U S P 2020To analyze the interactions between nursing and hospitalized high-risk pregnant women regarding the possibilities and limits of providing care guided by the principle of...
OBJECTIVE
To analyze the interactions between nursing and hospitalized high-risk pregnant women regarding the possibilities and limits of providing care guided by the principle of comprehensiveness.
METHOD
A qualitative study based on the conceptual framework of comprehensiveness and developed from the precepts of thematic content analysis. Data were collected through open interviews and observation of the care scenario of twelve nursing professionals with hospitalized high-risk pregnant women.
RESULTS
Twelve (12) nursing professionals participated in the study. Nursing practices are portrayed from two thematic categories: "Embracement: emotional and informational support" and "Assessing and monitoring gestational risk". The findings revealed intentions to embrace women, providing informal and emotional support, but under weaknesses in intersubjective relationships. There is an emphasis on "technical success", not always sufficiently articulated with "practical success" in care actions, with harm to achieving comprehensiveness.
CONCLUSION
The findings revealed that an emphasis on the biomedical management of obstetric risk and structural and organizational limitations of work end up hindering incorporating into daily care the concerns and knowledge necessary for constructing its comprehensiveness.
Topics: Adult; Female; Hospitalization; Humans; Interviews as Topic; Nurse-Patient Relations; Nursing Staff, Hospital; Pregnancy; Pregnancy, High-Risk; Pregnant Women; Young Adult
PubMed: 32401887
DOI: 10.1590/s1980-220x2018036903557 -
Asian Nursing Research Aug 2022The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. (Review)
Review
PURPOSE
The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties.
METHODS
The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and test-retest reliability.
RESULTS
The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's α for the scale was 0.931, and the test-retest reliability coefficient was 0.968.
CONCLUSION
The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.
Topics: Bereavement; Factor Analysis, Statistical; Female; Grief; Humans; Midwifery; Perinatal Death; Pregnancy; Professional Competence; Psychometrics; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35716897
DOI: 10.1016/j.anr.2022.06.002 -
Midwifery May 2022To determine the relationship between perceived obstetric violence and the risk of postpartum depression (PPD). (Observational Study)
Observational Study
OBJECTIVE
To determine the relationship between perceived obstetric violence and the risk of postpartum depression (PPD).
DESIGN
A cross-sectional observational study SETTING: During 2019 in Spain PARTICIPANTS: 782 women who had given birth in the preceding 12 months in Spain.
MEASUREMENTS
Online questionnaires were distributed to the women via their midwives and women's associations. The questionnaire included sociodemographic and clinical variables, and questions regarding the mothers' perception of obstetric violence globally and in its different forms: verbal, physical and psycho-affective. The response rate was 93.65%. Crude and adjusted odds ratios (OR and aOR, respectively) were estimated using binary logistic regression. Risk of PPD was estimated by the Edinburgh Postnatal Depression Scale (EPDS).
FINDINGS
The mean EPDS score was 8.34 points (standard deviation: 3.80), with 25.4% (199) at risk of PPD (≥ 10 points). Risk factors for PPD included, multiparity (aOR: 1.62, 95% CI:1.10-2.39), newborn NICU admission (aOR: 1.93, 95% CI: 1.06-3.51), experiencing verbal obstetric violence (aOR: 2.02, 95% CI: 1.35-3.02), and psycho-affective obstetric violence (aOR: 2.65, 95% CI: 1.79-3.93). The perception of support during pregnancy, birth, and the puerperium was found to be a protective factor: aOR 0.15 (95% CI: 0.04-0.54) for women who perceived enough support and aOR 0.13 (95% CI: 0.0-0.45) for women who received much support KEY CONCLUSIONS: One in four women are at risk of PPD. Multiparous women, those whose newborn required NICU admission, those who lacked partner support, and those who experienced verbal or psycho-affective obstetric violence had a higher prevalence of PPD risk.
FUNDING
The authors declare that this study was conducted without funding.
