Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many wome...Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.展开更多
BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal m...BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials ...Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials and Methods: This descriptive-analytical study was performed on 216 Iranian nursing and midwifery students in 2011-2012, utilizing Sarason Anxiety Inventory, demographic checklist and the average mark of students in the period of midterm and final exam. Multinomial logistic regression analyses by reporting odds ratios and their 95% confidence intervals were performed by SPSS17 software to assess the relationship between test anxiety and academic performances. Results: Mild, moderate and sever test anxiety was observed in 30.6, 43.1 and 26.4 percent of students respectively. Test anxiety was significantly related to academic performance (average), major and city. Also, there was 52.9% decrease for odds of having sever anxiety (compared to mild anxiety) with 1 point increase in average (OR = 0.471, 95% CI = (0.298 - 0.745) and p = 0.001). Conclusions: Due to inverse relationship between test anxiety and academic performance, performing preventive programs such as in time treatment of anxiety, empowering the students to deal with anxiety and conducting consulting services for how to studying are very important. Consequently it would be a big step in decreasing the test anxiety and therefore in improving the academic performance.展开更多
Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That c...Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That condition related to the proportion of midwifery students and case of childbirth woman was an imbalance. Midwifery students must prepare this competence in an education with childbirth care experience from practice in the laboratory and in the field of practice. Reflective learning is an appropriate learning method that uses experience as the basis of learning to improve childbirth care competence of midwifery students. Objective: This study is to analyze the effect of reflective learning implementation in childbirth care practice to improve students’ competence. Method: This research uses quasi-experimental design with non-equivalent control group design. The respondents were midwifery students in the fourth semester who had experienced the theory of childbirth care. There were totally 64 samples, 34 samples for treatment group and 30 samples for control group. Data were analyzed by using unpaired t test, Mann Whitney U and linear regression. Results: The respondents were homogeny in motivation and grade point of average (GPA). The improvement of childbirth care competency is influenced by treatment of 19.064 with R2 = 57.7%. Conclusion: The implementation of reflective learning in childbirth care practice affected the improvement of students’ competence.展开更多
Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognize...Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.展开更多
Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to asse...Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.展开更多
BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety...BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.展开更多
Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery....Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. The survey feedback will help develop and strengthen curriculum for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s Bazar and at the birth centers in the surrounding rural communities. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education;training and clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from graduation from the midwifery diploma program was sixteen months. All the respondents felt comfortable managing most maternal issues but felt further training was important. They also identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors. Conclusion: Training and increasing the number of midwives are crucial strategies for reducing maternal and neonatal mortality. There is a significant need for long-term placement and commitment of midwives to rural areas in Bangladesh. Health systems and organizations employing midwives must be accountable for the continuing education, mentorship, and supportive needs of midwives.展开更多
Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in N...Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.展开更多
Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardizat...Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. Aim: To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. Methods: The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. Results: Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. Conclusion: Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.展开更多
Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using...Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting.Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts.A grid was made to identify core findings and compare them reciprocally.Results:Thirty-six qualitative studies met the inclusion criteria.The literature comprised of 32 first key concepts.Eight second-order constructs emerged,and three third-order interpretations were generated.The three overarching themes were:(1)midwives perceived themselves as providing culturally competent and high quality women-centered care;(2)they valued their profession but saw it as complex and challenging;(3)as health professionals,they reported a variety of organizational,cultural,and professional barriers to providing women-centered care.Conclusions:While performing a specific task in the task shifting context,midwives perceived their crucial roles and responsibilities,along with achieved value and reward.However,due to a range of existing barriers,the caring task posed great challenges in completely implementing women-centered care.It is essential for systems to identify and eliminate these barriers early,to consider midwives’emotional well-being,and to develop overall strategies to better support the midwifery workforce.Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.展开更多
Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 202...Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .展开更多
Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, s...Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.展开更多
Objective: to evaluate the value of doula midwifery in pregnant women for their mood, stage of labor and satisfaction. Methods: from March 1, 2020 to March 1, 2021, 78 pregnant women in our hospital were selected and ...Objective: to evaluate the value of doula midwifery in pregnant women for their mood, stage of labor and satisfaction. Methods: from March 1, 2020 to March 1, 2021, 78 pregnant women in our hospital were selected and divided into two groups under the coin method. The control group received routine delivery care, while the observation group received whole-course doula delivery. The emotional state, duration of labor and nursing satisfaction of the two groups of pregnant women were compared. Results: SAS anxiety score (36.69±5.15) and SDS depression score (35.51±6.84) of the observation group were lower than those of the control group, while the satisfaction score (95.63±2.12) of the observation group was higher than that of the control group (P < 0.05). The duration of the first, second and third stages of labor and the total duration of labor in the observation group were (8.31±2.25) hours, (0.55±0.15) hours, (0.20±0.12) hours and (8.25±2.21) hours shorter than those in the control group (P < 0.05). Conclusion: midwifery with doula can better improve pregnant women's emotional state and clinical satisfaction, and has a positive effect on shortening the duration of labor.展开更多
Objective: to effectively analyze the clinical nursing effect of painless childbirth, holistic nursing and responsible midwifery. Methods: 64 parturients were randomly selected from May 2020 to December 2020. Divided ...Objective: to effectively analyze the clinical nursing effect of painless childbirth, holistic nursing and responsible midwifery. Methods: 64 parturients were randomly selected from May 2020 to December 2020. Divided into the experimental group /32 cases/implementation of routine nursing and responsible midwifery holistic nursing;Routine group /32 cases/routine nursing. The clinical application effect of different nursing care in painless delivery was compared between the two groups, and the rate of cesarean section and natural delivery, the rate of neonatal asphyxia, the rate of postpartum hemorrhage and other aspects of anxiety and depression scores were compared between the two groups. Results: the different nursing measures implemented in the two kinds of puerpera painless childbirth were systematically analyzed. Among them, the experimental group, which implemented the related responsibility on-site and overall nursing measures in all aspects of puerpera painless childbirth was significantly better than the conventional group. The data management of cesarean section rate, natural childbirth rate and anxiety and depression scores in the two groups had clinical statistical significance, P < 0.05. Conclusion: by analyzing the painless delivery of the two groups of parturients, the effective cover measures implemented in the experimental group can improve the scoring effect of psychological anxiety and depression, and ultimately promote the overall nursing satisfaction of the responsible midwifery. The overall nursing satisfaction of the experimental group is significantly better than that of the conventional group. At the same time, it can relieve the bad mood of the parturient. The nursing method can be popularized in the nursing of puerpera painless childbirth.展开更多
Objective: to analyze and explore the clinical effect of midwifery nursing with responsibility midwives in parturition. Methods: fifty-eight parturients in our hospital were selected and divided into model group and c...Objective: to analyze and explore the clinical effect of midwifery nursing with responsibility midwives in parturition. Methods: fifty-eight parturients in our hospital were selected and divided into model group and control group with 29 cases in each group. Control group: routine nursing, model group: responsibility midwife midwifery nursing. The therapeutic effects of the model group and the control group in this study were recorded and analyzed in detail. Results: after using the responsibility midwife midwifery nursing, each index of the model group was better than the control group (P<0.05), the difference was statistically significant. Conclusion: responsibility midwife midwifery nursing has good nursing effect on parturient, and it is suggested to continue clinical research and use.展开更多
Objective: to observe the application effect of childbirth ball combined with free posture midwifery nursing for primiparas. Methods: according to a total of 100 pregnant and lying-in women admitted to our hospital in...Objective: to observe the application effect of childbirth ball combined with free posture midwifery nursing for primiparas. Methods: according to a total of 100 pregnant and lying-in women admitted to our hospital in recent years, they were randomly divided into two groups: the control group and the observation group. The control group used conventional midwifery care, while the observation group used delivery ball combined with free body position midwifery care in addition to conventional care during childbirth. Comprehensive evaluation and analysis were made on the delivery time, delivery bleeding and pain indicators of the two groups of lying-in women, and relevant conclusions were drawn. Results: the delivery time of the observation group was significantly shorter than that of the control group, and the amount of hemorrhage during delivery was less. The pain index is obviously lower, which reduces the pain of the parturient, P < 0.05, and is relatively safer and more effective for the overall delivery process. The labor pain scores (VAS, VRS, PPI) of the observation group were lower than those of the control group (P < 0.05). Conclusion: the delivery method of delivery ball combined with free body position midwifery nursing has a very wide range of significance for reducing the pain of the parturient, reducing the amount of bleeding and shortening the delivery time of the parturient, greatly improving the success rate of delivery, and is worthy of promotion and application in clinical aspects.展开更多