Topics: Cross-Sectional Studies; Depression, Postpartum; Female; Humans; Infant, Newborn; Male; Postpartum Period; Pregnancy; Prevalence; Risk Factors; Violence
PubMed: 35272086
DOI: 10.1016/j.midw.2022.103297 -
BMC Pregnancy and Childbirth Aug 2022The majority of maternity care is provided by female midwives who have either become mothers or are of childbearing age, but there is limited research exploring... (Review)
Review
BACKGROUND
The majority of maternity care is provided by female midwives who have either become mothers or are of childbearing age, but there is limited research exploring midwives' own personal childbearing experiences. This integrative review aims to explore the published literature and research on midwives' own experiences of pregnancy and childbirth.
METHOD
An integrative review of the literature was conducted after relevant articles were identified through a search of: five electronic databases (Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Scopus, and Google Scholar), cited reference lists, and networking with peers. Similar and contrasting patterns and relations within the literature were identified and grouped into themes and subthemes.
RESULTS
Twenty articles were included in the review and four overarching themes were identified. Insider knowledge plays a role in decision making encompassed the way midwives used their knowledge to choose; a preferred mode of birth, maternity care provider, model of care, and place of birth. Navigating the childbirth journey demonstrated how some midwives were able to use their insider knowledge to achieve agency, while others had difficulty achieving agency. This theme also revealed the 'midwife brain' that midwives need to manage during their childbearing journey. The theme impact of care on the birth experience described how the type of care the midwives received from maternity care providers affected their overall birth experience. The fourth theme from midwife to mother explains their preparedness for childbirth and their transition to motherhood.
CONCLUSION
For childbearing midwives, there is a potential conflict between their position as knowledgeable experts in maternity care, and their experience as mothers. Whilst they can use their insider knowledge to their advantage, they also experience heightened fear and anxiety through their pregnancy. It is important for maternity care providers to acknowledge and support them and provide balanced and tailored care that acknowledges the woman within the professional midwife and the professional midwife within the woman.
Topics: Delivery, Obstetric; Female; Humans; Maternal Health Services; Midwifery; Nurse Midwives; Parturition; Pregnancy; Qualitative Research
PubMed: 35971098
DOI: 10.1186/s12884-022-04962-y -
Journal of Education and Health... 2022Delay in the diagnosis and management of obstetric complications lead to raised mortality rate. This can be curtailed by appropriate implementation of the educational... (Review)
Review
BACKGROUND
Delay in the diagnosis and management of obstetric complications lead to raised mortality rate. This can be curtailed by appropriate implementation of the educational intervention among the health-care providers. Hence, this review aimed to identify the literature evidence of the efficacy of various educational interventions training in the management of obstetric complications.
MATERIALS AND METHODS
We searched PUBMED, Web of Science, SCOPUS, Google Scholar, Cochrane, and maternity care databases with studies published from 2011 to 2021 for identifying studies related to this educational intervention review using MeSH terms and free terms. The search process was also done on the websites of the World Health Organization and the reproductive health library in the English language. From the 1823 abstracts reviewed, 16 studies were included (15 quasi-experimental, 01 randomized clinical trial, and 01 exploratory research design). We identified studies that included skill assessment of nurses, midwives, auxilliary nurse-midwives (ANMs), medical students, interns, and doctors after implementing various educational interventions.
RESULTS
According to the findings of this literature, achieving enhanced nursing management of obstetric complications has been developed. Especially, it suggests through better nursing training and education and also by providing sufficient resources, time, and coordination with obstetric specialists, nurses and midwives will be able to implement their care roles, which include proper diagnosis, appropriate intervention, advanced care, client education, and psychological support. The efficacy of each educational intervention varies and depends on the participants' understanding, interest, and the advancement of the teaching-learning method used.
CONCLUSION
This systematic review reveals abroad and logical move towards the evaluation of various educational interventions in the field of obstetric complications. Among all the educational interventions implemented, mobile application, and simulation-based training play a major role in improving the knowledge and skills of health-care providers in the management of obstetric complications.
PubMed: 36003245
DOI: 10.4103/jehp.jehp_1392_21 -
PloS One 2019The availability and retention of healthcare professionals in rural areas and remote areas is a challenge to the health sector worldwide. Attracting people who are most...
The availability and retention of healthcare professionals in rural areas and remote areas is a challenge to the health sector worldwide. Attracting people who are most likely to be interested in rural practice can be conducive to the sustainable availability of health services in rural areas where health facilities are typically understaffed and existing professionals often underqualified. This article aims to contribute to the rural pipeline evidence, and reports on the findings of a study that investigated the career choices of midwifery and obstetric nurse students in Mali. The article enquires into the relationship between their intention to practice in rural areas and the different components of the rural pipeline. A mixed method study using a survey, semi-structured interviews, and document analysis was conducted from October to December 2017 on third-year midwifery and obstetric nurse students and school-managers. Descriptive statistics and bivariate analysis were performed for quantitative data, and content analysis was carried out for the qualitative data. Key findings suggest that students prefer urban locations for living and for work. The intention to work in rural areas seems to be influenced by the current living situation (currently living in a rural area) or having attended secondary school or professional training in rural areas.
Topics: Attitude of Health Personnel; Career Choice; Mali; Midwifery; Motivation; Obstetric Nursing; Rural Health Services; Students, Nursing
PubMed: 31498819
DOI: 10.1371/journal.pone.0222266 -
The Cochrane Database of Systematic... Oct 2012Historically, women have been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has become the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Historically, women have been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has become the exception rather than the routine.
OBJECTIVES
Primary: to assess the effects of continuous, one-to-one intrapartum support compared with usual care. Secondary: to determine whether the effects of continuous support are influenced by: (1) routine practices and policies; (2) the provider's relationship to the hospital and to the woman; and (3) timing of onset.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2012).
SELECTION CRITERIA
All published and unpublished randomised controlled trials comparing continuous support during labour with usual care.
DATA COLLECTION AND ANALYSIS
We used standard methods of The Cochrane Collaboration Pregnancy and Childbirth Group. Two review authors independently evaluated methodological quality and extracted the data. We sought additional information from the trial authors. We used random-effects analyses for comparisons in which high heterogeneity was present, and we reported results using the average risk ratio (RR) for categorical data and mean difference (MD) for continuous data.
MAIN RESULTS
Twenty-two trials involving 15,288 women met inclusion criteria and provided usable outcome data. Results are of random-effects analyses, unless otherwise noted. Women allocated to continuous support were more likely to have a spontaneous vaginal birth (RR 1.08, 95% confidence interval (CI) 1.04 to 1.12) and less likely to have intrapartum analgesia (RR 0.90, 95% CI 0.84 to 0.96) or to report dissatisfaction (RR 0.69, 95% CI 0.59 to 0.79). In addition, their labours were shorter (MD -0.58 hours, 95% CI -0.85 to -0.31), they were less likely to have a caesarean (RR 0.78, 95% CI 0.67 to 0.91) or instrumental vaginal birth (fixed-effect, RR 0.90, 95% CI 0.85 to 0.96), regional analgesia (RR 0.93, 95% CI 0.88 to 0.99), or a baby with a low five-minute Apgar score (fixed-effect, RR 0.69, 95% CI 0.50 to 0.95). There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, or breastfeeding. Subgroup analyses suggested that continuous support was most effective when the provider was neither part of the hospital staff nor the woman's social network, and in settings in which epidural analgesia was not routinely available. No conclusions could be drawn about the timing of onset of continuous support.
AUTHORS' CONCLUSIONS
Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.
Topics: Delivery, Obstetric; Female; Humans; Labor, Obstetric; Midwifery; Obstetric Nursing; Perinatal Care; Pregnancy; Randomized Controlled Trials as Topic
PubMed: 23076901
DOI: 10.1002/14651858.CD003766.pub4 -
BMC Pregnancy and Childbirth Dec 2023The American College of Obstetricians and Gynecologists, in its opinion of the Committee on Midwifery Practice, points out that planned home birth is a woman's and...
BACKGROUND
The American College of Obstetricians and Gynecologists, in its opinion of the Committee on Midwifery Practice, points out that planned home birth is a woman's and family's right to experience, but also to choose and be informed about, their baby's place of birth. The aim of this study was to understand obstetric nurses' perceptions of planned home childbirth care within the framework of the Brazilian obstetric model.
METHOD
A qualitative study, with Snowball Sampling recruitment, totaling 20 obstetric nurses through semi-structured interviews between September 2022 and January 2023, remotely, using the Google Meet application and the recording feature. After the data had been collected, the material was transcribed in full and subjected to content analysis in the thematic modality with the support of ATLAS.ti 8.0 software.