Objective: to analyze the effect of continuous midwifery nursing and routine nursing on vaginal trial labor. Methods: the sample size was 90 cases, all of which were pregnant women with scar uterus. They were randomly...Objective: to analyze the effect of continuous midwifery nursing and routine nursing on vaginal trial labor. Methods: the sample size was 90 cases, all of which were pregnant women with scar uterus. They were randomly divided into control group and observation group. Routine intervention was applied in the control group, and continuous midwifery intervention was applied in the whole process of observation group. Results: observation group were significantly better, P < 0.05. Conclusion: the whole process of continuous midwifery nursing effect is better.展开更多
Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, ...Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, 2022 pregnant women 100 cases, combined with the difference of the care mode will be divided into two groups: control group (routine midwifery care) and observation group (midwifery care). Each group has 50 cases, statistical comparison two groups of natural delivery rate, neonatal Apgar score, 2h postpartum bleeding volume, neonatal asphyxia rate, labor time and satisfaction. Results: in terms of natural delivery rate, neonatal Apgar score, and nursing satisfaction, the observation group was significantly higher than the control group, with significant differences, statistical advantages, p0.05;for the neonatal asphyxia rate and labor time, the observation group was significantly smaller than the control group, with significant differences and statistical advantages, p0. 05 Conclusion: applying the responsibility system care mode to obstetric maternal can greatly affect the delivery mode, maternal and infant outcomes. Specifically, it is beneficial to improve the maternal natural delivery rate, neonatal Apgar score, satisfaction, etc., but also can effectively reduce maternal 2h postpartum blood loss, neonatal asphyxia rate, labor time, etc., so has a strong application value.展开更多
文摘Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.
文摘BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
文摘Background and Aim: Given the dramatic decline in the ability of test due to test anxiety, the goal of this study was to evaluate the relationship between test anxiety and academic performances in students. Materials and Methods: This descriptive-analytical study was performed on 216 Iranian nursing and midwifery students in 2011-2012, utilizing Sarason Anxiety Inventory, demographic checklist and the average mark of students in the period of midterm and final exam. Multinomial logistic regression analyses by reporting odds ratios and their 95% confidence intervals were performed by SPSS17 software to assess the relationship between test anxiety and academic performances. Results: Mild, moderate and sever test anxiety was observed in 30.6, 43.1 and 26.4 percent of students respectively. Test anxiety was significantly related to academic performance (average), major and city. Also, there was 52.9% decrease for odds of having sever anxiety (compared to mild anxiety) with 1 point increase in average (OR = 0.471, 95% CI = (0.298 - 0.745) and p = 0.001). Conclusions: Due to inverse relationship between test anxiety and academic performance, performing preventive programs such as in time treatment of anxiety, empowering the students to deal with anxiety and conducting consulting services for how to studying are very important. Consequently it would be a big step in decreasing the test anxiety and therefore in improving the academic performance.
文摘Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That condition related to the proportion of midwifery students and case of childbirth woman was an imbalance. Midwifery students must prepare this competence in an education with childbirth care experience from practice in the laboratory and in the field of practice. Reflective learning is an appropriate learning method that uses experience as the basis of learning to improve childbirth care competence of midwifery students. Objective: This study is to analyze the effect of reflective learning implementation in childbirth care practice to improve students’ competence. Method: This research uses quasi-experimental design with non-equivalent control group design. The respondents were midwifery students in the fourth semester who had experienced the theory of childbirth care. There were totally 64 samples, 34 samples for treatment group and 30 samples for control group. Data were analyzed by using unpaired t test, Mann Whitney U and linear regression. Results: The respondents were homogeny in motivation and grade point of average (GPA). The improvement of childbirth care competency is influenced by treatment of 19.064 with R2 = 57.7%. Conclusion: The implementation of reflective learning in childbirth care practice affected the improvement of students’ competence.
文摘Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.
文摘Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.
文摘BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.
文摘Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. The survey feedback will help develop and strengthen curriculum for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s Bazar and at the birth centers in the surrounding rural communities. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education;training and clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from graduation from the midwifery diploma program was sixteen months. All the respondents felt comfortable managing most maternal issues but felt further training was important. They also identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors. Conclusion: Training and increasing the number of midwives are crucial strategies for reducing maternal and neonatal mortality. There is a significant need for long-term placement and commitment of midwives to rural areas in Bangladesh. Health systems and organizations employing midwives must be accountable for the continuing education, mentorship, and supportive needs of midwives.
文摘Introduction: Midwifery is the art of caring for women during childbearing. It is practiced throughout the world according to the norms, traditions and cultural practices found in each country. Maternal mortality in Nigeria is high but there are wide variations between the geopolitical zones of the country. Government has established the midwives service scheme (MSS) as part of efforts towards reversing the country’s unacceptably high maternal mortality trends. To improve these indices, the MSS in Nigeria engaged newly graduated unemployed and retired midwives to work temporarily in rural areas. The midwives are posted for twelve months to selected primary care facilities linked through a cluster model in which four such facilities with the capacity to provide basic essential obstetric care are clustered around a secondary care facility with the capacity to provide comprehensive emergency obstetric care. This brief review is an attempt at exploring the impact of the midwives service scheme on maternal and neonatal indices in Nigeria. Main content: The outcome of the MSS four years has been an improvement though unevenly and marginally, in these indices in the various geopolitical zones of Nigeria. Improvements have been noticed in maternal indices such as antenatal care attendance, women receiving two doses of tetanus toxoid and number of deliveries by skilled personnel. Also reduction in maternal and neonatal mortality has been observed over the years following introduction of the scheme. Major challenges however, include lack of essential drugs, poor accommodation facilities for MSS staff, irregular payment of their remuneration and lack of water/power supply to some designated facilities for the scheme. Recommendations and conclusions: It is therefore recommended that 24 hours availability of essential drugs at primary healthcare centers be maintained. This should happen in conjunction with regular payment of full entitlements and benefits and provision of secured, habitable and good accommodation for MSS staff. Finally, aggressive community mobilization should continue in order to engender community involvement and participation for sustainable program development.
文摘Background: Quality education is one of the important factors in empowering midwives to provide quality health care services to mothers and newborns irrespective of their practice settings. Due to lack of standardization of the duration, content, and structure of midwifery education and different pathways to midwifery across the world, midwives may lack the confidence to deliver quality health care services in the main domain of the ICM competences. Aim: To assess the confidence of final year midwifery students in the domain of new-born care based on the ICM midwifery competencies. Methods: The first phase consisted of a quick situation analysis of midwifery education and regulation in Zambia, followed by a cross-sectional survey through a self-administered questionnaire to assess the confidence of final year midwifery students. Results: Most (51.9%) of the respondents were aged between 18 and 28 years, and majority of them were placed in Levels 1, 2 and 3 Hospitals and also clinics for their clinical practice, with between one hundred to ten thousand annual births, followed by 16.9% who were placed in Level 3 hospitals only. Most students (38.3%) reported receiving classroom instruction by both Lecture and Demonstration. Few students (22.7%) responded that they were not satisfied with their clinical supervision, while 77.3% were satisfied. There was significant association between confidence to perform skills independently and having enough time to practice on models in the labs (p value = 0.024), confidence when practiced for the first time on mothers (p value = 0.007) and satisfaction with supervision during clinical practice (p value = 0.000). Binary logistic regression of characteristics associated with confidence to perform new-born skills independently revealed significant association between satisfaction with clinical supervision and confidence to perform skills independently, 95% CI [1.83, 15.37]. Conclusion: Midwifery students need quality training both theoretically and practically in order for them to gain confidence in newborn care upon completion of their training. They need adequate time to practice on models in the skills laboratory, and need adequate clinical supervision for them to gain confidence in performing new born skills independently.
基金The study was funded by the National Natural Science Foundation of China(Grant No.71874030).
文摘Objective:This study aimed to explore the existing knowledge about midwives’views and experiences of providing care for women in the context of task shifting.Methods:We conducted a qualitative systematic review using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting.Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts.A grid was made to identify core findings and compare them reciprocally.Results:Thirty-six qualitative studies met the inclusion criteria.The literature comprised of 32 first key concepts.Eight second-order constructs emerged,and three third-order interpretations were generated.The three overarching themes were:(1)midwives perceived themselves as providing culturally competent and high quality women-centered care;(2)they valued their profession but saw it as complex and challenging;(3)as health professionals,they reported a variety of organizational,cultural,and professional barriers to providing women-centered care.Conclusions:While performing a specific task in the task shifting context,midwives perceived their crucial roles and responsibilities,along with achieved value and reward.However,due to a range of existing barriers,the caring task posed great challenges in completely implementing women-centered care.It is essential for systems to identify and eliminate these barriers early,to consider midwives’emotional well-being,and to develop overall strategies to better support the midwifery workforce.Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.