RESULTS
Obstetric care at home emerged as a counterpoint to hospital care and the biomedical model, providing care at home based on scientific evidence and humanization, bringing qualified information as a facilitator of access and financial costs as an obstacle to effective home birth.
CONCLUSION
Understanding obstetric nurses' perceptions of planned home birth care in the context of the Brazilian obstetric model shows the need for progress as a public policy and for strategies to ensure quality and regulation.
Topics: Pregnancy; Female; Infant, Newborn; Child; Humans; Home Childbirth; Brazil; Midwifery; Delivery, Obstetric; Perinatal Care
PubMed: 38066510
DOI: 10.1186/s12884-023-06161-9 -
International Journal of Disaster Risk... Jul 2023COVID-19 has become a global pandemic, which necessitates that health workers be capable of protecting themselves and their patients. This article aimed to describe...
Exploring the knowledge, attitudes, behaviors and training needs of obstetric and gynecological nurses regarding COVID-19 during the peak period of the pandemic in middle-risk areas of China: A cross-sectional study.
BACKGROUND
COVID-19 has become a global pandemic, which necessitates that health workers be capable of protecting themselves and their patients. This article aimed to describe knowledge levels, attitudes, behaviors and training needs regarding COVID-19 among obstetric and gynecological nurses in medium-risk areas during the pandemic.
METHOD
A cross-sectional survey of obstetric and gynecological nurses in medium-risk areas was performed during the peak period of the pandemic in China. The main survey tool was the self-designed COVID-19 Knowledge, Attitude, Behavior and Training Needs Questionnaire. Pearson correlation analysis was conducted to analyze the relationships among knowledge, attitudes, behaviors and training needs.
RESULTS
A total of 599 nurses were recruited, of whom 27.7% failed the knowledge part of the questionnaire. Positive correlations were found between knowledge and attitudes (r = 0.100, P = 0.015) and between attitudes and behaviors (r = 0.352, P = 0.000) regarding occupational protection against COVID-19. A total of 88.5% of nurses preferred online training to traditional training, and more than 70% believed that demonstration of and training in operations by their own department were effective ways to learn about how to protect themselves against COVID-19.
CONCLUSION
The higher the level of knowledge about the disease was, the more positive the attitude toward occupational protection, and consequently, the more actively protective behaviors were adopted. Training affected nurses' knowledge of COVID-19 occupational protection and promoted positive attitudes, which further facilitated the effective prevention and control of the disease. Online training with demonstrations are recommended for COVID-19 training of nurses.
PubMed: 37216169
DOI: 10.1016/j.ijdrr.2023.103746 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2022Medical education's treatment of obstetric-related anatomy exemplifies historical sex bias in medical curricula. Foundational obstetric and midwifery textbooks teach...
Medical education's treatment of obstetric-related anatomy exemplifies historical sex bias in medical curricula. Foundational obstetric and midwifery textbooks teach that clinical pelvimetry and the Caldwell-Moloy classification system are used to assess the pelvic capacity of a pregnant patient. We describe the history of these techniques-ostensibly developed to manage arrested labors-and offer the following criticisms. The sample on which these techniques were developed betrays the bias of the authors and does not represent the sample needed to address their interest in obstetric outcomes. Caldwell and Moloy wrote as though the size and shape of the bony pelvis are the primary causes of "difficult birth"; today we know differently, yet books still present their work as relevant. The human obstetric pelvis varies in complex ways that are healthy and normal such that neither individual clinical pelvimetric dimensions nor the artificial typologies developed from these measurements can be clearly correlated with obstetric outcomes. We critique the continued inclusion of clinical pelvimetry and the Caldwell-Moloy classification system in biomedical curricula for the racism that was inherent in the development of these techniques and that has clinical consequences today. We call for textbooks, curricula, and clinical practices to abandon these outdated, racist techniques. In their place, we call for a truly evidence-based practice of obstetrics and midwifery, one based on an understanding of the complexity and variability of the physiology of pregnancy and birth. Instead of using false typologies that lack evidence, this change would empower both pregnant people and practitioners.
Topics: Female; Humans; Parturition; Pelvimetry; Pelvis; Pregnancy
PubMed: 35202515
DOI: 10.1002/ar.24880