文摘Introduction: International migration has always existed, primarily as a means to find economic opportunity. Recently, the number of health care professionals seeking to work outside Albania is growing rapidly. In 2021 alone, 1073 nurses left Albania. The departure of health care professionals is reflected in education where it can be observed that a good part of the students who finished the bachelor’s level program did not enroll to continue the second level of study in the master’s. The student’s decision not to continue further levels of education has brought consequences from programs shutting down due to lack of students and forcing the university to spread out the few remaining students to other programs. Objective: The purpose of the study was to explore the opinions of Midwifery Students studying at the Bachelor level, regarding their professional future and continuing education. Methodology: This is a cross-sectional study. In this study are included the students of the bachelor level of education. Student participating are studying Midwifery in the 2022-2023 academic year, at the Faculty of Technical Medical Sciences at the University of Medicine, Albania. Results: The students on average believe they can find a job as a midwife. The career is relatively safe and the profession of midwifery will ensure economic well-being for them. Most of the students hope to emigrate and develop their professional career outside of Albania. This was a surprise given that most frequent answers given by the students for not continuing their Master’s level education was the fact that the program was not accredited, their Bachelor’s diploma was also not accredited and so not recognized by other countries, the cost of continuing their studies was too high and their desire for a better economic and social status which they cannot get in Albania. The majority of students participating in the study identified emigration as the main way they plan to further their studies. Conclusions and Recommendations: Although the students had willingly chosen to continue the midwifery diploma, as they thought it would provide them with a proper future, this dignified professional future was seen as unattainable in Albania so they are seeking it out in more developed countries. A significant number of health professionals prefer to continue their second cycle studies in another country. The professional security within their home country does not satisfy the students. As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that will address the needs of all parties involved. .
文摘Background: Many countries across the world are facing an ongoing shortage of midwife practitioners due to several reasons such as increased workload, working overtime, poor-quality midwifery care, low staff morale, stress and burnout, lack of opportunity for training, lack of management support, financial issues and lack of recognition and compromised autonomy. Purpose: To explore the reasons behind nurses’ hesitance to apply for midwifery specialization. The objectives of this study were to understand the challenges that lie in front of Omani nurses and the motivational factors to apply for a midwifery programme. Method: Exploratory qualitative study was conducted at the largest tertiary hospital in Oman. Purposive sampling was applied for participant recruitment. Face-to-face interviews and focus group discussions were used as data collection methods. The study included general nurses, nurses in charge working in the maternity unit as well as nurses whose applications were accepted for midwifery education. Qualified midwives were excluded. The data collection process yielded twenty-five nurses. The interview protocol highlighted the impact and perception of the midwifery specialization on nurses’ careers. Thematic analysis was employed for data analysis. Results: Three over-arching major themes were identified. These are 1) nurses’ perceptions about the nature of work in maternity wards, the nurses have positive perception toward working in maternity wards and labor room because of working exclusively with female patients and their babies 2) factors influencing the decision to study midwifery specialization, work overload, stress, lack of support from administration were the most common reason behind the nurses not to apply for midwifery specialization and 3) support and recommendations required for midwives, the nurses mentioned that their identity, promotions and support from the administration will encourage them to apply for midwifery specialization. Conclusion: One of the main reasons that hindered nurses from applying to midwifery specialization is the false belief that midwives cannot work outside the delivery suite (DS). The second reason was the stress that midwives encounter at DS, and this was perceived by general nurses who did not work at DS. These challenges could be mitigated by leadership support, midwifery profession identity, as well as financial recognition for the midwives.
文摘Objective: to evaluate the value of doula midwifery in pregnant women for their mood, stage of labor and satisfaction. Methods: from March 1, 2020 to March 1, 2021, 78 pregnant women in our hospital were selected and divided into two groups under the coin method. The control group received routine delivery care, while the observation group received whole-course doula delivery. The emotional state, duration of labor and nursing satisfaction of the two groups of pregnant women were compared. Results: SAS anxiety score (36.69±5.15) and SDS depression score (35.51±6.84) of the observation group were lower than those of the control group, while the satisfaction score (95.63±2.12) of the observation group was higher than that of the control group (P < 0.05). The duration of the first, second and third stages of labor and the total duration of labor in the observation group were (8.31±2.25) hours, (0.55±0.15) hours, (0.20±0.12) hours and (8.25±2.21) hours shorter than those in the control group (P < 0.05). Conclusion: midwifery with doula can better improve pregnant women's emotional state and clinical satisfaction, and has a positive effect on shortening the duration of labor.
文摘Objective: to effectively analyze the clinical nursing effect of painless childbirth, holistic nursing and responsible midwifery. Methods: 64 parturients were randomly selected from May 2020 to December 2020. Divided into the experimental group /32 cases/implementation of routine nursing and responsible midwifery holistic nursing;Routine group /32 cases/routine nursing. The clinical application effect of different nursing care in painless delivery was compared between the two groups, and the rate of cesarean section and natural delivery, the rate of neonatal asphyxia, the rate of postpartum hemorrhage and other aspects of anxiety and depression scores were compared between the two groups. Results: the different nursing measures implemented in the two kinds of puerpera painless childbirth were systematically analyzed. Among them, the experimental group, which implemented the related responsibility on-site and overall nursing measures in all aspects of puerpera painless childbirth was significantly better than the conventional group. The data management of cesarean section rate, natural childbirth rate and anxiety and depression scores in the two groups had clinical statistical significance, P < 0.05. Conclusion: by analyzing the painless delivery of the two groups of parturients, the effective cover measures implemented in the experimental group can improve the scoring effect of psychological anxiety and depression, and ultimately promote the overall nursing satisfaction of the responsible midwifery. The overall nursing satisfaction of the experimental group is significantly better than that of the conventional group. At the same time, it can relieve the bad mood of the parturient. The nursing method can be popularized in the nursing of puerpera painless childbirth.
文摘Objective: to analyze and explore the clinical effect of midwifery nursing with responsibility midwives in parturition. Methods: fifty-eight parturients in our hospital were selected and divided into model group and control group with 29 cases in each group. Control group: routine nursing, model group: responsibility midwife midwifery nursing. The therapeutic effects of the model group and the control group in this study were recorded and analyzed in detail. Results: after using the responsibility midwife midwifery nursing, each index of the model group was better than the control group (P<0.05), the difference was statistically significant. Conclusion: responsibility midwife midwifery nursing has good nursing effect on parturient, and it is suggested to continue clinical research and use.
文摘Objective: to observe the application effect of childbirth ball combined with free posture midwifery nursing for primiparas. Methods: according to a total of 100 pregnant and lying-in women admitted to our hospital in recent years, they were randomly divided into two groups: the control group and the observation group. The control group used conventional midwifery care, while the observation group used delivery ball combined with free body position midwifery care in addition to conventional care during childbirth. Comprehensive evaluation and analysis were made on the delivery time, delivery bleeding and pain indicators of the two groups of lying-in women, and relevant conclusions were drawn. Results: the delivery time of the observation group was significantly shorter than that of the control group, and the amount of hemorrhage during delivery was less. The pain index is obviously lower, which reduces the pain of the parturient, P < 0.05, and is relatively safer and more effective for the overall delivery process. The labor pain scores (VAS, VRS, PPI) of the observation group were lower than those of the control group (P < 0.05). Conclusion: the delivery method of delivery ball combined with free body position midwifery nursing has a very wide range of significance for reducing the pain of the parturient, reducing the amount of bleeding and shortening the delivery time of the parturient, greatly improving the success rate of delivery, and is worthy of promotion and application in clinical aspects.
文摘Objective: to analyze the effect of continuous midwifery nursing and routine nursing on vaginal trial labor. Methods: the sample size was 90 cases, all of which were pregnant women with scar uterus. They were randomly divided into control group and observation group. Routine intervention was applied in the control group, and continuous midwifery intervention was applied in the whole process of observation group. Results: observation group were significantly better, P < 0.05. Conclusion: the whole process of continuous midwifery nursing effect is better.
文摘Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, 2022 pregnant women 100 cases, combined with the difference of the care mode will be divided into two groups: control group (routine midwifery care) and observation group (midwifery care). Each group has 50 cases, statistical comparison two groups of natural delivery rate, neonatal Apgar score, 2h postpartum bleeding volume, neonatal asphyxia rate, labor time and satisfaction. Results: in terms of natural delivery rate, neonatal Apgar score, and nursing satisfaction, the observation group was significantly higher than the control group, with significant differences, statistical advantages, p0.05;for the neonatal asphyxia rate and labor time, the observation group was significantly smaller than the control group, with significant differences and statistical advantages, p0. 05 Conclusion: applying the responsibility system care mode to obstetric maternal can greatly affect the delivery mode, maternal and infant outcomes. Specifically, it is beneficial to improve the maternal natural delivery rate, neonatal Apgar score, satisfaction, etc., but also can effectively reduce maternal 2h postpartum blood loss, neonatal asphyxia rate, labor time, etc., so has a strong application value.
